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Virginia Commonwealth University

Theses and Dissertations

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Variability In Perceptions Of Complementary Health Approaches Among Graduate Student Trainees, Delaney C. Bilodeau Jan 2024

Variability In Perceptions Of Complementary Health Approaches Among Graduate Student Trainees, Delaney C. Bilodeau

Theses and Dissertations

Complementary Health Approaches (CHAs) encompass a diverse range of practices which are often used both independently and alongside conventional medical treatments. Understanding how graduate students training in different fields perceive CHAs is important because these professional trainees will go on to occupy roles as healthcare practitioners, researchers, policy makers, and consumers. This study used sequential rank agreement methods (Ekstrøm, Gerds, & Jensen, 2019) to investigate variations in perceptions of CHAs in a sample of graduate students (N = 416) from 140 possible training programs. Ratings of CHA familiarity, perceptions of CHA legitimacy, and willingness to recommend CHAs were compared …


Anti-Immigration-Related Stressors And Latine Immigrant Well-Being: The Role Of Family & Community Resilience, Lisa S. Fuentes Jan 2023

Anti-Immigration-Related Stressors And Latine Immigrant Well-Being: The Role Of Family & Community Resilience, Lisa S. Fuentes

Theses and Dissertations

Anti-immigrant rhetoric and policies have continued to adversely impact Deferred Action for Childhood Arrivals (DACA) and Temporary Protection Status (TPS) beneficiaries (Arevalo et al., 2015; Cleary, 2017; Li, 2015; Sangalang et al., 2018). There have been numerous attempts to revoke DACA, TPS, and other policies that temporarily protect immigrant families. Although the number of resilience literature has grown, more strength-based approaches are still needed. Additionally, given that familismo (familism) and collectivism are key cultural values for Latine families (Campos et al., 2019; Corona et al., 2017), it is imperative to explore family and community resilience among Latine immigrants to gain …


Home Disruption And Substance Use: The Moderated-Mediating Role Of Family Conflict And Stress Among Racial-Ethnic Minoritized College Students, Geovani Muñoz Jan 2023

Home Disruption And Substance Use: The Moderated-Mediating Role Of Family Conflict And Stress Among Racial-Ethnic Minoritized College Students, Geovani Muñoz

Theses and Dissertations

The COVID-19 pandemic has disproportionately impacted first-generation college students who identify as racial-ethnic minorities (REM). Aside from the academic and health repercussions caused by COVID-19, little is known if home disruptions have increased substance use for REM college students. Specifically, increased home disruptions may directly relate to substance use and indirect relationships through increased family conflict and stress. Therefore, this master's thesis examined the direct relationships between home disruption and substance use. I also examined the relationships between home disruption and family conflict, as well as home disruption and stress. Further, I also investigated the relationships between family conflict and …


Black Racial Identity And Externalizing Symptoms: The Regulatory Role Of Dyadic Relationships, Sultan A. Hubbard Jan 2023

Black Racial Identity And Externalizing Symptoms: The Regulatory Role Of Dyadic Relationships, Sultan A. Hubbard

Theses and Dissertations

This study explored caregiver impact on Black racial identity (BRI) and externalizing through the integration of BRI, racial socialization (RS), and social support theoretical frameworks. The study used 85 Black undergraduates (Mean age =19.3, SD=3.43) who rated three caregivers, respectively. Restricted maximum likelihood estimation was conducted to estimate variance components. BRI, RS, internalizing, and externalizing variables reflected significant trait effects and dyadic effects. However, racial centrality and public regard did not reflect significant dyadic effects. Participant burden due to randomization of caregivers and items likely suppressed dyadic effects. Moreover, caregivers who evoked private regard were perceived as having high cultural …


The Lived Experience Of Postpartum Sleep For Black And White Women, Ashley R. Macpherson Jan 2023

The Lived Experience Of Postpartum Sleep For Black And White Women, Ashley R. Macpherson

Theses and Dissertations

This qualitative study utilized a phenomenological research approach (van Manen, 1990), and intersectional feminist lens (Collins, 2000; Crenshaw ,1989; hooks, 2000), to uncover the lived experience of sleep in the postpartum period. Participants were 10 mothers who were less than 12 months postpartum. Data collection consisted of in-depth interviews. Data analysis procedures followed recommendations by van Manen (1990, 1997). In order to increase the trustworthiness and rigor of the study, the researcher engaged in reflexive journaling, member checking, and peer debriefing. The results were organized into six themes; 1) the importance of the sleep environment, 2) anxiety and hypervigilance, …


Sleep And Health Behaviors In A Safety-Net Primary Care Setting, Sahar Sabet Jan 2023

Sleep And Health Behaviors In A Safety-Net Primary Care Setting, Sahar Sabet

Theses and Dissertations

Nearly half of all premature deaths in the United States are attributable to preventable and modifiable health risk behaviors. For decades, the leading behavioral health contributors to morbidity and mortality are tobacco use, physical inactivity, and alcohol consumption. Medication adherence is a relatively less studied yet critical interrelated health behavior that is tied to health and treatment outcomes. Sleep, an important pillar of health, is a daily and modifiable behavior that shows promise as a health behavior facilitator. Better understanding the dynamics of these modifiable health behaviors is essential for the improvement of health promotion, particularly among underserved populations (e.g., …


Examining The Impact Of Parental Racial Socialization And Critical Consciousness On Black Adolescents’ Coping With Racism-Related Stress, Chandler Alexandra Golden Jan 2022

Examining The Impact Of Parental Racial Socialization And Critical Consciousness On Black Adolescents’ Coping With Racism-Related Stress, Chandler Alexandra Golden

Theses and Dissertations

In addition to universal stressors, Black adolescents also experience racism-related stressors. The physical and emotional consequences of racism-related stressors can be harmful to Black youth. To mitigate racism-related stress, Black youth may engage in various forms of coping. Critical consciousness and racial socialization are culturally relevant factors that have been protective against the negative impact of racism-related stress, with coping as one mechanism that undergirds this protection. Moreover, research has also begun to theorize critical action as a type of racialized coping. Past research has largely examined the impact of critical consciousness and racial socialization on coping separately and yielded …


Racism Experiences And Mental Health: An Examination Of Direct, Vicarious, And Appropriated Racism Experiences On Mental Health Symptom Expression, Christina Barnett Jan 2022

Racism Experiences And Mental Health: An Examination Of Direct, Vicarious, And Appropriated Racism Experiences On Mental Health Symptom Expression, Christina Barnett

Theses and Dissertations

The current study aimed to corroborate existing models of racism-related experiences by creating an explanatory model that operationalized direct, vicarious, and appropriated racism experiences. This study explored whether the factors of direct and vicarious racism experiences influenced mental health outcomes via appropriated racism experiences in a sample of Black women. This association was not present. However, results showed a positive association between vicarious and direct racism experiences, as well as predictive relations between direct and vicarious racism experiences and depression and trauma symptoms. Results, limitations, implications, and recommendations for future research are included.

Keywords: vicarious racism, appropriated racism, direct racism, …


Culturally Relevant Coping Strategies Within Bicultural Latine College Students In The Face Of Anti-Immigrant Sentiment And Policy, Cindy M. Hernandez Jan 2022

Culturally Relevant Coping Strategies Within Bicultural Latine College Students In The Face Of Anti-Immigrant Sentiment And Policy, Cindy M. Hernandez

Theses and Dissertations

Despite their protective potential against anti-immigrant sentiment and policy, the connections between bicultural identity development and culturally relevant coping among temporarily documented Latinx college students remain unstudied. Therefore, this study (a) describes culturally relevant coping strategies used by bicultural Latinx college students, (b) examines the role cultural identity plays in bicultural Latinx college students’ coping strategies, and (c) illuminates the role institutional level systems play in liminally-documented college students’ coping with anti-immigrant sentiment and policy. Participants in this study included 16 Latine college students (Mage = 21.19, SD = 3.21) with DACA (n = 14) or TPS (n = …


An Examination Of The Impacts Of Childhood Trauma On Healthy Intimate Relationships In College-Aged African Americans, Broquelynn D. Shepard Jan 2021

An Examination Of The Impacts Of Childhood Trauma On Healthy Intimate Relationships In College-Aged African Americans, Broquelynn D. Shepard

Theses and Dissertations

For African Americans, the dynamics of relationships are rooted in childhood experiences of unconditional love, restraint, and respect. These experiences help individuals form their understanding of how relationships function. Experiencing healthy relationships has an enduring impact on social development and interpersonal relationships. However, regarding studies on childhood trauma and intimate relationships, there is insufficient literature that includes African American samples as the primary foci of the research. Due to gaps in extant literature, the present study aims to explore whether experiences of healthy intimate relationship in African Americans are associated with childhood trauma (neglect, emotional, sexual, and physical abuse). Using …


Interpersonal Trauma And Mental Health Among Lgbq+ College Students: Examining Social Support And Trauma-Related Drinking As Mediators, Eryn Delaney Jan 2021

Interpersonal Trauma And Mental Health Among Lgbq+ College Students: Examining Social Support And Trauma-Related Drinking As Mediators, Eryn Delaney

Theses and Dissertations

Despite the increased risk of childhood, adulthood, and lifetime interpersonal trauma among LGBQ+ individuals, existing research that has examined the influence of interpersonal trauma on mental health has primarily focused on LGBQ+ adolescents and samples of LGBQ+ community-based adults, and less on LGBQ+ emerging adults in college. Additionally, limited work has focused on mechanisms that might explain the relations between these variables. Thus, the current study tested the relations between interpersonal trauma (i.e., childhood sexual abuse, adulthood sexual victimization, and lifetime physical assault and IPV) and mental health outcomes (i.e., anxiety symptoms, depressive symptoms, and PTSD symptoms), and examined social …


Expand Your Horizon: Investigating An Online Intervention For Weight Bias Internalization, Alexandria Davies Jan 2021

Expand Your Horizon: Investigating An Online Intervention For Weight Bias Internalization, Alexandria Davies

Theses and Dissertations

Weight bias internalization (WBI; i.e., self-directed weight stigma or the degree to which individuals apply negative weight-based stereotypes to themselves), is problematic because it is associated with increased stress, emotional eating, healthcare avoidance, and exercise avoidance. Thus, WBI exacerbates health disparities and there is an urgent need to create treatments that address this concern. The current study examined the preliminary effectiveness of a previously developed online body gratitude journaling intervention (i.e., Expand Your Horizon) compared to an active control writing condition in emerging adult women with WBI. Racially/ethnically diverse women (N=100; n=49) or Expand Your Horizon ( …


“Is Therapy For Me?” Perceptions Of Therapy Inclusivity And Willingness To Seek Help Among Black Emerging Adults, Randl B. Dent Jan 2020

“Is Therapy For Me?” Perceptions Of Therapy Inclusivity And Willingness To Seek Help Among Black Emerging Adults, Randl B. Dent

Theses and Dissertations

Mental health issues are prevalent among Black emerging adults; however, they tend to underutilize mental healthcare services. The goals of the current study were to examine whether: (1) perceived therapy inclusivity would predict willingness to utilize mental healthcare services and (2) the relationship between perceived therapy inclusivity and willingness would be moderated by two indices of racial identity (i.e., centrality and private regard). Results provide evidence that greater perceptions of therapy inclusivity are associated with greater willingness to seek mental health services even after controlling for factors, such as gender, self-stigma, and previous mental healthcare utilization. Additionally, there was no …


An Integrated Exploration Of The Contextual, Relational, And Individual Factors That Impact High School Completion Among African Americans, Lesley B. Winchester Jan 2020

An Integrated Exploration Of The Contextual, Relational, And Individual Factors That Impact High School Completion Among African Americans, Lesley B. Winchester

Theses and Dissertations

African American students are consistently reported as having among the lowest high school graduation rates when compared to other races (U.S. Department of Education, 2018). While many studies have sought to explore the potential risks of high school dropout, the intention of this study is to examine the factors that support the exemplary resilience of those students who do complete high school. The present study adopts the framework of García Coll et al.’s, (1996) integrative model of developmental competencies in minority children, as it seeks to identity whether and how contextual (spiritual, educational, cultural); relational (caregiver psychological and physical …


Can School Be A Source Of Trauma? Assessing Academic Traumatic Stress As A Mechanism Underlying The Health Outcomes Of Black Undergraduate Students, Ebony A. Lambert Jan 2020

Can School Be A Source Of Trauma? Assessing Academic Traumatic Stress As A Mechanism Underlying The Health Outcomes Of Black Undergraduate Students, Ebony A. Lambert

Theses and Dissertations

Research examining Black students’ school experiences demonstrates that exposure to oppressive power dynamics in schools may lead to adverse physiological and psychological consequences. Recent conceptualizations in public discourse further posit that traumatic educational experiences, operationalized here as academic trauma or the cumulative toll of adverse and oppressive experiences in academic settings, may influence Black students’ wellbeing even after they have graduated. However, academic trauma has yet to be investigated empirically, and the health contributions of such educational harm remain unstudied. Moreover, little is known about how culturally-relevant personal characteristics (e.g., emotion regulation strategies) influence Black students’ reactivity to academic trauma. …


A Microlongitudinal Study Of Menopause Symptoms And Problematic Eating In Midlife Women, Dana R. Schreiber Jan 2020

A Microlongitudinal Study Of Menopause Symptoms And Problematic Eating In Midlife Women, Dana R. Schreiber

Theses and Dissertations

Women in midlife are at risk for engagement in problematic eating behavior which is associated with negative mental and physical health outcomes. Despite this risk, little is known about precipitating factors that may increase risk in this population. One specific, yet unstudied, factor that may increase risk for problematic eating in midlife women is menopause, which is characterized by distinct symptomatology (e.g., vasomotor symptoms, negative mood, sleep). The purpose of the current study was to investigate the associations among psychological, behavioral, and social symptoms of menopause and problematic eating behavior in midlife women using both retrospective and prospective methodologies. As …


Work Hope And Work Volition: Exploring The Influence Of Community College Students’ Rurality And Socioeconomic Status, Jesse A. Wingate Jan 2020

Work Hope And Work Volition: Exploring The Influence Of Community College Students’ Rurality And Socioeconomic Status, Jesse A. Wingate

Theses and Dissertations

Data from a sample of community college students (N = 478) in Virginia were used to examine relations among rurality, socioeconomic status, work hope, and work volition. Socioeconomic status, work hope, and work volition were positively associated. However, rurality, measured both as a continuous and categorical variable, was not correlated with work hope or work volition. Additional analyses showed convergence between measures of work hope and work volition confirming construct similarity. Results, limitations, implications, and recommendations for future study are included.


A Meta-Analysis Investigating The Correlation Between Treatment Integrity And Youth Client Outcomes, Ruben G. Martinez Jan 2020

A Meta-Analysis Investigating The Correlation Between Treatment Integrity And Youth Client Outcomes, Ruben G. Martinez

Theses and Dissertations

Objective: The relation between treatment integrity and youth client outcomes in psychosocial treatment research has implications for therapist training, study design, and study interpretation. Despite work done in this area, this relation remains unclear. The aim of the current study was to meta-analyze and describe characteristics of investigations of integrity and outcome in youth.

Method and Analytic Plan: A total of N = 30 studies were identified. Conceptual and methodological factors were coded. Pearson’s r represented the magnitude of the integrity-outcome correlation. Robust variance estimation was used to account for dependency of within-study effect sizes. Two models were run with …


An Intuitive Eating Intervention For College Women With Disordered Eating: Evaluating Two Accessible And Affordable Approaches, Carolyn B. Burnette Jan 2020

An Intuitive Eating Intervention For College Women With Disordered Eating: Evaluating Two Accessible And Affordable Approaches, Carolyn B. Burnette

Theses and Dissertations

Undergraduate women of all racial and ethnic groups engage in disordered eating behaviors (DEBs) at alarming rates. Most women do not receive treatment, with the largest disparities observed in women of color and those at higher weights. Prevailing interventions have limitations that could exacerbate these disparities, such as an emphasis on the thin ideal, which is often considered less relevant for some women of color. This is concerning, as disordered eating is often chronic and symptom crossover is common. Thus, a transdiagnostic, inclusive secondary prevention approach could enhance outcomes by addressing the spectrum of DEBs in diverse women. The purpose …


Impact Of A Culturally-Relevant Support Program And Latinx Adolescents' Help Seeking Services: An Academic-Latinx Community Service Partnership To Enhance Culturally Responsive Services For Latinx Immigrant Youth., Lisa S. Fuentes Jan 2020

Impact Of A Culturally-Relevant Support Program And Latinx Adolescents' Help Seeking Services: An Academic-Latinx Community Service Partnership To Enhance Culturally Responsive Services For Latinx Immigrant Youth., Lisa S. Fuentes

Theses and Dissertations

Latinxs, in general, report logistical barriers that contribute to utilizing fewer healthcare services and/or not knowing how to navigate the healthcare system. In addition to underutilizing healthcare services, Latinx immigrant youth also report higher levels of negative attitudes towards mental health. However, little is still known regarding factors that impact these attitudes with Latinx immigrant youth, as well as the community support efforts that are available to this specific group. Using a semi-structured interview on 12 Latinx immigrant youth, this master’s thesis explored: (1) the attitudes towards mental health, (2) attitudes towards mental health services, (3) and the experiences of …


Conceptualization Of Body Image And Eating Disorders Among South Asian American Women: A Qualitative Investigation, Neha J. Goel Jan 2019

Conceptualization Of Body Image And Eating Disorders Among South Asian American Women: A Qualitative Investigation, Neha J. Goel

Theses and Dissertations

Though it is known that eating disorders (EDs) affect individuals of all racial/ethnic backgrounds (Cheng, Perko, Fuller-Marashi, Gau, & Stice, 2019), people of color tend to be overlooked in the ED literature. South Asian Americans, a specific subset of individuals traditionally categorized within the larger umbrella group of “Asians,” have been notoriously neglected in both the broader mental health literature, and in the ED literature (Inman, Devdas, Spektor, & Pendse, 2014; Iyer & Haslam, 2003, 2006). Currently, very little information exists on the etiology and presentation of EDs amongst South Asian communities. Even less is known about culturally-specific barriers to …


Race, Health, And Social Support On Campus: An Exploration Of Discrimination On Health And Fraternity/Sorority Membership For African American College Students, Alexandra M. Munson Jan 2019

Race, Health, And Social Support On Campus: An Exploration Of Discrimination On Health And Fraternity/Sorority Membership For African American College Students, Alexandra M. Munson

Theses and Dissertations

African American college students face a myriad of unique race related stressors on campus, yet there is a gap of knowledge on how these experiences may impact overall health as well as what may mediate these effects. The goal of the current study was threefold. First, it was to better understand the relationship between health outcomes and the experience of discrimination on college campuses for African American students. Second, it further investigated the research of Pieterse & Carter (2007), to explore if perceived discrimination influences health outcomes above and beyond general life stress in the emerging adult population. Lastly, it …


Racism, Healthcare Provider Trust, And Medication Adherence Among Black Patients In Safety-Net Primary Care: A Strength-Based Approach, Mickeal Pugh Jr Jan 2019

Racism, Healthcare Provider Trust, And Medication Adherence Among Black Patients In Safety-Net Primary Care: A Strength-Based Approach, Mickeal Pugh Jr

Theses and Dissertations

Integrated primary care has been incorporated into a variety of healthcare settings. The benefits of these services are empirically supported by a plethora of studies, which highlight the integration of behavioral and physical healthcare to be beneficial for both patient and healthcare providers. Integrated care models are typically incorporated in Veterans Affairs hospitals, general primary care facilities, and community clinics. Community-based clinics, such as safety-net clinics, typically serve underrepresented populations, and research has shown several mental and physical health disparities to exist among minority populations. Further, the minority stress model posits that distal and proximal minority-based stress processes can result …


Investigating The Presence And Correlates Of Anti-Thin Bias In Adults, Alexandria Davies Jan 2018

Investigating The Presence And Correlates Of Anti-Thin Bias In Adults, Alexandria Davies

Theses and Dissertations

Weight stigma is associated with negative health outcomes across the BMI continuum. However, few studies have examined weight discrimination targeting people with low body weights. This investigation explored the presence of anti-thin bias, defined as the belief that people with low BMIs have undesirable personality characteristics. Participants were randomly assigned to read one of six vignettes about women that differed by race (White and Black) and weight status (slightly underweight, normal weight, and slightly overweight). Negative personality characteristics were more likely to be ascribed to both underweight and overweight women, compared with normal weight women. Furthermore, participants were significantly more …


Critical Consciousness, Racial Identity, And Appropriated Racial Oppression In Black Emerging Adults, Keyona Allen Jan 2018

Critical Consciousness, Racial Identity, And Appropriated Racial Oppression In Black Emerging Adults, Keyona Allen

Theses and Dissertations

The present study explored private regard and public regard, two subcomponents of racial identity, as mediators of the association between critical consciousness and appropriated racial oppression. In a sample of 75 Black emerging adults, ages 18-25, the current study examined (1) the relationships between critical consciousness, racial identity, and appropriated racial oppression and (2) whether racial identity mediates the relationship between critical consciousness and appropriated racial oppression. Relationships in the expected direction were evident between private regard and both critical consciousness and appropriated racial oppression. Relationships in the expected direction were evident between public regard and critical consciousness. Further, mediation …


Influence Of Cultural Strengths On The Relationships Among Acculturative Stress, Racism, And Mental And Physical Health In Latino Immigrants, Annahir N. Cariello Jan 2018

Influence Of Cultural Strengths On The Relationships Among Acculturative Stress, Racism, And Mental And Physical Health In Latino Immigrants, Annahir N. Cariello

Theses and Dissertations

The Latino immigrant population in the United States has grown rapidly, now standing at over 56 million people. Due to this increase in Latino immigrants, investigation of their mental and physical health is crucial. Few studies have investigated conjointly both physical and mental health in Latino immigrant adults. Daily discrimination and acculturative stress have been found to affect the mental and physical health of Latino immigrants. Cultural strengths including social support, religiosity, and enculturation have been linked to Latino immigrant health. In the minority stress model, cultural strengths have been theorized to moderate relationships between discrimination and health. The purpose …


Bed And Breakfast: The Role Of Sleep And Affect In Breakfast Intake, Ashley R. Macpherson Jan 2018

Bed And Breakfast: The Role Of Sleep And Affect In Breakfast Intake, Ashley R. Macpherson

Theses and Dissertations

Breakfast intake is associated with numerous positive physical and mental health outcomes, yet breakfast skipping remains common in adults. Chronotype and sleep show potential as predictors of breakfast intake; however the existing literature has methodological limitations and fails to examine how psychological mechanisms might explain the relation between sleep and breakfast. The current investigation explored the association of means and variability of sleep behaviors (bedtime, midsleep, sleep duration) as predictors of breakfast intake frequency and high-protein breakfast intake frequency. Additionally, the role of positive and negative affect as mediators in the sleep—breakfast association was examined. Hierarchical regressions and PROCESS parallel …


A Stakeholder Examination Of Gestational Weight Gain Guidelines, Melissa Kwitowski Jan 2018

A Stakeholder Examination Of Gestational Weight Gain Guidelines, Melissa Kwitowski

Theses and Dissertations

Obesity is a significant health concern for women of childbearing age. More than 40% of women have a Body Mass Index (BMI) in the overweight or obese ranges at the time they conceive, posing significant health risks for both mother and child. Excessive weight gain during pregnancy is common and associated with numerous deleterious complications. The Institute of Medicine published gestational weight gain (GWG) guidelines based on prepregnancy BMI. However, more than 50% of women gain in excess of these recommendations. Further, many women report receiving minimal guidance from their healthcare providers regarding weight gain, nutrition, and physical activity during …


Three Measures Of Coping In Video Games (Civ-Iii): The Development, Construct Validation, And Profile Analysis Of The Civ-Iii, Chelsea M. Hughes Jan 2017

Three Measures Of Coping In Video Games (Civ-Iii): The Development, Construct Validation, And Profile Analysis Of The Civ-Iii, Chelsea M. Hughes

Theses and Dissertations

Video games provide a competitive, goal-oriented environment. They involve individuals who often seek intentionally to frustrate their opponents’ goals. The gaming community is made up of players who vary in their interpersonal style, learning histories, and skill levels. In this rich and dynamic environment, stress is a common experience. Given the prevalence of gameplay in the population and the frequency of gameplay among gamers, it is important to examine coping responses to stressors, particularly maladaptive ones. The present research entails three studies. In Study 1, I use exploratory factor analyses to develop three scales purported to measure maladaptive coping strategies …


Pathways Linking Clinician Demographics To Mental Health Diagnostic Accuracy: An International Perspective, Julia Brechbiel Jan 2017

Pathways Linking Clinician Demographics To Mental Health Diagnostic Accuracy: An International Perspective, Julia Brechbiel

Theses and Dissertations

Significant research efforts have focused on examining the effect of patient factors on providing diagnoses across clinical settings; however, the influence of clinician demographics have received less attention. This study aimed to understand the impact of nonclinical factors such as clinician characteristics and response time on diagnostic accuracy. The study used data from a WHO field study of the ICD-11 development (n = 1822) that required clinicians to diagnose two case vignettes. Clinicians’ slower response times had a significant positive impact on their rates of diagnostic accuracy. However, there was no evidence that clinicians’ demographic features were directly related to …