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Full-Text Articles in Social and Behavioral Sciences

Experiences Of Black American Millennials: A Qualitative Study Of Internalized And Externalized Coping In The Face Of Racial Trauma, Natalia Angelique Giles Dec 2023

Experiences Of Black American Millennials: A Qualitative Study Of Internalized And Externalized Coping In The Face Of Racial Trauma, Natalia Angelique Giles

Doctoral Dissertations

The experiences Black Americans have faced when standing against racial trauma have impacted the Black community for generations. Though previous generations faced overt styles of racism throughout the eras of slavery and Jim Crow, the invalidation and discrimination have remained consistent within the experiences of the Black American millennial (BAM) generation. Current experiences BAMs face are a combination of both overt and covert styles of racism, which increase mental exhaustion, reduce motivation, and leave the individual psychologically defenseless. The purpose of this qualitative study was to examine the experiences of BAMs in the face of racial trauma. This qualitative research …


Mental Health And Experiences Of Pregnancy Among Black Women And Birthing People With Type 1 Diabetes (T1d), Madeleine E. Marcus Aug 2023

Mental Health And Experiences Of Pregnancy Among Black Women And Birthing People With Type 1 Diabetes (T1d), Madeleine E. Marcus

Doctoral Dissertations

This dissertation explored the potential effects of intersections of oppression (i.e., anti-Black racism, diabetes discrimination, and sexism) on mental health and pregnancy experiences among Black women and birthing people with Type 1 diabetes (T1D). Previous studies about pregnancy and T1D have included mainly white, cisgender women. Three participants qualified for inclusion in the present study and participated in semi-structured interviews, which the researcher analyzed using an interpretative phenomenological analysis (IPA) framework. Participants described feeling uncertain about whether aspects of their pregnancy experiences were related to obstetric and/or medical racism. Similarly, participants sometimes seemed uncertain about how racism may affect their …


Faith Influences On Health Of Rural Appalachian Older Adults In East Tennessee: An Ethnonursing Study, Karina Elizabeth Strange May 2023

Faith Influences On Health Of Rural Appalachian Older Adults In East Tennessee: An Ethnonursing Study, Karina Elizabeth Strange

Doctoral Dissertations

As the U.S. older adult population increases and diversifies, healthcare providers need innovative, cost-effective, and culturally congruent approaches to gerontological nursing care. Decades of multidisciplinary evidence demonstrate that spirituality enhances older adult holistic health. However, although research about spirituality and nursing has become more culturally diverse, little is known about spirituality-health linkages of rural Appalachian older adults (RAOAs). This knowledge gap is significant because Appalachia leads the country in mortality related to chronic comorbidities such as heart disease, cancer, and depression. Given age, poverty, limited transportation, and health provider shortage areas, RAOAs experience severe health disparities. Moreover, spirituality is an …


Clinicians' Perspectives On The Effectiveness Of Trauma - Focused Cognitive Behavioral Therapy With African American Children: A Qualitative Study, Jada Carter Aug 2022

Clinicians' Perspectives On The Effectiveness Of Trauma - Focused Cognitive Behavioral Therapy With African American Children: A Qualitative Study, Jada Carter

Doctoral Dissertations

Literature exploring clinicians' perspectives on the effectiveness of trauma-focused cognitive behavioral therapy with African American children who suffer from trauma-related disorders is very limited. The current study examined clinicians' perspectives on the TF-CBT model when utilized with this population, including their experiences working with African American children and families with observable types of trauma-related disorders. This research study also explored the various facets of trauma that African Americans encounter in childhood and the barriers that prevent them from receiving adequate mental health care. Thematic analysis was utilized to explore themes that emerged when treating African American children with TF-CBT. Five …


Quality Of Life For Women With Chronic Lyme Disease: A Socioeconomic Investigation, Dale M. Jones Jun 2022

Quality Of Life For Women With Chronic Lyme Disease: A Socioeconomic Investigation, Dale M. Jones

Doctoral Dissertations

This is a mixed methods investigation of how chronic Lyme disease, including Lyme-like diseases and co-infections, affects the quality of life of women who have chronic Lyme. Both quantitative and qualitative methods were used during three phases of research: a 91-question survey instrument followed by focus group discussions and written narratives. The research considered the socioeconomic impact on quality of life in five areas: obtaining a diagnosis, relationships and personal support systems, struggles with the medical system, the ability to work, and access to treatment. There were 500 responses to the survey, of which 373 were analyzed; 11 participants in …


“In The Skin I’M In…I Represent A Different Version Of What Help Looks Like:” Black Women Sport Psychology Professional’S Experiences In Applied Sport Psychology, Sharon R. Couch May 2022

“In The Skin I’M In…I Represent A Different Version Of What Help Looks Like:” Black Women Sport Psychology Professional’S Experiences In Applied Sport Psychology, Sharon R. Couch

Doctoral Dissertations

Black Feminist Applied Sport Psychology (BFASP) is a culturally inclusive theoretical framework for centering Black women’s experiences in applied sport psychology (Carter et al., 2020; Couch et al., 2022). For the past two decades, (White) Feminist applied sport psychology professionals (FASPPs) described the experiences of Black women as unique but were overlooked in research and participant pools due to the prioritization of White women's and Black male sport experiences. (Carter & Davila, 2017; Carter & Prewitt-White, 2014; Gill, 2020; Hyman et al., 2021). The purpose of this study was to explore the life and work experiences of BASPPs (i.e., faculty, …


Using A Cognitive Behavioral Approach In Individual Counseling With Patients Undergoing Bariatric Surgery, Nina Marie Ditommaso May 2021

Using A Cognitive Behavioral Approach In Individual Counseling With Patients Undergoing Bariatric Surgery, Nina Marie Ditommaso

Doctoral Dissertations

Morbid obesity is linked to physical and psychological well-being. Bariatric surgery has shown tremendous success with rapid weight loss in the patient population with morbid obesity. These patients experience issues with weight regain post-surgery, which can be linked to psychological and social factors. Despite this, mental health counseling is rarely offered in bariatric surgery programs. The primary investigator used a six-session Cognitive Behavioral Therapy (CBT) approach in individual counseling with patients following bariatric surgery. The primary investigator used a single case research design to treat four participants. The primary investigator measured the effectiveness of a six-session CBT treatment, assessing for …


Clinical Work With Adult Male Incest Survivors: Therapeutic Themes And Perspectives, Kathryn B. Rosenberg Aug 2020

Clinical Work With Adult Male Incest Survivors: Therapeutic Themes And Perspectives, Kathryn B. Rosenberg

Doctoral Dissertations

For psychotherapists, encountering clients who have experienced sexual trauma or abuse is inevitable, whether or not the abuse is disclosed to the therapist; however, mental health professionals receive extremely limited (if any) training on how to identify or effectively support adult clients who are survivors of childhood sexual abuse (CSA). Many people who experienced CSA, especially those who identify as male, remain isolated and invisible in their suffering as adults even within therapeutic spaces, facing what feel like insurmountable barriers – both internal and external – to getting help. When sexual abuse is intrafamilial, these barriers are both amplified and …


Evaluating The Effectiveness Of Peer Engagement And Knowledge (Peak): A Community-Based Group Intervention For Youth In Hawai‘I, Jennifer T. T. Ho May 2019

Evaluating The Effectiveness Of Peer Engagement And Knowledge (Peak): A Community-Based Group Intervention For Youth In Hawai‘I, Jennifer T. T. Ho

Doctoral Dissertations

This study is a program evaluation with a mixed methods design that evaluated the effectiveness of Peer Engagement and Knowledge (PEAK), a six-week community-based group intervention that incorporates mindfulness-based interventions (MBIs) to address multiple health behaviors for multiracial youth in Hilo, Hawai‘i. A total of 51 youth, ages 12-23 years old, participated in this study which included pre-/posttest analyses of health risk factors such as substance use and depression and health promoting factors such as resilience, self-esteem, and mindfulness. Responses from two subsets of participants, who engaged in a focus group (n = 11) and composed gratitude letters ( …


Efficacy Of Integrated Mental Health Care With Dual Diagnosis Patients And Their Utilization Of Psychiatric Emergency Services, Denton Scott May 2019

Efficacy Of Integrated Mental Health Care With Dual Diagnosis Patients And Their Utilization Of Psychiatric Emergency Services, Denton Scott

Doctoral Dissertations

Historically, patients with dual diagnosis have been subjected to ineffective treatment and negative attitudes from healthcare providers. Further, these patients are plagued with myriad afflictions that exist beyond substance abuse and mental illness. The treatments and collateral damage associated with the diagnosis impose excessive healthcare costs and can be of significant detriment to society. Largely, patients suffering from dual diagnosis do not receive adequate treatment. As such, psychiatric emergency services are frequently utilized as an alternate treatment, wherein the main focus of care is on the substance abuse alone. This study argues that solely treating the substance abuse is not …


The Impact Of Ptsd And History Of Involvement In The Criminal Justice System On Medication Treatment Success In Opioid Use Disorder, Kirk Sanger Mar 2019

The Impact Of Ptsd And History Of Involvement In The Criminal Justice System On Medication Treatment Success In Opioid Use Disorder, Kirk Sanger

Doctoral Dissertations

This analysis examined the impact of post-traumatic stress disorder (PTSD), history of trauma, and a history of involvement in the criminal justice system (CJS) on treatment outcomes related to medication treatment for opioid use disorder. This study employed a secondary analysis of data derived from a multi-state, multi-site treatment center focused on substance abuse and more specifically opioid use disorder treatment. The total sample size was 19,970 patients. The majority of the sample received treatment in Massachusetts, was white, and non-Hispanic. Those with PTSD accounted for 9.5% of the sample, while 12% had a history of trauma. Just under 1/4 …


The Impact Of Perceived And Observed Food Environments On Fruit And Vegetable Consumption And Obesity: A Theory-Based Study Among U.S. Older Adults, Qianzhi Jiang Jul 2018

The Impact Of Perceived And Observed Food Environments On Fruit And Vegetable Consumption And Obesity: A Theory-Based Study Among U.S. Older Adults, Qianzhi Jiang

Doctoral Dissertations

The overall diet quality of U.S. older adults is less than optimal, featured by inadequate fruits and vegetables (FV), whole grains and dairy, and excessive sodium and fat. The current food environment can be challenging for older adults to improve their FV consumption. Both perceived and observed food environments are linked to FV consumption and health outcomes such as Body Mass Index (BMI) with mixed results. My research was guided by a social-ecological framework and the theory of planned behavior (TPB) to identify environmental supports for FV consumption in older adults. Adults aged 60 and older in Massachusetts, Iowa, and …


The Impact Of Depressive Symptoms On Cognitive Decline And Risk For Dementia, Katheryn Conde May 2018

The Impact Of Depressive Symptoms On Cognitive Decline And Risk For Dementia, Katheryn Conde

Doctoral Dissertations

As of 2011, the life expectancy for Latinos in the U.S. was 81.6 years, which is higher compared to non-Hispanic Blacks (75.3 years), non-Hispanic Whites (79 years), and Hispanic Black populations (74.9 years; Arias, 2011; Arias, 2015). Latinos have higher age specific prevalence of dementia, which is higher than African Americans and non-Hispanic Whites (Gurland et al.,1999). Latinos experience Alzheimers disease symptoms 6.8 years earlier, with the average onset of 67.6 years which is younger than non-Hispanic Whites (73.1 years; Clark et al., 2005). Furthermore, older Latinos tend to experience depression at a rate of 13% and 35% with the …


A Program Evaluation Of A Drug And Alcohol Family Treatment Program, Katrina Ramirez May 2018

A Program Evaluation Of A Drug And Alcohol Family Treatment Program, Katrina Ramirez

Doctoral Dissertations

The current study is a program evaluation at John Muir Behavioral Health, Center for Recovery. The research determined the effectiveness of the program at Center for Recovery that is offered to patients that struggle with substance use disorder and their families. The purpose of this study is to assess patients’ behavioral, cognitive and social/environmental factors as it relates to their commitment to sobriety and examine how the involvement of family members influences the patient’s recovery process. I utilized a mixed methodology of quantitative and qualitative interviews of patients and family members. The findings suggest depressive symptoms were negatively correlated with …


There Is A Monster In My House, Cultura Cura Uncovering 11 Milliones De Sueños: Understanding The Emotional And Psychological Experiences Of Undocumented And Mixed-Status Youth And Finding Healing Spaces, Belinda Marie Hernandez-Arriaga Jan 2017

There Is A Monster In My House, Cultura Cura Uncovering 11 Milliones De Sueños: Understanding The Emotional And Psychological Experiences Of Undocumented And Mixed-Status Youth And Finding Healing Spaces, Belinda Marie Hernandez-Arriaga

Doctoral Dissertations

This research gives voice to the emotional experiences of mixed-status and undocumented youth, and explores the Mexican cultural arts as a healing space for this community of children. This research expands our mental health understanding of undocumented and mixed status children, capturing the undocu-trauma these participants describe in narrating the chronic fear they live with. Their stories speak to the monster of fear, la migra, witches in the field, Trump, racism, societal violence and trauma that is invisible in their home but alive in their daily lives. The participants in this study narrate the power of the cultural arts to …


Dissociation And Sexual Trauma: The Moderating Role Of Somatization, Amineh Abbas Dec 2014

Dissociation And Sexual Trauma: The Moderating Role Of Somatization, Amineh Abbas

Doctoral Dissertations

This study examined various types of trauma, with an emphasis on sexual trauma across the lifespan, in a clinical sample of male and female adult outpatients assessed for trauma, somatization, and dissociation. Two hundred forty-five adult outpatients at the University of Tennessee Psychological Clinic were administered the Dissociative Experiences Scale (DES), the Traumatic Experiences Checklist (TEC), and Symptom Checklist-90-Revised (SCL-90-R), as part of the routine intake procedure. Of those individuals, 200 patients completed the questionnaires correctly and were included in the final study sample. The experience of sexual trauma indeed accounted for additional variance in somatization scores over and above …


Interpreting, Stephanie Jo Kent Aug 2014

Interpreting, Stephanie Jo Kent

Doctoral Dissertations

What do community interpreting for the Deaf in western societies, conference interpreting for the European Parliament, and language brokering in international management have in common? Academic research and professional training have historically emphasized the linguistic and cognitive challenges of interpreting, neglecting or ignoring the social aspects that structure communication. All forms of interpreting are inherently social; they involve relationships among at least three people and two languages. The contexts explored here, American Sign Language/English interpreting and spoken language interpreting within the European Parliament, show that simultaneous interpreting involves attitudes, norms and values about intercultural communication that overemphasize information and discount …


Communication, Control, And Time: The Lived Experience Of Uncertainty In Adolescent Pregnancy, Elizabeth Dortch Dalton Aug 2014

Communication, Control, And Time: The Lived Experience Of Uncertainty In Adolescent Pregnancy, Elizabeth Dortch Dalton

Doctoral Dissertations

This study qualitatively examined the lived experience of uncertainty among pregnant adolescents. Utilizing a phenomenological approach, long interviews were conducted with 10 pregnant adolescent women between the ages of 15-18 years. Interviews were transcribed and analyzed using the process of phenomenological explication. Data, emergent themes, memos, and a detailed audit trail were maintained using the qualitative data analysis package Nvivo 10 for Mac (beta version). Findings can be summarized with eight themes that underlie the essence of uncertainty in adolescent pregnancy: suspicion and denial, disclosure and reactions, controlling the flow of information, relational renegotiation, the emerging reality of pregnancy, information …


Evidence Based Practice Implementation: Perceptions And Expectations Of Master Of Social Work Students, Mholi Kent Vimba May 2012

Evidence Based Practice Implementation: Perceptions And Expectations Of Master Of Social Work Students, Mholi Kent Vimba

Doctoral Dissertations

Abstract

Efforts to develop sustainable Evidence-Based Practice (EBP) implementation strategies in work settings have been generally unsuccessful. Scholars have focused on perceptions of workers already in work settings to identify implementation barriers and facilitators. None have focused on perceptions of social workers in training. This nationwide non-probability correlational study assessed Master of Social Work (MSW) students’ perceptions of EBP using a self-administered online survey. A total of 212 (57%) completed this survey with 164 (43%) timed out.

Perceptions were assessed using three sets of questions corresponding to the independent variables: EBP knowledge, attitude toward EBP and EBP self-efficacy. A …


Career Development And Employment Concerns Of Employment-Seeking Students With Psychiatric Disabilities, Sarah Charlotte Helm May 2012

Career Development And Employment Concerns Of Employment-Seeking Students With Psychiatric Disabilities, Sarah Charlotte Helm

Doctoral Dissertations

Although some literature chronicles the career development of college students with other types of disabilities, students with psychiatric disabilities have been practically invisible in research focused on this topic. Yet evidence suggests that the number of students with documented psychiatric disabilities attending institutions of higher education is on the rise. Thus, the purpose of the study was to describe the career development and employment concerns of employment-seeking students with psychiatric disabilities.

A qualitative research design was used to gain in-depth information from the perspective of students with psychiatric disabilities, specifically case study. The participants were seven undergraduate students from three …


Gender And Posttraumatic Stress Disorder Screening In The Military: A Measurement Study, Mark Allan Oliver Aug 2010

Gender And Posttraumatic Stress Disorder Screening In The Military: A Measurement Study, Mark Allan Oliver

Doctoral Dissertations

The Primary Care Posttraumatic Stress Disorder (PC-PTSD) screen (Prins et al., 2003) is used by the Department of Defense to identify military members who are at increased risk of PTSD. This screen has been offered to all returning deployers since 2005. However, validation studies of PC-PTSD scores from military samples have seldom employed a significant number of female subjects and no published studies have examined it for gender bias. Ruling out bias is important because routine under-identification of PTSD risk in any group could result in hindered access to needed assessment and/or care. With the current proportion of military females …


Examining The Ability Of The Halstead -Reitan Battery And The Wide Range Achievement Test To Utilize Severity In Discriminating Among Alzheimer's Dementia Patients, Gina Gibson-Beverly Jul 2007

Examining The Ability Of The Halstead -Reitan Battery And The Wide Range Achievement Test To Utilize Severity In Discriminating Among Alzheimer's Dementia Patients, Gina Gibson-Beverly

Doctoral Dissertations

Measuring change in cognitive status is essential for the diagnosis, prognosis, and treatment of brain dysfunction. Psychological abilities are differentially affected by brain dysfunction severity, as some abilities are more vulnerable to brain dysfunction than others. Neuropsychological assessments can be viewed as a continuum of "hold" and "don't hold" tests. "Hold" tests assess abilities that remain stable in spite of brain dysfunction, while "don't hold" tests measure skills that are significantly compromised by brain impairment. The present study ranks the Halstead-Reitan Battery (HRB) and the Wide Range Achievement Test (WRAT) subtests based on their ability to discriminate between two levels …


Evaluation Of A Sleep Hygiene Program To Improve Inmate Sleep Quality, Jennifer F. Hodges-Crowder Jul 2007

Evaluation Of A Sleep Hygiene Program To Improve Inmate Sleep Quality, Jennifer F. Hodges-Crowder

Doctoral Dissertations

Research investigating the effectiveness of treatments for inmates with poor sleep quality appears minimal. Some difficulties related to poor sleep quality can be addressed effectively with little time and expense. Studies show that psychoeducational interventions are effective in reducing sleep complaints and improving sleep quality in a variety of populations including college students and adults. However, the effect of sleep hygiene interventions on inmate sleep complaints is unknown. Thus, the purpose of this study was to evaluate a psychoeducational intervention program aimed at improving prison inmate sleep habits, length, and quality.

Participants of this study were inmates at a department …


Sleep Quality Of College Students And Its Relationship To Coping Styles And Well-Being, Cathy Alison Word Jul 2006

Sleep Quality Of College Students And Its Relationship To Coping Styles And Well-Being, Cathy Alison Word

Doctoral Dissertations

College students suffer from more sleep disturbances than the general population. Sleep difficulties in college students can lead to lower levels of performance, memory, and cognitive ability, as well as increased levels of anxiety and decreased levels of well-being. Sleep quality is known to impact individuals' physical and psychological health, which are indicators of well-being. Sleep also appears to influence individuals' choices of coping strategies. Sleep quality is also highly correlated with college students' emotional response to stress. The relationships between and among sleep quality, well-being, and coping style have not been fully examined. The purpose of this study was …


Effect Of Comorbid Psychiatric Disorders On Measures Of Group Cohesion In Substance Abusers, Sharon Bradford Robbins Jul 2005

Effect Of Comorbid Psychiatric Disorders On Measures Of Group Cohesion In Substance Abusers, Sharon Bradford Robbins

Doctoral Dissertations

Substance dependence and treatment have been the focus of research for a number of years. Recently more attention has been directed toward identifying the most appropriate treatments for people with more complicated substance disorders, those with substance dependence and mental illness. The current study examined three aspects of group cohesion, a necessary condition for effective outcomes, in 64 substance abusers with a comorbid mental illness. The rated aspects of group cohesion included overall group climate, individual group members' self-worth, and each member's perception of the relationship with the group leader. Groups were divided according to profiles based on results from …


Biomechanical And Temporal Measurement Of Pharyngeal Swallowing For Stroke Patients With Aspiration, Youngsun Kim May 2004

Biomechanical And Temporal Measurement Of Pharyngeal Swallowing For Stroke Patients With Aspiration, Youngsun Kim

Doctoral Dissertations

This study compared three pharyngeal swallowing measurements: Pharyngeal Delay Time (PDT), Stage Transition Duration (STD), and Delayed Pharyngeal Swallow (DPS) on the correct classification of three groups of subjects. These groups were: 15 stroke patients who aspirated (aspirators), 15 stroke patients who did not aspirate (non-aspirators) and 15 normal subjects.

Overall, the STD had highest mean classification among the three pharyngeal swallowing measurements. All three measures has a significant difference between aspirators and normal subjects. None of the measurements showed a difference between non-aspirators and normal subjects. The aspirators and the normal subjects were classified correctly most often; whereas the …


Psychological Effects Of Martial Arts Training: Fear Of Physical Assault And Self -Esteem, Robert C. Clanton Apr 2004

Psychological Effects Of Martial Arts Training: Fear Of Physical Assault And Self -Esteem, Robert C. Clanton

Doctoral Dissertations

The purpose of this study was to examine gender differences in the effects of martial arts training on self-esteem and fear of physical assault. Two studies were performed. The Fear of Physical Assault Scale was developed in the first study in order to measure individuals' perceived vulnerability to attack. Results indicated that the instrument was a reliable measure. Males scored significantly higher on the scale, indicating that they tend to perceive themselves as less vulnerable and more competent at defending themselves against physical assault. The second study examined the effects of martial arts training on the self-esteem and fear of …


An Exploration Into Gender Role Conflict, Attitudes Toward Females, And Relationship Beliefs, Julia M. Wood Apr 2004

An Exploration Into Gender Role Conflict, Attitudes Toward Females, And Relationship Beliefs, Julia M. Wood

Doctoral Dissertations

Gender role conflict and negative attitudes toward females have been areas of increasing concern since the early 1970s. Research has shown that both gender role conflict and negative attitudes toward females cause complications for the person with such perspectives. Relationships are an area that has been impacted by gender role conflict and attitudes toward females. Determining the impact that gender role conflict and attitudes toward females have upon each other and upon relationship beliefs will increase awareness of the seriousness of these complications allowing clinicians to focus therapeutic interventions on methods that will increase relationship quality.

Using the Gender Role …


Self -Esteem And Sense Of Entitlement In Violent And Nonviolent Criminal Behavior, Susan Frank Apr 2004

Self -Esteem And Sense Of Entitlement In Violent And Nonviolent Criminal Behavior, Susan Frank

Doctoral Dissertations

There are two conflicting theories concerning self-esteem in violent and nonviolent criminal behavior. One theory proposes that low self-esteem is more influential than high self-esteem in an individual's decision to participate in criminal behavior, whereas the other theory proposes the opposite. Limited research is available concerning the role that sense of entitlement has in criminal behavior, beyond its previously explored role in rape. The first purpose of this study was to clarify the role of self-esteem in criminal behavior by having individuals currently incarcerated for both violent and nonviolent crimes complete the Self-Esteem Rating Scale. Using the scores obtained on …


Psychological Reactance As A Personality Characteristic: Relationships To Attachment And Autonomy, Maurine Traville Hargrove Ladner Apr 2003

Psychological Reactance As A Personality Characteristic: Relationships To Attachment And Autonomy, Maurine Traville Hargrove Ladner

Doctoral Dissertations

Psychological reactance is a construct that motivates people to restore lost or threatened freedoms (Brehm, 1966). Research is beginning to show that psychological reactance may be related to family of origin dynamics. Autonomy is developed through a secure attachment. Dowd (1993) stated that autonomy is fostered by an optimal level of reactance, and one's personal identity is dependent on the development of a flexible autonomy. This study explored the relationship between psychological reactance and attachment. Additionally, research has suggested that level of reactance may be related to level of autonomy. This relationship was empirically explored. Participants were assessed using the …