Health Psychology Commons^™

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 …

Behavioral Indicators Of Reflective Functioning In Mother-Child Dyadic Interactions, Rachel Clingensmith

Electronic Theses and Dissertations

Positive parenting practices and secure attachments are consistently linked to healthy child outcomes (Ainsworth & Bowlby, 1991; Waters et al., 2000). Research on cognitive processes that scaffold parental behaviors which contribute to secure attachment is an essential contribution to the literature, particularly given the potential for early intervention with at-risk families. Parental Reflective Functioning (PRF) is a construct of increasing interest which has been linked to secure attachments and positive child outcomes, with one commonly used self-report measure of PRF being the Parental Reflective Functioning Questionnaire (PRFQ; Camoirano, 2017; Clingensmith, 2021; Luyten et al., 2017). As such, the purpose of …

Approaching Trans Healthcare Competency: The Implementation Of Trans Health Education For Medical Providers In Appalachia, Rebecca Altschuler

Electronic Theses and Dissertations

Barriers to competent and safe healthcare disproportionately impact people who are marginalized because of their race, ethnicity, gender, or socioeconomic status. It is well documented that transgender patients in particular experience barriers to both accessing care and receiving high quality, non-discriminatory care (Hatzenbuehler & Pachankis, 2016; James et al., 2016; Rahman et al., 2019; Safer et al., 2016). This lack of access to culturally competent healthcare services contributes to health disparities that disproportionately impact the trans community. Literature on barriers to competent care for trans patients indicates that providers experience discomfort related to their ability to provide competent care (Safer …

K-5 Elementary Alternative Program: A Case Study, William E. Scheuer Iv

Electronic Theses and Dissertations

The purpose of this case study was to examine how the K-5 elementary alternative program All Students Can Thrive (ASCT) used student-centered learning practices to influence the whole child. There is a lack of research on K-5 elementary alternative programs, such as ASCT, and specifically those that integrate student-centered learning practices to influence the whole child. Literature does not contain universally accepted interventions that are effective in the elementary alternative setting to help students return to the mainstream classroom setting better prepared to display appropriate behaviors when a student is removed from a mainstream classroom setting due to disruptive behaviors. …

Look, But Don’T Touch: Impact Of Covid-19 On The Nicu Caregiver, Rebecca C. Otwell-Dove

Electronic Theses and Dissertations

Admission of an infant into the neonatal intensive care unit (NICU) is an experience that has been associated with a variety of both positive and negative health outcomes for parent and child. While both the setting name and the admitted population alludes to a sole focus on the affected infant, what often remains underrecognized is the impact on the ones who care for the newborn long before and longer after their NICU stay. Given the recency and unprecedented impact of the COVID-19 pandemic, very little research has examined the impact of COVID-19-specific stress on the experience of parents of infants …

Adverse Childhood Experiences And Quality Of Life: A Mediating Role Of Physical Activity And Executive Function, Loni Parrish

Electronic Theses and Dissertations

ACEs have been associated with heightened risk for a range of chronic health problems, substance use, and cognition in adulthood (Center for Disease Control (CDC), 2019; Hinojosa et al., 2017). One potential protective factor is physical activity (McEwen, 2016; Wu et al., 2013). Physical activity is associated with sustaining overall health, improving mental health by reducing symptoms of depression and anxiety (Murri et al., 2019; Sharma et al., 2006; Tasci et al., 2019), and maintaining a healthy body weight and BMI (WHO, 2021). Therefore, this study examined whether barriers to physical activity, physical activity levels, and executive outcomes serve as …

Optimism And Physical Health-Related Quality Of Life In Chronic Illness: Mediating Effects Of Control Beliefs And Health Behaviors, Morgan Treaster

Electronic Theses and Dissertations

Among persons living with, or recovering from, chronic illness, poor physical health-related quality of life is a concern, as current and residual illness symptoms and treatment side effects may deleteriously impact physical functioning and fulfillment of daily roles. Numerous cognitive, emotional, and behavioral factors may impact perceptions of health status. Optimism, for example, is conceptualized as belief in the occurrence of positive future outcomes, and is beneficially associated with physical health-related quality of life. Further, optimism may contribute to enhanced perceptions of control and efficacy over disease symptoms and general health, manifesting as proactive health behaviors (e.g., wellness behaviors; treatment …

Identity-Specific Positive Psychology Intervention For Sexual Minorities: A Randomized Control Trial, Sarah Job

Electronic Theses and Dissertations

Sexual minorities experience mental and physical health disparities in comparison to heterosexual individuals due to minority stress (Branstrom et al., 2016; Kerridge et al., 2017; Meyer, 2003). Positive psychology interventions have improved mental and physical health (Antoine et al., 2018; Lambert D'raven et al., 2015), and therefore these interventions have potential to address health disparities. The current study tested an identity-specific intervention (n = 30) to a general positive psychology intervention (n = 30) and a control group (n = 30) among sexual minorities. This built on a recent pilot study which tested the efficacy of an …

Psychological Distress And Susceptibility To Disease In The Infant And Early Childhood Mental Health (Iecmh) Workforce In The Time Of The Covid-19 Pandemic, Ashley Sexton

Undergraduate Honors Theses

Chronic stress, anxiety, and depression can have many adverse effects on physical health, including immunosuppression and increased susceptibility to disease. For the last year, the world has endured sustained stress caused by the COVID-19 pandemic which has had its own impact on mental health. Stress from COVID-19 will likely have an even greater impact on the Infant and Early Childhood Mental Health (IECMH) workforce due to the stressful nature of their work. Self-care has been shown to improve overall wellbeing and act as a buffer for stress. Therefore, the current study aims to investigate if IECMH workers with clinically significant …

Intrinsic Religiousness And Its Relation To Health Outcomes, Joseph Barnet

Electronic Theses and Dissertations

Religiousness, broadly defined, has been shown to be predictive of a variety of health outcomes. Past literature surrounding religiousness research has utilized different definitions and measures for the meaning of religiousness. How religiousness is defined can influence its relationship in relation to health outcomes. The present study utilized a measure for intrinsic religiousness, which is defined as an internalization of the tenets of a particular faith. The present study examined whether intrinsic religiousness predicts problematic or illicit substance use or pornography use in a sample of participants that included mostly undergraduate students from the Appalachian region, as well as some …

The Loss-Processing Framework, Lawrence Childress

Electronic Theses and Dissertations

The circumstances of responding to loss due to human death are among the most stressful experiences encountered in life. Although grief’s symptoms are typically considered essential to their gradual diminishment, possible negative impacts of complications related to grief are also well known, and have been associated with detriments to mental and physical health. Grief, however, can also generate transformative positive change. Thus, albeit ineludible, responding to loss is not uniformly experienced, expressed, or understood. It is also culturally-shaped, making attempts to define “normal” grief, as well as to label some grief “abnormal”—and to medicalize it—possibly problematic. Bereavement (the situation surrounding …

Trauma Informed Care Training Initiative: Implementation Study In Appalachia, Mattie V. Raza

Undergraduate Honors Theses

This study aims to evaluate the implementation of Trauma-Informed Care (TIC) trainings in Johnson City, Tennessee, and the surrounding Appalachian area. Previous TIC trainees were sent an email survey asking them if they had followed through with their plan to implement the training at their place of work or in other areas of their lives. The response rate for this study was 2%, possibly due to extraneous variables such as the Coronavirus Pandemic and the lag time between the initial training and survey follow-up. The responses that were analyzed indicated promise for the practical implementation of TIC concepts at the …

Measurement Of Nontheistic And Theistic Spirituality: Initial Psychometric Qualities Of The Inclusive Spiritual Connection Scale, Valerie M. Hoots

Electronic Theses and Dissertations

Spirituality represents a key part of life for the majority of U.S. adults and there is a growing body of research supporting relationships between spirituality and numerous health outcomes. Governing healthcare organizations have acknowledged the role religiousness and spirituality play in comprehensive and holistic patient care. While the U.S. shows documented trends towards diverse expressions of spirituality, existing theory-driven measures of spirituality are largely theocentric. The current study concludes a multiphase project that aimed at the outset to develop an inclusive measure of spirituality and establish initial psychometric evidence, validating its use across both theistic and nontheistic spiritual populations. The …

Thwarted Interpersonal Needs, Depression, And Sleep Disturbances In Primary Care: Does Gratitude Help You Sleep?, Heather R. Altier

Electronic Theses and Dissertations

Sleep disturbances are prevalent in primary care patients and can be exacerbated by interpersonal dysfunction and depression. As well, thwarted interpersonal needs (TIN), including thwarted belongingness and perceived burdensomeness, contribute to depression. However, the presence of gratitude, a cognitive-emotional protective factor, may improve symptoms. We longitudinally examined the mediating role of depressive symptoms on the relation between TIN and sleep disturbances, and the moderating role of gratitude on the TIN-sleep disturbances and depression-sleep disturbances linkages. Our primary care patient sample (N = 223) completed self-report surveys at baseline (T1) and at a one-year follow-up (T2; n = 97). Patients …

Weight Status As A Moderator Of Low Self-Esteem And Poor Sexual Functioning, Madison Hinkle

Electronic Theses and Dissertations

Researchers have found that self-esteem and weight status can impact numerous aspects of an individual’s life, including reproductive health issues. However, there has been limited research specifically examining how self-esteem may affect female sexual functioning. The current study aims to examine whether self-esteem is a significant predictor of sexual functioning, and whether this relationship may change as a function of women’s weight status. Participants consisted of 730 women ranging from 18 to 49 years of age, who were recruited through an online questionnaire. Results indicate that higher levels of self-esteem predict better sexual functioning and weight status was found to …

Managing Stress In A Constantly-Changing Workforce, Lorri Burch-Hubbard

Electronic Theses and Dissertations

When staffing reductions occur in the workplace, staff left behind may face increased stress, may not be given the support they need to manage the feelings caused by the reduction. This study was conducted to evaluate the impact of stress caused by staffing reductions has on medical technologists (MT), medical technicians (MLT) and respiratory therapists (RT), and to identify any common methods of stress management used by those staff who remain in the organization.

Literature research showed the negative impact stress can have on individuals when it is not addressed, such as decreased work performance, health issues, and even the …

Polysubstance Exposure And Its Relationship To Pharmacological Treatment Characteristics, Parker Miller

Undergraduate Honors Theses

Neonatal Abstinence Syndrome (NAS) remains an ever-growing public health issue and a continued avenue for future research. The research question for this retrospective study was whether polysubstance exposure is related to the dose of medication the infant received or to the number of opioid-medications required to treat the infants’ withdrawal symptoms? The hypothesis for the retrospective study was there will be a significant relationship between polysubstance exposure and the dose of medication the infant received as well as the number of opioid-medications required to treat the infants’ withdrawal symptoms. A bivariate correlational indicated that there was not a significant association …

Relationship Satisfaction & Diet: Exploring The Mechanisms Through Which Intimate Relationships Influence Physical Health, Lindsey Robinson, Dylan Hillock, Dr. Josh Novak

Southeastern Council on Family Relations Conference

Understanding how intimate relationships influence physical health has been an important topic of focus; however, research remains unclear on the mechanisms through which this influence occurs. The purpose of this study was to examine how relationship satisfaction relates to diet quality, through mental health (depression and anxiety) and diet self-efficacy. Using a dyadic mediation model with a sample of 234 heterosexual couples, researchers found that women's higher relationship satisfaction was associated with better diet through lower depression and higher diet self-efficacy. Results revealed the same association between women's relationship satisfaction and diet through lower anxiety. Interestingly, rather than mediation through …

Childhood Abuse, Religiosity, And Opioid Use: Findings From The National Epidemiologic Survey On Alcohol And Related Conditions Data, James E. Lewis

Electronic Theses and Dissertations

Religiosity is adopting a belief system surrounding concepts of purpose, meaning, and value through an institution that has already defined these concepts prior to the individual member attending and that member’s degree of participation. Religiosity does have protective factors against negative health outcomes. This protective influence was evaluated in this study. Data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions were examined to learn about the relationship between protective effects of religious participation on substance abuse, and whether this association weakened for individuals who have experienced higher levels of childhood abuse. A binary logistic regression …

We All Need Somebody To Lean On: Social Support As A Protective Factor For Individuals With Childhood Adversity, Rachel Clingensmith

Electronic Theses and Dissertations

Extensive research has shown that childhood adversity impacts development across the lifespan and has been linked to numerous negative health outcomes. Depression symptoms are one such outcome that has been associated with ACE exposure. The literature also indicates emotion regulation may be a mediator between ACEs and depression outcomes. The primary aim of this study (N = 766) is to investigate pathways leading from ACEs to depression and potential protective factors. It was hypothesized that difficulties in emotion regulation would mediate the link between ACEs and later depressive symptoms, social support would moderate the pathway between difficulties in emotion regulation …

Employer Perceptions Of Addiction Recovery And Hiring Decisions, Haley Henderson, Valerie Hoots, Joseph Barnet, Andrea D. Clements

ETSU Faculty Works

Abstract Addiction to drugs and alcohol is a widespread, and ever-growing problem in American society today. Individuals who undergo treatment for their addiction often find it difficult to gain employment due to employers' negative perceptions of addiction. Previous research has found that many employers have a stigma of those in addiction recovery. However, little research has been done to determine if these stigmas affect hiring decisions. Drug and alcohol misuse are prominent in the Appalachian area, which presents an issue for employers in the area who maintain a drug-free work place or who have a stigma of those in addiction …

Identifying Intimate Partner Violence: A Review Of Three Measures For Implementation In Primary Care Settings, Matthew W. Henninger, Andrea D. Clements

ETSU Faculty Works

No abstract provided.

Resilience Among Survivors Of Adverse Childhood Experiences In Appalachia, Bridget Jeter

Electronic Theses and Dissertations

The empirical investigation of adverse childhood events (ACEs) and their relationship with health and well-being outcomes in later life is increasing. Less is known about factors that may promote resilience for those who have survived such challenges, such as how resilience may be facilitated for those with ACEs residing in a marginalized region such as South Central Appalachia. Multidimensional spirituality, social support, stigma related to ACEs, and Appalachian acculturation may serve as both valid cultural factors and potential indicators of resilience. Cross-sectional, simultaneous multiple regression analysis was performed on data collected from 272 adult patients of a South Central Appalachian …

Exploring The Relationship Between Religiousness And Video Game Addiction, Joseph Barnet

Electronic Theses and Dissertations

Religiousness has been shown to have an inverse relationship with at least some types of addiction. The present study examined whether intrinsic religiousness predicts substance addiction and video game addiction in a sample of participants that included mostly undergraduate students from the Appalachian region, as well as some participants surveyed with the use of social media advertisements. Intrinsic religiousness has been defined as internalizing the tenets of one’s faith. Participants self-reported their religiousness using the Religious Surrender and Attendance Scale – 3 (RSAS-3), which has been shown to measure intrinsic religiousness. Religiousness as measured by the RSAS-3 predicted lower levels …

Psychosocial Well-Being And Efforts To Quit Smoking In Pregnant Women Of South-Central Appalachia, Brittney Stubbs, Valerie Hoots, Andrea D. Clements, Beth Bailey

ETSU Faculty Works

Introduction: Psychosocial well-being variables from the Tennessee Intervention for Pregnant Smokers (TIPS) study, a longitudinal smoking cessation study in South-Central Appalachia, were investigated as potential predictors of smoking status.

Methods: A sample of 1031 pregnant women participated in an expanded 5A's (Ask, Advise, Assess, Assist, Arrange) program, from 2008 to 2011. Measures of stress, self-esteem, depressive symptoms, and disordered eating collected by interview during the first trimester, or during the third trimester in a combined interview if participants began prenatal care late, were hypothesized to differ among three groups of participants: pregnant women who never smoked, pregnant women who smoked …

Pocket Ace: Neglect Of Child Sexual Abuse Survivors In The Aces Study Questionnaire, Robyn Dolson

Electronic Theses and Dissertations

In 1998, a seminal study on adverse childhood experiences (ACEs) and subsequent health risks catapulted ACEs and the study questionnaire into the zeitgeist. However, its childhood sexual abuse (CSA) item is problematic as it requires the perpetrator have been 5-years or older than the victim. To assess whether some survivors’ CSA is not identified by the current item, whether their exclusion prevents access to services requiring a four-threshold ACE score, and how their health outcomes compared to other CSA groups and controls, an international sample of 974 women completed an online survey assessing their current health and CSA history using …

Pyschosocial Well-Being And Efforts To Quit Smoking In Pregnant Women Of South-Central Appalachia, Brittney Stubbs

Undergraduate Honors Theses

A sample of 1,031 pregnant women from five prenatal practices participated in Tennessee Intervention for Pregnant Smokers (TIPS), an expanded 5A’s (Ask, Advise, Assess, Assist, Arrange) program. Stress, self-esteem, depressive symptoms, and disordered eating were hypothesized to differ among three groups: pregnant women who never smoked, pregnant women who smoked but quit prior to birth, and pregnant women who smoked and did not quit prior to birth. Smokers who quit were lower in stress and higher in self-esteem than those who did not quit. Non-smokers were lowest in stress and depression, and highest in self-esteem. These findings may lead to …

Self-Rated Health, Healthcare Satisfaction, Healthcare Adherence, And Medical Mistrust: The Moderating Role Of Rurality, Stephanie Alu

Undergraduate Honors Theses

The current study is part of a broader study called the Women’s Reproductive Health Survey (WRHS) which aimed to examine various aspects of women’s life experiences. This study examined the moderating effect of rurality on several factors of healthcare in a sample of women between the ages of 18 and 50. Self-rated health (SRH) was hypothesized to predict healthcare satisfaction, healthcare adherence, and medical mistrust. Furthermore, rurality was hypothesized to weaken the relationships between SRH and healthcare satisfaction and adherence; it was further hypothesized to exacerbate the relationship between SRH and medical mistrust. A survey containing a single-item measure of …