Clinical Psychology Commons^™

Collaborative Models Of Care In The Appalachian Region Of Tennessee: Examining Relationships Between Level Of Collaboration, Clinic Characteristics, And Barriers To Collaboration, Jeffrey Ellison

Electronic Theses and Dissertations

Decades of research have shown that there are significant advantages to maintaining close communicative and collaborative relationships between primary care and behavioral health providers. Fiscal, structural, and systemic barriers, however, often restrict the degree to which such interprofessional collaboration can occur. In the present study the authors examined relationships between primary care clinics in the Appalachian region’s characteristics (i.e., clinic type, rurality, and clinic size), barriers (i.e., fiscal, structural, and systemic) reported to using increased collaboration, and the level of collaboration used at a particular clinic.

For the present study 136 surveys were completed by providers working in primary care …

An Examination Of Risk And Protective Factors For Suicidal Behavior In A Low-Income, Underserved Primary Care Sample, Kristin L. Walker

Electronic Theses and Dissertations

Suicidal behavior, including ideation and attempts, is a significant public health problem. Due to the complexity of suicidal behavior, it is necessary to consider an array of factors that could serve as risk and protective factors. Previous research has shown that deficits in social problemsolving ability are associated with increased risk for suicidal ideation and attempts; conversely, problem solving strengths are associated with reduced risk. This dissertation project, consisting of 3 individual manuscripts, was designed to explore the relationship between social problemsolving ability and suicidal behavior in low-income primary care patients. Furthermore, additional constructs including health related quality of life, …

Health-Related Quality Of Life And Suicidal Behaviors In Primary Care Patients: Conditional Indirect Effects Via Interpersonal Needs And Depressive Symptoms, Catherine Rowe

Electronic Theses and Dissertations

Suicide is a public health problem and complex relationships exist between intrapersonal suicide risk factors and interpersonal risk factors. Health-related quality of life (HRQL) may interact with difficulties with interpersonal relationships and psychopathology. We examined thwarted interpersonal needs and depressive symptoms as potential mediators on the association between HRQL and suicidal behaviors. It was hypothesized that thwarted interpersonal needs would mediate the association between HRQL and suicidal behavior, and that this mediating effect would be dependent on the moderating effect of depressive symptoms. It was hypothesized that thwarted interpersonal needs and then depressive symptoms would sequentially mediate the association between …

Explaining Combat Related Posttraumatic Stress Disorder: An Integrated Mental Illness And Military Process Model, Mandi F. Deitz

Electronic Theses and Dissertations

The purpose of the current study was to examine a process model of combat-related and mental-illness related processes that explain increased likelihood of Posttraumatic Stress Disorder (PTSD). This dissertation proposed the development of PTSD may occur due to cultural, social, and self-related pathways associated with veterans’ dual encounters with combat (i.e., severity) and mental illness symptoms. Participants were 195 military veterans recruited from multiple sites and strategies to maximize sample size and representation. Participants were asked to complete several self-administered assessment inventories, including: the Posttraumatic Stress Disorder Checklist-Military, the Trauma Symptom Checklist, the Combat Experiences scale, the Self-Stigma of Mental …

Mental Health Referral In Primary Care: Influence Of A Screening Instrument And A Brief Educational Intervention, Michael T. Miesner

Electronic Theses and Dissertations

Although less than half of all patients with mental disorders seek mental health treatment per se, approximately 80% of all people will visit their primary care physician (PCPs) within a year (Strosahl, 1998). However, it is not well understood how to best handle patients presenting with mental health issues in primary care practices. The purpose of this project was to implement an intervention involving a screening measure for anxiety and mood disorders in a primary care setting to increase the volume of anxiety and mood disorder screening, to increase the accuracy of disorder detection, and to also enhance PCPs patterns …

Rural Pediatric Primary Care Practice Patterns As A Result Of An On-Site Behavioral Health Consultant: A Retrospective Analysis, Kayla D. Mccarter

Undergraduate Honors Theses

Nationally, it has been estimated that 10 to 21% of children with psychosocial concerns are seen in primary care settings (Jellinek et al., 1999; McInerny, Szilagyi, Childs, Wasserman & Kelleher, 2000; Palermo et al., 2002). Often, however, children go undiagnosed with/treated for psychosocial concerns in pediatric primary care due to lack of physician time and poor referral rates to mental health providers. Evaluations of integrated care models, in which a behavioral health consultant is present in primary care practices, has shown to increase the availability of mental health services (Stancin, Perrin, & Ramirez, 2009). Using extant data from patient records …

Traumatic Life Events And Symptoms Of Anxiety: Moderating Effects Of Adaptive Versus Maladaptive Coping Strategies, Alishia Foster

Electronic Theses and Dissertations

The experience of trauma is prevalent among young adult college students and is often associated with poor mental health outcomes such as symptoms of anxiety. Not all individuals who have experienced trauma, however, develop anxiety, perhaps due to individual-level adaptive characteristics, such as use of adaptive rather than maladaptive coping strategies. Yet, little research has examined the interrelationships between the experience of trauma, specific types of coping strategies, and subclinical anxiety symptoms. A sample of 915 undergraduate students completed self-report measures of trauma, coping strategies, and anxiety symptoms. We hypothesized that traumatic life events would be associated with anxiety symptoms, …

Actively Caring About The Actively Caring Survey: Evaluating The Reliability And Validity Of A Measure Of Dispositional Altruism, Philip Randall

Electronic Theses and Dissertations

Geller’s Actively Caring Survey (ACS) was theorized to measure person states deemed necessary to “Actively Care” or act altruistically toward others. Empirical research of the ACS has been limited, and this researcher sought to evaluate its reliability, validity, and factorial consistency. Undergraduate students (n = 1,095) completed the measure online. Hypotheses were partially supported. Unrotated primary component analysis found the ACS to be a unitary measure with 73.3% of the items loading onto the first factor. The ACS showed excellent internal consistency. Convergent and divergent validity with existing measures (i.e., the Big 5 Personality, Marlowe-Crowne Social Desirability, Cognitive Failures …

Technology Use In Rural Appalachia: A Pilot Study Of The Implications For Pediatric Behavioral Health, Courtney E. Lilly

Electronic Theses and Dissertations

Technology is a promising means for increasing rural individuals’ access to behavioral healthcare. However, the range of technology use in rural areas is currently unknown. The aims of this study were to examine the use of technology in rural areas, the relationship between technology use and willingness to access pediatric mental health services via videoconferencing, and this relationship within the context of other critical variables linked to service uptake. Data were collected at 2 pediatric primary care clinics. While no significant relationship was found between technology use and willingness to use videoconferencing, a significant relationship emerged between previous service seeking …

Who Done It? Rurality Vs. Ses As Critical Factors In Evaluating The Prevalence Of Child Psychosocial Concerns In Primary Care, Robert M. Tolliver

Electronic Theses and Dissertations

The purpose of this study was to evaluate the prevalence of child psychosocial concerns in rural primary care, hypothesized to be greater than national averages due to lacking mental health services in rural areas. This study was an examination of the role of SES, various definitions of “rural,” and the interaction of SES and rurality, in predicting parent-reported child psychosocial concerns in Appalachian primary care clinics. Caregivers presenting with their child at one of 8 pediatric primary care sites (n=2,672) were recruited to complete a measure assessing demographics and the Pediatric Symptom Checklist (PSC). Results showed that while rural status …

Perceived Barriers And Facilitators To Mental And Behavioral Health Screening And Treatment In Primary Care For Women In Northeast Tennessee, Sarah K. Hill

Electronic Theses and Dissertations

Between one quarter and one third of all primary care patients meet criteria for at least one mental disorder. However, many women are not screened for mental disorders as recommended by the literature. Some studies suggest even lower rates of screening and treatment in rural areas. This researcher sought to identify barriers and facilitators to mental and behavioral health screening and treatment for women in primary care and solicit feedback on how to ameliorate perceived barriers. Given the limited extant data describing rural Appalachian women’s perceptions of barriers and facilitators to receiving mental health services an exploratory qualitative analysis was …

Empathy And Threatened Egotism In Men’S Use Of Violence In Intimate Relationships, Jessica H. Turner

Electronic Theses and Dissertations

The current study was undertaken to explore the relationship between self-esteem, narcissism, and empathy with intimate partner violence perpetration among men in 2 samples: college students and inmates. The sample was analyzed both as an aggregate and separately. A negative relationship was hypothesized between intimate violence perpetration and both self-esteem and empathy. A positive relationship was expected between intimate violence perpetration and narcissism. A 2-way interaction was examined between self-esteem and narcissism as a test of threatened egotism, defined as high self-esteem coupled with high narcissism, which was not expected in the current study. Empathy was hypothesized to moderate the …

Further Assessment Of The Psychometric Properties Of The Sex Offender Attitude Scale, Brandon C. Bogle

Electronic Theses and Dissertations

Sex offenses in the United States are a major public health concern. Attitudes toward sex offenders are generally very negative and to be officially identified as a sex offender brings on collateral consequences that reduce incentives not to reoffend. The extent to which attitudes toward sex offenders affect discriminatory behaviors and collateral consequences is not fully understood. The Sex Offender Attitude Scale was developed in an attempt to reliably and accurately measure attitudes and stigma toward sex offenders. Initial analyses indicated the SOAS was a reliable and valid instrument. This study aimed to provide additional evidence of the psychometric properties …

Adult's Perceptions Of Children's Aggressive Play With Advertised And Non-Advertised Toys., Lori J. Klinger

Electronic Theses and Dissertations

This study examined adults’ perceptions of aggression in toys and toy commercials targeted toward young boys. The subjects, 262 undergraduate psychology students, completed the Buss/Perry Aggression Questionnaire and rated either a videotape of 10 boy-oriented toy commercials or slides of 10 non-advertised boy-toys. Parental status, exposure to an advertised versus non-advertised toy, and level of self-reported aggression were assessed to determine their relationship to perceptions of aggressiveness in a toy’s image and predicted play with the toy.

Univariate analyses of variance and paired sample t-tests were conducted. The results indicate that toys advertised in commercials are judged to portray more …