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Full-Text Articles in Social and Behavioral Sciences

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard May 2026

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …


Association Between Decisional Conflict And Quality Of Life Among Parents With A Child Undergoing Hospital-Based Treatment For A Recent Cancer Diagnosis, Augustine Provencio Sep 2025

Association Between Decisional Conflict And Quality Of Life Among Parents With A Child Undergoing Hospital-Based Treatment For A Recent Cancer Diagnosis, Augustine Provencio

Doctoral Dissertations

Having a child with a chronic illness, such as cancer, can cause families significant distress. Parents of these children must make frequent decisions relating to their child’s care. Depending on factors such as health literacy and support from medical staff, parents may have varying levels of decisional conflict (DC) throughout the decision-making process. Compounding stress throughout their child’s illness can often contribute to lower levels of health-related quality of life (HRQoL) while their child is receiving hospital-based treatment. Parents with a non-English language preference (NELP) often have greater challenges navigating healthcare systems due to a lack of resources and limited …


The Association Between Uncertainty, Reproductive Distress, And Avoidance In Assigned Female At Birth Adolescent And Young Adult (Aya-F) Cancer Survivors, Devon Ann Pons May 2024

The Association Between Uncertainty, Reproductive Distress, And Avoidance In Assigned Female At Birth Adolescent And Young Adult (Aya-F) Cancer Survivors, Devon Ann Pons

Doctoral Dissertations

Family building and fertility is a complex component of survivorship for assigned female at birth Adolescent and Young Adult’s (AYA-F’s), often accompanied by a mix of cognitive uncertainty, emotional uncertainty, reproductive distress, and avoidance. These psychological components present in survivorship for AYA-F’s can impact coping, identity development, and individualized care plans throughout survivorship. This novel examination of data from a cross sectional study shed light on the associations between reproductive distress, uncertainty, and avoidance and how they are experienced differently by various subgroups within the sample.

Results demonstrate that reproductive distress fully mediated the association between emotional uncertainty and avoidance, …


The Walking Threat: Traits Of Pathogen Avoidance, Pathogen Threat Proximity And Functional Flexibility, Lahai Alexander Massaquoi Wicks May 2024

The Walking Threat: Traits Of Pathogen Avoidance, Pathogen Threat Proximity And Functional Flexibility, Lahai Alexander Massaquoi Wicks

Doctoral Dissertations

The threat of infection to humans is unwavering, and it is increased through social interaction, which human life is based around. This has been demonstrated through the recent SARS-CoV-2 pandemic, where social distancing was recommended to prevent the spread of the virus. Therefore, it is important to understand both the behavioral and physiological defenses that we possess against illness. However, the characteristics of the relationship between the behavioral immune system (BIS) and the physiological immune system (PIS) are still murky. This dissertation sought to better understand how the BIS considers the costs of mounting an immune response via functional flexibility …


Mental Health And Experiences Of Pregnancy Among Black Women And Birthing People With Type 1 Diabetes (T1d), Madeleine E. Marcus Aug 2023

Mental Health And Experiences Of Pregnancy Among Black Women And Birthing People With Type 1 Diabetes (T1d), Madeleine E. Marcus

Doctoral Dissertations

This dissertation explored the potential effects of intersections of oppression (i.e., anti-Black racism, diabetes discrimination, and sexism) on mental health and pregnancy experiences among Black women and birthing people with Type 1 diabetes (T1D). Previous studies about pregnancy and T1D have included mainly white, cisgender women. Three participants qualified for inclusion in the present study and participated in semi-structured interviews, which the researcher analyzed using an interpretative phenomenological analysis (IPA) framework. Participants described feeling uncertain about whether aspects of their pregnancy experiences were related to obstetric and/or medical racism. Similarly, participants sometimes seemed uncertain about how racism may affect their …


The Grindr Complex: The Behavioral Health Impact Of Sexual Racism On Latinx Men Who Have Sex With Men, Luisalfredo Plascencia Aug 2023

The Grindr Complex: The Behavioral Health Impact Of Sexual Racism On Latinx Men Who Have Sex With Men, Luisalfredo Plascencia

Doctoral Dissertations

Given the social history surrounding the issue of HIV/AIDS in the LGBTQ+ community and the unique and intersectional experiences that Latinx Men who have Sex Men (MSM) have in their community, this dissertation’s research will contribute to the growing work on sexual racism and how it correlates with various elements of behavioral health. The study investigated the moderation impact of Latinx cultural values of caballerismo and familismo on the relationship between experiences sexual racism to mental health symptoms. The study also examined the moderation of caballerismo and familismo and psychological flexibility on the relationship between experiences of sexual racism to …


Psychological Determinants Of Physical Activity And The Prediction Of Physical Activity Levels In African American Men, Alvin L. Morton Iii Dec 2022

Psychological Determinants Of Physical Activity And The Prediction Of Physical Activity Levels In African American Men, Alvin L. Morton Iii

Doctoral Dissertations

African American (AA) men experience disproportionally higher rates of non-communicable, chronic diseases (e.g., cardiovascular, type 2 diabetes, and renal failure) than White men. Physical activity (PA) is known to reduce the progression of CVD, type 2 diabetes, and renal failure. National statistics illustrate that AA men are less likely to get sufficient levels of PA to obtain health benefits. Although many factors (e.g., biomedical, socio-cultural) influence participation in PA, the psychological factors at the individual level are essential to beginning and maintaining activity. Therefore, understanding the psychological determinants of PA in AA men and their associations with meeting national guidelines …


Ambivalent Sexism And Condom Use Self-Efficacy Amongst Men Who Bottom: A Serial Mediation Model, Elliott Nolan Devore Aug 2022

Ambivalent Sexism And Condom Use Self-Efficacy Amongst Men Who Bottom: A Serial Mediation Model, Elliott Nolan Devore

Doctoral Dissertations

The effects of gendered power dynamics between men and women during sexual encounters are well documented in the literature. Specifically, internalizing sexist beliefs about masculine dominance and feminine submission is related to worse sexual health outcomes. Less is known, however, about gendered power dynamics between men having sex. Those who engage in anal sex as the receptive partner (i.e., bottom) are feminized and shamed in various cultures, viewed as submissive, and may have internalized sexist beliefs and, thus, sexual role prejudice. Consequently, bottoms may feel less sexual autonomy, which influences their condom use self-efficacy. This is important given that bottoms …


Investigating Person-Specific Profiles Of Readiness-To-Exercise: Exploring Associations With Hypothetical Experiential Outcomes And Perceived Relevance, Cory Beaumont Aug 2022

Investigating Person-Specific Profiles Of Readiness-To-Exercise: Exploring Associations With Hypothetical Experiential Outcomes And Perceived Relevance, Cory Beaumont

Doctoral Dissertations

Autoregulation is a person-adaptive strategy wherein exercise workloads are adjusted to match one’s readiness (e.g., acute mental, physical, perceptual state). Prior work demonstrated that structural features of readiness profiles (i.e., which factor(s) are most important) differ across individuals. As this work relied on mathematical modeling, research is needed to understand the informational utility of person-specific profiles (PSPs) of readiness. Purpose: Model heterogeneity in PSPs of readiness (Aim 1), explore associations between PSP factor scores and forecasted experiences to hypothetical muscle-strengthening exercise (Aim 2), and explore participants’ perceptions of relevance and utility regarding their PSP (Aim 3). Methods: For …


Patient Reported Outcomes In Sickle Cell Disease Examined Within A Conceptual Model, Swapandeep Mushiana, Marsha Treadwell Phd, Sherif M. Badawy Md, Ms, Liliana Preiss Phd, Allison King Md Mph Phd, Barbara Kroner Phd, Yumie Chen Bs, Jeffrey Glassberg, Victor Gordeuk Md, Nirmish Shah Md, Angie Snyder Phd Mph, Theodore Wun Md Aug 2021

Patient Reported Outcomes In Sickle Cell Disease Examined Within A Conceptual Model, Swapandeep Mushiana, Marsha Treadwell Phd, Sherif M. Badawy Md, Ms, Liliana Preiss Phd, Allison King Md Mph Phd, Barbara Kroner Phd, Yumie Chen Bs, Jeffrey Glassberg, Victor Gordeuk Md, Nirmish Shah Md, Angie Snyder Phd Mph, Theodore Wun Md

Doctoral Dissertations

Objective: To examine the relations between patient reported outcomes (PROs) within a conceptual model for adults with sickle cell disease (SCD) ages 18 – 45 years enrolled in the Sickle Cell Disease Implementation Consortium (SCDIC) registry. We hypothesized that patient and SCD related factors and barriers to care would independently contribute to functioning as measured using the PRO domains. Additionally, pain and other SCD related complications are expected to impact the relation between the variables. Methods: Participants completed a 48-item survey that included socio-demographics and PRO measures, such as social functioning, pain impact emotional distress, and cognitive functioning. …


Impact Of Moral Injury For Ethnic/Racial Minority Male Veterans, Kristopher Kern May 2021

Impact Of Moral Injury For Ethnic/Racial Minority Male Veterans, Kristopher Kern

Doctoral Dissertations

Trends in demographics of post-9/11 veterans (deployments to the Middle East after 2001) describe this group as having higher survival rates, increased service-connected disabilities, and more racially diverse (NCVAS, 2018; Schnurr et al., 2009; Tanelian & Jaycox, 2008). Additionally, their deployment experiences include combat-related experiences that contradict personal moral beliefs, later named “moral injury” (MI) (Litz et al., 2009). Currier, Holland, and Mallot (2015) describe MI as intense emotions of shame, guilt, and anger alongside maladaptive behaviors emerging after “witnessing and/or participating in warzone events that challenge one’s basic sense of humanity” (p. 231).

The research on MI continues to …


Understanding The Healthcare Experiences Of Lgbtq+ People: An Adaptation Of The Daily Heterosexist Experiences Questionnaire, Conor Smith May 2021

Understanding The Healthcare Experiences Of Lgbtq+ People: An Adaptation Of The Daily Heterosexist Experiences Questionnaire, Conor Smith

Doctoral Dissertations

LGBTQ+ people's experiences of heterosexism, which are common in the healthcare system, are linked to poor health outcomes. There are no measures of LGBTQ+ people’s experiences in healthcare settings which could be used by healthcare systems and providers to improve the quality of their care for this vulnerable population. The Daily Heterosexist Experiences Questionnaire (DHEQ), developed using the minority stress model, measures the general stressful life experiences of LGBTQ+ people. This project aimed to adapt the DHEQ for use in healthcare settings.

A mixed-methods study was conducted to create the Daily Heterosexist Experiences Questionnaire-Healthcare (DHEQ-H). Semi-structured interviews focused on the …


The Use Of Mindfulness Meditation To Increase The Efficacy Of Mirror Visual Feedback For Reducing Phantom Limb Pain In Amputees, Nicolas Sebastian Mills May 2021

The Use Of Mindfulness Meditation To Increase The Efficacy Of Mirror Visual Feedback For Reducing Phantom Limb Pain In Amputees, Nicolas Sebastian Mills

Doctoral Dissertations

Phantom limb pain is a chronic pain condition that negatively impacts the lives of over half of amputees, and results in considerable morbidity. Currently, there is no gold standard for treatment for phantom limb pain. However, a frequently used intervention is the use of mirror visual feedback, in which the amputee watches the reflection of the adjacent non-amputated limb move and exercise. In the last few decades, mindfulness-based interventions have been increasingly used with individuals living with different types of chronic pain. This study attempts to discover if the addition of a mindfulness-based intervention, such as guided meditation, will augment …


Efficacy Of Integrated Mental Health Care With Dual Diagnosis Patients And Their Utilization Of Psychiatric Emergency Services, Denton Scott May 2019

Efficacy Of Integrated Mental Health Care With Dual Diagnosis Patients And Their Utilization Of Psychiatric Emergency Services, Denton Scott

Doctoral Dissertations

Historically, patients with dual diagnosis have been subjected to ineffective treatment and negative attitudes from healthcare providers. Further, these patients are plagued with myriad afflictions that exist beyond substance abuse and mental illness. The treatments and collateral damage associated with the diagnosis impose excessive healthcare costs and can be of significant detriment to society. Largely, patients suffering from dual diagnosis do not receive adequate treatment. As such, psychiatric emergency services are frequently utilized as an alternate treatment, wherein the main focus of care is on the substance abuse alone. This study argues that solely treating the substance abuse is not …


Evaluating The Effectiveness Of Peer Engagement And Knowledge (Peak): A Community-Based Group Intervention For Youth In Hawai‘I, Jennifer T. T. Ho May 2019

Evaluating The Effectiveness Of Peer Engagement And Knowledge (Peak): A Community-Based Group Intervention For Youth In Hawai‘I, Jennifer T. T. Ho

Doctoral Dissertations

This study is a program evaluation with a mixed methods design that evaluated the effectiveness of Peer Engagement and Knowledge (PEAK), a six-week community-based group intervention that incorporates mindfulness-based interventions (MBIs) to address multiple health behaviors for multiracial youth in Hilo, Hawai‘i. A total of 51 youth, ages 12-23 years old, participated in this study which included pre-/posttest analyses of health risk factors such as substance use and depression and health promoting factors such as resilience, self-esteem, and mindfulness. Responses from two subsets of participants, who engaged in a focus group (n = 11) and composed gratitude letters ( …


The Role Of Meaning-Making In Posttraumatic Growth Among Eritrean Refugees With Posttraumatic Stress Disorder, Yacob Tewolde Tekie Aug 2018

The Role Of Meaning-Making In Posttraumatic Growth Among Eritrean Refugees With Posttraumatic Stress Disorder, Yacob Tewolde Tekie

Doctoral Dissertations

The study examined the moderating role of meaning made, meaning making and social support on the relationship between negative life events and posttraumatic stress disorder (PTSD), anxiety and depression as well as the facilitating role of these moderating variables for posttraumatic growth(PTG). Eritrean refugees (N = 135) who were residing in Europe were recruited. The results showed that post-migration living difficulties significantly related with negative outcomes. In addition, the results showed that social support moderated the relationship between the number of traumatic life events and anxiety symptoms. However, meaning made and social support were not significant moderators on the …


A Program Evaluation Of A Drug And Alcohol Family Treatment Program, Katrina Ramirez May 2018

A Program Evaluation Of A Drug And Alcohol Family Treatment Program, Katrina Ramirez

Doctoral Dissertations

The current study is a program evaluation at John Muir Behavioral Health, Center for Recovery. The research determined the effectiveness of the program at Center for Recovery that is offered to patients that struggle with substance use disorder and their families. The purpose of this study is to assess patients’ behavioral, cognitive and social/environmental factors as it relates to their commitment to sobriety and examine how the involvement of family members influences the patient’s recovery process. I utilized a mixed methodology of quantitative and qualitative interviews of patients and family members. The findings suggest depressive symptoms were negatively correlated with …


An Examination Of Music Majors' Perceived Barriers To Complying With An Exercise Program, Matthew William Seitz Dec 2017

An Examination Of Music Majors' Perceived Barriers To Complying With An Exercise Program, Matthew William Seitz

Doctoral Dissertations

This dissertation focused on a mixed-methods exploration of the barriers and motivation to exercise in a sample of music majors at a large southeastern university. Due to dietary concerns and other obstacles to engaging in regular exercise, musicians are at a greater dietary and cardiovascular risk than the general population. Previous research has revealed music majors, in general, do not identify as exercisers. This comes with its obvious health risks. Self-determination theory and exercise identity literature posits individuals who more strongly identify as exercisers and who are more intrinsically motivated to exercise will workout more often and more consistently than …


The Effects Of Trade Competition On Health, And Determinants Of Workplace Behavior, Thomas Clayton Mcmanus Aug 2015

The Effects Of Trade Competition On Health, And Determinants Of Workplace Behavior, Thomas Clayton Mcmanus

Doctoral Dissertations

My dissertation consists of three essays related to workplace behavior. In the first paper, we design a controlled laboratory experiment to study image motives in a setting where decisions signal intelligence. The experiment results show that in some settings social scrutiny can discourage individuals from making choices that signal their intelligence, despite evidence that the signal was privately valuable. In the second paper, we study the effect of Chinese import competition on occupational safety and health at US manufacturers. We find that a change in US trade policy and Chinese import shocks significantly increases worker injury and illness rates in …


Dissociation And Sexual Trauma: The Moderating Role Of Somatization, Amineh Abbas Dec 2014

Dissociation And Sexual Trauma: The Moderating Role Of Somatization, Amineh Abbas

Doctoral Dissertations

This study examined various types of trauma, with an emphasis on sexual trauma across the lifespan, in a clinical sample of male and female adult outpatients assessed for trauma, somatization, and dissociation. Two hundred forty-five adult outpatients at the University of Tennessee Psychological Clinic were administered the Dissociative Experiences Scale (DES), the Traumatic Experiences Checklist (TEC), and Symptom Checklist-90-Revised (SCL-90-R), as part of the routine intake procedure. Of those individuals, 200 patients completed the questionnaires correctly and were included in the final study sample. The experience of sexual trauma indeed accounted for additional variance in somatization scores over and above …


Positive Functioning Among Chinese Adolescents: Conceptualizing A Framework And Testing Effects Of Parenting, Mingzhu Xia Dec 2011

Positive Functioning Among Chinese Adolescents: Conceptualizing A Framework And Testing Effects Of Parenting, Mingzhu Xia

Doctoral Dissertations

Chinese adolescents’ development has received increasing attention over recent decades. However, following a traditional deficit model, most of the attention has been on problematic functioning of adolescents (e.g. depression). This emphasis is not consistent with evidence that the large majority of Chinese adolescents do not manifest such problem behaviors. Little is known about positive functioning among Chinese adolescents and how it is related to key socialization practices such as parenting. The purpose of the present study was to begin to fill these gaps.

Using theory, past empirical practice, and characteristics of Chinese culture, the study posited a second-order structure for …


Distress Tolerance, Experiential Avoidance, And Negative Affect: Implications For Understanding Eating Behavior And Bmi, Christen Nicole Mullane Aug 2011

Distress Tolerance, Experiential Avoidance, And Negative Affect: Implications For Understanding Eating Behavior And Bmi, Christen Nicole Mullane

Doctoral Dissertations

Distress tolerance and experiential avoidance are important aspects of the coping process. In the current study, both were examined in relation to Body Mass Index and self-reported disturbances in mood and eating behavior. Distress tolerance was measured behaviorally and via self-report to elucidate the manner in which a) the ability to tolerate emotional distress, and b) the ability to persist behaviorally in the presence of stress-inducing stimuli were related to self-reported levels of depression, anxiety, maladaptive eating habits, and bodily concerns. A sample of 73 undergraduate students participated, and height, weight, and waist circumference were measured. Increased experiential avoidance was …


Type I Diabetes Mellitus In Children And Pre-Adolescents: Affective, Behavioral, And Social Correlates, Meredith P. Schwartzman Dec 2007

Type I Diabetes Mellitus In Children And Pre-Adolescents: Affective, Behavioral, And Social Correlates, Meredith P. Schwartzman

Doctoral Dissertations

Type I diabetes mellitus (T1DM) is the most common metabolic disorder among children and adolescents (Wysocki, Greco, & Buckloh, 2003) and research has indicated that children with T1DM are more likely to develop clinical depression and anxiety relative to children without T1DM. Building on this literature, the present study utilized a multi-method assessment strategy of self- and parent-reported depression, anxiety, behavioral regulation (i.e. internalizing and externalizing behaviors), social competence, personality, and family dynamics to identify whether preadolescents with T1DM were distinguishable from children without T1DM, and also whether psychosocial differences were evident in the T1DM group as a function of …