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Who am I now?: distress and growth after trauma

Description
This study examined four research questions investigating relationships among the experience of trauma, identity development, distress, and positive change. There were 908 participants in the study, ranging in age from 18 to 24 which is known as the period of emerging adulthood. Participants completed an online survey regarding their exposure…

This study examined four research questions investigating relationships among the experience of trauma, identity development, distress, and positive change. There were 908 participants in the study, ranging in age from 18 to 24 which is known as the period of emerging adulthood. Participants completed an online survey regarding their exposure to trauma and reactions to these experiences. The first research question examined the experience of trauma for the sample. The second question examined group differences among the participant's identity status, gender, and posttraumatic stress disorder (PTSD) diagnostic status on the hypothesized variables. In general, comparisons among the four identity status groups found participants who experienced greater identity exploration (diffused and moratorium) experienced more distress, whereas the identity status groups that reported greater identity commitments (foreclosed and achieved) were associated with positive change. Similar findings were found for PTSD diagnostic status indicating more distress and identity exploration for participants with the diagnosis and more positive change and identity commitments for participants without the diagnosis. Female participants were found to experience more PTS symptoms, centrality of the trauma event, and positive growth than males. Examination of the relationships between trauma severity and posttraumatic growth revealed an inverted U-shaped relationship (quadratic) that was a significant improvement from the linear model. An S-shaped relationship (cubic) was found for the relationship between trauma exposure and posttraumatic growth. Regression analyses found the centrality of the trauma event to one's identity predicted identity distress above and beyond the experience of trauma. In addition, identity distress and the centrality of the trauma contributed to the variance for identity exploration, while only identity distress contributed to identity commitments. Finally, identity development significantly predicted positive change above and beyond, identity distress, centrality of the trauma event, and the experience of trauma. Collectively, these results found both distress and growth to be related to the experience of trauma. Distress within one's identity can contribute to difficulties in the psychosocial stage of identity development among emerging adults. However, the resolution of identity exploration towards commitments to goals, roles, and beliefs, can help trauma survivors experience resilience and growth after stressful experiences.
ContributorsWiley, Rachel (Author) / Robinson-Kurpius, Sharon (Thesis advisor) / Stamm, Jill (Committee member) / Kinnier, Richard (Committee member) / Arizona State University (Publisher)
Created2013
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Personal conceptualization and use of mindfulness: developing an emerging model using a grounded theory framework

Description
An exploratory qualitative study was conducted using a grounded theory approach (Charmaz, 2006) to examine the subjective experiences of mindfulness. Semi-structured interviews were conducted with 10 individuals who practice mindfulness on a regular basis. Data analysis revealed domains related to the experience, conditions, strategies and consequences related to the practice…

An exploratory qualitative study was conducted using a grounded theory approach (Charmaz, 2006) to examine the subjective experiences of mindfulness. Semi-structured interviews were conducted with 10 individuals who practice mindfulness on a regular basis. Data analysis revealed domains related to the experience, conditions, strategies and consequences related to the practice of mindfulness. The following main themes emerged: subjective experience, mechanism of practice, use of metaphors, contextual influences, and shift in perception. An emerging theoretical model related to the experience of mindfulness is also proposed. Implications, limitations and suggestions for future research are discussed.
ContributorsMejia, Araceli (Author) / Kurpius, Sharon (Thesis advisor) / Arciniega, Miguel (Committee member) / Kinnier, Richard (Committee member) / Arizona State University (Publisher)
Created2013
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Diagnosing mental health disorders in primary care: : evaluation of a new training tool

Description
Major Depressive Disorder (MDD) and Posttraumatic Stress Disorder (PTSD) are highly prevalent illnesses that can result in profound impairment. While many patients with these disorders present in primary care, research suggests that physicians under-detect and suboptimally manage MDD and PTSD in their patients. The development of more effective training interventions…

Major Depressive Disorder (MDD) and Posttraumatic Stress Disorder (PTSD) are highly prevalent illnesses that can result in profound impairment. While many patients with these disorders present in primary care, research suggests that physicians under-detect and suboptimally manage MDD and PTSD in their patients. The development of more effective training interventions to aid primary care providers in diagnosing mental health disorders is of the utmost importance. This research focuses on evaluating computer-based training tools (Avatars) for training family physicians to better diagnose MDD and PTSD. Three interventions are compared: a "choice" avatar simulation training program, a "fixed" avatar simulation training program, and a text-based training program for training physicians to improve their diagnostic interviewing skills in detecting and diagnosing MDD and PTSD. Two one-way ANCOVAs were used to analyze the differences between the groups on diagnostic accuracy while controlling for mental health experience. In order to assess specifically how prior mental health experience affected diagnostic accuracy the covariate of prior mental health experience was then used as an independent variable and simple main effects and pairwise comparisons were evaluated. Results indicated that for the MDD case both avatar treatment groups significantly outperformed the text-based treatment in diagnostic accuracy regardless of prior mental health experience. For the PTSD case those receiving the fixed avatar simulation training more accurately diagnosed PTSD than the text-based training group and the choice-avatar training group regardless of prior mental health experience. Confidence ratings indicated that the majority of participants were very confident with their diagnoses for both cases. Discussion focused on the utility of avatar technology in medical education. The findings in this study indicate that avatar technology aided the participants in diagnosing MDD and PTSD better than traditional text-based methods employed to train PCPs to diagnose. Regardless of experience level the fixed avatar group outperformed the other groups for both cases. Avatar technology used in diagnostic training can be user-friendly and cost-effective. It can also have a world-wide reach. Additional educational benefit could be provided by using automated text analysis to provide physicians with feedback based on the extent to which their case diagnostic summaries cover relevant content. In conclusion, avatar technology can offer robust training that could be potentially transferred to real environment performance.
ContributorsSatter, Rachel (Author) / Kinnier, Richard (Thesis advisor) / Mackenzie, James (Committee member) / Claiborn, Charles (Committee member) / Arizona State University (Publisher)
Created2012
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How yoga masters experience mindfulness

Description
This study addressed the questions: What is the experience of mindfulness by yoga masters? How can such experiences inform the counseling intervention of mindfulness? In a qualitative study, individuals who held the minimum credentials E-RYT 200 (i.e., Experienced Registered Yoga Teacher 200 Hour) were interviewed. The verbatim interviews were analyzed…

This study addressed the questions: What is the experience of mindfulness by yoga masters? How can such experiences inform the counseling intervention of mindfulness? In a qualitative study, individuals who held the minimum credentials E-RYT 200 (i.e., Experienced Registered Yoga Teacher 200 Hour) were interviewed. The verbatim interviews were analyzed using the phenomenological approach. Two categories of themes emerged describing mindfulness as a state of being and a practice of awareness. The common themes describing mindfulness as a state of being include: conscious awareness, feeling bliss, the present moment, interconnectedness, and compassionate evolution. The common themes describing mindfulness as a practice of awareness include: waking the body, balanced practice, the power of pranayama, refining abilities, obstacles to awareness, a holistic practice, and external supports. The results of this study suggest that mindfulness is multifaceted and ephemeral; however, with regular practice it becomes more consistently maintained. As a practice of awareness, mindfulness develops through a hierarchy of techniques moving from the external to the internal including both self and other. Discussion focuses on how these experiences can be applied in counseling interventions.
ContributorsBeyer, Gina (Author) / Kinnier, Richard (Thesis advisor) / Glidden-Tracey, Cynthia (Committee member) / Hutchinson, Joel (Committee member) / Arizona State University (Publisher)
Created2012
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Reducing Polypharmacy with Mobile Apps Among Mental Health Patients

Description

Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions, treatment failure, patient dissatisfaction, and lack of treatment control. The…

Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions, treatment failure, patient dissatisfaction, and lack of treatment control. The associated practice challenges have led to the following PICOT question. In persons with mental health issues receiving care at an outpatient mental health clinic, does engaging in mindfulness practice versus no mindfulness practice change polypharmacy use over a 3-month period?

The project purpose was to evaluate the effectiveness of Insight Timer mobile mindfulness app at helping patients self-manage distressing symptoms and reduce polypharmacy. Over three weeks, mental health clinic nurse practitioners (NPs) voluntarily recruited patients (n=12) over age 18 using as needed prescriptions (PRNs), and agreed to use Insight Timer mobile mindfulness app for adjunct symptom management. Consenting participants downloaded the mobile app, and completed a brief questionnaire measuring PRN use at the start of app use, and PRN use at their next visit. A Wilcoxon signed-rank test indicated a 10-week mindfulness app trial did not significantly lower total PRN doses compared with pre-app dosing (Z = -.534, p = .593). Paired t-tests revealed no significant change in pre (M = 65.17, SD = 28.64) versus post (M = 67.75, SD = 20.22) OQ45 life functionality results (t(11) = -.420, p = .683) (d = .121) as a result of app use.

Clinically relevant results illustrated 83.33% of participants taking greater than nine PRN doses over the study period used the app six times or more in place of medication. High PRN users employed the app frequently in place of medication regardless of total PRN doses taken. Practice implications and sustainability recommendations include incorporating mobile app use in treatment plans for high PRN users and educating NP’s on the tangible benefits of mindfulness apps in reducing polypharmacy and easing symptom distress on an ongoing basis.
Keywords: mindfulness, mhealth, mobile apps, mobile smart phone, online, RCT, behavior change, polypharmacy.
ContributorsPierce, Albert (Author) / Guthery, Ann (Thesis advisor)
Created2019-04-29