Social and Behavioral Sciences Commons^™

An Analogue Study Of Expected Working Alliance And Hope With Victims Of Military Sexual Trauma Among Civilian And Military-Oriented Therapists, Alishia D. Salyer

Dissertations

Victims of military sexual trauma (MST) face unique challenges as they pursue mental health treatment and supportive care. Understanding what factors impact potential treatment outcomes is critical in aiding in their recovery (Castro et al., 2015; Kroviak, 2020). Although a substantial amount of research has been conducted to evaluate prevalence and client factors associated with treating victims of MST (Teit et al., 2015; Turchik & Wilson, 2010), little is known about therapists’ factors including therapists’ expectations working with such clients. The purpose of this study was to examine the relationships between therapist type (military-affiliated versus civilian), therapist gender, client gender, …

Effects Of A Self-Forgiveness Intervention On Recovery From Substance Use Disorders, Michael Saltzman

Dissertations

Previous research has highlighted the relationship between shame, guilt, and problematic substance use (Gueta, 2013; Luoma et al., 2019; McGaffin et al., 2013; Rahim & Patton, 2015). Self-forgiveness has been associated with positive outcomes for individuals in recovery with substance use disorders (SUDs), though only one prior study has explored the effects of a selfforgiveness intervention for individuals in treatment (Scherer et al., 2011). This study examines the effects of a self-forgiveness intervention on state shame and guilt, state self-forgiveness, and drug avoidance self-efficacy, and it is the first intervention study to focus on self-forgiveness for individuals with SUDs receiving …

The Influence Of Demographic, Social, And Economic Factors On Referral For Heart Failure Services, Catherine Elaine Kelty

Dissertations

Patients with end-stage advanced heart failure must go through an extensive evaluation process before being selected for either heart transplantation or left ventricular assist device (LVAD). This evaluation not only assesses a patient’s medical need for advanced heart failure treatments but also includes an assessment of psychosocial and economic factors that may affect a patient’s success post-treatment. While it is important to allocate scarce resources, such as donated organs, to the patients who will benefit the most, there is also a need for equity in the allocation of and access to healthcare services. This raises the question of whether patients …

Generation Status, Ethnic Identity, Colonial Mentality, And Enculturation In Filipino Americans, Kamille Patricia Urmaza La Rosa

Dissertations

Filipino Americans’ psychological experiences pertaining to their generation status, ethnic identity, enculturation, and colonial mentality are rarely studied in counseling psychology due to inconsistent disaggregation of Asian American and Pacific Islander (AA&PI) data (Agbayani-Siewert, 2004; Espiritu, 2003; Nadal et al., 2010; Okamura, 2013). Literature suggests that the study of these constructs related to their mental health can guide more culturally informed care for this historically excluded population (David & Nadal, 2013; Nadal, 2020). The current study used an exploratory design to test six research hypotheses and accomplish the following: examine relationships between the constructs, investigate intergenerational differences, validate a measure …

The Influence Of Integrated Behavioral Health Primary Care Setting On The Utilization Of Mental Health Services And Depression Treatment Response Among Men, Tendai Masiriri

Dissertations

The 2010-2013 National Health Interview Survey showed that nearly 9% of men had daily feelings of anxiety or depression, yet less than 41% sought help for their symptoms (Blumberg et al., 2016). Men are more reluctant than women to seek help (Angst et al., 2002; Brownhill et al., 2005). The failure to seek help among men is associated with multiple factors related to stigma and gender, yet male suicide rates are approximately 3-5 times higher than their female counterparts. However, they have a higher likelihood of seeking help from a medical provider rather than a mental health provider. If men …

An Examination Of Types Of Health Insurance And The Reported Prevalence Of Autism In The United States, Jennifer L. Thompson

Dissertations

The prevalence of Autism Spectrum Disorders continues to rise despite barriers of changes to diagnostic criteria and lack of insurance coverage. Increases in prevalence affect costs associated with a disorder since cost of health care services are often estimated based on utilization of services. This can also affect an individual’s ability to access to health care services. To equitably distribute autism services to individuals an accurate estimation of the true prevalence of autism is needed.

Access to health care can be influenced by the type of insurance coverage a person holds. Other factors, such as socio-economic status, ethnicity, location of …

Preclinical Behavioral Assessment Of Chronic, Intermittent Low-Dose Psilocybin In Rodent Models Of Depression And Anxiety, Harmony I. Risca

Dissertations

Recent studies have demonstrated the clinical efficacy of psychedelic-assisted psychotherapy for treatment-resistant depression and anxiety. Amidst the overall success of recent clinical trials using a single high dose of psilocybin, anecdotal reports indicate anxiolytic and antidepressant effects following a repeated low dose regimen. As therapeutic outcomes are often tightly intertwined with the individual’s subjective experience, animal models are used as objective measures to investigate the underlying mechanisms responsible for the putative antidepressant/anxiolytic effects of psychedelics. Three rodent models predictive of anxiolytic or antidepressant effects were used to evaluate effects of chronic intermittent low dose (CILD) psilocybin treatment; the Light/Dark conflict …

Evaluation Of Telehealth Training To Teach The Stimulus Identification Questionnaire And Multiple Stimulus Without Replacement, Andrea Perez

Dissertations

The field of behavioral gerontology has seen a paucity in literature within the past 15 years focused on updating training technology and teaching best practice skills to staff. Specifically, there is a need to expand the breadth of training research focus areas could more broadly the elderly population (e.g., increasing engagement), to ensure that trainings are designed to equip caregivers with the skills to be independent, and finally, given the frequent staffing challenges experienced by aging settings (Harrington et al., 2020), to explore effective and efficient training techniques that are alternatives to lengthy, in-person training modalities. Given the personnel challenges, …

Behavioral Economic Modeling Of The Effects Of Symptom, Severity, And Cost On Seeking Medical Care, Mark J. Rzeszutek

Dissertations

While the United States has some of the highest healthcare spending in the world, it has some of the worst health outcomes. For example, maternal mortality in the United States is almost five times as high as in other similarly wealthy countries. It also has the highest rates of avoidable deaths. One of the reasons for this may be the cost of accessing healthcare due to privatized insurance. For example, Americans may avoid important preventive medical visits and other health screeners due to cost. While lack of health insurance has been correlated with decreased health utilization, a precise understanding of …

Psychological Wellbeing And Sense Of Community Among African Americans: Does Purpose In Life Matter?, Yatesha D. Robinson

Dissertations

This dissertation examined the relationships between sense of community, purpose in life, and psychological wellbeing among African Americans. It investigated whether purpose in life moderated the relationship between sense of community and psychological wellbeing. Although previous studies have linked a sense of community and purpose in life with wellbeing, few studies have examined these relationships among African Americans using a multidimensional model. The data for the current analysis were drawn from the third wave of the National Survey of Midlife Development in the United States study (MIDUS 3), collected between 2013–2014. The sample included 98 African American men (n …

A Study Of Communication Practices Between Office And Field-Based Personnel In Home Healthcare Agencies, Ruth M. Bates-Hill

Dissertations

The population of developed countries is rapidly aging. People want to age in their residence, and as they advance in years, most people will need assistance with activities of daily living and perhaps medical assistance to remain at home. Home health aides provide a large portion of such care. However, the annual turnover rate of home health aides exceeds 60% due to factors such as low wages, poor benefits, and a challenging work environment. Many studies have been conducted to elucidate the factors contributing to job satisfaction in the home health aide population, yet despite decades of research, turnover among …

Acculturation, Psychological Well-Being And Substance Use Behaviors In Asian Indian Americans, Sonia Y. Amin

Dissertations

The American population is becoming more diversified with increases in the number of immigrants and refugees entering the country. These new Americans bring distinct cultural values, traditions, and worldviews. With this diversity, an important need has arisen to better understand the interplay of culture, physical, and mental health concerns that affect specific racial and ethnic populations. This increase in knowledge and awareness will aid in the development and provision of culturally-sensitive mental health services. The stress of immigration and the multifaceted sociocultural and psychological adaptations involved in adjusting to living in a new country with a Eurocentric dominant culture can …

A Phenomenological Study Of Faculty Members’ Experiences With Attempting To Integrate Religion And Spirituality Into Counseling Psychology Doctoral Training, Theresa M. Nutten

Dissertations

Religion and spirituality (R/S) are two of several multicultural variables salient to some clients seeking counseling, therefore psychologists are expected to be sensitive to and respectful of R/S in professional duties (APA, 2017a; APA, 2017b). However, research has shown that the integration of topics of R/S into the training of psychology graduate students has been minimal at best (Brawer et al., 2002, Hage et al., 2006, Saunders et al., 2014; Schafer et al., 2011; Schulte et al., 2002; Vogel et al., 2013). There are potential logistical and personal barriers to the inclusion of religion and spirituality into mental health training …

A Signal Detection Framework For Evaluating The Effects Of Feedback On Stroke Recognition, Jordan D. Bailey

Dissertations

The impact of stroke on the lives of individuals and the healthcare system is considerable. Damage from stroke can be reduced if the treatment is administered at the appropriate time so early recognition is essential. One problem is that strokes present in a variety of ways that sometimes do not fit into the Facial drooping, Arm weakness, Speech difficulties and Time (FAST; American Heart Association, 2019) acronym. Signal detection is one way to measure decision making under conditions of uncertainty (e.g., discriminating stroke symptoms and risk factors from other symptoms, and non-risk factors). The methodology also allows us to consider …

Can A Brief Online Intervention Change Low-Income Caregivers’ Reported Use Of Spanking? A Randomized Controlled Trial, Hilary L. Richardson

Dissertations

Spanking is commonly used by parents (64-94%) in the United States as a strategy for managing undesirable child behaviors. Research has found that the use of spanking is particularly high among young mothers, low-income parents, and African American families. Decades of literature on the use of spanking has identified abundant detrimental outcomes for children such as increased externalizing behaviors, decreased long-term compliance, and less guilt following misbehavior, as well as serious outcomes in adulthood such as depressed mood and alcohol/drug use. There is also a risk for spanking to escalate to physical abuse. Thus, safer, more effective discipline strategies are …

Training Practitioners On The Effects Of Psychotropic Medication Via A Web-Based Platform, Anita Li

Dissertations

Many individuals diagnosed with autism spectrum disorders (ASD) receive multiple therapeutic services in an attempt to supplement behavioral therapy. These services include pharmacological interventions. Two drugs, risperidone (Risperdal) and aripiprazole (Abilify), are FDA-approved to treat “irritability” in children with ASD. Research shows that the effects of risperidone and aripiprazole on irritability varies greatly across treated individuals. Therefore, individualized monitoring and evaluation must be conducted to provide the physician with data to determine if the medication is resulting in desired changes and effects. Certified behavior analysts are trained in data collection and experience high levels of contact with individuals diagnosed with …

From The Boots On The Ground: A Comparison Of The Attitudes And Beliefs Of Military Members And Mental Health Professionals Regarding The Moral Injury Construct, Karis L. Callaway

Dissertations

An increasing amount of research conducted in recent years indicates that, in addition to Posttraumatic Stress Disorder, moral injury is a key concept to recognize when considering the deployment experiences of service members. Although related to Posttraumatic Stress Disorder, which is a fear-based mental health diagnosis, moral injury is a distinct concept. It acknowledges the possible prolonged negative psychological, social, and spiritual consequences that may occur after experiences that challenge and transgress one’s deeply held moral beliefs. Events such as perpetration of harm, failing to protect or prevent harm, and witnessing or learning about distressing acts committed by influential others …

A Phenomenological Investigation Of Women’S Infertility And Miscarriage Grief Experiences, Tristan Mcbain

Dissertations

Infertility and miscarriage are reproductive losses that often produce grief reactions in affected women. This phenomenological study investigated the grief experiences of infertility and miscarriage through the ambiguous loss and disenfranchised grief frameworks in order to better understand both the obscurity of reproductive loss and how the resulting grief may be invalidated.

Sixteen women volunteered to participate in this study and each fell into one of the following three categories: women affected by infertility without miscarriage (4); women affected by miscarriage without infertility (4); and women affected by infertility and miscarriage (8). A phenomenological hermeneutic approach was utilized to uncover …

Qualitative Analogue Study On Student Therapist’S Reactions To Client Suicidality, Cynthia A. Beevers

Dissertations

Suicidal clients are a reality for both professional and student therapists providing counseling (Chemtob et al., 1988; Dexter-Mazza & Freeman, 2003; Goodman, 1995; Howard, 2000; Jacobson, Ting, Sanders, & Harrington, 2004; Kleespies, Penk, & Forsyth, 1993; Kleespies, Smith, & Becker, 1990; Mackelprang, Karle, & Cash, 2014; McAdams & Foster, 2000). Previous research has investigated the experiences of professional therapists working with suicidal clients, but little is known about student therapists’ experiences with suicidal clients. Only two studies were found investigating the experiences of student therapists working with suicidal clients (Kleespies et al., 1993; Kleespies et al., 1990). However, in the …

Primary Care Physician Delivered Brief Behavioral Intervention For Adult Obesity And Associated Health Conditions, Julia C. Huston

Dissertations

Obesity is a chronic health condition with prevalence rates that have continued to rise steadily over the past 30 years to the point that it has now been declared a global epidemic and a serious public health concern. Obesity is associated with significant physical and economic costs, primarily resulting from co-occurring health conditions that increase the risk of morbidity including type II diabetes, hypertension, dyslipidemia, stroke, coronary heart disease, and respiratory problems. Despite the dissemination of several obesity treatments, including pharmacotherapy, lifestyle modification, and bariatric surgery, the prevalence and severity of obesity continues to rise. Federal guidelines recommend the use …

Demonstrating Functional Analytic Psychotherapy As An Independent Variable In Efficacy Research: A New Measure Of Treatment Fidelity, Lindsey E. Knott

Dissertations

Functional Analytic Psychotherapy (FAP) is a contextual behavior therapy that takes an in session, in vivo focus to improve client outcomes. This in vivo (IV) focus is distinctive of FAP and involves the therapist utilization of contingencies in session to decrease problematic response classes and increase more adaptive response classes (i.e., a differential reinforcement procedure). This contingent responding is proposed to be FAP’s mechanism of action leading to client change. FAP efficacy research mainly consists of small n single-case studies or group designs combing FAP with another CBT intervention. Maitland & Gaynor (2012) offered recommendations for increasing FAP efficacy research, …

Assessment For Mild Cognitive Impairment: Striving For Best Practice, Julie Leigh Dalmasso

Dissertations

This dissertation is a series of three studies aimed at determining the best assessment practices for mild cognitive impairment (MCI) that can employed by speech-language pathologists (SLPs). The first study was non-experimental and descriptive examining whether three commonly used assessment instruments yielded similar categorical results. The data were analyzed to determine whether the Eight-Item Interview to Differentiate Aging and Dementia (AD8), the Mini-Mental State Examination (MMSE), and the Cognitive-Linguistic Quick Test (CLQT) identified the same participants from a neurotypical sample as having cognitive deficits. Very little agreement was found amongst the three tools.

Study two was modified to include two …

Evaluation Instruction In Council On Education For Public Health Accredited Master Of Public Health Schools And Programs, Kristin Ann Hobson

Dissertations

Despite the increasing role of evaluation in public health practice and research (Association of Schools and Programs of Public Health [ASPH], 2006; Institute of Medicine [IOM], 1998; Public Health Functions Steering Committee, 2008; United States Government Accountability Office [GAO], 2012), as well as Henry and Mark’s (2003) assertion of a need for systematic evidence on evaluation training and education, the literature continues to lack studies on evaluation instruction in Council on Education for Public Health (CEPH)-accredited Master of Public Health (MPH) schools and programs. As such, this study explored evaluation instruction in CEPH-accredited MPH schools and programs in the following …

Three Essays On Informal Payments In The Health Care Sector In Russia, Alexandra Polovinka

Dissertations

Health care is one of the most corrupt sectors in Russia. In 2015 twenty percent of patients paid a bribe for the health care services once or twice, and thirteen percent more than twice (Russian Public Opinion Research Center, 2015). Using data on adults from over 5,000 households in Russia, this three-essay study analyzes out-of-pocket formal (official) and informal (unofficial, bribes) payments for the health care.

In the first essay, I study whether there is a difference in the amount of unofficial pay-ments across five types of health care services (ambulance, inpatient, outpatient, dental, and medical checkups) and two types …

Piloting A Screening Tool For Eating And Eating-Related Behavior, Michael N. Reynolds

Dissertations

Obesity is a common medical condition associated with negative health and social outcomes. Obesity has a primary malleable behavioral cause, eating more calories than are metabolized. While metabolic rate is malleable with exercise, eating can more quickly add calories than exercising can subtract them. In the past, behavioral weight-loss treatment studies relied on multi-component package interventions that have shown reliable patterns of participant weight-loss during treatment and weight-regain in follow-up. Those findings could be conceptualized as an ABA withdrawal design, eating behavior returns to baseline after the prosthetic contingencies of the treatment study are withdrawn. We must develop ways to …

The Effects Of Schedule Density Of Reinforcement For Alternative Behavior On Resurgence, Kathryn M. Kestner

Dissertations

Resurgence is the reemergence of a previously extinguished response when an alternative response no longer produces reinforcement. Although returning to previously successful methods for obtaining reinforcement is likely advantageous, resurgence also occurs in the form of treatment relapse. An individual may return to problematic behavior (e.g., aggression, self-injury, drug use) when an alternative behavior (e.g., communication response, coping skill, social behavior, etc.) is no longer successful at producing a reinforcer. Behavior analysts rely on treatments based on differential reinforcement of alternative behavior, and resurgence has been demonstrated following changes to reinforcement schedules due to errors in treatment integrity or intentional …

Functional Analysis Of Gambling, Mack S. Costello

Dissertations

Given high rates of gambling and the growing population of disordered gamblers, there is a need to develop assessment strategies with improved treatment validity. More specifically, assessment strategies are needed that identify the controlling variables for disordered gambling and, thus, provide guidance in the selection of treatment and prevention strategies. This study sought to develop a functional analysis for gambling by utilizing a simulated gambling environment in which contextual variables hypothesized to be causally linked to disordered gambling could be systematically manipulated. Seven experienced gamblers participated in the multi-element, single-subject experimental study. Participants who endorsed at least some problems from …

Preferences For Evidence-Based Depression Treatments: An Emphasis On Patient-Focused Care, Lauren A. Frye

Dissertations

Research indicates most depressed patients in the general U.S. adult population seek depression treatment in primary care settings where the prevailing method of treatment is antidepressant medication. Although primary care physicians regard this approach as a preferable first line method of depression treatment, studies indicate many patients do not. Several studies have found depressed patients in these settings prefer psychotherapy or counseling over anti-depressant medication. Many advocate patient preferences should be integral to the treatment decision making process. There is a demonstrated propensity towards psychotherapy or counseling over antidepressant medication among depression patients. However, it is unclear which psychological depression …

Increasing Physical Activity In Young Adults With Autism Spectrum Disorder, Katherine B. Lalonde

Dissertations

Experts recommend that individuals walk 10,000 steps or more per day and doing so has been shown to have several health benefits. Unfortunately, many people fall short of 10,000 steps per day. Exercise levels are characteristically lower in people with Autism Spectrum Disorders (ASD) than in people without ASD. The present study comprised two experiments that used goal setting and reinforcement to increase physical activity in young adults with ASD. The first study employed a multiple-baseline-across-participants design in combination with a reversal design to determine the effects of a treatment package on the number of daily steps taken by young …

An Evaluation Of The Primary Care Providers’ Perspective Of The Effects Of Moderate Alcohol Consumption On Health, Gisele Tchamba

Dissertations

The complexity of health benefits of moderate alcohol consumption (MAC) is well documented. From the World Health Organization recent report, impact of harm from alcohol consumption was 3.3 million deaths or 5.9 percent of all global deaths (WHO, 2014).

Yet, the benefits of MAC for better health and longer life expectancy compared with abstinence are advocated in numerous studies (Nova, Baccan, Zapatera and Marcos, 2012). However, the nature of alcohol, its role on human sufferings has generated disagreements in the scientific community. Analysis of the results of early studies advocating better health for moderate drinkers, reveal discrepancies regarding the influence …