Mental and Social Health Commons^™

Exploring Factors In The Relationship Balance Assessment, Thomas B. Luttrell

Loma Linda University Electronic Theses, Dissertations & Projects

While studies have highlighted the role of gendered power in relationships, many assumptions have not been quantitatively tested due to a lack of measures for power. This study uses exploratory factor analysis to construct a dyadic assessment of relative power and equality in relationships. This assessment would be useful for research and for clinical work with couples to help raise awareness of the balance of power in their relationship. Equality is defined as a mutual process in which both partners demonstrate that they hold equal value in the relationship, whereas inequality is when there is a relative imbalance of value …

Getting To The Doctor: Bpss Factors Of Health Care Utilization In Fragile Families, Veronica P. Kuhn

Loma Linda University Electronic Theses, Dissertations & Projects

The number of fragile families where a child is born to unwed parents has increased greatly over the past half-century and now represents a diverse population in the United States (Ventura, 2009). These families, who are predominantly African American and Hispanic (Hummer & Hamilton, 2010) and are more likely to live in poverty and experience poorer health, face significant barriers to access and utilize health care services (De Marco & De Marco, 2009; Williams, 2008). Limited research exists on how these facets of the illness experience might differ for fragile families whose resources are limited prior to illness. The Biopsychosocial …

Paternal Depression In The Peripartum Period: An International Delphi Study, Cassidy J. Freitas

Loma Linda University Electronic Theses, Dissertations & Projects

This dissertation aims to reach consensus on the defining factors of Paternal Peripartum Depression (PPPD) as well as identify research priorities through the Delphi method. Peripartum Depression is a major health issue for parents and their children. Fathers are at risk for peripartum depression due to the changes in identity, relationship, and biology they face during their transition to parenthood. A father’s mental health plays an intimate role in the overall health and outcomes of his family, but up until this point has been significantly overlooked. Due to the paucity of research and lack of clear consensus on the identifying …

Becoming An Ally: Multi-Family Group Therapy Pilot With Low-Income Families, Julie Virginia Estrella

Loma Linda University Electronic Theses, Dissertations & Projects

The increasing demand for couple and family therapists (CFT) in integrated health care settings requires CFTs to learn to effectively serve low-income families. Resilience literature suggests that building families’ resilience and social support directly impacts a family’s chances for socioeconomic mobility. Multi-family group therapy (MFGT) offers an effective vehicle for increasing resilience and social support. This dissertation examines the link between family resilience and poverty and presents an ecological, solution-focused, family resilience lens applied through a pilot MFGT program, Bouncing Forward Family (BFF) Groups, for low-income families. This dissertation includes two publishable papers, and the first focuses on the BFF …

Music Listening As Therapy, David M. Rosenblatt

Loma Linda University Electronic Theses, Dissertations & Projects

Music is a universal phenomenon and is a real, physical thing. It is processed in neural circuits that overlap with language circuits, and it exerts cognitive, emotional, and physiological effects on humans. Many of those effects are therapeutic, such as reduced symptoms of physical and mental ailments. Music is the result of the elements rhythm, melody, harmony, timbre, dynamics, and form. Rhythm is the focus of pop music, and melody is the focus of classical music. The mind perceives and organizes music in learned, consistent ways in order to generate predictions and extract meaning. There are perceptual laws and information …

Developing Dyadic Measurements In Marriage And Family Therapy: The Dyadic Supervision Evaluation, Adrian Avila

Loma Linda University Electronic Theses, Dissertations & Projects

This study applies integrative developmental theory and a common factors approach in evaluating and describing how Marital and Family Therapy trainee’s progress in mastering the core competencies set forth by the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) through the process of clinical supervision. More specifically, this project evaluates the internal reliability, construct validity, and predictive validity of the Dyadic Supervision Evaluation (DSE). The important role and influence of clinical supervision as well as the next steps for validating and evaluating dyadic, developmental, core competencies and common factors measurements in clinical supervision are discussed.

Communities In Action: Participatory Assessments As An Initial Stage In Critical Consciousness Raising And Community Capacity Building, Carizma Amila Chapman

Loma Linda University Electronic Theses, Dissertations & Projects

This paper presents the findings of two participatory community assessments conducted in Punta Raton and El Venado, two small coastal towns in Southern Honduras. The community assessments were designed and implemented to establish a baseline of community awareness and action, an important step in community development and environmental sustainability. The aim was to: build community partnerships, identify key stakeholders, facilitate dialogues about concerns, identify local and external resources required for progress, and construct actions plans targeting key communal concerns. The assessments were found to be successful in engaging community members and identifying local needs and resources. However, challenges in intervention …

Humor's Effect On Short-Term Memory In Older Adults: An Innovative Wellness Paradigm, Gurinder Singh Bains

Loma Linda University Electronic Theses, Dissertations & Projects

Context: With ageing, the detrimental effects of stress can impair the ability to learn and sustain memory. Humor and the associated mirthful laughter can reduce stress by decreasing the hormone cortisol. Chronic release of cortisol can damage hippocampal neurons leading to impairment of learning and memory. Objectives: To examine the effect of watching a humor video on short term memory in older adults. Design: A randomized, controlled trial. Setting: Loma Linda University, Loma Linda, CA. Participants: 30 subjects: 20 normal healthy, older adults, 11 males and 9 females; 10 Type 2 Diabetic older adults, 6 males and 4 females. Intervention: …

Co-Constructing Cultural Attunement With Latino Clients In Couple Therapy, Marco Antonio Elias-Juarez

Loma Linda University Electronic Theses, Dissertations & Projects

There is a need for culturally attuned approaches for couple’s therapy with Mexican/ Mexican-American people (Falicov, 2009). However, there have been few theoretical frameworks to conceptualize cultural attunement, and attunement has been primarily understood as a skill or as an attitude rather than as a relationship or as a series of clinical concepts with steps to follow (Hoskins, 1999; Oakes, 2011). From the social constructionist perspective, cultural attunement is related to the cultural context and cultural interactions that shape beliefs and attitudes about what is meaningful in establishing deep relationships for Latino and non-Latino therapists and their Mexican and Mexican-American …

Student Healthcare Providers' Illness Narratives: Impact On Family-Focused Care, Lindsey Ann Lawson

Loma Linda University Electronic Theses, Dissertations & Projects

In this study, we interviewed 30 students training for three areas of healthcare: medicine, nursing, and medical family therapy (MedFT). Through grounded theory analysis of these interviews, we looked to understand how these providers connected their own experiences with illness to their clinical work, particularly in including patients’ family members in care. The majority of participants, and especially those in medicine and nursing disciplines, described a tension between their desire to connect with patients and families and their developing definition of professionalism. For others, the impact of students’ personal experiences with illness seemed to provide a different definition of professionalism, …

Effects Of Parental Trauma Experience On Second Generation Cambodian Americans, Sophorn Theam Choau

Loma Linda University Electronic Theses, Dissertations & Projects

This study explores the parent-child relationship between second generation Cambodian Americans (SGCA) and their first generation parents, as reported by SGCA. Specifically this study examined the effects of parental trauma from the Khmer Rouge (Cambodian genocide), on SGCA in relation to SGCA's mental health status, parent-child communication, cohesion, flexibility, and academic achievements. This study was conceptualized through the effects of intergenerational trauma. A quantitative approach was used to analyze the data. Instruments used to measure the variables in the research included Harvard Trauma Questionnaire Revised Cambodian Version (HTQ), Brief Symptom Inventory-18 (BSI-18), Family Adaptability and Cohesion Evaluation Scales (FACES-IV), and …

Study Of Brief Single Session Medical Family Therapy With Low-Income Patients, Mayuri Pandit

Loma Linda University Electronic Theses, Dissertations & Projects

Medical Family Therapy (MedFT) has been promoted as beneficial for vulnerable patient populations. However, there is a need for MedFT effectiveness studies with longitudinal randomized control trials. Thus, this pilot study investigated the results of a brief single session of MedFT over a one-week period with low-income primary care patients. Effectiveness in this study was defined as increasing a sense agency and communion and decreasing psychological distress. Results suggested that over time, MedFT may increase some sense of agency for lower-income patients, increase patient satisfaction with care, increase family support for patients with higher education, and decrease depression symptoms for …

Physician Couples: A Qualitative Inquiry Focused On Gendered Power And Marital Equality, Sarah C. Stuchell

Loma Linda University Electronic Theses, Dissertations & Projects

How couples “do” gender and power in their marriages is a relevant topic for today’s couples. Despite social changes toward equality in many realms, gender continues to organize relationships in ways that give husbands more power than wives. However, some contemporary couples make conscious decisions to resist forces toward organizing according to stereotypical gender ideals and to “do” gender differently in their relationships. For couples in which one or both is a physician, power is also deeply embedded in the physician status, with families tending to organize around the physician’s demands. While these effects reinforce male dominance when the husband …

Maternal Smoking, Weight Status And Preecalmpsia And Eclampsia Risk Among Women Living In San Bernardino County, Fiona Bedelia Lewis

Loma Linda University Electronic Theses, Dissertations & Projects

Preeclampsia is defined as pregnancy-induced hypertension affecting between 2% and 8% of pregnancies and accounting for about 10-15% of maternal deaths worldwide. Eclampsia is defined as the occurrence of one or more episodes of seizures in a pregnant woman related only to a preeclampsia diagnosis. Preeclampsia, if poorly managed, can progress to eclampsia resulting in injury and death to both mother and infant. The etiology of preeclampsia is not completely understood. Oxidative stress leading to abnormal placenta development and endothelial dysfunction are thought to be key components in the biological mechanism of preeclampsia.

Modifiable risk factors include maternal body weight …

Negotiating Marital Care: Co-Creating The Connected Egalitarian Relationship, Lena Lopez Bradley

Loma Linda University Electronic Theses, Dissertations & Projects

Research suggests that couples seek connection and equality within the marital relationship, yet they continue to struggle due to the continued impact of traditional gender ideologies (Coontz, 2006; Knudson-Martin & Mahoney 2009). The current body of literature reveals little about how specific relational negotiation practices contribute to attaining an equal and connected relationship over time. This study utilizes grounded theory methodology and a feminist social constructionist framework to explore how traditional gender constructs impact couples’ ability to negotiate connected egalitarianism within relationship over time.

The analysis of 68 interviews with two sets of couples—parents of children 5 years old and …

Buffering Effect Of Relational Support In African American Marriages, Aimee Galick

Loma Linda University Electronic Theses, Dissertations & Projects

Racial discrimination is a common experience for African Americans in this country. Racial discrimination can have a negative effect on the physical and mental health of marital partners, as well the quality and stability of the relationship. Few studies investigate relational support as an important coping strategy. Bodenmann's (1995) divorce-stress model asserts that positive dyadic coping strategies such as relational support can buffer partners and marriages from the negative consequences of stress. Socio-emotional relational therapy (SERT) provides marital and family therapists with a model of relational support in couple relationships. SERT's definition formed the basis for the conceptualization of relational …

Couple's Relationship With Diabetes: Transformation, Partnership, And Management, Ruth Houston Barrett

Loma Linda University Electronic Theses, Dissertations & Projects

This study used an MFT perspective to examine a model of three bio-psychosocial constructs, seeking to depict key dimensions of what makes couples successful in managing the demanding self-care regimen of diabetes. The model includes a meaning and emotion-oriented construct called relationship with diabetes, a psychosocial relational construct of diabetes-specific partnering support, and their direct and indirect effects on an endogenous construct of success in diabetes management. Surveys from 118 adult couples with diabetes provided data to test the hypothesized path and measurement model. Correlational and multiple regression analysis examined variable relationships, factor analysis examined construct dimensionality, and structural equation …

Second Generation Korean-American Parents: Social Context Influence On Parenting, Lana H. Kim

Loma Linda University Electronic Theses, Dissertations & Projects

Korean-American families are an underrepresented group within the family therapy literature. In particular, the realities and lived experiences of American born second generation Korean-American parenting couples is limited. Therefore, this qualitative grounded theory dissertation used a social constructionist lens to understand how American born second generation Korean-Americans, raised amidst contrasting Korean and western cultural ideologies, conceptualize parenting and position themselves in relation to their children within parent-child relationships. Semi-structured interviews were conducted with 20 parenting couples of children between 0-10 years of age to illuminate ways in which multiple cultural discourses, bicultural socialization, and racialized experiences influence the parenting process. …

Second Generation Korean-American Parents: Social Context Influence On Parenting, Lana H. Kim

Loma Linda University Electronic Theses, Dissertations & Projects

Korean-American families are an underrepresented group within the family therapy literature. In particular, the realities and lived experiences of American born second generation Korean-American parenting couples is limited. Therefore, this qualitative grounded theory dissertation used a social constructionist lens to understand how American born second generation Korean-Americans, raised amidst contrasting Korean and western cultural ideologies, conceptualize parenting and position themselves in relation to their children within parent-child relationships. Semi-structured interviews were conducted with 20 parenting couples of children between 0-10 years of age to illuminate ways in which multiple cultural discourses, bicultural socialization, and racialized experiences influence the parenting process. …

Relational Interdependent Self Construal, And Spiritual Maturity As Predictors Of Marital Satisfaction, Conroy Everton Reynolds

Loma Linda University Electronic Theses, Dissertations & Projects

This study examined the extent to which relationality is implicated in relationship satisfaction. Specifically, this study examined the role of two relational variables, Spiritual Maturity and Relational Interdependent Self Construal, in predicting the variance in marital satisfaction, after controlling for number of children, religion, employment status, education, length of marriage and household income among married heterosexual couples in Antigua. The Caribbean Island of Antigua is comprised primarily of persons of African descent, deeply religious, but who are influenced by western ideas and values. The results of this study reveal the importance of spirituality but not relational self- construal as a …

Successful Again Through A Family Resilience Lens, A'Verria Sirkin Martin

Loma Linda University Electronic Theses, Dissertations & Projects

This study examined successful aging through a family resilience lens by developing a psychometrically tested assessment that can be used to measure family and individual resilience in a population of older adults and by then applying these latent structures to predict successful aging across four domains; self-rated successful aging, psychosocial health, cognitive decline, and physical health. Data from 1,006 older adults were analyzed in three steps. The first identified the underlying latent structure through principle component (exploratory) factor analysis (EFA). The second included the use of confirmatory factor analysis to validate the structure from the first step. The third utilized …

Engaging Men: Optimum Transformation Conditions For Domestic Violence Offenders, Benjamin Pierre Scott

Loma Linda University Electronic Theses, Dissertations & Projects

This study explored which conditions are optimal for supporting domestic violence offenders in reducing recidivism thereby enabling long-term sustainability of healthy relationships. This study’s objectives were to identify the role of current interventions in creating optimal conditions for change in domestic violence offenders, determining what motivational strategies are effective in producing meaningful engagement in treatment, identifying relational treatment methods and processes that are (are not) effective in reducing domestic violence recidivism, and what is needed programmatically to be effective in decreasing recidivism. Qualitative data from semi-structured interviews were analyzed using the methodology of grounded theory. Collection and analysis of the …

Development Of A Contextual Model For The Treatment Of Infidelity, Kirstee Williams

Loma Linda University Electronic Theses, Dissertations & Projects

Family systems theory has a history of critique by feminists for ignoring larger societal processes, thus inadvertently assuming equality in processes that are not inherently equal (e. g., Goldner, 1985; Hare-Mustin, 1978). Current research suggests that gendered power processes continue to organize how heterosexual partners relate to each other, making it difficult for couples to build mutually satisfying relationships (Coontz, 2005; Knudson-Martin & Mahoney, 2009). These same societal processes also influence both the etiology of affairs and recovery from them. Therefore, resolution of infidelity involves the interplay of many complex issues, of which gender, power, and culture are part (Williams, …

Building An Mft Outpatient Practice Through Contract Procurement: A Case Study, Anthony T. Alonzo

Loma Linda University Electronic Theses, Dissertations & Projects

[Abstract Not Included]

Trauma Of The Sudden Death Of A Child: The Impact On Couple Relationship, Blessing Okoro Rellias

Loma Linda University Electronic Theses, Dissertations & Projects

A traumatic life event such as the death of a child can be very devastating and confusing for many couples and people tend to respond in different ways to such trauma due to different factors such as gender differences. Research studies have traditionally focused on the personal effects of trauma on individual family members, whereas less attention centered on the systemic outcomes and consequences that trauma has on family functioning especially from the couples' perspective. Previous research has indicated that parents who lost their children to sudden death are likely to have serious mental distress and some disruption in functioning. …

The Grief Experience Of Caregivers When The Child Has A Life Threatening Illness, Avigail Ward

Loma Linda University Electronic Theses, Dissertations & Projects

Using a mixed method approach, this study explored the impact of attachment styles on the grief experience of parents and guardians of a child who has a hematological or oncological illness. The grief experience was evaluated through the lenses of Chronic Sorrow, Ambiguous Loss and Anticipatory Grief. This study was conducted at the Loma Linda University Medical Center Hematology Oncology Pediatric Clinic and was completed by 106 participants who responded to a quantitative survey with open-ended questions. An open-ended questionnaire regarding the impact of the child’s illness on the couple relationship was completed by six couples. The results indicated that …

Marital Experience And Spirituality Among Physician Couples, Elisabeth Vonegen Esmiol

Loma Linda University Electronic Theses, Dissertations & Projects

This study will examine how marital experience and spirituality interact in the lives of physician couples. Physicians’ increasing openness to spiritual issues inherent in treating the ill and suffering (King, 2000; Thorsen, Harris & Oman, 2001), the growing number of women entering the medical profession and becoming physician and dual physician couples (Levinson & Lurie, 2004; Brotherton & Etzel, 2008), and physicians’ work-related stress (Transue, 2004; Wicks, 2006) and the resulting pressures and time constraints on medical marriages (Sotile & Sotile, 2000) make studying this population particularly relevant. Interviews with twenty two married, professional couples, in which at least one …

Yearnings: Stories Of Insecure Attachment And The Journey To Connect To God, John Bracy

Loma Linda University Electronic Theses, Dissertations & Projects

Utilizing grounded theory and the semi-structured interviews of25 participants, this study sought to understand how an insecure attachment affects one's relationship with God. Participants' stories suggested that: I) one's struggle to connect with God was a part of their struggle to connect with others; 2) that experiencing others as safe and responsive contributed to building a more secure attachment with God; and 3) that attachment is less a fixed style and more of an ongoing process: defined as gradual changes made by the participants towards the set-goal of feeling safe and secure. Four major processes were identified: I) finding what …

African Americans With Diabetes: Couples’ Support Program Development Project, Zanetta Fern Carlene Van Putten

Loma Linda University Electronic Theses, Dissertations & Projects

Diabetes is reaching epidemic proportions in the United States with a record 25.8 million diagnosed in 2010 compared to 20.8 million in 2005. African Americans have the highest prevalence of diabetes in the United States. Social support related to medical conditions has been found effective in increasing treatment adherence. The purpose of this study is to gain a clearer understanding of diabetes support within African American couples’ relationships. This study explores the definition of support from the perspective of African American couples when at least one member has been diagnosed with diabetes. Couples were recruited from Riverside and San Bernardino …

How Transnational Couples Deal With Teen Substance Use: A Socio-Contextual View, Alicia Marquez

Loma Linda University Electronic Theses, Dissertations & Projects

Using the lenses of social constructionism and critical feminist theory, this dissertation examines how transnational Mexican couples in the agricultural town of Mecca, Southern California, respond to the crisis created by their adolescent children using illegal substances.

As part of the Contemporary Couples’ Study of Loma Linda University, sixteen

families were interviewed about how this problem affected their lives. The rich stories

collected were analyzed using the Strauss and Corbin (1998) guidelines for qualitative

research, in order to identify grounded theory that would inform services to this population.

Results suggest that these couples’ relationships are organized around the world of …