Social and Behavioral Sciences Commons^™

Sticking To The Recipe: How Do Adherence And Differentiation To A Cbt Protocol Affect Client Outcomes In Youths With Anxiety?, Ruben G. Martinez

Theses and Dissertations

Objective: Understanding the pathways through which treatments work to change symptom and diagnostic outcomes is important to the development and delivery of evidence-based treatments. This study assessed the extent to which adherence (therapist’s delivery of prescribed therapeutic interventions) and differentiation (therapist’s delivery of non-prescribed therapeutic interventions) to Coping Cat, a CBT program, affected client symptom and diagnostic outcomes. Method: The Therapy Process Observational Coding System for Child Psychotherapy – Revised Strategies Scale (McLeod et al., 2015) was used to characterize therapeutic interventions delivered within and outside of the Coping Cat program with youths aged 7-15 receiving treatment in one efficacy …

Racial And Ethnic Differences In Receipt Of Immediate Breast Reconstruction Surgery: Do Hospital Characteristics Matter?, Jaya Shankar Khushalani

Theses and Dissertations

Immediate Breast Reconstruction Surgery (IBRS) is associated with better quality of life among women who undergo a mastectomy. Despite insurance coverage for IBRS, utilization of IBRS remains low. Data from publicly available sources for 2010-2012 are used to examine the association between hospital characteristics receipt of IBRS by patients. Minority-serving status, low bed size, for-profit ownership, non-teaching status, high competition, low density of plastic surgeons in the market and non-metropolitan location are associated with lower likelihood of receipt of IBRS.

Racial and ethnic minorities are less likely to receive IBRS. A mixed effects logistic regression model with interactions between Black/Hispanic …

Three Measures Of Coping In Video Games (Civ-Iii): The Development, Construct Validation, And Profile Analysis Of The Civ-Iii, Chelsea M. Hughes

Theses and Dissertations

Video games provide a competitive, goal-oriented environment. They involve individuals who often seek intentionally to frustrate their opponents’ goals. The gaming community is made up of players who vary in their interpersonal style, learning histories, and skill levels. In this rich and dynamic environment, stress is a common experience. Given the prevalence of gameplay in the population and the frequency of gameplay among gamers, it is important to examine coping responses to stressors, particularly maladaptive ones. The present research entails three studies. In Study 1, I use exploratory factor analyses to develop three scales purported to measure maladaptive coping strategies …

The Role Of Mindfulness In The Regulation Of Behavior Among Those Prone To Negative Urgency, Alexandra M. Martelli

Theses and Dissertations

Negative emotions can be challenging to regulate, and for some individuals can lead to failures of behavior regulation. The present study is an initial effort to explore the role that mindfulness may play in fostering effective behavior regulation among those prone to high negative urgency (NU). Eighty undergraduate students were recruited based on their high or low scores of NU. First, participants completed a self-report measure of mindfulness (Mindful Attention Awareness Scale; MAAS), an Emotional Go/No Go task in an fMRI scanner, and then reported alcohol consumption. Results showed that those with high in NU had low levels of mindfulness …

Self-Forgiveness In Romantic Relationships: The Impact On The Perpetrator And The Relationship, Jaclyn M. Moloney

Theses and Dissertations

Two studies were conducted to determine how self-forgiveness and other perpetrator reactions influence the perpetrator and the victim after a romantic relationship transgression. Study 1 used a longitudinal design to determine how guilt and shame predicted the trajectory of self-forgiveness, self-excusing, and self-punishing in participants who had recently been the perpetrator of a romantic relationship transgression.

Those experiencing higher guilt at baseline had higher self-forgiveness starting out and those lower on guilt starting out had a greater change in self-forgiveness. Those experiencing more guilt at baseline experienced less change in self-forgiveness over time. Shame was not significantly related to self-forgiveness …

The Development Of The Therapy Process Observational Coding System - In-Session Involvement, Emily J. Wheat

Theses and Dissertations

In-session client involvement (i.e., participation in in-session therapeutic tasks) is hypothesized to be a necessary component of youth therapy and associated with positive outcomes. However, research on in-session client involvement has been slowed by definitional problems. At present, the field has not yet adopted a single definition of client involvement that is applicable across different theoretical orientations, which has impacted the measurement of this construct. To remedy this problem, the field needs to adopt a definition of in-session client involvement that includes important components (i.e., behavioral, affective, and cognitive) of this construct that applies across different theoretical orientations and use …

Longitudinal Bidirectional Relations Between Subtypes Of Anxiety And Callous-Unemotional Traits In Early- To Mid-Adolescence, Stephanie A. Hitti

Theses and Dissertations

Callous-Unemotional (CU) traits are characterized by limited empathy, lack of guilt or remorse, and callous use of others. They are a risk factor for adult psychopathy, especially when comorbid with conduct problems. Thus, efforts to identify risk factors and consequences of CU traits have been prominent. One construct that may act as both a risk factor for and consequence of CU traits among youth is anxiety. While the most consistent finding is in this literature is a negative relation between CU traits and anxiety, findings have been mixed. The present study examined bidirectional relations between three subtypes of anxiety (i.e. …

Parent-Fostered Enrichment Activities And Academic Outcomes In Middle Childhood, Princess-Melissa T. Washington-Nortey

Theses and Dissertations

Despite numerous educational reforms, elementary school children in the United States continue to lag behind their peers from other developed countries on reading, math and science outcomes. Many interventions focus on strategies aimed at increasing the amount of classroom work children undertake. However, the key to improving outcomes may lie in out of school enrichment activities that facilitate learning. Drawing from Eccles Expectancy-Value theory(Simpkins, Fredricks, & Eccles, 2012), the current study focuses on assessing the impact of parent-fostered enrichment activities on child academic outcomes in the first three years of elementary school. Using secondary data from Early Childhood Longitudinal Study …

The Institute Of New Feelings: Plastic Identities And Imperfect Surfaces, Weijian Zhou

Theses and Dissertations

Digital media are moldable spaces where an image is simultaneously a thought. This instance and flexibility enables digital existences to be malleable, transformative, situational, and unstable. They are plastic images. Video games generate digital bodies that are a fusion of subjectivities and cybernetic simulations, in a perceivable and ambiguous process. Such bodies are extensions of ourselves, being girlish, imperfect, unfinished and happening—digesting and emitting clusters of feelings, regardless of our biological gender and age. The performative experience of play is progressively departing from spectacle, gambling and competition, and increasingly shifting towards an emotional journey of alternate realities, spreading subjectivities into …

Effects Of Cumulative Risk On Asthma Outcomes In Urban Children And Adolescents, Samantha A. Miadich

Theses and Dissertations

Pediatric asthma disproportionately affects racial/ethnic minority children and children living in low-income, urban areas. Many families living in low-income, urban areas experience a number of stressors that can place children/adolescents at risk for worse asthma outcomes. This study examined the impact of a cumulative risk model of stressors (e.g., ED visits, quick-relief medication use, lung function, asthma control, QOL) in urban children (7-12 years) with persistent asthma. This study further aimed to examine both the original cumulative risk model and an adolescent-specific cumulative risk model as predictors of asthma outcomes in a sample of 60 adolescents (13-17 years). Asthma-related caregiver …

Open / Close: Assimilating Immersive Spaces In Visual Communication, Anika Sarin

Theses and Dissertations

I am interested in two spaces obverse to each other: open and closed. An open space develops organically based on how people inhabit it. Interacting with an open space is a dynamic, sporadic, multisensory, immersive, and subjective experience. In such spaces, we are confronted with an alternative aesthetic, one that is in conflict with the seamlessness of a closed space. A closed space is anchored on definite variables like structure, use and boundaries. While interaction between people and space is important, the space is tightly controlled and interaction is designed. Through this thesis project, I present a method that metaphorically …

Advocate Or Traditional Bureaucrat: Understanding The Role Of Esl Supervisors In Shaping Local Education Policy Toward Immigrant Communities, Grant E. Rissler

Theses and Dissertations

As recent immigrants seek a productive and dignified life in “new immigrant destinations” that have little historical experience with immigration, public education systems serve a key function in immigrant integration efforts. In a federal system increasingly focused on accountability, a crucial sub-set of education policy and local responsiveness to immigration is English language instruction and services for Limited English Proficient (LEP) students and parents.

In such contexts, the role that local bureaucrats play, and whether they actively represent the interests of the newfound diversity of community members, are crucial questions if strongly held American ideals of social equity and equal …

The Identity Formation Of South Asians: A Phenomenological Study, Shabana Shaheen

Theses and Dissertations

This research explores the lived experiences of South Asians college students. This research, through a qualitative study that is rooted in the philosophy of phenomenology, explores the essence South Asians’ identity formation. Qualitative data was collected through semi-structured interviews with South Asian college students. The data analysis was under a phenomenological lens that centered the lived experiences and the essence of these experiences in the results. Seven themes emerged from this phenomenological study: negotiating bicultural identity, model minority expectations, meaningful impact of religious spaces, understandings of intra-community tensions, racialization of Islamophobia, understandings of South Asian identity and efficacy of Asian …

Implementing Integrated Care In Family Medicine: Description And Outcomes In An Underserved Population, Zach Radcliff

Theses and Dissertations

Introduction: Family physicians provide access to medical and behavioral healthcare for many underserved populations. Integrating behavioral health clinicians into primary care practices has been proposed as one of the most effective ways to increase access to necessary behavioral health services for many Americans. Integrated behavioral healthcare (IBHC) has begun to be implemented in family medicine practices but there is limited research examining the impact for patients and clinic staff. This study begins to fill this gap in the literature by examining the effects of implementing integrated behavioral healthcare in an urban family medicine clinic in a medically underserved area.

Objective: …

Health Aid In Africa: Placement, Service Utilization, And Benefit, Carrie Dolan

Theses and Dissertations

While the health sector has attracted significant foreign aid, evidence on the effectiveness of this support is mixed. This dissertation examines the allocation of health aid within the context of placement, service utilization, and benefit. The first paper examined the sub-national allocation of Chinese development aid projects across Africa. I determined how political preferencing of Chinese aid specifically, allocating aid to the birth region of the current political leader differs across sectors such as health, education, and transportation. I find some evidence that aid, more broadly defined, is subject to political preferencing in recipient countries, which could potentially limit its …

Affordability, Utilization And Satisfaction With Care: A Policy Context For Improving Health Care Experiences, Anushree M. Vichare

Theses and Dissertations

Disparate healthcare experiences continue to pose a challenge; vulnerable populations such as low-income and racial and ethnic minorities may not be able to afford or utilize care when needed or receive quality care. The sources of disparities are complex and multi-factorial, which include health care system-level factors such as insurance and health care workforce. It is relatively less known to what extent these contribute to disparities related to a patient’s overall health care experience across three important domains – affordability, utilization and satisfaction with care.

This dissertation has three objectives. First, to assess how insurance benefit design affects health care …

Undocumented Students In Higher Education: A Case Study Exploring Street-Level Bureaucracy In Academic Advising, Fai Howard

Theses and Dissertations

Immigration is arguably among the most divisive global and national issues at present. In the U.S., undocumented persons (the DREAMers) who arrived to the U.S. as children have been the central focus of legislation and debate. As of 2013, the undocumented population has increased from less than a million in 1980, then reaching 12.2 million in 2006, to an estimated population of 11.3 million (Passel, Cohn, Krogstand, & Gonzalez-Barerra, 2014) just a few short years ago. For the numerous undocumented students who have excelled academically and socially, and make positive contributions to their communities, the goal of obtaining a college …

Designing Effective Messages To Promote Future Zika Vaccine Uptake, Jeanine Guidry

Theses and Dissertations

The Zika virus is associated with the devastating birth defect microcephaly, and while a vaccine was not yet available in early-2017, several were under development. It is imperative to identify effective communication strategies to promote uptake of a new vaccine, particularly among women of reproductive age. Moreover, though the Zika outbreak has received much social media attention, little is known about these conversations on Instagram. The purpose of this dissertation, therefore, was to understand current Zika-focused communication on Instagram and to inform effective communication strategies to promote future Zika vaccine uptake intent.

The study aims were: (1) explore Zika conversations …

The Justification Of Prejudice Toward Childfree Women, Annalucia Bays

Theses and Dissertations

Previous research suggests that women without children are perceived negatively by others and experience adverse outcomes in various settings. This study investigated psychosocial justifications of prejudice toward childfree women. Participants (N = 891) completed measures of right-wing authoritarianism (RWA), the internal (IMS-S) and external (EMS-S) motivations to respond without sexism, and prejudice toward childfree women (i.e., perceived disadvantages of being childfree, evaluations of childfree women, and perceptions of childfree women’s warmth). Most participants also completed one or more justification measures of hostile sexism (HS), benevolent sexism (BS), gender-specific system justification (GSSJ), and femininity ideology. Results indicated that greater RWA …

State-Based Human Rights Violations And Terrorism, Eray Karlidag

Theses and Dissertations

In this dissertation, I examine the within-country and between-country effects of state-based human rights violations on annual counts of total, fatal and attributed attacks. I use the Global Terrorism Database (GTD) for my outcome variables and Political Terror Scale (PTS) to measure state-based human rights violations.

Scholars argue that repressive governments that silence dissidents and close all avenues of political expression increase the likelihood of terrorism and other acts of violence against the state (Gurr, 1970; Crenshaw, 1981; DeNardo, 1985; Piazza, 2017). In such circumstances, terrorism and acts of violence against the state may serve as a defense mechanism against …

Examining Health Behaviors In College Students With And Without Chronic Conditions, Duc-Thi J. Barsell

Theses and Dissertations

Many college students are in a developmental period in which they are transitioning from pediatric to adult health care. This time period can be challenging for all college students and especially for students with a chronic condition. The current study investigated the association between various health-related factors (health locus of control [HLOC], health literacy, health self-efficacy, and health-related quality of life [HRQOL]) and health behaviors in college students, as well as the moderating effect of having a chronic condition on those associations. These health behaviors were further operationalized as healthy lifestyle behaviors (preventative and wellness behaviors, dietary behaviors, physical activity) …

Using Restoration-Oriented Coping And The Dual Process Model With Bereaved Undergraduates, Farah J. Aslanzadeh

Theses and Dissertations

Approximately 60% of college seniors lost at least one family member or friend since beginning college (Cox, Dean, & Kowalski, 2015). Research reveals that bereaved students are more likely than their nonbereaved peers to struggle with academic problems and attrition (Cousins, Servaty-Seib & Lockman, 2017), highlighting the importance of identifying protective factors for this group of individuals. Researchers have identified restoration-oriented coping as a helpful coping mechanism in other samples (Caserta & Lund, 2007; Caserta, Lund, Utza, & de Vries, 2009). Despite qualitative evidence suggesting bereaved undergraduates often employ restoration-oriented coping, no research has formally assessed the effects of restoration-oriented …

Synchrony And Concordance: A Multilevel Analysis Of The Effects Of Individual Differences During A Co2 Challenge, Rachel E. Wallace

Theses and Dissertations

Emotion theories posit that emotion systems (e.g., behavior, self-report, physiology) should be related when an emotion is being elicited because this serves an adaptive purpose and allows the individual to respond appropriately to the present situation. Oftentimes, this coherent relationship is not found, and research has hypothesized that the type of analyses used and lack of examination of individual differences could be affecting this relationship. Most studies examine the relationship between emotion systems between-subjects when within-subjects analyses may be more appropriate. The present study examined the relationship between self-reported distress (SUDS) and heart rate, and whether trait differences of anxiety …

A Multi-Method Exploration Of The Genetic And Environmental Risks Contributing To Tobacco Use Behaviors In Young Adulthood, Elizabeth K. Do

Theses and Dissertations

Tobacco use remains the leading preventable cause of morbidity and mortality in both the United States and worldwide. Twin and family studies have demonstrated that both genetic and environmental factors are important contributors to tobacco use behaviors. Understanding how genes, the environment, and their interactions is critical to the development of public health interventions that focus on the reduction of tobacco related morbidity and mortality. However, few studies have examined the transition from adolescent to young adulthood – the time when many individuals are experimenting with and developing patterns of tobacco use. This dissertation thesis seeks to provide a comprehensive …

Walking In Beauty: Responsive And Responsible Health And Healing Among Virginia American Indian People, Amy J. Prorock-Ernest

Theses and Dissertations

Little is systematically known about the collective health and well-being of Virginia American Indian people. This study sought to explore the meaning of health and healing among Virginia American Indian people in the context of a reservation-based, non-federally funded health clinic. Using an emergent approach to qualitative research grounded in a constructivist inquiry paradigm and guided by Indigenous research principles, a total of 24 in-depth, semi-structured interviews were conducted with 17 American Indian service-users of the Clinic. Through an inductive thematic analysis of participant stories, a framework for understanding responsive and responsible health and healing was derived. The framework includes …

Exploring The Role Of Motivational Interviewing In Adolescent Patient-Provider Communication About Type 1 Diabetes, Laura J. Caccavale

Theses and Dissertations

Type 1 diabetes (T1D) is one of the most common pediatric chronic illnesses. Glycemic control among patients with T1D often deteriorates during adolescence; yet little is known about the most effective way for providers to communicate with adolescents to prevent this decline. Given the importance of effective communication, examination of effective patient-provider communication strategies is needed. The current investigation used Motivational Interviewing (MI) as a framework to help characterize naturally-occurring adolescent patient-provider communication in medical encounters and examined the relations between provider communication and T1D self-management and control.

Participants were five pediatric endocrine providers and 55 adolescents with T1D (49% …

Impact Of School-Based Sex Education On College Students’ Rape Myth Acceptance: An Exploratory Analysis, Erika Carpenter

Theses and Dissertations

Research indicates nearly one-fourth of college women fall victim to sexual assault (Cantor et. al., 2015). Two predictors of high proclivity to rape are endorsement of rape myths and adherence to traditional gender norms (King & Roberts, 2011). Additionally, research shows school-based sex education in the United States presents gender and sexual norms in troubling ways that disproportionately harm women (Kendall, 2013). However, research on sexual assault and rape myths have not examined the impact school-based sex education has on rape supportive attitudes. This study aimed to bridge that gap by using original survey data from undergraduate students at a …

What's Haunting Jackson Ward? Race, Space, And Environmental Violence, Rachel Spraker

Theses and Dissertations

This research is about examining the way in which racialized environmental violence contributes to exploitative social relations becoming embedded in the everyday world. I argue that the space of the everyday has been produced through cycles of social relations proceeding from and/or tied to racialized environmental violence. I continue the work of critical scholars in asserting that social and environmental violence is linked in the same ideological impulse which seeks to hide itself behind a variety of alienating processes. The slow way in which environmental violence works is particularly impactful in these processes because of its attritional lethality, contributing to …

Bridging The Empathy Gap: Effects Of Brief Mindfulness Training On Helping Outgroup Members In Need, Daniel R. Berry

Theses and Dissertations

Witnessing others in need can be felt similarly to experiencing it oneself (empathy) and motivates assistance of those in need (prosocial action). It is well-documented that empathy can occur automatically, but when those in need are not members of a social ingroup, empathy and prosocial action are undermined. One major ingroup—outgroup division in American and in other countries is based on race. Although most condemn racial discrimination, empathy and prosocial action are often lower, however unintentionally, in interracial contexts. In light of this empathy gap, it is important to identify psychological factors that could bolster empathy and prosocial action toward …

The Development Of The Treatment Integrity - Efficient Scale For Cognitive Behavioral Treatment For Youth Anxiety (Ties-Cbt-Ya), Meghan Smith

Theses and Dissertations

Brief, easy to use, psychometrically strong (i.e., pragmatic) instruments are needed to support implementation research; the current study assessed whether it was possible to develop a pragmatic observational treatment integrity instrument and reduce the amount of time coders spend making treatment integrity ratings (while maintaining score validity) of therapists delivering two protocols of individual cognitive-behavioral treatment (ICBT) for youth anxiety in research and practice settings. The 12-item instrument was derived from four observational treatment integrity instruments with promising score reliability and validity that assess adherence, competence, differentiation, and alliance. A sample of 106 youths (M age = 10.12, SD …