Medicine and Health Sciences Commons^™

Social And Cultural Processes That Impact Physical Activity Among South Asian Americans Managing Hypertension: A Mixed Methods Study, Sugandha Gupta

Dissertations, Theses, and Capstone Projects

Cardiovascular disease (CVD), the number one cause of death in the U.S., disproportionately affects South Asian Americans (SAAs). Physical activity is a modifiable health behavior that can reduce cardiovascular risk. Health behaviors, such as physical activity, occur within specific social and cultural contexts and are influenced by multiple factors at multiple levels of the social ecological model. This dissertation aimed to provide a rich, culturally-informed understanding of the factors at multiple levels – individual, interpersonal, and cultural –associated with physical activity among SAAs at risk for CVD. A sequential exploratory mixed methods approach was employed to examine social and cultural …

The Impossible Situation? Impasse As Psychotherapeutic Paralysis, Possibility, And Progress, Leo Cancelmo

Dissertations, Theses, and Capstone Projects

Psychotherapeutic impasse has long been understood in the clinical literature as treatment stagnation and even failure, both from one-person and two-person psychodynamic perspectives. However, there is a dearth of empirical research that delves deeper to understand this complex and rich phenomenon. Using semi-structured interviews with nine psychodynamic therapists speaking about individual adult patients, this study examined experiences of impasse to better understand treatments that become embroiled in a kind of paralysis. Qualitative analyses revealed dyads where patients were conceptualized as struggling chronically with negative feelings about themselves and others, and who experienced traumatic personal histories. Impasse in and of itself …

A Survey Study Of Speech-Language Therapists’ Experiences With Teletherapy At The Onset Of The Covid-19 Crisis, Jason A. Rosas

Dissertations, Theses, and Capstone Projects

The present study aimed to understand how delivering pediatric treatment services via ‘teletherapy’ affected speech-language therapists (SLTs) during the initial outbreak of the COVID-19 pandemic crisis in 2020. SLTs reported on their experiences with the change from in-person to remote service delivery via two national surveys distributed at the start of the pandemic between April 2020 and July 2020. To explain SLTs’ survey responses, this dissertation introduced the Professional Adaptation Model (PA Model). The PA Model facilitated evaluation of the SLTs’ professional environment and the psychological constructs of their professional identity believed to influence the transition to speech-language teletherapy. Specifically, …

Effects Of Chronic Stress On Safety Processing And Physiology In The Medial Prefrontal-Amygdala-Basal Forebrain Circuit, Itamar S. Grunfeld

Dissertations, Theses, and Capstone Projects

Chronic stress increases generalization of fear to non-threatening cues, a key symptom in numerous psychiatric mood disorders. However, the mechanisms through which stress impacts safety learning remain poorly understood. To probe the relationship between stress and safety learning, this dissertation employed multiple behaviors, in conjunction with in-vivo multisite physiology during explicit safety and fear discrimination learning. In Chapter 1, I outline the role of chronic stress in driving neurological adaptations that result in generalized fear and highlight how this occurs because of impaired safety cue encoding. In Chapter 2, I show that chronic stress in the form of social defeat …

Discrimination, Psychological Well-Being, And Racial Importance In U.S. Native-Born And Caribbean Black Americans, Jaime E. Mccaw

Dissertations, Theses, and Capstone Projects

Objective: The present study examines the experiences of perceived discrimination and psychological well-being among two non-Hispanic Black American ethnic groups, Black Americans whose sole known country of origin is the United States and Black Americans with Caribbean heritage. Lifetime and everyday discrimination, life dissatisfaction, low self-esteem, hopelessness, and psychological distress are explored for each group. The impact of racial identity importance on each of these experiences is explored through self-identification with an identity that is defined racially or nationally (e.g., Black, American, or both equally), and the interaction between ethnicity and sex is considered.

Methods: Data are from adults recruited …

Reducing Fear Overgeneralization With Safety Learning: Attention Bias As A Moderator, Boyang Fan

Dissertations, Theses, and Capstone Projects

Anxiety disorders are the most prevalent mental health condition and affect one out of nine individuals around the world. Fear generalization is a neurocognitive mechanism thought to maintain and exacerbate anxiety, and thus is an important target of therapeutic interventions. Yet, intervention research and practice place relatively little emphasis on its importance. Given that a significant proportion of individuals do not respond to extant treatments of anxiety disorders, a strengthened focus on fear generalization may inform the development and personalization of new treatment approaches. Recent notions have linked fear generalization to failures in distinguishing between signals that predict the occurrence …

Effects Of Prenatal Cannabis Exposure On Offspring Emotional Development And Stress Response, Alexandra Pritchett

Dissertations, Theses, and Capstone Projects

While cannabis may be used by women during pregnancy, its effects on their offsprings’ developing stress response system are still largely unknown. The binding sites for the active chemicals in cannabis are operational at early time points in fetal development and are expressed in key limbic brain structures. The body’s natural endocannabinoid system serves as an important regulator of the stress response. Longitudinal studies have associated prenatal exposure with increased fearfulness and mood disturbances in offspring, but, despite the growing evidence of emotional dysfunction, there remains a critical gap in knowledge explaining how early prenatal exposure may lead to future …

Training And Individual Predictors Of Attitudes Toward Serious Mental Illness Amongst Clinical Psychology Doctoral Students, Lauren K. O'Connor

Dissertations, Theses, and Capstone Projects

Clinical psychologists are grossly underrepresented in treatment provision for individuals with serious mental illness (SMI; Roe, Yanos, Lysaker, 2006). Systemic (e.g., emergence of managed care) and training-based (e.g., limitations to SMI specific training) factors contribute to the establishment of this underrepresentation, while mental health stigma amongst psychologists may play a role in perpetuating it. Many individual and experiential factors have been found to impact clinicians’ attitudes toward those with SMI (Henderson et al., 2014; Schulzes, 2007). Though many of these factors are present and relevant from the beginning of one’s career and may involve elements related to training, little research …

A Randomized Controlled Trial Of Psychological Outcomes Of Mobile Guided Resonant Frequency Breathing In Young Adults With Elevated Stress During The Covid-19 Pandemic, Al Amira Safa Shehab

Dissertations, Theses, and Capstone Projects

Deep breathing practices have shown promise in reducing stress, anxiety, and depression in different populations, including young adults. Specifically, resonant frequency breathing can exert an impact on stress response systems through the vagus nerve and the hypothalamo-pituitary-adrenal (HPA) axis. This may induce reductions in stress and improvement in emotion regulation. Young adults, including college students, tend to be at a higher risk for psychological distress, as they face several psychosocial challenges. The COVID-19 pandemic has imposed new and unique stressors that resulted in higher levels of stress and emotional symptoms and it has been shown that this may have placed …

Informed Consent: Foundations And Applications, Joanna Smolenski

Dissertations, Theses, and Capstone Projects

Since its advent in the 20th century, informed consent has become a cornerstone of ethical healthcare, and obtaining it a core obligation in medical contexts. In my dissertation, I aim to examine the theoretical underpinnings of informed consent and identify what values it is taken to protect. I will suggest that the fundamental motivation behind informed consent rests in something I’ll call bodily self-sovereignty, which I argue involves a coupling of two groups of values: autonomy and non-domination on the one hand, and self-ownership and personal integrity on the other. I will then go on to consider two 'case …

Food Restriction And Body Image Distortion In Pregnant Mothers: Outcomes For Exposed Children, Kathryn M. Dana

Dissertations, Theses, and Capstone Projects

Background: Developmental trajectories in the growing child do not originate at birth. Rather, critical periods may exist in pregnancy, during which the determinants of malnutrition are especially vulnerable to the effects of stress and other complications. Prenatal malnutrition has been consistently associated with negative consequences for the growth, development, and overall physical and mental health of affected offspring in both human and animal models. While most available literature on human prenatal malnutrition comes from famine research, there is some evidence that restrictive eating disorders in pregnant women may be associated with similar outcomes.

Hypotheses: We hypothesize that prenatal exposure to …

Overcoming Challenges In The Assessment And Treatment Of Problem Behavior In Adults With Autism, Julia A. Iannaccone

Dissertations, Theses, and Capstone Projects

Problematic behaviors, such as self-injurious behavior or aggression, demonstrated by adults with autism spectrum disorder (ASD), create many significant life complications, some life-threatening. Applied Behavior Analysis (ABA) is established as an evidence-based approach to treat problem behavior for children with ASD and shows promise as an effective treatment for adults, yet little research has been conducted within the adult population. Assessment and treatment of problem behavior with adults is often challenging due to funding limitations, increased severity and complexity of problem behavior, and underqualified staff. The purpose of the present study was to overcome these challenges by (1) identifying a …

Attachment, Exploration, And Internalized Homonegativity, Gregory J. Gagnon

Dissertations, Theses, and Capstone Projects

Background: Internalized homonegativity (IH; a.k.a. internalized homophobia), has been implicated in health disparities between lesbian, gay, and bisexual persons (LGBs) and their heterosexual peers. Yet, little available research has explored factors that may increase or decrease IH.

Objective: This dissertation investigates relations between child and adult attachment and IH. It further examines the mediating and moderating roles of exploration and mentalization, respectively, in the attachment–IH relation.

Method: One hundred fifty cisgender LGB adults participated in two waves of an online survey. The first assessed recalled child–maternal and child–paternal attachment and current attachment to the romantic partner. The second, conducted two …

Object Relations, Identity Formation, And Transitional Space In Religious Conversion, Arielle Rubenstein

Dissertations, Theses, and Capstone Projects

Conversion between broad religious groups is a life transformation undertaken by 15% of Americans, yet it has seldom been studied closely from a psychodynamic perspective. The psychological study of conversion began with a Protestant paradigm of sudden and total transformation of the self, and over time came to characterize different manifestations of conversion to more diverse religious groups. Research on conversion has primarily sought to understand whether conversion is essentially a psychopathological phenomenon, and has led to a multiplicity of both positive and negative, at times contradictory, findings. Research has shown that conversion is associated with insecure attachment, neurotic personality …

The Impact Of A Single Session Of Mindfulness Meditation On The Attentional Blink In Non-Meditators, Arielle L. Klopsis

Dissertations, Theses, and Capstone Projects

Attentional resources are limited therefore a stimulus can go undetected if it closely follows another target by 200-500ms. This phenomenon is known as the attentional blink. Mindfulness meditation has been shown to be beneficial in target detection and in decreasing the attentional blink. Since there is no standard for the type of meditation or duration of practice that leads to attention benefits, this study compares the two most popular types of meditation in a group of non-meditators: focused attention and open monitoring meditation. This study utilized an attentional blink paradigm to measure if a single session of mindfulness meditation can …

The Development Of Face Morphing Task To Assess Self Other Differentiation, Esen Karan

Dissertations, Theses, and Capstone Projects

Self-Other Differentiation (SOD) refers to a developmental process of acquiring a consolidated, integrated, and individuated sense of self. SOD develops at a) perceptual (e.g., facial perception) and b) representational (e.g., traits, mental states, and beliefs) levels. Impairments in representational SOD (R-SOD) are associated with many forms of psychopathology, particularly borderline personality disorder (BPD) and narcissistic personality disorder (NPD). Few studies to date have examined the perceptual aspects of SOD (P-SOD), which are hypothesized to develop from infancy onwards in tandem and in interaction with R-SOD. Given that the human face is one of the key characteristics that humans use to …

Emotion Processing Deficits In Psychopathy: Does Cueing To Relevant Facial Features Increase Cognitive And Emotional Empathy?, Shawn E. Fagan

Dissertations, Theses, and Capstone Projects

Psychopathy is a multifaceted disorder characterized by a lack of cognitive and emotional empathy. The traditional model of psychopathy divides the disorder into two factors: Factor 1 consists of the interpersonal and affective traits of psychopathy while Factor 2 measures antisocial behaviors and lifestyle choices. The attention-to-the-eyes hypothesis argues that psychopathic individuals have impaired emotion recognition (specifically for fear) due to deficits in orienting attention to salient facial features like the eyes. Psychopathic individuals also display blunted autonomic responding to emotional stimuli, though whether this is due to attention-orienting deficits remains to be clarified. The present project investigated whether empathy-related …

Does Ethnic Identity, In-Group Preference, And Acculturation Protect Latinas With A History Of Interpersonal Trauma From Developing Symptoms Of Ptsd?, Evelyn M. Ramirez

Dissertations, Theses, and Capstone Projects

Previous research suggests ethnic identity, a sense of belonging to a particular cultural group, may be protective against symptoms of post-traumatic stress disorder (PTSD). However, the role of ethnic identity, in-group preference (i.e., an individual’s preference for interactions with members of their own ethnic group) and acculturation (i.e., the level of comfort with the mainstream culture) have not been investigated as protective factors for Latinas with a history of interpersonal and sexual trauma. In this study, ethnic identity, in-group preference and acculturation were assessed via self-report on the Scale of Ethnic Experience in two samples of undergraduate Latina and non-Latina …

Impact Of Religiosity And Level Of Acculturation On Cultural Alignment: An Exploration Of Terror Management Mechanisms Among Muslim American Women, Farah T. Goheer

Dissertations, Theses, and Capstone Projects

ABSTRACT

Impact of Religiosity and Level of Acculturation on Cultural Alignment: An Exploration of Terror Management Mechanisms among Muslim American Women

by

Farah Taha Goheer, M.A.

Advisor: Joel Sneed, Ph.D.

Background: Terror management theory (TMT) is based upon the notion that human beings require ongoing psychological protection from the unyielding, existential threat of death. A large body of evidence has shown that human beings manage death-related terror by aligning with and endorsing the dominant views of their cultural worldviews. Notably, as immigrants experience a new culture, worldviews become rearticulated to incorporate elements of host and heritage cultures. However, it is …

Clinical Characteristics And Neuroanatomical Predictors Of Acute Antidepressant Outcome For Patients With Comorbid Depression And Mild Cognitive Impairment, Jeffrey N. Motter

Dissertations, Theses, and Capstone Projects

Background: Older adults presenting with both a depressive disorder (DEP) and cognitive impairment (CI) represent a unique, understudied population. The classification of cognitive impairment severity continues to be debated though it has recently been subtyped into late (LMCI) versus early (EMCI) stages. Previous studies have found associations between treatment outcome and both cortical thickness and white matter hyperintensities (WMH), though report inconsistent directionality and affected regions. In this study, we examined baseline clinical characteristics and neuroanatomical features as prognostic indicators for older adults with comorbid DEP and CI participating in an open antidepressant trial. EMCI is hypothesized to have greater …

Mindfulness In Medicine: Modified Mindfulness-Based Stress Reduction (Mbsr) Program Among Future Doctors, Virtue Sankoh

Dissertations, Theses, and Capstone Projects

Medical trainees are at particular risk for stress-related illness, including mental health problems such as suicidal ideation, substance abuse, and mood disorders. A vast literature on mindfulness-based stress reduction (MBSR), consisting of mindfulness education and structured meditative practices, has consistently demonstrated that MBSR and related mindfulness-based interventions improve mental and physical health, as well as one’s overall sense of well-being. Moreover, theorists and researchers have begun to suggest further that mindfulness plays a particular role in social cognition, or social-emotional learning. Medical schools have long been interested in ways to improve the “soft skills” related to interpersonal connectedness that are …

Diagnosing The Will To Suffer: Lovesickness In The Medical And Literary Traditions, Jane Shmidt

Dissertations, Theses, and Capstone Projects

Throughout Western medical history, unconsummated, unreturned, or otherwise failed love was believed to generate a disorder of the mind and body that manifested in physiological and psychological symptoms. This study traces the medical and literary history of lovesickness from antiquity through the 19^th century, emphasizing significant moments in the development of the medical discourse on love. The project is part of the recent academic focus on the intersection between the humanities and the medical sciences, and it situates literary texts in concurrent medical and philosophical debates on afflictions of the psyche. By contextualizing the fictional works within the scientific …

Casualties Of Racism: Racial And Ethnic Discrimination And Suicidal Thoughts And Behaviors Among Racial And Ethnic Minority Emerging Adults, Lillian Anais Polanco

Dissertations, Theses, and Capstone Projects

The evidence demonstrating that experiences of racial/ethnic discrimination is detrimental to the mental health of racial/ethnic minority youth is unequivocal. What remains unclear, however, is whether racial/ethnic discrimination increases vulnerability for suicidal thoughts and behaviors in particular, and if so, what are the underlying mechanisms to explain this relation. Drawing upon the Race-based Traumatic Stress Theory (Carter, 2007), which suggests that some individuals may experience racial/ethnic discrimination as a traumatic stressor, and thus, eliciting a traumatic stress response, the present study examined posttraumatic stress reactions (i.e., posttraumatic stress, depression, dissociation, stress sensitivity) as mediators in the relation between racial/ethnic discrimination …

Underlying Contribution Of Executive Functioning To Cognition And Academic Achievement In Individuals With Dystrophinopathy, Robert Fee

Dissertations, Theses, and Capstone Projects

Dystrophinopathy is a genetic disorder that results in the lack of or abnormal expression of the protein dystrophin. It is a disorder that alters cell structure and function, impacts the developing brain and brain function, presents with multi-domain cognitive deficits, and influences both mood and behavior. Cognitive impairments appear to be more localized to specific areas of functioning rather than a global deficit; however, deficits have been identified across multiple cognitive domains including language and aspects of executive functioning. A careful examination of the cognitive phenotype and its association to mutations affecting CNS isoforms is necessary to clarify the neuropsychological …

What’S Your Story? Assessing Childhood Maltreatment Using The Thematic Apperception Test In An Adult Inpatient Population., Thachell C. Tanis

Dissertations, Theses, and Capstone Projects

There is a robust evidence that childhood maltreatment contributes to the development of adult psychopathology (Brown & Anderson, 1991; Johnson, Cohen, Brown, Smailes, & Bernstein 1999; Johnson, Smailes, Cohen, Brown, & Bernstein, 2000; Ruggiero et al., 1999). However, the identification of childhood maltreatment remains a methodological problem that results in inconsistencies in the reported incidence and psychological sequelae of maltreatment. A primary method for identifying histories of childhood maltreatment among adults is retrospective self-report measures which are susceptible to multiple biases (Briere, 1992; Cicchetti & Rizley, 1981; Shaffer, Huston, & Egeland, 2008). This present study suggests that childhood maltreatment can …

Dancing, Mindfulness, And Our Emotions: Embracing The Mind, Body, And Sole, Alisha M. Collins

Dissertations, Theses, and Capstone Projects

This capstone project examines dance, as an intervention and mindfulness practice that assists with managing our emotions. There is a need for dance therapy in social institutions such as, healthcare facilities, schools, and community centers. Dance therapy has the potential to reduce negative emotions, create mindfulness, improve self-expression, and promote a healthy well-being. I am proposing that dance therapy is applied as a regular practice in social institutions to develop mindfulness and promote emotional stability.

In this study, I argue that dance therapy can contribute to our well-being long term. In addition to this written thesis, a visual component of …

Memory In Memoir & Biography: Science, Place, And Agency, Johnathan E. Longo

Dissertations, Theses, and Capstone Projects

This thesis explores modern scientific understanding of memory in humans and how it affects works of life writing. Scientific research shows that memory is unreliable and often misunderstood by the general public, and this has implications for different forms of life writing. This paper uses biographies, memoirs, and hybrid forms of life writing to explore how memory, with all its limitations, is used in service of a life story. How do writers of these sub-genres use memory and why are those strategies different from one another? Questions of agency and authority over written and spoken material make the issues still …

Psychosocial Correlates Of Post-Traumatic Stress Disorder Symptoms And Well-Being Among Hispanic World Trade Center Rescue And Recovery Workers, Dianne Ciro

Dissertations, Theses, and Capstone Projects

Thousands of first responders are estimated to have endured extremely distressing experiences during their recovery efforts at the 9/11 World Trade Center (WTC) site. While the effects of 9/11 continue to be studied, few studies have examined how rescue and recovery workers have been coping since 9/11 and how their coping is associated with their psychological well-being. Moreover, we do not know how distinct coping patterns may be associated with post-traumatic growth, experiences of positive emotion, or quality of life among WTC responders.

This study compared coping differences among Hispanic, Non-Hispanic White, and Non-Hispanic Black first responders. In addition, it …

A Conceptualization Of The Body In Psychodynamic And Body-Based Psychotherapies: Areas Of Overlap And Possibilities For Integration, Aleksandra Rayska

Dissertations, Theses, and Capstone Projects

The distinction between verbal and nonverbal psychotherapies is clearly visible in theory and clinical practice. Moreover, this duality of approaches promotes a split between the body and the mind, defining them as separate from each other. This dissertation helps bridge the divide between the literature in body-based therapies and verbally-based psychotherapy by (i) exploring the conceptual frame used to understand the body in psychodynamic therapy (ii) identifying the areas of overlap between psychodynamic theory and theories that underlie body-based psychotherapies, and (iii) proposing ways in which psychodynamic and body-based theories can inform one another. A clinical case was used to …

Cortical Thickness Abnormalities Within The Salience And Reward Networks In Older Depressed Adults With Apathy, Monique A. Pimontel

Dissertations, Theses, and Capstone Projects

Background and Significance: Apathy is a common comorbidity in late-life depression. Among older depressed adults, apathy is associated with a number of adverse outcomes, including increased disability, comorbid illness, and mortality. The etiological substrates of apathy in late-life depression nonetheless remain poorly understood, and little is known about its optimal treatment. To this end, the aim of the current study was to examine cortical abnormalities within the salience (SN) and reward networks (RN), two brain systems involved in the processing of incentive salience that may underlie the syndrome of apathy in older depressed adults.

Methods: We examined the association between …