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Virginia Commonwealth University

Theses and Dissertations

2018

Articles 1 - 30 of 60

Full-Text Articles in Social and Behavioral Sciences

Critical Consciousness, Racial Identity, And Appropriated Racial Oppression In Black Emerging Adults, Keyona Allen Jan 2018

Critical Consciousness, Racial Identity, And Appropriated Racial Oppression In Black Emerging Adults, Keyona Allen

Theses and Dissertations

The present study explored private regard and public regard, two subcomponents of racial identity, as mediators of the association between critical consciousness and appropriated racial oppression. In a sample of 75 Black emerging adults, ages 18-25, the current study examined (1) the relationships between critical consciousness, racial identity, and appropriated racial oppression and (2) whether racial identity mediates the relationship between critical consciousness and appropriated racial oppression. Relationships in the expected direction were evident between private regard and both critical consciousness and appropriated racial oppression. Relationships in the expected direction were evident between public regard and critical consciousness. Further, mediation …

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Why Katniss Everdeen Is Our Favorite Feminist – An Analysis Of The Heroine Of The Hunger Games Film Saga And Her Reception By Young Female Spectators, Paula Talero Álvarez Jan 2018

Why Katniss Everdeen Is Our Favorite Feminist – An Analysis Of The Heroine Of The Hunger Games Film Saga And Her Reception By Young Female Spectators, Paula Talero Álvarez

Theses and Dissertations

THROUGH THE FIGURE OF FICTIONAL CHARACTER KATNISS EVERDEEN, THIS DISSERTATION STUDIES HOW THE FILM INDUSTRY SIMULTANEOUSLY ENTRENCHES AND DISRUPTS GENDER, SEXUAL, AND RACIAL NORMATIVITIES. THE PROJECT USES TEXTUAL ANALYSIS AND PARTICIPANT RESEARCH TO ANALYZE HOW THE FILMS AND NOVELS OF THE HUNGER GAMES SAGA ENCAPSULATE BOTH DOMINANT AND ALTERNATIVE CONCEPTIONS RELATED TO FEMININITY, MASCULINITY, WOMANHOOD, AND MOTHERHOOD. IT ALSO EXPLORES IF AND HOW THE FEMALE HEROINE CAN BE READ AS FEMINIST AND PRODUCES A SENSE OF EMPOWERMENT. I CONCLUDE THAT ALTHOUGH THE INDUSTRY IS PRODUCING NEW MODELS OF WOMANHOOD THAT CHALLENGE TRADITIONAL GENDER ROLES, IT STILL PERPETUATES ROMANTIC IDEALS AND …

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Validation Of Virginia's Juvenile Risk Assessment Instrument, Jessica P. Schneider Jan 2018

Validation Of Virginia's Juvenile Risk Assessment Instrument, Jessica P. Schneider

Theses and Dissertations

Utilizing a validated risk assessment tool to predict future offending is recommended as best practices in corrections by a number of professional organizations (Latessa & Lovins, 2010). Guided by the risk-needs-responsivity model, risk assessment tools have evolved to help inform criminal justice practitioners by identifying offenders most in need of intervention or supervision, guiding the case plan to optimize outcomes (Bonta & Andrews, 2007). The Virginia Department of Juvenile Justice (DJJ) utilizes the Youth Assessment and Screening Instrument (YASI) at all stages of contact with youthful offenders, including intake, probation, commitment, and parole (DJJ, 2016). However, risk assessment instruments do …

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Predictors Of Resilient Outcomes Among Juvenile Offenders, Kristina A. Mcguire Jan 2018

Predictors Of Resilient Outcomes Among Juvenile Offenders, Kristina A. Mcguire

Theses and Dissertations

Research on resilience has almost completely bypassed the juvenile justice literature. Using data on 1,354 youth from the Pathways to Desistance study, the present study examined associations between individual, community, and familial risk and promotive factors and resilient outcomes, specifically gainful activity, in juvenile offenders. Results of both logistic and hierarchical regression models indicated significant associations between resilient outcomes in each domain: specifically individual (age at first arrest, motivation to succeed), community (geographic location, exposure to violence), and family (socioeconomic status, parental monitoring) predictors. Finally, this paper discusses reasons for non-significant findings and directions for future research on resilience among …

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Social And Emotional Adjustment Across Aggressor/Victim Subgroups: Do Aggressive-Victims Possess Unique Risk?, Kelly E. Oconnor Jan 2018

Social And Emotional Adjustment Across Aggressor/Victim Subgroups: Do Aggressive-Victims Possess Unique Risk?, Kelly E. Oconnor

Theses and Dissertations

Both theory and empirical evidence support the existence of “aggressive-victims,” a subgroup of youth who have been found to experience the negative outcomes associated with being an aggressor and being a victim. It remains unclear, however, if aggressive-victims possess risk factors that are unique from youth who are either aggressive or victimized. The present study sought to: (a) identify subgroups of seventh grade adolescents who differ in their patterns of aggression and victimization, (b) determine the number and structure of subgroups differ by school or sex, and (c) investigate whether aggressive-victims differ from all other subgroups in their social and …

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Factors Influencing Perceptual Distance, Calvin J. Hall Iii Jan 2018

Factors Influencing Perceptual Distance, Calvin J. Hall Iii

Theses and Dissertations

Previous research shows that social biases, such as pro-White racial bias, can influence a person's decisions and behaviors (Correll et al. 2007; Mekawi & Bresin, 2015). Studies also suggest that social biases may influence basic functions like visual perception (Cesario & Navarrete, 2014); however, few studies have examined the relationship between visual perceptions and threat (Cesario, Placks, Hagiwara, Navarrete, & Higgins, 2010; Todd, Thiem, & Neel, 2016). The current research aims to investigate whether implicit pro-White preference can influence basic functions like visual perception. A secondary aim of this study is to examine the role of threat in this relationship. …

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Bed And Breakfast: The Role Of Sleep And Affect In Breakfast Intake, Ashley R. Macpherson Jan 2018

Bed And Breakfast: The Role Of Sleep And Affect In Breakfast Intake, Ashley R. Macpherson

Theses and Dissertations

Breakfast intake is associated with numerous positive physical and mental health outcomes, yet breakfast skipping remains common in adults. Chronotype and sleep show potential as predictors of breakfast intake; however the existing literature has methodological limitations and fails to examine how psychological mechanisms might explain the relation between sleep and breakfast. The current investigation explored the association of means and variability of sleep behaviors (bedtime, midsleep, sleep duration) as predictors of breakfast intake frequency and high-protein breakfast intake frequency. Additionally, the role of positive and negative affect as mediators in the sleep—breakfast association was examined. Hierarchical regressions and PROCESS parallel …

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A Stakeholder Examination Of Gestational Weight Gain Guidelines, Melissa Kwitowski Jan 2018

A Stakeholder Examination Of Gestational Weight Gain Guidelines, Melissa Kwitowski

Theses and Dissertations

Obesity is a significant health concern for women of childbearing age. More than 40% of women have a Body Mass Index (BMI) in the overweight or obese ranges at the time they conceive, posing significant health risks for both mother and child. Excessive weight gain during pregnancy is common and associated with numerous deleterious complications. The Institute of Medicine published gestational weight gain (GWG) guidelines based on prepregnancy BMI. However, more than 50% of women gain in excess of these recommendations. Further, many women report receiving minimal guidance from their healthcare providers regarding weight gain, nutrition, and physical activity during …

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Effects Of Electronic Cigarette Liquid Solvents Propylene Glycol And Vegetable Glycerin On User Nicotine Delivery, Heart Rate, Subjective Effects, And Puff Topography, Tory Spindle Jan 2018

Effects Of Electronic Cigarette Liquid Solvents Propylene Glycol And Vegetable Glycerin On User Nicotine Delivery, Heart Rate, Subjective Effects, And Puff Topography, Tory Spindle

Theses and Dissertations

Electronic cigarettes (ECIGs) are a class of tobacco products that use a heating element to aerosolize a liquid, typically containing nicotine, allowing for user inhalation. Despite their rapid growth in popularity, little is known about ECIGs including how certain device and liquid factors influence nicotine delivery, user physiological and subjective responses, and puffing behavior (puff topography). Limited pre-clinical research has demonstrated that the ratio of two solvents commonly found in ECIG liquids, propylene glycol (PG) and vegetable glycerin (VG), may have an influence on the nicotine content of ECIG aerosols. However, the extent to which PG:VG ratio in ECIG liquids …

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Ageism Among Healthcare Professionals: The Influence Of Personal Aging Anxiety, Job Role, And Work Setting On Attitudes Toward Older Patients, Jennifer L. K. Inker Jan 2018

Ageism Among Healthcare Professionals: The Influence Of Personal Aging Anxiety, Job Role, And Work Setting On Attitudes Toward Older Patients, Jennifer L. K. Inker

Theses and Dissertations

Older adults make up a significant and increasing proportion of the U.S. population and are frequent users of healthcare services. Ageism in healthcare, driven by an incomplete and narrowly biomedical perspective on aging, has been linked to various problematic outcomes for older patients, including under- and over-treatment. The purpose of this study was to use the theory of relational ageism to explore the relationship between personal aging anxiety among healthcare professionals and their attitudes to older patients, considering the potentially moderating factors of job role and work setting. Using convenience sampling, clinical healthcare professionals working for a mid-sized, regional healthcare …

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Mental Health Difficulties And Service Use Of Incarcerated Women: The Influence Of Violence Perpetration And Victimization, Rachel C. Casey Jan 2018

Mental Health Difficulties And Service Use Of Incarcerated Women: The Influence Of Violence Perpetration And Victimization, Rachel C. Casey

Theses and Dissertations

The present study aimed to expand the knowledge base regarding incarcerated women’s experiences with violence and their mental health with the goal of identifying avenues for more tailored, compassionate responses to their mental health difficulties in both macro and direct practice contexts. To achieve this aim, a secondary data analysis was performed using data from the Survey of Inmates in State Correctional Facilities (SISCF) completed by the Bureau of Justice Statistics (BJS) in 2004. Six research questions pertaining to women’s experiences with violence and their mental health difficulties and service utilization guided the inquiry, which involved univariate, bivariate, and multivariate …

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Longitudinal Relations Between Adhd Symptoms And Substance Use Across The Transition To College And Evaluation Of Promotive And Protective Factors, Melissa R. Dvorsky Jan 2018

Longitudinal Relations Between Adhd Symptoms And Substance Use Across The Transition To College And Evaluation Of Promotive And Protective Factors, Melissa R. Dvorsky

Theses and Dissertations

The prevalence of substance use and related problems increases during adolescence and peaks in young adulthood with substantial increases during the transition from high school to college (Johnston et al., 2018). However, these increases are not universal for all students (White et al., 2006), and there is substantial variation in rates of substance use during the first year of college (Borasri et al., 2007; Frisher et al., 2007). It is important to identify the individual and environmental factors that serve as risk factors for substance use as well as factors that may promote or protect against use during the high …

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Investigating The Presence And Correlates Of Anti-Thin Bias In Adults, Alexandria Davies Jan 2018

Investigating The Presence And Correlates Of Anti-Thin Bias In Adults, Alexandria Davies

Theses and Dissertations

Weight stigma is associated with negative health outcomes across the BMI continuum. However, few studies have examined weight discrimination targeting people with low body weights. This investigation explored the presence of anti-thin bias, defined as the belief that people with low BMIs have undesirable personality characteristics. Participants were randomly assigned to read one of six vignettes about women that differed by race (White and Black) and weight status (slightly underweight, normal weight, and slightly overweight). Negative personality characteristics were more likely to be ascribed to both underweight and overweight women, compared with normal weight women. Furthermore, participants were significantly more …

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The Experiences Of School Counseling Directors In Relation To Job Satisfaction And Leadership, Robyn Walsh Jan 2018

The Experiences Of School Counseling Directors In Relation To Job Satisfaction And Leadership, Robyn Walsh

Theses and Dissertations

The current literature on school counselor job satisfaction does not address the experiences of school counseling directors. This is a unique set of counselors due to their role as leaders and supervisors in the building. Therefore, this study sought to better understand the experiences of school counseling directors in relation to job satisfaction and leadership. The researcher collected data through 10 interviews with participants having met the criteria of serving as a school counseling director of a middle or high school, supervising a department of at least two counselors, and working in the role for at least two years. Data …

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Loyalty Program Effectiveness: An Examination Of Mainstream And Niche Sport Fan-Team Relationships, Lisa S. Rufer Jan 2018

Loyalty Program Effectiveness: An Examination Of Mainstream And Niche Sport Fan-Team Relationships, Lisa S. Rufer

Theses and Dissertations

The purpose of this study was to explore the efficacy of using loyalty programs on sport fans’ relationship quality and fan engagement toward sport organizations. This study also sought to explore which relationship quality and fan engagement factors potentially differed as a result of using loyalty programs. Since there are two major defined sport levels, differences were explored across niche and mainstream sport organizations. Using relationship marketing as the theoretical framework, participants (n = 678) were administered a 55-item instrument that included revised relationship quality and fan engagement scales. Quantitative data were used to run confirmatory factor analyses, analyses of …

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Does Emotion Regulation Moderate The Association Between Impairment And Depression In Adolescents With Adhd?, Laura D. Eddy Jan 2018

Does Emotion Regulation Moderate The Association Between Impairment And Depression In Adolescents With Adhd?, Laura D. Eddy

Theses and Dissertations

In comparison with their peers, adolescents with ADHD are at increased risk for developing depression, with prevalence estimates for comorbid depression ranging from 14% to 20%. Youth with comorbid ADHD and depression are at greater risk for multiple negative outcomes compared to youth with ADHD alone, including suspension from school, failing a grade, or difficulties in peer relationships. Identifying risk factors for depression among adolescents with ADHD is important for facilitating early identification and treatment efforts. Research completed to date indicates that interpersonal impairment and emotion regulation may mediate the relationship between ADHD and depression. However, a comprehensive longitudinal model …

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Queer Health Equity And Cervical Cancer: Identifying Social Determinants Of Papanicolaou Test Uptake In A Sample Of Sexual Minority Women And Gender Nonbinary Individuals, Ariella R. Tabaac Jan 2018

Queer Health Equity And Cervical Cancer: Identifying Social Determinants Of Papanicolaou Test Uptake In A Sample Of Sexual Minority Women And Gender Nonbinary Individuals, Ariella R. Tabaac

Theses and Dissertations

Sexual minority women (SMW) demonstrate lower rates of cervical cancer screening than heterosexual women. This is concerning as lesbian and bisexual women tend to engage in higher rates of substance-related cancer risk behaviors, unprotected sex, and tend to have higher body mass indices, all of which are risk factors for cancer development. Another major risk factor, screening avoidance, places SMW at increased risk for the development of high grade cervical lesions in the absence of early detection practices, which is likely to impact overall cervical cancer morbidity in this population. The aim of the present study was to utilize the …

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A Laboratory Study Of Stress Reactions To Witnessing A Police Killing Of An Unarmed Black Man: Discrimination, Distress Tolerance, Ethnic Identity, And Risk-Taking, Michael A. Trujillo Jan 2018

A Laboratory Study Of Stress Reactions To Witnessing A Police Killing Of An Unarmed Black Man: Discrimination, Distress Tolerance, Ethnic Identity, And Risk-Taking, Michael A. Trujillo

Theses and Dissertations

Black individuals have been disproportionately targeted by law enforcement, most notably in shooting deaths at the hands of police, and has contributed to a general distrust of law enforcement. A rise in citizen journalism has helped document excessive use of force by police on video; however, little is known how individuals respond to viewing this type of media. A history of race-based stress is likely to contribute to an expectation of racism and may impact how individuals respond to videos of the treatment of unarmed Black men at the hands of police, with some evidence suggesting ethnic identity may moderate …

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Learning Together In Highland Park To Build Civic Capacity, Grace Leonard Jan 2018

Learning Together In Highland Park To Build Civic Capacity, Grace Leonard

Theses and Dissertations

This thesis examines the work of nonprofit organizations collaborating with communities to build civic capacity in North Highland Park, a neighborhood in Richmond, Virginia. Place-focused planning strategies during the twentieth century diminished civic capacity in the community and fostered isolation. Today, collaborative community work in Highland Park is incorporating the assets, resources and knowledge held in the community into strategies to improve quality of life using collaborative learning. A case study approach closely analyzes community engagement and revitalization processes in North Highland Park between 2011 and 2017. Nonprofit organizations mobilized and led a group of community-based collaborators, including nonprofit staff …

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Influence Of Cultural Strengths On The Relationships Among Acculturative Stress, Racism, And Mental And Physical Health In Latino Immigrants, Annahir N. Cariello Jan 2018

Influence Of Cultural Strengths On The Relationships Among Acculturative Stress, Racism, And Mental And Physical Health In Latino Immigrants, Annahir N. Cariello

Theses and Dissertations

The Latino immigrant population in the United States has grown rapidly, now standing at over 56 million people. Due to this increase in Latino immigrants, investigation of their mental and physical health is crucial. Few studies have investigated conjointly both physical and mental health in Latino immigrant adults. Daily discrimination and acculturative stress have been found to affect the mental and physical health of Latino immigrants. Cultural strengths including social support, religiosity, and enculturation have been linked to Latino immigrant health. In the minority stress model, cultural strengths have been theorized to moderate relationships between discrimination and health. The purpose …

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Abuse Liability Of An Electronic Cigarette In Traditional Cigarette Smokers, Sarah F. Maloney Jan 2018

Abuse Liability Of An Electronic Cigarette In Traditional Cigarette Smokers, Sarah F. Maloney

Theses and Dissertations

Electronic cigarettes have grown in popularity across the U.S. and concerns have been raised about their abuse liability. The purpose of the current study was to evaluate and compare the abuse liability of an electronic cigarette with and without nicotine to a nicotine inhaler (the Nicotrol inhaler) and participants’ own brand of cigarettes. A total of 24 smokers attended four sessions in which the abuse liability of each product was examined using the Multiple-Choice Procedure (MCP), nicotine delivery, nicotine abstinence symptom suppression, and subjective reinforcing effects. Results revealed that the nicotine containing and non-nicotine containing electronic cigarette had a higher …

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Investigating Racial Bias In Perceptions Of Free Will, Courtney J. Alderson Jan 2018

Investigating Racial Bias In Perceptions Of Free Will, Courtney J. Alderson

Theses and Dissertations

The overarching goal of this study was to examine whether perceptions of others’ free will would differ depending on perceiver race as well as target race. The current study proposed that such a racial bias may be one mechanism by which racial disparities in medical treatment recommendations arise. By bridging findings from four different lines of research (i.e., the literatures on racial health and medical treatment disparities, racial bias, free will beliefs, and social identity), it was hypothesized that: (1) participants would perceive greater amounts of free will for a hypothetical racial ingroup patient than an outgroup patient; (2) such …

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From Blacker The Berry To Darker The Flesh: Gendered Racial Microaggressions, Ethnic Identity, And Black Women’S Sexual Behaviors, Chelsie E. Dunn Jan 2018

From Blacker The Berry To Darker The Flesh: Gendered Racial Microaggressions, Ethnic Identity, And Black Women’S Sexual Behaviors, Chelsie E. Dunn

Theses and Dissertations

Race- and gender-related contextual factors influence Black women’s sexual behaviors, attitudes, and outcomes. Contextual factors of Black women’s sexual behaviors include stereotypes, microaggressions, ethnic identity, and self-concept. Little to no research has examined race- and gender-specific microaggressions (i.e., gendered racial microaggressions; GRM) impact on Black women's sexual health. Responsively, using an intersectional approach, this study hypothesized that ethnic identity’s influence on the relationship between GRM and sexual behavior (i.e., condom use, lifetime sexual partners) is conditional on self-conceptualization moderated effect on ethnic identity and sexual behavior. Participants included 124 unmarried Black women, recruited from mTurk, a southeastern university and community. …

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Secondary Student Information Literacy Self-Efficacy Vs. Performance, Jen Spisak Jan 2018

Secondary Student Information Literacy Self-Efficacy Vs. Performance, Jen Spisak

Theses and Dissertations

The amount of information in the world has grown exponentially in the last generation. Students often believe that growing up as digital natives means they have advanced information literacy skills. However, school librarians are not seeing evidence of this in their schools. The purpose of this study was to determine if secondary students overestimate their information literacy (IL) abilities, if relationships exist between IL self-efficacy and performance, and if grade level or self-efficacy level changes those relationships. To accomplish this, data were collected from two middle schools and three high schools from a total of 397 students in grades 6, …

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“We’Re All In This Together:” Exploring The Effectiveness And Responsiveness Of Nonprofits In Promoting The Socioeconomic Integration Of Refugees, Brittany Keegan Jan 2018

“We’Re All In This Together:” Exploring The Effectiveness And Responsiveness Of Nonprofits In Promoting The Socioeconomic Integration Of Refugees, Brittany Keegan

Theses and Dissertations

When a person is forced to flee their home due to violence or the fear of persecution, they must seek refuge elsewhere – either within the borders of their home country or in a new country. Those who travel to another country in search of safety and protection are known as refugees, and as world conflicts continue, the number of refugees around the world is steadily increasing. As refugees integrate into their new communities, they often receive support from nonprofit organizations once government assistance has ceased. This mixed method study uses 60 open-ended, first-person interviews with refugees and nonprofit service …

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The Experiences That Promote Success For Students With Intellectual Disability In Postsecondary Education, Kimberly S. Handsome Jan 2018

The Experiences That Promote Success For Students With Intellectual Disability In Postsecondary Education, Kimberly S. Handsome

Theses and Dissertations

This in-depth qualitative, phenomenological (Smith & Fowler, 2009) research study attempted to understand the experiences of young adults with intellectual disability who had completed a 2-year, inclusive postsecondary education program. 13 participants (4 former students with ID, 5 parents, and 4 Postsecondary Education staff members) participated in semi-structured interviews. Interviews were coded to provide themes amongst each individual group of participants. A document review was also conducted to better understand the program components and add validity to self-reports from interviews. Results were analyzed and used to provide implications for future research and program development.

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Discrimination, Mental Health, And Preparedness For Aging In Trans(Gender)/Gender-Nonconforming Adults, Richard S. Henry Jan 2018

Discrimination, Mental Health, And Preparedness For Aging In Trans(Gender)/Gender-Nonconforming Adults, Richard S. Henry

Theses and Dissertations

This cross-sectional study examined relationships among discrimination, mental health (i.e., depression and anxiety), preparation for aging (i.e., familiarity and planning), social support, death attitudes, and aging anxiety among TGNC adults (N = 154). Neither discrimination nor mental health predicted preparation for aging familiarity or planning. Discrimination did, however, predict both anxiety and depression, although only the non-affirmation subscale was a unique predictor of both. As discrimination and mental health were not a significant predictor of preparedness for aging in the previous regressions, the hypothesized mediation model and subsequent moderated mediation models were not conducted. Additional exploratory multiple regressions were …

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Shared Genetic And Environmental Influences On Fear, Anxiety, Posttraumatic Stress, And Brain Morphometry, Chelsea Sawyers Jan 2018

Shared Genetic And Environmental Influences On Fear, Anxiety, Posttraumatic Stress, And Brain Morphometry, Chelsea Sawyers

Theses and Dissertations

Anxiety disorders (ADs) and stress-related disorders are some of the most common psychiatric disorders in the United States. Like other c0mplex psychiatric illness, genetics and neuroimaging research has focused on understanding their underlying neurobiology. Areas within the fear-network play important roles in threat perception, fear conditioning/learning, cognitive processing, and modulation of fear responses including contextual modulation and extinction and have been implicated in ADs as well as stress disorders such as posttraumatic stress disorder (PTSD). The primary gap in the current search for underlying biological mechanisms is in whether biomarkers associated with disorders share genetic influences with the disorders they …

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Structured Poetic Expressions For Emerging Adults Experiencing Bereavement, Kelcie D. Willis Jan 2018

Structured Poetic Expressions For Emerging Adults Experiencing Bereavement, Kelcie D. Willis

Theses and Dissertations

Previous research has produced heterogeneous findings regarding the effectiveness of expressive writing in reducing grief symptomatology among the bereaved (e.g., Collison, 2016; Lichtenthal & Cruess, 2010; Stroebe et al., 2006). The purpose of this study was to address these mixed results by exploring the effects and linguistic characteristics of a novel writing task (i.e., the acrostic poem) among bereaved undergraduates, using an innovative data analysis technique (i.e., Linguistic Inquiry and Word Count). The current study recruited 68 undergraduates who had lost a loved one. Participants were randomly assigned to write over multiple days using the acrostic poem, emotional disclosure prompt, …

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Evaluating And Reducing The Effects Of Misclassification In A Sequential Multiple Assignment Randomized Trial (Smart), Jun He Jan 2018

Evaluating And Reducing The Effects Of Misclassification In A Sequential Multiple Assignment Randomized Trial (Smart), Jun He

Theses and Dissertations

SMART designs tailor individual treatment by re-randomizing patients to subsequent therapies based on their response to initial treatment. However, the classification of patients being responders/non-responders could be inaccurate and thus lead to inappropriate treatment assignment. In a two-step SMART design, by assuming equal randomization, and equal variances of misclassified patients and correctly classified patients, we evaluated misclassification effects on mean, variance, and type I error/ power of single sequential treatment outcome (SST), dynamic treatment outcome (DTRs), and overall outcome. The results showed that misclassification could introduce bias to estimates of treatment effect in all types of outcome. Though the magnitude …

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