Mental and Social Health Commons^™

Beyond Symptoms: Examining Perinatal Mental Health Care Among Black, Indigenous And People Of Color With Polyendocrine Metabolic Ovarian Syndrome, Vinaya Thomas

Electronic Theses and Dissertations

Perinatal mood and anxiety disorders (PMADs) are as a public health concern in the United States. Individuals from minoritized racial/ethnic groups face a significantly elevated risk of maternal morbidity, mortality, mental health disorders, and associated adverse outcomes. Emerging studies also reveal a higher likelihood of experiencing perinatal mental health concerns in individuals with polycystic ovarian syndrome (PCOS), currently known as polyendocrine metabolic ovarian syndrome (PMOS). People who identify as Black, Indigenous, or a person of color (BIPOC) face unique healthcare challenges given the added structural and social burdens. This online survey study aimed to 1) understand the relationship between PMOS …

An Assessment Of Accessibility And Affordability Of Inpatient Psychiatric Care In Tennessee, Kailee Havrda

Electronic Theses and Dissertations

Introduction: Access to mental health has seen changes over the past decade, but little research and attention have been given to access to inpatient psychiatric facilities. Inpatient psychiatric care is crucial for patients experiencing mental health emergencies who need immediate access to care. Gaps in spatial accessibility, affordability, and the access and assessment process were identified due to a lack of available information in the field.

Methods: Secondary data from the Tennessee Department of Health were used to assess financial accessibility through payer source charges and patient encounters, as well as through mapping of inpatient psychiatric facilities and conducting drive …

Cultural Humility, A Salve For Romantic Relationship Conflict, Lena Blum

Electronic Theses and Dissertations

Conflict communication and having a relationship consisting of differing sociocultural backgrounds (DISC Couples) have been viewed as obstacles or at best hindrances of relationship satisfaction in earlier couples’ psychology literature. More recent literature makes an argument that it is not merely conflict communication or the differences of culture within a couple, but rather how couples navigate both conflict and differences that impact relationship satisfaction. The present work aims to investigate the role of cultural humility in the association between cultural conflict communication and relationship satisfaction, as well as its relationship with the frequency of cultural conflict communication among DISC couples. …

The Resilient Mother: Exploring Factors That Buffer The Influence Of Early Childhood Trauma On Maternal Self-Efficacy, Brigid Magdamo

Electronic Theses and Dissertations

Childhood maltreatment and toxic stress pose significant risks to both individuals and communities, yielding negative outcomes that can perpetuate across generations— a phenomenon known as intergenerational trauma. Early intervention is imperative to disrupt this cycle of adversity and promote positive outcomes. One promising approach involves leveraging protective and promotive factors that cultivate resilience. Individuals with higher levels of benevolent childhood experiences (BCEs) and greater social support tend to exhibit enhanced self-efficacy, thereby potentially buffering the detrimental effects of childhood trauma. Furthermore, the perinatal period presents a critical juncture where maternal well-being significantly impacts both mother and child. The current study …

Examining The Effects Of Perceived Need, Suicidal Ideation, And Interpersonal Shame On Help-Seeking Attitudes In Asian Pacific Islander Desi Americans, Kristen Jiin Park

Electronic Theses and Dissertations

This study examined relationships among suicidal ideation, perceived need for mental health services, interpersonal shame, and help-seeking attitudes in a sample of APIDA adults (N = 175). Guided by Andersen's Socio-behavioral Model of Help- Seeking Behaviors (1968) and the Interpersonal Shame Inventory framework (Wong et al., 2014), the study investigated whether interpersonal shame moderated the relationships between suicidal ideation and help-seeking attitudes, and between perceived need and help-seeking attitudes. Participants completed an online survey assessing demographic and study variables. Results indicated that perceived need and gender were associated with more favorable mental health help-seeking attitudes among APIDA adults. These findings …

"Help Me Live It The Way You Do": Grounding Singaporean Responses To The Rorschach Situation, Casey Y. Lee

Electronic Theses and Dissertations

Contemporary research on the Rorschach and culture is striking for the latter’s disappearance as a variable of significance (Meyer et al., 2015; Meyer et al., 2007; Mihura et al., 2013; Viglione & Hilsenroth, 2001). This erasure is chronicled and reproduced in the narratives of universal objectivity, of extensive international meta-analyses, of replications, of standardized norms (Ritzler, 2004; Smith et al., 2018; Smith et al., 2020; Weiner, 2004). A different story emerges, however, when we ask, how has culture disappeared? The proposed study is a multimethod qualitative analysis of Singaporean responses to the Rorschach, aimed at generating sensitive yet critical discourses …

Kindergarten Teachers’ Perceptions, Experiences, And Challenges Using Visual Supports For Children With Autism, Jasmine M. Mcnair

Electronic Theses and Dissertations

This qualitative case study examined kindergarten teachers’ perceptions, experiences, and challenges related to the use of visual supports for students with autism spectrum disorder in East Texas. Grounded in cognitive load theory, the study explored whether visual supports enhance learning outcomes by reducing cognitive overload. Four research questions addressed teachers’ perceptions of effectiveness, implementation challenges, the influence of teacher attitudes, and differences based on teaching experience. The researcher collected data through semistructured interviews with 10 kindergarten inclusion teachers and supplemented by classroom observations. Thematic analysis revealed five primary themes: emotional impact and student growth, visual supports as essential instructional tools, …

Navigating The Dark Side: Emotional Labor's Impact On Hr Professionals' Wellness, Esmeralda Amelia Rendón

Electronic Theses and Dissertations

This qualitative descriptive study was designed to document and describe how female-identifying human resource (HR) generalist practitioners serving as sole or primary employee relations practitioners in small- to medium-sized organizations across the United States experience and manage emotional labor in their roles, cope with its demands, and how these experiences impact their wellness and perceptions of organizational support. Despite the centrality of emotional labor (EL) in human resource professionals’ (HRPs) roles, little was known about how HRPs in these underresourced environments cope with these demands. Data were collected through semistructured virtual interviews with eight participants and analyzed using Braun and …

Values-Based Clinical Ethics: A New Model Of Health And Ethics Consultation For Patients Suffering In Extremis, Adam Trainer

Electronic Theses and Dissertations

This dissertation argues that contemporary clinical ethics is inadequately equipped to support patients suffering in extremis because it relies on an insufficiently discriminating account of health and a constrained model of moral reasoning. Drawing on Bernard Lonergan, it reconceives health as an emergent, multi-layered, heuristic notion shaped by biological, psychological, social, and existential goods. On that basis, it critiques principlism’s global applicability thesis and the undergirding claim that its principles form part of the common morality, arguing that this justificatory structure is philosophically insufficient and practically limited for clinical ethics in cases marked by profound suffering, moral plurality, and normative …

Predictors Of Elevated Borderline Personality Disorder And Pai-Bor Scores: The Role Of Psychological, Trauma, And Treatment Factors, Isabel Avendano Gil

Electronic Theses and Dissertations

Borderline Personality Disorder (BPD) is a complex and multifaceted mental health condition that significantly affects individuals' emotional, cognitive, and interpersonal functioning. BPD is characterized by impulsivity, emotional dysregulation, unstable relationships, and self-destructive behaviors, and often results in significant impairment across multiple life domains. Previous research has consistently identified Adverse Childhood Experiences (ACEs), particularly sexual abuse (SA), as key contributors to the development of BPD. These early traumas are closely associated with core features of the disorder, including affective instability, identity disturbance, impulsivity, and maladaptive interpersonal patterns.

Psychotherapeutic interventions, such as Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT), have …

Feasibility Of Assessing Dietary Patterns And Anxiety In College Students: A Pilot Study Using Nutrition Questionnaires, Gad-7, And Asq, Kylie Ford

Electronic Theses and Dissertations

Anxiety is highly prevalent among college students representing a significant public health concern. Research indicates that dietary patterns may influence mental health outcomes; however, the practicality of collecting comprehensive dietary and psychological data in college populations remains unclear. This pilot study assessed the feasibility of evaluating dietary patterns and anxiety using self-report instruments. Participants completed the Nutrition and Eating Habit questionnaire, the Generalized Anxiety Disorder-7 (GAD-7), and the Anxiety Sensitivity Questionnaire (ASQ). Although twenty-one students were recruited, survey completion rates were low, with only seven participants completing the nutrition questionnaire necessary to calculate the Dietary Inflammatory Index (DII). Descriptive analyses …

Accessing Campus Mental Health Services In A Nigerian Southwestern University: Barriers To Academic Success, Caroline Dada

Electronic Theses and Dissertations

Mental health disorders are a significant health concern among higher education institutions in sub-Saharan Africa, including Nigeria. A substantial treatment gap exists in the Nigerian healthcare system, and this gap is further worsened by cultural and religious barriers, which reinforce stigma that discourages students from seeking professional help. This qualitative narrative inquiry explored the barriers students encountered when accessing mental health services at a university in Southwestern Nigeria, to increase service access. Qualitative semistructured interviews were conducted with seven professional mental health providers at a university counseling center between March and April 2025. Inductive thematic analysis was used to identify …

Building Relationships: Does Perceived Counselor Cultural Humility Improve Client Satisfaction Of Mental Health Services Within Therapeutic Dyads Of Dissimilar Identities?, Noah Schoch

Electronic Theses and Dissertations

A wealth of clinical research has uncovered the presence of mental health treatment disparities and a lack of treatment consistency when working with clients of dissimilar identities. The purpose of this dissertation study was to investigate potential causes for the observed disparities minoritized individuals have experienced and understand if cultural humility was a variable that affected mental health treatment satisfaction when counselor-client had dissimilar cultural identities. This was achieved through the following research questions: (1) What is the relationship between the extent of client perceived racial/ethnic similarity within the therapeutic dyad and client-rated mental health treatment satisfaction? (2) What is …

Likes For Love: Examining The Relationship Of Sociocultural Factors On Social Media Influences Of Instagram Use For Young Black Women, Cheria S. Jackson

Electronic Theses and Dissertations

In recent years there has been a push toward studying ethnic minority women related to the psychological implications of image and beauty, as historically the focus has been on the experiences of European women (Awad et al., 2015). Black women must process sexual development, attitudes, and behaviors through the lens of the sexual scripts and stereotypes of their ethnic group and must negotiate between mainstream and culture specific norms of sexuality (Daniels and Zurbriggen, 2016; Jerald et al., 2017). The presence of these scripts signifies a difference between Black women and other races about how they may internalize and react …

The Multicultural Orientation Framework In Couple Therapy, Jasmine R. Davis

Electronic Theses and Dissertations

Couples’ cultural values and beliefs are important to their relational connection. Cultural values and beliefs can be sources of strength in relationships, but they can also lead to impasses. As such, clinicians and researchers could benefit from a cultural framework to inform conceptualization and treatment when working with couples. The Multicultural Orientation (MCO) framework has three pillars: cultural humility, cultural comfort, and cultural opportunities. The MCO framework is empirically supported for use in individual and group psychotherapy but has not been applied to couple therapy. This dissertation includes two parts. First, we outline a conceptual framework for the application of …

Transgender Individuals’ Experiences Of Ruptures And Repairs In Group Psychotherapy, Gabrielle W. Kaufman

Electronic Theses and Dissertations

As the political climate across the United States worsens for transgender and gender diverse (TGD) individuals (Harmon, 2025), it has become increasingly important to attend to the mental health needs of this population (James et al., 2016). Group therapy is a widely used treatment modality that is often more accessible than individual therapy (Burlingame & Strauss, 2021) and provides unique interpersonal opportunities (Burlingame et al., 2016). While it is expected that TGD individuals face unique challenges in group therapy due to their gender identities (Chen et al., 2020), very little is actually known about the experiences of TGD individuals participating …

“My Body Was Never Mine”: An Arts-Based Phenomenological Analysis Of Queer And Trans Adolescent Involuntary Psychiatric Hospitalization Experiences, Megan Doyle

Electronic Theses and Dissertations

Involuntary psychiatric hospitalization has life-saving and crisis-stabilizing intentions for queer and trans adolescents experiencing mental health crises; however, there are significant concerns about the adverse effects of this practice. This study employed two interwoven qualitative methods, interpretative phenomenological analysis and arts-based research, to gain a deeper understanding of queer and trans individuals’ adolescent experiences of involuntary psychiatric hospitalization. The theory of abolition was applied to examine the carcerality and identity-based oppression embedded within this procedure. Participant narratives and artwork revealed how involuntary psychiatric hospitalization is non-affirming for queer and trans young people in crisis, and the impacts of experiencing coercion, …

Exploration Of The Cultural Beliefs, Values, And Practices Of African American/Black Women Or Birthing Persons Regarding Postpartum Depression: A Focused Ethnography, Stephanie Jacobs

Electronic Theses and Dissertations

Introduction: Postpartum depression (PPD) is the most prevalent perinatal mental health illness in women, affecting approximately 10% to 20% of all women in the United States, and a disproportionately higher number of African American women. The aim of this study was to explore the cultural beliefs, values, and practices of African American/Black women or birthing persons regarding postpartum depression.

Research Question: What are the cultural beliefs, values, and practices of African American/Black women or birthing persons regarding postpartum depression?

Methodology: A focused ethnography was chosen for this study and consisted of semi-structured interviews. Data was transcribed and analyzed …

Evaluating The Predictive Value Of Basc-3 Anxiety Scale And Working Memory Index Scores For Clinically Significant Test Anxiety: A Comprehensive Analysis Of Non-Classifiable Cases, Des'tiana S. Williams

Electronic Theses and Dissertations

This dissertation will explore how test anxiety (TA) affects working memory (WM) and whether certain factors can help predict higher levels of test anxiety. Anxiety has been defined as a common experience that can show up in various forms—like general worry, social fears, panic attacks, and specific phobias (APA, 2022). It was described as often triggering our natural “fight-or-flight” response, which can impact our ability to focus, think clearly, and remember things. For students, test anxiety has been especially challenging, affecting how they perform in high-stakes academic settings. Using data from a university based psychological assessment center, this study will …

Evaluating The Predictive Value Of Basc-3 Anxiety Scale And Working Memory Index Scores For Clinically Significant Test Anxiety: A Comprehensive Analysis Of Non-Classifiable Cases, Des'tiana S. Williams

Electronic Theses and Dissertations

This dissertation will explore how test anxiety (TA) affects working memory (WM) and whether certain factors can help predict higher levels of test anxiety. Anxiety has been defined as a common experience that can show up in various forms—like general worry, social fears, panic attacks, and specific phobias (APA, 2022). It was described as often triggering our natural “fight-or-flight” response, which can impact our ability to focus, think clearly, and remember things. For students, test anxiety has been especially challenging, affecting how they perform in high-stakes academic settings. Using data from a university based psychological assessment center, this study will …

The Role Of Adolescent Depression Heterogeneity And Resilience Resources In Adulthood Cardiometabolic Health And Depressive Symptoms, Samantha R. Scott

Electronic Theses and Dissertations

Depression in adolescence is a major public health problem and is a risk factor for early-onset cardiometabolic disease. Although adolescent depression is a risk factor for poor cardiometabolic health, depression is heterogeneous and associations may differ by sex. Additionally, if risk factors such as depression can predict adulthood cardiometabolic health, resilience factors (e.g., social, school, neighborhood) that are protective for depression may also be protective for physical health, but this is an ongoing area of research. The goals of the current dissertation were to gain a better understanding of what depressive symptom presentations in adolescents are most concerning for adulthood …

Representation Of Diseases And Health Care In Selected African Gyno-Texts, Rachael K. Aderoju

Electronic Theses and Dissertations

This study explores the interdisciplinary field of literature and medicine through a feminist psychoanalytic lens, focusing on how Nigerian female writers represent illness, healthcare, and medical ethics in post-independence gyno-texts. Traditionally, scholarship in this field has centered on andro-texts (literary works authored by men), leaving a critical gap in the exploration of women’s perspectives. This research addresses that gap by analyzing nine prose works authored by Nigerian women, including texts by Chimamanda Ngozi Adichie, Ayobami Adebayo, Lola Shoneyin, and Samira Haruna Sanusi. These texts are examined for their portrayal of diseases such as infertility, cancer, bipolar disorder, and renal failure, …

Leadership And Peer Support Of Surgeons Post-Adverse Event: A Phenomenological Study, Maxine E. Trent

Electronic Theses and Dissertations

Abstract Surgeons are leaving the active practice of surgery and fewer physicians are pursuing surgical training, as a result the United States is predicted to have a shortage of surgeons until 2050. Surgery hosts a multitude of occupational stressors, one of which is interoperative adverse events and the subsequent experience of second victims. The literature indicates surgeons prefer psychological/emotional support from peers after interoperative adverse events. However, best practices for how to deliver peer and leadership support responses when surgeons experience second victims have not been established. This was a phenomenological qualitative study targeting practicing surgeons across the United States. …

Achieving Health Equity For Minorities, Marginalized And Vulnerable Populations: The Ethical Challenge For Improving Addiction Health Services And Policies In The Health Care System, Jasia A. Baig

Electronic Theses and Dissertations

During the past few decades, health disparities and substance misuse have transformed into unprecedented healthcare crises facing contemporary society. Although enormous contributions through policies and interventions have been made to promote health equity, substantial health inequalities and disparities persist, particularly in addiction health services and policies at multiple healthcare system levels for the marginalized, minoritized, and vulnerable populations.

The thesis of this dissertation asserts that a biopsychosocial ‘systems’ thinking towards treating addictive disorders along with systematic interventions and coordinated improvements specifically focused on minorities, marginalized and vulnerable populations at research, clinical, public health and global levels will significantly reduce health …

Investigating Mental Health Outcomes Of National Collegiate Athletic Association (Ncaa) Division I Student-Athletes At The University Of Louisville, 2019-2023., Paul Harvey

Electronic Theses and Dissertations

Mental health outcomes among collegiate student-athletes, has become a broader concern in the 21^st century. This study examines prevalence and incidence of anxiety and depression amongst student-athletes at the University of Louisville from 2019-2023 across different Sports Groups. The prevalence of anxiety was found to be 20.22% and risk of anxiety was 15.65%. The prevalence of depression was found to be 13.11% and risk of depression was 18.75%. Logistic regression was used to estimate the association between sports groups and anxiety/depression. There was a borderline association between sports groups and prevalence of anxiety after confounder adjustment (OR=1.86, 95% CI: …

The Effects Of Loving-Kindness Meditation (Lkm) On Relationship Satisfaction In Couple Therapy, Ruimeng Gao

Electronic Theses and Dissertations

This thesis explores the integration of loving-kindness meditation (LKM) into couple therapy sessions and its impact on relationship satisfaction. Meditation, historically rooted in religious practices, has increasingly been adopted in Western therapeutic contexts due to its demonstrated benefits for mental health and interpersonal well-being. Although mindfulness-based interventions have gained popularity in psychotherapy, research specifically examining the use of LKM in couple therapy remains limited. This study investigates whether incorporating LKM into therapy sessions enhances relationship satisfaction compared to standard therapy alone. Couples were randomly assigned to either a control group, which received standard therapy, or an experimental group, which practiced …

Investigating The Role Of The Hypocretin/Orexin System In A Novel Model Of Polysubstance Dependence, Tyler Zarin

Electronic Theses and Dissertations

Substance use disorders (SUD) in the United States are steadily increasing. Potent and dangerous substances such as methamphetamine (MA) and fentanyl (FEN) are often co-used as a polysubstance (POLY), either intentionally or unknowingly as FEN is a common adulterant. SUD is characterized by physiological and psychological dependence involving the negative reinforcement of anhedonia and withdrawal which drive hypermotivated drug-taking behaviors. Current theory suggests that recruitment of hypocretin/orexin (HCRT) neuropeptide in reward and stress associated brain regions contributes to drug dependence. Despite strong evidence for HCRT’s role in mono-drug dependence, a relevant model for POLY dependence has yet to be developed, …

Management Of Aggressive And Disruptive Behavior In The Emergency Department Using De-Escalation Techniques And Simulation: A Quality Improvement Project To Improve The Knowledge And Confidence Of Emergency Department Nurses And Clinical Staff, Ernestine Darby-Littlejohn

Electronic Theses and Dissertations

Abstract

Approximately 40% of all healthcare workers have reported episodes of violence by patients over the last 2 years. This Veteran’s Health Agency reported 824 disruptive events reported in the last 5 years, of which 56 occurred in the emergency department. Research shows that interventions are not always timely, resulting in the clinical staff requesting the Veteran’s Health Agency Police to intervene when a veteran’s level of stress is escalating. The gap in practice is shown to be related to a lack of knowledge in the clinical staff in managing high stress levels exhibited by some veterans, limited knowledge of …

Improving Outcomes Of Depression Through Implementation Of Depression Screenings At A College Health Center, Shelby Leigh Hanigan

Electronic Theses and Dissertations

Depression is a common phenomenon. Depression and suicidality are a problem on university campuses. This quality improvement Doctor of Nursing project aimed to establish the importance of routine depression screenings within a college health clinic. The purpose of this project was to determine if implementing routine depression screenings at a university health clinic will or will not increase the number of counseling referrals when compared to the absence of depression screenings in place within an identified timeframe. This protocol screened for depression in college-aged students and suggested care to those students who screened positive. It also led an interprofessional team …

The Ethics Of Involuntary Psychiatric Hospitalization: A Comprehensive Analysis Of Policies, Practice, And Ethical Oversight, Mariah Chobany

Electronic Theses and Dissertations

As a specialized field of medicine, psychiatry presents unique ethical challenges and dilemmas distinct from other medical disciplines. A particularly complex aspect of psychiatric care involves the involuntary treatment of patients who may be unable to make informed decisions about their care or participation in research due to the debilitating effects of their psychiatric condition. This presents a significant challenge for providers and researchers, particularly concerning capacity issues and the informed consent process. Despite the intricacies and complexities of ethical dilemmas in psychiatric treatment and research, there is a notable lack of comprehensive guidance in policies and practices on addressing …