Clinical Psychology Commons^™

Profiles Of Family Functioning In Pediatric Hematology-Oncology Patients: Longitudinal Associations With Child Well-Being, Sydney Sumrall

Theses and Dissertations

This study aims to assess 1) patterns of family functioning and 2) longitudinal associations between family functioning patterns and well-being in a vulnerable cohort of children with chronic illness. Caregivers of hematology (16.4%) and oncology (83.6%) patients ages 7-20 (N=55; M_age = 13.3 [SD = 2.7]; 52.7% female; 45.5% non-Latinx White, 38.2% Black or African American, 12.7% Latinx, 1.8% Asian, and 1.8% multi-racial,) reported on family functioning via the Family Assessment Device. Cluster analyses identified three mutually exclusive clusters: one high adaptive group, one moderate adaptive group, and one maladaptive group. Group membership was not significantly …

Addressing Death Distress In Caregivers Of Patients With Malignant Glioma, Kelcie D. Willis

Theses and Dissertations

The field of psychosocial oncology seeks to improve the quality of life of patients and families affected by cancer. This task becomes increasingly important when there are limited, non-curative treatment options, a high probability of recurrence, and rapid functional decline, such as in the case of a malignant glioma (MG). Indeed, the diagnosis of a MG is associated with negative sequalae that often translates to higher caregiver burden. Caregivers—who must manage the functional decline of the patient, changes within the family, and a complicated medical system—often feel overwhelmed, isolated, and ill-equipped to handle these myriad responsibilities. While they also report …

Predicting Medication Adherence Patterns During The Maintenance Phase Of Treatment For Pediatric Leukemia And Lymphoma: A Model Of Individual- And Family-Level Factors, Stephanie M. Romo

Theses and Dissertations

Adherence during the maintenance phase of pediatric cancer treatment is critical to prevent relapse and ensure long-term, event-free survival. Yet, little research has been done to examine individual- and family-level factors that may relate to adherence during the maintenance phase of treatment, particularly among Latinx patients. This is surprising given findings demonstrating that children who miss more than 5% of their prescribed oral chemotherapy medicine, most commonly 6-mercaptopurine (6MP), are 2.5-2.7 times more likely to relapse than children who take 95% or more of their prescribed 6MP. Pediatric cancer patients face unique adherence challenges given the importance of family involvement …

E-Cigarette Use And Perceptions Among Adolescents With Attention-Deficit/Hyperactivity Disorder: The Role Of Parental Messages About Tobacco, Mayra S. Ramos

Theses and Dissertations

Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of using e-cigarettes compared to their neurotypical peers. Parent-adolescent communication about tobacco use and number of ADHD symptoms can influence adolescents’ perceptions of e-cigarettes and their e-cigarette use. Adolescents with ADHD (n = 80) completed questionnaires assessing parental messages about tobacco use; e-cigarette harm perceptions; susceptibility to use e-cigarettes; and e-cigarette use. Parents reported on messages about tobacco use, adolescent’s ADHD symptomatology, and completed demographic questionnaires. Twenty-percent of adolescents reported e-cigarette ever use. Adolescent girls were significantly more likely to report higher e-cigarette harm perceptions than boys. Parents reported providing messages …

Differential Identification Of Hyperacusis And Misophonia: Implications Of Discrete Decreased Sound Tolerance (Dst) Condition Subtypes, Rachel E. Wallace

Theses and Dissertations

Hyperacusis and misophonia are two conditions of decreased sound tolerance (DST) studied in the psychological literature due to their association with psychological symptoms and mechanisms. DSTs are differentiated from normal sound sensitivity due to the reported impairment and distress individuals experience. Researchers suggest that DSTs are differentiated by types of sounds and emotional reactions elicited, such that hyperacusis is a fear and pain response to ordinary environmental sounds perceived as uncomfortably loud, and misophonia is an anger and disgust response to human-made sounds, but these distinctions, and associated characteristics, have not been empirically demonstrated. Undergraduate students (N = 1572) …

The Correlation Between Maternal Postpartum Depression And Child Psychopathology, T'Keyah I. Vaughan

Theses and Dissertations

Background: Postpartum depression (PPD) is a phenomenon that affects nearly 10-15% of pregnancies in the US. It is characterized by depressed mood or anhedonia and lasting for more than 2 weeks. PPD changes how moms interact with family members and child-rearing behavior. Depression is a phenomenon that is also known to affect the psychopathology of children. However, the specifics of how postpartum depression impacts children remains controversial. Many studies do not control for major depressive disorder which makes it difficult to disentangle the impact depression has within the first year of life. Furthermore, other PPD risk factors may be confounding …

Effect Of A 14-Day Mindfulness Intervention On Daily Desire Experiences And Desire Regulation, Nabila Farhin Jahan

Theses and Dissertations

A growing body of research suggests that mindfulness, a receptive attentiveness to one’s present moment experiences, has the potential to adaptively regulate habitual behaviors. No prior study has tested the effect of mindfulness interventions on people’s daily desire experiences to inform the potential for adaptive desire regulation. The present exploratory randomized controlled trial examined the effect of a 14-day smartphone-based mindfulness intervention (versus a coping control intervention) on the frequency, intensity, duration, and enactment of everyday desires in 19 participants. The desire domains included basic need-based desires (i.e., for food, drink, sleep) and secondary desires (e.g., for sex, media, social …

Implementing Integrated Care In Family Medicine: Description And Outcomes In An Underserved Population, Zach Radcliff

Theses and Dissertations

Introduction: Family physicians provide access to medical and behavioral healthcare for many underserved populations. Integrating behavioral health clinicians into primary care practices has been proposed as one of the most effective ways to increase access to necessary behavioral health services for many Americans. Integrated behavioral healthcare (IBHC) has begun to be implemented in family medicine practices but there is limited research examining the impact for patients and clinic staff. This study begins to fill this gap in the literature by examining the effects of implementing integrated behavioral healthcare in an urban family medicine clinic in a medically underserved area.

Objective: …

Mechanisms Of Motivational Interviewing In A Parent-Focused Pediatric Obesity Intervention, Nadia Islam

Theses and Dissertations

Pediatric obesity is a major public health epidemic with serious physical and psychological consequences. Difficulty engaging families in treatment is a significant obstacle in addressing pediatric obesity, especially among underserved populations. Motivational interviewing (MI) is a collaborative, person-centered communication style that has been shown to reduce attrition, increase attendance, and improve patient treatment adherence; however, little is known about the process of MI and how it improves treatment engagement. This study examined clinician and parent language in a pre-treatment MI session that increased initial engagement in a parent- focused pediatric obesity intervention (N= 81). Results showed that increased parent change …

A Hierarchical Linear Modeling Approach To Predicting Trajectories Of Posttraumatic Growth In Veterans Following Acquired Physical Disability, Lisa Goldberg Looney

Theses and Dissertations

The purpose of this study was to examine potential predictors of PTG across time in Veterans with acquired physical disabilities. Specifically, this study aimed to understand how various demographic and injury characteristics, coping styles, appraisals of injury, and social support might predict trajectories of PTG from discharge from inpatient rehabilitation through 12 months after baseline. Initial curvature analyses suggested that a cubic polynomial trend best fit the movement of PTG over time, generally conforming to an initial increase, decrease, and then plateau or slight increase. Four HLMs were run to examine whether demographic and injury characteristics, coping styles, appraisals of …

The Role Of N-Acetyl-L-Cysteine (Nac) As An Adjuvant To Opioid Treatment In Patients With Inadequately Controlled Chronic Neuropathic Pain, Thomas B. Moore

Theses and Dissertations

Introduction. While opioid medications are commonly prescribed for management of neuropathic pain (NP), long-term use has been associated with increased risk for overdose, drug interactions and addiction. New strategies are necessary to better manage chronic pain, thereby reducing need for opioid medications and their associated adverse consequences. N-acetyl-L-cysteine (NAC), an over-the-counter supplement, has shown promise in the treatment of psychiatric and addictive disorders. In addition, NAC has shown promise for reducing physiological signs of NP in laboratory rat models, prompting this study.

Purpose. The present study was an open-label clinical trial of NAC as an adjuvant to opioid treatment for …

Chronic Pain Causal Attributions In An Interdisciplinary Primary Care Clinic: Patient-Provider And Provider-Provider Discrepancies, Bryan Jensen

Theses and Dissertations

The purpose of the present study was to investigate the influence of pain causal attributions on patient pain-related functioning, treatment engagement, and clinical outcomes. Additionally, the impact of discordant pain causal attributions between patients and their providers as well as between interdisciplinary providers was examined. Patients rated their pain functioning and causal pain attributions during a regular clinic visit. Following the patient’s visit both the behavioral medicine provider and internal medicine resident provided ratings of similar pain-related functioning domains and causal attributions. Follow-up data were collected from the electronic medical record three months following that clinic visit. Overall, results revealed …

The Effects Of Pet Ownership On Anxiety And Depression Among Trauma-Exposed College Students, Dung N. Nguyentran, Marlene A. Michniak, James J. Jung, Christine Q. Do

Undergraduate Research Posters

Rates of anxiety and depression are prevalent in college students and can be attributed in part to stress and trauma-related events. However, studies suggest that pet ownership has the possibility of alleviating symptoms of anxiety, depression, negative emotions, and suicide. The purpose of this study was to determine the relationship between pet ownership and levels of anxiety and depression among those who have experienced a traumatic event. The sample was comprised of five hundred and forty-seven VCU students who completed an online survey from Spit for Science during their junior year. Linear regressions were performed to determine the nature and …

The Role Of Psychology In Integrated Primary Care For Complex Patients: Effects On Mental Health, Utilization Of Medical Services, And Physiological Markers Of Health, Danielle C. Worthington

Theses and Dissertations

This study served as an initial evaluation of integrated psychology services within a clinic designed to serve uninsured patients with complex medical concerns and high utilization histories at the Medical College of Virginia in Richmond, Virginia. The current study evaluates patient outcomes, and more specifically, it further quantifies and describes the role that psychologists play in the primary care setting and their impact on utilization of medical care and in improved health outcomes. Additionally, the study evaluates psychologists’ success at treating mental and behavioral health conditions within the primary care model. The present study demonstrates that patients with complex medical …

Follow-Up Evaluation Of Treatment For Anxiety And Depression Provided In A University-Based Primary Care Clinic, Renée M. Grinnell

Theses and Dissertations

Although integrated primary care psychology services are becoming increasingly common, the literature lacks adequate research support for the longitudinal durability of treatment effects following the conclusion of brief primary care interventions. This study served as a follow-up program evaluation of psychological services for depression and anxiety provided at the Medical College of Virginia’s Ambulatory Care Center in Richmond, Virginia. Data were collected on 47 adult primary care patients who received treatment for depression and/or anxiety between six and 18 months prior to the follow-up telephone call. Data were collected on the trajectory of depression scores throughout and following treatment, treatment …

The Ticking Of The “Biological Clock”: Worry About Future Fertility In Nulliparous Women, Karen E. Kersting

Theses and Dissertations

Abstract

Title: The Ticking of the “Biological Clock”: Worry about Future Fertility in Nulliparous Women

By: Karen Kersting, M.A., M.S.

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University.

Virginia Commonwealth University, 2013.

Major Director: Kathleen M. Ingram, J.D., Ph.D.

Associate Professor of Psychology

Department of Psychology

Modern women are waiting until later in their lives to have children than women of previous generations, a trend influenced by a number of factors including financial stability, dating norms, and career goals and responsibilities. As women age, their fertility may decline …