Social and Behavioral Sciences Commons^™

"I Stayed There The Whole Night": Exploring Caregivers' Experiences With The Healthcare System When Caring For A Parent At The End Of Life, Lillian Mehran

Dissertations and Theses

Background: In the United States, there are nearly 53 million individuals serving as caregivers to a loved one. Half of all caregivers are caring for a parent or parent-in-law, and 79% of caregivers are caring for a person aged 50 or older. In New York State, there are an estimated 4.1 million caregivers who collectively provide over 2.6 billion hours of unpaid care, with those caring for a person at the end of life providing twice as many hours of caregiving per week compared to other caregivers. The number of individuals requiring caregiving is expected to increase as a significant …

A Study Of Verbal Rumination, Relationships, Stress And Identity On Health Communication In Collegiate Athletics, Landon Mary Ellen Kemp

Dissertations and Theses

College athletes are a unique group of individuals as they face many positive and negative challenges when competing in a collegiate sport. Verbal rumination is repetitive talk about a particular issue, accompanied by adverse effects for an individual. Verbal rumination is a common strategy athletes use to cope with difficulties along with managing challenging situations in their athletic program. To explore factors that might inspire or impede verbal rumination in collegiate athletics, the present study examines the quality of coach and teammate relationships, perceived stress and athlete identity. Results revealed the impact of relationships between coaches and athletes in respect …

Challenges To Career As A Source Of Meaning And Satisfaction Among Certified Athletic Trainers In The United States Of America, Nicole Marie Glasgow

Dissertations and Theses

There is a high prevalence of burnout in the athletic training profession. Similar to what has been found in other healthcare professions, burnout is correlated with lack of job satisfaction, high turnover, and decreased productivity. In phase one of this study, the purpose was to investigate whether there was a relationship between perceived career meaning and burnout among certified athletic trainers. In phase two, the purpose of the study was to explore the lived experiences of meaningfulness and purposefulness by certified athletic trainers. The overall objective of the research was to generate an understanding of factors associated with burnout in …

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 …

An Examination Of Hiv Risk, Testing And Prevention Intervention Participation Among Vulnerable Youth, Bianca V. Lopez

Dissertations and Theses

Background: Young gay, bisexual and other men who have sex with men (YGBM) of color are disproportionately affected by HIV and bear the burden of the disease in the United States. Gay and bisexual men – referred to in surveillance systems as men who have sex with men (MSM) – continue to be the risk group most severely affected by HIV in the United States. The dissertation study explored factors related on HIV prevention intervention participation, HIV testing and sexual risk behaviors among YGBM ages 13-29 in the Bronx. Additionally, this dissertation endeavored to study the concept of “intervention fatigue”, …

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. …

Mechanisms Of Value-Biased Prioritization In Fast Sensorimotor Decision Making, Kivilcim Afacan-Seref

Dissertations and Theses

In dynamic environments, split-second sensorimotor decisions must be prioritized according to potential payoffs to maximize overall rewards. The impact of relative value on deliberative perceptual judgments has been examined extensively, but relatively little is known about value-biasing mechanisms in the common situation where physical evidence is strong but the time to act is severely limited. This research examines the behavioral and electrophysiological indices of how value biases split-second perceptual decisions and the possible mechanisms underlying the process. In prominent decision models, a noisy but statistically stationary representation of sensory evidence is integrated over time to an action-triggering bound, and value-biases …

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 …

Rates Of Developmental And Behavioral Screening Of Young Children: Implications For Health Care Policy And Practice, Shirley Berger

Dissertations and Theses

Background: The skills and capacities developed during early childhood are the foundation for a child’s future academic functioning, economic productivity, and lifelong health and mental health. When young children have developmental delays or disabilities, early identification and intervention lead to better outcomes; however, only a minority are identified before school entry. Primary care is an important setting for identification of developmental and behavioral conditions as most young children attend well-child visits regularly and parents expect developmental guidance from pediatricians. Two key pediatric preventive services are recommended: developmental monitoring/surveillance at every well-child visit and developmental screening at 9 months, 18 months, …

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 …

Sexual Behavior And Substance Use Among Women Across The Spectrum Of Sexual Orientation, Margaret M. Wolff

Dissertations and Theses

Background: Compared to non-sexual minority women, sexual minority women are at greater risk for substance use and abuse, sexual risk behaviors, and unplanned teen pregnancy; few studies measure differing associations by sexual orientation (e.g., identity, behavior, attraction) or discordance (e.g., heterosexually-identified women with female partners) components. Minority stress may explain sexual minority women’s health disparities; thus, as U.S. policies evolve to reflect growing acceptance of all sexual minorities, research should examine sexual minority women’s health risk behaviors using multidimensional constructs of sexual orientation.

Methods: Using the female sample of the 2002-2013 National Survey of Family Growth (Aims 1-2 n=25,523; …

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 …