Medicine and Health Sciences Commons^™

Discriminative Nursing Care Practices Towards Patients With Opioid Use Disorder In The Hospital Setting: How Knowledge And Social Attitudes Impact Care Delivery, Jeanne Adam Bernier

Doctoral Dissertations

Discriminative nursing care (DNC) practices towards patients with opioid use disorder (OUD) is a current phenomenon negatively affecting patient care and patient outcomes. It leads to delays in care, insufficient pain control, and feelings of guilt and shame, and it is linked to self-isolation, social isolation, social rejection, and even unemployment and housing disruption which perpetuate a dangerous cycle of inequity that is hard to overcome. In some cases, OUD stigmatization even increases morbidity and mortality rates. OUD stigmatization and discrimination are real problems in today’s health care climate due to the vast number of people affected by OUD and …

Experiences Of Black American Millennials: A Qualitative Study Of Internalized And Externalized Coping In The Face Of Racial Trauma, Natalia Angelique Giles

Doctoral Dissertations

The experiences Black Americans have faced when standing against racial trauma have impacted the Black community for generations. Though previous generations faced overt styles of racism throughout the eras of slavery and Jim Crow, the invalidation and discrimination have remained consistent within the experiences of the Black American millennial (BAM) generation. Current experiences BAMs face are a combination of both overt and covert styles of racism, which increase mental exhaustion, reduce motivation, and leave the individual psychologically defenseless. The purpose of this qualitative study was to examine the experiences of BAMs in the face of racial trauma. This qualitative research …

Tiktok Use And Body Dissatisfaction: Examining Direct, Indirect, And Moderated Relations, Danielle Leigh Mink

Doctoral Dissertations

In this study, we examined potential indirect and moderated effects in the relations between the use of TikTok, a video-based appearance-related social networking site, and body dissatisfaction among a sample of approximately 475 United States’ young adult college women residing in the Southeast. We hypothesized that TikTok use would be directly and indirectly related to body dissatisfaction through more upward appearance comparison and more body surveillance in serial. We also hypothesized that exposure to body positive media and social media literacy (both commercial and peer) would moderate or buffer both the direct and indirect links between TikTok use and body …

Clinicians' Perspectives On The Effectiveness Of Trauma - Focused Cognitive Behavioral Therapy With African American Children: A Qualitative Study, Jada Carter

Doctoral Dissertations

Literature exploring clinicians' perspectives on the effectiveness of trauma-focused cognitive behavioral therapy with African American children who suffer from trauma-related disorders is very limited. The current study examined clinicians' perspectives on the TF-CBT model when utilized with this population, including their experiences working with African American children and families with observable types of trauma-related disorders. This research study also explored the various facets of trauma that African Americans encounter in childhood and the barriers that prevent them from receiving adequate mental health care. Thematic analysis was utilized to explore themes that emerged when treating African American children with TF-CBT. Five …

“In The Skin I’M In…I Represent A Different Version Of What Help Looks Like:” Black Women Sport Psychology Professional’S Experiences In Applied Sport Psychology, Sharon R. Couch

Doctoral Dissertations

Black Feminist Applied Sport Psychology (BFASP) is a culturally inclusive theoretical framework for centering Black women’s experiences in applied sport psychology (Carter et al., 2020; Couch et al., 2022). For the past two decades, (White) Feminist applied sport psychology professionals (FASPPs) described the experiences of Black women as unique but were overlooked in research and participant pools due to the prioritization of White women's and Black male sport experiences. (Carter & Davila, 2017; Carter & Prewitt-White, 2014; Gill, 2020; Hyman et al., 2021). The purpose of this study was to explore the life and work experiences of BASPPs (i.e., faculty, …

Community Based Participatory Research Informed Manualization And Piloting Of E-Training Of A Modified Dialectical Behavior Therapy Intervention, Annika M. Miyamoto

Doctoral Dissertations

This study explores the efficacy of delivering modified dialectical behavior therapy (m-DBT) to direct support staff who work with seriously mentally ill patients with neurocognitive deficits using remote web-based technology. The partnering facility for this study is a residential skilled-nursing facility that provides 24-hour care to individuals under conservatorship. Using a previously piloted m-DBT protocol, qualitative feedback was gathered from four participants with background training in psychology and varying experiences with DBT. All participants had direct knowledge of the treatment environment and experience working with the patient population. Gathered feedback was used to revise the m-DBT protocol to be used …

The Use Of Mindfulness Meditation To Increase The Efficacy Of Mirror Visual Feedback For Reducing Phantom Limb Pain In Amputees, Nicolas Sebastian Mills

Doctoral Dissertations

Phantom limb pain is a chronic pain condition that negatively impacts the lives of over half of amputees, and results in considerable morbidity. Currently, there is no gold standard for treatment for phantom limb pain. However, a frequently used intervention is the use of mirror visual feedback, in which the amputee watches the reflection of the adjacent non-amputated limb move and exercise. In the last few decades, mindfulness-based interventions have been increasingly used with individuals living with different types of chronic pain. This study attempts to discover if the addition of a mindfulness-based intervention, such as guided meditation, will augment …

Clinical Work With Adult Male Incest Survivors: Therapeutic Themes And Perspectives, Kathryn B. Rosenberg

Doctoral Dissertations

For psychotherapists, encountering clients who have experienced sexual trauma or abuse is inevitable, whether or not the abuse is disclosed to the therapist; however, mental health professionals receive extremely limited (if any) training on how to identify or effectively support adult clients who are survivors of childhood sexual abuse (CSA). Many people who experienced CSA, especially those who identify as male, remain isolated and invisible in their suffering as adults even within therapeutic spaces, facing what feel like insurmountable barriers – both internal and external – to getting help. When sexual abuse is intrafamilial, these barriers are both amplified and …

Identity Development In Transgender Women Of Color: An Interpretative Phenomenological Analysis, Angel Tseng

Doctoral Dissertations

Transgender women of color have been at the forefront of LGBT rights moments in the U.S. and has been credited for leading the Stonewall resistance (Roberts, 2018). Though much has changed since Stonewall, transgender women of color still face harassment, discrimination, and many other barriers and health risks today. One of the many challenges faced by transgender women of color is identity conflict. The purpose of the study was to examine the identity development processes of transgender women of color. This qualitative research study utilized Interpretative Phenomenological Analysis to explore the lived experiences and narratives of individuals from this community …

Black Women Surviving Sexual Trauma: The Cultural Components Used To Aid Recovery, Charrin Kimble

Doctoral Dissertations

The physical and psychological impacts women face as a result of sexual trauma has been researched extensively. While sexual trauma affects all women, far less attention has been given to cultural impacts on Black female survivors. Black women have unique experiences with sexual trauma due to the intersection of racism and sexism. Given the sociohistorical context of Black women and sexual trauma, research is needed to understand how cultural factors may aid the recovery process of Black women. This qualitative study examined the lived experiences of Black women who survived sexual trauma to understand the role cultural factors may have …

Efficacy Of Integrated Mental Health Care With Dual Diagnosis Patients And Their Utilization Of Psychiatric Emergency Services, Denton Scott

Doctoral Dissertations

Historically, patients with dual diagnosis have been subjected to ineffective treatment and negative attitudes from healthcare providers. Further, these patients are plagued with myriad afflictions that exist beyond substance abuse and mental illness. The treatments and collateral damage associated with the diagnosis impose excessive healthcare costs and can be of significant detriment to society. Largely, patients suffering from dual diagnosis do not receive adequate treatment. As such, psychiatric emergency services are frequently utilized as an alternate treatment, wherein the main focus of care is on the substance abuse alone. This study argues that solely treating the substance abuse is not …

The Role Of Stigma On Mental Health Service-Seeking Among Armenian-American Men, Anthony Saroyan

Doctoral Dissertations

This study examined the role of stigma on mental health service-seeking among Armenian-American men who self-identified as having lived through or currently are living with a mental health issue. This qualitative study utilized interpretive phenomenological analysis to ensure that the lived experiences of Armenian-American men are represented through their perspective. A total of six participants engaged in this study. All participants self-identified as male and as having experienced a mental health issue, have utilized mental health services at least once in their lifetime, resided in the San Francisco Bay Area, and as being of Armenian descent. Through exploring the lived …

Structurally Rich Movement: Measuring Movement For Empirical Psychology And Examining The Dynamic Complexity Of Affect Regulation In Behavior, Michael Timothy Finn

Doctoral Dissertations

Movement not only permeates human life, but structures dimensions of experience. Phenomenological theory points to the dynamic congruency of movement and emotion, via the body schema, as shaping affectivity. For psychology, this calls for an understanding of behavior beyond being discrete events, but also manifesting kinetic melodies. Yet there is a gap in existing methodology for empirically studying the three-dimensional characteristics of human movement continuously across segments of the body. A potential line of research in this area, implicit affect regulation capacities, was described to inform the selection of instrumentation, measurement, and calculations of dynamic structure that would, theoretically, best …

The Impact Of Depressive Symptoms On Cognitive Decline And Risk For Dementia, Katheryn Conde

Doctoral Dissertations

As of 2011, the life expectancy for Latinos in the U.S. was 81.6 years, which is higher compared to non-Hispanic Blacks (75.3 years), non-Hispanic Whites (79 years), and Hispanic Black populations (74.9 years; Arias, 2011; Arias, 2015). Latinos have higher age specific prevalence of dementia, which is higher than African Americans and non-Hispanic Whites (Gurland et al.,1999). Latinos experience Alzheimers disease symptoms 6.8 years earlier, with the average onset of 67.6 years which is younger than non-Hispanic Whites (73.1 years; Clark et al., 2005). Furthermore, older Latinos tend to experience depression at a rate of 13% and 35% with the …

The Effects Of Electronic Treatment Reminder Cues On Relapse Prevention, Kathrin Ritter

Doctoral Dissertations

Substance use is highly prevalent in the United States, and although treatments designed to reduce substance use have shown promise, relapse rates between 40% and 70% following treatment have been reported in recent studies. Given the high rate and chronicity of relapse following substance abuse treatment, conducting research aimed to develop techniques to lower the risk of relapse following treatment is imperative. A promising option to reduce relapse is to use treatment reminder cues, or cues that are salient features of the treatment environment that can be used to extend the effects of treatment into non-treatment settings. This study investigated …

Testing Claims Of Efficacy And Mechanism Of Action For Emotion Focused Couples Therapy: A Dyadic Case Study Using Time-Series Design, Albert Jun-Wei Wong

Doctoral Dissertations

The overall purpose of this study was to test claims regarding both the efficacy and mechanism of change for Emotion Focused Couple Therapy (EFT). Although a number of treatment outcome studies have been conducted on EFT, the vast majority of these studies emanate from the research laboratories associated with the two founders of EFT. Additionally, most EFT research has examined treatment outcome rather than mechanisms of change. This study used a time-series single-case experimental design approach to examine both the efficacy and the mechanisms of change in EFT for couple distress. I systematically tracked the symptoms of couple distress across …

Dissociation And Sexual Trauma: The Moderating Role Of Somatization, Amineh Abbas

Doctoral Dissertations

This study examined various types of trauma, with an emphasis on sexual trauma across the lifespan, in a clinical sample of male and female adult outpatients assessed for trauma, somatization, and dissociation. Two hundred forty-five adult outpatients at the University of Tennessee Psychological Clinic were administered the Dissociative Experiences Scale (DES), the Traumatic Experiences Checklist (TEC), and Symptom Checklist-90-Revised (SCL-90-R), as part of the routine intake procedure. Of those individuals, 200 patients completed the questionnaires correctly and were included in the final study sample. The experience of sexual trauma indeed accounted for additional variance in somatization scores over and above …

Belief In The Efficacy Of Psychotherapy (Bep): Psychometric Scale Development And Examination Of Theoretical Correlates, Erin Gray Volpe

Doctoral Dissertations

This study develops a psychometric scale measuring the extent to which an individual expects psychotherapy to be effective: The Belief in the Efficacy of Psychotherapy (BEP). Based in the research that describes expectations for therapy as process expectations or outcome expectations, the BEP scale is developed to measure outcome expectations for therapy exclusively (i.e., is psychotherapy helpful?). Current expectancy measures vastly underrepresent outcome expectations in particular, and BEP will be the first to focus solely on outcome expectations. Additionally, the proposed BEP scale measures the general cultural belief system (i.e., non-patients) and their beliefs about psychotherapy and therapists specifically, …

The Effects Of A Brief Mindfulness Intervention On Lab-Based Aggression, Amanda Eliza Seavey

Doctoral Dissertations

Aggression and violence are severe and prevalent problems associated with numerous negative health consequences and increased health care costs. Prevalence rates vary with the highest rates being among young adult populations. Some research indicates that aggression perpetration is an attempt at controlling negative affect. Therefore, many have posited that emotion regulation may be an amenable risk factor for violence and aggression, and interventions such as mindfulness-based therapies designed to enhance emotion regulation and distress tolerance may be helpful. Previous research has found positive effects on psychological well-being using even brief mindfulness interventions. Thus, the current study aimed to investigate how …

Effects Of Gender Composition Of Target And Sender Dyads On The Tendency To Infer Lies, Byron J. Simoneaux

Doctoral Dissertations

Lying is so common in human behavior that some have labeled it a social skill. Despite the ubiquity of lies, humans have consistently been found to be poor lie detectors. Attempts have been made to improve the accuracy of human lie detection. Unfortunately, the most successful training only improves accuracy slightly above the level of chance. Because of its importance to society, considerable effort has been aimed at developing methods to help determine when people are lying. Researching how and why humans infer that another person is lying has the potential to advance the understanding of lie detection. Researchers have …

Behavioral Activation Of Religious Behaviors: Treating Depressed College Students With A Randomized Controlled Trial, Maria Elizabeth Anne Armento

Doctoral Dissertations

Abstract

Although spiritual or religious behaviors are sometimes targeted within behavioral activation protocols (Hopko & Lejuez, 2007; Hopko, Lejuez, Ruggiero, & Eifert, 2003), the efficacy of a protocol that exclusively develops a religiously-based behavioral repertoire has not been investigated. This randomized controlled study investigated the efficacy of a brief protocol for religious action in behavioral activation (PRA-BA) relative to a no-treatment “support” condition among mild to moderately depressed undergraduate students (n = 50). PRA-BA consisted of an individualized one-session intervention and 2-week activation interval. Clinical outcomes assessed depression, environmental reward, anxiety, and quality of life. Repeated measures ANOVAs indicated …

A Comparison Of Big Five And Narrow Personality Traits In Relation To Academic Performance, Laura Lee Wright

Doctoral Dissertations

The present study investigated the relationship between the Big Five personality traits (Agreeableness, Conscientiousness, Emotional Stability, Extraversion, and Openness), as well as the relationship of more narrow personality traits, with academic performance. The issue of whether personality measures that have been contextualized to either school or work better predict academic performance than generalized measures is also addressed through the use of multiple personality instruments. Results from a correlation analysis indicated that Openness, Conscientiousness, Agreeableness, and Emotional Stability were all significantly positively related to academic performance, in this case, college course grade, while Extraversion was significantly negatively related. The same correlation …

Justification Mechanisms In The Conditional Reasoning Test For Aggression And Their Relation To Defense Mechanisms, Cheryl Delaine Barksdale

Doctoral Dissertations

The Conditional Reasoning Test for Aggression (CRT-A; James, 1998; James & McIntyre, 2000) is an inductive reasoning test designed to assess the extent to which individuals use implicit reasoning biases – known as justification mechanisms (JMs) – to justify engaging in behavioral aggression. James and colleagues (James, 1998; James & Mazerolle, 2002; James et al., 2005) have consistently described the CRT-A as an indirect measure of these implicit cognitions, or JMs, but they recently reframed their discussion of the test to emphasize its theoretical grounding in the concept of defense mechanisms (A. Freud, 1936/1966). In particular, they indicated that the …

The Influence Of Level Of Training And Gender On Counseling Outcome In A University Counseling Center, Scott Andrew Sokoloski

Doctoral Dissertations

This study examined the effects of counselor level of training and gender on counseling outcome in a university counseling center environment. Data was collected from an archival database of approximately 4500 clients seen over a six-and-a-half year time period at a mid-sized Southeastern university counseling center. The Outcome Questionnaire 45.2 was used to measure client outcome, which consists of 45-items scored on a five-point Likert scale. The OQ produces three subscale scores (Symptom Distress, Interpersonal Relations, and Social Role) and a Total Score. The Social Role subscale was found to have low reliability in this study, and was omitted from …

Examining The Ability Of The Halstead -Reitan Battery And The Wide Range Achievement Test To Utilize Severity In Discriminating Among Alzheimer's Dementia Patients, Gina Gibson-Beverly

Doctoral Dissertations

Measuring change in cognitive status is essential for the diagnosis, prognosis, and treatment of brain dysfunction. Psychological abilities are differentially affected by brain dysfunction severity, as some abilities are more vulnerable to brain dysfunction than others. Neuropsychological assessments can be viewed as a continuum of "hold" and "don't hold" tests. "Hold" tests assess abilities that remain stable in spite of brain dysfunction, while "don't hold" tests measure skills that are significantly compromised by brain impairment. The present study ranks the Halstead-Reitan Battery (HRB) and the Wide Range Achievement Test (WRAT) subtests based on their ability to discriminate between two levels …

Female Faculty Experiences Of Discrimination In Higher Education, Kylie Gray Cole

Doctoral Dissertations

The primary purpose of this study was to obtain a description of women faculty members’ experiences of discrimination in higher education. The phenomenological research methodology informed the study. Seventeen participants were asked to respond to the question, “Can you tell me about your experience of discrimination as a faculty member in a higher education institution?” The interviews were in-depth and unstructured. Verbatim transcripts of the audio-taped interviews were completed and a phenomenological research group analyzed the data using the phenomenological method. Two grounds and three main themes emerged from the data. The first ground was Minimize/Describe Discrimination. This captured the …

Sleep Quality Of College Students And Its Relationship To Coping Styles And Well-Being, Cathy Alison Word

Doctoral Dissertations

College students suffer from more sleep disturbances than the general population. Sleep difficulties in college students can lead to lower levels of performance, memory, and cognitive ability, as well as increased levels of anxiety and decreased levels of well-being. Sleep quality is known to impact individuals' physical and psychological health, which are indicators of well-being. Sleep also appears to influence individuals' choices of coping strategies. Sleep quality is also highly correlated with college students' emotional response to stress. The relationships between and among sleep quality, well-being, and coping style have not been fully examined. The purpose of this study was …

Returning Home And Leaving Again: A Phenomenological Investigation Of A Sojourner’S Experience, Victoria Christofi

Doctoral Dissertations

Two studies were conducted for this project. The goal of the first study was to describe the structure of the experience of individuals who have returned home after their stay abroad. The goal of the second study was to describe the structure of the experience of individuals who have returned to the country in which they studied, after having returned home. To accomplish these goals, phenomenological interviews were conducted with seventeen participants. In the first study, nine participants were interviewed in their own country after they had been abroad for their studies. In the second study, eight participants were interviewed; …

A Search For Important Stimulus Variables In The Early Family Relationships Of Schizophrenic Patients, Robert F. Horner

Doctoral Dissertations

Summary and Conclusions

Ten male schizophrenic patients and their control subjects were matched on the variables age, education, and socioeconomic status by occupation. The Pascal-Jenkins Behavioral Scales (Pascal & Jenkins, 1960b) were used to investigate the stimulus situations presented by grandparents, parents, and siblings in the first ten years of the subjects’ lives. The experiment was replicated with ten additional experimental subjects and their controls.

The stimulus categories “Mother” and “Father” were found to be highly significant in both experiments. This suggested that the schizophrenic patients had more general deprivation of needs by parents in the early years. Specifically defined …