Social and Behavioral Sciences Commons^™

Antipsychotic Medication Administration In Oregon Assisted Living/Residential Care Settings: Analyzing An Action Situation, Sarah Dys

Dissertations and Theses

Antipsychotic medication use (APU) in assisted living and residential care (AL/RC) settings is an under-studied and controversial health policy issue. APU in older adults with dementia is associated with an increased risk of falls, hospitalizations, and early mortality. I operationalize the Institutional Analysis and Development Framework using a situational analysis approach, an extension of grounded theory methods, to explore the APU in Oregon AL/RC settings. Regulatory deficiency citations, Oregon AL/RC population data, and semi-structured interviews suggest that staff role clarity, organizational characteristics, and perceived agency influence decision-making around APU. AL/RC providers and caregivers are forced to simultaneously balance and prioritize …

Incarceration And Suicide: Do The Risk Factors Differ For Civilians And Veterans?, Rheannon Gail Ramsey

Dissertations and Theses

Suicide is one of the leading causes of death in United States jails and prisons. Many researchers have looked at suicides in prisons and what can potentially cause suicidal ideation but there are conflicting findings among civilian incarcerated populations and United States military veteran incarcerated populations.

The intent of this study is to examine which risk factors are most prevalent among adults in custody, with a focus on mental health and substance use or abuse and how these risk factors differ between incarcerated civilians and incarcerated veterans. Using survey data from the 2002 Survey of Inmates in Local Jails conducted …

Returning To Rejection: Outcomes And Boundary Conditions Of Mental Illness Stereotypes, Stefanie Fox

Dissertations and Theses

Mental illness is a common condition in the United States, with over 20% of working age adults managing a mental illness condition in a given year. Disclosure of mental illness is often required for workers to take advantage of employer-provided resources (e.g., accommodations), yet use of resources is exceedingly low (less than 10%). Negative stigma-related outcomes are a top reason for which individuals delay the use of resources. Using an experimental design in an online data collection of 242 participants over two time points, the current study builds on existing organizational diversity literature to examine the stereotypes associated with mental …

Individual And Community Supports That Impact Community Inclusion And Recovery For Individuals With Serious Mental Illnesses, Rachel Elizabeth Terry

Dissertations and Theses

The current dissertation presents two published manuscripts and discusses a third study that explored the role of social support in promoting community participation for individuals with serious mental illnesses. The first manuscript investigated sense of community as a potential mediating factor between community participation, psychological distress, and mental health functioning utilizing quantitative methods. The results indicated that sense of community acted as a partial mediator between community participation and psychological distress, as well as mental health functioning. The second manuscript is a literature review that explored the influence of social support on community integration for individuals with serious mental illnesses. …

To Disclose Or Not To Disclose? Self-Disclosure Of Mental Health In The Workplace, Samantha Margaret Reynolds

Dissertations and Theses

When making the decision to disclose a mental illness, individuals may be met with a number of factors that impact disclosure. This study examines the relationship between self-stigma, psychological safety, social support and self-disclosure of mental illness in the workplace. The present study surveyed 756 participants and found a positive relationship between stigma and self-disclosure as well as a positive relationship between social support and self-disclosure. For work outcomes, there was a negative relationship between both job satisfaction and productivity in relation to self-disclosure. This study potentiates the antecedents and consequences of self-disclosure of mental illness and how it impacts …

Attrition And Psychotherapy, Jesse Barrington Homan

Dissertations and Theses

Attrition in psychotherapy, also known as dropout, is a problem that affects clients who terminate, their families, therapists, mental health systems, and the overall community. Research on attrition is vast. However, the majority of this research has been done post hoc, relied on quantitative methods, and looked primarily at client demographic variables as the predictors of attrition. This has resulted in inconsistent findings, offers little to no useful information about attrition, and appears to blame clients for failed therapy. There has been little research on attrition from the perspective of clients who terminate. This study was designed to answer the …

Urbanicity As A Moderator Of The Relationship Between Stigma And Well-Being Outcomes For Individuals With Serious Mental Illnesses, Emily Leickly

Dissertations and Theses

During the deinstitutionalization movement in the 1960s, community mental health centers and supportive and affordable housing for people with serious mental illnesses (SMI) was concentrated in economically disadvantaged urban centers. Today, these urban centers are becoming increasingly gentrified and unaffordable for people with SMI. Affordability is no longer synonymous with urban living, and supportive housing for people with SMI is increasingly found in non-urban areas. Given this shift, it is important to understand the potential impacts of non-urban living on people with SMI. Non-urban environments provide potential benefits for the general population, including reduced traffic and increased proximity to the …

Impactful Care: Addressing Social Determinants Of Health Across Health Systems, Nicole Lisa Friedman

Dissertations and Theses

There is emerging evidence that addressing health-related social needs through enhanced clinical-community linkages can improve health outcomes and reduce costs. Unmet health-related social needs, such as food insecurity, inadequate or unstable housing, and lack of access to transportation may increase the risk of developing chronic conditions, reduce an individual's ability to manage these conditions, increase health care costs, and lead to avoidable health care utilization. In response, work on social needs is happening across large health systems in the United States, but the pace of progress is slow and accountability is diffuse.

The goal of this applied research project is …

Development And Validation Of The Workplace Mental Illness Stigma Scale (W-Miss), Nicholas Anthony Smith

Dissertations and Theses

Although 1 in 5 Americans will experience a mental illness at some point, each year people with mental illnesses continue to face high levels of stigmatization and discrimination at work. Recognizing this, many organizational researchers and practitioners have sought to improve workplaces for employees with mental illness through a variety of organizational interventions. Unfortunately, few interventions are thoroughly evaluated. One barrier to evaluating such interventions is the lack of a theoretically meaningful measure of workplace mental illness stigma. In this dissertation, I proposed to develop and evaluate such a measure (the W-MISS) based on Jones, Farina, Hastorf, Markus, Miller, and …

Exploring The Association Of Victimization And Alcohol And Marijuana Use Among American Indian Youth Living On Or Near Reservations: A Mixed Methods Study, Lindsay Nicole Merritt

Dissertations and Theses

Adolescent substance use research has yet to consider victimization as a potential risk factor contributing to alcohol and marijuana use among American Indian youth living on or near reservations, despite the presence of traumatic experiences, childhood adverse events, racism, and discrimination. Contribution to this lack of attention may be due to little being known about American Indian youth victimization. Even less is known about its association with alcohol and marijuana use in general and for those youth living on or near reservations in particular.

This study utilizes mixed methods with a nationally representative sample of American Indian youth living on …

Is Therapy Going To The Dogs? Evaluating Animal Assisted Therapy For Early Identified At-Risk Children, Leah Faith Brookner

Dissertations and Theses

This study explores the historical context of human-animal relationships and examines the important ways that humans benefit from various types of interactions with domesticated animals. Therapeutic approaches that incorporate animals have been shown to have multiple benefits, including improved physical and mental health. Although this area of study is still largely overlooked in scientific fields of study, including social work, Animal Assisted Therapy (AAT) has become increasingly prevalent in various mental health settings. Despite its popularity and anecdotal support, research on the benefits of AAT with children is minimal; there are no studies examining the ways in which this approach …

Understanding Neighborhood Satisfaction For Individuals With Psychiatric Disabilities: A Mixed Methods Study, Amy Leigh Shearer

Dissertations and Theses

Physical and social characteristics of neighborhoods are important to resident satisfaction for clinical and nonclinical populations. This study draws upon data collected from a sample of 172 individuals with psychiatric disabilities living in 16 supportive housing sites in the Portland, Oregon metropolitan area. Research questions explore the extent to which subjective and objective measures of neighborhood physical and social environments contribute to neighborhood satisfaction for this population. Mixed methods were employed to construct a detailed understanding of the factors that influence satisfaction with one's neighborhood of residence. Predictor variables were neighborhood social climate, neighborhood physical quality, perceptions of safety, crime …

Social Support And Depression Symptomatology Post Injury In Division 1 Athletes, Alyssa Catherine Tiedens

Dissertations and Theses

The way in which an athlete responds to the injury--emotionally, behaviorally, and cognitively--can significantly affect the athlete's mental health in a negative way if not handled appropriately. There are different forms of social support that are known to be helpful with coping during specific stages of injury. The purpose of this study was to examine the relationship between perceived levels of social support and depression symptomatology post injury in Division 1 collegiate athletes at Portland State University (PSU).

Participants were PSU student athletes (n=115). Variables: social support amount (SSQN), social support satisfaction (SSQS), and depression symptomatology (CESD-R) score. Selected injured …

Transgender Patients' Experiences Of Discrimination At Mental Health Clinics, Corrine Ann Stocking

Dissertations and Theses

The transgender population is makes up about 0.3% of the U.S. population (Gates 2011). The term transgender is both an identity and an umbrella term used to describe people who do not adhere to traditional gender norms (Institute of Medicine 2011). Transgender people experience many barriers to services, negative health outcomes, and discrimination (Fredrikson-Goldsen et al. 2013; Institute of Medicine 2011; Eliason et al. 2009; Hendricks & Testa 2012). Mental health clinics are an important site for understanding transgender peoples' experiences due to being a gatekeeper for other medical services and their role in helping transpeople with issues surrounding coming …

A Cross-Sectional Study Of Student-Athlete Needs Satisfaction And Well-Being, Abigail M. Gunnink

Dissertations and Theses

Grounded in self-determination theory (Deci & Ryan, 2000), the purpose of this study was to examine (a) the effects of the social environment, as defined by the divisions of the Department of Athletics, on student-athletes' perceptions of basic needs satisfaction, (b) the effects of basic needs satisfaction on well-being, and (c) the effects of time demands, during in-season and off-season, on well-being, among student-athletes at Portland State University (PSU). Participants were student-athletes at PSU (n = 118). The participants completed a multi-section survey assessing basic needs satisfaction and well-being. Cumulative mean scores highlighted the satisfaction of the basic psychological needs …

Gender And Prescription Painkiller Misuse: Findings From The 2011 National Survey On Drug Use And Health, Robin Jo Clough

Dissertations and Theses

This study examines the effects of gender and social bonds on the experience of prescription painkiller misuse for men and women. The theoretical framework for the project is Travis Hirschi's social control theory (1969), and the social bond elements of attachment, commitment, involvement, and belief, which emphasizes the importance of these bonds in creating a "stake in conformity" for the individual, leading to acceptance of social norms and desistence from deviance. This theory, however, is relatively silent with regard to gender differences and was developed to examine delinquency in an all male sample of adolescents. The elements of this theory …

Bringing Functional Family Probation Services To The Community: A Qualitative Case Study, Denise Lynmarie Austin

Dissertations and Theses

In March 2011, Multnomah County's Juvenile Services Division (JSD) in Portland, Oregon implemented a new program model called Functional Family Probation Services, a case management model based on the principles of Functional Family Therapy. Under this model JSD Juvenile Court Counselors deliver Functional Family Probation Services to medium and high-risk youth on probation; both to the youth and their family in their home. This qualitative case study examined the extent to which the Juvenile Court Counselors and Community Justice Managers implemented Functional Family Probation Service's components and recorded their opinions regarding Functional Family Probation Services as a case management model. …

"Who Would Have Thought, With A Diagnosis Like This, I Would Be Happy?": Portraits Of Perceived Strengths And Resources In Early-Stage Dementia, Jutta Elisabeth Ataie

Dissertations and Theses

This study used photovoice methodology to explore how people with early-stage dementia use their perceived strength and resources to cope with the illness. Purposive sampling was used to recruit participants. Thirteen women and seven men age 57 to 90 (mean 73.4) with MMSE scores ranging from 20 to 28 (mean 25.6) participated in the project. Participants were provided with a disposable camera and invited to take photographs relevant to their well-being. The photographs provided the means for participants to take the lead in dialogue sessions about their coping response.

Grounded theory analysis revealed that initially, early-stage dementia precipitated a disruption …

The Historical, Political, Social, And Individual Factors That Have Influenced The Development Of Aging And Disability Resource Centers And Options Counseling, Sheryl Dejoy Elliott

Dissertations and Theses

This thesis reports on the perspectives and experiences of policymakers, advocates, agency supervisors, and experts in the field of gerontology, about the development of Aging and Disability Resource Centers (ADRC) programs and Options Counseling (OC). By examining the foundations upon which ADRCs and OC are built, this study sought to inform future research about the effectiveness of existing practice, increase understanding of best practices, and clarify whether these emerging services are accomplishing original goals.

ADRCs and OC intend to address long-term care issues and healthcare needs by providing a single entry point to the social service system. ADRCs offer information, …

Empowerment In Community-Based Participatory Research With Persons With Developmental Disabilities: Perspectives Of Community Researchers, Erin Elizabeth Stack

Dissertations and Theses

Community-based participatory research (CBPR) is a research approach that benefits from the expertise of community members being involved in the research along all stages of a project (Israel et al., 2003). CBPR is often utilized with marginalized populations in order to amplify a community's voice on important issues in their lives (Bastida, Tseng, McKeever, & Jack, 2010; Minkler & Wallerstein, 2008). In the past, persons with disability have been excluded from research in order to protect them from exploitation. This practice of exclusion undermines opportunities for persons with disabilities to be independent and make decisions that are important for themselves …

Humor-Related Social Exchanges And Mental Health In Assisted Living Residents, Ann Elizabeth Mcqueen

Dissertations and Theses

Social contact is known to be vital for older adults' mental and physical health, but few studies of social interactions have taken place in long-term care settings. The current study investigated whether the psychological well-being of assisted living residents was influenced by factors associated with residents' social interactions involving humor. Specific aims of the present study were to develop and test a measure related to humor-related social exchanges, to examine how humor-related social exchanges affect residents' mental health, and to explore whether humor-related social exchanges mediated the effects of resident and facility characteristics on indices of mental health. One hundred …

Exploring Support Network Structure, Content, And Stability As Youth Transition From Foster Care, Jennifer E. Blakeslee

Dissertations and Theses

Many older youth in foster care lack adequate resources and ongoing support in their social networks as they transition into young adulthood, while other youth in these circumstances experience stable social networks providing comprehensive support. Systematically measuring the supportive personal and service-oriented relationships in youth networks expands the scope of inquiry in this area by identifying patterns of social network structure, member composition, and relational qualities that are associated with more or less support provision through formal and informal relationships. These can also be measured over time to observe changes in network form and content and assess network stability. This …

Predictors Of Depression In American Indian Adolescents, Quang Duong-Tran

Dissertations and Theses

Discriminant analysis was conducted to examine the empirical use of psychosocial variables and stressful life events scales in classifying depressed and non-depressed American Indian adolescents using a standardized criterion measure. Subjects attending a Bureau of Indian Affair boarding school were administered a mental health screening survey and were interviewed within four weeks using the Diagnostic Interview Schedule f or Children-Revised (DISC-R). Three models of discriminant analysis were used to determine the overall and incremental variance contributed by the stressful life events scales and the related psychosocial variables (i.e., gender, perceived social support from family and from friends, self-esteem, and depressive …

Toward Predicting Completion Of Substance Abuse Treatment, Rebecca Lee Bragg

Dissertations and Theses

This investigation attempts to identify factors which influence whether or not someone is likely to drop out of a chemical dependency treatment program. Dropping out is defined as someone who leaves treatment against medical advice.

The subjects were patients from a private, non-profit, medically based, residential program. Nine demographic characteristics were abstracted from the charts on file for the patients at the treatment center. Two groups of 45 patients each were selected from the inpatient population. One group, the Completed Treatment group, comprised patients who had completed the 28 day program. The second group, the AMA Discharge group, comprised patients …

The Relationship Of The Perception Of Choice And Positive Behavior Change In Adolescent Residential Treatment With Future Success In The Community, Rita Harding Mcclellan

Dissertations and Theses

The purpose of this study was to explore the relationship of clients' perception of choice in treatment planning and the clients' positive behavior changes made within the treatment setting, with the clients' successful return to the community after release from the residential treatment setting.

Effects Of Stress Management Instruction And Anxiety Monitoring In Adult Day Treatment Population, Jack Blanton Wills

Dissertations and Theses

This study examines the effectiveness of a particular stress management intervention with adult outpatients diagnosed as chronic schizophrenics. The setting for the study was the Portland, Oregon, Veteran's Administration, Outpatient Clinic, Day Treatment Center. The intervention was composed of two factors; 1) stress management training and 2) Behavior-Graph Instruction. Both of these were presented using a psychoeducational model of classroom instruction, role play, and discussion.

Internal External Locus Of Control And The Choice Of Therapy, Marlene Eid

Dissertations and Theses

The purpose of this study was to determine whether a relationship exists between the scores subjects obtain on Rotter's Internal-External Locus of Control Scale and the type of therapy they prefer. Two hundred and fifty-four students in general psychology classes were given Rotter's Scale. Considering their upper- and lower-third scores, 54 were classified as " Internals," 53 as "Externals." Subjects also were given written descriptions of both psychoanalytic and behavioristic therapies. Each of these descriptions dealt with the goal and the specific therapeutic procedure of the respective therapies. Subjects were asked to identify which therapy they preferred and to provide …

Career Lines In The Area Of Mental Retardation, Charlotte Ballard

Dissertations and Theses

In the past few years there has been a large growth in the number of facilities and services provided to the mentally retarded in the community, as contrasted to the institutional setting.

This thesis reviews some of the factors involved in the transition to community care for the mentally retarded as a background for an examination of the characteristics and perceptions of the persons who provide community care.

The Psychological Intervention Of Group Therapy For Women Coping With Genital Herpes, Susan D. Ferguson

Dissertations and Theses

Three groups of women who had been diagnosed as having genital herpes completed a series of psychological assessments over the course of the four-month research period. One group received two-hour weekly group psychotherapy sessions for eight consecutive weeks as a mode of treatment intervention. Two control groups were used for efficacy of treatment comparison. One control group consisted of regular members of a local self-help chapter for herpes victims. The second control group was formed from those volunteers willing to participate, but who did not choose, or desire, any form of treatment, Outcome measures reflected a greater improvement in psychological …

Development Of An Mmpi Scale To Predict Therapeutic Response To Lithium Carbonate, Neal Allen Hayden

Dissertations and Theses

Common medications utilized in the treatment of psychosis include lithium carbonate and the major tranquilizers. The efficacy of lithium is well established in the treatment of manic-depressive patients exhibiting symptoms of mania. The major tranquilizers treat a broader range of psychotic disorders including schizophrenia.

In the treatment of manic-depressive illness, lithium produces normalization of affect with few side effects. However, since the interval between therapeutic and toxic dosages is narrow, lithium treatment must be closely monitored to avoid severe physical problems and even death. When a schizophrenic is incorrectly diagnosed as manic-depressive, and is treated with lithium, the patient does …