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Full-Text Articles in Entire DC Network
Whom Does Psychology Serve_ Neocolonialism In Peruvian Psychology, Yassira Armero, Andrés Costilla, Josephine Hwang
Whom Does Psychology Serve_ Neocolonialism In Peruvian Psychology, Yassira Armero, Andrés Costilla, Josephine Hwang
Psychology from the Margins
This article presents a review of the colonial past that has marked Peruvian society and has managed to remain in it through the neocolonialism. The purpose of this article is to account for how instrumental political use of psychology, and sometimes psychiatry, has been and continues to be used to favor the people who exercise power and to perpetuation the current system. For this, some examples of how this work has been carried out are described. Specifically, mention is made of how "ethnic hierarchies" were supported with the eugenic model, the "normal" was up justifying the subjugation of the indigenous …
Liberation Psychology: Drawing On History To Work Toward Resistance And Collective Healing In The United States, Hannah K. Heitz
Liberation Psychology: Drawing On History To Work Toward Resistance And Collective Healing In The United States, Hannah K. Heitz
Psychology from the Margins
With the onset of the Covid-19 pandemic and increased media coverage of systemic racism, the necessity to work toward liberation and collective healing has become increasingly salient. While psychology has prided itself on being ahistorical in the past, there is much that can be learned from scholars, activists, and movements that have fostered positive change. Ignacio Martín-Baró, Spanish-born Jesuit scholar, social psychologist, and founder of liberation psychology, worked toward significant positive social change and liberation prior to his death. In one of his last interviews, Martín-Baró outlined tasks that could be used to facilitate liberation: 1) recovering historical memory; 2) …
Dsm Discrimination And The Lgbt Community: Using The History Of Diagnostic Discrimination Against Sexual Minorities To Contextualize Current Issues In Transgender And Gender Diverse Mental Healthcare, Ginelle Wolfe, Nicole Fogwell
Dsm Discrimination And The Lgbt Community: Using The History Of Diagnostic Discrimination Against Sexual Minorities To Contextualize Current Issues In Transgender And Gender Diverse Mental Healthcare, Ginelle Wolfe, Nicole Fogwell
Psychology from the Margins
This paper provides a historical context of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (DSM) related to sexual orientation and gender identity. We use the historical context of psychology’s discrimination against sexual minorities (e.g., lesbian, gay, and bisexual persons) to critique current discriminatory practices targeting gender diverse (i.e., trans, nonbinary, and other not cisgender) persons- specifically, the explicit pathologizing of gender variance. The events that led to the removal of homosexuality as a diagnosis are discussed, as are subsequent diagnoses related to sexual orientation and gender identity that continue to pathologize gender variance. We conclude by deriving …
Personality And Psychopathology Correlates Of Institutional Misconduct Among Juvenile Offenders, Paula Floyd
Personality And Psychopathology Correlates Of Institutional Misconduct Among Juvenile Offenders, Paula Floyd
Dissertations
Juvenile delinquency is a national concern, as delinquent behavior is associated with a host of poor psychosocial outcomes during later adolescence and adulthood. To address delinquency, it is important to understand psychological adjustment among adolescents who have already made contact with the juvenile justice system. One way to explore adjustment within this population involves examining personality and psychopathology correlates of institutional misconduct (i.e., behavioral infractions while incarcerated). While there is a robust body of literature regarding personality and psychopathology correlates of misconduct in adult inmate samples, there has been far less work devoted to these relationships among justice-involved youth. Furthermore, …
Molecular Pathways Of Major Depressive Disorder Converge On The Synapse, Gabriel R Fries, Valeria A Saldana, Johannes Finnstein, Theo Rein
Molecular Pathways Of Major Depressive Disorder Converge On The Synapse, Gabriel R Fries, Valeria A Saldana, Johannes Finnstein, Theo Rein
Faculty, Staff and Student Publications
Major depressive disorder (MDD) is a psychiatric disease of still poorly understood molecular etiology. Extensive studies at different molecular levels point to a high complexity of numerous interrelated pathways as the underpinnings of depression. Major systems under consideration include monoamines, stress, neurotrophins and neurogenesis, excitatory and inhibitory neurotransmission, mitochondrial dysfunction, (epi)genetics, inflammation, the opioid system, myelination, and the gut-brain axis, among others. This review aims at illustrating how these multiple signaling pathways and systems may interact to provide a more comprehensive view of MDD's neurobiology. In particular, considering the pattern of synaptic activity as the closest physical representation of mood, …
Psychophysiological Effects Of Increasing Awareness Of Nondual Consciousness In Young Adults With Depression And Anxiety, Milena Braticevic
Psychophysiological Effects Of Increasing Awareness Of Nondual Consciousness In Young Adults With Depression And Anxiety, Milena Braticevic
CONSCIOUSNESS: Ideas and Research for the Twenty-First Century
Young adults increasingly suffer from anxiety and depression during the time of transition into adulthood. This research study examined the effects of increasing awareness of nondual consciousness in young adults who were experiencing various levels of anxiety and depression. The methodology was mixed-method and included four 1-hour group-based sessions over 4 weeks. Increasing awareness of nondual consciousness through educational, experiential, and behavioural components resulted in reduction in the average depression score from 19.4 (borderline clinical depression) to 10 (normal), and reduction in the average anxiety score from 12.7 (moderate anxiety) to 6.9 (mild). Participants reported increased mental, emotional, physical, and …
Gender Differences In College Drinkers: The Role Of Masculine Norms, Jared A. Davis
Gender Differences In College Drinkers: The Role Of Masculine Norms, Jared A. Davis
USF Tampa Graduate Theses and Dissertations
Drinking among college students has remained a prominent problem within the United States, with more than 50% of college students drinking alcohol, 30% considered binge drinkers, and 9% considered heavy drinkers (SAMHSA, 2018). Evidence also shows that males are more likely to partake in risky drinking behaviors (e.g., binge drinking or drinking to intoxication) and are at higher risk to be diagnosed with a alcohol use disorder when compared to women (Iwamoto et al. 2014; Grant et al., 2004). Recent findings suggest that adherence to particular masculine norms as a risk factor for problematic alcohol use among men (Mahalik, 2000; …
The Impact Of Political Beliefs On Ethical Framework In Adults
The Impact Of Political Beliefs On Ethical Framework In Adults
Journal of Interdisciplinary Undergraduate Research
This study aimed to examine the differences between major political philosophies in the United States and whether these beliefs influence a person’s ethical views. This research was a non-experimental correlation design, using a survey methodology with adult participants. The participants were asked to complete the 39-item The Impact of Political Beliefs on Ethical Frameworks in Adults Survey. A Pearson’s r was conducted to determine the relationship between political beliefs and ethical frameworks. The results showed a slightly positive correlation that was statistically significant [r(166) = .28, p = .000]. Therefore, there was sufficient evidence to support the research hypothesis: there …
Correlates Of Psychological Well-Being In Older Adults With Treatment-Resistant Depression, Selmi Kallmi
Correlates Of Psychological Well-Being In Older Adults With Treatment-Resistant Depression, Selmi Kallmi
Dissertations
The purpose of this study was to examine the factors that are associated with psychological well-being in older adults with late-life depression and determine if social participation moderates and/or mediates these relationships. This dissertation study utilized secondary pre-treatment data collected from the “Optimum: Optimizing Depression Treatment in Older Adults” study (Cristancho et al. (2019). Community dwelling older adults (N = 369) were included if they currently met criteria for MDD, had failed at least two prior trials of MDD medication treatment, and were able to visit the study site to participate in cognitive and physical functioning assessments. Hierarchical multiple regressions …
The Moderating Role Of Positive Religious Coping And Workplace Spirituality In The Relationship Between Level Of Traditional And Covid-19 Related Stressors Encountered And Mental Health In Hospitality Workers, Danielle Grace Defacci
The Moderating Role Of Positive Religious Coping And Workplace Spirituality In The Relationship Between Level Of Traditional And Covid-19 Related Stressors Encountered And Mental Health In Hospitality Workers, Danielle Grace Defacci
Doctoral Dissertations and Projects
Higher levels of workplace and COVID-related stressors appear clearly linked to poorer mental health outcomes, and evidence is emerging that suggests positive religious coping (PRC) and workplace spirituality (WS) are both related to better mental health outcomes. It could be that PRC and WS buffer the impact of high stress levels on mental health. However, only one study exists that has explored the moderating effect of PRC in the stress-mental health relationship, and no studies exist exploring the moderating effect of WS in the stress-mental health relationship. Therefore, this study looked at the moderating role of PRC and WS in …
A Qualitative Exploration Of Formation And Change In Attachment To God, Virginia Watson Cashion
A Qualitative Exploration Of Formation And Change In Attachment To God, Virginia Watson Cashion
Doctoral Dissertations and Projects
This study consisted of a phenomenological exploration of the lived experience of individuals who identify as Christians, examined within the context of attachment to God. Eleven Ph.D. students enrolled in an online program at an evangelical institution in the southeastern United States were interviewed. The interviews were conducted online, recorded (audio and video), and transcribed within the MS Teams app. Data was analyzed, codes were established, and themes were identified. Analysis revealed that while one’s relationship with God was meaningful and secure, all indicated the presence of seeking (greater connection to God) language. Second, attachment terms were often used to …
Adaptation Of Three Psychological Measurement Instruments Assessing The Impact Of The Covid-19 Pandemic: Fear Of Covid-19 Scale, Coronavirus Anxiety Scale, And Altruism, Angela Oktavia Suryani, Laura Fransisca Sudarnoto, Benedicta Prihatin D. Riyanti
Adaptation Of Three Psychological Measurement Instruments Assessing The Impact Of The Covid-19 Pandemic: Fear Of Covid-19 Scale, Coronavirus Anxiety Scale, And Altruism, Angela Oktavia Suryani, Laura Fransisca Sudarnoto, Benedicta Prihatin D. Riyanti
International Conference on Assessment and Learning (ICAL)
The COVID-19 pandemic has been going on for more than two years and has caused problems for the world community. One of the impacts of COVID-19 is psychological barriers, including decreased well-being, increased stress, anxiety, depression, loss of family members, and being laid off. Is there still energy in a difficult situation like this to give empathy and have a sense of wanting to help without reward (altruism)? The psychological condition of the impact of COVID-19 is the background for the need to carry out valid and reliable psychological measurements. This study aims to identify the psychometric properties of three …
Longitudinal Associations Between Personal Growth And Cognitive Functioning In Adulthood, Masahiro Toyama
Longitudinal Associations Between Personal Growth And Cognitive Functioning In Adulthood, Masahiro Toyama
Psychology Faculty Research
Objectives: While personal growth has been found to be associated with multiple aspects of health in adulthood, its associations with cognitive functioning have not been fully understood. The present study aimed to assess both directions of such longitudinal associations.
Method: Using data from the second wave (Time 1 [T1]) and third wave (Time 2 [T2]) of the Midlife in the United States (MIDUS) study (N = 4,206; mean age = 56.0 [standard deviation (SD) = 12.3]), a longitudinal measurement model containing latent variables of episodic memory and executive function was first constructed. Built on the measurement model, a …
How To Survive College As An Acoa: The Effectiveness Of University Resources On Helping Acoas Socially And Psychologically Succeed During Their Academic Career, Kelly Buchan
Senior Theses
In 2019, 14.5 million people ages 12 and older had Alcohol Use Disorder (AUD), but only 10% received treatment (National Institute on Alcohol Abuse and Alcoholism [NIAAA], 2022). Parental drinking problems can directly affect children, or “Adult Children of Alcoholics.” Of the few studies targeting ACoAs, results show that ACoAs not only have higher risks of mental illness, but they also have lower GPAs and social health (Schroeder & Kelley, 2008). Thus, this study assessed the extent to which perceptions of the college drinking environment are related to higher depression rates in ACoAs, certain drinking motivations, and reluctance to use …
Stress Arising From The Covid-19 Pandemic: Impacts On Coparenting Quality And Child Internalizing And Externalizing Problems, Michelle R. Ebrahim
Stress Arising From The Covid-19 Pandemic: Impacts On Coparenting Quality And Child Internalizing And Externalizing Problems, Michelle R. Ebrahim
Honors Program: Senior Projects (Public)
Since emerging in late 2019, the highly contagious coronavirus disease (COVID-19) has caused worldwide disruptions, with major shutdowns in school, work, and other aspects of life. These stressors uniquely impacted families with young children. The present study investigated the impact of the pandemic on family functioning and risk for child internalizing and externalizing problems during the first year after the pandemic. The study included three waves of data collection from a larger longitudinal study aimed at understanding how couples navigate the prenatal-postpartum transition and the impacts of the family on early child development. We found that family pandemic-related stress was …
A Mixed Methodological Examination Of Older Adults’ Psychological Reactance Toward Caregiving Messages From Their Adult Children, Hannah Ball, Keith Weber, Alan K. Goodboy, Christine E. Kunkle, Christa L. Lilly, Scott A. Myers
A Mixed Methodological Examination Of Older Adults’ Psychological Reactance Toward Caregiving Messages From Their Adult Children, Hannah Ball, Keith Weber, Alan K. Goodboy, Christine E. Kunkle, Christa L. Lilly, Scott A. Myers
Communication Faculty Articles and Research
This study extends psychological reactance theory (PRT) to family caregiving by exploring autonomy-threatening messages adult child caregivers use to gain compliance from older adult parents. Results of focus groups and interviews with older adult care recipients (Study One) and caregivers (Study Two) corroborated three types of autonomy-threatening messages, which were used to test PRT (Study Three). Older adults (N = 281) were randomly assigned a caregiving message and answered reactance-related survey questions. Results supported serial mediation: relative to an autonomy-supporting message, two types of autonomy-threatening messages (i.e., offering directives, expressing doubt) triggered greater freedom threat, which amplified reactance. In …
Burnout In The Field Of Forensic Psychology And Intervention Techniques, Taylor Gary
Burnout In The Field Of Forensic Psychology And Intervention Techniques, Taylor Gary
Dissertations
Forensic psychologists are at a heightened risk for encountering vicarious trauma, compassion fatigue, and burnout, all of which influence quality and continuity of care (Sansbury et al., 2015). The current literature review aims to discuss how burnout relates specifically to the field of forensic psychology. For the purposes of this discussion, clinical psychologists who perform forensic duties, as well as board certified forensic psychologists are considered. Research questions that are addressed in this discussion include what the existing research states regarding vicarious trauma in forensic settings, likely gender differences in burnout and vicarious trauma, and documented interventions that appear most …
Impact Of Childhood Trauma On Skin Conductance Response To Fear, Safety, And Reward, Tristan Alana Gregg
Impact Of Childhood Trauma On Skin Conductance Response To Fear, Safety, And Reward, Tristan Alana Gregg
Master's Theses (2009 -)
Trauma is associated with neurological and physiological differences that can persist years after trauma exposure. Physiologically, trauma has been associated with altered responses to cues in the environment, most commonly threatening stimuli. For instance, in participants who experience trauma during adulthood, such individuals exhibit heightened physiological arousal. Conversely, other studies have found that childhood trauma may be associated with blunted physiological arousal. Most of this research has involved threatening cues, but previous research suggests that trauma is also associated with aberrant physiological arousal responses to positive or rewarding cues. Skin conductance responses (SCRs) are a commonly utilized measure of physiological …
Evaluating Interest In Clinical Trial Participation For The Treatment Of Pediatric Food Allergy, Perry Allen Catlin
Evaluating Interest In Clinical Trial Participation For The Treatment Of Pediatric Food Allergy, Perry Allen Catlin
Master's Theses (2009 -)
Food allergy (FA) is a chronic medical condition that affects one out of every 13 children in the United States. Researchers have recently begun utilizing double-blind, placebo-controlled clinical trials to test novel biological treatments designed to retrain the immune system to be less reactive to food allergens. Although these treatments remain in the clinical trial stage, evidence suggests that individuals differentially engage with these options based on a variety of factors. Using a socioecological framework, this study sought to evaluate the effect of child, parent, and family-level factors on parental interest in clinical trial participation for the treatment of pediatric …
Correlations Between Peripheral Levels Of Inflammatory Mediators And Frontolimbic Structures In Bipolar Disorder: An Exploratory Analysis, Satyajit Mohite, Haitham Salem, Thiago Cordeiro, Jonika Tannous, Benson Mwangi, Sudhakar Selvaraj, Jair C Soares, Marsal Sanches, Antonio L Teixeira
Correlations Between Peripheral Levels Of Inflammatory Mediators And Frontolimbic Structures In Bipolar Disorder: An Exploratory Analysis, Satyajit Mohite, Haitham Salem, Thiago Cordeiro, Jonika Tannous, Benson Mwangi, Sudhakar Selvaraj, Jair C Soares, Marsal Sanches, Antonio L Teixeira
Faculty, Staff and Student Publications
BACKGROUND: Altered peripheral immune/inflammatory system and brain volumetric changes have been implicated in the pathophysiology of bipolar disorder (BD). This study aimed to evaluate how peripheral levels of cytokines are related to volumetric brain changes in euthymic patients with BD.
METHODS: Euthymic patients with BD (n = 21) and healthy controls (n = 22) were enrolled in this exploratory study. Blood samples were collected on the same day of clinical assessment and neuroimaging. Cytokines were measured through cytometric bead array method. Neuroimaging data were acquired using a sagittal three-dimensional magnetic resonance imaging T1-weighted fast field echo sequence and was processed …
The Importance Of Low Iq To Early Diagnosis Of Autism, Kristina Denisova, Zhichun Lin
The Importance Of Low Iq To Early Diagnosis Of Autism, Kristina Denisova, Zhichun Lin
Publications and Research
Abstract
Some individuals can flexibly adapt to life’s changing demands while others, in particular those with Autism Spectrum Disorder (ASD), find it challenging. The origin of early individual differences in cognitive abilities, the putative tools with which to navigate novel information in life, including in infants later diagnosed with ASD remains unexplored. Moreover, the role of intelligence quotient (IQ) vis-à-vis core features of autism remains debated. We systematically investigate the contribution of early IQ in future autism outcomes in an extremely large, population-based study of 8000 newborns, infants, and toddlers from the US between 2 and 68 months with over …
Consistency Of Sleep Across Development And Relations To Executive Functions; Applications To Emerging Adults Transitioning To College And Adolescents With Spina Bifida, Laura Nicholson
Dissertations
College Students, Development, Executive Functioning, Inhibition, Sleep consistency, Spina Bifida
Helpful Or Harmful: The Impact Of Shame And Guilt On Concealment In Adulthood Following Childhood Trauma, Xiomara Vanessa Senior
Helpful Or Harmful: The Impact Of Shame And Guilt On Concealment In Adulthood Following Childhood Trauma, Xiomara Vanessa Senior
Theses and Dissertations
The current study aimed to examine the moderating role of shame and guilt in the associations between types of childhood maltreatment and levels of self-concealment. Childhood maltreatment has been linked to emotions such as shame and guilt that elicit schemas of self-doubt, incompetence, and failure (Cohen et al., (2011). When an individual internalizes these thoughts and emotions, they may act in maladaptive ways such as avoidance, fear, dissociation, and possible concealment within adulthood (Dorahy & Clearwater, 2012, Smetana et al., 2019). De Seve et al. (2020) recently found that shame proved to be a mediator in the relationship between self-concealment …
Examining Executive Dysfunction In Dementia: Vascular Etiology As A Contributor To Greater Impairment, Julianne Szemko
Examining Executive Dysfunction In Dementia: Vascular Etiology As A Contributor To Greater Impairment, Julianne Szemko
Theses and Dissertations
Objective: The present study examines executive functioning and overall neuropsychological functioning within a memory disorder clinic population with a specific focus on examining performance on the Modified Wisconsin Card Sorting Test (M-WCST) among individuals with and without cerebrovascular disease. Method: This study utilized test data collected between 2018-2022 from the research database at the Health First Memory Disorder Clinic (HFMDC) in Melbourne, Florida. Participants were included if they completed a brief neuropsychological evaluation (BNE) at the HFMDC with the M-WCST, Trail Making Test - Form B (TMT-B), and Color/Word subtest of the Golden Stroop as part of their battery and …
Reducing Prejudice Through Law: Evidence From Experimental Psychology, Sara Emily Burke, Roseanna Sommers
Reducing Prejudice Through Law: Evidence From Experimental Psychology, Sara Emily Burke, Roseanna Sommers
Articles
Can antidiscrimination law effect changes in public attitudes toward minority groups? Could learning, for instance, that employment discrimination against people with clinical depression is legally prohibited cause members of the public to be more accepting toward people with mental health conditions? In this Article, we report the results of a series of experiments that test the effect of inducing the belief that discrimination against a given group is legal (versus illegal) on interpersonal attitudes toward members of that group. We find that learning that discrimination is unlawful does not simply lead people to believe that an employer is more likely …
The Social Determinants Of Ideal Cardiovascular Health: A Global Systematic Review, Farah Qureshi, Kelb Bousquet-Santos, Sakurako S. Okuzono, Elaine Tsao, Scott Delaney, Anne-Josie Guimond, Julia K. Boehm, Laura D. Kubzansky
The Social Determinants Of Ideal Cardiovascular Health: A Global Systematic Review, Farah Qureshi, Kelb Bousquet-Santos, Sakurako S. Okuzono, Elaine Tsao, Scott Delaney, Anne-Josie Guimond, Julia K. Boehm, Laura D. Kubzansky
Psychology Faculty Articles and Research
This systematic review synthesizes research published from January 2010-July 2022 on the social determinants of ideal cardiovascular health (CVH) carried out around the world and compares trends in high-income countries (HICs) to those in low- and middle-income countries (LMICs). 41 studies met inclusion criteria (n = 28 HICs, n = 13 LMICs). Most were from the United States (n = 22) and cross-sectional (n = 33), and nearly all evaluated associations among adults. Among studies conducted in LMICs, nearly all were from middle-income countries and only one was carried out in low-income country. Education (n = …
Surveying The Stigma: How The Plhiv Stigma Index Acts As A Validated Framework To Measure Healthcare Discrimination And How It Can Be Adapted To Quantify Mental Health Stigma, Keeley Lariviere
Independent Study Project (ISP) Collection
The PLHIV Stigma Index is an ongoing, international study conducted by and for people living with HIV to measure the stigmatization that people living with HIV experience. As a model that has been proven successful in translating to targeted advocacy campaigns, this paper theorizes on how this Stigma Index could be broadened to capture other aspects of healthcare discrimination. With a growing demand for mental health support and a critically underdeveloped mental healthcare framework, understanding the stigma and discrimination that exist for people living with depression is a good place to start. Using mixed methods analysis from existing literature and …
Autism Assessment In The Schools: A Review Of Rating Scales And Observation Systems., Jaime Flowers, Dallin Marr, Nina Ellis-Hervey, Trudy Georgio, Jessica Cuitareo
Autism Assessment In The Schools: A Review Of Rating Scales And Observation Systems., Jaime Flowers, Dallin Marr, Nina Ellis-Hervey, Trudy Georgio, Jessica Cuitareo
Journal of Human Services: Training, Research, and Practice
School psychologists are tasked with assessing students with Autism Spectrum Disorders (ASD). While not used alone, ASD measures can help practitioners make informed decisions regarding special education eligibility. The purpose of this paper is to review the psychometric strengths and weaknesses of the following measures: Autism Diagnostic Interview, Revised (ADI-R); Autism Diagnostic Observation Schedule, Second Edition (ADOS-2); Autism Spectrum Rating Scale (ASRS); Childhood Autism Rating Scale, Second Edition (CARS-2); and Gilliam Autism Rating Scale, Third Edition (GARS-3).
Predictors Of Student Knowledge Of Counselor Identity: Human Services & Related Mental Health Courses, Cortny Stark, Kylie Rogalla, Heather Cook, Joseph D. Wehrman
Predictors Of Student Knowledge Of Counselor Identity: Human Services & Related Mental Health Courses, Cortny Stark, Kylie Rogalla, Heather Cook, Joseph D. Wehrman
Journal of Human Services: Training, Research, and Practice
Professional organizations and the field at large have made great strides towards solidifying the professional identities of mental health professionals. Despite these efforts, public knowledge of different types of helping professionals remains limited. Public understanding of helping professionals’ identities is critical to mental health literacy, and has a significant impact on health outcomes. Post-secondary education provides many students with exposure to information regarding types of helping professionals, and their scope of practice. This expansion study engages students completing college-level courses to clarify those variables that predict student knowledge and perceived scope of practice of a variety of counselors.
A Longitudinal Study Of Pain In Youth And Young Adults With Spina Bifida: Three Studies Based On The Bio-Neuropsychosocial Model, Diana Margaret Ohanian
A Longitudinal Study Of Pain In Youth And Young Adults With Spina Bifida: Three Studies Based On The Bio-Neuropsychosocial Model, Diana Margaret Ohanian
Dissertations
Family Functioning, Neuropsychology, Pain, Pain Coping, Psychological Adjustment, Spina Bifida