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Articles 301 - 330 of 371

Full-Text Articles in Clinical Psychology

Examining The Effectiveness And Efficiency Of Two Delivery Models To Teach Children Abduction Prevention Skills, Kimberly E. Seckinger-Bancroft Dec 2010

Examining The Effectiveness And Efficiency Of Two Delivery Models To Teach Children Abduction Prevention Skills, Kimberly E. Seckinger-Bancroft

Dissertations

Nearly all children receive abduction prevention training. Most traditional education programs increase the learner's knowledge, but often fail to produce concomitant behavior change. Behavioral Skills Training (BST) is a multicomponent, behavior-based training strategy with empirical support demonstrating its effectiveness in teaching children safety skills, behavioral generalization and maintenance over time. BST, however, is restricted by financial, human and time costs and limited resources to implement the training protocol. These factors likely limit widespread adoption of the training model. This study examined the use of computer-based instruction that emphasized active responding and mastery level performance requirements to teach school-aged children abduction …


Testing The Efficacy Of A Computerized Behavioral Activation Treatment Of Depressive Disorders, Alyssa H. Kalata Aug 2010

Testing The Efficacy Of A Computerized Behavioral Activation Treatment Of Depressive Disorders, Alyssa H. Kalata

Dissertations

The present study sought to examine the feasibility and preliminary efficacy of a computerized behavioral activation treatment for depressive disorders (IMMBA), while also investigating potential mechanisms of action involved in the treatment of depression through the use of behavioral activation. Nine adults who met criteria for either Major Depressive Disorder or Dysthymic Disorder were recruited from Kalamazoo, Portage, and surrounding areas in Southwestern Michigan. All participants received ten sessions of IMM-BA treatment. Symptoms of depression and related information were assessed at pretreatment and one-week, onemonth, three-month, and six-month follow-up through the use of the Beck Depression Inventory - II (BDI-II), …


Trauma, Dissociation, And Traumatic Stress At A Trauma Center Serving Low-Income Children And Adolescents, Krista Kohl Jan 2010

Trauma, Dissociation, And Traumatic Stress At A Trauma Center Serving Low-Income Children And Adolescents, Krista Kohl

Dissertations

Exposure to trauma continues to be a pervasive and detrimental experience in the lives of children and adolescents in impoverished, urban communities. This study explored the relationships among trauma, dissociation, and posttraumatic stress in a clinic-referred sample of children and adolescents living in urban poverty. Trauma was investigated broadly, including a range of traumatic experiences, with particular attention given to different types, chronicity, multiple exposures, and severity of trauma. Dissociation was investigated as a mediator, or mechanism of the relationships among trauma and posttraumatic stress symptoms, internalizing and externalizing behaviors. Moderators included gender, age, and adverse experiences. Results confirmed that …


Psychosocial Development, Well-Being, And Internalizing Symptoms During Emerging Adulthood: An Examination Of Mediating And Moderating Factors, Jennifer Paley Edidin Jan 2010

Psychosocial Development, Well-Being, And Internalizing Symptoms During Emerging Adulthood: An Examination Of Mediating And Moderating Factors, Jennifer Paley Edidin

Dissertations

The current study was the second part of a longitudinal study, which sought to explore psychosocial development in an older population of emerging adults. Specifically, it examined cross-sectional and longitudinal relations between psychosocial development and internalizing symptoms, as well as between psychosocial development and well-being. Possible mediating and moderating factors were also considered. Two hundred and twelve eligible individuals from one private Midwestern University and one small private college on the East Coast, who completed measures as college seniors, were invited to participate in the second wave of the study, approximately 1½ years after graduation. Participants were asked to complete …


Neuropsychological Assessment Of Executive Functioning And Its Association With Depressive Symptomology, Erica Jean Kalkut Jan 2010

Neuropsychological Assessment Of Executive Functioning And Its Association With Depressive Symptomology, Erica Jean Kalkut

Dissertations

The current study explored the construct of executive functioning and neuropsychological measurement techniques used to assess executive functioning (EF). Two current comprehensive measures of executive functioning include the Behavior Rating Inventory of Executive Functioning-Adult Version (BRIEF-A) and the Delis-Kaplan Executive Functioning System (D-KEFS). The BRIEF-A is a self-report questionnaire that reportedly assesses behaviors associated with EF, and the D-KEFS is a battery of tests that are objectively administered by a trained examiner to directly measure different manifestations of EF ability. This study examined the relationship between gender and general intellectual ability on EF and investigated each measure's construct validity in …


In Whose Best Interest? Using An Experimental Vignette To Assess Factors Influencing Placement Decisions In Child Welfare, Jeff Sieracki Jan 2010

In Whose Best Interest? Using An Experimental Vignette To Assess Factors Influencing Placement Decisions In Child Welfare, Jeff Sieracki

Dissertations

Building on prior research that utilizes clinical vignettes to analyze child welfare placement decisions (Briar, 1963; Britner & Mossler, 2002; Donnelly, 1980; Drury-Hudson, 1999; Gold, et al., 2001; Taylor, 2006), the present study employs an experimental format to assess the relative importance that social workers place on variables related to placement decisions, and to study any differences regarding decision making that may emerge amongst the child welfare professionals themselves. The study consists of a single hypothetical vignette that will be sent to social workers in the state of Illinois. Prior to administration of the questionnaire, multiple experts in the field …


Towards A New Measure Of Playfulness: The Capacity To Fully And Freely Engage In Play, Rebecca Cornelli Sanderson Jan 2010

Towards A New Measure Of Playfulness: The Capacity To Fully And Freely Engage In Play, Rebecca Cornelli Sanderson

Dissertations

The current study involved the development and validation of a new measure of playfulness, the Project Joy Playfulness Scale (PJPS). The PJPS was designed specifically as a brief teacher-report measure for use in the preschool classroom. Playfulness was hypothesized to include four dimensions: Active Engagement, Internal Control, Joyfulness, and Social Connection. Blending academic knowledge with on-the-ground clinical experience, the measure was collaboratively developed and then tested in two separate phases of data collection.

In the first phase of the study, two hundred and twenty-two preschool students aged three to five were rated by two classroom teachers on the alpha version …


A Molecular Analysis Of Training Multiple Versus Single Manipulations To Establish A Generalized Manipulative Imitation Repertoire, Breanne K. Hartley Dec 2009

A Molecular Analysis Of Training Multiple Versus Single Manipulations To Establish A Generalized Manipulative Imitation Repertoire, Breanne K. Hartley

Dissertations

This study evaluates the necessity of training multiple versus single manipulativeimitations per object in order to establish generalized manipulative-imitation. Training took place in Croyden Avenue School's Early Childhood Developmental Delay preschool classroom in Kalamazoo, MI. Two groups of 3 children each were trained to imitate in order to determine the most appropriate number of manipulations required (per object) to establish a generalized manipulative-imitation repertoire. Three children received single-manipulations training, and 3 children received multiple-manipulations training. It was anticipated that the multiple-manipulations training group would acquire a greater amount of generalized manipulative-imitation because the training required that the children discriminate between …


Validating The Attitudes Toward Sex Offenders Scale, Charmeka. Whitehead Dec 2009

Validating The Attitudes Toward Sex Offenders Scale, Charmeka. Whitehead

Dissertations

This study investigated the reliability and validity of the Attitudes Toward Sex Offenders Scale (ATS) measurement by assessing attitudes of counselors in training towards juvenile sex offenders. The specific aims of this study were to determine (a) internal consistency of the ATS, (b) construct validity of the ATS based on exploratory factor analysis, and (c) the degree to which this instrument has convergent and discriminate validity. The intellectual merit of this study was to provide appropriate scale validation of the ATS so that it might be used to assess attitudes of mental health professionals who work with juvenile sex offenders. …


The Effect Of Holland's Person-Environment Fit On Trait Anger, Interpersonal Conflict At Work, And Workplace Aggression, Aimee Chantelle Pseekos Aug 2009

The Effect Of Holland's Person-Environment Fit On Trait Anger, Interpersonal Conflict At Work, And Workplace Aggression, Aimee Chantelle Pseekos

Dissertations

This study examined the effect of Person-Environment fit, as defined by Holland's (1997) theory, on trait anger, interpersonal conflict at work, and workplace aggression in a sample of employees in the United States. Job satisfaction was also examined with regard to concurrent and discriminant validity information for this sample. Results indicated that there was not a statistically significant effect of Person- Environment fit on trait anger, interpersonal conflict at work, or workplace aggression. The concurrent and discriminant validity of findings was supported through relationships between job satisfaction, Person-Environment fit, and workplace aggression. Limitations and implications for further research related to …


Attachment Anxiety And Avoidance: Relationship To Body Image And Exercise Behavior, Kathryn Louise Brown Aug 2009

Attachment Anxiety And Avoidance: Relationship To Body Image And Exercise Behavior, Kathryn Louise Brown

Dissertations

This study was designed to investigate the role of attachment anxiety and avoidance in predicting persons' body image, body appreciation, and obligatory exercise behavior. Two hundred and twenty eight participants (100 men and 128 women) completed the Relationship Scales Questionnaire (RSQ; Griffin & Bartholomew, 1994), Multidimensional Body-Self Relations Questionnaire (MBSRQ; Cash, 2000), Body Appreciation Scale (BAS; Avalos et al., 2005), and Obligatory Exercise Questionnaire (OEQ; Pasman & Thompson, 1988). Results provided at least partial support for many of the hypotheses. The current study replicated results from previous research pertaining to the relationship between attachment and body image. However, the results …


A Psychometric Evaluation Of The Revised Optimism-Pessimism Scale Of The Mmpi-2, Ginger Burge Debrule Aug 2009

A Psychometric Evaluation Of The Revised Optimism-Pessimism Scale Of The Mmpi-2, Ginger Burge Debrule

Dissertations

The present study tested the psychometric properties of the Revised Optimism-Pessimism Scale (PSM-R) of the MMPI-2. This scale purportedly measures the respondent's explanatory style on a dimension of optimism and pessimism. Participants included 92 college undergraduates and 2,729 participants from archived outpatient data. The PSM-R is a reliable measure, based on test-retest reliability and internal consistency. However, the construct validity of the measure is questionable. Evaluation of the PSM-R items suggests that the items are not all related to the optimism-pessimism construct. In addition, convergent validity of the PSM-R was assessed using measures of attributional style, dispositional optimism, hope, depression, …


A Longitudinal Examination Of Outcomes Related To Emotional Abuse In Children, Lauren Seale Fryer Aug 2009

A Longitudinal Examination Of Outcomes Related To Emotional Abuse In Children, Lauren Seale Fryer

Dissertations

Emotional abuse has been linked to both intemalizing and extemalizing outcomes in adults and children, even after controlling for the presence of physical and/or sexual abuse in childhood (Braver, Bumberry, Green, & Rawson, 1992; Gibb et al., 2001; Kaufman & Cicchetti, 1989; Kim & Cicchetti, 2006). The developmental/organizational perspective, as well as attachment theory, suggests that emotional abuse occurring in childhood will result in disrupted views of subsequent relationships, leading to maladaptive outcomes such as aggression, depression, and low self-esteem (Cicchetti & Toth, 1995). The current study examined these relations in an archival sample of lowincome urban children ages 5 …


Informed Consent As A Predictor Of Working Alliance And Perception Of Counselor/Psychotherapist, Scott E. Kerby Aug 2009

Informed Consent As A Predictor Of Working Alliance And Perception Of Counselor/Psychotherapist, Scott E. Kerby

Dissertations

Client informed consent is an important component and ethical dimension of counseling and psychotherapy required by each of the mental health professions. The purpose of this study was to examine the extent to which informed consent in counseling/psychotherapy may relate to client perceptions of the working alliance, measured by the Working Alliance Inventory - Short Version (WAI-S) (Tracey and Kokotovic, 1989), and clients' general opinion of the counselor/psychotherapist, measured by the short form of Counselor Rating Form (CRF-S) (Corrigan and Schmidt, 1983). In particular, the study investigated: (1) how discussion and understanding of informed consent related to client perceptions of …


Phenomenological Study Of Resilience In The Lives Of White, Midlife Lesbian Psychologists In Clinical Practice, Melissa A. Lidderdale Aug 2009

Phenomenological Study Of Resilience In The Lives Of White, Midlife Lesbian Psychologists In Clinical Practice, Melissa A. Lidderdale

Dissertations

The unique experiences and adversities encountered by midlife lesbian therapists have not been directly investigated. How the midlife lesbian women in this study were influenced by their individual experiences and cultural changes, both in general society and within the mental health profession, are paramount to more fully understanding the adversities, support, and resilience that they experienced while becoming psychologists. Due to the scarcity of empirical literature pertaining to the therapist's experience of resilience and the paucity of empirical literature related to resilience in lesbians, phenomenological research methods were chosen for this study. The goal of this study was to provide …


The Comparative Efficacy Of Dosed, Enhanced Dosed, Prolonged Exposure, And Mindfulness In The Reduction Of Anxiety, Sophie Rubin Jun 2009

The Comparative Efficacy Of Dosed, Enhanced Dosed, Prolonged Exposure, And Mindfulness In The Reduction Of Anxiety, Sophie Rubin

Dissertations

Exposure-based treatments have proven effective in treating a range of fears and phobias and can be accounted for by mechanisms described in behavioral theory. Enhanced dosed and dosed-only exposure are promising new behavioral approaches for treating fears and phobias. Fifty participants with speech anxiety were randomly assigned to a prolonged exposure condition (PE), a dosed-only exposure condition (DE), a positively enhanced dosed exposure condition (PDE), a negatively-supplemented dosed exposure condition (NDE), or a mindfulness enhanced dosed exposure condition (MDE). End of session results for all of the enhanced groups resulted in significantly lower subjective ratings of discomfort than the non-enhanced …


Training The Execution Of Single-Case Research Methodology Skills In An Early And Intensive Behavioral Intervention Setting, Jessa R. Love Apr 2009

Training The Execution Of Single-Case Research Methodology Skills In An Early And Intensive Behavioral Intervention Setting, Jessa R. Love

Dissertations

Early and intensive behavioral intervention (EIBI) for children with autism is a fruitful area for conducting research on clinically relevant problems in an attempt to investigate some of the unanswered questions about which procedures are most effective and efficient. Unfortunately, it is unlikely that therapists providing these services have received adequate training in conducting relevant single-case design research in this area. Providing such therapists with the skills needed to implement single-case design research protocols could improve the use of the scientist-practitioner model in these settings and greatly expand the base of scientific knowledge in the area.

Behavioral Skills Training (BST; …


Acceptability Of Interventions To Staff In Long-Term Care Settings For Older Adults: Comparing Ratings And Hierarchical Selection, Jonathan C. Baker Apr 2009

Acceptability Of Interventions To Staff In Long-Term Care Settings For Older Adults: Comparing Ratings And Hierarchical Selection, Jonathan C. Baker

Dissertations

Older adults and their caregivers generally prefer behavioral interventions over medications in treatment acceptability studies (Osterkamp, Mathews, Burgio, & Hardin, 1997). However, previous acceptability studies have primarily examined ratings, which did not force the responder to select between treatment options. Additionally, recent advances in behavioral treatment technologies (Carr & LeBlanc, 2003) and pharmacotherapy (Schneider, 1999) warrant revisiting treatment acceptability for older adults. The present investigation examined treatment acceptability of behavioral, pharmacological, and sensory interventions using a treatment acceptability rating scale, treatment selections, and direct report of treatments used in a six-month window. Fifty-six staff from nursing homes in the Mid-West …


Investigating The Effects Of Observer Presence And Feedback On Individuals' Work-Related Behavior, Angela R. Lebbon Apr 2009

Investigating The Effects Of Observer Presence And Feedback On Individuals' Work-Related Behavior, Angela R. Lebbon

Dissertations

Direct observation procedures have been widely used by applied behavior analysts to examine the effects of various interventions, however, recent research examining the effects of the observer's presence on behavior has found that participants behave in ways that are not representative of their behavior in the absence of an observer. Furthermore, recent research has demonstrated that both reactivity and habituation are idiosyncratic and it remains unclear which variables mediate reactive effects with individuals. Researchers have discussed the necessity of identifying and measuring reactive effects in order to discover variables (e.g., discriminative stimulus properties) that may mediate reactive effects. Previous research …


The Relations Among Parental Monitoring And Warmth, And Adolescent Externalizing And Internalizing Distress: The Effects Of Parent And Adolescent Perception Of Neighborhood Danger, Jonathan Goldner Jan 2009

The Relations Among Parental Monitoring And Warmth, And Adolescent Externalizing And Internalizing Distress: The Effects Of Parent And Adolescent Perception Of Neighborhood Danger, Jonathan Goldner

Dissertations

Parental monitoring and warmth have traditionally been studied in the context of white, middle-class families. This paper adds to recent research that has begun to explore what levels of these parenting behaviors are optimal for the prevention of adolescent psychopathology in impoverished, urban high crime areas. It also takes into account parent and child perceptions of neighborhood danger. This study employs a longitudinal design, with data collected at two times points one year apart, among a sample of 240 African American young adolescents and their parents in urban, high crime neighborhoods. It aims to study parental monitoring, parental warmth, parent …


Gender Differences In Antecedents To Academic And Personal Well-Being In Urban Youth: What Is The Role Of Social Support?, Erin Caskey Jan 2009

Gender Differences In Antecedents To Academic And Personal Well-Being In Urban Youth: What Is The Role Of Social Support?, Erin Caskey

Dissertations

Urban youth are an important, yet understudied population. Moreover, the vast majority of existing research has focused on negative outcomes. Recently, there has been a trend in the field of adolescent research toward creating models that attempt to understand and explain why some members of at-risk populations are able to overcome adversities and to achieve successful adaptation. The present study investigated the relationships between perceived social support, gender, academic outcomes, and personal well-being in urban youth. Overall, perceived social support was found to be related to many outcome variables for males and females. Gender differences were found in the relationships …


Increasing Narrative Coherence In The Bereaved: The Effect Of Narrative Review On Grief Reaction, Stefanie Suzon Boswell Aug 2008

Increasing Narrative Coherence In The Bereaved: The Effect Of Narrative Review On Grief Reaction, Stefanie Suzon Boswell

Dissertations

In order to investigate the utility of an experimental expressive writing intervention designed to increase narrative coherence (write about loss combined with review of previous narratives) as a potential bereavement intervention, it was compared to a standard expressive writing intervention (write about loss with no opportunity for review), and two trivial writing conditions (one with and one without opportunity for review). Although all writing groups experienced beneficial effects across time, participants in the experimental and standard conditions reported significantly greater personal growth as a function of time when compared to control participants.


The Effect Of Writing As Exposure Therapy On Ptsd Symptoms, Daniel Scott Debrule Aug 2008

The Effect Of Writing As Exposure Therapy On Ptsd Symptoms, Daniel Scott Debrule

Dissertations

The majority of empirically supported treatments for Posttraumatic Stress Disorder involve some form of exposure, which desensitizes an individual to traumarelated information. Theoretical work has suggested that the mechanism of exposure may explain the tendency for writing to lessen symptoms, and empirical evidence of writing and PTSD symptoms suggests that modifying the writing paradigm may result in better symptom relief. The present investigation aimed to compare the efficacy of an exposurebased writing intervention to the standard writing paradigm. A total of 68 undergraduates that were screened for PTSD symptoms were randomly assigned to write about their most severe trauma for …


Emotion Recognition And The Propensity To Engage In Sexually Coercive Behaviors: A Study With College Males, Beth J. Dietzel Aug 2008

Emotion Recognition And The Propensity To Engage In Sexually Coercive Behaviors: A Study With College Males, Beth J. Dietzel

Dissertations

Several variables have been investigated over the past years as risk factors for sexual aggression. Among them, substance use/abuse, family environment, attitudes towards women, and lack of empathy. Although researchers have identified several risk factors, predicting aggressive behaviors continues to be a difficult task. One variable that has received less attention in the literature is men's emotion recognition skills. Do men's emotion recognition skills affect their propensity to aggress?

The purpose of this study was to investigate emotion recognition skills/deficits and how such skills predict propensity to engage in sexually coercive behavior. There were two main goals of this study. …


Combined Cognitive Behavioral Treatment Plus Caregiver Sessions For Childhood Depression, Dikla Eckshtain Aug 2008

Combined Cognitive Behavioral Treatment Plus Caregiver Sessions For Childhood Depression, Dikla Eckshtain

Dissertations

Childhood depression is intimately related to the family context and caregiver-child relations, but only a limited number of treatment outcome studies for depressed youth have formally included members of the family in the intervention. To address this discrepancy the present study evaluated the efficacy of adding caregiver sessions to individual cognitive behavioral therapy (CBT) for the treatment of depressed youth. The treatment included 16 individual sessions and 7 caregiver sessions administered in the child's school to promote accessibility. Fifteen children (10 females and 5 males ranging in age from 8-13), who met inclusion criteria based on self-report and interview measures …


Using Virtual Reality Enhanced Behavioral Skills Training To Teach Street-Crossing Skills To Children And Adolescents With Autism Spectrum Disorders, Tina R. Goldsmith Aug 2008

Using Virtual Reality Enhanced Behavioral Skills Training To Teach Street-Crossing Skills To Children And Adolescents With Autism Spectrum Disorders, Tina R. Goldsmith

Dissertations

Children with Autism Spectrum Disorders (ASDs) often have poor safety skills due to their insensitivity to subtle environmental cues and poor problem solving in the face of stressful tasks. These skill deficits threaten their physical well-being and limit their personal independence. An effective intervention model for teaching safety skills is behavioral skills training (BST). The effects of this 4-part intervention, which includes Instructions, Modeling, Rehearsal, and Feedback, improve with the addition of in situ training. However, creating realistic, safe, and logistically feasible contexts for rehearsal of skills may prove difficult, if not impossible. Virtual reality (VR) may present a solution. …


A Comparison Of Maintenance-Training Methods For Children Diagnosed With Autism, Nicholas L. Weatherly Aug 2008

A Comparison Of Maintenance-Training Methods For Children Diagnosed With Autism, Nicholas L. Weatherly

Dissertations

The current study evaluated the effects of two different maintenance-training methods and one control condition on skill maintenance within a public-school classroom for children diagnosed with autism. The two training methods involved the use of either a continuous-reinforcement schedule or a thinned partial-reinforcement schedule during 20 overlearning training sessions following skill acquisition. The control condition did not involve any overlearning following skill acquisition. Three children were each taught two curricular programs, with each program involving the two training methods and the control condition using a multielement design. Overlearning using a thinned partial-reinforcement schedule reliably produced greater maintenance across all participants, …


Mindfulness In Childbirth: An Investigation Of The Effects Of Mindfulness Training On Maternal Satisfaction With Childbirth And Obstetric Outcomes, Brenda L. Bratton Jun 2008

Mindfulness In Childbirth: An Investigation Of The Effects Of Mindfulness Training On Maternal Satisfaction With Childbirth And Obstetric Outcomes, Brenda L. Bratton

Dissertations

This study investigated the effects of mindfulness training on obstetric outcomes and maternal satisfaction with childbirth. We were interested in whether mindfulness training was more effective than a control group receiving psychoeducation on stress reduction. The goal of the intervention group was to increase participants' moment-to-moment awareness of thoughts, feelings, and body sensations during childbirth so that they would respond to these experiences rather than react to them in an automatic manner. These strategies were hypothesized to help a laboring woman minimize fear or anxiety associated with pain and complications and be more adaptive to whatever circumstances arose. Repeated measures …


Disruptive Effects Of Aβ Oligomers To The Radial-Arm Maze Performance Of Rats, Kineta Lynn Morgan-Paisley Jun 2008

Disruptive Effects Of Aβ Oligomers To The Radial-Arm Maze Performance Of Rats, Kineta Lynn Morgan-Paisley

Dissertations

Converging lines of research have implicated a causal relationship between oligomers of amyloid-β and the cognitive impairments associated with Alzheimer's disease (AD); however, very few studies have provided direct experimental evidence of this relationship and none of those studies have used an established model of working memory. The present study used an established model of working memory, the radial-arm maze, to examine the effects of amyloid-β oligomers on the memory of two groups of rats. The experimental group received ICV injections of the culture media (CM) of Chinese Hamster Ovary (CHO) cells transfected with a human mutation of APP containing …


A Qualitative Exploration Of First-Generation Asian Indian Women In Cross-Cultural Marriages, Monica Thiagarajan Dec 2007

A Qualitative Exploration Of First-Generation Asian Indian Women In Cross-Cultural Marriages, Monica Thiagarajan

Dissertations

The literature on Asian Indian women has not adequately addressed the experiences that first generation Asian Indian women face while going through the process of making the decision to marry cross-culturally. The purpose of this exploratory study was to identify, describe, and understand the struggles, challenges, and conflict experienced by Asian Indian women who decide to marry cross-culturally and to understand the consequences of the decision on the lives of these women and their interpersonal relationships.

Initial and follow-up phone interviews were conducted with eight Asian Indian women who had experienced cultural and familial challenges regarding their decision to marry …