Health Psychology Commons^™

Starting With Story, Not Symptom: Narrative Collapse And Cultural Repair In Appalachia, Wayne Coombs Ph.D.

Journal of Appalachian Health

Appalachia’s opioid crisis reflects uneven burdens, especially in distressed coalfield counties, and it cannot be solved by symptom tracking alone. This commentary argues for a narrative shift, starting with story and cultural repair alongside clinical care. Narrative collapse is defined here as the loss of shared, dependable public meaning across groups, not the absence of storytelling in families, churches, and recovery circles. Trauma science suggests that chronic threat reshapes nervous systems across generations, making safety a prerequisite for renewed trust. Drawing on narrative identity research, the piece proposes peer story work as infrastructure that can reduce shame, support treatment engagement, …

A Mixed Method Investigation On The Effects Of Information And Motivation On Self-Regulation Skills And Fruit And Vegetable Consumption, Kristen Buford

Theses and Dissertations--Psychology

Introduction: The purpose of this research study is to understand the interplay between health information and health motivation on eating behaviors in African American emerging adults. Greater knowledge of nutrition is linked to healthier eating outcomes, but the motivations that individuals possess about their ability to improve their health also play a pivotal role. However, the joint effect of such constructs (i.e., information and motivation) on eating behaviors is unknown. Emerging adults are still developing their capacities to exercise their health autonomy, and this developmental period represents an opportunity to intervene before the onset of age-related chronic diseases in middle …

Childhood Chronic Illness: Assessing Emerging Adults’ Engagement In Social Activities And Predicted Money For Comfort In The Future, Mediated By Money Responsibility And Comparison To Others, Austin B. Mathews

Theses and Dissertations--Family Sciences

The purpose of this study is to examine the relationships between emerging adults’ engagement in social activities and their prediction of having money for comfort in the future. Data used was from the Panel Study of Income Dynamics (PSID) with individuals selected having at least one chronic illness that began during childhood. The study tested a series of hypothesis which tested the relationships between engagement in social activities and predicted money for comfort in the future, as well as, money responsibility and comparison to others as mediating variables. Significant associations were found between frequency of engagement in sports and money …

Talking About Cancer And Tobacco (Tact) Study With Lgbtq Patients And Their Care Providers, William Bowling

Theses and Dissertations--Psychology

Due to multilevel factors, including a high prevalence of tobacco use, the burden of some cancers is disproportionately higher in the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community than the general population. Evidence-based tobacco treatment delivery with high rates of tobacco cessation would be a powerful tool for secondary cancer prevention in the LGBTQ community, yet few studies have explored this issue. The current study aimed to 1) uncover both positive and negative aspects related to the lived experience and treatment of LGBTQ cancer survivors who use tobacco, 2) elucidate barriers and facilitators of tobacco treatment and cessation, and …

Resilience After Prenatal Substance Exposure: Exploring The Role Of Cumulative And Specific Protective Factors In Predicting Toddlerhood Temperament Profiles, Anjeli Elkins

Theses and Dissertations--Psychology

Objective

Prenatal exposure to common substances, including nicotine, marijuana, cocaine, methamphetamine, opiates, and alcohol, has been linked to a wide range of psychiatric disorders and neurodevelopmental impairments. Identifying protective factors that may improve temperament profiles in toddlers who have experienced prenatal substance exposure may protect against these adverse outcomes and is crucial for developing targeted early interventions.

Methods

Participants (n=92; Mage = 28.7 years; 47.0% White) were biological mothers of toddlers (Mage = 22.6 months) with prenatal substance exposure. Mothers responded to an online survey that gathered information on substance use during pregnancy, proposed perinatal protective factors, and child temperament. …

Responses To Tobacco Use Screening And Tobacco Cessation Assistance Offers Among Rural And Ubran Cancer Survivors At An Nci-Designated Comprehensive Cancer, Abigayle Feather

Theses and Dissertations--Psychology

Smoking after cancer diagnosis is associated with poor outcomes while smoking cessation can improve quality of life and promote survival. Although there are calls for equitable tobacco treatment delivery in cancer and other healthcare settings, disparities in tobacco-related disease burden persist. In the context of an outpatient cancer center’s population-based tobacco treatment program, this study examines the association between cancer survivors’ rural and Appalachian residence and 1) current tobacco use status, 2) decision to decline cessation assistance, and 3) reason for declining assistance. A cross-sectional, retrospective analysis was conducted using electronic health record data from 16,839 adults (64.04% female, 88.49% …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Relationship Between Anticipated Stress And Individuals’ Health-Related Behaviors, Julie Parsons

Theses and Dissertations--Psychology

Prior work in assessing the relationship between stress and health behaviors has identified the complex and multi-directional nature of these relationships. However, minimal work has assessed the possible relationships between stress anticipation and health behaviors such as diet, physical activity, and sleep outcomes in individuals. This work seeks to address this gap by conducting a daily diary study assessing within-person associations between stress anticipation and health behaviors over the course of a week. We hypothesized that daily stress anticipation would be negatively associated with dietary scores, physical activity engagement reports, sleep quality, and sleep duration while being positively correlated with …

Psychological Impacts In Exercise Riders And Professional Jockeys Following Injury, Kelley M. Renner

Theses and Dissertations--Kinesiology and Health Promotion

One of the most well-known equestrian sports, horse racing, is not only a cornerstone of Kentucky’s economy, but also a vital part of its culture, with professional jockeys playing an essential role in the local communities and traditions that define the state. Despite its popularity and financial impact, mental health challenges within the sport have continually been shrouded in silence and ignored in research (Ball et al., 2007). Equally concerning is the high injury prevalence, and psychological impact of these injuries (e.g., psychological distress, depression, anxiety, loss of identity, and self-esteem (King et al., 2022; Losty et al., 2019; McConn-Palfreyman …

The Effect Of Cytomegalovirus Infection On Daily Stress Processes In Early Adulthood, Elana Gloger

Theses and Dissertations--Psychology

Chronic stress increases risk for disease, poor health, and early mortality. Cytomegalovirus (CMV), a common latent herpes virus, may promote neurological changes that increase vulnerability to chronic stress by way of self-regulatory deficits, though this has yet to be directly tested. Investigating CMV at younger ages is crucial to understand the effect of CMV across the lifespan and identify modifiable health-factors for future anti-aging interventions. The present study aimed to investigate how, and for whom, CMV associates with daily stress processes in early adulthood.

Participants (N = 108, M_age = 19.7, 83.3% female, 72% White) completed an in-person lab …

A Mixed-Methods Study Exploring Free Nicotine Replacement Therapy As A Strategy To Promote Tobacco Treatment Equity At Cancer Center Cessation Initiative Sites, Marguerite A. Webster

Theses and Dissertations--Psychology

Nicotine replacement therapy (NRT) is a safe, efficacious smoking cessation treatment for cancer patients; however, equitable access is limited due to insurance gaps. Offering free NRT to patients with cancer has potential to increase tobacco treatment engagement and promote equity. This mixed-methods study aims to describe how some Cancer Center Cessation Initiative (C3I) sites implemented free NRT within their tobacco treatment programs (TTPs) to inform future development of equitable TTPs. Participating sites’ (N=9) TTP and patient population characteristics were assessed via survey and analyzed with descriptive statistics. Semi-structured interviews were conducted with 16 individuals and analyzed using directed …

Body-Based Harassment And Eating Disorder Symptomology In Cisgender, Transgender, And Gender Nonconforming Individuals, Sharla D. Biefield

Theses and Dissertations--Psychology

Past research estimates that over 60% of adolescents and young adults report eating disorder symptomology (EDS), increasing their risk for psychiatric and physical comorbidities, substance abuse, and self-harm. EDS rates are also higher among transgender and gender nonconforming (TGNC) individuals. TGNC individuals also experience higher rates of bias-based harassment, than their cisgender peers. Much of this harassment is body-based harassment (BBH), such that the harassment often targets aspects of an individual’s body. The current study utilized a pantheoretical framework, incorporating minority stress theory and objectification theory, and a multi-method approach to investigate (1) if BBH increases TGNC individuals’ risk for …

The Effect Of Physical Activity Courses On The Motivation For Physical Activity In College Students: A Scoping Review, Erica Fauste Waizenhofer Hill

Theses and Dissertations--Kinesiology and Health Promotion

The lack of physical activity and exercise participation has been an ongoing
problem for young adults aged 18-24. Universities and colleges worldwide offer a variety of required and elective physical activity courses for college credit to increase active participation in lifelong healthy lifestyles. This scoping review collected studies on college students’ motivation to participate in physical activity. The courses were taught using methods based on motivational theories. The authors of the studies collected information from the students before and after the classes to gather data on the theoretical framework’s effect on the students, if any. This review compiles this information, …

A Content Analysis Of Reddit Comments Discussing Fibroadenoma Appraisal And Decision Making, Hayley Marie Kay Stahl

Theses and Dissertations--Communication

Though fibroadenomas are clinically benign in most cases, clinical research suggests that these lesions can cause diagnosis-related physical health complications and psychological distress. However, this research is limited and should be investigated further. Thus, this study aimed to explore how patients appraise their fibroadenoma diagnosis uncertainty. Additionally, this study sought to determine if a correlation existed between appraisal and decision making as well as identify the factors that influence the most common treatment decision: removal. Data was retrieved from Reddit discussions for a content analysis. These discussions were then qualitatively analyzed using codebooks associated with this study’s research questions. Findings …

Pain Interference Across Chronic Pain Populations: Variability And Associated Psychosocial Processes, Stephanie Judge

Theses and Dissertations--Psychology

Chronic pain is one of the most common health complaints, yet the limited effectiveness of existing treatment options suggests that chronic pain is still not fully understood. The goals of this study are to identify and organize well-established and emerging psychosocial factors associated with pain interference, clarify the nature of between- and within-diagnostic group differences in psychosocial and demographic factors associated with pain interference, and identify interactions among diagnostic and psychosocial factors associated with pain interference.

Community-dwelling participants (N = 284) completed a one-time survey which included demographic information, information about pain and diagnosis, and five existing measures that assess …

Promotion Of Early Recognition Of Depression To Improve Health Related Quality Of Life In Pediatric Oncology Patients, Jennifer Blankenship

DNP Projects

Background: Depression and anxiety are serious complications of cancer and deemed a challenging diagnosis due to the symptoms of depression mimicking common side effects of chemotherapy and radiation. Signs/symptoms frequently are underrecognized thus appropriate treatment is delayed, compromising the health-related quality of life (HRQOL) for pediatric oncology patients.

Purpose: Analyze existing physician and Advanced Practice Provider (APP) clinical practice regarding depression, via a pre- and post-survey and educational PowerPoint on the use of the Center for Epidemiological Studies Depression Scale for Children (CES-DC) to promote early recognition of depression.

Methods: A prospective, single-arm, study was completed in the Kentucky Children’s …

"Think Of The Situation In A Positive Light": A Look At Cognitive Reappraisal, Affective Reactivity And Health, Jessica Chloe Maras

Theses and Dissertations--Psychology

How individuals regulate their emotions is critical for maintaining health and well-being. For example, reframing a stressful situation in a positive light, a form of cognitive reappraisal, is beneficial for health and well-being outcomes. However, it is currently unclear why this relationship exists. One potential mechanism could be how one emotionally reacts to stressors in daily life, termed affective reactivity. The current study examined longitudinal associations that spanned 20 years between cognitive reappraisal and health outcomes and subjective well-being and if affective reactivity mediated this relationship. Participants completed waves 1-3 of the Midlife in the United States (MIDUS) Survey series …

When Worlds Collide: An Intersectional Approach To Understanding The Relationship Experiences Of Bisexual-Identifying Asian Men With Same And Different Gender Partners, Cheryl Kwok

Theses and Dissertations--Educational, School, and Counseling Psychology

The relationship experiences of bisexual-identifying men of color have been neglected in psychological studies of race, gender, and sexuality. Few studies, if any, have examined the relationship experiences of Asian bisexual men, even though this population’s multiple marginalized and stigmatized social identities increase their health risks (Bryant-Davis, 2007; Carter, 2007; Ching et al., 2018). Bisexuality is commonly defined by an individual’s intimate partner attraction and/or behavior (e.g., Swan & Habibi, 2018), making relationship experiences fundamental to bisexual identity. More generally, intimate relationships can contribute to and/or pose challenges to psychological well-being (Feinstein, et al., 2016; Whitton et al., 2018), yet …

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 …

A Test Of The “Teachable Moment” Heuristic’S Relevance For Understanding Cancer Survivors’ Health Behavior Motivation And Performance: A Cross-Sectional Study, Gabriella Puleo

Theses and Dissertations--Psychology

Cancer diagnosis has potential to motivate health behavior changes to promote better health outcomes. The Teachable Moment Heuristic is a parsimonious, transtheoretical framework for understanding the conditions under which behavior change might occur, with constructs that include affective, cognitive, and social factors. This exploratory study aimed to measure the three primary constructs of the Teachable Moment, evaluate the extent to which they are associated with cancer survivors’ motivation to adopt favorable health behaviors, and explore their potential as a model for health behavior performance. Participants (n = 93) in this cross-sectional study were adult breast, prostate, colorectal, lung, and …

Helping The Have-Nots: Examining The Relationship Between Rehabilitation Adherence And Self-Efficacy Beliefs In Acl Reconstructed Naia And Ncaa Dii And Diii Female Athletes, Myles Tutin Englis

Theses and Dissertations--Kinesiology and Health Promotion

Anterior cruciate ligament injuries are among the most common and traumatic sport-related injuries, and often negatively impact one’s quality of life during and post-rehabilitation. For many NCAA Division I and professional female athletes, rehabilitation is streamlined with a multidisciplinary team, including sport psychology. For others (e.g., NAIA, NCAA Division II, III athletes) this may not always be the case, as many of these athletic programs may not have the resources to meet the various needs of injured and rehabilitating female student-athletes. In these instances, rehabilitation motivation, adherence, and success may be more dependent on the athletes’ individual resources and personalities, …

The Centrality Of Disclosure Decisions To The Illness Experience For Youth With Chronic Conditions: A Qualitative Study, Roberta Lynn Woodgate, Pauline Tennent, Sarah C. Barriage, Nicole Legras

Information Science Faculty Publications

The aim of this paper is to illuminate findings of disclosure experiences for youth living with chronic illness using a non-categorical approach. The findings were derived from a larger qualitative study framed by social constructivist grounded theory that sought to understand youth's involvement in healthcare decision-making in the context of chronic illness. Fifty-four youth participated in the study, ranging from 9 to 24 years. Three main themes representing the youth's perspectives and experiences of disclosing chronic illness were identified: (1) disclosure is central to the illness experience; (2) spectrum of disclosure; and (3) navigating others' reactions to disclosure. The findings …

Incentive Sensitization For Exercise Reinforcement To Increase Exercise Behaviors, Kyle D. Flack, Harry M. Hays, Jack Moreland

Dietetics and Human Nutrition Faculty Publications

Individuals can be sensitized to the reinforcing effects of exercise, although it is unknown if this process increases habitual exercise behavior. Sedentary men and women (body mass index: 25–35 kg/m², N = 52) participated in a 12-week aerobic exercise intervention. Exercise reinforcement was determined by how much work was performed for exercise relative to a sedentary alternative in a progressive ratio schedule task. Habitual physical activity was assessed via accelerometry. Post-intervention increases in exercise reinforcement predicted increases in physical activity bouts among those who expended over 2000 kcal per week in exercise and who compensated for less than …

Development And Psychometrics Of The English Version Of The Itch Cognitions Questionnaire, Carolyn J. Heckman, Christina Schut, Mary Riley, Anke Ehlers, Rodrigo Valdes-Rodriguez, Jörg Kupfer, Uwe Gieler, Jerod L. Stapleton

Health, Behavior & Society Faculty Publications

BACKGROUND: The aim of this study was to validate the English version of the Itch Cognition Questionnaire in a sample of patients with chronic itch due to psoriasis or atopic dermatitis. An English-language version of an instrument assessing itch-related cognitions is needed since cognitions can contribute to a worsening of itch, and chronic itch is prevalent in English-speaking counties and internationally.

METHODS: The German Itch Cognitions Questionnaire was translated into English, and cognitive interviewing was conducted to finalize item wording. Internal and test-retest reliability, item discrimination, responsiveness to change, and construct, convergent, and discriminant validity were assessed in a national …

Social Constraint, Social Support And Psychological Functioning In Rural And Nonrural Cancer Survivors, Jessica N. Rivera-Rivera

Theses and Dissertations--Psychology

This cross-sectional study identified the nature and strength of the relationship between social and psychological functioning, and explored if these relationships differ as a function of environmental and personal characteristics.

Participants (n=87) consist of breast, prostate, colorectal, lung, and head and neck cancer survivors who were diagnosed within the past five years. Cancer survivors were recruited through a cancer registry and outpatient clinics. Data collection involved questionnaire and medical records review.

In linear regression models for distress, social constraint demonstrated a stronger relationship with general distress (β = .37 vs. β = -.26), anxiety and depression ( …

Cancer Patients’ Tobacco Use And Tobacco Treatment Referral Response: Implementation Outcomes At A National Cancer Institute- Designated Cancer Center, Tia Borger

Theses and Dissertations--Psychology

Smoking after cancer diagnosis is linked to cancer-specific and all-cause mortality among other adverse outcomes. Yet, 10-20% of U.S. cancer survivors are current smokers. Implementation of evidence-based tobacco treatment in cancer care facilities is widely recommended, yet rarely accomplished. This study focuses on the early outcomes of a tobacco treatment program integrated within an NCI-designated cancer center. Participants consist of 26,365 patients seen at the cancer center during the first 18 months of implementation. The study is a retrospective chart review of patients’ tobacco use, and among current users, patients’ treatment referral response. Over 99% of patients were screened for …

Maladaptive Personality Traits And Health Behaviors, Health Perceptions, And Inflammatory Biomarkers In Older Adults, Joshua R. Oltmanns

Theses and Dissertations--Psychology

Traits from dimensional models of normal-range personality have been shown to predict physical health outcomes including health behaviors, health perceptions, disease, and mortality. Maladaptive traits of personality disorders may predict even more variance in physical health indicators. Dimensional models of maladaptive personality traits are replacing categorical models of personality disorder, and the five-factor model of personality disorder (FFMPD) has been shown to be a useful dimensional model of maladaptive traits. However, there has been little work investigating the criterion validity of the FFMPD for predicting physical health indicators. The present study examines FFMPD scales in the prediction of health behaviors, …

Is Athlete Activism A Predictor Of Resilience?, Travis Robert Scheadler

Theses and Dissertations--Kinesiology and Health Promotion

Several athletes have taken personal responsibility to engage in activism, often with hopes of bringing social and political change. While scholars have identified several barriers preventing athletes from engaging in activism (e.g., public criticism, status and job loss, withdrawal of funding, anticipated distress; Cunningham & Regan, 2012), other scholars have identified personal benefits from engaging in activism (e.g., improved confidence, self-concept, belief in change, agency, life meaning; Klar & Kasser, 2009; Rabkin et al., 2019). Distress from the barriers, however, may be prerequisites to enhancing resilience, a theoretical construct that may help explain the benefits of activism. Thus, by applying …

A Systematic Review Of Mindfulness Interventions’ Impact On Athlete Emotional Distress & Wellbeing, Trevor Nathan Tierney

Theses and Dissertations--Kinesiology and Health Promotion

Mindfulness-based interventions’ (MBIs) effectiveness for improving wellbeing and reducing emotional distress is well-documented in both clinical and non-clinical sections of the general population (McAlarnen & Longshore, 2017). Although mindfulness has been shown to be effective with these populations, less is known about the specific effects for athletes. The effects of MBI’s for athletes may be different given that the intention for MBIs in the sport context is typically to improve performance, where in most other contexts it is not (Gardner & Moore, 2012). Furthermore, athletes are a distinct population who possess unique factors on which their wellbeing and mental health …

Cognition, Repetitive Thought, And Systemic Inflammation In The Midlife In The United States Study, Elana M. Gloger

Theses and Dissertations--Psychology

Segerstrom et al. (2017) found that more repetitive thought (RT) was related to lower interleukin-6 (IL-6), in older adults at average IQ. This study aimed to replicate and extend this finding in midlife adults, with a daily measure of RT, and additional inflammatory biomarkers. 153 participants were drawn from the Midlife in the United States (MIDUS) Refresher project; ages 25-70 (M = 45.07, SD = 10.96), 50.3% female, and 83% Caucasian. Cognition was assessed via the Brief Test of Adult Cognition by Telephone, biological data via fasted blood draw, and RT data were collected as part of the National …