Clinical Psychology 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 …

Perceptions, Attitudes, And Experiences Of Persons Who Work In Forensic Mental Health Systems, Abigail Wiser

Electronic Theses and Dissertations

The forensic mental health system serves clients with dual needs —serious mental health concerns like psychosis and suicidality, and management of risk. Experiences and perceptions of professional and direct care staff may impact daily and therapeutic interactions and client success. These experiences may be marked by stigma, such as beliefs about what led to hospitalization, treatability of mental health concerns, and intentionality of behavior. Understanding this stigma, as well as the role of vicarious trauma, workplace burnout, and other relevant individual factors, may help us understand staff experiences and guide training, thus improving client care. 146 staff members across three …

Understanding College Student Expectancies Of Simultaneous Engagement In Multiple Risk Behaviors: A Measurement Development And Model Testing Study, Shelby Whalen

Electronic Theses and Dissertations

Risky behaviors, actions that may cause physical, psychological, social, or economic harm to oneself or others, are prevalent among college students. While significant research has focused on single high-risk behaviors of alcohol use, drug use, gambling, and gaming separately, students frequently engage in multiple high-risk behaviors simultaneously, such as drinking alcohol while gambling. Research shows that students have distinct and specific expectancies about what happens when they engage in a risk behavior, however, minimal research has examined students’ perceptions or reasons for simultaneous poly-risk behavior engagement. This multi-phase project characterized students’ outcome expectancies for simultaneous poly-risk behavior combinations, developed and …

The Memphis Gambling Screen: A Clinical Validation Study Of An Enhanced-Readability Self-Report Measure For Gambling Disorder, Natasha Bourgoin

Electronic Theses and Dissertations

Precise identification of gambling disorder can be difficult when commonly used screeners vary in clarity and diagnostic accuracy. The Memphis Gambling Screen (MGS) was developed as an enhanced-readability self-report measure to improve item comprehension and strengthen the diagnostic accuracy of DSM-5 gambling disorder. This study evaluates the psychometric properties and diagnostic accuracy of the MGS with a combined sample of individuals seeking treatment for problem gambling or substance use disorder and college students with a recent history of gambling (N = 232). Participants completed a demographic questionnaire, the MGS, and another commonly used measure, the Problem Gambling Severity Index …

Exploring The Link Between Substance Use Severity And Self-Stigma: The Moderating Role Of Enacted Stigma, Alaya Shelton

McNair Culminating Research Projects

Self-stigma has been shown to negatively impact treatment engagement, recovery, and reintegration outcomes among individuals with substance use and criminal histories (Moore et al., 2023). Further, prior research has shown that markers of an individual’s substance use treatment history (e.g., number of prior treatment episodes and perceived substance use severity; Hammarlund et al., 2018; Luoma et al., 2012; Silveira et al., 2016) and negative experiences with medical professionals (Hoover et al., 2022; Muncan et al. 2020) are closely linked to self-stigma. While these factors independently contribute to one’s level of self-stigma, to our knowledge, no prior work has examined how …

The Development And Evaluation Of A Group Therapy Program For Perinatal Loss In Rural Appalachia, Hope O'Neill

Electronic Theses and Dissertations

Perinatal loss can have vast adverse psychological consequences and has limited psychotherapeutic options to assist with those outcomes. Currently, there is no gold standard psychotherapy for the treatment of perinatal grief. Group therapy has proven to be an effective modality for various populations and has been shown to be beneficial for perinatal loss and the subsequent psychological outcomes. This study utilized a previously conducted systematic review to develop and evaluate a group psychotherapy for perinatal loss. The ten sessions of the group were completed by two participants and several constructs were explored pre- and post-intervention: grief, depression, anxiety, post-traumatic stress, …

Psychometric Properties Of The Interpersonal Style Questionnaire (Isq) And The Patterns Of Thinking Survey (Pots), Genevieve Allison

Electronic Theses and Dissertations

Self-regulation is a complex concept that includes multiple interacting factors, and it is studied across multiple fields of psychological research. Various theoretical models have been offered to explain this concept. Although models differ in their definitions of self-regulation, all consistently posit that it consists of emotional, behavioral, interpersonal, and cognitive domains. The current study examined the psychometric properties of two novel measures – 1) McVay and Stinson Interpersonal Style Questionnaire (ISQ) and 2) Stinson and McVay Patterns of Thinking Survey (POTS) – utilizing both a clinical and nonclinical sample. Results indicate that these measures are comprised of three factors across …

Does Self-Compassion Buffer Against The Potential Effects Of Perfectionism And Psychopathology On Non-Suicidal Self-Injury?, Natasha Bourgoin

Electronic Theses and Dissertations

University students with increased rates of reported perfectionism, anxiety, and depression, are vulnerable to non-suicidal self-injury (NSSI). However, not all students with psychological distress engage in NSSI, suggesting protective factors may help to mitigate this risk. The present study examined the relation between perfectionism and NSSI, via the mediating effects of anxiety and depression, and the moderating role of self-compassion. Participants were 338 university students (67% female; 87% White) who completed several self-report measures. Students with greater perfectionism reported higher levels of anxiety and depressive symptoms and, in turn, more NSSI engagement. Self-compassion and several self-compassionate domains attenuated connections between …

Attitudes Toward Harm Reduction Among Criminal Legal Staff, Diamond Meadows

Electronic Theses and Dissertations

Substance use disorders (SUDs) are prevalent among individuals interacting with the criminal legal system (Moore et al., 2019). Despite the high rates of individuals with SUDs interacting with the criminal legal system, there continue to be barriers to integrating harm reduction approaches within the system. Harm reduction approaches (i.e., medication assisted treatment) are effective in reducing the negative consequences associated with substance use and the pathway to recovery for many. The purposes of this study are to: 1. examine the psychometric properties of the Harm Reduction Acceptability Scale (HRAS) among criminal legal staff, 2. explore individual differences in staff attitudes …

Learning To Be Trauma-Informed: An Examination Of Individual-Level Factors Predicting Perceptions Of And Response To Trauma-Informed Practice Trainings, Kelly Daniel

Electronic Theses and Dissertations

Trauma is a substantial threat to public health. As such, significant effort has been exerted into developing interventions which mitigate the consequences of trauma. Trauma-informed practice (TIP) aims to alleviate the effects of trauma by building policies and practices focused on safety, trust, transparency, support, collaboration, and empowerment. This study investigated how individual-level factors, including readiness for organizational change, perceived benefit of TIP training, and personal trauma history affect one’s ability to apply a TIP lens in a sample (n =100) of members of a graduate-level college. Further, it explored if one’s perceptions of and response to trauma-informed practice training …

Exploring The Impacts Of Medical Invalidation On Postpartum Parents With Pcos, Shalini Venkat

Electronic Theses and Dissertations

Individuals with polycystic ovary syndrome (PCOS) face an increased risk of poor perinatal health, yet little is known about whether negative healthcare experiences contribute toward these outcomes. Patients with PCOS have reported experiencing invalidation by healthcare providers; however, the effects of these encounters in postpartum populations remain unclear. Using data from an online survey, the current study investigated whether PCOS status moderated the relationships between invalidating communication by healthcare providers, pregnancy and birth complications, postpartum depression, and postpartum anxiety. While experiences of invalidating communication by healthcare providers predicted worse perinatal health, those with PCOS solely experienced an increased risk of …

Mindfulness As A Protective Factor In Women’S Sexual Health, Shana Byerley

Electronic Theses and Dissertations

Many women who experience physical health complaints also report sexual dysfunction across a variety of domains including decreased arousal, desire and satisfaction. Although there are well-established connections between disease-specific populations and sexual dysfunction, less research has focused on women who experience somatic symptoms more broadly. Similarly, mindfulness as a treatment intervention has been applied across many facets of sexual functioning, but mindfulness as a trait characteristic has been less explored in its connections with generalized somatic complaints. Further, the within-domain interactions between facets of mindfulness and domains of sexual dysfunction have not been previously explored. Using data from an online …

The Intersection Of Appalachian Identity And Gambling Behavior, Noah S. Anderson

Electronic Theses and Dissertations

This study examined the relation between Appalachian identity and gambling behavior among students in central Appalachia (n = 395). One-way ANOVAs revealed no significant differences in engagement, F(2, 392) = 0.65, p = .523, or severity, F(2, 392) = 0.33, p = .718, across identification groups. Moderated regression showed that identity did not significantly moderate the engagement–severity relation (B = 0.073, p = .099), though engagement itself was a strong predictor of harm (B = 0.696, p < .001, R² = .521). Negative affect predicted both engagement (B = 0.074, p = .001) and severity (B = 0.069, p = .001), while identity remained non-significant. Logistic regression found that identity predicted gambling engagement (Exp(B) = 1.18, p = .034) only when controlling for severity. These findings relay the importance of empirical efforts in Appalachia and suggest that Appalachian identity may not be an independent risk factor in gambling behavior.

Pilot Implementation Of Mom Power In The Appalachian Highlands: Acceptability And Effectiveness Of A Parenting Group For Mothers With High Psychosocial Need, Megan Wolff

Electronic Theses and Dissertations

Children need safe, stable, and nurturing relationships with a caregiver for optimal development. Maternal childhood adversity, traumatic life experiences, and mental health challenges can adversely impact parenting beliefs and behaviors in ways that compromise a caregiver’s ability to create and sustain a healthy caregiving environment for their child(ren). In the professional world of infant and early childhood mental health (IECMH), policies, providers, and programs work together to promote optimal child and family wellbeing to reduce the intergenerational transmission of risk and to empower resilience in families and communities. The present study investigated the feasibility, acceptability, and effectiveness of the pilot …

Exploring Young Adults’ Implicit Theories Of Emotion And Emotion Dysregulation On Parental Emotion Socialization And Internalizing Symptomology, Daryl Parungao

Electronic Theses and Dissertations

Research regarding emotion socialization suggests parents’ responses towards their children’s negative emotions, which may be characterized as either emotion dismissive or emotion coaching behaviors, are associated with children’s well-being into adulthood. A heuristic model of emotion socialization suggests that child-level factors related to emotion processing may moderate this association (Eisenberg, 1998), which warrants further examination when considering relevant risk factors for mental health disorders such as anxiety and depression. This dissertation explored how parent emotion socialization responses interact with young adults’ beliefs about the controllability of emotions and their difficulties with emotion regulation with regard to their impact on young …

Exploring Predictors Of Treatment Dropout In Primary Care Behavioral Health Using Andersen’S Behavioral Model Of Health Services, Mara W. Sindoni

Electronic Theses and Dissertations

A recent meta-analysis indicated a 19.7% dropout rate from outpatient mental health care. Andersen’s Behavioral Model of Health Services identifies predisposing, enabling, and need factors as potential predictors of treatment dropout. The Primary Care Behavioral Health (PCBH) model aims to improve accessibility of mental health care but research on dropout in this setting is lacking. This study examined bivariate relationships between Andersen's factors and dropout in PCBH, and interviewed participants about their intentions to attend subsequent PCBH visits. No statistically significant bivariate relationships were found, likely due to small sample size (n = 15). Reflexive Thematic Analysis identified two themes …

Adolescent Externalizing Symptoms And Parent Emotion Socialization: An Examination Of Longitudinal Effects And Differences By Adolescent Sex, Cheston West

Electronic Theses and Dissertations

Adolescence is an important developmental context with several changes in social and emotional functioning. Though adolescents are gaining independence from their caregivers, they still engage in dynamic interactions with their caregivers who remain key figures in their lives. When adolescents express emotions, caregivers engage in various behaviors in response to these expressions, a process known as emotion socialization. This process has mostly been examined as a parent-driven construct in which parent emotion socialization impacts child-level outcomes, namely internalizing symptoms, with limited research on externalizing symptoms. However, available literature demonstrates that child-level characteristics (e.g., externalizing symptoms) are linked to differences in …

Does Self-Care Moderate The Association Between Adverse Childhood Experiences, Trauma Symptoms, And Parental Reflective Functioning?, Vinaya Thomas

Electronic Theses and Dissertations

Unresolved adverse and traumatic experiences in parents can amplify the risk of perpetuating intergenerational transmission of trauma. Parents’ positive and adaptive practices such as self-care might act as a protective factor against this ripple effect. This study investigated whether self-care moderated the relationship between parental ACEs, post-traumatic stress symptoms, and parental reflective functioning in mothers who are experiencing high psychosocial stress (n = 59) residing in rural Appalachia. Within our sample, there was no statistically significant linear relationship between our predictors, ACE score and PTSD symptoms, and our outcome of interest, maternal pre-mentalizing. We did not find empirical support for …

Perceived Stigma's Influence On The Association Between Suicide Risk Severity And Help-Seeking For Suicidal Crises, Donna Zastrow

Electronic Theses and Dissertations

Introduction: Unfortunately, research examining help-seeking for suicide is limited. This study examined age, race, gender, suicide risk severity, and perceived stigma as predictors of formal and informal help-seeking behaviors individuals engage in during suicidal crises, and explored perceived stigma as a moderator of the relationship between risk severity and help-seeking. Method: Data from 80 college students who had experienced a past suicidal crisis were analyzed using two moderation analyses. Results: Rates of formal (67.5%) and informal (86.2%) help-seeking were high in the study sample. Higher suicide risk severity was positively associated with formal help-seeking (b = …

Associative Stigma Among Criminal Legal Staff: Measurement And Relation To Job Factors, Shania Siebert

Electronic Theses and Dissertations

A sizeable portion of the United States (U.S.) population works within the criminal legal system, and individuals who have legal involvement are a highly stigmatized population. Research suggests working with stigmatized populations can result in the transfer of stigma to professionals, referred to as associative stigma. While qualitative studies indicate there are negative perceptions related to working in criminal legal settings, there is no quantitative research on criminal legal staff’s experience with associative stigma and how it impacts job-related factors. The purpose of this study was to 1) examine the psychometrics of an adapted measure to quantitatively assess associative stigma …

Co-Rumination, Psychological Inflexibility, And Internalizing Symptoms In Adolescence, John Parigger

Electronic Theses and Dissertations

Two risk factors for anxiety and depression in adolescence were examined: co-rumination, which occurs when friends excessively talk about problems; and psychological inflexibility, which occurs when one avoids negative feelings and fails to act on values. I hypothesized that psychological inflexibility would exacerbate the effect of co-rumination on adolescent anxiety and depression. Participants were 167 adolescents (Mage = 14.60 years, SD = 1.3; 65.7% cisgender males) who completed standard measures as part of an online survey. Results indicated no moderation effect, but there were main effects of co-rumination and psychological inflexibility on depression symptoms. Co-rumination may relate to …

Symptom Clusters In Individuals Seeking Treatment For Gambling Disorder, Blaine Stiglets

Electronic Theses and Dissertations

The fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) presents the criteria for Gambling Disorder (GD) as a unidimensional construct where each additional symptom corresponds to increased severity. Many individuals experience addiction symptoms in specific symptom clusters, with membership to one profile of symptoms or other better-representing disorder severity than raw symptom counts. This study explored whether similarly informative symptom clusters exist among adults seeking treatment for gambling harms. The sample included 444 adults (Mage= 44.95) who completed an assessment of DSM criteria for GD at intake. Through a latent class analysis of GD criteria, three …

Do Emotion Dysregulation And Internalized Shame Mediate The Relationship Between Borderline Personality Disorder Symptomology And Criminal Involvement?, Madison Smith

Electronic Theses and Dissertations

Borderline personality disorder (BPD) is a severe and debilitating mental disorder that is over-represented within the criminal legal system (CLS), with 15-29.5% of individuals in the CLS meeting criteria. However, little research has examined mechanisms leading to criminal involvement within this population. Potential mechanisms include positive/negative emotion dysregulation and internalized shame, which (aside from positive emotion dysregulation) have been linked to criminal involvement in other populations. Research has yet to examine these constructs as mechanisms explaining criminal involvement among individuals with BPD. This study examined positive/negative emotion dysregulation and internalized shame as mechanisms of the relationship between BPD and criminal …

Adverse Childhood Experiences And Sexual Functioning: A Mediation Analysis Of Difficulties In Emotional Regulation, Haven Travis

Undergraduate Honors Theses

Sexual dysfunction can lead to a negative impact upon a person’s mental and relational health, including relational and overall distress, poor relationship and sexual satisfaction, and clinical mood disorders such as depression. Moving upstream to identify factors that may predict sexual dysfunction would therefore be beneficial for early intervention in at-risk populations. History of childhood trauma is one such factor that may influence sexual functioning later in life. While adverse childhood experiences (ACEs) have been less studied in association with sexual dysfunction, there is some evidence to indicate that they may be related. ACEs have been shown to increase the …

The Implications, Magnitude, And Development Of Traumatic Brain Injury For Individuals Undergoing Treatment For Opioid Use Disorder, Hannah G. Mitchell

Electronic Theses and Dissertations

There is an established bidirectional relation between substance use and traumatic brain injuries (TBIs). Despite the high rate of prescribing opioids for pain management following a TBI and the epidemic of opioid use disorder (OUD) in the United States, scarce research has specifically analyzed the association between TBI and OUD. In a series of three interrelated manuscripts, the present study will first examine the prevalence and features of TBIs among persons seeking treatment for OUD. Next, the present study will evaluate the association between TBI and indicators of risky health behaviors and OUD severity, including the risk of overdose and …

Nonmedical Stimulant Use In An Undergraduate College Student Sample: Demographics, Academics, Stress, And Other Substance Use, Ashley Skye Vanover, Meredith K. Ginley, Shelby Whalan

Undergraduate Honors Theses

Nonmedical use of prescription stimuluants (NMUS) can cause adverse outcomes for college students including academic impediments, such as a lowered GPA, and polyuse of illicit substances (Garcia et al., 2021; Holt & McCarthy, 2019; Norman & Ford, 2018). The current study investigated the demographics, academics, stress, and polysubstance use between students who endorsed NMUS and those who did not in an undergraduate college population sample at a large public university in the Southeast. The sample consisted of 429 undergraduate students who completed online measures of demographics, perceived stress, stressful life events, and substance use. Overall, 3.4% of the sample reported …

Knowledge, Attitudes, And Readiness For Integrated Behavioral Health Services Among Primary Care Providers In East Tennessee, Baylee Rose

Undergraduate Honors Theses

Introduction: Individuals in rural areas tend to face unique barriers to accessing mental health care. One possible solution to make mental health services more accessible could be to integrate behavioral healthcare providers into primary care practices. However, the successful integration of behavioral health services into rural primary care is likely reliant on the knowledge, attitudes, and readiness of the primary care practice to initiate the process of integration. The current study aims to describe knowledge, attitudes, and readiness to adopt integrated behavioral health services among primary care providers in rural South-Central Appalachia and to examine how providers’ knowledge and attitudes …

Obstetric Violence And Postpartum Adjustment: Exploration Of Risk And Resilience Factors, Hope O'Neill

Electronic Theses and Dissertations

Obstetric violence includes acts of abuse, coercion, or disrespect that occur during the labor process. The present study explores how obstetric violence impacts a person’s postpartum psychosocial adjustment. This study used a subset of data (N = 339) from a larger online study, which attempted to explore multiple facets of a person’s postpartum health. The psychological constructs examined are postpartum depression and postpartum anxiety. Additional constructs assessed were protective and risk factors: self-compassion and medical mistrust. Self-compassion and medical mistrust were examined by using moderation models. Additional analyses were completed using simple regression models to explore whether obstetric violence predicts …

Sexual Trauma, Health, And The Moderating Effect Of Psychological Flexibility And Inflexibility, Gabrielle A. Caselman

Electronic Theses and Dissertations

Sexual trauma is linked to adverse health outcomes (e.g., D’Andre et al., 2011). Given the negative sequelae of sexual trauma, exploration of factors that influence the relation between sexual trauma and health outcomes is crucial. Current literature suggests that psychological flexibility and inflexibility may be factors in promotion of individuals’ health or pathology (e.g., Gloster et al., 2017). The current study sought to explore the variability in psychological flexibility and inflexibility among participants and the potential moderating effects of psychological flexibility and inflexibility on the relation between sexual trauma and both mental and physical health outcomes.

Moderation analyses failed to …

Gratitude And Sleep Quality In Primary Care: Mediating Effects Of Health Self-Efficacy, Health Behaviors, And Psychopathology, Heather R. Altier

Electronic Theses and Dissertations

Sleep disturbances are prevalent among primary care patients, and psychological dysfunction, including stress, anxiety, and depression, are robust contributors to poor sleep health. Yet, the presence of potential protective characteristics, such as health self-efficacy and engaging in adaptive health behaviors, may mitigate such outcomes. Gratitude (i.e., recognition and appreciation of experiences, relationships, and surroundings), a positive psychological cognitive-emotional characteristic, may serve as a catalyst of these beneficial downstream effects, given its association with improved health functioning and sleep. In a sample of primary care patients (N = 869) from 50 urban and 30 rural practices in Germany, health self-efficacy …