Medicine and Health Sciences Commons^™

The Relationship Between Parental Trauma History And Perceptions Regarding Their Child’S Healthcare And Utilization Of Healthcare Services, Krishna Patel

Theses and Dissertations

Abstract

TITLE: The Relationship Between Parental Trauma History and Perceptions Regarding Their Child’s Healthcare and Utilization of Healthcare Services

Adverse child events (ACEs) have been associated with a number of physical and mental health problems and have also been linked to increased health care utilization. While parents who have an ACE history may tend to seek healthcare services for themselves, limited studies have examined the impact of their trauma history on seeking healthcare services for their child. Healthcare utilization may also depend on the parents’ level of health anxiety, as well as their anxiety about their child’s health status. This …

Investigating The Longitudinal Relationship Between Social Motivation And Depression In Autistic Adults, Robyn H. Himelstein

Theses and Dissertations

Autism affects individuals across the lifespan, yet there tends to be limited research and services for autistic adults. This is especially concerning given that autistic adults have high mental health needs, with depression being one of the most common and clinically significant co-occurring conditions. We explored the longitudinal relationships between social motivation, social access (i.e., having opportunities for meaningful social interactions), loneliness, and depression in N=303 autistic adults ages 18-65. Participants completed online surveys about social behavior and wellbeing three times over 3–4 months. We hypothesized that an interaction between higher social motivation and lower social access at Time 1 …

From “Cowardice” To “Shellshock”: The Definition And Treatment Of Mental Health In The United States Marine Corps During The Age Of The Great War, Itzel Marquez

Theses and Dissertations

The aim of my master’s thesis is to study how the United States’ Marine Corps recognized, defined, and treated mental health issues during the Great War and how this translated into the treatment of Marines by their peers and commanding officers. Similar to other countries that fought in the Great War, also referred to as World War I, the United States witnessed intense discussions about the psychological effects of war. The question of whether and how modern warfare affected troops’ mental health was addressed by all branches of the United States’ military. Yet, the issue of mental health in the …

Cross Cultural Adaptation And Validation Of A Self-Reporting Tool To Assess Health-Related Quality Of Life For Egyptians With Extremity Bone Sarcomas In Childhood Or Adolescence, Nesma Farid

Theses and Dissertations

Validated self-reporting tools are required to evaluate the functional outcome and health-related quality of life (HRQOL) for Egyptians who had extremity bone sarcomas in their childhood or adolescence. Thus, we pursued cross-cultural adaptation and validation of the pediatric Toronto Extremity Salvage Score (pTESS) and Toronto Extremity Salvage Score (TESS) to assess the physical function of children and adult survivors following surgeries of extremity bone sarcomas. Modified versions of pTESS and TESS, which contain additional mental domains, were developed to allow the evaluation of HRQOL using a specific instrument for childhood bone cancer. The internal consistency of the original pTESS and …

How Do Differences In Giving And Receiving Social Support Predict The Frequency Of Substance Use And Polysubstance Use Among Those Who Use Opioids, Afifa Ahmed

Theses and Dissertations

Little is known about the association between giving and receiving social support and substance use frequency. This study investigates how social support can predict substance use and polysubstance use in adults who use opioids and other substances. Survey data demonstrated significant associations between giving emotional support and heroin use frequency.

Experiences And Perceptions Of Bilingual Spanish-English Latinx Clients And Bilingual Spanish-English Latinx Therapists In Psychotherapy: A Systematic Review, Irvin I. Navarrete

Theses and Dissertations

As the bilingual Spanish-English Latinx population in the United States increases, so will the need for culturally and linguistically competent mental health therapists. While past research has focused on providing culturally competent care, the role of language in the process of psychotherapy has received limited attention. This study aimed to comprehensively analyze the existing literature on bilingual Spanish-English Latinx clients’ and bilingual Spanish-English Latinx therapists’ experiences and perceptions within a bilingual psychotherapy setting and identify recommendations to enhance language proficiency. A systematic review was conducted and identified nine studies for inclusion. Results highlight seven themes focusing on bilingual Spanish-English Latinx …

Effectiveness Of Cognitive Behavioral Therapy Versus Therapeutic Play For Hospitalized Children Diagnosed With Cancer: An Integrative Systematic Review, Dianne Kong

Theses and Dissertations

Psychotherapy provides essential coping mechanisms and strategies for children who are diagnosed with cancer, as they experience the extraordinary burden of physical, emotional, and mental strains. While many medical advancements have been made within the past few decades, progress related to psychotherapy for pediatric cancer patients has not been commensurate, evidenced by the limited current literature. Given the sparsity of relevant research, it is presently difficult to compare and evaluate the various psychotherapeutic interventions available for pediatric oncology patients. Additionally, there are significant challenges in providing psychotherapeutic care for patients and their families, including lack of consistency, disruption of care, …

The Use Of Dance And Movement For The Embodied Healing Of Interpersonal Trauma In Women And Girls: A Systematic Review, Catherine Xinyu Liang

Theses and Dissertations

Interpersonal trauma is a serious and devastating problem for women and girls from all walks of life. Research has shown that there are physiological consequences for experiencing trauma, and as such, treatment for trauma may need to target the body. Dance/Movement Therapy (DMT) has been emerging in the current literature as one body-oriented treatment approach that is effective in helping women and girls heal from interpersonal trauma. This review examines how practitioners are currently using DMT for this population, what treatment outcomes have been observed, and what the racial/ethnic identities and international contexts are for survivors who have benefited from …

Application Of Third-Wave Cognitive-Behavioral Interventions In The Treatment Of Obsessive-Compulsive Disorder, Emily Hanna

Theses and Dissertations

Obsessive-compulsive disorder (OCD) has a high comorbidity rate, with substantial risks for anxiety, mood, and substance use disorders. Exposure and response prevention (ERP) is considered the first-line psychotherapy treatment for OCD. While highly efficacious, not all patients achieve full remission with ERP, and given the chronicity of OCD and its sensitivity to stress-related events, many patients struggle with ongoing symptoms. A growing area of research has been the use of third-wave behavioral and cognitive therapies that potentially enhance patients’ willingness to engage with exposure-based treatment and provide strategies to cope with residual symptoms. This integrative systematic review summarizes and synthesizes …

Family-Based Support As Social Determinants Of Health Protective Factor On Depression Of Parents Of Children With Autism Spectrum Disorder, Bisola E. Duyile

Theses and Dissertations

All parents experience challenges in their caregiving roles (Barańczuk & Pisula, 2020). However, parents raising a child/children with disabilities experience different social barriers (Oliver, 1996) that may also contribute to additional stressors in their caregiving role (Tomeny, 2016). Although these parents, on average, have reported greater symptoms of depression than parents of typically developing children, research shows that parents who reported receiving social support had lower symptoms of depression and stress (Das et al., 2017; Singh et al., 2017). Through the social determinants of health (SDOH) framework (ODPHP, 2022), the present study investigated informal/family-based support and its protective impact on …

The Effect Of Childhood Maltreatment On Psychotherapy Effectiveness In Adulthood: Implications For Counselors, Michael Hillerman

Theses and Dissertations

Recent gains in understanding the effects of childhood maltreatment on the development of the brain and nervous system, combined with the revelation that nearly all psychiatric neuroimaging studies have had an unrecognized confound in childhood maltreatment, imply the possibility that psychotherapy treatment effectiveness studies have been similarly confounded by childhood maltreatment. This study examines whether treatment-seeking adults exposed to childhood maltreatment respond differently to psychotherapy than do individuals who report no history of childhood maltreatment. Response to therapy is conceptualized in this study as reduction in symptom measures pre- and post- treatment, as well as client dropout. It is hypothesized …

Impact Of Teacher Cognition On The Implementation Of Social- Emotional Learning Practices For El Students, Madeline Bliske

Theses and Dissertations

There is a well-established achievement and graduation rate gap between English Learner (EL) students and their monolingual English-speaking peers (U.S. Department of Education, 2020). The current study focuses on teacher cognition and characteristics that may impact the likelihood that they will implement culturally and linguistically sustaining (CLS) social-emotional learning (SEL) practices for EL students within their classroom. Specifically, I descriptively analyze whether personal, professional, or school characteristics are associated with teachers’ perception of EL students SEL competencies or implementation of CLS SEL practices. Utilizing the Theory of Planned Behavior (TPB), I evaluate whether teacher cognition (i.e., behavioral attitudes, subjective norms, …

Effect Of Covid-19 On The Wellbeing Of Healthcare Professionals In Public Isolation Hospitals In Egypt, Shaimaa Sabbah

Theses and Dissertations

One of the most vulnerable groups severely hit by the COVID-19 pandemic has been the Healthcare Professionals (HCPs), especially the physicians, pharmacists, and nurses who work in public Isolation hospitals. The Egyptian medical syndicate declared the death of more than 600 physicians from February 2020 till January 2022. In the meantime, the Egyptian government has worked on different policies for relieving the negative effects of the pandemic on this vulnerable group; however, easing restrictions, no total lockdown implementation, and monitoring bureaucracy has negatively affected the wellbeing of those HCPs. The study aims to figure out recommended policies to protect HCPs’ …

Chronic Adolescent Stress As A Predictive Factor For The Risk Of Developing Ptsd-Like Symptoms In Adulthood, Grace K. Young

Theses and Dissertations

Post-traumatic stress disorder is a stress and trauma based psychological disorder that is defined by the DSM-IV as an anxiety disorder that affects approximately 7.8% of people in the United States. PTSD is when those who suffer a traumatic event have intense and distressing feelings, emotions, and memories for a prolonged period of time after the event. A prominent feature of PTSD is the impaired ability to properly extinguish a fear response after a dangerous trigger or stressor is no longer present, also known as safety learning. Stressors are threats perceived within the environment that activate a response within the …

Sleep Self-Efficacy, Loneliness, And Physical Activity: Assessing The Pathways Between Sleep Quality And Mental Health Using Structural Equation Modeling, Amber M. Fox

Theses and Dissertations

Although there is robust empirical support that poor sleep contributes to declines in mental health, explanations of this relationship remain unclear. The purpose of the present study was to examine the pattern of associations between sleep quality, sleep self-efficacy, loneliness, physical activity, and mental health among U.S. adults across the lifespan, and whether they differed by gender or age group. A structural equation model with invariance analysis was developed and examined data from 2,300 adults (M_age = 44.1, SD = 16.78) participating in the online study Investigating Sleep Longitudinally Across Normal Development (ISLAND). Sleep quality was measured by …

Systematic Review Regarding The Use Of Mindfulness-Based Mobile Applications To Reduce Psychological Symptoms And Enhance Well-Being Among General And Clinical Population Adults: Benefits, Limitations And Future Directions, Brian Clawson

Theses and Dissertations

Mindfulness is now utilized throughout Western Society and is part of the growing behavioral health, self-help, and wellness movements. Mobile applications have become increasingly popular for a wide variety of uses related to physical health, mental health, and self-improvement. Therefore, mindfulness-based mobile applications have promise both as stand-alone tools for end-users seeking self-help resources and as clinician-recommended adjunctive tools to enhance the process and outcomes of professional therapy. This systematic review identified, reviewed, and synthesized the findings from studies (n = 29) concerning the impact of mindfulness-based mobile applications on specific aspects of psychological functioning in both the general population …

Interpersonal Psychotherapy For Depressed Adolescents: A Systematic Review Of Quantitative Studies Exploring Effectiveness, Concomitant Findings, And Mediating And Moderating Variables, Luke Rex

Theses and Dissertations

Depression is one of the leading causes of illness and disability among adolescents. According to the National Institute of Mental Health (2022), almost one-fifth of adolescents ages 12 to 17 years in the United States had at least one major depressive episode in 2020, representing 4.1 million people, and over half did not receive any treatment. An interpersonal approach to therapy for adolescents known as Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), developed by Dr. Laura Mufson, has been regarded as having well-established efficacy in treating depressed adolescents. This systematic review of quantitative studies (without meta-analysis) was conducted to (a) examine …

The Influence Of Comorbid Gad On Er Utilization In Urban Youth With Asthma, David A. Karpe

Theses and Dissertations

Current literature indicates a strong association between asthma and the early onset of comorbid generalized anxiety disorder (GAD) in minors and their primary caregivers. Studies show that asthma prevalence increases with certain demographic factors, such as ethnicity, socioeconomic status, and housing quality. Evidence also suggests that GAD influences decision-making, especially when deciding to utilize emergency room (ER) services for asthma-related concerns. This study analyzed the effect of comorbid GAD on minors with asthma and ER utilization. The data were provided by an earlier Stress & Justice Study (S&J) baseline survey, an investigation aimed at understanding the impact of parental criminal …

Anxiety And Social Withdrawal Among Children: Associations With Emotion Awareness And Emotion Regulation Strategy Use At The Intra- And Interpersonal Levels, Janae Ellen Teer

Theses and Dissertations

Anxiety and social withdrawal are two frequently experienced internalizing conditions among children. These early-onset challenges are associated with numerous maladaptive outcomes in the academic, social, and psychological domains (Levitt & Merrill, 2009; Long, 2018; Sanchez et al., 2018; Shernoff et al., 2017). While identifying anxious and socially withdrawn children in the classroom is difficult as symptoms generally occur internally, distinguishing between the conditions is perhaps more challenging as the two are closely associated, oftentimes overlapping constructs (Barzeva et al., 2019; Rubin et al., 2009). Particularly, it is unclear whether anxiety and social withdrawal are similarly or differently associated with key …

Adoption Of A Self-Care Therapy Mobile App: Application Of Uses And Gratification Theory, Self-Efficacy, And Response Efficacy, Sue Lim

Theses and Dissertations

This study examines factors that influence people’s decision to adopt a self-care therapy chatbot utilizing the uses and gratification theory, self-efficacy, and response efficacy frameworks. Existing literature has shown a large gap between supply and demand of mental health services as well as major barriers that prevent people from seeking services. Therapy chatbots offer the potential to address the gap and the barriers. This research used Woebot, a widely used and clinical evaluated therapy bot, and examined the influence of 6 uses and obtained gratification variables, two self-efficacy scales, and response efficacy on intentions of use. Quantitative analysis of the …

A Coupled Hazard Simulation And Post-Disaster Resource Optimization Framework, Stephen M. Cunningham

Theses and Dissertations

Extreme events, such as natural or human-caused disasters, cause mental health stress in affected communities. While the severity of these outcomes varies based on socioeconomic standing, age group, and degree of exposure, disaster planners can mitigate potential stress-induced mental health outcomes by assessing early, intermediate, and long-term treatment interventions by social workers and psychologists. However, local and state authorities are typically underfunded, understaffed, and have ongoing health and social service obligations that constrain mitigation and response activities. A resource assignment framework is developed as a coupled-state transition and linear optimization model that assists planners in optimally allocating constrained resources and …

Understanding College Student Emotional Functioning During Covid-19, Dominique Marie Giroux

Theses and Dissertations

The novel coronavirus has resulted in mass infection and death. To prevent spread of the virus, colleges and universities shut down and transitioned to remote learning, which mandated all college students to leave residential housing and relocate to a permanent address. Previous literature suggests college students who experienced housing displacement due to a natural disaster reported heightened distress and poorer overall functioning (Davis, Grills-Taquechel, & Ollendick, 2010). Prior to the COVID-19 outbreak, college student mental health was deemed a public health concern, however, it is expected to worsen following the outbreak (Galea, Merchant, & Lurie, 2020). Researchers suggest peer support …

The Harm In Seeking Care: Assessing The Relationship Between Healthcare Discrimination And Healthcare Avoidance Behaviors In The Past Year And Since The Start Of The Coronavirus Pandemic In A Transgender And Gender Independent Sample, Kyle L. Mason

Theses and Dissertations

Background: Gender minorities encounter a myriad of barriers to accessing general and gender affirming healthcare. Financial disparities impacting affordability of healthcare costs and insurance-based denials for gender-affirming care are among prominent barriers discussed. Considerations of the prevalence of stigma, discrimination, and erasure of gender minority identities must not be neglected when seeking to understand healthcare accessibility and utilization in this population. Previous researchers have examined gender minority patients’ experiences of discrimination in healthcare settings and delaying care due to fear of discrimination. There is a dearth of knowledge about the relationship between lifetime exposure to varied forms of healthcare discrimination …

The Role Of Insurance Coverage In Outpatient Substance Use Disorder Treatment Referral, Utilization, And Outcomes, Huyen Pham

Theses and Dissertations

Opioid-related overdoses increased dramatically in recent years. Medicaid plays a predominant role in paying for opioid use disorder (OUD) treatment. However, there is a critical gap in understanding the role of Medicaid coverage in referrals to treatment, treatment utilization, and treatment retention. The three studies used observational and quasi-experimental (i.e., natural experiment) designs leveraging state and year variation in Medicaid expansion to characterize the role of Medicaid coverage in OUD treatment. We found that individuals with OUD with Medicaid insurance were more likely to use outpatient treatment, whereas those who were uninsured were more likely to use self-help groups only. …

Policies Addressing Barriers To Low-Income Women And Children’S Health Care Utilization In The United States And Kenya: The Role Of Physician Payments And Cash Transfer Programs, Muloongo Simuzingili

Theses and Dissertations

This dissertation examined two policies to improve low-income women and children’s healthcare utilization: physician payments and cash transfer programs. Higher physician payments increase the supply of healthcare services while cash transfers increase individuals’ demand for healthcare services. Cash transfer programs can improve health outcomes, yet the extent to which they are a cost-effective strategy is largely understudied. Therefore, this dissertation examines three overarching research questions:

1. Are Medicaid physician fees associated with access to substance abuse disorder (SUD) treatment among low-income women of reproductive age?
2. Do economic preferences moderate cash transfer program effects on children’s health care utilization? Evidence from a …

Therapists' Perspectives On Aiding Individuals To Maintain Social Connection While Struggling With Health Concerns, Shari Howington-Carlin

Theses and Dissertations

This applied dissertation was designed to explore therapists’ perspectives on aiding individuals to maintain social connection while struggling with health concerns. Social relationships support physical and psychological well-being, yet individuals struggling with physical or mental health issues often have difficulty maintaining their relationships. Therapists, as health professionals, often discuss physical as well as emotional health concerns with their patients, including components of physiological and psychological heath care. Emerging neuroscience is aiding in understanding how research in this field supports early intervention for health outcomes around healthy social and family relationships during chronic disease or illness onset.The researcher conducted a phenomenological …

Exploring The Aftermath Of Cyber And Traditional Bullying Victimization Of Adolescent’S Mental Health And Academic Success, Latasha L. Young

Theses and Dissertations

The problem addressed in the research study was that cyber bullying and traditional bullying continued to increase at the research site during the past 4 years. The purpose of the study was to determine the influences of mental health services that were designed to decrease the negative effects of both cyber and traditional bullying on adolescent clients’ health and academic performance. This applied dissertation was designed to examine the experiences of cyber and traditional bullying victimization of adolescents’ mental health and academic success, within a large southern state in the United States, to provide practical solutions to address the concerns …

Opioid System's Involvement In Ketamine's Antidepressant-Like Effects, Fan Zhang

Theses and Dissertations

Depression is one of the most debilitating disorders in the world. The currently available medications typically have a 2-4 week delay in their therapeutic effects and are ineffective for about 40% of patients. In 2000, a subanesthetic dose (0.5 mg/kg i.e.) of the dissociative anesthetic ketamine was reported to have both rapid and robust antidepressant effects in in treatment-resistant depressed patients. However, the mechanisms responsible for ketamine’s antidepressant effects remain unclear. In 2018, a clinical study reported that pretreatment with the nonselective opioid antagonist naltrexone attenuated the rapid antidepressant effect of ketamine in depressed patients. The current study investigated the …

The Role Of Community Belongingness In The Mental Health And Well-Being Of Black Lgbtq Adults, Keith Justin Watts

Theses and Dissertations

The impact of racial and sexual minority stigma, prejudice, and discrimination on the mental health and well-being of Black and LGBTQ individuals, respectively, has been well documented in the literature. Research on these relationships for Black LGBTQ individuals who are multiply marginalized due to their position at the social intersections of gender identity, sexual orientation, and race/ethnicity is less common. Belongingness to identity-based communities can protect against the negative impact of these minority stressors for Black and LGBTQ individuals and aid coping processes. However, Black LGBTQ individuals often experience stigma and discrimination in their racial, sexual, and gender minority communities …

Psychological Sense Of Community Among Older Adults In Puerto Rico Two Years After Hurricane María, Thomas D. Buckley

Theses and Dissertations

Hurricane María devastated Puerto Rico in 2017 and resulted in adverse long-term outcomes. Psychological sense of community (PSOC) may serve as a protective factor against the effects of Hurricane María for older adults in Puerto Rico. Using a three-paper format, this dissertation draws on a resilience framework and theories of PSOC and the Ecological Theory of Aging to examine the role of PSOC among older adults in Puerto Rico two years after Hurricane María.

Paper one is a scoping review of the concept of PSOC in research with community dwelling older adults. I begin by presenting findings on study characteristics …