Social and Behavioral Sciences Commons^™

Therapist-Level Moderation Of Within- And Between-Therapist Process-Outcome Associations, Alice E. Coyne

Doctoral Dissertations

Objective: Although higher-quality patient-therapist alliance and more positive patient outcome expectation (OE) consistently predict improvement in psychotherapy, most research has failed to capture the inherent nuance in these process-outcome relations by parsing them into within-therapist (i.e., differences between patients treated by the same therapist) and between-therapist (i.e., differences between therapists’ average process/outcome ratings across all patients in their caseloads) components. Moreover, the few studies that have done so have produced mixed results, suggesting the possibility of systematic variability in these associations (i.e., moderators). One potential source of such variability could be providers themselves; that is, different therapists could use these …

Neural Precursors Of Apathy And Depressive Symptoms In Amnestic Mild Cognitive Impairment, Molly A. Mather

Doctoral Dissertations

Depressive symptoms and apathy are common in amnestic mild cognitive impairment (aMCI) and are associated with increased risk of conversion to Alzheimer’s disease (AD). The shared neuropathological model of neuropsychiatric symptoms (NPS) in AD suggests that symptoms of depression and anxiety represent noncognitive manifestations of neuropathological changes. Neurodegeneration in aMCI occurs in areas of the brain that support emotion regulation, including the limbic system and prefrontal control regions. Depression and apathy in aMCI have been linked to atrophy in the limbic system and prefrontal cortex and reduced connectivity in resting-state networks. However, it is not yet established whether neural changes …

A Minority Within A Minority: Exploring Identity Development In Relation To Mental Health Outcomes Within The Black Deaf Community, Nekolas Milton

Doctoral Dissertations

Black Deaf people are a double minority group that faces discrimination on multiple fronts. There is little literature on the relationship of cultural identity development and mental health concerns of this marginalized group. This study employs a mixed method approach to examine this relationship and explore the extant culturally tailored interventions targeted towards Black Deaf adults in a clinical setting. There were two phases of this project. Phase 1 included qualitative interviews with service providers of black deaf people to ascertain the type of culturally tailored interventions that are in place for this population. 5 themes emerged: systemic issues, mental …

Majority To Minority Shift: Experiences For American Born Chinese College Students From Predominant Chinese American Communities To Predominantly White Institutions, Joseph C. Chung

Doctoral Dissertations

This research aimed to fill the gap in literature by focusing on the experiences of American born Chinese college students that moved from ethnically dense Majority Minority Chinese American Communities (MMCAC) to attend Predominantly White Institution (PWI) college/universities. The study utilized a Grounded Theory qualitative approach, which led to the development of 6 categories or themes from 17 concepts and 48 codes. These were based on data from 10 participants across two phases with two interviews each (initial and follow-up). The 6 themes “Previous MMCAC Environment,” “Identity,” “New PWI Environment,” “Values,” “Transition Experience,” and “Mental Health'' provided the descriptive experience …

Stigma And Social-Emotional Health In Youth With Learning Differences, Kelsey Maki

Doctoral Dissertations

Youth diagnosed with specific learning disorder (SLD) and/or attention deficit hyperactivity disorder (ADHD), defined collectively for the purposes of this study as youth with learning differences, experience poorer social-emotional health outcomes in comparison to their typically developing peers. These youth additionally experience stigma from their peers, teachers, and broader community, which may impact social-emotional health. As a secondary data analysis of a larger study, the present study investigated the role of stigma consciousness alongside demographic variables, self-esteem, and peer relationships in social-emotional health outcomes. Due to the possible differences between youth diagnosed with SLD, ADHD, and comorbid SLD/ADHD, group differences …

Experiences Of Uc Santa Barbara Female Alumni Exposed To A Gender-Based Mass Shooting, Erin G. Carpenter

Doctoral Dissertations

Over the past five decades, mass shootings have emerged as a highly politicized, social problem that generates considerable public sentiment and media attention (Elsass et al., 2014; Rocque & Duwe, 2018; Shultz et al., 2014). Moreover, the increase in mass shootings carried out on or near college campuses have led researchers to focus more intently on the predictors and consequences that characterize these types of attacks (Boykin & Orcutt, 2018; Elsass et al., 2014; Fox & Savage, 2009). One college mass shooting that has received limited empirical attention is the 2014 mass shooting that occurred in Isla Vista, a town …

Patient Reported Outcomes In Sickle Cell Disease Examined Within A Conceptual Model, Swapandeep Mushiana, Marsha Treadwell Phd, Sherif M. Badawy Md, Ms, Liliana Preiss Phd, Allison King Md Mph Phd, Barbara Kroner Phd, Yumie Chen Bs, Jeffrey Glassberg, Victor Gordeuk Md, Nirmish Shah Md, Angie Snyder Phd Mph, Theodore Wun Md

Doctoral Dissertations

Objective: To examine the relations between patient reported outcomes (PROs) within a conceptual model for adults with sickle cell disease (SCD) ages 18 – 45 years enrolled in the Sickle Cell Disease Implementation Consortium (SCDIC) registry. We hypothesized that patient and SCD related factors and barriers to care would independently contribute to functioning as measured using the PRO domains. Additionally, pain and other SCD related complications are expected to impact the relation between the variables. Methods: Participants completed a 48-item survey that included socio-demographics and PRO measures, such as social functioning, pain impact emotional distress, and cognitive functioning. …

The Relationship Education Workshop And Its Impact On Learned Healthy Relationship Outcomes And Self-Compassion In The Emerging Adulthood Population, Ashley N. Russell

Doctoral Dissertations

The present study examined the effectiveness of the Relationship Education workshop (Davila, 2020) on several outcome measures for its target population, emerging adults. The Relationship Education workshop is comprised of two consecutive three hour sessions which take place a week apart. Participants were recruited from a southeastern state university campus. Participants were given a thorough and group-discussion based didactic focusing on the relationship competency skills of insight, mutuality, and emotion regulation with other core focuses, including relational decision making and adaptive relationship beliefs. Participants who completed the Relationship Education workshop were hypothesized to show improvement in these target domains as …

Impact Of Moral Injury For Ethnic/Racial Minority Male Veterans, Kristopher Kern

Doctoral Dissertations

Trends in demographics of post-9/11 veterans (deployments to the Middle East after 2001) describe this group as having higher survival rates, increased service-connected disabilities, and more racially diverse (NCVAS, 2018; Schnurr et al., 2009; Tanelian & Jaycox, 2008). Additionally, their deployment experiences include combat-related experiences that contradict personal moral beliefs, later named “moral injury” (MI) (Litz et al., 2009). Currier, Holland, and Mallot (2015) describe MI as intense emotions of shame, guilt, and anger alongside maladaptive behaviors emerging after “witnessing and/or participating in warzone events that challenge one’s basic sense of humanity” (p. 231).

The research on MI continues to …

Understanding The Healthcare Experiences Of Lgbtq+ People: An Adaptation Of The Daily Heterosexist Experiences Questionnaire, Conor Smith

Doctoral Dissertations

LGBTQ+ people's experiences of heterosexism, which are common in the healthcare system, are linked to poor health outcomes. There are no measures of LGBTQ+ people’s experiences in healthcare settings which could be used by healthcare systems and providers to improve the quality of their care for this vulnerable population. The Daily Heterosexist Experiences Questionnaire (DHEQ), developed using the minority stress model, measures the general stressful life experiences of LGBTQ+ people. This project aimed to adapt the DHEQ for use in healthcare settings.

A mixed-methods study was conducted to create the Daily Heterosexist Experiences Questionnaire-Healthcare (DHEQ-H). Semi-structured interviews focused on the …

Provider Perspectives: Working With The Male Lifer Reentry Population, Laura R. Marker Dr.

Doctoral Dissertations

The passage of Proposition 57 in California creates a path to parole for individuals who experienced long-term continuous incarceration. For the first time, men who experienced long-term incarceration are joining reentry populations in California, establishing an emerging subpopulation of men on parole who were incarcerated for life sentences or experienced long-term continuous incarceration. In the San Francisco Bay Area, most of these men will receive mental health services provided by Community Mental Health agencies or California Department of Rehabilitation and Correction (CDRC). Research suggests that men who experience continuous long-term incarceration may have symptoms of Post-Incarceration Syndrome (PICS).

However, few …

The Effectiveness Of A Transaffirmative Cognitive Behavioral Therapy Group-Based Intervention To Help Transgender Individuals Suffering From Depression, Joy Riach

Doctoral Dissertations

Transgender individuals report higher levels of elevated symptoms of depression and anxiety due to psychological distress caused by pervasive transphobic discrimination and prejudice that persist in pathologizing and stigmatizing their lived experiences. An important first step would be to develop, implement, and assess transaffirmative interventions that address the mental health issues that this population is particularly susceptible to, such as depression. This current study was designed to assess the effectiveness of one such culturally adapted intervention, which was a 5-week-long, group-based therapy developed for treating depression in transgender individuals using cognitive behavioral therapy (CBT). This was then followed with one …