Bachelor of Science (BS), Ohio University, 2023, Translational Health

The goals of this study were to 1) determine the prevalence of adverse childhood experiences (ACEs) and their impact on health and health-risk behaviors and 2) assess body composition, salivary cortisol, and phase angle (PhA) with high, moderate, low, or no exposure to ACEs in college-aged Appalachian adults (≥18 y). Methods. College students completed an anonymous questionnaire (Phase 1) about ACEs, positive experiences, adult resiliency, perceived stress, food insecurity, and health. A subsample participated in the Phase 2 in-person portion to measure body composition, PhA, and resting/reactive cortisol. One-way ANOVAs and correlation analyses were used to analyze the sample. Results. In Phase 1 (N=611, 86.3% ≤25 y, 64.0% female, 81.0% Caucasian, 52.4% heterosexual), only 3.6% (n=22) reported no ACEs, while 34.7% (n=212) reported ≥8. Positive experiences (r=-0.62), perceived stress (r=0.37), resiliency (r=-0.53), and food insecurity (r=0.25) were significantly correlated with ACEs score (p<0.001). In Phase 2 (N=42, 78.6% ≤25 y, 64.3% female, 40.5% Caucasian, 78.5% heterosexual), body fat percentage was significantly correlated with ACE level (r=0.31, p=0.044). ACEs scores were not correlated with PhA (r=-0.08), resting or reactive cortisol (r=-0.04), or visceral adipose tissue (r=0.28) (p>0.05). Conclusions. The prevalence of ACEs is high amongst this sample of young adults and though significant physiological changes were not seen, health perceptions and behaviors were impacted. Future research should focus on a slightly older age group to identify when specifically physiological changes due to ACEs begin to manifest.

Committee: Cheryl A Howe (Advisor); Joseph A Bianco (Advisor) Subjects: Behavioral Psychology; Behavioral Sciences; Developmental Biology; Developmental Psychology; Health; Neurobiology; Physiology; Psychology; Social Psychology

Doctor of Philosophy, University of Akron, 2017, Marriage and Family Counseling/Therapy

The purpose of the present study was to replicate the Adverse Childhood Experiences (ACE) study framework, using relationship outcomes, and studied within the context of couple relationships. A thorough review of the literature on trauma, its prevalence, prior studies on ACEs, trauma and couples, and partner selection is presented. A secondary data analysis of 146 couples from a clinical source was used to test the present study's hypotheses. Actor-Partner Interdependence Model (APIM) was used to test the hypothesis that an individual's ACE exposure history would be negatively related to both their own and their partner's reported relationship quality. A cluster analysis was used to test the hypothesis that couples could be statistically grouped by ACE score combinations, and an ANOVA was used to test average group differences on relationship quality. Regression analyses were used to test hypotheses about partner selection. Results from the analysis include: (1) a small but significant negative impact of an individual's ACEs on their own reported relationship quality, but no finding of a significant impact on their partner's reported relationship quality; (2) a small but significant relationship between partner ACE scores; (3) a preliminary ability to group couples by ACE score combinations into three clusters (Low-Low, High-Moderate, Moderate-High) and a small but significant difference between two of the clusters; (4) an increased likelihood that couples will be partnered with those who have more similar than different ACE scores, and a significant trend that as ACEs increase, the likelihood of being partnered with someone who has similar ACEs will decrease; (5) a small but significant dose-response relationship between increasing ACEs and the likelihood of being partnered with someone who has more than minimal ACEs. Further discussion of the results, implications, limitations of the study, and future research directions are also included.

Committee: Karin Jordan Dr. (Committee Chair); Wondimu Ahmed Dr. (Committee Member); Rikki Patton Dr. (Committee Member); Rebecca Boyle Dr. (Committee Member); David Tefteller Dr. (Committee Member) Subjects: Behavioral Sciences; Developmental Psychology; Families and Family Life; Individual and Family Studies; Mental Health

Bachelor of Arts (BA), Ohio University, 2024, Spanish

This thesis examines the long-term effectiveness of the feminist efforts that took place during the Dominican Republic's Trujillato (1930-1961), or Trujillo dictatorship, as a potential reason for which the Caribbean nation experiences high rates of intimate partner violence toward women, specifically via feminicides, in the 21st century. Using ecological systems theory, social learning theory, the ACEs (adverse childhood experiences) model, and feminism, this cultural-historical analysis considers the relationship between the dictatorship and Dominican families to identify the long-term impact on Dominicans today. Specifically, in order to determine what and how many protective and risk factors were present during the time period, the recently added five community ACEs are applied to the feminist efforts. The findings reveal: (1) the risk factors greatly outweighed the protective factors, (2) women's inaction, avoidance, or active participation in supporting the dictatorship ultimately upheld machista values, and (3) maternal feminism alone as a tool to promote women's rights does not function under a dictatorship. Thus, given the failure to successfully decrease rates of violence against women in the present, this thesis proposes three solutions to address the human rights violation. First, the Dominican government should publicly recognize that the Trujillato worsened the environment that currently promotes and allows for violence against women. Second, the social work profession should expand the ACEs model so that the five community ACEs apply to groups of people, not just to individuals. Finally, all those organizations and individuals with Western perspectives who work with survivors should strive to perceive the roots of the social problem within the context of the country and the citizens affected. Further research suggests conducting official interviews with Dominicans to gather their firsthand experiences, carrying out a study in which the five community (open full item for complete abstract)

Committee: Lisa Skeens (Advisor) Subjects: Caribbean Studies; Foreign Language; Latin American Studies; Social Work

Master of Arts in Psychology, Cleveland State University, 2022, College of Sciences and Health Professions

Adverse Childhood Experiences (ACEs) are associated with a variety of negative outcomes, including criminal and violent behaviors (Milaniak & Widom, 2015). Prior research indicates that antisocial personality traits such as callousness may play a mediating effect on the relationship between ACEs and criminality (Baglivio et al., 2020). Further, the developmental period in which childhood maltreatment occurs may be related to greater criminality (Thornberry et al., 2010). This research project aims to examine how ACEs relate to criminality in emerging adults, with consideration of antisocial personality traits and the developmental period of experiencing childhood abuse. This study hypothesizes: (A) Both higher reported maltreatment ACEs and household dysfunction ACEs will uniquely relate to criminal activity. (B) A prevalence of antisocial traits (i.e., callousness and cold-heartedness) will mediate the relationship between maltreatment ACEs and criminality, relating to an increased engagement in criminality. (C) Among those who experienced physical, psychological, or sexual abuse, the age of onset of abuse will moderate the relationship between maltreatment and criminality, with adolescent occurring abuse leading to a higher engagement in criminal activity and violence. Through online data collection of emerging adults (N=343), results indicated that maltreatment ACEs associated with higher criminality, however, this study failed to establish a mediation model of antisocial traits between maltreatment ACEs and criminality. Among individuals who experienced emotional abuse, the developmental period of experiencing abuse moderated the relationship between maltreatment and criminality, with those experiencing childhood-limited abuse and low-maltreatment being at the lowest risk for engaging in crime. Researchers should continue to examine how the combination of specific ACEs may contribute to criminal outcomes. Future research should also explore the development and (open full item for complete abstract)

Committee: Elizabeth Goncy (Committee Chair); Tawana Jackson (Committee Member); Ilya Yaroslavsky (Committee Member) Subjects: Clinical Psychology; Psychology

Doctor of Psychology (Psy.D.), Xavier University, 2022, Psychology

Over the past two decades, public health research has demonstrated that Adverse Childhood Experiences (ACEs) are associated with significant and prolonged physical and mental health problems (Campbell et al., 2016; Felitti et al., 1998; Gilbert et al., 2015; Greif Green et al., 2010; Horwitz et al., 2001; Mersky et al., 2013), demanding investigation into factors that may mitigate such poor outcomes. One potential factor that may attenuate the negative impact of ACEs on individuals' mental health is social support. An important source of social support is sibling relationships (Furman & Buhrmester, 1985; Goetting, 1986; Lempers & Clark-Lempers, 1992; Scholte et al., 2001; Wellman & Wortley, 1989). The purpose of the current study was to examine if the perceived quality of sibling relationships may moderate the negative impact of ACEs on wellbeing in adulthood. Data was collected from a total of 439 participants (Mage = 35.06, SD = 11.20; 73.6% White or European American; 62.4% male). Results revealed that sibling relationships characterized by higher perceived warmth—and, interestingly, higher perceived conflict and rivalry—attenuated the negative impact of ACEs on wellbeing in adulthood. Additionally, higher ACE-IQ scores predicted lower wellbeing when participants' overall sibling relationship was characterized by relatively high, but not low, perceived quality. Future research should consider the nuances in the measurement of conflict and rivalry in the context of sibling relationships, and conceptualize overall sibling relationship quality accordingly. Such research will help determine whether overall sibling relationship quality is a factor that can mitigate the negative impact of ACEs on wellbeing.

Committee: Tammy Sonnentag Ph.D. (Committee Chair); Kathleen Hart Ph.D., ABPP (Committee Member); Stacey Raj Ph.D. (Committee Member) Subjects: Developmental Psychology; Families and Family Life; Health; Personal Relationships; Psychology; Public Health

DNP, Kent State University, 2022, College of Nursing

Background: Adverse Childhood Experiences (ACEs) are a group of potentially traumatic events that occur in the first 18 years of life. ACEs are divided into three categories, abuse, neglect, and household challenges, each of which has additional subcategories. A set of standardized questionnaires exist addressing the ACE categories and a score ranging from 0-10 is traditionally provided as a result. ACE scores greater than 2 have been shown to increase all-cause mortality of individuals over their lifetime. ACEs have been shown to have a strong relationship with chronic diseases including obesity, hypertension, diabetes, and hyperlipidemia, as well as risky behavior choices and high-risk sexual behaviors (HRSB) (Brown et al., 2009). HRSBs include early coitarche, unprotected intercourse, having multiple sexual partners, use of recreational drugs and a history of sexually transmitted infections (STIs) including chlamydia, gonorrhea, trichomonas, Human Immunodeficiency Virus, Human Papilloma Virus, and Herpes (Tariq & Gupta, 2020). Patients with an ACE score of 2 have a 61% increased risk and ACE >4 have a 107% increased risk of contracting an STI compared with those with and ACE score of 0 (London et al., 2017). The identification of patients with elevated ACE score in combination with adult health outcomes will help to provide a more well-rounded approach to mental and physical health. Given this, it is important to consider several factors which may lead to inaccuracy of screening. Further, many adults do not have a primary care provider and utilize easy access clinics for urgent/emergent care needs (Alcala et al., 2017). Identifying patients with elevated ACE score in combination with adult health outcomes will help to provide a more well-rounded approach to mental and physical health. Objectives: The primary objectives are to determine if women ages 18-40 with an ACE score >2 are at an increased risk for high-risk sexual behaviors (lifetime sexual partner (open full item for complete abstract)

Committee: Dr. Eldora Lazaroff (Committee Chair); Dr. Marilyn Nibling (Committee Member); Dr. Jo Dowell (Committee Member) Subjects: Gynecology; Health; Health Care; Health Education; Mental Health; Nursing; Obstetrics; Public Health; Womens Studies

Doctor of Philosophy, University of Akron, 2021, Counselor Education and Supervision

Previous research indicates that screening for parental Adverse Childhood Experiences (ACEs) is a significant tool for identifying children at risk for maltreatment, in order to intervene and prevent the long-term effects of ACEs. Pediatricians have been tasked with screening for parental ACEs at well child visits, as first line of defense. Studies show that less than half of pediatricians are screening for ACEs (Szilagyi et al., 2016) and there was no literature found on the screening practices of mental health providers. The purpose of the current study was twofold, 1) to increase our understanding of licensed mental health provider's familiarity with the seminal ACE study and their endorsement of the impacts of parental adverse childhood experiences (ACEs), and 2) to understand the influence that these factors and licensed mental health provider's personal exposure to ACEs have on their practice of screening for parental ACEs. A total of 277 mental health providers, licensed in the Midwest, completed a web-based survey consisting of a demographic questionnaire, an adapted version of the American Academy of Pediatrics (AAP) 85th Periodic Survey (PS85) (AAP, 2013), and an ACE questionnaire that included both traditional and expanded ACE items for the present study. Through the employment of three separate simple linear regressions, the results of this study indicated that 1) degree of familiarity with the seminal ACE study was not a significant predictor of frequency of screening for parental ACEs, 2) degree of endorsement of the impacts of parental ACEs is a significant predictor of frequency of screening for parental ACEs, and 3) personal exposure to ACEs was a significant predictor of frequency of screening for parental ACEs. However, previous literature and descriptive statistics of this study indicate that mental health providers are screening for parental ACEs more than pediatricians, which would indicate an increased awareness of the need to screen, (open full item for complete abstract)

Committee: Heather Katafiasz (Committee Chair); Rikki Patton (Committee Member); David Tefteller (Committee Member); Wondimu Ahmed (Committee Member); Delila Owens (Committee Member) Subjects: Counseling Education

Doctor of Philosophy (PhD), Ohio University, 2020, Counselor Education (Education)

Historically, human beings and human behavior and health have been viewed through the lens of disease and dysfunction, rather than a lens of wellness and growth (Seligman, 2000). Mental health care and health care in general, still widely utilize the medical model, which focuses on illness (Seligman & Csikszentmihalyi, 2000). When examining mental health care and overall health, it is valuable to utilize a holistic approach that focuses on positive psychology and growth. This exploratory, cross-sectional study utilizes a positive psychology approach and examines adverse childhood experiences (Felitti et al., 1998), psychological capital (Luthans, Youssef, & Avolio, 2007), and students' subjective well-being and mental health (Keyes, 2002). Adverse childhood experiences, or ACEs, are measured utilizing the adverse childhood experiences (ACE) questionnaire which is comprised of 10 yes or no questions and assesses traumatic events in childhood. The PsyCap consists of four measures which include Hope, Efficacy, Resilience, and Optimism (HERO), which are assessed through the PsyCap Questionnaire (PCQ) (Luthans, Luthans, & Jensen, 2012). Mental health and subjective well-being are measured utilizing Keyes Mental Health Continuum-Short Form (MHC-SF) which includes a mental health score, well-being clusters, that include emotional, social, and psychological, and mental health categories that range from languishing to flourishing (Keyes, 2009). The objectives of the study included evaluating the relationship between adverse childhood experiences (ACE), psychological capital, mental health, and well-being. Further objectives included to evaluate the relationship between psychological capital and mental health, to determine variability in psychological capital utilizing the adverse childhood experiences score as a predictor, and to determine variability in mental health and well-being by utilizing the ACE score as a predictor. Descriptive statistics, correlation (open full item for complete abstract)

Committee: Christine Suniti Bhat Dr. (Advisor); Yegan Pillay Dr. (Committee Member); Peter Mather Dr. (Committee Member); Gordon Brooks Dr. (Committee Member) Subjects: Counseling Education

Doctor of Education (Ed.D.), Bowling Green State University, 2020, Leadership Studies

Many school leaders have found that to reach an environment that encompasses the tools and supports for student success, a whole child approach is required to address academic, social and emotional obstacles that many students face. In recent years, the development of early warning intervention and monitoring systems (EWIMS) in urban high schools serve as a strategy for educators to apply interventions through multi-tiered systems of supports (MTSS). Research notes that almost half of today's students enter school having experienced at least one adverse childhood experience (ACE), such as abuse, neglect, and other household dysfunctions. The trauma from ACEs may impede a child's progress in school. Therefore, it is imperative that school leaders guide the staff in creating a trauma-sensitive environment (TSE) to help students overcome trauma, and focus on academics. Studies have revealed that transformational leaders are favored in the effort to effectively set a clear vision and motivate stakeholders to focus on the individual needs of the students and their academic achievement. The purpose of this study was to examine the success of an EWIMS on the identification of students who display the potential to drop out of school. A quasi-experimental posttest only comparison group design, included four statistical analyses. A chi-square of association justified the use of the selected cohort. An independent samples t-test compared a sum of student days in attendance and a logistic regression analysis examined predictive factors of on-time graduation. The findings of the t-test in this study did not show a statistically significant difference in the means of students receiving intervention. The researcher speculated factors that may have contributed to the lack of significance included a low rate of student participation or a dearth of fidelity in implementation. Conversely, the findings of the analysis of the logistic regression test revealed a predi (open full item for complete abstract)

Committee: Judith Jackson May Ph.D. (Advisor); Nora Engebretsen-Broman Ph.D. (Other); Matthew Lavery Ph.D. (Committee Member); Patrice McClellan Ed.D. (Committee Member); Patrick Pauken J.D., Ph.D. (Committee Member) Subjects: Education; Secondary Education

Doctor of Philosophy, Miami University, 2019, Educational Leadership

Studies reveal that low-SES male students struggle to succeed in classrooms far more frequently than their mainstream classmates --- additionally, they have histories of truancy, transiency, anger issues, behavioral problems, and their middle-class educators claim they possess subpar language, academic, and social skills --- all of which collectively disadvantage them further in schools as compared with their middle-class peers (Aliakbari & Faraji, 2011; Darder, Torres, & Baltodano, 2017; Filmer, 2000; Gabrenya, 2003; Gorski, 2013; Greene, 2008; Hamre & Pianta, 2001; Jensen, 2010; Lemon & Watson, 2011). The lived realities of males with low SES routinely leave them vulnerable in traditional schools, as class structures, unexamined common sense assumptions, and privileged social conditions are found to act as agents that elevate middle and upper class students' successes while reducing educational access and opportunities for low-SES males (Entwisle, Alexander, & Olson, 2007; Filmer, 2000; Giroux, 2009; Hannon, 2003; Jensen, 2010). The pronounced class differential compounds low-SES students' burdens, since middle-class teachers are largely unaware and inexperienced with the life challenges these students routinely navigate; too often they are assigned blame for failures out of their control (McGregor, Mills, Riele, Baroutsis, & Hayes, 2017), deteriorating their membership with schooling, and leaving them to cope with their barriers in isolation (Catalano, Oesterle, Fleming, & Hawkins, 2004; Sorrels, 2015). This qualitative backyard study interrogates the experiences of five low-SES, at-risk males in an alternative school who failed in traditional schools, to gain insights related to the influence of gender, meritocracy, social class, life circumstances, and wealth in schooling from their first-person, narrative, storied perspectives as outsiders in educational spaces. Concluding recommendations focus on strengthening adult/student connectedness, eliminating punitiv (open full item for complete abstract)

Committee: Thomas Poetter (Committee Chair); Denise Baszile (Committee Member); Joel Malin (Committee Member); James Shiveley (Committee Member) Subjects: Education Policy; Educational Leadership