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Full-Text Articles in Clinical Psychology

Psilocybin With Acceptance And Commitment Therapy (Act) For The Treatment Of Social Anxiety Disorder (Sad), Aspen E. Allred Mar 2024

Psilocybin With Acceptance And Commitment Therapy (Act) For The Treatment Of Social Anxiety Disorder (Sad), Aspen E. Allred

University Honors Theses

Social Anxiety Disorder (SAD) is a debilitating mental health condition characterized by an overwhelming fear and anxiety of social rejection that can lead to chronic patterns of social behavioral avoidance. Despite the existence of traditional efficacious treatments, a significant number of individuals either do not respond to treatment or experience a recurrence of symptoms over extended periods, spanning 10-12 years. Acceptance and Commitment Therapy (ACT), a form of acceptance-based behavioral therapy considered part of the "third wave" of cognitive behavioral therapies, has shown promising results in early studies, comparable to those of Cognitive Behavioral Therapy (CBT) that is considered the …


Disordered Eating Behaviours In Adolescents With And Without A Formal Ed Diagnosis: Comparing Individual And Contextual Factors, Eve G. Chapnik Aug 2023

Disordered Eating Behaviours In Adolescents With And Without A Formal Ed Diagnosis: Comparing Individual And Contextual Factors, Eve G. Chapnik

Electronic Thesis and Dissertation Repository

This study explored various psychosocial factors associated with disordered eating in adolescents accessing mental health services across Ontario, Canada. Data were collected using the interRAI Child and Youth Mental Health (ChYMH) assessment tool and participants were categorized into three groups: individuals with diagnosed eating disorders (ED, n=207), disordered eating without a formal ED diagnosis (sub-ED, n=888), and other treatment-seeking youth (non-ED, n=3285). The ED and sub-ED groups did not differ in many ways, presenting with a similarly greater prevalence of mental health issues, and dysfunctional family and peer relationships, in comparison to non-ED youth. However, the ED …


Hippocampal Volume And The Detection Of Mild Cognitive Impairment In An Older Adult Population: Assessing Performance On Cognitive Screeners Administered In-Person And Electronically, Kristen Fabrizi Jul 2023

Hippocampal Volume And The Detection Of Mild Cognitive Impairment In An Older Adult Population: Assessing Performance On Cognitive Screeners Administered In-Person And Electronically, Kristen Fabrizi

Dissertations

The present study investigated how performance on in-person and electronic neuropsychological assessment measures predicted subcortical hippocampal volume and cognitive decline consistent with mild cognitive impairment. It was hypothesized that the Montreal Cognitive Assessment would display better predictive strength than the Cogstate Brief Battery when evaluating subcortical hippocampal volume measured via structural magnetic resonance imaging. It was further hypothesized that the Montreal Cognitive Assessment would be more sensitive to predicting group membership to the diagnostic classification of mild cognitive impairment compared to the Cogstate Brief Battery. The sample included 445 older adult participants selected from the Alzheimer’s Disease Neuroimaging Initiative 3. …


Moral Injury To Inform Analysis Of Post-Traumatic Stress Disorder, Amanda Julia Manea Apr 2023

Moral Injury To Inform Analysis Of Post-Traumatic Stress Disorder, Amanda Julia Manea

Senior Theses

Post-traumatic stress disorder (PTSD) is a mental health condition that almost one out of ten veterans struggle with. Although the National Center for PTSD has made extensive progress in characterizing and developing new treatments for PTSD, most veterans still experience symptoms of PTSD following treatment. Novel avenues of investigation, such as developing algorithms to review electronic health record (EHR) data and better understanding moral injury, are being pursued to address the gap that still exists when it comes to treating veterans. Moral injury is the individual evaluation of exposure to a potentially morally injurious event (PMIE) and can lead to …


Single-Case Pilot Study For Longitudinal Analysis Of Referential Failures And Sentiment In Schizophrenic Speech From Client-Centered Psychotherapy Recordings, Travis A. Musich Apr 2023

Single-Case Pilot Study For Longitudinal Analysis Of Referential Failures And Sentiment In Schizophrenic Speech From Client-Centered Psychotherapy Recordings, Travis A. Musich

Dissertations

Though computational linguistic analyses have revealed the presence of distinctly characteristic language features in schizophrenic disordered speech, the relative stability of these language features in longitudinal samples is still unknown. This longitudinal pilot study analyzed schizophrenic disordered speech data from the archival therapy audio recordings of one patient spanning 23 years. End-to-end Neural Coreference Resolution software was used to analyze transcribed speech data from three therapy sessions to identify ambiguous pronouns, referred to as referential failures, which were reviewed and confirmed by multiple raters. Speech samples were analyzed using Google Cloud Natural Language API software for sentiment variables (i.e., score, …


Classifying Severe And Enduring Anorexia Nervosa: A Literature Review, Phoenix Black Mar 2023

Classifying Severe And Enduring Anorexia Nervosa: A Literature Review, Phoenix Black

University Honors Theses

Little focus is placed on the subsection of the eating disorder patient population who struggle chronically with their illness. This review synthesizes research on the topic to identify gaps in knowledge and reflect on implications for diagnosis and classification of severe and enduring anorexia nervosa. There was some variability between both clinicians and researchers who focused on this patient population, which is discussed based on different classifying criteria used to include or exclude an individual into the study. This review considers traditional methods used for classifying psychiatric diagnoses in relation to this disorder.


The Relationship Between Loneliness And Experiential Avoidance After Implementation Of A Self-Compassion Intervention, Alyssa Mielock Jan 2023

The Relationship Between Loneliness And Experiential Avoidance After Implementation Of A Self-Compassion Intervention, Alyssa Mielock

Graduate Research Theses & Dissertations

An individual’s perception of a social relationship is distinct from an individual’s difficulty forming and maintaining social relationships. Loneliness is defined as an individual’s distress resulting from the discrepancy between perceived and desired social relationship quality. In the short term, loneliness may act as a motivator for an individual to seek social support to minimize distress. However, long-term loneliness is associated with physical and psychological impairments. There have been several risk factors identified that contribute to chronic loneliness, such as social isolation, psychopathology, and ineffective coping strategies. Ineffective coping may be one mechanism by which loneliness is associated with psychopathology …


Examining Measurement Invariance Of The Pios And Pios-R Across Christian, Jewish, And Muslim Groups, Johanna Anita Younce Jan 2023

Examining Measurement Invariance Of The Pios And Pios-R Across Christian, Jewish, And Muslim Groups, Johanna Anita Younce

Graduate Research Theses & Dissertations

The Penn Inventory of Scrupulosity (PIOS) was developed in a sample of primarily Christian participants. Since scrupulosity is intertwined with religion, it is important to establish that the PIOS and its revised version (PIOS-R) are invariant across the religions with which the measure is primarily utilized: Christianity, Islam, and Judaism. Additionally, there was inconsistency in the literature as to the factor structure of the PIOS/PIOS-R, so three of the models in the literature each were examined and compared for the PIOS and the PIOS-R. 718 participants were recruited through MTurk and reported affiliation with either Christianity (n = 274), Islam …


Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy Jan 2023

Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy

Walden Dissertations and Doctoral Studies

Little is known as to the age-related presentation of somatic complaints of those diagnosed with generalized anxiety disorder in primary care settings. A retrospective medical records review sought to identify the affective symptoms of generalized anxiety disorder (GAD) by age as recorded by primary care providers and to test the association of these symptoms by age. Guided by Engle’s (1977) biopsychosocial (BPS) model, a large administrative claim database system was used to derive a sample of 1,336, including 500 patients diagnosed with generalized anxiety disorder between 2018 to 2021. Binary logistics regression, one-way ANOVA, chi-square, correlation, and logistical regression with …


Occupational Burnout Factors Among Correctional Mental Health Providers, Morgan Gruhot Jan 2023

Occupational Burnout Factors Among Correctional Mental Health Providers, Morgan Gruhot

Walden Dissertations and Doctoral Studies

Burnout rates of correctional employees are higher than employees in the general public. The purpose of this study was to identify how occupational factors impact burnout rates among correctional mental health workers. Grounded in the job-demands theoretical model, this study compared burnout rates among mental health staff within county jails and state prisons. Burnout was measured using the Maslach Burnout Inventory and Occupational factors were measured using the Areas of Work life Survey and Pandemic Experience and Perception Survey. Data was analyzed using IBM SSPS software to address multiple a priori directional research questions. Research questions considered how occupational factors …


Occupational Burnout Factors Among Correctional Mental Health Providers, Morgan Gruhot Jan 2023

Occupational Burnout Factors Among Correctional Mental Health Providers, Morgan Gruhot

Walden Dissertations and Doctoral Studies

Burnout rates of correctional employees are higher than employees in the general public. The purpose of this study was to identify how occupational factors impact burnout rates among correctional mental health workers. Grounded in the job-demands theoretical model, this study compared burnout rates among mental health staff within county jails and state prisons. Burnout was measured using the Maslach Burnout Inventory and Occupational factors were measured using the Areas of Work life Survey and Pandemic Experience and Perception Survey. Data was analyzed using IBM SSPS software to address multiple a priori directional research questions. Research questions considered how occupational factors …


Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy Jan 2023

Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy

Walden Dissertations and Doctoral Studies

Little is known as to the age-related presentation of somatic complaints of those diagnosed with generalized anxiety disorder in primary care settings. A retrospective medical records review sought to identify the affective symptoms of generalized anxiety disorder (GAD) by age as recorded by primary care providers and to test the association of these symptoms by age. Guided by Engle’s (1977) biopsychosocial (BPS) model, a large administrative claim database system was used to derive a sample of 1,336, including 500 patients diagnosed with generalized anxiety disorder between 2018 to 2021. Binary logistics regression, one-way ANOVA, chi-square, correlation, and logistical regression with …


Religiosity, Daily Rosary, And Well-Being Of Catholics In College During The Pandemic, Michael Raul Rios Jan 2023

Religiosity, Daily Rosary, And Well-Being Of Catholics In College During The Pandemic, Michael Raul Rios

Walden Dissertations and Doctoral Studies

Before and since the Coronavirus pandemic, college students suffered from increasing rates of mental health conditions affecting their well-being. Researchers have requested more studies on prayer as a strategy to address well-being issues. The purpose of this anonymous online survey study (N = 59) was to discover if there were any associations between religiosity and well-being, daily Rosary frequency and well-being, and if daily Rosary frequency mediated an association between religiosity and well-being of Catholic students in college in the United States during the pandemic in 2021. Participants were recruited via social media, listservs, email, one nationwide organization, the Walden …


How Sleep Disturbances Affect Those With Borderline Personality Disorder And The Implications For Treatment, Molly L. Schmanke Jan 2023

How Sleep Disturbances Affect Those With Borderline Personality Disorder And The Implications For Treatment, Molly L. Schmanke

Regis University Student Publications (comprehensive collection)

This thesis argues that there is limited research on Borderline Personality Disorder’s comorbidity with sleep disorders, and by pointing out the gaps in knowledge this will encourage researchers and doctors to consider this topic as important in the health care field. Sleep disorders can be anything from reduced total sleep time, fragmented sleep, and changes in sleep architecture, and all of these can cause and be caused by disruption of the circadian clock. There are various ways in which circadian clock disruption can cause diseases, cancer, and mental disorders through genes, sleep, and the environment. Borderline Personality Disorder comorbid with …


Therapists’ Demonstrated Multicultural Competence In Treating Latinx Immigrants, Dulce Diaz Benitez Dec 2022

Therapists’ Demonstrated Multicultural Competence In Treating Latinx Immigrants, Dulce Diaz Benitez

Graduate Theses and Dissertations

Studies suggest that health disparities occur when people from marginalized communities receive care that is inadequate based on their cultural needs (USDHHS, 2011). Multicultural competence (MCC) models have been proposed to provide a framework of the competencies that therapists should develop to work with multicultural populations (Sue et al., 1992). Researchers have questioned the validity of measures, which are mostly based on therapist self-report (Cartwright, 2008). The multicultural case conceptualization ability task has been used in previous studies as a measure of demonstrated cultural competence using a vignette to assess case conceptualization abilities (Ladany et al., 1997). However, it has …


Evaluating The Impact Of A Safe Exercise Training Workshop On Knowledge And Self-Efficacy To Manage Dysfunctional Exercise Among Eating Disorders Clinicians At Alsana Eating Disorders Center, Danika A. Quesnel Jun 2022

Evaluating The Impact Of A Safe Exercise Training Workshop On Knowledge And Self-Efficacy To Manage Dysfunctional Exercise Among Eating Disorders Clinicians At Alsana Eating Disorders Center, Danika A. Quesnel

Electronic Thesis and Dissertation Repository

Engaging in dysfunctional exercise (DEX) is detrimental to eating disorders (EDs) prognosis, although common amongst clients. Though nutritionally supported exercise can improve ED treatment outcomes, without negatively impacting weight restoration, clinicians remain hesitant to address DEX, perhaps due to a lack of information and training. The current study examined the effects of a Safe Exercise at Every Stage (SEES) training on clinician knowledge and self-efficacy in managing DEX in ED treatment. Eating disorders clinicians completed measures before (n = 96) and after (n = 44) SEES training to assess their knowledge and self-efficacy around treating DEX, with a …


Effects Of Music Exposure On Autobiographical Memory In Alzheimer's Patients: A Systematic Review And Meta-Analysis, Gregory Vance May 2022

Effects Of Music Exposure On Autobiographical Memory In Alzheimer's Patients: A Systematic Review And Meta-Analysis, Gregory Vance

Honors Theses

The progression of Alzheimer’s disease is primarily characterized by a loss of memory concerning past events, as well as a lack in ability to create new memories. While this spans across many subsets of memory, such as recognition, recall, and autobiographical memory, there seems to be a lesser impact on musical memory in those with Alzheimer’s. Multiple studies have suggested that exposure to music and introduction of music therapy can even improve other aspects of memory in Alzheimer’s patients. This systematic review and meta-analysis sought to examine the relationship between music exposure and autobiographical memory specifically. A pool of electronic …


Sleep Self-Efficacy, Loneliness, And Physical Activity: Assessing The Pathways Between Sleep Quality And Mental Health Using Structural Equation Modeling, Amber M. Fox Jan 2022

Sleep Self-Efficacy, Loneliness, And Physical Activity: Assessing The Pathways Between Sleep Quality And Mental Health Using Structural Equation Modeling, Amber M. Fox

Theses and Dissertations

Although there is robust empirical support that poor sleep contributes to declines in mental health, explanations of this relationship remain unclear. The purpose of the present study was to examine the pattern of associations between sleep quality, sleep self-efficacy, loneliness, physical activity, and mental health among U.S. adults across the lifespan, and whether they differed by gender or age group. A structural equation model with invariance analysis was developed and examined data from 2,300 adults (Mage = 44.1, SD = 16.78) participating in the online study Investigating Sleep Longitudinally Across Normal Development (ISLAND). Sleep quality was measured by …


The Experience Of Providing Direct Care To Children Victims Of Boko Haram Insurgencies In Nigeria, Felicia Etuke Jan 2022

The Experience Of Providing Direct Care To Children Victims Of Boko Haram Insurgencies In Nigeria, Felicia Etuke

Walden Dissertations and Doctoral Studies

The insurgency of terrorism leaves lasting economic, social, academics, spiritual, religious, and psychological effects, but often children’s psychological welfare is neglected in the aftermath of terrorist attacks. Boko Haram’s presence in Nigeria has left many children orphaned, displaced, and impoverished. Thus, there is a need to highlight the importance of the role that care providers play in securing the psychological health of the child victims of Boko Haram insurgency. This qualitative, phenomenological study explored the experiences of care providers to the child victims of Boko Haram insurgency in Nigeria. Compassion fatigue theory was used as a theoretical framework for the …


Evaluation Of A Public School District Nutrition Education Program In Southern California’S San Diego County, Donielle Cohen Jan 2022

Evaluation Of A Public School District Nutrition Education Program In Southern California’S San Diego County, Donielle Cohen

Walden Dissertations and Doctoral Studies

The prevalence of obesity among children and adolescents has markedly increased in several developed countries in recent years. Researchers have examined different factors that contribute to overweight and obesity in children and adolescents but have not fully explored the psychological impact of obesity on this population. The effectiveness of nutrition education programs in addressing the effects of obesity is also understudied. The primary purpose of this evaluative case study was to examine the impact of the Harvest of the Month nutritional educational program, which was adopted by San Diego County public schools in 2005, on the nutritional habits and psychosocial …


Educational Level As A Moderator Between Stress And Suicidal Ideation Among Law Enforcement Officers, Sittipong Permsookjit Jan 2022

Educational Level As A Moderator Between Stress And Suicidal Ideation Among Law Enforcement Officers, Sittipong Permsookjit

Walden Dissertations and Doctoral Studies

Law enforcement officers are exposed to occupation-related stress at a level greater than any other occupation, save war combatants, such stress can lead to suicidal ideation. There is a growing trend of suicidal ideation among law enforcement officers. This trend will threaten the stability of society if it is allowed to continue. Educational level has been shown to improve quality of life and is considered a quantitative resource. Using the theoretical framework of appraisal theory, this study’s purpose was to examine the moderating effects of educational level on stress and suicidal ideation among law enforcement officers. A total of 72 …


Examining The Utility Of Auditory Processing Tests In Clinical Neuropsychology, Behnaz Sarlak Jan 2022

Examining The Utility Of Auditory Processing Tests In Clinical Neuropsychology, Behnaz Sarlak

Walden Dissertations and Doctoral Studies

Memory loss has been a concern in patients with neurodegenerative disease, as it can cause cognitive problems such as speech and language issues. Clinicians need to use reliable, assessable, noninvasive, repeatable, and inexpensive tools to diagnose memory impairment. There is a gap in the literature on whether specific cognitive tests provide valid, reliable, cost and time-effective methods for screening for dementia. The purpose of this quantitative correlational study was to examine if the Seashore, the Speech-Sound Perception Test, the SCAN-A test, Logical Memory, Verbal Paired Associates, and Digit Span Test can predict whether an individual has been diagnosed with Alzheimer’s …


Can It Heal And Hurt?: Survivors Of Sexual Assault Share The Benefits And Challenges Of Sexual Assault Support Group Participation, Brittni Gettys Jan 2022

Can It Heal And Hurt?: Survivors Of Sexual Assault Share The Benefits And Challenges Of Sexual Assault Support Group Participation, Brittni Gettys

West Chester University Doctoral Projects

Research exploring the relationships among trauma survivors is largely non-existent. This study aimed to explore the effects of relationships among individuals with a shared experience of sexual trauma within the group therapeutic context of sexual assault support groups. This study sought to examine the potential buffering and supportive effects of social support between sexual assault survivors, while also exploring the potential negative effects of shared trauma that may occur from the potentially triggering nature of seeking support from other sexual assault survivors. These complex dynamics were explored through examining the relationships and experiences of sexual assault survivors who have attended …


Evaluating The Relationship Between Orthorexia Nervosa, Eating Disorder Symptomatology, And Related Psychological Constructs In An Undergraduate Mixed-Gender Sample, Kimberly Marie Martinez Jan 2022

Evaluating The Relationship Between Orthorexia Nervosa, Eating Disorder Symptomatology, And Related Psychological Constructs In An Undergraduate Mixed-Gender Sample, Kimberly Marie Martinez

Legacy Theses & Dissertations (2009 - 2024)

The pursuit of a healthy lifestyle has become a central focus of Western societies over the past few decades. As rates of chronic conditions, such as obesity and type II diabetes, continue to rise, so too has the desire to maintain one’s optimal state of health. For some, the pursuit of a healthy diet becomes an obsession that interferes with one’s physical and psychological wellbeing. Orthorexia Nervosa (ON) is a proposed eating disorder characterized by a pathological fixation on healthy eating. Unlike other established eating disorders (EDs), ON is focused on the quality of one’s diet, rather than the quantity …


Cerebellum-Seeded Functional Connectivity Changes In Trait-Anxious Individuals Undergoing Attention Bias Modification Training, Katherine Elwell Jul 2021

Cerebellum-Seeded Functional Connectivity Changes In Trait-Anxious Individuals Undergoing Attention Bias Modification Training, Katherine Elwell

All NMU Master's Theses

Anxiety and anxiety related disorders are increasing at a drastic rate in the past decade, with the NIMH reporting that 31.1% of U.S. adults will experience an anxiety disorder at some point in their lives. Anxiety is commonly characterized by increased attention bias to threat. Attention Bias Modification (ABM) is a new treatment used to reduce individual’s attention bias towards threat. The extent to which ABM leads to underlying neural changes is still unknown. The cerebellum is a neglected brain structure, with new research provides evidence that cerebellum’s functional connectivity and shared networks with threat processing regions has a direct …


Treatment Access For Dual Diagnosis Substance Use And Mental Health Disorders, Pedro Banuelos May 2021

Treatment Access For Dual Diagnosis Substance Use And Mental Health Disorders, Pedro Banuelos

Electronic Theses, Projects, and Dissertations

In 2018, of 1.3 million Latinx adults in the United States facing concurrent issues with substance use disorders (SUD) and mental health disorders (MHD) 93% remained untreated for either diagnosis. This is concerning since Substance Abuse and Mental Health Services Administration (SAMHSA) data reveals that this population is at greater risk for suicidal thoughts, plans, and attempts. They also face structural barriers such as employment, housing, legal involvement, and insurability that further impede access to treatment.

This study’s purpose was to examine barriers to accessing treatment for Latinx populations confronting co-occurring SUDs and MHDs. This study used a qualitative design …


The Experiences Of Iraqi Refugees In Canada: A Life History Study Of War And Resilience In The Aftermath Of Migration, Nada Nessan Feb 2021

The Experiences Of Iraqi Refugees In Canada: A Life History Study Of War And Resilience In The Aftermath Of Migration, Nada Nessan

Electronic Thesis and Dissertation Repository

This thesis reports on a life history narrative on the experiences of Iraqi refugees who resettled in Canada after living through war. The aim of this study is to help change the narrow perspectives on the mental health of war affected populations to a broader perception shaped by cultural and social aspects and to inform the development of meaningful and cultural relevant programs and policies with a particular attention to the concept of resilience.

The first part of the study presents the chronological narratives, or profiles. of eight participants. The second part of the study is a thematic discussion of …


Antecedents Of Borderline Personality Disorder And Antisocial Personality Disorder: An Examination Of Gene X Environment Interactions, Amy L. Medina Feb 2021

Antecedents Of Borderline Personality Disorder And Antisocial Personality Disorder: An Examination Of Gene X Environment Interactions, Amy L. Medina

Dissertations, Theses, and Capstone Projects

Current thinking suggests that genotypes associated with impulse-control disorders and negative emotionality, such as monoamine oxidase-a (MAOA), interact with negative early environmental factors like childhood maltreatment and develop into the disorders know as Borderline Personality Disorder (BPD) and Antisocial Personality Disorder (ASPD). Using existing data from a prospective cohort design study of the consequences of child abuse and neglect, participants (N = 896 represent individuals with documented histories of child abuse and neglect and a matched comparison group that were followed up into adulthood and interviewed. A subsample of 631 participants gave permission for DNA extraction and analyses during …


Psychological Distress And Relationship Satisfaction Among Survivors Of Sexual Violence, Alyssa Campbell Jan 2021

Psychological Distress And Relationship Satisfaction Among Survivors Of Sexual Violence, Alyssa Campbell

Theses and Dissertations--Family Sciences

The World Health Organization (WHO; 2002) has indicated that sexual violence is a serious public health concern, and both the WHO and the United Nations (UN) have declared that violence against women, in particular, is a profound violation of human rights (UN General Assembly, 1993; WHO, 2017). Although the systemic and negative impact of trauma on family and intimate relationships have been well documented, the empirical literature regarding the effects of adult sexual trauma on relationship satisfaction is less robust. These studies are designed to address this gap and will do so with analyses centered on an understudied population: the …


The Experience Of Therapists Working With Mexican American Children Of Substance Abusing Parents, Tracy M. Basile Jan 2021

The Experience Of Therapists Working With Mexican American Children Of Substance Abusing Parents, Tracy M. Basile

Walden Dissertations and Doctoral Studies

AbstractThe need for culturally competent mental health providers and the Mexican American immigrant population in the United States are growing. This study focused on themes from therapists’ narratives that may help to comprehend the intricacy of difficulties facing Mexican American children living with substance-abusing parents. The firsthand knowledge and experiences of the therapists who have worked with this population provided a basic understanding of what to expect and which therapeutic interventions may work best for both the child and their parents. The purpose of this narrative inquiry was to qualitatively identify therapists’ lived experiences and understand how they interacted with …