Master of Arts (MA), Bowling Green State University, 2017, Psychology/Clinical

The majority of college students report having had at least one hook up experience, meaning that most have engaged in some form of sexual activity outside of romantic relationships or dating and without the expectation of a future relationship. This project aimed to provide a balanced account of the ways in which college students may experience hook-ups as both psychosocially adaptive and maladaptive and the ways in which various coping strategies may relate to their psychological adjustment and decision making with regard to alcohol and condom use when hooking up. This study surveyed 317 college students at a mid-size state university to (1) examine the extent to which hooking up itself elicits emotional reactions that are both positive and negative; (2) investigate the prevalence of various psychosocial and religious/spiritual coping struggles and resources with hooking up; and (3) determine whether specific types of coping tended to be linked to general psychosocial adjustment. Results showed that both men and women endorsed a mix of positive and negative emotions, with more positive than negative emotional reactions. However, women had significantly lower scores on positive emotions and higher scores on negative reactions than did men. For women, greater reliance on more healthy coping mechanisms such as seeking emotional support, institutional support, and positive reframing tended to be linked to greater flourishing. For certain more religious individuals, even low levels of hook-up behavior may contribute to a range of r/s struggles that in turn are tied to poorer psychological adjustment. Implications for both research and practice are discussed.

Committee: Annette Mahoney (Advisor); Kenneth I. Pargament (Committee Member); Anne Gordon (Committee Member) Subjects: Clinical Psychology; Counseling Psychology; Psychology; Religion; Spirituality

Doctor of Philosophy, The Ohio State University, 2005, Psychology

This study describes the development of the Measurement of Acculturation Strategies for People of African Descent (MASPAD), a multidimensional instrument designed to assess acculturation strategies (i.e., Traditionalist, Integrationist, Assimilationist, and Marginalist) along the dimension of beliefs and behaviors. Three studies were conducted to describe the development of the MASPAD and to assess its psychometric properties. Data was collected from 497 participants of African descent in Atlanta, Columbus, Los Angeles, and New York City. Confirmatory factor analysis and independent raters provided evidence for the multidimensional structure of the MASPAD. Pearson correlation coefficients supported the purported orthogonality of the MASPAD subscales. The MASPAD was a strong predictor of dimensions of worldview and cultural values. Moreover, the Traditionalist Beliefs subscale interacted with the Global Severity Index to predict confidence in therapist. Future directions for this body of research are discussed.

Committee: Frederick Leong (Advisor) Subjects:

MA, Kent State University, 2024, College of Arts and Sciences / Department of Sociology and Criminology

The COVID-19 pandemic has had widespread effects on many aspects of well-being, including psychological distress. For particularly vulnerable populations, such as college students, the pandemic has presented unique challenges and coping responses. This study uses a Stress Process Model to examine the relationship between COVID-related stressors and psychological well-being among college students. Using data from a Northeast Ohio university's survey (N=7,248), the study employs three separate regression models to examine the mediating effects of psychosocial resources (perceived social support) on psychological distress, substance use and flourishing. Preliminary findings suggest the pandemic significantly impacted students' mental health, with substance use varying among demographic and psychological distress categories. The study contributes valuable insights into the effects of COVID-related stress on student populations while incorporating aspects of positive well-being, informing future research and intervention strategies.

Committee: Kristen Marcussen (Advisor) Subjects: Sociology

Doctor of Philosophy, University of Akron, 2024, Counseling Psychology

Police culture is based on traditional masculinity ideology and traditional gender beliefs (Silvestri, 2017), and is a male-dominated profession (Ashlock, 2019). As dictated by masculine norms, police officers do not typically disclose struggles with mental health (Demou et al., 2020), and tend to face several barriers regarding seeking professional psychological treatment. This is problematic due to the myriad mental health concerns faced by police officers, such as PTSD, anxiety, and depression, resulting from work related stress (Demou et al., 202; Papazoglou & Anderson, 2014; Haugen et al., 2012). Police officers experience high levels of self -stigma related to mental health problems (Karaffa &Koch, 2016), andreportlow levels of perceived organizational supportwithin their departments (Tucker, 2015), which may influence their attitudes regarding help-seeking. The aim of the current study was to gain a deeper understanding of the potential contributingmechanisms to the negative help-seekingattitudes consistently foundamong police officers. Using Gender Role Strain Paradigm (Pleck, 1981) as the primary contextual framework, the current study evaluated the role that masculinity ideology, self-stigma, perceived organizational support, and help-seeking attitudes play in police officer distress. Two moderated mediation models with one moderator were used within this study, as well as one mediation model and two moderation models. The current sample consisted of 456 current police officers and results suggested that perceived organizational support plays a significant moderating role in the relationship between masculinity ideology and help-seeking behaviors; such that perceived organizational support weakens the negative relationship between masculinity ideology and help seeking attitudes. The current study also demonstrated that, in general, masculinity ideology is significantly and negatively related to help-seeking attitudes.

Committee: John Queener (Advisor); David Baker (Committee Member); Ingrid Weigold (Committee Member); Margo Gregor (Committee Member); Ronald Levant (Committee Member); Dimitria Gatzia (Committee Member) Subjects: Psychology; Psychotherapy

Master of Arts in Psychology, Cleveland State University, 2023, College of Sciences and Health Professions

The COVID-19 pandemic is a collective trauma that caused profound disruptions in day-to-day life and negatively impacted the psychological well-being of many emerging adults. Existing research shows that experiencing quarantine due to disease exposure or illness exacerbates psychological distress, particularly among people with existing symptoms of posttraumatic stress disorder (Solomon et al., 2021). Research points to problematic alcohol and other substance use as a mechanism in the development and maintenance of PTSD (Tripp et al., 2020). However, alcohol and other substance use has yet to be implicated in the exacerbation of PTSD symptoms among emerging adults in the context of the COVID-19 pandemic. The present study attempts to address these gaps in the scientific literature. It was hypothesized that A) pre-pandemic PTSD symptoms will positively associate with PTSD symptoms measured during the pandemic, B) problematic alcohol and other substance use will mediate the relationship between pre-pandemic PTSD symptoms and PTSD symptoms during the pandemic, and C) emerging adults who experience quarantine due to COVID-19 exposure or illness will report elevated symptoms of PTSD relative to those who did not. Participants (N=39) from the first wave of the study completed measures for the second wave of the study via an online survey between December 2021 and March 2022. Participants reported on their symptoms of psychological distress, use of alcohol and other substances, and quarantine experience. As expected, symptoms of PTSD at wave 1 predicted symptoms of PTSD at wave 2. However, no mediating effects of problematic alcohol or other substance use on the association between PTSD symptoms at waves 1 and 2 were detected. Similarly, quarantine experience was not found to moderate the relationship between PTSD symptoms at waves 1 and 2. These results suggest that symptoms of PTSD among young adults worsened under the conditions of the COVID-19 pandemic, but there was n (open full item for complete abstract)

Committee: Elizabeth Goncy (Advisor); Kathleen Reardon (Committee Member); Ilya Yaroslavsky (Committee Member) Subjects: Psychology; Public Health

Doctor of Philosophy, The Ohio State University, 2023, Nursing

Collegiate polyvictimization is a serious, but understudied, phenomenon. Scientific knowledge regarding polyvictimization in college students has been hindered by a focus on non-collegiate populations, use of a limited number of outcome variables, or examination of only a singular victimization experience. The major consequence of these limitations has been the emergence of apparent knowledge gaps in the existing polyvictimization literature. As such, this dissertation aimed to complete a latent class analysis (LCA) using a sample of college students (n = 36,986), from a national dataset, to identify typologies of victimization and associated substance use. Through LCA, four classes distinguished by victimization emerged: high/poly, verbal/discrimination, sexual/discrimination, and low/no. Logistic regression models suggest that students allocated to the high/poly, verbal/discrimination, and sexual/discrimination classes have higher rates of substance use than the low/no class – with students in the high/poly class reporting the highest use of substances overall. Casual mediation analyses also suggest that psychological distress is higher in all classes, save for the low/no class, and that psychological distress partially mediates the relationship between latent class membership and substance use. Findings indicate an urgent need for screening and early identification of polyvictimization to improve collegiate mental health outcomes.

Committee: Bernadette Melnyk (Advisor); Christina Dyar (Committee Member); Barbara Warren (Committee Member); Sharon Tucker (Committee Member) Subjects: Nursing

MA, University of Cincinnati, 2022, Arts and Sciences: Psychology

Having a toxic or abusive boss can make a person's experience at work a nightmare. But for some, getting away from the abusive boss does not end the nightmare. This study focuses on assessing the relationship between past experiences of abusive supervision and long-term psychological distress. Additionally, this study assesses the many factors that can impact the relationship between abusive supervision and long-term psychological distress. Data from a total of 94 participants was used to investigate several hypotheses. Eighty-one of these participants discussed experiences with a past abusive boss, while 13 discussed experiences with a current abusive boss. A regression analysis performed on the data of the past abusive supervision group showed a significant positive correlation between past experiences of abusive supervision and long-term psychological distress. Moderating effects of length of exposure to abuse, gender, race, amount of work experience, distance from abuse in time, level of positive affect, and types of coping behaviors were also assessed. The results showed that only problem focused coping had a significant impact on the relationship between past experiences of abusive supervision and psychological distress, with the data indicating that the more problem-focused coping strategies participants engaged in, the lower the impact of abusive supervision on psychological distress. Exploratory findings, further insights into the results, possible implications of this study, its limitations, and direction for future research are also discussed.

Committee: Donna Chrobot-Mason Ph.D. (Committee Member); Suzanne Masterson Ph.D. (Committee Member); Megan Church-Nally Ph.D. (Committee Member) Subjects: Psychology

Doctor of Philosophy in Urban Education, Cleveland State University, 2022, College of Education and Human Services

Internalized racism, also referred to as appropriated racial oppression, refers to the phenomenon of people of color adopting negative racist messages about their worth and abilities. The internalization of racism by members of the targeted group results in an experience of self-degradation and self-alienation and the assumption of one's inferiority, which is directly related to issues of self-esteem, self-confidence, shame, depression, and anxiety. This study used structural regression with moderation and mediation to explore the possibility of internalized racism as a mediating variable and black identity and perceived social support as possible moderators. A sample of 639 participants (MAge = 35.29, SDAge = 10.09) who identified as Black and/or African American were included in the study. The findings indicated that internalized racism partially mediated the relationship between racial microaggressions and depression and anxiety, where approximately 50 percent of the relationships were explained by internalized racism. Additionally, the findings indicated that centrality and private regard aspects of Black identity weakened the relationship between racial microaggressions and depression and anxiety. Finally, the findings indicated that social support weakens the relationship between racial microaggressions and depression and anxiety.

Committee: Julia Phillips Ph.D. (Committee Co-Chair); Adam Voight Ph.D. (Committee Co-Chair); Jeffrey Snyder Ph.D. (Committee Member); Graham Stead Ph.D. (Committee Member); Tawanda Greer-Medley Ph.D. (Committee Member) Subjects: Counseling Psychology; Psychology

MA, Kent State University, 2022, College of Arts and Sciences / Department of Psychological Sciences

The novel coronavirus (COVID-19) pandemic is a widespread salient stressor and continues to contribute to individual- and societal-level psychological burdens. With traumatic stressors, resources such as social support and coping self-efficacy (CSE) may protect against poor mental health outcomes. CSE involves how confident one is in their ability to cope effectively with challenges or threats, and higher CSE is an important predictor of better posttraumatic recovery. Moreover, social support can enable and improve CSE. The current study examined the potential protective roles of social support and CSE in attenuating posttraumatic stress disorder (PTSD) symptoms. Participants (n = 612; 59% female) completed questionaries assessing psychological distress (Kessler Psychological Distress Scale) at baseline and 6-month follow-up, and social support (Interpersonal Support Evaluation List-12), CSE (Coping Self-Efficacy Scale), and PTSD symptoms (Impact of Event Scale-Revised) at six months. PTSD symptoms were also evaluated using a semi-structured interview (PTSD Symptom Scale – Interview for DSM-5) at the 6-month follow-up for a subset of participants. First, Pearson correlations between study measures were conducted. Next, a path analysis was conducted using SPSS Amos to examine the direct and indirect pathways from psychological distress to PTSD symptoms that are accounted for by social support and CSE. Lastly, a Pearson correlation was conducted between the IES-R and PSS-I-5 to examine the convergent validity between a self-report measure and semi- structured interview that assesses PTSD symptoms. All associations between study measures were significant and in the expected directions. Greater baseline psychological distress was associated with higher levels of PTSD symptoms (r = .51, p < .001) six months later. Higher levels of CSE were associated with lower levels of PTSD symptoms (r = -.49, p < .001). All direct effects in the path analysis were significant except (open full item for complete abstract)

Committee: Joel Hughes (Advisor); Amy Sato (Committee Member); John Gunstad (Committee Member); John Updegraff (Committee Member) Subjects: Clinical Psychology; Mental Health; Psychology

Doctor of Philosophy, University of Akron, 2022, Counseling Psychology

The current study utilized a social learning and achievement goal theory framework to examine and explicate the relationship between multidimensional perfectionism and psychological distress, and the moderating effect of two types of motivational climate among Division I-III student-athletes. Results indicated nonsignificant interaction effects between multidimensional perfectionism and the coach-created motivational climate. However, results did yield support for maladaptive perfectionism and an ego-involving climate as significant, interrelated risk factors for psychological distress, with latter serving as the condition from which maladaptive perfectionistic tendencies may emerge. Overall, the findings highlight the significance of competitive environments and athlete perfectionism, as well as the need for additional research on protective and risk factors for psychological distress in this population. Clinical implications and directions for future research are discussed.

Committee: Margo Gregor (Committee Co-Chair); Ingrid Weigold (Committee Co-Chair); Ronald Otterstetter (Committee Member); Suzette Speight (Committee Member); John Queener (Committee Member); Dawn Johnson (Committee Member) Subjects: Behavioral Sciences; Counseling Psychology; Mental Health; Psychology

Doctor of Philosophy, The Ohio State University, 2021, Nursing

Background. African American women experience preterm birth (PTB)—births <37 completed weeks gestation—at 1.5 times the rate of non-Hispanic white women. This persistent health inequity leads to high infant mortality and high morbidity rates for surviving infants. Neighborhood disorder (e.g., housing vacancy, litter, crime) has been related to maternal psychological distress and PTB. Higher levels of neighborhood disorder, maternal psychological distress, and increased risk of PTB have been related to epigenetic modifications, and specifically to DNA methylation (DNAm) of stress-related, glucocorticoid (GC) pathway genes. To our knowledge, no published study has examined the relationship between perceived neighborhood disorder, maternal psychological distress, DNAm of GC pathway genes, and PTB in general or within the highest risk group among U.S. women–African Americans. The purpose of this study was to examine the relationships among perceived neighborhood disorder, maternal psychological distress, DNA methylation of six candidate GC pathway genes (AVP, CRH, CRHBP, FKBP5, HSD11B2, NR3C1), and gestational age at birth in pregnant African American women. Methods. This prospective cohort study was a subsample of women who participated in the NIH R01 study, Social stressors and inflammation: A mixed methods approach to preterm birth (R01MD001575, PI Giurgescu). Forty-four African American women—22 women with preterm birth and 22 women with full-term birth (FTB)—18-45 years of age and 8-18 weeks gestation were selected for the study. The women completed questionnaires and had peripheral blood samples collected for DNAm analysis. Results. We report 14 differentially methylated (FDR < 0.05) cytosine-phosphorus-guanine (CpG) dinucleotides between women with PTB and women with FTB. In addition, perceived neighborhood disorder was significantly associated (p<0.05) with average methylation beta levels at 15 dinucleotides in five of six candidate genes, perceived neigh (open full item for complete abstract)

Committee: Cindy Anderson (Advisor); Carmen Giurgescu (Committee Member); Jodi Ford (Committee Member); Alai Tan (Committee Member); Amy Mackos (Committee Member) Subjects: Genetics; Health Care; Nursing; Obstetrics

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

The misuse of alcohol and other drugs has a significant negative impact worldwide, in the United States, and particularly among vulnerable young adults. Undergraduate college students face additional risks for alcohol or drug use due to the significant transitions occurring in their personal, social, and environmental lives. The consequences of alcohol or drug use to the college student population and relevant stakeholders are well documented. To prevent and mitigate the negative consequences of college students' alcohol or drug use, it is essential to understand factors that predict those behaviors. More specifically, it imperative to understand factors that predict alcohol or drug use that results in negative consequences, or problematic use. Psychological distress and impulsivity have been identified as predictors of other high-risk behaviors among college students, but their predictability of problematic alcohol or drug use among the undergraduate college student is not yet fully understood. Gaps in the literature regarding the psychological distress, impulsivity, and substance-using behaviors among this population include a lack of focus on drugs other than alcohol, a lack of differentiation between problematic and non-problematic use, and significant variability in the definitions and operationalization of alcohol and drug use related variables. The primary purpose of the present study with 481 participants was to investigate whether psychological distress (i.e., depression, anxiety, and stress) and impulsivity among undergraduate college students between the ages of 18 and 25 could predict problematic alcohol or drug use. A secondary aim of this study was to determine whether there was a relationship between problematic alcohol use and problematic drug use. Findings indicated that impulsivity was predictive of problematic alcohol use, and depression and impulsivity were predictive of problematic drug use. Neither anxiety nor stress were predictive of problema (open full item for complete abstract)

Committee: Christine Bhat (Committee Chair); Gordon Brooks (Committee Member); Tamarine Foreman (Committee Member); Yegan Pillay (Committee Member) Subjects: Behaviorial Sciences; Counseling Education; Higher Education

Doctor of Philosophy, Case Western Reserve University, 2019, Nursing

Background: Advancement in technologies has contributed to patients surviving critical illness, but continuing to live with chronically critically ill conditions. A majority of such patients experience transient or persistent states of decisional impairment requiring family members or authorized surrogate decision makers to render treatment decisions. Abrupt transition to the surrogate decision maker role often evokes heightened stress. Research shows that emotion regulation can help manage situational stress. Purpose: To examine the associations among emotion regulation, role stress, and psychological distress in surrogate decision makers of chronically critically ill patients in intensive care units. Methods: A descriptive, secondary analysis of 120 surrogate decision makers of chronically critically ill patients from various intensive care units within an academic medical center in Northeast Ohio. Parent investigation data were used to address the following questions: (1) what are the associations among emotion regulation (cognitive reappraisal & expressive suppression), role stress, psychological distress, and demographic variables of age, gender, ethnicity, kinship, advance directives, and living will of surrogate decision makers of chronically critically ill patients? (2) what is the relationship between emotion regulation and psychological distress while controlling for surrogate decision makers' demographic variables? (3) does role stress mediate the relationship between emotion regulation and psychological distress while controlling for demographic variables of surrogate decision makers of chronically critically ill patients? Pearson r and Spearman rho correlations and Multiple Regression tests were conducted to answer these questions. Findings: Statistically significant associations included: role stress and psychological distress (r = .29, p < .01), gender and role stress ((r = .22, p < .05), gender and psychological distress (r = .27, p < .01), kinship (open full item for complete abstract)

Committee: Ronald Hickman Dr. (Committee Chair); Jaclene Zauszniewski Dr. (Committee Member); Mathew Plow Dr. (Committee Member); Arin Connell Dr. (Committee Member) Subjects: Health Sciences; Nursing

Master of Arts (MA), Bowling Green State University, 2019, Psychology/Clinical

China has become a leading source of international college students for Western countries, including the USA, the UK, Australia, New Zealand, and Canada. Given Chinese students' increasingly large contribution to the college population and financial import (tuition, travel expenses, other expenses, etc.) to the host countries, their specific needs in community services such as mental health and counseling should be addressed. Studies across different countries have explored the challenges associated with overseas experiences. These studies indicate that international college students, relative to domestic students, face higher levels of stress given the additional acculturative challenges. Research has further shown that Chinese international students reported high levels of psychological distress (depression, anxiety, stress). However, there is little research either investigating the measurement of unique stressors experienced by Chinese International Students or developing culturally sensitive interventions for their stress management. In the current two-part study, we aimed to, first, identify unique stressors of Chinese international students in the United States; and second, further design a culturally relevant Acceptance and Commitment Therapy intervention focused on helping Chinese international students manage the transition from their home country to the United States. Additionally, we ran a pilot study (randomized clinical trial) to examine the effectiveness of this intervention. Focus groups results revealed ten major domains of acculturative stress experienced by Chinese International Students. An acculturative stress measure, the Unique Stress of Chinese International Students (USCIS), was developed from the focus groups. The USCIS contains 103 items and demonstrated excellent internal consistency and convergent validity based on a sample of 30 Chinese International Students. Results of the pilot study based on a sample of 8 participants showed pre (open full item for complete abstract)

Committee: William O'Brien Ph.D (Advisor); Yiwei Chen Ph.D (Committee Member); Dryw Dworsky Ph.D (Committee Member) Subjects: Psychology

MA, Kent State University, 2017, College of Arts and Sciences / Department of Sociology and Criminology

Previous research finds that breast cancer is less stigmatized than cervical cancer based on the different factors contributing to each disease. Utilizing data from the 2013 National Health Interview Survey, a nationally representative survey on broad health topics, I examine (1) whether a stigmatized cancer diagnosis results in greater psychological distress; and, (2) the extent to which the relationship between a cancer diagnosis and psychological distress is moderated by perceptions of neighborhood social cohesion. I hypothesized not only that women with cervical cancer experience greater distress, but also that they perceive themselves as more socially isolated compared to their counterparts suffering from breast cancer. Controlling for sociodemographic and neighborhood characteristics, I employ OLS regression to test my hypotheses. Findings show that women with cervical cancer do, indeed, experience more psychological distress than women with breast cancer. Moreover, for women with cervical cancer, perceptions of neighborhood social cohesion act as a buffer, thus narrowing the mental health gap between women with cervical and breast cancer. These findings add to the growing literature involving the stress process and neighborhood characteristics on psychological distress. They also have the potential to inform practitioners and policy makers about the benefits of focusing interventions at the neighborhood level in order to alleviate mental health disparities among subgroups that may be more vulnerable to psychological distress.

Committee: Manacy Pai Ph.D. (Advisor); Richard Adams Ph.D. (Committee Co-Chair); Kristen Marcussen Ph.D. (Committee Member) Subjects: Sociology

BS, Kent State University, 2017, College of Arts and Sciences / Department of Psychological Sciences

Latina adolescents are at increased risk for developing symptoms of psychological distress. They often face higher levels of poverty and lower education levels than other adolescent groups, in addition to experiencing acculturative stressors. Adolescent Latina mothers experience additional stressors related to parenting at a young age. Social support has been shown to reduce risk for psychological distress; however, there are several factors that influence this relation. The association of perceived social support from adolescent mothers' mothers and fathers on psychological distress was examined. Familism, a family-centric Latino value, was examined as a potential moderator in the relation between social support and distress, as adolescents who endorse more familistic values may take advantage of support provided by mothers and fathers better than adolescents who endorse fewer values. Preliminary correlations revealed that support from adolescents' mothers and fathers was associated with lower distress. Hierarchical regression analyses revealed that after controlling for adolescent age, financial stress, and negative life events, mother support was no longer associated with lower distress; father support was still associated with lower distress. Additionally, familism did not moderate the relationship between social support and distress for mother or father support. Findings contribute to the body of research on father support, but further research is needed to examine the quality and importance of support providers to determine why there were differences in distress between those perceiving mother and father support.

Committee: Josefina Grau Ph.D. (Advisor); Christopher Flessner Ph.D. (Committee Member); Angela Neal-Barnett Ph.D. (Committee Member); Rhonda Richardson Ph.D. (Committee Member) Subjects: Psychology

Doctor of Philosophy, University of Akron, 2017, Counseling Psychology

The Strong Black Woman (SBW) stereotype represents a potentially salient cultural and historically oppressive influence on Black women's mental health. Strong Black Woman has been defined as the cultural prescription for Black women to embody strength internally and to express strength externally (Abrams, Maxwell, Pope, & Belgrave, 2014; Beauboeuf-Lafontant, 2009). The present study examined the mental health implications of internalizing the SBW stereotype. Specifically, the relationships between the SBW stereotype, suppression, psychological distress, and Africultural coping were examined in a community sample of 289 Black women. The results indicated that suppression mediated the positive relationship between the SBW stereotype and depression and anxiety, but did not mediate the relationship between the SBW stereotype and stress. Moderated mediation analyses found that the indirect effect of the SBW stereotype on depression and anxiety through suppression was dependent upon spiritual-centered coping. Notably, utilizing more spiritual-centered coping strategies lessened the SBW stereotype's relation to anxiety and depression for participants. Collective coping was not found to be a significant moderator in the moderated mediation analyses. Overall, the results provide empirical support for negative outcomes associated with adhering to the SBW stereotype. The study includes implications for SBW ideology, suggestions for culturally relevant interventions to prevent and treat mental health issues in Black women, and directions for future research.

Committee: Suzette Speight PhD (Advisor); John Queener PhD (Committee Member); Amber Hewitt PhD (Committee Member); Ingrid Weigold PhD (Committee Member); Toni Bisconti PhD (Committee Member) Subjects: Counseling Psychology

Master of Arts (MA), Bowling Green State University, 2016, Psychology/Clinical

War is a worldwide problem that exposes families to extreme acts of violence, disrupts family economic and parenting conditions, and can result in poor family psychological outcomes. The contagion of violence model suggests that violence spreads like an infectious disease across levels of the social ecosystem (Boxer et al., 2013). The contagion of violence model also aligns with the family stress model (Conger et al., 1992) in which financial strain and, more recently, exposure to community violence (Westbrook & Harden, 2010), have been shown to increase psychological distress in parents, which in turn leads to poorer parenting behaviors. Exposure to political violence has not yet been tested in the family stress model, but because political violence has been related to increased parental distress and higher rates of child abuse (e.g., Catani, Schauer, & Neuner, 2008), research suggests that exposure to political violence should function as a stressor in the model. Research has also shown that there are differences in parenting across child gender (Dwairy et al., 2006) which may moderate the family stress model. Using a three wave longitudinal study of Palestinian mothers, the present study found that overall exposure to political violence had an indirect effect on mothers' use of punishment and that this relation was mediated by mothers' averaged wave 1 and 2 distress (aggression, depression, and intimate partner violence); however, the indirect effect through intimate partner violence was moderated by sex of the child. Family income did not have a significant effect on parenting behaviors; neither exposure to political violence nor family income had a significant effect on parental monitoring. Future parenting interventions may benefit from targeting parental distress to decrease corporal punishment within the context of war and thus decrease the mental health effects of violence on children and their families.

Committee: Eric Dubow (Advisor); Carolyn Tompsett (Committee Member); Dara Musher-Eizenman (Committee Member) Subjects: Clinical Psychology; Psychology

Master of Arts, The Ohio State University, 2016, Psychology

Chronic stress has been commonly observed in cancer patients and is associated with immune system down regulation. The effect of stress on immunity in hematologic cancers such as chronic lymphocytic leukemia (CLL) has not been studied despite the role of immune system dysfunction in CLL's pathogenesis. In a phase II clinical trial, 154 patients with relapsed/refractory CLL received ibrutinib, provided blood samples, and completed a self-report measure of psychological stress specific to cancer over an 18-month treatment period (nine assessments).Targeted treatments like ibrutinib have been effective in reducing disease progression in CLL, despite the occurrence of lymphocytosis, which is an increase in absolute lymphocyte counts (ALC) and marker of progressive disease. Controlling for demographic, health status, number of prior treatments, and CLL genetic risk (del17p) factors, random changepoint models were estimated to evaluate the impact of stress on ALC trajectories. Stress was associated with pretreatment ALC (ß_0 = 0.13; 95% CI = 0.02, 0.25) but did not impact the timing of lymphocytosis (fx1= 0.03, CI = -0.15, 0.22), or the treatment response before (ß_x1= -0.11, CI = -0.23, 0.01) and after (dx1=0.10, -0.01, 0.22) lymphocytosis. Stress affects pre-treatment ALC but has little impact on ALC trajectories after beginning drug therapy. Additional analysis showed that lymphocytosis occurs later in the treatment trajectory for individuals classified as drug non-responders by 18-months compared to those regarded as drug responders (fx2 = -0.95; CI= -1.50, -0.41), though it is unclear whether clinical or demographic risk factors can predict these groups. Results suggest patients exhibit similar ALC trajectories after ibrutinib initiation. Distress screening and management should be initiated prior to cancer treatments.

Committee: Barbara Andersen PhD (Advisor); Julian Thayer PhD (Committee Member); Baldwin Way PhD (Committee Member) Subjects: Psychology

Psy. D., Antioch University, 2016, Antioch Seattle: Clinical Psychology

This study completed a critical review of psychologists' mental health by developing a conceptual analysis based on the current empirical literature of the mental health needs of clinical psychologists. Distress among psychologists was explored by examining the following domains: (a) examining the prevalence of mental illness and psychological distress that exist among them, (b) examining the barriers they encounter to seeking treatment when experiencing this distress, and (c) reviewing current interventions and integrating remedies for access to mental health care that best meets psychologists' needs. Results included several themes within each domain shaping a contextual picture of some of the challenges faced by psychologists and gaps that need to still be further addressed. The following five themes were found within the domain of lifetime prevalence of mental illness and psychological distress among psychologists: psychiatric disorders reported reaching at approximately 81%, substance use (primarily ethanol) vacillating from 1% to 70%, psychological distress ranging from 10% to 74%, impairment varying from 4.6% to 63%, as well as burnout and compassion fatigue found stretching to 80%. There dominant barriers in place that created obstacles for psychologists to access appropriate and effective mental health services, which included: limited insight, education and prevention strategies lacking, keeping distress secretive, institutions of psychology being unsupportive to the distressed psychologists, utilizing reactive interventions versus preventative ones, lacking evidence-based research on psychologists' distress along with interventions that remediate stress, an unsupportive and avoidant culture when dealing with psychological distress, and limited psychotherapy resources. There are at least six suggestions identified for intervening with psychologists facing barriers to accessing care, which included: educating and increasing awareness, improving systemic inf (open full item for complete abstract)

Committee: Mark Russell Ph.D., ABPP (Committee Chair); Bill Heusler Psy.D. (Committee Member); Ward Colin Ph.D. (Committee Member) Subjects: Clinical Psychology; Psychology; Psychotherapy; Public Health