Social and Behavioral Sciences Commons^™

U.S. Military Veterans Transition To Two Midwest Universities: Post-Traumatic Stress Disorder, Moral Injury, And Academic Outcomes, Malychanh T. Bartlett

Dissertations

Abstract

Objective: To examine the association between posttraumatic stress disorder (PTSD) and moral injury (MI) and the extrinsic factors of the degree of negative patterns of healthy behaviors and negative experiences in an academic setting, the moderating effects of social support on PTSD and MI symptomatology, and the perception of academic success and positive perception of academic experience. Additionally, to examine the mediating effect of intrinsic factors (perceived academic experience) on academic outcomes objectively and subjectively.

Background: Student veterans as non-traditional students face challenges transitioning to the academic environment. Some have underlying mental and psychological complications of PTSD and MI, …

Treatment Outcome From Cognitive Processing Therapy Examined Three Ways, Sophie Haven

Dissertations

Cognitive Processing Therapy (CPT), a Cognitive Behavioral Therapy for treating Post Traumatic Stress Disorder (PTSD), is an evidence-based treatment that has been demonstrated to be effective in treating PTSD. Nonetheless, CPT can have a high rate of treatment non-completion. Attrition from therapy has been operationally defined using multiple contrasting methods. Understanding attrition using a definition with the most clinical utility is essential to improving outcomes from efficacious treatments. Two clinically relevant definitions for attrition, session attendance and symptom improvement, are critical to understanding attrition. Combining information from both definitions, to create four separate groups, will provide more accurate information about …

Self-Compassion And Experiential Avoidance: Potential Pathways To Posttraumatic Growth, Julia Sager

Dissertations

Social support has been identified as one of the most consistent predictors of posttraumatic growth (PTG). Although the role of social support in the process of PTG is informative, social support is intrinsically reliant on other people. Identifying internal, potentially malleable, factors that are associated with PTG is essential for developing preventative interventions to improve trauma-related outcomes and increase levels of PTG among trauma survivors. Internal processes such as self-compassion and experiential avoidance may promote, or interfere with, deliberate processing and the subsequent development of PTG; however, this has not yet been examined in the literature. Thus, the primary aims …

Gottman Processes And Couple Outcomes While Navigating Infertility, Clayton Brigance

Dissertations

Infertility remains one of the most difficult relational contexts for couples. However, some research suggests that some couples actually increase their overall satisfaction in their relationship through infertility due to a deeply shared emotional experience. To the knowledge of the author of this dissertation, no studies exist which explain how couples arrive at their relational outcomes through the experience of infertility. These studies within this dissertation add to the present literature by explaining how couples may arrive at their relational outcome through the lens of Gottman Method Couple Therapy (GMCT). For both studies presented here, 902 participants were recruited through …

Correlates Of Psychological Well-Being In Older Adults With Treatment-Resistant Depression, Selmi Kallmi

Dissertations

The purpose of this study was to examine the factors that are associated with psychological well-being in older adults with late-life depression and determine if social participation moderates and/or mediates these relationships. This dissertation study utilized secondary pre-treatment data collected from the “Optimum: Optimizing Depression Treatment in Older Adults” study (Cristancho et al. (2019). Community dwelling older adults (N = 369) were included if they currently met criteria for MDD, had failed at least two prior trials of MDD medication treatment, and were able to visit the study site to participate in cognitive and physical functioning assessments. Hierarchical multiple regressions …

Rethinking Binge Eating Disorder: Is Resource Depletion The Missing Link?, Laura Fewell

Dissertations

Binge eating disorder (BED), the most prevalent of the eating disorders, is associated with significant mental health impairments, high healthcare costs and utilization, and increased mortality. Yet little is known about the mechanisms involved in binge eating, and existing BED theories are incomplete. Scholars have recently suggested that resource depletion, or the state of reduced self-regulation abilities, may apply to BED, but no identified studies have experimentally examined this relationship. The purpose of the current study was to examine the role of resource depletion in binge eating behaviors. Ego anxiety, discomfort anxiety, and dietary restraint were also examined as potential …

Posttraumatic Stress Symptoms, Anger, And Substance Use As Risk Factors For Trauma Revictimization, Hannah E. Walker

Dissertations

Maltreatment survivors are at an increased risk for adult revictimization. Yet, existing work has specifically focused on sexual revictimization, and it is unclear what factors increase one’s risk for revictimization more broadly. Posttraumatic stress symptoms (PTSS), anger, and substance use have been identified as potential risk factors for sexual revictimization. Still, the role of these variables is ambiguous in the broader revictimization framework. There is also a lack of understanding regarding the roles of the DSM-5 posttraumatic stress disorder (PTSD) symptom clusters and revictimization. This study aims to: 1) examine the links between maltreatment and revictimization and three factors (i.e., …

What’S Religion Got To Do With It?: Differing Religiosity Domains’ Association With College Students’ Sexual Consent During First-Time Intercourse, Kaylee Richmond

Dissertations

Within the U.S., 36% of women and 17% of men report experiencing sexual assault (Smith et al., 2017). The absence of sexual consent is often regarded as a defining component of sexual assault (Beres, 2014); thus, a potential area to examine to decrease rates of perpetration and victimization. To date, there has been a lack of research on contextual factors that are likely related to sexual consent, with a general focus on external consent (i.e., verbal/behavioral indicators; Muehlenhard et al., 2016). The present study examined the role of a contextual factor, religiosity, on sexual consent processes during the context of …

Trauma And Alcohol/Substance Use: The Role Of Self-Regulation Flexibility, Saankari Anusha Challa

Dissertations

Despite a high comorbidity rate between trauma/PTSD and problematic alcohol/substance use, there is only a small body of work investigating moderators and mediators in this relationship. Few studies have examined the role of self-regulation, composed of coping and emotion regulation, in the context of PTSD and problematic substance use. Prior work has generally measured self-regulation categorically, with strategies labeled as maladaptive or adaptive, and therefore failing to account for the adaptiveness of the strategy in particular contexts. The present study is the only one to date to examine self-regulation flexibility in the relationship between posttraumatic symptoms (PTSS) and problematic alcohol/substance …

Heart Rate Variability Following Treatment For Ptsd: Testing The Polyvagal Theory, Brittany F. Goodman

Dissertations

Posttraumatic stress disorder (PTSD) has been linked to lower heart rate variability (HRV), including measures of vagal tone. Treatments targeting the autonomic nervous system (ANS) have demonstrated efficacy in improving vagal tone, but it is less clear whether similar effects can also be achieved with cognitive therapies. The polyvagal theory has suggested that symptoms of social dysfunction are linked to vagal tone through a phylogenetically organized response to stress. HRV was collected during rest, reactivity (exposure to personalized trauma scripts), and recovery using a scripted imagery paradigm in female PTSD positive physical and sexual assault survivors (N = 41) …

Impact Of Aging Information On The Continuing Education Preferences Of Behavioral Health Clinicians, Nicholas Schmidt

Dissertations

The United States population is aging rapidly and the behavioral health workforce is ill-prepared to meet the concurrent rise in demand for services for older adults. Clinicians specializing in working with older adults make up a very small portion of providers and the majority of service provision falls on general practitioners. The discipline of counseling has emphasized multicultural competencies in training and practice but has not specified standards of competence for work with older adults; little is known about the interests and training preferences of Licensed Professional Counselors (LPCs). This study examined the impact of receiving foundational information about aging …

Moth To A Flame: An Investigation Of The Personality Traits And Early-Life Trauma Histories Of Women Who Have Survived Adult Relationships With Men With Pathological Narcissism, Michelle D. Roberts

Dissertations

Although emotional and psychological abuse, in addition to physical assault, are now commonly accepted as aspects of Intimate Partner Violence (IPV), narcissistic abuse as a subset of IPV is not widely recognized or understood. Due to the extremely debilitating, chronic mental health effects of narcissistic abuse (Bremner, 2008; Campbell, 2002; Yoon et al., 2009), this study sought to explore the experiences, personalities, early-life (childhood) trauma histories and mental health outcomes of heterosexual women who self-identify as having been in an adult romantic relationship with a man with pathological narcissism. Specifically, this study aimed to identify the nature and frequency of …

Uncertainty In The Context Of End-Of-Life Communication In Heart Failure, Caleb Pardue

Dissertations

End-of-life communication between patients, their family members, and healthcare providers is essential to quality care at the end-of-life. Advance care planning is increasingly utilized to facilitate end-of-life communication, but heart failure patients in particular face numerous challenges to achieving adequate end-of-life communication. Extant literature has highlighted the inherent uncertainty in heart failure as a barrier to end-of-life communication as well as the role of time perspective on the experience of heart failure patients, but little empirical research has been conducted to examine the impact of these constructs. The sample included 168 participants with heart failure who were recruited online through …

Assessing A Cognitive Model Of Trauma-Related Sleep Disturbance, Rebecca Chesher

Dissertations

Sleep disturbance is a symptom of many mental health disorders that may negatively affect cognition and mood. Trauma-related sleep disturbance is a core reaction of traumatic stress and PTSD, similar to symptoms experienced by individuals with insomnia or other sleep-wake disorders. Although the cause and symptom progression of trauma-related sleep disturbance may be very different, research and clinical practice assess and treat it with measures and interventions designed for general insomnia. Using a cognitive model of insomnia modified for trauma-related sleep disturbance, the current study assessed the relations between select trauma and sleep variables within the proposed constructs of: 1) …

Exclusionary Beliefs, Multicultural Ideology, Empathy, And Perceived Threat: A Comprehensive Model Of Anti-Immigrant Prejudice, Reigna El-Yashruti

Dissertations

Despite the increased movement of people across national borders, anti-immigrant sentiment continues to pose challenges to immigrant mental health and disrupt intergroup relations. In the USA, where over 14% of the population is comprised of foreign-born individuals, immigrants continue to face prejudice from both the public and political administration. Intergroup Threat Theory (ITT) explains this prejudice as stemming from the perception that the out-group poses a threat to the cultural purity, economic stability, or physical safety of the in-group. Traits that promote group exclusion, such as perceived group superiority (i.e. Right-Wing Authoritarianism; RWA, Social Dominance Orientation; SDO, cultural dominance; CD) …

Psychological Factors Related To Physical Activity In Adult Congenital Heart Disease, Tyler Pendleton

Dissertations

Adults with congenital heart disease (ACHD) are a new and growing medical population. While medical interventions previously focused on reducing rates of infant mortality, current research suggests increased risk of premature mortality in ACHD may be partially due to acquired cardiovascular disease. One lifestyle intervention to reduce acquired cardiovascular risk is physical activity. Physical activity has been supported in the research as a safe, efficacious, and tolerable intervention for many ACHD; however, most patients do not engage in recommended levels of physical activity. The purpose of this study was to investigate psychological factors related to physical activity in ACHD. Participants …

Neurobiological Mechanisms Of Cognitive Processing Therapy For Post-Traumatic Stress Disorder: A Brain Network Approach, Tessa Vuper

Dissertations

Psychotherapy research is increasingly targeting both psychological and neurobiological mechanisms of therapeutic change. This trend is evident in and applicable to post-traumatic stress disorder (PTSD) treatment research given the high nonresponse rate of individuals with PTSD who undergo cognitive-behavioral therapy (CBT). A review of the literature investigating neurobiological mechanisms of CBT in PTSD reveals inconsistent results that fail to fully support dual process or learning models of CBT effects in the brain. However, network-based models of psychopathology provide a new framework from which to understand both mental disorder symptoms and therapeutic mechanisms. The current study investigated a) whether brain networks …

Women’S Sexual Satisfaction In The Context Of Midlife Relationships: Examining An Ecological Model And Intergenerational Caregiving, Katherine M. Arenella

Dissertations

This study examined an ecological model of sexual satisfaction in midlife women in relationships, and paid particular attention to the role of intergenerational caregiving in predicting satisfaction. Participants were 1,411 midlife women in relationships who participated in the Midlife in the United States (MIDUS) national study. Using split samples for replication purposes, data from this survey were examined to test the hypothesis that an ecological model - including the macrosystem level variable of religiosity, the exosystem level variables of SES, social support, and parenthood, the mesosystem level variables of relationship satisfaction, affectual solidarity, relationship length, and sexual functioning, and the …

Ptsd Symptom Interaction Among Victims Of Interpersonal Violence: A Network Analysis, Robert Graziano

Dissertations

Along with numerous combinations of symptoms, posttraumatic stress disorder (PTSD) is linked to high dropout and non-response rates in treatment. Poor treatment response may be due to an inaccurate conceptualization of PTSD. One newer approach to the conceptualization of psychopathology is network theory. Network theory posits that symptoms both directly and indirectly reinforce each other, with connections between symptoms varying in strength. Previous studies of network theory and PTSD have found intrusive symptoms to be highly central, but have not included samples of individuals traumatized by interpersonal violence. Because trauma type has been shown to predict symptom presentations, this represents …

Examining The Gender- And Sexuality-Related Cognitive “Stuck Points” Of Men And Women With Experiences Of Adult Sexual Assault: Implications For Cognitive Processing Therapy, Marin Beagley

Dissertations

Cognitive Processing Therapy (CPT) is considered a gold-standard psychotherapy protocol for the treatment of posttraumatic stress symptoms secondary to a variety of traumatic events. Despite its demonstrated efficacy, there is research to suggest CPT may not be as effective in reducing PTSD symptoms for men with an adult sexual assault trauma as it is for their female counterparts. The purpose of the present study was to determine whether CPT treatment outcome discrepancies may be attributable to gender differences in posttraumatic cognitions, or “stuck points.” As the act of sexual victimization is incongruent with socially prescribed masculine gender norms, it was …

Same-Sex Sexual Coercion Among Women: The Impact Of Minority Stress On Perpetration And Victimization Experiences Of Women Of Diverse Sexual Identities, Allison Kirschbaum

Dissertations

The purpose of the current study was to investigate women’s experiences with same-sex sexual coercion perpetration and victimization. Specifically, I sought to explore the role that the stress of living as a sexual minority plays in these experiences as well as to determine whether the psychological variables of perceived powerlessness, psychological distress, social support, and alcohol use mediate the relationship between minority stress and perpetration and victimization experiences. Data were collected online from self-identified women and individuals assigned female at birth who reported experiencing genital sexual contact with another woman (N=339). Of the cisgender women in the sample, 31.6% reported …

Evaluation Of A Brief Online Alcohol Intervention For College Students: The Role Of Race-Specific Normative Feedback, Racial/Ethnic Identity, And Readiness To Change, Jacob Scharer

Dissertations

Brief online interventions are effective for reducing alcohol use among college students. However, some research has suggested that these interventions may be less effective for African American students. This study evaluated the acceptability and efficacy of a widely available brief online alcohol intervention in a sample of African American and Caucasian college students through a randomized controlled trial. The aims of this study were to determine if providing race-specific normative feedback impacted treatment efficacy for African American students, and if this effect was moderated by racial/ethnic identity and readiness to change. Participants were 310 heavy drinking African American and Caucasian …

Psychological Correlates Of Diverse Coerced Sexual Experiences: Clarifying Classes And Severity Continuums Of Sexual Act And Coercive Tactic, Sara Kern

Dissertations

Although different coerced sexual experiences have been associated with different psychological symptoms (e.g., Davis et al., 2014), many limitations have plagued previous classification systems and severity continuums of coerced sexual experiences. The present study aimed to uncover meaningful differences across classes of coerced sexual experiences for the dimensions of sexual act and coercive tactic to inform future classification systems and severity continuums. Participants with a history of coerced sexual experiences (N = 402) completed an online survey about their worst or only coerced sexual experience, identifying the worst (or only) sexual act and the worst (or only) coercive tactic that …

Understanding Comorbid Depression In The Context Of Ptsd Through Underlying Dimensions, Melissa Turkel

Dissertations

Depression co-occurs with Posttraumatic Stress Disorder at a high rate, resulting in numerous complications for pathology and treatment. More research is needed regarding variables that may explain this common comorbidity. One possible variable is that of underlying dimensions, latent factors that give rise to these manifestations of psychopathology. This study explored potential underlying mechanisms of comorbid PTSD and depression, including negative affect, rumination, emotion dysregulation, neuroticism, and behavioral inhibition. While previous studies have investigated these dimensions individually, there is a dearth of research that simultaneously investigates multiple dimensions or determines the relative contributions of underlying dimensions to psychopathology. Thus, the …

Validation Of The Barkley Deficits Of Executive Functioning Scale-Short Form, Brian Sheble

Dissertations

The Barkley Deficits of Executive Functioning-Short Form (BDEFS-SF) is a short rating scale measuring executive functioning in adults. The BDEFS-SF was developed using the 5 highest loading questions from the BDEFS-LF. Consequently, the psychometric qualities of the BDEFS-SF were not investigated using formal methods. In this study, the psychometric attributes of the BDEFS-SF were examined using two separate but similar groups. The first group of 264 men and women aged 18-35 years old completed the BDEFS-SF via an internet survey. The second group of 36 men and women aged 18-35 years old completed the BDEFS-SF and individualized assessments of executive …

Family Care Partners Of Chronically Ill Older Adults: The Role Of Uncertainty In Illness, Jillian Pine

Dissertations

Abstract This study integrated research on family care partners of older adults and

research on uncertainty in chronic illness. Previous findings were extended by examining care partners of older adults with multiple chronic conditions and highlighting early-stage undiagnosed cognitive impairment as a uniquely unclear condition. Participants were 45 women assisting community-dwelling, earlier generation older adults with multiple chronic health conditions and a prognosis of more than six months. Online survey data were used to test the hypotheses that increased illness uncertainty would be associated with increased care partner-recipient relationship strain and increased care partner perceived stress. This study also hypothesized …

Why Giving Up The Keys Can Be Terrifying: Examining Driving Retirement Through A Terror Management Theory Paradigm, Perri Navarro

Dissertations

Driving retirement, or giving up the keys, is a current topic of interest in the gerontological literature. Most adults will outlive their ability to drive safely, yet do not plan for driving retirement, although planning for driving retirement appears to result in better outcomes. The current study examined the possibility that older adults avoid driving retirement because it is a mortality prime (reminder of death), as well as the possible role of implicit self-esteem in buffering against mortality concerns specifically in an older adult population. Participants in the current study (n=90) were randomly assigned into one of three …

Clinician Bias In The Diagnosis Of Posttraumatic Stress Disorder: How Clinician Characteristics And Training May Relate To Diagnosis, Renee Boeck

Dissertations

As our understanding of PTSD has advanced, changing demographics in the United States over the past few decades have led to a growing awareness of the mental health needs of an increasingly diverse and multicultural population. Research on ethnoracial differences in PTSD has had mixed results and additional research exploring possible contributing factors is needed to better explain observed differences. This study explored the presence of and contributing factors to clinician bias in the diagnoses of PTSD based on race and context. It examined whether clinicians were more likely to diagnose PTSD in a Black or White man due to …

Examining The Relationship Between Posttraumatic Stress Symptoms And Posttraumatic Growth: Pathways To Thriving In The Face Of Adversity, David Strasshofer

Dissertations

Research has largely focused on the negative physical and psychological consequences of trauma exposure. In contrast, posttraumatic growth is a relatively recent addition to our understanding of people’s response to life’s struggles. Posttraumatic growth (PTG) is conceptualized as positive changes in a person’s life following a cognitive struggle in the aftermath of trauma. However, PTG research is a relatively nascent line of empirical inquiry and there are several major unanswered questions about the construct and its utility. Part of this is due to conflicting findings related to the relationship between PTG and psychological distress and adaptive significance. The current study …

Validation Of The Multilayered Gender Identity Questionnaires, Philip Eiseman

Dissertations

Gender identity shapes the ways transgender adults experience themselves and relate to the world around them. Although research and theory suggest that gender identity is a multidimensional construct, most measures of gender identity have viewed gender as primarily a unitary construct tied to the gender binary. The aim of this study was to develop and validate the Multilayered Gender Identity Questionnaires (MGIQ), a set of measures of gender identity, in a sample of transgender adults. Qualitative data collected through focus groups with transgender adults (N = 7) helped refine and develop these measures. A series of analyses involving a …