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Articles 6151 - 6180 of 48979
Full-Text Articles in Entire DC Network
Experiences Of Discrimination And Stress In People With And Without Hiv: Associations With Experimental Pain Sensitivity And Substance Use, Joanna Hobson
All ETDs from UAB
People living with HIV (PLWH) are at an increased risk for experiencing not only discrimination, but the adverse health outcomes that are related to discrimination. Specifically, studies have identified direct relationships between HIV, discrimination and substance use, pain, poor sleep (e.g. insomnia symptoms) and depression. Thus, this study aimed to elucidate the relationships between discrimination, stress, experimental pain sensitivity, mood and substance abuse. We used various questionnaires to measure mood and health behavior. Lastly, participants underwent a series of pain experiments to measure group differences in experimental pain sensitivity. We found group differences in cortisol levels (p = .031) and …
Measuring Resilience In Black Families, Destiny Shanell Kelly
Measuring Resilience In Black Families, Destiny Shanell Kelly
All ETDs from UAB
Black families play a unique role in navigating risk and adversity, operating as a source of various protective factors to combat challenges faced. Given the historical and current role that racism plays in the everyday lives of Black individuals, culturally specific protective mechanisms have manifested as a defense for these encounters. Many of these protective factors are instilled at the family level, helping all family members maintain healthy functioning or be resilient, such as social support, ethnic-racial socialization, and racial identity. However, current measures of family resilience do not incorporate these culturally relevant protective mechanisms into the measures, preventing Black …
Pubertal Timing In Relation To Epigenetic Aging And Mortality Risk In Young Adulthood, Marlon Goering
Pubertal Timing In Relation To Epigenetic Aging And Mortality Risk In Young Adulthood, Marlon Goering
All ETDs from UAB
Early pubertal timing is associated with adverse health outcomes in adulthood, which may be mediated by DNA methylation-based epigenetic changes associated with accelerated aging and mortality risk. However, only few studies examined links between pubertal timing and epigenetic aging and these focused mainly on females, relied on retrospective reports of single pubertal events, and did not examine protective factors and underlying mechanisms. Thus, this dissertation examined two distinct dimensions of pubertal timing (i.e., phenotypical pubertal timing relative to age and self-perceived pubertal timing relative to peers) in relation to subsequent epigenetic aging and mortality risk in adulthood together with sex …
Sleep And Stigma: Novel Factors In The Relationship Between Weight Status And Cognitive Function?, Lindsay M. Stager
Sleep And Stigma: Novel Factors In The Relationship Between Weight Status And Cognitive Function?, Lindsay M. Stager
All ETDs from UAB
U.S. obesity rates are rising. Impaired cognitive function (CF) negatively correlates with obesity and may impact food consumption. However, the mechanisms of action demand assessment. This study aimed to identify adiposity-based differences in adolescent CF and food consumption and determine the roles of sleep and stigma within these relationships. Adolescents completed questionnaires including the Behavior Rating Inventory of Executive Function and Brief Version of the Stigmatizing Situations Inventory assessing weight stigma. Actigraphy and food diaries assessed typical sleep duration and food consumption. Participants then completed two sleep conditions in a randomized order: adequate (AS; >8 hours asleep) and restricted (RS; <5 hours asleep) sleep. Each condition was preceded by a 2-night washout period (9 hours in bed per night) and followed by a morning lab visit involving a cognitive battery and self-serve breakfast. Adolescents with healthy weight (HW) demonstrated greater performance-based episodic memory compared to adolescents with overweight/obesity (OWOB), but self-reported poorer inhibition, self-monitoring, and planning/organizing. Findings were similar in models using total body fat percent (TBF%) as a predictor, and stigma did not mediate these relationships. Adiposity did not relate to typical self-reported food consumption. RS predicted poorer performance-based global cognition, fluid cognition, and cognitive flexibility for adolescents with OWOB and improved cognitive flexibility among adolescents with HW. Adolescents with OWOB also had poorer attention compared to adolescents with HW following RS, while there were no group differences following AS. Findings were similar in models using TBF% as a predictor. However, adolescents with TBF% elevated above 42, also had poorer processing speed following RS, and the relationship between sleep and attention did not vary based on TBF%. RS also predicted decreased consumption of total calories, calories from processed foods, and fat for both BMI groups. This study increases understanding of the relationships among weight, CF, and food consumption, and the roles of sleep and stigma within these relationships. Adolescents with OWOB were more vulnerable to the negative cognitive effects of RS and RS predicted decreased consumption of calories and fat. Promotion of improved sleep hygiene and duration may be critical for the cognitive health of adolescents with OWOB.
Everyday Functioning In Middle Aged And Older Adults With Hiv: Factors That Influence Everyday Functioning And Awareness Of Functioning, Alexandra Elaine Jacob
Everyday Functioning In Middle Aged And Older Adults With Hiv: Factors That Influence Everyday Functioning And Awareness Of Functioning, Alexandra Elaine Jacob
All ETDs from UAB
With combination antiretroviral therapy (cART), the population of older people living with HIV (PLWH) is growing. There is a need to better understand everyday functioning, including instrumental activities of daily living (IADLs), to improve real-world outcomes for this clinical population. This dissertation attempts to (1) characterize factors related to self-report and performance of IADLs in PLWH, (2) examine correlates of self-awareness for functional abilities, and (3) apply a theoretical model to examine complex relationships between factors that impact self-awareness for functional abilities. Participants in these retrospective analyses included 260 PLWH who completed a comprehensive neurobehavioral evaluation including neuropsychological tests, measures …
The Effects Of The Home Food Environment On Habits Towards Foods, Demetria R. Pizano
The Effects Of The Home Food Environment On Habits Towards Foods, Demetria R. Pizano
All ETDs from UAB
Habits are the learned and reinforced behavioral patterns that predict an individual's tendencies to engage in an action in their environment (Gardner, de Bruijn & Lally, 2011). Behaviors consistently triggered by an environmental context, such as a home, allow the formation of habitual responses towards health practices such as food consumption (van't Riet et al., 2011). The home food environment (HFE), the availability and access to healthy foods, influences an individual's food selection and consumption behaviors that ultimately shape their eating habits (Nilsen, Roback, Brostrom, & Ellstrom, 2012). Similarly, an individual's executive function (EF), which represents their cognitive ability to …
Designing Organizational Systems To Support Achievement Of Performance Goals In Student Mental Health, Maritza Prieto Rodriguez
Designing Organizational Systems To Support Achievement Of Performance Goals In Student Mental Health, Maritza Prieto Rodriguez
Walden Dissertations and Doctoral Studies
Delivering first-rate services that addresses the needs of high school students is crucial to the structural sustainability for a counseling department within a high school setting. A well-planned improvement of the structural profile of a counseling department which supports students seeking mental health assistance will become an important part in capacity building. The focus of this study was to recognize the necessity for creating a specific and successful plan that will support both counselors and students within a high school counseling center. The Baldrige Excellence Framework was used to direct this case study of a behavioral health organization in the …
Impact Of A Narrative Language Intervention On Language, Behavior, And Self-Concept Among Bilingual Children With Developmental Language Disorder, Nancy Tarshis Ma, Ms, Ccc-Slp, Kathleen Mcgrath Mss, Lsw, Ida Barresi Ma, Ccc-Slp, Risa Battino Ms, Ccc-Slp, Bcs-F, Sarah Henderson Msed, Ms, Ccc-Slp, Shankar Viswanathan Drph, Jee-Young Moon Phd, Karen Bonuck Phd
Impact Of A Narrative Language Intervention On Language, Behavior, And Self-Concept Among Bilingual Children With Developmental Language Disorder, Nancy Tarshis Ma, Ms, Ccc-Slp, Kathleen Mcgrath Mss, Lsw, Ida Barresi Ma, Ccc-Slp, Risa Battino Ms, Ccc-Slp, Bcs-F, Sarah Henderson Msed, Ms, Ccc-Slp, Shankar Viswanathan Drph, Jee-Young Moon Phd, Karen Bonuck Phd
Developmental Disabilities Network Journal
The growing research on narrative interventions is promising but has gaps regarding cultural/linguistic diversity and outcomes beyond language. We evaluated whether a structured, oral narrative intervention affects narrative language, problem behaviors, and self-concept in a diverse group of children with developmental language disorder. A 10-session intervention was implemented within routine care. Baseline and follow-up data included: (a) Narrative recordings—coded by therapists using the CUBED Narrative Language Measure, (b) Child Behavior Checklist—a parent-reported behavioral assessment, and (c) the Piers-Harris Children’s Self-Concept Scale. Among the sample’s n = 33 children, aged 6-16, 55.6% were bilingual. Post intervention, participants’ narrative language scores improved …
Acknowledgments, Matthew T. Wappett Ph.D.
Acknowledgments, Matthew T. Wappett Ph.D.
Developmental Disabilities Network Journal
No abstract provided.
An Examination Of The Mediating Role Of Eudaimonic Well-Being In The Relationship Between Psychological Flexibility And Subjective Well-Being, Tara M. Bello
Morehead State Theses and Dissertations
A thesis presented to the faculty of the College of Science and Engineering at Morehead State University in partial fulfillment of the requirements for the Degree Master of Science by Tara M. Bello on September 6, 2024.
Bipoc Counseling And Health Service Psychology Graduate Students’ Experience Of Racism And Sense Of Belonging: A Conditional Mediation Analysis Of Coping And Social Support, Erica Pinney
Dissertations
This study sought to understand the relationship between experiences of racism within academic settings and sense of belonging to the field of Counseling/Health Service Psychology (C/HSP) for BIPOC graduate students. Further, this study sought to understand the potential mediating role of engagement coping in this relationship, as well as the conditional effect of high, neutral, or low perception of race-related social support from faculty/peers. Two-hundred forty-nine BIPOC C/HSP students responded to survey questions measuring frequency of racial/ethnic microaggressions, sense of belonging to C/HSP, engagement styles of coping with racism (Education/Advocacy and Resistance), and perception of availability of racism-related social support …
Early Childhood Foundations Of Adolescents' Critical Consciousness In Under-Resourced And Minoritized Communities: The Roles Of Prosocial Behavior And Cognitive Self-Regulation In Middle Childhood, Zahra F. Naqi-Hasnain
Early Childhood Foundations Of Adolescents' Critical Consciousness In Under-Resourced And Minoritized Communities: The Roles Of Prosocial Behavior And Cognitive Self-Regulation In Middle Childhood, Zahra F. Naqi-Hasnain
Dissertations
As Black and Latino teens from under-resourced backgrounds remain vulnerable to oppressive forces, critical consciousness has emerged as a developmental asset that involves understanding, reflecting upon, and acting against inequitable social structures. However, scholars have yet to determine how critical consciousness may fit into a developmental framework, leaving unanswered questions regarding the roots of adolescents’ critical consciousness. By integrating sociopolitical and developmental frameworks, this dissertation empirically examined how early environmental factors and individual competencies set the stage for critical consciousness during adolescence, via prosocial and self-regulatory skills during middle childhood. Longitudinal data were drawn from the Chicago School Readiness Project …
Identifying And Characterizing Cognitive Profiles In Midlife Females: A Latent Profile Analysis, Hannah Hagy
Identifying And Characterizing Cognitive Profiles In Midlife Females: A Latent Profile Analysis, Hannah Hagy
Dissertations
Females are at two-thirds greater risk of developing Alzheimer’s disease (AD) than males. Due to this notable sex difference in cognitive aging and disease burden, there has been an increased focus on understanding the critical role of the menopausal transition (decline in fertility during midlife) as it relates to cognitive functioning across midlife. Thus, the present cross-sectional study used a sample of midlife females at different stages in the menopausal transition (N=202; Age 40-60 years) as part of a larger, multimodal design study, to elucidate distinct cognitive profiles while accounting for education, which were then characterized by other demographic factors, …
Napping, Sleep, And Affect In Adolescents: A Daily Diary And Actigraphy Study, Elizabeth Rea
Napping, Sleep, And Affect In Adolescents: A Daily Diary And Actigraphy Study, Elizabeth Rea
Dissertations
Adolescents in the United States do not typically attain enough quality sleep at night due to a combination of biological maturation and academic and social commitments, leading to poor cognitive, mental, and physical health outcomes. Naps may compensate for inadequate sleep; however, little is known about how napping affects nocturnal sleep and mood over time among adolescents who are poor sleepers. The present study used daily diary and actigraphy data collected over 15 days in a sample of evening-chronotype, poor sleeping adolescents (n=99; Mage=15.85 (SD=0.99); 44% Male, 55% Female; 46% White, 30% Black, 12% More than one race, 8% Other, …
Resiliency And Positive Childhood Experiences: Implications For Black Youths' Mental And Behavioral Health And School Engagement, Sharnequa Nashay Hunter
Resiliency And Positive Childhood Experiences: Implications For Black Youths' Mental And Behavioral Health And School Engagement, Sharnequa Nashay Hunter
Dissertations
Two independent studies were conducted to examine the buffering impact of positive childhood experiences on Black youths’ mental and behavioral health and school engagement outcomes. The purpose of Study 1 was to investigate the potential moderating effects of positive childhood experiences on the relationship between adverse childhood experiences and the occurrence of mental or behavioral health conditions (anxiety, depression, ADHD/ADD, and/or a behavioral/conduct problem) and school engagement, using secondary data from the 2020 National Survey of Children’s Health, a survey completed by primary caregivers. The study sample included 2,201 Black youth ages 6-17 across the United States. Logistic regression and …
Understanding Stress, Strengths, And Strategies To Support Immigrant Youth: A Bundled Dissertation, Sarah Jolie
Understanding Stress, Strengths, And Strategies To Support Immigrant Youth: A Bundled Dissertation, Sarah Jolie
Dissertations
In the study of child development and mental health of Latine and immigrant and refugee youth, it is necessary to understand their cultural experiences and stress experiences in the U.S. The present project aims to address culture, stress, and the development of internalizing outcomes among Latine, immigrant, and refugee youth across two important stages of development: middle childhood and adolescence. The first study provides a comprehensive review of Latine children’s immigration experiences, the effects of exposure to multiple stressors, cultural factors, and intervention implications. The second study provides a focused examination of the impact of two culturally relevant stressors among …
Asian Americans’ Experiences Of Covid-Related Discrimination: Collective Identity, Critical Consciousness, And Intergroup Solidarity, Han Na Lee
Dissertations
The outbreak of the coronavirus disease (COVID-19) has stirred fear and panic with a surge of anti-Asian hate in the United States. Racial discrimination was exacerbated by labeling COVID19 as “the Chinese virus” and blaming Asians and Asian Americans as the source of the virus. Within the exacerbated xenophobic and racist rhetoric since the COVID outbreak in 2019, racial discrimination was amplified towards anyone who phenotypically presented as “Asian.” It is unclear how various Asian ethnic individuals identify with their Asian American identity while experiencing the intensified discrimination. Specifically, experiencing COVID-related racism and group-based rejection may increase or decrease Asian …
Comparing Caregiver-Teacher-Adolescent Mental Health Reporting: Examining Changes Over Time And Related Outcomes Among Youth Involved In The Child Welfare System, Jennifer Osborne
Comparing Caregiver-Teacher-Adolescent Mental Health Reporting: Examining Changes Over Time And Related Outcomes Among Youth Involved In The Child Welfare System, Jennifer Osborne
Dissertations
The benefits of psychological assessment are particularly salient for children and youth in the child welfare system, as youth in contact with the system are more likely to experience mental health symptoms, disorders, and comorbidities as compared to youth in the general population. These assessments often utilize multiple reporters, as emerging evidence indicates that utilizing multiple more effectively captures the mental health experiences of children and youth. However, the extant literature has consistently observed only low-to-moderate (i.e., .2-to-.3) agreement across informants, including among dyads in contact with the child welfare system. Several factors are associated with level of agreement across …
Associations Between Neighborhood Factors And Adherence In Youth With Spina Bifida: The Mediating Role Of Parental Stress And Youth Internalizing Symptoms, Breana Lyn Bryant
Associations Between Neighborhood Factors And Adherence In Youth With Spina Bifida: The Mediating Role Of Parental Stress And Youth Internalizing Symptoms, Breana Lyn Bryant
Master's Theses
Spina bifida (SB) is a birth defect that impacts physical, medical, and neuropsychological functioning. Physical complications like hydrocephalus and bladder dysfunction require daily adherence to complex medical regimens. Additionally, youth with SB are more likely to have symptoms of anxiety and depression which can impact their ability to master their regimens. Evidence in other pediatric populations have examined the impact of family factors, like parental stress, and individual-level predictors of self-management outcomes, yet few have examined how the broader context, like neighborhoods, impact outcomes. Therefore, the current study examined (1) the level of the neighborhood vulnerability and acute healthcare services …
Generations After Us (Undergoing Stress): An Exploration Of Interpersonal Violence And Loss On Psychosocial Functioning At The Parent, Child, And Family Level, Kaleigh Valencia Wilkins
Generations After Us (Undergoing Stress): An Exploration Of Interpersonal Violence And Loss On Psychosocial Functioning At The Parent, Child, And Family Level, Kaleigh Valencia Wilkins
Dissertations
Previous studies propose that interpersonal violence and loss, parenting, and attachment each individually contribute to child and family distress. The following studies aimed to further explore these effects across and within various generational groupings. The first study explored exposure to community violence at the parent level and at the child level in an attempt to understand how such stress impacts parents’ perceptions of family functioning in African-American and Latine families. Findings suggested that family functioning is weakened the most when both a parent and adolescent are exposed and when just a parent was exposed. The second study examined differences in …
Covid Lockdown Impact On Education: Analyzing Test Scores By State And Age, Angel Watson, Abby Jenson, Hannah White
Covid Lockdown Impact On Education: Analyzing Test Scores By State And Age, Angel Watson, Abby Jenson, Hannah White
Undergraduate Research Symposium
The COVID pandemic lockdowns gave rise to profound changes around the world. From remote jobs to mask mandates, the US had to find ways to combat the pandemic. One of these ways was to enact lockdowns where people had to stay home if they were not “non-essential workers” and remain at least 6 feet away in public spaces. Some states implemented longer lockdowns with stricter mask mandates while others had no rigid mandates or lockdowns. This led to the mass shift to remote learning in school around the US. This study examines the relationship between lockdown length in the different …
Cognition And Inflammation In Youth With Perinatal Hiv, Megan Niehaus, Julie Mannarino, Jacob Bolzenius, Tori Frerichs, Robert Paul
Cognition And Inflammation In Youth With Perinatal Hiv, Megan Niehaus, Julie Mannarino, Jacob Bolzenius, Tori Frerichs, Robert Paul
Undergraduate Research Symposium
Background: Perinatally acquired HIV (PHIV) remains a major global health challenge. Approximately 90% of the global population of PHIV reside in low- or middle-income countries (LMICs) where access to antiretroviral therapy (ART) remains incomplete, particularly for PHIV. With PHIV, the brain is exposed to the virus during critical periods of brain development without the immunological benefits from ART. Unlike adults with horizontally acquired HIV whose nadir CD4+ Tcell count is a strong correlate of cognitive difficulties that persist after sustained use of ART, cognitive symptoms among PHIV youth are independent of traditional HIV disease metrics. Prior studies indicate that PHIV …
Employment Status & Opioid Use Frequency, Muhammad Mirza, Jake Sauer, Ryan Carpenter
Employment Status & Opioid Use Frequency, Muhammad Mirza, Jake Sauer, Ryan Carpenter
Undergraduate Research Symposium
Previously submitted; simply submitting poster
Association Between Unmet Needs And Happiness In Women Living With Breast Cancer In A Multiethnic, Middle-Income Setting, Nithiya Sinarajoo
Association Between Unmet Needs And Happiness In Women Living With Breast Cancer In A Multiethnic, Middle-Income Setting, Nithiya Sinarajoo
Student Works (2020-2029)
While improved breast cancer survival rates are commendable, healthcare professionals and stakeholders must acknowledge potential strains on the healthcare system and society if optimal support and survivorship programs are not established. A global shift towards personalized, holistic patient care is crucial. However, implementing such care in a low- and middle-income country like Malaysia faces significant barriers. Positive psychology, which focuses on fostering positive emotions, has shown promise in promoting better health and longevity in healthy populations. However, research on the concept of happiness, both as a predictor of health outcomes and as a patient-reported outcome in cancer settings, remains limited. …
Emotional Design Of Lecture Slides During Anatomy Lectures: Effect On Mood, Cognitive, Load And Memory Retention, Joshua Raj Narayanan
Emotional Design Of Lecture Slides During Anatomy Lectures: Effect On Mood, Cognitive, Load And Memory Retention, Joshua Raj Narayanan
Student Works (2020-2029)
This study investigates the efficacy of emotional design in Anatomy and Medical education, a subject hitherto unexamined in emotional design studies. Further, unlike previous studies, this study utilised a natural learning environment rather than computer-based lessons. We investigated how the emotional design of lecture slides impacts mood, cognitive load and memory retention in first-year anatomy students studying medicine and dentistry in Universiti Malaya across three separate lectures. The control group (medical students) were exposed to emotionally neutral slides, while the experiment group (dental students) were exposed to emotionally positive slides. Questionnaires were used to assess changes in participants' mood, as …
Homeless Individuals’ Experiences Of Access To Personal Hygiene And Sanitary Products And Processes During Menstruation, Chele Taylor-Jennifer
Homeless Individuals’ Experiences Of Access To Personal Hygiene And Sanitary Products And Processes During Menstruation, Chele Taylor-Jennifer
Walden Dissertations and Doctoral Studies
Homelessness and period (menstruation) poverty are recurring global phenomena. In the United States, approximately 220,000 women experience homelessness annually. Studies have shown that approximately 35% of individuals who menstruate experience period poverty while living in Baltimore, Maryland. The theoretical foundation was Wollstonecraft‘s theory of feminism. To better understand this phenomenon, a general qualitative study was conducted using semistructured interviews with 18 people who were once homeless while menstruating. Through data collection and analysis, five themes emerged: (a) women have had to find creative ways of addressing menstruation; (b) women have had to find creative ways of addressing the personal hygiene …
Interoception In Pregnancy: Implications For Peripartum Depression, Paul W. Savoca, Laura M. Glynn, Molly M. Fox, Misty C. Richards, Bridget L. Callaghan
Interoception In Pregnancy: Implications For Peripartum Depression, Paul W. Savoca, Laura M. Glynn, Molly M. Fox, Misty C. Richards, Bridget L. Callaghan
Psychology Faculty Articles and Research
"In this perspective piece, we propose a novel mechanistic framework for peripartum depression in which improved interoceptive functioning in pregnancy and postpartum typically protects against depressive symptoms, but when there is a failure to improve interoception, the result is an inability to maintain metabolic efficiency, which ultimately poses risk for depression. First, we will review an emerging theory that links the modeling and predictive regulation of metabolic resources as central to the expression of many depressive symptoms. Then, focusing on the period of pregnancy to articulate the framework, we will discuss the physiological changes induced by pregnancy that place an …
Promoting Leadership Wellbeing In Behavioral Health Organizations, Mychalbrianne Chatigny
Promoting Leadership Wellbeing In Behavioral Health Organizations, Mychalbrianne Chatigny
Walden Dissertations and Doctoral Studies
In this case study the strategies and hindrances in the well-being for leaders in a behavioral health organization located in the southern United States were explored. The study was framed around the Baldrige Excellence Framework focusing specifically on the components of leadership, workforce, and strategy. Data were collected including semi-structured interviews, analysis of numerous internal documents, and secondary sources of peer reviewed articles, and organizational websites and media. The results of this study revealed the organization demonstrated a commitment to maintaining a positive working environments and promoting their workforce’s well-being. Themes that emerged from data analysis revealed leaders’ recognition in …
Effective Methods In Communicating Assessment Results To Individuals With Limited English Proficiency: A Survey Of Current Psychologists’ Practices., Dee Vang
Theses and Graduate Projects
The use of language interpreters is a primary solution for providing inclusive language services when conducting psychological assessments for people with limited English proficiency. However, this approach has limitations that have negatively affected the ability of clients with limited English proficiency to comprehend assessment results and adhere to recommendations. The purpose of this study was to improve the current understanding of effective methods for communicating assessment results to persons with limited English proficiency (PLEP) and working with language interpreters. Eight participants were interviewed about their current methods of communicating results and working with language interpreters during a feedback session. Consensual …
Expanding On The Factor Structure And Construct Validity Of The Short-Term Assessment Of Risk And Treatability (Start), Haomin Chen
USF Tampa Graduate Theses and Dissertations
Research finds better reentry/recidivism program outcome when individuals receive service that matches their risks and needs. It is thus essential to measure recidivism risks and needs appropriately. The Short-Term Assessment of Risk and Treatability (START) is a clinically-oriented instrument that assesses risks of future violence/offending and identifies areas for treatment. We see its potential use as an assessment tool for reentry/recidivism programming. More empirical evidence is needed to identify the psychometric properties of the instrument in this setting before it may be used in practice. The current thesis explored the factor structure of the START strengths and vulnerabilities scales using …