Mental and Social Health Commons^™

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 …

Client/Therapist Feedback And The Role Of The Alliance On Psychotherapy Outcomes, Elizabeth Preston Cisneros

Loma Linda University Electronic Theses, Dissertations & Projects

Through a system of patient-focused outcomes research which has employed a quality assurance system for tracking client progress in therapy, there has been consistent evidence that utilizing the system to identify those who are not responding to treatment and warning their therapist about the client’s risk significantly improves client outcomes in psychotherapy. Although outcomes have been improved, significant proportions of clients have treatment failures or see no improvement in therapy. Moreover, feedback to therapists appears to be most effective in improving outcomes for the minority of clients who are already at risk of treatment failure.

Attempts to augment the feedback …

Diagnosing And Treating Adhd: Discipline Differences, Lisa Marie Lliteras

Loma Linda University Electronic Theses, Dissertations & Projects

According to Barkley (2005), attention deficit hyperactivity disorder (ADHD) is one of the most common reasons children are referred to mental health workers in the United States and is now one of the most prevalent psychiatric disorders associated with childhood. The diagnostic criteria and labels for ADHD have changed over the last several decades, and with each change the prevalence rate for ADHD has increased (Wolraich & Baumgaertel, 1997). This increase in the prevalence of ADHD has led to a need for clinicians from different disciplines to assess and treat ADHD. As such, several guidelines from professional associations have been …

Therapeutic Modalities And Educational Approaches In Clergy Stress Reduction, Shaun Tress Campbell

Loma Linda University Electronic Theses, Dissertations & Projects

Clergy are listed among administrators, social workers, healthcare providers, fire fighters, and police officers as professionals with high levels of occupational stress (Hill et al., 2003; Greenberg, 1990). Clergy are valuable resources to the American culture in that they perform an array of services to comfort and assist others. From natural catastrophes to personal misfortune, pastors are often expected to be present to offer consolation or to extend ecclesiastical services. Researchers have found that pastors are the primary mental health counselors for tens of millions of Americans (Weaver et al., 2002). Darling et al. (2004) report, "Clergy in U.S. culture …

Marital Satisfaction And Intimacy: Gender Role Attitudes And Spousal Support In Botswana, Kagelo Henry Rakwena

Loma Linda University Electronic Theses, Dissertations & Projects

In this study, the predictors of marital satisfaction and intimacy were examined within an African context that is characterized by a fast growing economy, migrant population, urbanization and industrialization. Specifically, this study examined the role of two relational variables, gender role attitudes and spousal support and two demographic variables, age and gender in predicting the variance in marital satisfaction and intimacy, after controlling for number of children, religion, occupation, education, length of marriage and household income among married individuals in Botswana. The results of this study reveal the importance of gender role attitudes and spousal support as key predictors of …

Psychosocial Factors Associated With Nicotine Dependence Among College Students : Are There Differences Between Social And Regular Smokers?, Devan Rae Romero

Loma Linda University Electronic Theses, Dissertations & Projects

Background. Cigarette smoking, the primary source of tobacco used by adults 18-25, has remained stable, at around 21-25%, in the college population since 2003. Many college students report their smoking as primarily a “social” behavior, which may reflect an emerging type of smoker. Ambiguity exists in defining and categorizing smokers in the college population.

Purpose. The purpose of this study was to examine psychosocial perceptions related to smoking among college students who currently smoke and those who do not smoke, and among different types of smokers. In addition, validation of self-reported smoking behavior with saliva cotinine was conducted in …

A Critical Constructionist View Of "At-Risk" Youth In Alternative Education, Rachelle Silverstein Touzard

Loma Linda University Electronic Theses, Dissertations & Projects

Family therapists and school counselors are increasingly called upon to provide services for youth in alternative education (Carver, Lewis, & Tice, 2010). Alternative education systems are programs for youth who have been defined as at risk. This study explored the at-risk discourse and asked the questions (a) how do youth and staff define the term at risk, (b) construct their experience in alternative education systems, and (c) experience their relationships with each other.

Combined elements from critical theory and a social constructionist perspective guided this study. A qualitative, grounded theory method was used that included semi structured interviews with …

The Development Of An Advanced Filial Therapy Model, Amy Cathleen Wickstrom

Loma Linda University Electronic Theses, Dissertations & Projects

This study sought to develop an advanced filial therapy model by examining the experiences of seven parents who participated in a preliminary advanced filial therapy intervention. These parents had previously completed a 10-week basic filial therapy model called Child Parent Relationship Therapy. A phenomenological qualitative design was employed, wherein data was obtained from parent playtime notes, researcher field notes, group process transcriptions, and focus groups. Parent experiences of the intervention were examined from a systems-relational lens, and four categories emerged, which include relational epiphanies, enhanced understanding of the playtimes, model format, and skill development. Additionally, a variety of themes were …

Predicting Systemic Confidence, Stephanie Inez Falke

Loma Linda University Electronic Theses, Dissertations & Projects

Using a mixed method approach, this study explored which educational factors predicted systemic confidence in master’s level marital and family therapy (MFT) students, and whether or not the impact of these factors was influenced by student beliefs and their perception of their supervisor’s beliefs about the value of systemic practice. One hundred and twenty graduate students in Commission on Accreditation for Marriage and Family Therapy Education-accredited (COAMFT) programs completed an online survey that assessed their training experiences, beliefs about systemic practice and perceptions of confidence. Quantitative findings revealed that students who reported greater research expectations in their program, obtained more …

Comparison Of Rationally-Derived And Empirically-Derived Methods For Predicting Failure In Residential Treatment, Jennifer Pester Grattan

Loma Linda University Electronic Theses, Dissertations & Projects

Patient-focused research methods have been used in adult mental health treatment to improve outcomes by tracking individual treatment response and comparing it with expected recovery patterns. One such approach has used rationally- and empirically-derived methods to analyze data from the OQ-45 and identify patients who are not responding as expected to treatment. Treatment is then adjusted, improving outcomes and lowering overall costs.

Similar but less extensive research has shown analogous methods can be used with children and adolescents. This would be particularly useful in residential treatment, which is an expensive and inadequately researched approach. This study used archival data gathered …

Profiles Of Drug Endangered Children: Investigation In A Clinical Sample, Imanie Samanmali Wijayaratne

Loma Linda University Electronic Theses, Dissertations & Projects

Despite the increase in children born prenatally exposed to methamphetamine, little is known about the cognitive and neuropsychological outcomes of these children. Research specific to prenatal-methamphetamine exposure is extremely limited and has been primarily restricted to rat studies. This research combined with the few studies examining children prenatally exposed to methamphetamine suggests that methamphetamine-exposure is associated with various cognitive and neuropsychological delays and is impacted by both biological and environmental factors. Given the scarcity of research in this area, the current study used archival data from a psychological assessment clinic to (1) describe the frequency of prenatal methamphetamine-exposure cases, (2) …

Accuracy Of A Rationally-Derived Method For Predicting Failure In Residential Treatment, Jennifer Pester Grattan

Loma Linda University Electronic Theses, Dissertations & Projects

Recent studies of adult mental health treatment have used patient-focused research methods to improve outcomes, by tracking treatment response and comparing it with expected recovery patterns. One such line of research has used rationally-derived and empirically-derived methods to analyze data gathered by the OQ-45 and identify patients who are not responding as expected to treatment. This allows for adjustment of treatment, which results in improved outcomes and lower overall costs.

Similar but less extensive research has provided evidence that these approaches may also improve outcomes in outpatient treatment for children and adolescents. These approaches might be particularly useful in residential …

Creating The Patient-Doctor-Family Relationship: Issues Of Power And Gender, Josephine M. M. Perez

Loma Linda University Electronic Theses, Dissertations & Projects

Objectives: To understand how patients, doctors, and families see, form, and commit to relationship and how power and gender influence their interpersonal processes and meanings.

Methods: Grounded theory methodology was used. There were six family medicine physicians, ten patients, and ten family members who participated. Physicians, patients, and family members were matched.

Results: Four themes emerged: types of patient-doctor-family relationships (extended family and traditional), types of care (relationship-centered care (RCC), family-oriented care (FOC), whole-person care (WPC), and patient-centered care (PCC)), commitment and intimacy, and interpersonal processes (perception of relationship shape, bonding, confidence and trust, equality and partnership, mutuality, …

Clergy Stress: Seventh-Day Adventist Pastors In Hong Kong, Singapore, And Taiwan, Onn Liang

Loma Linda University Electronic Theses, Dissertations & Projects

This research utilized an expanded ABC-X model of family stress, one that incorporated the culture and boundary ambiguity constructs of the contextual approach as a paradigm to examine the outcomes of job-related stress experienced by the Seventh-day Adventist pastors in Hong Kong, Singapore, and Taiwan. All together 89 Adventist pastors or 86.4% of the total pastoral workforce in the three regions participated in the 52 self-administered questionnaire survey. In addition, two focus groups made up of 15 pastors in Taiwan were utilized to generate descriptive data related to pastors and their families in the context of stressful situations. This research …

An Evaluation Of Interventions Designed To Impact Nurses : A Pilot Project, Pamela G. Bing Perry

Loma Linda University Electronic Theses, Dissertations & Projects

This pilot project was designed from a systems approach as defined within the field of marriage and family (MFT). Systems theory has been used successfully in examining and working with organizational relationships as exemplified in the work of Edwin H. Friedman. His contribution includes several books specifically developed for use in organizations; one that was tailored for religious groups; and another for managers (Friedman, 2007). While other MFT modalities have also been used effectively with organizations, the complexity of the influences operating within an organization most closely matches the systems approach. For this reason, this is the conceptual framework applied …

Fetal Cocaine Exposure Causes Epigenetic Changes In The Rat Heart, Kurt D. Meyer

Loma Linda University Electronic Theses, Dissertations & Projects

Cocaine abuse continues to be prevalent in the United States and other industrialized nations, in addition to the negative health effects that cocaine abuse has on the user, a mother who uses cocaine while pregnant also exposes the developing fetus to cocaine. Although there have been many studies of the effects of cocaine on the adult heart, studies of cocaine on the fetal heart and its potential delayed pathophysiological effects on cardiac function in adult offspring are extremely limited. The studies of the present project sought to enhance the understanding of the effect of cocaine exposure on the fetal heart …

The Effects Of A Psychoneuroimmunology Based Lifestyle Intervention In Modifying The Progression Of Major Depression In Clinically Depressed Adults, Ruth A. Tanyi

Loma Linda University Electronic Theses, Dissertations & Projects

Chronic stress can lead to poorly controlled upsurges of cortisol and dysregulation of the hypothalamic pituitary-adrenal axis, thereby contributing to major depression. Hence, researchers have begun to examine the effects of individual psychoneuroimmunology (PNI) interventions and their impact on modifying stress and depression. However, there is a lack of studies that have examined the composite effect(s) of a PNI-based lifestyle intervention and major depression. Thus, this randomized interventional study examined the composite effect(s) of a PNI-based lifestyle intervention: combined progressive muscle relaxation and spiritual guided imagery and humor as an adjunct therapy to modifying the progression of depression. Participants were …

A Psychoeducational Group Intervention For Fibromyalgia Patients, Derek O. Bacchus

Loma Linda University Electronic Theses, Dissertations & Projects

This study examined the effect of a multidisciplinary psychoeducational treatment group on Fibromyalgia Syndrome (FMS) pain, depression, catastrophizing, and quality of life. The Short-Form McGill Pain Questionnaire (SF-MPQ), Center for Epidemiologic Studies Depression Scale (CES-D), Coping Strategies Questionnaire (CSQ), and the World Health Organization Quality of Life Assessment—Abbreviated Version were used to assess these constructs in 15 participants. The sample was composed entirely of female participants and was predominantly middle aged, which is typical of the FMS population. Two separate groups of FMS patients—seven in Group 1, eight in Group 2—completed a 10-week psychoeducational intervention where they were presented with …

The Prevalence And Determinants Of Health Risk Behaviors Among High School Students In Mexico, Nellie León

Loma Linda University Electronic Theses, Dissertations & Projects

The Centers for Disease Control and Prevention report that despite health promotion efforts, adolescents continue to engage in behaviors that put them at risk for morbidity and mortality. Alcohol consumption, illicit drug use, smoking, and risky sexual behaviors are among the behaviors that contribute to leading causes of morbidity and mortality in youth; these four behaviors were explored in this study. An observational cross-sectional design was utilized. The Youth Risk Behavior Survey from the Centers for Disease Control and Prevention was utilized to assess the prevalence of the four risk behaviors among high school students in Jalisco, Mexico. Items constructed …

Social Cognitive Predictors Of Diabetes Outcomes In Latinos And Whites, Diana Brown

Loma Linda University Electronic Theses, Dissertations & Projects

Investigating health care disparities in ethnic minority populations is an increasingly urgent issue as these disparities lead to higher morbidity and mortality in minorities (National Center of Health Statistics, 2000). There is clear evidence that Latino Americans, the fastest growing minority group in the United States, are more likely to be diagnosed with and experience more severe complications from type 2 diabetes than Anglo Americans. This study surveyed 38 White and 33 Latino diabetes patients from outpatient clinics in an academic medical center. Cultural values (individualism and collectivism), mental health (social support, mental health), and self-efficacy (diabetes and exercise) were …

The Evaluation Of Sharper Future: A Community-Based Sex Offender Treatment Program, Lindsay M. Cunningham

Loma Linda University Electronic Theses, Dissertations & Projects

A program evaluation of Sharper Future’s Substance Abuse Services Coordinating Agency (SASCA) sex offender treatment program was conducted in order to ascertain whether the program is meeting its treatment goals as outlined by the SASCA contract and Sharper Future program goals. The participants of this evaluation were 248 past male Sharper Future clients who had been mandated to treatment at the Sharper Future facilities and were funded by the SASCA program. The data used in this program evaluation was archival, as it existed in the clients’ file as supplied by the Sharper Future clinics that run a SASCA treatment program. …

Promoting Animals For Well-Being And Self-Acceptance With The Human Patient, Vicki J. Marquardt

Loma Linda University Electronic Theses, Dissertations & Projects

Few empirical studies have been conducted in order to scientifically measure the benefits of using animals with individuals suffering from neurological disorders, or traumatic brain injuries, with or without the inclusion of chronic pain. This study looked at the benefit of using horses in the therapeutic setting, by measuring the levels of anxiety, depression, self-esteem and quality of life pre- and post-therapy, in individuals diagnosed with Multiple Sclerosis (MS). Three groups were used in this study, and were measured pre and post therapy over an eight week period of time. The first group did not participate in the therapy at …

A Theory Of Positive Mental Health, Jason D. Rowden

Loma Linda University Electronic Theses, Dissertations & Projects

For many decades psychological research has erred on the side of looking toward pathology and has neglected to define what positive mental health functioning is on an individual level (Dahlsgaard, Peterson, & Seligman, 2005, p. 203). Without a sound theory of positive mental health, the field of psychology is left guessing as to its meaning. The importance of having a clear definition of mental health cannot be underscored enough. Without a clear understanding of mental health, the field of psychology is forced to function with varying opinions, defined by each clinician. The goal of the current thesis is to contribute …

Arginine Vasopressin And Male Attachment: A Marital And Family Therapy Perspective, Calvin James Thomsen

Loma Linda University Electronic Theses, Dissertations & Projects

Social neuroscience offers a promising way to understand some dimensions of adult attachment. Arginine vasopressin (AVP) is a neuropeptide with significant implications for human social behavior and it provides an important testing ground to explore links between social/interpersonal neurobiology and attachment. It has a distinctive impact on the social/relational behavior of certain male animals, most notably prairie voles. It fosters monogamy, creates attachment to both mate and offspring, and increases affiliation and a desire for physical proximity with other animals of the species. There has been much speculation that it might play a similar role with human males. This study …

Family Variables As Predictors Of Adolescent Substance Abuse Treatment Outcome, Gina R. Sillo

Loma Linda University Electronic Theses, Dissertations & Projects

The current study sought to investigate the importance of family variables as they potentially predict treatment outcome for adolescents at two intensive outpatient drug treatment programs. A growing body of research has demonstrated that family dynamics serve to influence drug using behaviors and substance abuse treatment. More specifically, empirical support has suggested that the quality of family relationships is an important factor serving to influence affective treatment. The current investigation considered two primary domains of family influence: family cohesion and family conflict. Results revealed that the study variables comprising these domains were not found to be associated with adolescent treatment …

The Psychophysiology Of Information Processing Differences In Eating Disorders, Kathryn Grace Truitt

Loma Linda University Electronic Theses, Dissertations & Projects

Maladaptive or dysfunctional cognitive factors are believed to be significant contributors to pathology in eating disorders. The emotional Stroop task was used to examine [the] these dysfunctional cognitive factors. A sample of 31 women (14 nonclinical controls, 13 BN, 4 AN) participated in this investigation, after exclusion for ocular and movement artifacts and equipment problems the remaining sample contained 4 women diagnosed with BN, 4 women diagnosed with AN, and 9 matched non-clinical control subjects. Participants completed an Emotional Stroop task comprised of 8 blocks of words. On each trial, a word was presented in one of four colors (black, …

A Geospatial Approach For New Perspectives On Satisfaction With Health Services In Malawi, Gideon Mazinga

Loma Linda University Electronic Theses, Dissertations & Projects

This dissertation explored the spatial pattern of user satisfaction with health services and factors, including policies that potentially explain the variation in the district-level of user satisfaction with health services. Nationwide secondary data was extracted from the 2002 Core Social Welfare Indicators Survey and the National Health Services Statistics databases obtained from National Statistics of Malawi. The National Health Facilities inventory obtained from the Malawi diffusion project was also geocoded to display the distribution of health care facilities in the country. Spatial autocorrelation and regression modeling techniques were applied on the national representative data set.

The spatial autocorrelation test revealed …

Efficacy Of Cognitive Therapy And Pharmacotherapy In Depression: A Meta-Analysis, Daniel B. Michel

Loma Linda University Electronic Theses, Dissertations & Projects

A meta-analysis comparing the long-term effectiveness of cognitive behavioral therapy (CBT) and pharmacotherapy in preventing relapse following treatment discontinuation was performed using published studies of depressed participants. Twenty-three articles met inclusionary criteria and were included in the analyses. Weighted effect sizes and moderators, treatment type, were calculated using statistical analysis software. Initially, fixed effects models were applied to the data, but due to significant between-group heterogeneity that could not be fully explained by treatment type, mixed effect models were used to account for the residual heterogeneity. Results indicated that overall, depressed individuals treated to remission with CBT evidence decreased relapse …

Religious Coping And Depression In Home Care Patients, Kirsten Ingheim

Loma Linda University Electronic Theses, Dissertations & Projects

This study examined the impact of a medical illness in 36 elderly male and female home health care patients with a primary diagnosis of heart disease, cancer, diabetes, or chronic obstructive pulmonary disease (COPD) and how they coped with their medical condition. Relationships between depression and religious coping, functional status, quality of life, and depression, as well as relationship between functional status and quality of life were investigated. In addition, a moderating effect of the relationship between functional status and depression by religious coping was explored. The participants completed the Religious Problem-Solving Scale (RPSS) (Collaborative, Deferring, and Self-Directing), the SF-12 …

A Model For Preventing Anorexia In College Students, Laura Ann Negin

Loma Linda University Electronic Theses, Dissertations & Projects

The prevalence of anorexia nervosa in the general population is relatively low, but anorexia is at the forefront of health concerns because of its seriousness. Unhealthy weight loss has numerous physical, psychological, and social consequences. Most seriously, the mortality rate for people with eating disorders is the highest of all the major psychiatric disorders.

This dissertation presents a model for preventing anorexia nervosa in a population of college students that includes a comprehensive institutional approach, psychoeducational software, a high-risk population, a holistic approach that identifies an individual’s personal risk factors and protective factors, and individual therapy.

The model is built …