Medicine and Health Sciences Commons^™

Reaching Resilience: A Multiple Case Study Of The Experience Of Resilience And Protective Factors In Adult Children Of Divorce, Denis' A. Thomas

Doctoral Dissertations

The purpose of this qualitative case study was to describe the experiences of resilience following parental divorce for university freshmen. Five participants were interviewed using a multiple case study methodology and Richardson’s (2002) resilience model as the theoretical framework. It examined how the three needs of Self-Determination theory (autonomy, relatedness, and competence) and the three categories of protective factors (individual, family, and community) contributed to resilience. Data were collected through demographic surveys, divorce artwork, resilience artwork, and interview transcriptions. General themes, typological self-determination need themes, and typological protective factor themes were developed for each individual and across cases. The findings …

Mental Health Provision To Hispanics In Idaho: Findings From A Provider Survey, Nicole Stickney

Boise State University Theses and Dissertations

Currently, Idaho’s mental health resources for Hispanics are not designed to meet their mental health needs. According to Jose Valle, the Chief of Children’s Mental Health at the Idaho Department of Health and Welfare Region III, there are no available data regarding prevalence rates for mental disorders among Hispanics in Idaho (personal communication, September 18, 2007), and little is known about what interventions work best among Hispanics (Gonzalez, 2006). As a first step in addressing the mental health needs of Hispanics in Idaho, information on the capacity of local providers to deliver culturally appropriate care is needed. The Idaho Partnership …

Predicting Systemic Confidence, Stephanie Inez Falke

Loma Linda University Electronic Theses, Dissertations & Projects

Using a mixed method approach, this study explored which educational factors predicted systemic confidence in master’s level marital and family therapy (MFT) students, and whether or not the impact of these factors was influenced by student beliefs and their perception of their supervisor’s beliefs about the value of systemic practice. One hundred and twenty graduate students in Commission on Accreditation for Marriage and Family Therapy Education-accredited (COAMFT) programs completed an online survey that assessed their training experiences, beliefs about systemic practice and perceptions of confidence. Quantitative findings revealed that students who reported greater research expectations in their program, obtained more …

Cognitive Processes And Race Differences: Possible Factors Contributing To Ptsd, Christina Fay

Graduate Theses

Past research suggest differences in racial group’s perceived experiences in traumatic situations and different ways of coping can affect individual levels of posttraumatic stress disorder (PTSD) symptoms. The author examined how race, methods of coping and risk/resilience factors interact with PTSD symptomology. A total of 28 Black, Hispanic and Non Hispanic Caucasian Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans were assessed for PTSD symptoms, methods of coping and risk/resilience factors related to deployment. Findings indicate no significant differences for minorities and non Hispanic Caucasians on level of PTSD symptoms. Findings indicate significant differences between minorities and non Hispanic Caucasians on …

The Development Of An Advanced Filial Therapy Model, Amy Cathleen Wickstrom

Loma Linda University Electronic Theses, Dissertations & Projects

This study sought to develop an advanced filial therapy model by examining the experiences of seven parents who participated in a preliminary advanced filial therapy intervention. These parents had previously completed a 10-week basic filial therapy model called Child Parent Relationship Therapy. A phenomenological qualitative design was employed, wherein data was obtained from parent playtime notes, researcher field notes, group process transcriptions, and focus groups. Parent experiences of the intervention were examined from a systems-relational lens, and four categories emerged, which include relational epiphanies, enhanced understanding of the playtimes, model format, and skill development. Additionally, a variety of themes were …

Comparison Of Rationally-Derived And Empirically-Derived Methods For Predicting Failure In Residential Treatment, Jennifer Pester Grattan

Loma Linda University Electronic Theses, Dissertations & Projects

Patient-focused research methods have been used in adult mental health treatment to improve outcomes by tracking individual treatment response and comparing it with expected recovery patterns. One such approach has used rationally- and empirically-derived methods to analyze data from the OQ-45 and identify patients who are not responding as expected to treatment. Treatment is then adjusted, improving outcomes and lowering overall costs.

Similar but less extensive research has shown analogous methods can be used with children and adolescents. This would be particularly useful in residential treatment, which is an expensive and inadequately researched approach. This study used archival data gathered …

Profiles Of Drug Endangered Children: Investigation In A Clinical Sample, Imanie Samanmali Wijayaratne

Loma Linda University Electronic Theses, Dissertations & Projects

Despite the increase in children born prenatally exposed to methamphetamine, little is known about the cognitive and neuropsychological outcomes of these children. Research specific to prenatal-methamphetamine exposure is extremely limited and has been primarily restricted to rat studies. This research combined with the few studies examining children prenatally exposed to methamphetamine suggests that methamphetamine-exposure is associated with various cognitive and neuropsychological delays and is impacted by both biological and environmental factors. Given the scarcity of research in this area, the current study used archival data from a psychological assessment clinic to (1) describe the frequency of prenatal methamphetamine-exposure cases, (2) …

A Longitudinal Study Of Fetal Tissue Transplantation Surgery: The Effects On Quality Of Life And Personality For Individuals With Parkinson's Disease, Cynthia C. Cole

Electronic Theses and Dissertations

Parkinson's disease (PD) is a chronic and progressive condition that affects the physical, emotional, and social functioning of individuals. Freed et al. (2001) conducted a double-blind sham-controlled trial to investigate the effectiveness of fetal tissue transplantation of those with PD. The authors investigated the effects of the surgery across the dimensions of physical and neurological functioning. A quality of life (QoL) study was conducted to determine if there were differences in QoL when comparing those who received the fetal tissue transplantation to those who received the sham surgery (McRae et al., 2004).

While there is little research on the effectiveness …

Fetal Cocaine Exposure Causes Epigenetic Changes In The Rat Heart, Kurt D. Meyer

Loma Linda University Electronic Theses, Dissertations & Projects

Cocaine abuse continues to be prevalent in the United States and other industrialized nations, in addition to the negative health effects that cocaine abuse has on the user, a mother who uses cocaine while pregnant also exposes the developing fetus to cocaine. Although there have been many studies of the effects of cocaine on the adult heart, studies of cocaine on the fetal heart and its potential delayed pathophysiological effects on cardiac function in adult offspring are extremely limited. The studies of the present project sought to enhance the understanding of the effect of cocaine exposure on the fetal heart …

Clergy Stress: Seventh-Day Adventist Pastors In Hong Kong, Singapore, And Taiwan, Onn Liang

Loma Linda University Electronic Theses, Dissertations & Projects

This research utilized an expanded ABC-X model of family stress, one that incorporated the culture and boundary ambiguity constructs of the contextual approach as a paradigm to examine the outcomes of job-related stress experienced by the Seventh-day Adventist pastors in Hong Kong, Singapore, and Taiwan. All together 89 Adventist pastors or 86.4% of the total pastoral workforce in the three regions participated in the 52 self-administered questionnaire survey. In addition, two focus groups made up of 15 pastors in Taiwan were utilized to generate descriptive data related to pastors and their families in the context of stressful situations. This research …

An Evaluation Of Interventions Designed To Impact Nurses : A Pilot Project, Pamela G. Bing Perry

Loma Linda University Electronic Theses, Dissertations & Projects

This pilot project was designed from a systems approach as defined within the field of marriage and family (MFT). Systems theory has been used successfully in examining and working with organizational relationships as exemplified in the work of Edwin H. Friedman. His contribution includes several books specifically developed for use in organizations; one that was tailored for religious groups; and another for managers (Friedman, 2007). While other MFT modalities have also been used effectively with organizations, the complexity of the influences operating within an organization most closely matches the systems approach. For this reason, this is the conceptual framework applied …

Creating The Patient-Doctor-Family Relationship: Issues Of Power And Gender, Josephine M. M. Perez

Loma Linda University Electronic Theses, Dissertations & Projects

Objectives: To understand how patients, doctors, and families see, form, and commit to relationship and how power and gender influence their interpersonal processes and meanings.

Methods: Grounded theory methodology was used. There were six family medicine physicians, ten patients, and ten family members who participated. Physicians, patients, and family members were matched.

Results: Four themes emerged: types of patient-doctor-family relationships (extended family and traditional), types of care (relationship-centered care (RCC), family-oriented care (FOC), whole-person care (WPC), and patient-centered care (PCC)), commitment and intimacy, and interpersonal processes (perception of relationship shape, bonding, confidence and trust, equality and partnership, mutuality, …

A Psychoeducational Group Intervention For Fibromyalgia Patients, Derek O. Bacchus

Loma Linda University Electronic Theses, Dissertations & Projects

This study examined the effect of a multidisciplinary psychoeducational treatment group on Fibromyalgia Syndrome (FMS) pain, depression, catastrophizing, and quality of life. The Short-Form McGill Pain Questionnaire (SF-MPQ), Center for Epidemiologic Studies Depression Scale (CES-D), Coping Strategies Questionnaire (CSQ), and the World Health Organization Quality of Life Assessment—Abbreviated Version were used to assess these constructs in 15 participants. The sample was composed entirely of female participants and was predominantly middle aged, which is typical of the FMS population. Two separate groups of FMS patients—seven in Group 1, eight in Group 2—completed a 10-week psychoeducational intervention where they were presented with …

Accuracy Of A Rationally-Derived Method For Predicting Failure In Residential Treatment, Jennifer Pester Grattan

Loma Linda University Electronic Theses, Dissertations & Projects

Recent studies of adult mental health treatment have used patient-focused research methods to improve outcomes, by tracking treatment response and comparing it with expected recovery patterns. One such line of research has used rationally-derived and empirically-derived methods to analyze data gathered by the OQ-45 and identify patients who are not responding as expected to treatment. This allows for adjustment of treatment, which results in improved outcomes and lower overall costs.

Similar but less extensive research has provided evidence that these approaches may also improve outcomes in outpatient treatment for children and adolescents. These approaches might be particularly useful in residential …

The Effects Of A Psychoneuroimmunology Based Lifestyle Intervention In Modifying The Progression Of Major Depression In Clinically Depressed Adults, Ruth A. Tanyi

Loma Linda University Electronic Theses, Dissertations & Projects

Chronic stress can lead to poorly controlled upsurges of cortisol and dysregulation of the hypothalamic pituitary-adrenal axis, thereby contributing to major depression. Hence, researchers have begun to examine the effects of individual psychoneuroimmunology (PNI) interventions and their impact on modifying stress and depression. However, there is a lack of studies that have examined the composite effect(s) of a PNI-based lifestyle intervention and major depression. Thus, this randomized interventional study examined the composite effect(s) of a PNI-based lifestyle intervention: combined progressive muscle relaxation and spiritual guided imagery and humor as an adjunct therapy to modifying the progression of depression. Participants were …

Multiscale Genomic Analysis Of The Corticolimbic System: Uncovering The Molecular And Anatomic Substrates Of Anxiety-Related Behavior, Khyobeni Mozhui

Theses and Dissertations (ETD)

Genetic diversity generates variation at multiple phenotypic levels, ranging from the most basic molecular to higher-order cognitive and behavioral traits. The far-reaching impact that genes have on higher traits is apparent in several neuropsychiatric conditions such as stress and anxiety disorders. Like most, if not all, neural phenotypes, stress, anxiety, and other emotion-related traits are extremely complex and are defined by the interplay of multiple genetic, environmental, experiential, and epigenetic factors.

The work presented in this dissertation is a multi-scalar, integrative analysis of the molecular and neuroanatomic substrates that underlie emotion-related behavior. The amygdala is a principle component of the …

Posttraumatic Stress Disorder In Combat Veterans And The Effect On Their Life And Marital Satisfaction, Amy Rodriguez Alford

Graduate Theses

Various studies have been conducted within our United States military service members and their problems with posttraumatic stress disorder (PTSD). There are several factors as to why a combat veteran can develop PTSD (Committee on Gulf War and Health, 2008) , PTSD could effect their life and marital satisfaction. The present study consisted of 15 married couples, in which the husband has served combat duty in Iraq or Afghanistan. The total level of PTSD symptomology was compared to each individual's life and marital satisfaction. There was no significance correlations found between the husbands' PTSD symptoms and their quality of life, …

Reflective Visual Journaling During Art Therapy And Counseling Internships, Sarah P. Deaver

Counseling & Human Services Theses & Dissertations

Visual journaling is thought to promote students' critical reflection upon their previous learning, their current experiences, and their ongoing professional growth. Research supports the value of written journals as educational tools that encourage reflection, but the potential for visual journaling to facilitate reflection has not been explored through systematic inquiry until now.

This qualitative multiple case study explored four art therapy students' and four counseling students' responses to visual journaling during their internships. They maintained their journals throughout one 15-week academic semester, and were interviewed four times over the course of the study. Data consisted of transcribed interviews and photographs …

Social Cognitive Predictors Of Diabetes Outcomes In Latinos And Whites, Diana Brown

Loma Linda University Electronic Theses, Dissertations & Projects

Investigating health care disparities in ethnic minority populations is an increasingly urgent issue as these disparities lead to higher morbidity and mortality in minorities (National Center of Health Statistics, 2000). There is clear evidence that Latino Americans, the fastest growing minority group in the United States, are more likely to be diagnosed with and experience more severe complications from type 2 diabetes than Anglo Americans. This study surveyed 38 White and 33 Latino diabetes patients from outpatient clinics in an academic medical center. Cultural values (individualism and collectivism), mental health (social support, mental health), and self-efficacy (diabetes and exercise) were …

The Prevalence And Determinants Of Health Risk Behaviors Among High School Students In Mexico, Nellie León

Loma Linda University Electronic Theses, Dissertations & Projects

The Centers for Disease Control and Prevention report that despite health promotion efforts, adolescents continue to engage in behaviors that put them at risk for morbidity and mortality. Alcohol consumption, illicit drug use, smoking, and risky sexual behaviors are among the behaviors that contribute to leading causes of morbidity and mortality in youth; these four behaviors were explored in this study. An observational cross-sectional design was utilized. The Youth Risk Behavior Survey from the Centers for Disease Control and Prevention was utilized to assess the prevalence of the four risk behaviors among high school students in Jalisco, Mexico. Items constructed …

The Effects Of Negative Childhood Experiences On The Severity Of Mental And Substance Abuse Disorders And Recidivism, Christie Lynn Gabriel

Theses Digitization Project

Overcrowded prisons are a growing problem in the United States. Currently, California prisons are over capacity 85%. Substance abuse increases the likelihood of criminality, for half of state prisoners admitted to being under the influence of drugs or alcohol at the time of their offense(s). A large portion of these individuals, once incarcerated, is also diagnosed with a mental illness. By researching dually diagnosed inmates who were participating in a 90-day in-custody treatment program, this study focuses on how negative family and school experiences become major contributors to adult mental and substance abuse disorders and criminality.

Identification Of Effective Outreach Methods For Mental Health Services To The Hispanic Population, Nidia Yamileth Canello

Theses Digitization Project

The purpose of this study was to find effective outreach methods to the Hispanic population to empower them to seek mental health services when they need them. Hispanics seek mental health services at a lower rate than mainstream America. This community is the most rapidly growing in San Bernardino County, and lack of early intervention when necessary may have costly consequences to Hispanics and society as a whole.

Seriously Mentally Ill Clients' Perspectives On Substance Use And Treatment, Ann Laverne Jankowski

Theses Digitization Project

The purpose of this study was to interview individuals with co-occurring disorders, who attend Dual Diagnosis Anonymous groups, to obtain their perspectives on the consequences and effects of substance use on their mental illness and their lives; their participation in and evaluation of treatment, and their willingness to stop, reduce, or continue to abstain from substance use.

Perceptions About The Effectiveness Of Play Therapy Among Parents, Maria Nina Joy Malasig Flores

Theses Digitization Project

This thesis will explore the perceptions about the effectiveness of play therapy among parents. This study will work with Bilingual Family Counseling Services, (BFCS) in Ontario, with their school based program. Their school based program runs throughout the Montclair and Ontario school districts and helps counsel children with behavioral problems who are from 5-12 years of age with play therapy. The issue that will be addressed in this study is to find out through the perception of the parent whether or not play therapy has been effective with their child. This study will survey parents about their child's progress throughout …

Barriers That Affect The Under Utilization Of Mental Health Services Among Foster Children, Haneen Sabah Alghita, Denise Nunez

Theses Digitization Project

There are many barriers that interfere with the utilization of mental health services which include instability of the foster child, county/budget restrictions, racial/ethnic inequality, delivery of service, lack of knowledge and understanding of mental health needs, inadequate training on mental health needs for children among foster parents, social worker caseload and lack of communication between Foster Care Social Worker (FCSW) and County Social Worker (CSW). The purpose of this research is to examine the various barriers that affect the under-utilization of mental health services among foster children. Participants included foster parents recruited from Riverside and San Bernardino County who are …

Parental Substance Abuse Services That Promote Family Reunification Under Adoption And Safe Families Act Timelines, Omeera Qadir

Theses Digitization Project

Parents involved in the child welfare system often receive substance abuse services. However, the Adoptions and Safe Families Act (ASFA) time frames for permanency may not be addressing all of the long-term needs of families who are involved within the system. The purpose of this research study was to assess the effectiveness of substance abuse services in promoting family reunification under the ASFA timelines for parents whose children are dependents of the Juvenile Court. The primary information being analyzed was the case files of 50 families who were involved in Riverside County Department of Public Social Services (DPSS), Children's Services …

The Effects Of Immediate Follow-Up On Psychiartric Rehospitalization Rates, Jennifer Erin Mccreight

Theses Digitization Project

The purpose of this study was to examine the effects of an immediate post hospitalization follow-up intervention on the rehospitalization rates of consumers of public mental health services with a classical experimental design. The intervention involves reinforcing the discharge plan, providing psychoeducation, encouraging medication adherence, and triaging each discharged client for additional needs.

Hispanics' Experience With Hospice Care, Maria Rosario Diaz

Theses Digitization Project

The purpose of this project was to learn about Hispanic's experience with hospice care and gain insight into their unique needs. The findings will offer Hospice programs with information on how to provide the most appropriate care to the Hispanic population. This study found that the quality of patient care transcended cultural and spiritual boundaries.

Substance Abuse Among The Aging Population: A Needs Assessment, Stephen Michael Clark

Theses Digitization Project

This needs assessment was composed of 33 clinicians' in Riverside and San Bernardino counties that work in the substance abuse field. This study was developed to test if there is a need to increase clinicians' knowledge level base when working with older adults age 65 plus with a substance abuse problem. This needs assessment looked at demographics and tested the differences between self reported knowledge and what instruments their agencies are currently using.

Perceptions Of Breast Cancer Patients On Communicating Sexuality-Related Issues, Farrah Joy Oblepias

Theses Digitization Project

The research project focused on the perceptions of breast cancer patients on addressing sexuality-related issues to their health care provider. A female breast cancer survivor is likely to have low sexual functioning when experiencing change in hormonal status, problems in partner relationships, and vaginal dryness. Moreover, women who undergo a mastectomy due to breast cancer had difficulties in their self-image and their sexual relationship with men.