Open Access. Powered by Scholars. Published by Universities.®
- Discipline
-
- Social and Behavioral Sciences (142)
- Psychology (85)
- Psychoanalysis and Psychotherapy (82)
- Psychiatric and Mental Health (62)
- Substance Abuse and Addiction (50)
-
- Counseling (49)
- Nursing (38)
- Psychiatry and Psychology (36)
- Other Mental and Social Health (29)
- Clinical Psychology (28)
- Counseling Psychology (22)
- Medical Specialties (22)
- Psychiatric and Mental Health Nursing (22)
- Community Health (21)
- Education (21)
- Sociology (21)
- Marriage and Family Therapy and Counseling (16)
- Cognitive Behavioral Therapy (15)
- Public Health (14)
- Child Psychology (13)
- Mental Disorders (13)
- Health Psychology (12)
- Public Affairs, Public Policy and Public Administration (11)
- Public Health and Community Nursing (11)
- Counselor Education (10)
- Psychological Phenomena and Processes (10)
- Social Work (10)
- Arts and Humanities (9)
- Institution
- Keyword
-
- Mental health (14)
- Depression (13)
- Mental Health (6)
- Stress (6)
- Anxiety (5)
-
- Attachment (5)
- Behavioral health (5)
- Children (4)
- Military (4)
- Nursing (4)
- Primary care (4)
- Psychology (4)
- Psychotherapy (4)
- Barriers (3)
- Counseling (3)
- Evaluation (3)
- Mindfulness (3)
- PTSD (3)
- Pediatric (3)
- Resilience (3)
- Screening (3)
- Substance abuse--Treatment (3)
- Substance use (3)
- Suicide (3)
- Veterans (3)
- Working alliance (3)
- Addiction (2)
- Adolescent (2)
- Autism (2)
- Behavioral Health (2)
- Publication Year
- Publication Type
Articles 91 - 120 of 285
Full-Text Articles in Mental and Social Health
Intimate Partner Violence Education For High School Students, Morgan Foster
Intimate Partner Violence Education For High School Students, Morgan Foster
Dissertations
Problem Adolescents are at risk for experiencing intimate partner violence (IPV). As early as seventh grade, over half of adolescents have reported being in a romantic relationship. Adolescent screening for and education of IPV is minimal, and only the Healthy Relationships Quiz developed by the U.S. Department of Health and Human Services [HHS] screens young adolescents across all aspects of IPV, including psychological and sexual violence. The purpose of this project was to develop an IPV education plan for high school students in a health course.
Methods An educational lesson plan for IPV was created for high school teachers.
Results …
Clinicians' Use Of Mhealth Applications In Interventions For Substance Use Disorders, James Daniel Bender
Clinicians' Use Of Mhealth Applications In Interventions For Substance Use Disorders, James Daniel Bender
Dissertations
The purpose of the study was to examine how clinicians are identifying, evaluating, and utilizing mHealth apps as treatment adjuncts with their clients who have a substance use disorder. A sample of 93 participants (20 males, 72 females, and 1 not listed) completed measures of demographics and inquiries about their use and evaluation of mHealth apps in their practices. Clinicians who work at mental health centers and private practicing clinicians were recruited. The majority of the sample (71%) reported that they had not utilized mHealth apps with their clients who have a substance use disorder diagnosis. Participants who have attended …
Examining Treatment Acceptability Of An Eight-Week Mindfulness-Based Stress Reduction Protocol, Blake William Palmer
Examining Treatment Acceptability Of An Eight-Week Mindfulness-Based Stress Reduction Protocol, Blake William Palmer
Dissertations
The goal of this study is to examine whether levels of perceived stress, experiential avoidance, personality traits including openness to experience and agreeableness, and demographic variables will predict the treatment acceptability (indicated by responses on the Treatment Acceptability and Adherence Scale) of an eight-week Mindfulness-Based Stress Reduction (MBSR) program. This study collected data in the Spring of 2019. The final number of participants in the study was 116 (40 females, 76 males, Mage = 36, age range: 22-69 years). Participants completed measures including the Perceived Stress Scale (PSS), Acceptance and Action Questionnaire-II (AAQ-II), the agreeableness and openness to Experience domains …
A Quantitative Assessment Of Marital Quality Among Couples In Kerala, India, Grace Kochuparambil
A Quantitative Assessment Of Marital Quality Among Couples In Kerala, India, Grace Kochuparambil
Dissertations
The increasing number of divorces and domestic violence in Kerala, India points out the need to assess marital quality among couples in Kerala. The lack of assessment tools in the native language prevents evaluating Malayali couples' marital relationships. The purpose of the proposed study was to examine couples' marital quality in Kerala and validate the translated Marital Adjustment Questionnaire (MAQ) and Marital Quality Scale (MQS), the M-MAQ and the M-MQS, respectively. The instruments were translated into Malayalam through a forward and backward translation. A quantitative survey research design collected data from a criterion[1]based sample of 260 couples in Kerala using …
Psychological Wellbeing And Sense Of Community Among African Americans: Does Purpose In Life Matter?, Yatesha D. Robinson
Psychological Wellbeing And Sense Of Community Among African Americans: Does Purpose In Life Matter?, Yatesha D. Robinson
Dissertations
This dissertation examined the relationships between sense of community, purpose in life, and psychological wellbeing among African Americans. It investigated whether purpose in life moderated the relationship between sense of community and psychological wellbeing. Although previous studies have linked a sense of community and purpose in life with wellbeing, few studies have examined these relationships among African Americans using a multidimensional model. The data for the current analysis were drawn from the third wave of the National Survey of Midlife Development in the United States study (MIDUS 3), collected between 2013–2014. The sample included 98 African American men (n …
Strategies Exemplary Mental Health Leaders Use To Stay Grounded While Working With Veterans, Audrey Dangtuw
Strategies Exemplary Mental Health Leaders Use To Stay Grounded While Working With Veterans, Audrey Dangtuw
Dissertations
Purpose. The purpose of this explanatory mixed method study was to identify and describe what exemplary mental health leaders in Puget Sound area mental health facilities serving veterans do to maintain their physical, emotional, intellectual, social, vocational, and spiritual health based on the six dimensions of Rosen's (2014) healthy leader model.
Methodology. An explanatory mixed methods approach was selected to allow the triangulation of data to increase the validity of the findings. The study analyzed quantitative surveys to identify how exemplary mental health leaders rate their use of grounded leadership strategies and qualitative semi-structured interviews to identify strategies exemplary mental …
A Descriptive Study Of Health-Related Risks And Outcome Differences By Loneliness Status In A Sample Of Older Veterans, Rachael Beard
A Descriptive Study Of Health-Related Risks And Outcome Differences By Loneliness Status In A Sample Of Older Veterans, Rachael Beard
Dissertations
There is a need to understand the influences and outcomes related to loneliness in veterans living with complex illness. Patients require self-care to manage complications and exacerbations associated with complex illness. Deficits in self-care result in negative health outcomes and drive resource utilization upward. The identification of potential factors related to self-care is important. Loneliness may be one factor that influences patients’ ability and desire to care for themselves. Descriptive correlational design was used to evaluate loneliness both as a predictor and outcome in veterans admitted to the hospital for three complex respiratory illnesses (heart failure, chronic obstructive pulmonary disease, …
Coping Skills, Emotional Intelligence, Attachment, And Resilience On Post-Traumatic Stress Disorder In Private Sector Emergency Medical Technicians, Brenda-Joyce Gonzales Orozco Markert-Green
Coping Skills, Emotional Intelligence, Attachment, And Resilience On Post-Traumatic Stress Disorder In Private Sector Emergency Medical Technicians, Brenda-Joyce Gonzales Orozco Markert-Green
Dissertations
Problem
Private sector Emergency Medical Technicians (EMTs) are first responders who respond to traumatic incident scenes along with firefighters and police officers. However, news agencies and the public do not acknowledge private sector EMTs with the same vigor or accolade as public sector EMTs, nor are the risks to life, health, and mental well-being recognized among this population. Thus, the research literature has been sparse regarding how private sector EMTs experience PTSD, and what unique risk factors and needs may be present.
Purpose Statement
The purpose of this study was to examine the relationship between PTSD symptoms and coping skills, …
Acculturation, Psychological Well-Being And Substance Use Behaviors In Asian Indian Americans, Sonia Y. Amin
Acculturation, Psychological Well-Being And Substance Use Behaviors In Asian Indian Americans, Sonia Y. Amin
Dissertations
The American population is becoming more diversified with increases in the number of immigrants and refugees entering the country. These new Americans bring distinct cultural values, traditions, and worldviews. With this diversity, an important need has arisen to better understand the interplay of culture, physical, and mental health concerns that affect specific racial and ethnic populations. This increase in knowledge and awareness will aid in the development and provision of culturally-sensitive mental health services. The stress of immigration and the multifaceted sociocultural and psychological adaptations involved in adjusting to living in a new country with a Eurocentric dominant culture can …
Demystifying First-Time Mothers’ Postpartum Mental Health: A Phenomenological Study Of The Transition To Becoming A Mother, Megan Dooley Hussmann
Demystifying First-Time Mothers’ Postpartum Mental Health: A Phenomenological Study Of The Transition To Becoming A Mother, Megan Dooley Hussmann
Dissertations
Becoming a mother is a significant life event that can greatly impact maternal mental health. Understanding maternal mental health is an important interdisciplinary goal because it could lead to mother’s receiving better care and support from both mental health and medical professionals. Seven first-time mothers with a baby under the age of one were interviewed for a phenomenological qualitative study, which investigated first-time mothers’ postpartum mental health experiences. This study was guided by two research questions: How do new mothers experience their postpartum mental health in comparison to how they experienced their mental health before having their baby, and how …
Comorbidity And Quality Of Life Of Hiv-Positive Adults Living In Supportive Housing, Rose Sharp
Comorbidity And Quality Of Life Of Hiv-Positive Adults Living In Supportive Housing, Rose Sharp
Dissertations
Problem: Life expectancy for people living with HIV significantly increased with widespread use of antiretroviral therapy, resulting in population increases in comorbidity prevalence. The increased burden of living with both HIV and comorbidities lowers health-related quality of life (HRQoL).
Methods: Using a descriptive, correlational, cross-sectional design, a convenience sample of HIV-positive adults was selected from seven supportive housing communities. Comorbidities were assessed using a modified Self-Administered Comorbidity Questionnaire, and HRQoL using the Patient-Reported Outcome Measurement Information System Scale v1.2 – Global Health.
Results: A sample of 17 (N = 17) adults reported a mean of 4.2 (SD = …
Comparison Study: Trauma-Focused Cognitive Behavioral Therapy And Acceptance And Commitment Therapy For Trauma, Colleen Marie Kirsch Hiltz White
Comparison Study: Trauma-Focused Cognitive Behavioral Therapy And Acceptance And Commitment Therapy For Trauma, Colleen Marie Kirsch Hiltz White
Dissertations
There is a need for more evidenced based treatments for adolescents with trauma related disorders. Currently, Trauma Focused Cognitive Behavioral Therapy (TF CBT) is the gold standard, but clients and clinician need the ability to choose between effective treatments. This study completed a direct comparison between six weeks of treatment in Acceptance and Commitment Therapy for Trauma and TF CBT via telehealth during the COVID-19 pandemic. Treatments were measured using the Clinician Administered PTSD Scale and the Child PTSD Symptom Scale. Both treatments were found to be effective in reducing trauma related symptoms in two 12-year-old females.
Predictors Of Positive Outcomes In Treating Individuals Diagnosed With Idd And Comorbid Psychiatric Disorders, Jacob Omondi Wasonga
Predictors Of Positive Outcomes In Treating Individuals Diagnosed With Idd And Comorbid Psychiatric Disorders, Jacob Omondi Wasonga
Dissertations
The purpose of this research was to evaluate the use of a new treatment protocol, the systemic treatment plan (STP) by identifying the predictors of positive treatment outcomes for individuals diagnosed with intellectual and developmental disabilities (IDD) and comorbid mental health conditions. This study examined the relationship between challenging behaviors, psychiatric conditions, and positive treatment outcomes for individuals with IDD and co-occurring disorders, particularly those individuals whose treatment was driven by the STP. A linear regression analysis was conducted to determine which challenging behaviors and psychiatric disorders best predict positive outcomes in systemically engaged treatment. The results from this study …
First-Time Practicum Students' Lived Experiences Of Case Presentations In Group Supervision: A Phenomenological Study, Jason Blakely Fischer
First-Time Practicum Students' Lived Experiences Of Case Presentations In Group Supervision: A Phenomenological Study, Jason Blakely Fischer
Dissertations
Although best practices of group supervision advise that supervisory methods match the developmental level of supervisees, research has shown that novices typically receive group supervision in the same manner as more experienced trainees. The prevalent use of case presentations in group supervision regardless of learners' level of clinical experience suggests contemporary practicum courses may be overlooking beginning students' unique, developmental characteristics and needs. Fifteen counseling students enrolled in CACREP-accredited master's degree programs across the United States were interviewed for a phenomenological study exploring their experiences of case presentations in practicum. Synchronous interviews conducted over video conferencing examined participants' emotional experiences …
Life After Menopause: Quality Of Life In Women Diagnosed With Polycystic Ovarian Syndrome After The Childbearing Years, Katelyn Baker
Life After Menopause: Quality Of Life In Women Diagnosed With Polycystic Ovarian Syndrome After The Childbearing Years, Katelyn Baker
Dissertations
Very little research has been conducted in regards to what happens after a woman diagnosed with PCOS is menopausal or post menopausal. This study researched the quality of life in women with PCOS before and after menopause in an attempt to compare the two groups.
Relationships Between Professional Development And Attitudes, Knowledge, And Skills In Play Therapy Among Counselors, Cynthia Ann Anderson
Relationships Between Professional Development And Attitudes, Knowledge, And Skills In Play Therapy Among Counselors, Cynthia Ann Anderson
Dissertations
Most counselors receive inadequate training in play therapy, through university counselor education programs, to counsel children using the method, which leaves novice counselors searching for workshops, institutes, conferences, or self-training to effectively meet the mental health needs of children with play therapy. In this first-of-its-kind study, the researcher investigated relationships between professional development and play therapy among working counselors and measured attitudes, knowledge and skills, and types of training in play therapy. A nonrandom sample of counselors were recruited from relevant online sources in this quantitative study. Attitudes, knowledge, and skills were measured by the self-reported Revised Play Therapy Attitude-Knowledge-Skills …
Building A Resilient Workforce: Programming For Commercial Content Moderation Staff, Miriah E. Steiger
Building A Resilient Workforce: Programming For Commercial Content Moderation Staff, Miriah E. Steiger
Dissertations
Commercial content moderators (CCM) review and remove controversial content from social media platforms, leading to potentially adverse mental health effects through secondary trauma exposure. Due to the problematic nature of their work, a U.S. based company hired mental health clinicians to design and instruct a resiliency program, developed based upon the psychological resilience literature. Regrettably, there is scarce peer-reviewed literature providing guidelines for best practices in program development or evaluations specific to this population to evaluate the program’s effectiveness. Therefore, this study investigated whether the resiliency program provided to CCM workers predicted resilience and well-being outcomes by use of the …
Donor Families’ Experiences From Initial Loss Forward: An Interpretative Phenomenological Analysis, Linda Sue Meeker
Donor Families’ Experiences From Initial Loss Forward: An Interpretative Phenomenological Analysis, Linda Sue Meeker
Dissertations
The purpose of this study was to examine the lives of those who have consented to organ donation at the time of an unexpected death of a loved one. The qualitative data illuminated participants’ experiences as members of donor families as they shared their observations and experiences from the initial loss forward. The participants in this study included eight women and one man who were the primary next-of-kin and the individual who provided consent to donate the organs. The results indicated that there are steps in the care of these families that could be improved, allowing for better care of …
Can A Brief Online Intervention Change Low-Income Caregivers’ Reported Use Of Spanking? A Randomized Controlled Trial, Hilary L. Richardson
Can A Brief Online Intervention Change Low-Income Caregivers’ Reported Use Of Spanking? A Randomized Controlled Trial, Hilary L. Richardson
Dissertations
Spanking is commonly used by parents (64-94%) in the United States as a strategy for managing undesirable child behaviors. Research has found that the use of spanking is particularly high among young mothers, low-income parents, and African American families. Decades of literature on the use of spanking has identified abundant detrimental outcomes for children such as increased externalizing behaviors, decreased long-term compliance, and less guilt following misbehavior, as well as serious outcomes in adulthood such as depressed mood and alcohol/drug use. There is also a risk for spanking to escalate to physical abuse. Thus, safer, more effective discipline strategies are …
Mitigating Suicide Risk Post-Discharge From Inpatient Crisis Stabilization: Safety Planning Intervention, Leighia M. Mcghee
Mitigating Suicide Risk Post-Discharge From Inpatient Crisis Stabilization: Safety Planning Intervention, Leighia M. Mcghee
Dissertations
Abstract
Purpose: The purpose of this program evaluation is to evaluate the effectiveness of a newly implemented safety planning intervention (SPI) tool, comparing patient outcomes relating to suicide attempt rates, emergency department (ED) encounter rates, and inpatient rehospitalizations rates pre and post its integration to care in a suburban behavioral health hospital.
Methods: A descriptive cohort design utilizing a retrospective chart review was completed over six months, three months pre, and three months post implementation of the SPI program. A convenience sample of inpatient charts was reviewed to assess the rate of suicide attempts, ED encounters frequencies, and hospitalization rates …
Compassion Fatigue And The Emergency Department, Alexandra Myers
Compassion Fatigue And The Emergency Department, Alexandra Myers
Dissertations
Problem The emergency department (ED) is a high-stress environment. Nurses exposed to this stress for prolonged periods are subject to compassion fatigue (CF). The purpose of this quality improvement project was to identify and reduce the level of CF in ED nurses by implementing Real Time Transformative Response© (RTR). RTR© is a technique that uses combinations of neurofeedback response awareness, biofield therapy intervention, and clearing of unwanted energy.
Method A purposeful sample of ED nurses working at a moderately-sized, suburban, Midwestern hospital ED who were scheduled to work 24-hours or more per week completed a Professional Quality of …
Exploration Of Physician Attitudes About Self-Care And Personal Mental Health: Possible Barriers To Physician Well Being, Candich Farrar
Exploration Of Physician Attitudes About Self-Care And Personal Mental Health: Possible Barriers To Physician Well Being, Candich Farrar
Dissertations
The present study was designed to examine physicians’ mental health, attitudes, and behaviors toward self-care and the utilization of mental health services. As the medical field can be very demanding and exhausting, it is believed that many physicians suffer from mental illnesses such as anxiety and depression. However, it was theorized that many physicians do not engage in adequate self-care regimes or seek support and suppress their symptoms, which may further exacerbate their illnesses. A thorough literature review was performed to explore the following: possible barriers to physicians seeking mental health services to address high rates of mental illnesses, physicians …
Social-Ecological And Protective Factor Approach To Managing Parental Incarceration, Jacquelyn Harris
Social-Ecological And Protective Factor Approach To Managing Parental Incarceration, Jacquelyn Harris
Dissertations
Mass imprisonment does not only impact the incarcerated individual; it also affects approximately five million children in the United States. Researchers identified and compare the impact of parental incarceration on child development. They acknowledged the protective factors across the lifecycle from a social-ecological perspective and specifically related to parental incarceration. The comprehensive literature review inspired an innovative model, the social-ecological and protective factor approach to managing parental incarceration. The primary goal of this model is to combat the detrimental effects of parental incarceration by identifying protective factors across the lifecycle and throughout the microsystem, mesosystem, and exosystem. This model is …
Bridging The Gap: Understanding Non-Offending Parental Responses To Their Children's Sexual Abuse., Jennifer Latreill, Psy.D.
Bridging The Gap: Understanding Non-Offending Parental Responses To Their Children's Sexual Abuse., Jennifer Latreill, Psy.D.
Dissertations
The parental response to children's disclosure of childhood sexual abuse (CSA) is the most critical and important factor regarding the child's post trauma trajectory and overall trauma resolution. Understanding parental responses and the factors that prompt acceptance versus disbelief among the non-offending parent (NOP) is vital to children's success following disclosure given the weight of the NOPs response and its impact on long-term consequences of CSA. This literature review provides a comprehensive summary of what may deter the NOP from recognizing intrafamilial sexual abuse, factors that may contribute to the NOPs disbelief following disclosure, and possible clinical implications of such …
Barriers And Facilitators To Opioid Use Treatment And Recovery Services During Pregnancy, Loralie Woods
Barriers And Facilitators To Opioid Use Treatment And Recovery Services During Pregnancy, Loralie Woods
Dissertations
Purpose: To identify barriers and facilitators to opioid use treatment and recovery services among pregnant and nonpregnant women who misuse opioids.
Background: Over 130 Americans die daily after overdosing on opioids. Women have not been immune from opioid use disorders (OUDs), with a 4-fold increase from 1999-2010. The prevalence of opioid use among pregnant women increased from 1.5 per 1,000 hospital deliveries to 6.5. Although the annual National Surveys on Drug Use and Health (NSDUH) has provided information on risk factors for OUD related to socioeconomic and demographic factors, no studies using this data have identified barriers to opioid use …
Anxiety, Attributions, And Marital Quality: A Mediation Model, Tara Vossenkemper
Anxiety, Attributions, And Marital Quality: A Mediation Model, Tara Vossenkemper
Dissertations
Marital quality plays a significant role in the physical and mental health of many people. The purpose of this study was to examine anxiety, attributions, and marital quality in a sample of females. The first two hypotheses aimed to assess the relationship between anxiety and marital quality, and the relationship between attributions and marital quality. The primary research question aimed to assess attributions as a mediator in the relationship between anxiety and marital quality. Participants (N = 358) completed a demographic questionnaire, the Quality Marriage Index (QMI; Norton, 1983), the Marital Adjustment Test (MAT; Locke & Wallace, 1959), the …
A Meta-Synthesis Of The American And The European Standards For The Accreditation Of Counseling Training Programs, Natalia Zapolsky
A Meta-Synthesis Of The American And The European Standards For The Accreditation Of Counseling Training Programs, Natalia Zapolsky
Dissertations
The purpose of this qualitative study was to explore how the European Standards for the accreditation of counseling training programs compare to CACREP standards and to each other. The differences and commonalities between standards have been defined through a meta-synthesis of integrated findings from a large body of inter-related qualitative studies and reinterpretation of the synthesized data.
This qualitative meta-synthesis research was intended to contribute to the process of counseling globalization by exploring the unique cultural features and aspects of the European and the U.S. accrediting systems for counseling training programs. This research revealed 1) the commonly recognized areas that …
Ethnic Identity Salience, Socioeconomic Status, And Attitudes Toward Seeking Mental Health Treatment As Predictors Of Receptivity To Community-Based Psychoeducation Among African American Men, Hadiya Suzanne Dubose-Smith
Ethnic Identity Salience, Socioeconomic Status, And Attitudes Toward Seeking Mental Health Treatment As Predictors Of Receptivity To Community-Based Psychoeducation Among African American Men, Hadiya Suzanne Dubose-Smith
Dissertations
Problem
Distrust and socioeconomic barriers are widely recognized as contributors to disparities in the healthcare system, particularly as it relates to mental health care (Lindinger-Sternart, 2015; National Alliance on Mental Illness, n.d.). African Americans continually experience societal pressures to disassociate with African American culture and to assimilate into mainstream culture. Perhaps accessing mental health services via a counselor is an extension of that pressure. In this way, the traditional counseling model for mental health intervention is a culturally counterintuitive approach for developing mental health among African American men. Men are a subset of the African American community that tends to …
Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan
Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan
Dissertations
Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).
Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.
Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …
From The Boots On The Ground: A Comparison Of The Attitudes And Beliefs Of Military Members And Mental Health Professionals Regarding The Moral Injury Construct, Karis L. Callaway
From The Boots On The Ground: A Comparison Of The Attitudes And Beliefs Of Military Members And Mental Health Professionals Regarding The Moral Injury Construct, Karis L. Callaway
Dissertations
An increasing amount of research conducted in recent years indicates that, in addition to Posttraumatic Stress Disorder, moral injury is a key concept to recognize when considering the deployment experiences of service members. Although related to Posttraumatic Stress Disorder, which is a fear-based mental health diagnosis, moral injury is a distinct concept. It acknowledges the possible prolonged negative psychological, social, and spiritual consequences that may occur after experiences that challenge and transgress one’s deeply held moral beliefs. Events such as perpetration of harm, failing to protect or prevent harm, and witnessing or learning about distressing acts committed by influential others …