Psychology Commons^™

Victim Or Villain: Female Resilience And Agency In The Face Of Trauma In Chimamanda Adichie’S, Purple Hibiscus (2003) And Tsitsi Dangarembga’S, Nervous Conditions (1988), Adaobi Juliet Chukwuma

Electronic Theses and Dissertations

As long as disparities persist in the way women are treated as compared to their male counterparts, the issue of gender will continue to call forth literary productions. For this reason, female writers are on a mission to dismantle the stereotypes that keep women confined to societal roles. Grounded in a feminist framework, this study focuses on the gender disparity theme in Chimamanda Adichie’s Purple Hibiscus and Tsitsi Dangarembga’s Nervous Conditions. The aim is to examine how these writers represent the trauma of women living in an African patriarchal system. The traumatic experiences of the female characters in both texts …

The Implications, Magnitude, And Development Of Traumatic Brain Injury For Individuals Undergoing Treatment For Opioid Use Disorder, Hannah G. Mitchell

Electronic Theses and Dissertations

There is an established bidirectional relation between substance use and traumatic brain injuries (TBIs). Despite the high rate of prescribing opioids for pain management following a TBI and the epidemic of opioid use disorder (OUD) in the United States, scarce research has specifically analyzed the association between TBI and OUD. In a series of three interrelated manuscripts, the present study will first examine the prevalence and features of TBIs among persons seeking treatment for OUD. Next, the present study will evaluate the association between TBI and indicators of risky health behaviors and OUD severity, including the risk of overdose and …

Behavioral Indicators Of Reflective Functioning In Mother-Child Dyadic Interactions, Rachel Clingensmith

Electronic Theses and Dissertations

Positive parenting practices and secure attachments are consistently linked to healthy child outcomes (Ainsworth & Bowlby, 1991; Waters et al., 2000). Research on cognitive processes that scaffold parental behaviors which contribute to secure attachment is an essential contribution to the literature, particularly given the potential for early intervention with at-risk families. Parental Reflective Functioning (PRF) is a construct of increasing interest which has been linked to secure attachments and positive child outcomes, with one commonly used self-report measure of PRF being the Parental Reflective Functioning Questionnaire (PRFQ; Camoirano, 2017; Clingensmith, 2021; Luyten et al., 2017). As such, the purpose of …

Approaching Trans Healthcare Competency: The Implementation Of Trans Health Education For Medical Providers In Appalachia, Rebecca Altschuler

Electronic Theses and Dissertations

Barriers to competent and safe healthcare disproportionately impact people who are marginalized because of their race, ethnicity, gender, or socioeconomic status. It is well documented that transgender patients in particular experience barriers to both accessing care and receiving high quality, non-discriminatory care (Hatzenbuehler & Pachankis, 2016; James et al., 2016; Rahman et al., 2019; Safer et al., 2016). This lack of access to culturally competent healthcare services contributes to health disparities that disproportionately impact the trans community. Literature on barriers to competent care for trans patients indicates that providers experience discomfort related to their ability to provide competent care (Safer …

K-5 Elementary Alternative Program: A Case Study, William E. Scheuer Iv

Electronic Theses and Dissertations

The purpose of this case study was to examine how the K-5 elementary alternative program All Students Can Thrive (ASCT) used student-centered learning practices to influence the whole child. There is a lack of research on K-5 elementary alternative programs, such as ASCT, and specifically those that integrate student-centered learning practices to influence the whole child. Literature does not contain universally accepted interventions that are effective in the elementary alternative setting to help students return to the mainstream classroom setting better prepared to display appropriate behaviors when a student is removed from a mainstream classroom setting due to disruptive behaviors. …

Look, But Don’T Touch: Impact Of Covid-19 On The Nicu Caregiver, Rebecca C. Otwell-Dove

Electronic Theses and Dissertations

Admission of an infant into the neonatal intensive care unit (NICU) is an experience that has been associated with a variety of both positive and negative health outcomes for parent and child. While both the setting name and the admitted population alludes to a sole focus on the affected infant, what often remains underrecognized is the impact on the ones who care for the newborn long before and longer after their NICU stay. Given the recency and unprecedented impact of the COVID-19 pandemic, very little research has examined the impact of COVID-19-specific stress on the experience of parents of infants …

Adverse Childhood Experiences And Quality Of Life: A Mediating Role Of Physical Activity And Executive Function, Loni Parrish

Electronic Theses and Dissertations

ACEs have been associated with heightened risk for a range of chronic health problems, substance use, and cognition in adulthood (Center for Disease Control (CDC), 2019; Hinojosa et al., 2017). One potential protective factor is physical activity (McEwen, 2016; Wu et al., 2013). Physical activity is associated with sustaining overall health, improving mental health by reducing symptoms of depression and anxiety (Murri et al., 2019; Sharma et al., 2006; Tasci et al., 2019), and maintaining a healthy body weight and BMI (WHO, 2021). Therefore, this study examined whether barriers to physical activity, physical activity levels, and executive outcomes serve as …

Optimism And Physical Health-Related Quality Of Life In Chronic Illness: Mediating Effects Of Control Beliefs And Health Behaviors, Morgan Treaster

Electronic Theses and Dissertations

Among persons living with, or recovering from, chronic illness, poor physical health-related quality of life is a concern, as current and residual illness symptoms and treatment side effects may deleteriously impact physical functioning and fulfillment of daily roles. Numerous cognitive, emotional, and behavioral factors may impact perceptions of health status. Optimism, for example, is conceptualized as belief in the occurrence of positive future outcomes, and is beneficially associated with physical health-related quality of life. Further, optimism may contribute to enhanced perceptions of control and efficacy over disease symptoms and general health, manifesting as proactive health behaviors (e.g., wellness behaviors; treatment …

Identity-Specific Positive Psychology Intervention For Sexual Minorities: A Randomized Control Trial, Sarah Job

Electronic Theses and Dissertations

Sexual minorities experience mental and physical health disparities in comparison to heterosexual individuals due to minority stress (Branstrom et al., 2016; Kerridge et al., 2017; Meyer, 2003). Positive psychology interventions have improved mental and physical health (Antoine et al., 2018; Lambert D'raven et al., 2015), and therefore these interventions have potential to address health disparities. The current study tested an identity-specific intervention (n = 30) to a general positive psychology intervention (n = 30) and a control group (n = 30) among sexual minorities. This built on a recent pilot study which tested the efficacy of an …

The Loss-Processing Framework, Lawrence Childress

Electronic Theses and Dissertations

The circumstances of responding to loss due to human death are among the most stressful experiences encountered in life. Although grief’s symptoms are typically considered essential to their gradual diminishment, possible negative impacts of complications related to grief are also well known, and have been associated with detriments to mental and physical health. Grief, however, can also generate transformative positive change. Thus, albeit ineludible, responding to loss is not uniformly experienced, expressed, or understood. It is also culturally-shaped, making attempts to define “normal” grief, as well as to label some grief “abnormal”—and to medicalize it—possibly problematic. Bereavement (the situation surrounding …

Intrinsic Religiousness And Its Relation To Health Outcomes, Joseph Barnet

Electronic Theses and Dissertations

Religiousness, broadly defined, has been shown to be predictive of a variety of health outcomes. Past literature surrounding religiousness research has utilized different definitions and measures for the meaning of religiousness. How religiousness is defined can influence its relationship in relation to health outcomes. The present study utilized a measure for intrinsic religiousness, which is defined as an internalization of the tenets of a particular faith. The present study examined whether intrinsic religiousness predicts problematic or illicit substance use or pornography use in a sample of participants that included mostly undergraduate students from the Appalachian region, as well as some …

Measurement Of Nontheistic And Theistic Spirituality: Initial Psychometric Qualities Of The Inclusive Spiritual Connection Scale, Valerie M. Hoots

Electronic Theses and Dissertations

Spirituality represents a key part of life for the majority of U.S. adults and there is a growing body of research supporting relationships between spirituality and numerous health outcomes. Governing healthcare organizations have acknowledged the role religiousness and spirituality play in comprehensive and holistic patient care. While the U.S. shows documented trends towards diverse expressions of spirituality, existing theory-driven measures of spirituality are largely theocentric. The current study concludes a multiphase project that aimed at the outset to develop an inclusive measure of spirituality and establish initial psychometric evidence, validating its use across both theistic and nontheistic spiritual populations. The …

Thwarted Interpersonal Needs, Depression, And Sleep Disturbances In Primary Care: Does Gratitude Help You Sleep?, Heather R. Altier

Electronic Theses and Dissertations

Sleep disturbances are prevalent in primary care patients and can be exacerbated by interpersonal dysfunction and depression. As well, thwarted interpersonal needs (TIN), including thwarted belongingness and perceived burdensomeness, contribute to depression. However, the presence of gratitude, a cognitive-emotional protective factor, may improve symptoms. We longitudinally examined the mediating role of depressive symptoms on the relation between TIN and sleep disturbances, and the moderating role of gratitude on the TIN-sleep disturbances and depression-sleep disturbances linkages. Our primary care patient sample (N = 223) completed self-report surveys at baseline (T1) and at a one-year follow-up (T2; n = 97). Patients …

Weight Status As A Moderator Of Low Self-Esteem And Poor Sexual Functioning, Madison Hinkle

Electronic Theses and Dissertations

Researchers have found that self-esteem and weight status can impact numerous aspects of an individual’s life, including reproductive health issues. However, there has been limited research specifically examining how self-esteem may affect female sexual functioning. The current study aims to examine whether self-esteem is a significant predictor of sexual functioning, and whether this relationship may change as a function of women’s weight status. Participants consisted of 730 women ranging from 18 to 49 years of age, who were recruited through an online questionnaire. Results indicate that higher levels of self-esteem predict better sexual functioning and weight status was found to …

Managing Stress In A Constantly-Changing Workforce, Lorri Burch-Hubbard

Electronic Theses and Dissertations

When staffing reductions occur in the workplace, staff left behind may face increased stress, may not be given the support they need to manage the feelings caused by the reduction. This study was conducted to evaluate the impact of stress caused by staffing reductions has on medical technologists (MT), medical technicians (MLT) and respiratory therapists (RT), and to identify any common methods of stress management used by those staff who remain in the organization.

Literature research showed the negative impact stress can have on individuals when it is not addressed, such as decreased work performance, health issues, and even the …

We All Need Somebody To Lean On: Social Support As A Protective Factor For Individuals With Childhood Adversity, Rachel Clingensmith

Electronic Theses and Dissertations

Extensive research has shown that childhood adversity impacts development across the lifespan and has been linked to numerous negative health outcomes. Depression symptoms are one such outcome that has been associated with ACE exposure. The literature also indicates emotion regulation may be a mediator between ACEs and depression outcomes. The primary aim of this study (N = 766) is to investigate pathways leading from ACEs to depression and potential protective factors. It was hypothesized that difficulties in emotion regulation would mediate the link between ACEs and later depressive symptoms, social support would moderate the pathway between difficulties in emotion regulation …

Childhood Abuse, Religiosity, And Opioid Use: Findings From The National Epidemiologic Survey On Alcohol And Related Conditions Data, James E. Lewis

Electronic Theses and Dissertations

Religiosity is adopting a belief system surrounding concepts of purpose, meaning, and value through an institution that has already defined these concepts prior to the individual member attending and that member’s degree of participation. Religiosity does have protective factors against negative health outcomes. This protective influence was evaluated in this study. Data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions were examined to learn about the relationship between protective effects of religious participation on substance abuse, and whether this association weakened for individuals who have experienced higher levels of childhood abuse. A binary logistic regression …

Resilience Among Survivors Of Adverse Childhood Experiences In Appalachia, Bridget Jeter

Electronic Theses and Dissertations

The empirical investigation of adverse childhood events (ACEs) and their relationship with health and well-being outcomes in later life is increasing. Less is known about factors that may promote resilience for those who have survived such challenges, such as how resilience may be facilitated for those with ACEs residing in a marginalized region such as South Central Appalachia. Multidimensional spirituality, social support, stigma related to ACEs, and Appalachian acculturation may serve as both valid cultural factors and potential indicators of resilience. Cross-sectional, simultaneous multiple regression analysis was performed on data collected from 272 adult patients of a South Central Appalachian …

Exploring The Relationship Between Religiousness And Video Game Addiction, Joseph Barnet

Electronic Theses and Dissertations

Religiousness has been shown to have an inverse relationship with at least some types of addiction. The present study examined whether intrinsic religiousness predicts substance addiction and video game addiction in a sample of participants that included mostly undergraduate students from the Appalachian region, as well as some participants surveyed with the use of social media advertisements. Intrinsic religiousness has been defined as internalizing the tenets of one’s faith. Participants self-reported their religiousness using the Religious Surrender and Attendance Scale – 3 (RSAS-3), which has been shown to measure intrinsic religiousness. Religiousness as measured by the RSAS-3 predicted lower levels …

Pocket Ace: Neglect Of Child Sexual Abuse Survivors In The Aces Study Questionnaire, Robyn Dolson

Electronic Theses and Dissertations

In 1998, a seminal study on adverse childhood experiences (ACEs) and subsequent health risks catapulted ACEs and the study questionnaire into the zeitgeist. However, its childhood sexual abuse (CSA) item is problematic as it requires the perpetrator have been 5-years or older than the victim. To assess whether some survivors’ CSA is not identified by the current item, whether their exclusion prevents access to services requiring a four-threshold ACE score, and how their health outcomes compared to other CSA groups and controls, an international sample of 974 women completed an online survey assessing their current health and CSA history using …

Do Healthcare Students Endorsing Stigma Of Mental Illness Screen For Suicidal Ideation? An Evaluation Of Knowledge, Attitudes, And Behaviors, Dannel K. Petgrave

Electronic Theses and Dissertations

The stigma of mental illness endorsed by healthcare professionals has been linked to adverse outcomes. This issue underscores the need for early anti-stigma interventions in the context of professional training. The present study measured stigma change and suicide screening behaviors among medical, nursing, and pharmacy students enrolled in an interprofessional Communication Skills for Healthcare Professionals course. The Mental Health Knowledge Schedule (MAKS; Evans-Lacko et al., 2010), Opening Minds Scale for Health Care Providers (OMS-HC; Modgill, Patten, Knaak, Kassam, & Szeto, 2014), and the Marlowe-Crowne Social Desirability Scale Form C (M-C SDS Form C; Reynolds, 1982) was administered at baseline (T …

Emotion Regulation And Eating: An Evaluation Of The Relationship Between Difficulties In Emotion Regulation And Eating Patterns In Obese Patients Seeking Bariatric Surgery, Brittany V. Williams

Electronic Theses and Dissertations

Obesity is a major health epidemic, impacting many people worldwide. Bariatric surgery is a common treatment for severe obesity and generally leads to improved overall health, remission of comorbid disease, and improved quality of life. Despite positive postsurgical results, many patients regain some to most of their weight following the procedure. Guidelines for presurgical psychological assessments have been developed to assist healthcare professionals in predicting outcomes for patients. Previous studies have focused on the impact of psychological illness on surgical outcomes, with mixed results. The current study aimed to assess the influence that difficulties in emotion regulation has on eating …

Development And Validation Of The Bisexual Microaggressions Scale, Emma G. Fredrick

Electronic Theses and Dissertations

Sexual minorities face stigmatizing experiences which can lead to disparities in physical and mental health, as well as social and economic resources. Additionally, research suggests that microaggressions, or small actions and comments that speak to a person’s prejudices, act as stigmatizing experiences and contribute to negative outcomes for the stigmatized. However, most studies of sexual minority health do not explore bisexual experiences uniquely, despite evidence that bisexuals have unique experiences of stigma and microaggressions. Those studies that do explore bisexual experiences find worse outcomes for bisexuals than their lesbian or gay counterparts. Thus, the current study developed a quantitative scale …

Early Childhood Adversity And Chronic Illness: An Examination Of A High Risk- Forensic Inpatient Population, Courtney L. Cook

Electronic Theses and Dissertations

Individuals exposed adverse childhood experiences (ACEs) are at increased risk of developing chronic illnesses in adulthood including heart disease, cancer, diabetes, and chronic pain. A relationship between ACEs and health risk factors contributing to chronic disease such as smoking, obesity, and sedentary lifestyle has also been established in prior literature. There is evidence that higher that individuals in forensic inpatient mental health samples are disproportionally exposed to ACEs, which may increase odds of chronic disease development. Despite this evidence, little research has examined the prevalence of ACEs and relationships between ACEs and chronic health conditions and risky health behaviors in …

Spirituality And Suicidal Behavior: The Mediating Role Of Self-Forgiveness And Psychache, Benjamin B. Hall

Electronic Theses and Dissertations

Growing evidence for protective factors of spirituality against physical and mental health related outcomes has led to the consideration of spirituality as a protective factor for suicidal behaviors. Although initial support for this association is promising, spirituality has yet to be explored as it relates to psychache. Additionally, self-forgiveness has emerged as an important protective factor of suicidal behavior, but has not been explored in the context of psychache. Following a model developed by Webb, Hirsch, and Toussaint (2015), the current project explores the protective role of spirituality on suicidal behavior based on three dimensions of spirituality: ritualistic, theistic, and …

Spirituality And Psychological Well-Being Among Als Caregivers: Hope And Perceived Stress As Mediators, Bridget R. Jeter

Electronic Theses and Dissertations

The empirical study of the salutary relationship between spirituality/religiousness and psychological well-being is burgeoning. However, mechanisms of this association have received less empirical attention. Theory suggests that spirituality/religiousness may lead to positive psychological characteristics such as hope, which may function as a means of coping in the context of a significant stressor or stressful situation. The perceived burden and stress associated with caring for individuals with chronic illnesses such as ALS is significant, and caregivers may be at risk for increased symptoms of depression, symptoms of anxiety, somatic symptoms, and other deleterious psychological well-being related outcomes. Within the context of …

Collaborative Models Of Care In The Appalachian Region Of Tennessee: Examining Relationships Between Level Of Collaboration, Clinic Characteristics, And Barriers To Collaboration, Jeffrey Ellison

Electronic Theses and Dissertations

Decades of research have shown that there are significant advantages to maintaining close communicative and collaborative relationships between primary care and behavioral health providers. Fiscal, structural, and systemic barriers, however, often restrict the degree to which such interprofessional collaboration can occur. In the present study the authors examined relationships between primary care clinics in the Appalachian region’s characteristics (i.e., clinic type, rurality, and clinic size), barriers (i.e., fiscal, structural, and systemic) reported to using increased collaboration, and the level of collaboration used at a particular clinic.

For the present study 136 surveys were completed by providers working in primary care …

Prevalence, Types, Risk Factors, And Course Of Intimate Partner Violence In Appalachian Pregnant Women, Tifani Fletcher

Electronic Theses and Dissertations

Intimate partner violence (IPV) during pregnancy can lead to a myriad of poor physical and psychological outcomes for both mother and child. There is a paucity of research examining IPV risk factors for rural pregnant women and on information regarding the course of the specific types of IPV throughout pregnancy. The current project was an investigation of the prevalence of IPV and IPV risk factors for different types of IPV in an Appalachian pregnant sample that contained women from both rural and nonrural locations (Study 1), and was an examination of the occurrence of any IPV and the different types …

Perceived Barriers And Facilitators To Mental And Behavioral Health Screening And Treatment In Primary Care For Women In Northeast Tennessee, Sarah K. Hill

Electronic Theses and Dissertations

Between one quarter and one third of all primary care patients meet criteria for at least one mental disorder. However, many women are not screened for mental disorders as recommended by the literature. Some studies suggest even lower rates of screening and treatment in rural areas. This researcher sought to identify barriers and facilitators to mental and behavioral health screening and treatment for women in primary care and solicit feedback on how to ameliorate perceived barriers. Given the limited extant data describing rural Appalachian women’s perceptions of barriers and facilitators to receiving mental health services an exploratory qualitative analysis was …

Who Done It? Rurality Vs. Ses As Critical Factors In Evaluating The Prevalence Of Child Psychosocial Concerns In Primary Care, Robert M. Tolliver

Electronic Theses and Dissertations

The purpose of this study was to evaluate the prevalence of child psychosocial concerns in rural primary care, hypothesized to be greater than national averages due to lacking mental health services in rural areas. This study was an examination of the role of SES, various definitions of “rural,” and the interaction of SES and rurality, in predicting parent-reported child psychosocial concerns in Appalachian primary care clinics. Caregivers presenting with their child at one of 8 pediatric primary care sites (n=2,672) were recruited to complete a measure assessing demographics and the Pediatric Symptom Checklist (PSC). Results showed that while rural status …