Mental and Social Health Commons^™

Understanding Veteran Perceptions About Mental Health And Its Treatment, Quinn Turner Stoddard

Dissertations and Theses

Mental health illnesses are a growing issue for a large part of the country, and veterans in particular are vulnerable to the numerous negative effects they pose. Despite the high number of people that may benefit from treatment, a variety of issues with trust, stigma, and attitudes may act as barriers to care utilization. In response, this study investigated the perceptions that veterans within the Pacific Northwest hold in regards to mental health treatment as well as their intentions to seek it out should they require it. Using the integrated model of behavioral prediction (IMBP), data was gathered about veterans’ …

"I Stayed There The Whole Night": Exploring Caregivers' Experiences With The Healthcare System When Caring For A Parent At The End Of Life, Lillian Mehran

Dissertations and Theses

Background: In the United States, there are nearly 53 million individuals serving as caregivers to a loved one. Half of all caregivers are caring for a parent or parent-in-law, and 79% of caregivers are caring for a person aged 50 or older. In New York State, there are an estimated 4.1 million caregivers who collectively provide over 2.6 billion hours of unpaid care, with those caring for a person at the end of life providing twice as many hours of caregiving per week compared to other caregivers. The number of individuals requiring caregiving is expected to increase as a significant …

Promoting Well-Being Among Intercollegiate Student-Athletes: A Gratitude Intervention Using Positive Psychology, Laura Kruger

Dissertations and Theses

Intercollegiate student-athletes face rising stress and pressures which challenge their well-being and mental health, and sometimes with alarming concerns. Over the years, supportive services and resources specifically available to student-athletes have not evolved at the same pace as student-athlete needs. Also, barriers and stigmas hinder student-athletes from readily accessing supportive mental health services. The high stress of student-athletes can contribute to the development of negative mental health symptoms and impairs positive well-being. Evidence supports how outreach initiatives help student-athletes. Positive psychology, including gratitude as a positive psychological state, has shown benefits to well-being. This experimental study design researched if the …

Intentional Misdiagnosis And Ethical Considerations Of Mental Health Counselors Working With Managed Care, Emily Lake

Dissertations and Theses

Abstract Research has discussed ethical dilemmas for professional counselors working with managed care. Professional counselors are faced with the implications of providing a diagnosis to clients to receive reimbursement by managed care and to assist clients in receiving care. The purpose of the study is to better understand the counselor’s role in intentional misdiagnosis due to billing requirements from insurance companies. Furthermore, the researcher is interested in the personal and professional characteristics of counselors predictive of the decision to engage in intentional misdiagnosis. Participants in this study were asked to complete the Marlowe-Crowne Social Desirability Scale and a researcher-created survey. …

A Study Of Verbal Rumination, Relationships, Stress And Identity On Health Communication In Collegiate Athletics, Landon Mary Ellen Kemp

Dissertations and Theses

College athletes are a unique group of individuals as they face many positive and negative challenges when competing in a collegiate sport. Verbal rumination is repetitive talk about a particular issue, accompanied by adverse effects for an individual. Verbal rumination is a common strategy athletes use to cope with difficulties along with managing challenging situations in their athletic program. To explore factors that might inspire or impede verbal rumination in collegiate athletics, the present study examines the quality of coach and teammate relationships, perceived stress and athlete identity. Results revealed the impact of relationships between coaches and athletes in respect …

Challenges To Career As A Source Of Meaning And Satisfaction Among Certified Athletic Trainers In The United States Of America, Nicole Marie Glasgow

Dissertations and Theses

There is a high prevalence of burnout in the athletic training profession. Similar to what has been found in other healthcare professions, burnout is correlated with lack of job satisfaction, high turnover, and decreased productivity. In phase one of this study, the purpose was to investigate whether there was a relationship between perceived career meaning and burnout among certified athletic trainers. In phase two, the purpose of the study was to explore the lived experiences of meaningfulness and purposefulness by certified athletic trainers. The overall objective of the research was to generate an understanding of factors associated with burnout in …

Ego-Feeling And Ego-Boundaries: An Examination Of The Work And Legacy Of Paul Federn, Samuel Selinger

Dissertations and Theses

Paul Federn was an important figure in the early development of psychoanalysis. He was, besides Sigmund Freud himself, the only founding member of the Vienna Psychoanalytic Society who was still a member when the society was disbanded by the Nazis in 1938. He was also an early pioneer in the use of psychoanalysis toward the understanding and treatment of psychosis, and was among the very first to consider the importance of the ego to psychoanalytic understanding of the mind and mental illness. This dissertation examines Federn’s key ideas-- ego-feeling and ego-boundaries-- their influence on later psychoanalytic formulations by Winnicott, Lewin, …

Youtube, Cyberbullying And Covid-19, Ani Shavliashvili

Dissertations and Theses

The purpose of this research is to uncover how people discuss bullying or cyberbullying experiences via YouTube videos before and after the start of the COVID-19 pandemic. Since people were indoors during the pandemic, individuals took to social media and left comments on YouTube about bullying. Since people could not discuss bullying in-person, it was interesting to see how people shared their views on bullying and cyberbullying via YouTube, as well as how that might have changed after the start of COVID-19. The purpose of this study is to demonstrate how social media platforms like YouTube provide a safe space …

Antipsychotic Medication Administration In Oregon Assisted Living/Residential Care Settings: Analyzing An Action Situation, Sarah Dys

Dissertations and Theses

Antipsychotic medication use (APU) in assisted living and residential care (AL/RC) settings is an under-studied and controversial health policy issue. APU in older adults with dementia is associated with an increased risk of falls, hospitalizations, and early mortality. I operationalize the Institutional Analysis and Development Framework using a situational analysis approach, an extension of grounded theory methods, to explore the APU in Oregon AL/RC settings. Regulatory deficiency citations, Oregon AL/RC population data, and semi-structured interviews suggest that staff role clarity, organizational characteristics, and perceived agency influence decision-making around APU. AL/RC providers and caregivers are forced to simultaneously balance and prioritize …

Incarceration And Suicide: Do The Risk Factors Differ For Civilians And Veterans?, Rheannon Gail Ramsey

Dissertations and Theses

Suicide is one of the leading causes of death in United States jails and prisons. Many researchers have looked at suicides in prisons and what can potentially cause suicidal ideation but there are conflicting findings among civilian incarcerated populations and United States military veteran incarcerated populations.

The intent of this study is to examine which risk factors are most prevalent among adults in custody, with a focus on mental health and substance use or abuse and how these risk factors differ between incarcerated civilians and incarcerated veterans. Using survey data from the 2002 Survey of Inmates in Local Jails conducted …

Returning To Rejection: Outcomes And Boundary Conditions Of Mental Illness Stereotypes, Stefanie Fox

Dissertations and Theses

Mental illness is a common condition in the United States, with over 20% of working age adults managing a mental illness condition in a given year. Disclosure of mental illness is often required for workers to take advantage of employer-provided resources (e.g., accommodations), yet use of resources is exceedingly low (less than 10%). Negative stigma-related outcomes are a top reason for which individuals delay the use of resources. Using an experimental design in an online data collection of 242 participants over two time points, the current study builds on existing organizational diversity literature to examine the stereotypes associated with mental …

An Examination Of Hiv Risk, Testing And Prevention Intervention Participation Among Vulnerable Youth, Bianca V. Lopez

Dissertations and Theses

Background: Young gay, bisexual and other men who have sex with men (YGBM) of color are disproportionately affected by HIV and bear the burden of the disease in the United States. Gay and bisexual men – referred to in surveillance systems as men who have sex with men (MSM) – continue to be the risk group most severely affected by HIV in the United States. The dissertation study explored factors related on HIV prevention intervention participation, HIV testing and sexual risk behaviors among YGBM ages 13-29 in the Bronx. Additionally, this dissertation endeavored to study the concept of “intervention fatigue”, …

Individual And Community Supports That Impact Community Inclusion And Recovery For Individuals With Serious Mental Illnesses, Rachel Elizabeth Terry

Dissertations and Theses

The current dissertation presents two published manuscripts and discusses a third study that explored the role of social support in promoting community participation for individuals with serious mental illnesses. The first manuscript investigated sense of community as a potential mediating factor between community participation, psychological distress, and mental health functioning utilizing quantitative methods. The results indicated that sense of community acted as a partial mediator between community participation and psychological distress, as well as mental health functioning. The second manuscript is a literature review that explored the influence of social support on community integration for individuals with serious mental illnesses. …

Mechanisms Of Value-Biased Prioritization In Fast Sensorimotor Decision Making, Kivilcim Afacan-Seref

Dissertations and Theses

In dynamic environments, split-second sensorimotor decisions must be prioritized according to potential payoffs to maximize overall rewards. The impact of relative value on deliberative perceptual judgments has been examined extensively, but relatively little is known about value-biasing mechanisms in the common situation where physical evidence is strong but the time to act is severely limited. This research examines the behavioral and electrophysiological indices of how value biases split-second perceptual decisions and the possible mechanisms underlying the process. In prominent decision models, a noisy but statistically stationary representation of sensory evidence is integrated over time to an action-triggering bound, and value-biases …

To Disclose Or Not To Disclose? Self-Disclosure Of Mental Health In The Workplace, Samantha Margaret Reynolds

Dissertations and Theses

When making the decision to disclose a mental illness, individuals may be met with a number of factors that impact disclosure. This study examines the relationship between self-stigma, psychological safety, social support and self-disclosure of mental illness in the workplace. The present study surveyed 756 participants and found a positive relationship between stigma and self-disclosure as well as a positive relationship between social support and self-disclosure. For work outcomes, there was a negative relationship between both job satisfaction and productivity in relation to self-disclosure. This study potentiates the antecedents and consequences of self-disclosure of mental illness and how it impacts …

Attrition And Psychotherapy, Jesse Barrington Homan

Dissertations and Theses

Attrition in psychotherapy, also known as dropout, is a problem that affects clients who terminate, their families, therapists, mental health systems, and the overall community. Research on attrition is vast. However, the majority of this research has been done post hoc, relied on quantitative methods, and looked primarily at client demographic variables as the predictors of attrition. This has resulted in inconsistent findings, offers little to no useful information about attrition, and appears to blame clients for failed therapy. There has been little research on attrition from the perspective of clients who terminate. This study was designed to answer the …

Urbanicity As A Moderator Of The Relationship Between Stigma And Well-Being Outcomes For Individuals With Serious Mental Illnesses, Emily Leickly

Dissertations and Theses

During the deinstitutionalization movement in the 1960s, community mental health centers and supportive and affordable housing for people with serious mental illnesses (SMI) was concentrated in economically disadvantaged urban centers. Today, these urban centers are becoming increasingly gentrified and unaffordable for people with SMI. Affordability is no longer synonymous with urban living, and supportive housing for people with SMI is increasingly found in non-urban areas. Given this shift, it is important to understand the potential impacts of non-urban living on people with SMI. Non-urban environments provide potential benefits for the general population, including reduced traffic and increased proximity to the …

Impactful Care: Addressing Social Determinants Of Health Across Health Systems, Nicole Lisa Friedman

Dissertations and Theses

There is emerging evidence that addressing health-related social needs through enhanced clinical-community linkages can improve health outcomes and reduce costs. Unmet health-related social needs, such as food insecurity, inadequate or unstable housing, and lack of access to transportation may increase the risk of developing chronic conditions, reduce an individual's ability to manage these conditions, increase health care costs, and lead to avoidable health care utilization. In response, work on social needs is happening across large health systems in the United States, but the pace of progress is slow and accountability is diffuse.

The goal of this applied research project is …

Development And Validation Of The Workplace Mental Illness Stigma Scale (W-Miss), Nicholas Anthony Smith

Dissertations and Theses

Although 1 in 5 Americans will experience a mental illness at some point, each year people with mental illnesses continue to face high levels of stigmatization and discrimination at work. Recognizing this, many organizational researchers and practitioners have sought to improve workplaces for employees with mental illness through a variety of organizational interventions. Unfortunately, few interventions are thoroughly evaluated. One barrier to evaluating such interventions is the lack of a theoretically meaningful measure of workplace mental illness stigma. In this dissertation, I proposed to develop and evaluate such a measure (the W-MISS) based on Jones, Farina, Hastorf, Markus, Miller, and …

Hospital-Based Services For Opioid Use Disorder: A Study Of Supply-Side Attributes, Kelsey Caroline Priest

Dissertations and Theses

The United States (U.S.) is in the midst of an opioid overdose epidemic. In the U.S., overdose deaths related to opioid exposure are the leading cause of accidental death, yet life-saving treatments, such as methadone or buprenorphine (opioid agonist therapy [OAT]), are underused. OAT underused is due, in part, to complex regulatory and health services delivery environments. Public health officials and policymakers have focused on expanding OAT access in the community (e.g. office-based buprenorphine treatment, and opioid treatment programs); however, an often-overlooked component of the treatment pathway is the acute care delivery setting, in particular hospitals.

Opioid use disorder (OUD)-related …

Framing Physical Activity: Weight Control Frames And Physical Activity Motivation, Kristin Spurkland

Dissertations and Theses

Public health institutions and popular media frequently frame weight loss and weight control as primary benefits of physical activity. This exploratory, descriptive study examined how respondents rated statements exemplifying three physical activity frames: a weight control frame, a medical frame, and an active embodiment frame. An anonymous, online survey was conducted in March 2018; respondents rated frame statements in terms of inspiring motivation to engage in physical activity, and in terms of perceived credibility. They also provided anthropometric data and physical activity data. Data were analyzed for the entire sample as well as stratified by multiple variables, including body mass …

Rates Of Developmental And Behavioral Screening Of Young Children: Implications For Health Care Policy And Practice, Shirley Berger

Dissertations and Theses

Background: The skills and capacities developed during early childhood are the foundation for a child’s future academic functioning, economic productivity, and lifelong health and mental health. When young children have developmental delays or disabilities, early identification and intervention lead to better outcomes; however, only a minority are identified before school entry. Primary care is an important setting for identification of developmental and behavioral conditions as most young children attend well-child visits regularly and parents expect developmental guidance from pediatricians. Two key pediatric preventive services are recommended: developmental monitoring/surveillance at every well-child visit and developmental screening at 9 months, 18 months, …

Exploring The Association Of Victimization And Alcohol And Marijuana Use Among American Indian Youth Living On Or Near Reservations: A Mixed Methods Study, Lindsay Nicole Merritt

Dissertations and Theses

Adolescent substance use research has yet to consider victimization as a potential risk factor contributing to alcohol and marijuana use among American Indian youth living on or near reservations, despite the presence of traumatic experiences, childhood adverse events, racism, and discrimination. Contribution to this lack of attention may be due to little being known about American Indian youth victimization. Even less is known about its association with alcohol and marijuana use in general and for those youth living on or near reservations in particular.

This study utilizes mixed methods with a nationally representative sample of American Indian youth living on …

Is Therapy Going To The Dogs? Evaluating Animal Assisted Therapy For Early Identified At-Risk Children, Leah Faith Brookner

Dissertations and Theses

This study explores the historical context of human-animal relationships and examines the important ways that humans benefit from various types of interactions with domesticated animals. Therapeutic approaches that incorporate animals have been shown to have multiple benefits, including improved physical and mental health. Although this area of study is still largely overlooked in scientific fields of study, including social work, Animal Assisted Therapy (AAT) has become increasingly prevalent in various mental health settings. Despite its popularity and anecdotal support, research on the benefits of AAT with children is minimal; there are no studies examining the ways in which this approach …

The Influence Of Sense Of Community On The Relationship Between Community Participation And Recovery For Individuals With Serious Mental Illnesses, Rachel Elizabeth Terry

Dissertations and Theses

The Community Mental Health Act of 1963 launched the deinstitutionalization movement, whereby individuals with serious mental illnesses were released from psychiatric hospitals and began living and receiving mental health care in the community (Carling, 1995). However, these actions have not necessarily integrated those individuals into all aspects of community life (Dewees, Pulice, & McCormick, 1996). This is unfortunate because people with serious mental illnesses frequently report that community integration is not only important to them, but that it also aids in reducing symptoms and promoting recovery (Townley, 2015). Although past research suggests that receiving mental health care in the community …

Foundational Knowledge And Other Predictors Of Commitment To Trauma-Informed Care, Stephanie Anne Sundborg

Dissertations and Theses

Trauma-informed care (TIC) is an approach to service delivery based on the understanding of the prevalence of psychological trauma among service users, knowledge about the impact trauma has on engagement to services, and recognition that service settings can be re-traumatizing. For more than a decade, momentum has been building on this topic. Practitioners are pursuing the knowledge and skills needed to implement trauma-informed service delivery, while organizations are building infrastructure and processes aimed at supporting this approach. Disciplines across many human service sectors are eager to incorporate TIC into policy and practice. Despite this enthusiasm, implementation efforts are slow. Acquiring …

Sexual Behavior And Substance Use Among Women Across The Spectrum Of Sexual Orientation, Margaret M. Wolff

Dissertations and Theses

Background: Compared to non-sexual minority women, sexual minority women are at greater risk for substance use and abuse, sexual risk behaviors, and unplanned teen pregnancy; few studies measure differing associations by sexual orientation (e.g., identity, behavior, attraction) or discordance (e.g., heterosexually-identified women with female partners) components. Minority stress may explain sexual minority women’s health disparities; thus, as U.S. policies evolve to reflect growing acceptance of all sexual minorities, research should examine sexual minority women’s health risk behaviors using multidimensional constructs of sexual orientation.

Methods: Using the female sample of the 2002-2013 National Survey of Family Growth (Aims 1-2 n=25,523; …

Dietary And Physical Activity Acculturation And Weight Status In Chinese College Students, Yanni Zhang

Dissertations and Theses

This cross-sectional study examined the relationships between length of residence in the United States (U.S.) and dietary and physical activity acculturation, and the relationships between dietary and physical activity acculturation and weight status in 55 Chinese college students. Length of residence in the U.S. was positively associated with larger portion size, greater amount of physical activity, and change in BMI in male participants. Adoption of a Western diet was associated with weight gain. Portion size change was positively associated with BMI change. Lunch size change was positively correlated with BMI change in males while negatively correlated with BMI change in …

Understanding Neighborhood Satisfaction For Individuals With Psychiatric Disabilities: A Mixed Methods Study, Amy Leigh Shearer

Dissertations and Theses

Physical and social characteristics of neighborhoods are important to resident satisfaction for clinical and nonclinical populations. This study draws upon data collected from a sample of 172 individuals with psychiatric disabilities living in 16 supportive housing sites in the Portland, Oregon metropolitan area. Research questions explore the extent to which subjective and objective measures of neighborhood physical and social environments contribute to neighborhood satisfaction for this population. Mixed methods were employed to construct a detailed understanding of the factors that influence satisfaction with one's neighborhood of residence. Predictor variables were neighborhood social climate, neighborhood physical quality, perceptions of safety, crime …

Social Support And Depression Symptomatology Post Injury In Division 1 Athletes, Alyssa Catherine Tiedens

Dissertations and Theses

The way in which an athlete responds to the injury--emotionally, behaviorally, and cognitively--can significantly affect the athlete's mental health in a negative way if not handled appropriately. There are different forms of social support that are known to be helpful with coping during specific stages of injury. The purpose of this study was to examine the relationship between perceived levels of social support and depression symptomatology post injury in Division 1 collegiate athletes at Portland State University (PSU).

Participants were PSU student athletes (n=115). Variables: social support amount (SSQN), social support satisfaction (SSQS), and depression symptomatology (CESD-R) score. Selected injured …