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- Creators: Arizona State University
Description
The purpose of this study was to examine if certain child demographics and risk modifiers of the child (i.e., anxiety sensitivity, depressive symptoms, anxiety control, and social competence) predict program response to a Child Anxiety Indicated Prevention and Early Intervention protocol (Pina, Zerr, Villalta, & Gonzales, 2012). This anxiety protocol focused on cognitive behavioral techniques (e.g., systematic and gradual exposure) that used culturally responsive implementation strategies (Pina, Villalta, & Zerr, 2009). The current study aims to investigate specific predictors of program response to this anxiety protocol. First, it was of interest to determine if child demographics and risk modifiers of the child at baseline would predict program response to the early anxiety intervention protocol. Second, it was of interest to see if an interaction with one of the four risk modifiers at baseline and sex or protocol condition would predict program response to the early anxiety intervention protocol. This study included 88 youth (59.14% Hispanic/Latino and 40.9% Caucasian) who were recruited through referrals from public schools and randomized to one of two protocol conditions (i.e., child-only or the child-plus-parent protocol), which had varying levels of mothers’ participation within the Child Anxiety Indicated Prevention and Early Intervention protocol (Pina et al., 2012). Participants ranged from 6 to 17 years of age (M = 10.36, SD = 2.73), and 48.9% were boys. The four risk modifiers were assessed using the Childhood Anxiety Sensitivity Index (CASI; Silverman, Fleisig, Rabian, & Peterson, 1991), Children's Depression Inventory (CDI; Kovacs, 1981), Anxiety Control Questionnaire for Children-Short Form (ACQ-C-S; Weems, 2005), and Social Competence scale from the Child Behavior Checklist (CBCL; Achenbach & Resorla, 2001). Program response was measured by pre-to-posttest changes in anxiety outcomes. Regarding the first aim, each of the four risk modifiers was related to pre-to-posttest changes in program response outcomes. Regarding the second aim for interactions between each of the four focal predictors, sex and protocol condition emerged as moderators. These results have potential implications for clinicians and researchers interested in understanding why some children might experience more or less change when participating in an early intervention protocol for anxiety.
ContributorsWynne, Henry (Author) / Pina, Armando (Thesis advisor) / Luthar, Suniya (Committee member) / Enders, Craig (Committee member) / Wolchik, Sharlene (Committee member) / Arizona State University (Publisher)
Created2017
Description
Suicide is one of the fastest-growing and least-understood causes of death, particularly in low and middle income countries (LMIC). In low-income settings, where the technical capacity for death surveillance is limited, suicides may constitute a significant portion of early deaths, but disappear as they are filtered through reporting systems shaped by social, cultural, and political institutions. These deaths become unknown and unaddressed. This dissertation illuminates how suicide is perceived, contested, experienced, and interpreted in institutions ranging from the local (i.e., family, community) to the professional (i.e., medical, law enforcement) in Nepal, a country purported to have one of the highest suicide rates in the world. Drawing on a critical medical anthropology approach, I bridge public health and anthropological perspectives to better situate the problem of suicide within a greater social-political context. I argue that these complex, contestable deaths, become falsely homogenized, or lost. During 18 months of fieldwork in Nepal, qualitative, data tracing, and psychological autopsy methodologies were conducted. Findings are shared through three lenses: (1) health policy and world systems; (2) epidemiology and (3) socio-cultural. The first investigates how actors representing familial, legal, and medical institutions perceive, contest, and negotiate suicide documentation, ultimately failing to accurately capture a leading cause of death. Using epidemiologic perspectives, surveillance data from medical and legal agencies are analyzed and pragmatic approaches to better detect and prevent suicidal death in the Nepali context are recommended. The third lens provides perceived explanatory models for suicide. These narratives offer important insights into the material, social, and cultural factors that shape suicidal acts in Nepal. Findings are triangulated to inform policy, prevention, and intervention approaches to reduce suicidal behavior and improve health system capabilities to monitor violent deaths. These approaches go beyond typical psychological investigations of suicide by situating self-inflicted death within broader familial, social, and political contexts. Findings contribute to cultural anthropological theories related to suicide and knowledge production, while informing public health solutions. Looking from the margins towards centers of power, this dissertation explicates how varying institutional numbers can obfuscate and invalidate suffering experienced at local levels.
ContributorsHagaman, Ashley (Author) / Wutich, Amber (Thesis advisor) / Hruschka, Daniel (Committee member) / Kohrt, Brandon (Committee member) / Arizona State University (Publisher)
Created2017
Description
In this dissertation Mexican American (MA) youths environmental risk contexts, HPA axis functioning and mental health symptomatology were investigated in two separate studies. In the first study, environmental risk contexts were examined utilizing a person-centered approach and focusing on MA adolescents' family, peer, and cultural risk factors in fifth grade (N = 750). Environmental contexts were then linked to mental health symptomatology in seventh grade. Results revealed three distinct environmental contexts: Low risk, Moderate risk-language, and High risk-peer. Youth in the High-risk peer context reported the highest levels of symptomatology; greater major depressive disorder (MDD), anxiety, conduct disorder (CD)/oppositional defiant disorder (ODD), and attention deficit hyperactive disorder (ADHD) symptoms than youth experiencing Low risk or Moderate risk-language context. Females, in particular, experiencing the High risk peer context appeared at greatest risk for MDD symptoms. Finally, adolescents in the Moderate risk-language context displayed similar levels of symptoms to the individuals in the Low risk context, with the exception of higher anxiety. This study suggested that MA youth live in unique environmental contexts and these contexts are differentially related to mental health symptomatology. In the second study, 98 MA youth participated in a three-day diurnal cortisol protocol in hopes of linking perceptions of discrimination and HPA diurnal cortisol rhythms. Results revealed that discrimination was related to greater overall cortisol output and marginally related to the cortisol awakening response and evening levels of cortisol. Results suggest that important physiological processes underlie the experiences of discrimination.
ContributorsZeiders, Katharine H (Author) / Roosa, Mark W. (Thesis advisor) / Doane, Leah D. (Committee member) / Dumka, Larry (Committee member) / Enders, Craig E. (Committee member) / Updegraff, Kimberly A. (Committee member) / Arizona State University (Publisher)
Created2011
Description
The purpose of this study was to evaluate whether five select scales of the MMPI-A (F, Scale 2, A-dep, A-lse, and A-aln) are predictive of a diagnosis of a major depressive episode according to the current DSM-IV-TR criteria. Participants were 90 girls and 58 boys in a clinical psychiatric setting. The study examined two separate hypotheses across the five scales. The first set of hypotheses tested whether a significant T-score on each of the five scales would predict a diagnosis of a major depressive episode in clinical adolescents. The second set of hypotheses attempted to step away from the constraints of diagnostic and statistical cut-off criteria and evaluated the ability of discrete T-scores of the MMPI-A in predicting the number of symptoms of a major depressive episode in clinical adolescents. Results indicated that none of the five scales were predictive of a diagnosis of a major depressive disorder in clinical adolescents. All but one scale (Scale 2) was significant in its ability to predict the number of depressive symptoms in clinical adolescents. Implications of this study include the need for a better diagnostic criteria for adolescent depression as well as re-evaluating the cut-off criteria of scales on the MMPI-A. Directions for future research are also discussed.
ContributorsPham, Tuyen T (Author) / Claiborn, Charles D. (Thesis advisor) / Homer, Judith (Committee member) / Gerkin, Richard D. (Committee member) / Fair, Christine (Committee member) / Arizona State University (Publisher)
Created2010
Description
Anxiety is one of the most common mental illnesses in the United States. In this project, I chose to explore how food is one of the most accessible and inexpensive ways of treating anxiety. This creative project examines the major key components of gut health including the balance of neurotransmitters and bacteria in the gut, restoring hydrochloric acid through celery juice, removing heavy metal toxins through food, eating fermented foods, and limiting refined carbohydrates, and high-sugar consumption. Additionally, this creative project explores my own personal journey through the implementation of foods that influence anxiety revealed in a systemic review over the course of a 6-week period.
ContributorsHunter, Madelyn Grace (Author) / Hart, Teresa (Thesis director) / Barth, Christina (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2021-05
Description
Our children come to school every day to learn, participate, and prepare for what the future will bring. Others come to school to find refuge and help from those who dedicate their lives to ensure they are well and safe. They come with their minds filled with hopes and dreams, while others walk around the hallways with their hearts filled with despair and uncertainty. Despite collaborative district efforts and improvements in student services, students continue to experience trauma related symptoms and other mental disorders at disconcerting rates. The school district reports that approximately 98% of students have experienced traumatic episodes and half of these students presented with significant distress from symptoms of Post-Traumatic Stress Disorder (Loudenback, 2016). At this school, approximately 25% of the student body has been referred, identified and treated for socio-emotional difficulties. These rates are often higher in students with learning disabilities participating in different academic programs. This action research study was conducted to evaluate how and to what extent does implementation of a resilience-based curriculum affect students’ resilience, Posttraumatic Stress Disorder (PTSD) symptoms, attitudes toward school and efficacy for coping. This project was implemented over ten consecutive weeks in an urban middle school in East Los Angeles to a group of twenty students in special education. The intervention consists of ten modules each with activities and strategies designed to raise the students’ resilience and overall well-being. Resilience Theory and Social Cognitive Theory provide the framework for understanding the problem of practice and informing the intervention. Research along with professional observations regarding the vulnerability of students in special education coupled with the lack of evidence-based practices that assist in their emotional development inspired this project. This action research relied on an explanatory sequential design where qualitative results explained and supported the results from the quantitative data. Following the explanatory design, quantitative data was collected analyzed followed by qualitative data upon completion of the intervention. Data collected from web-based surveys and focus groups demonstrate that their participation in the resilience-based intervention increased their resilience, more specifically self-efficacy and problem solving skills while reducing PTSD symptoms. Results also showed students improved their attitudes toward school and ability to cope with stress. Quantitative and qualitative data merging, interpretation, and relation to both theory and research are discussed along with the study’s limitations, implication for research and practice, and concluding thoughts.
ContributorsDussan, Francisco Jose (Author) / Gee, Elizabeth (Thesis advisor) / Wolf, Leigh (Committee member) / Elsasser, Jim (Committee member) / Arizona State University (Publisher)
Created2021
Description
The COVID-19 pandemic has affected many aspects of daily life due to social distancing guidelines, including physical exercise. Prior research indicates that physical activity is a potent resilience factor against stress’ impact on mental health. Further, research suggests that social integration and participation positively contributes to mental well-being. Yet, one aspect of physical activity that may be particularly impacted by social distancing guidelines is the social context. It is unclear if those who participated in social physical activity prior to the COVID pandemic are more impacted by the restrictions placed on these behaviors. In a sample of 519 adults in the United States, the current longitudinal study examined whether participation in social physical activity, compared to individual physical activity, moderates the influence of pandemic stress on mental health and whether there are gender differences between men and women in these associations. Study results indicated physical activity did benefit mental health during the COVID pandemic. However, greater social physical activity did not buffer against the negative impact of stress. Future research should examine other variables potentially influencing these relationships, and examine them under non-pandemic conditions.
ContributorsKaneris, Marianna Irene (Author) / Mickelson, Kristin (Thesis advisor) / Hall, Deborah (Committee member) / Mean, Lindsey (Committee member) / Arizona State University (Publisher)
Created2022
Description
Although adverse events cannot always be prevented, the negative outcomes on development can potentially be modified by considering methods of fostering positive emotional and behavioral responses. The study examined biopsychosocial health outcomes in the presence of uncontrollable adverse childhood events with the goal of identifying a potential intervention to increase resilience, health, and safe behaviors among at-risk children. It was hypothesized that adverse events can result in positive biopsychosocial outcomes in the presence of high scores on the Positive Emotion, Engagement, Relationships, Meaning, and Accomplishments (PERMA) model of well-being, self-efficacy, gratitude, and the ability to envision a positive future self. The study retrospectively examined adverse childhood events and present behavioral, emotional, and physical health outcomes. Participant (n = 685) data were analyzed using Hayes PROCESS (v3.5) to test all components of the moderation model. Results suggest that as adverse events increase, health adversity also increases. However, those with high intrapersonal strengths showed better health outcomes. Through understanding intrapersonal pathways in the presence of adverse events, the study can potentially identify mechanisms important for promoting resilient outcomes in childhood that could cascade into adulthood.
ContributorsBraunstein, Bailey Marie (Author) / Mickelson, Kristin (Thesis advisor) / Hall, Deborah (Committee member) / Lindstrom-Johnson, Sarah (Committee member) / Arizona State University (Publisher)
Created2022
Description
Latinx sexual minority adults experience diverse types of discrimination, including heterosexism and ethnic/racial discrimination, which may contribute to worse physical health. Yet little research has examined how intersectional forms of discrimination, for example, discrimination within another marginalized community contribute to physical health. Greater experiences of discrimination can lead to greater psychological distress which may then exacerbate physical symptoms. It was hypothesized that the association between intersecting forms of discrimination and physical symptom severity would be mediated by psychological distress. Participants (N = 369) identified as Latinx/Hispanic/Latino and as a sexual or gender minority. Data were collected via a self-report web-based survey. Using structural equation modeling, this study tested two theory-informed structure equation models (SEM) proposing pathways between perceived general and within-group discrimination (i.e., Model 1 = racism and racism within LGBTQ+ community; Model 2 = heterosexism and heterosexism within ethnic/racial community), psychological distress (i.e., anxiety and depression), and physical symptom severity. Both structural models demonstrated good fit to the data. As hypothesized, heterosexist discrimination (β = .184, p = .007) and racist discrimination (β = .284, p = .001) significantly predicted higher physical symptom severity in their respective models. Depression symptoms significantly mediated the association between ethnic/racial discrimination and physical symptom severity (β = .189, p = .003). Similarly, greater frequency of heterosexism within one’s ethnic/racial community was indirectly related with worse physical symptoms severity via depression (β = .200, p = .002). No other indirect effects were significant. Findings from this study support that Latinx sexual minority adults may be at risk for discrimination from outside and within their own minority groups which has detrimental effects on health. Noteworthy, depressive symptoms appeared to mediate the effects of heterosexism in one’s ethnic/racial group on physical symptoms. These results highlight how overlapping forms of stigma have differential effects on health via psychological distress. These findings have important clinical and scientific implications in understanding how overlapping forms of discrimination affect health among Latinx sexual minority adults.
ContributorsRenteria, Roberto (Author) / Capielo Rosario, Cristalís (Thesis advisor) / Cerezo, Alison (Committee member) / Dillon, Frank (Committee member) / Arizona State University (Publisher)
Created2022
Description
Transgender populations display disproportionately poorer health outcomes compared to the general population. On average, these populations tend to experience decreased well-being in part through increased mental health concerns (e.g., anxiety, depression) and poorer physical and behavioral health status. Understanding the process by which these deleterious outcomes occur for this population is integral to developing interventions. This thesis aimed to examine whether experiences of gender dysphoria and body dissatisfaction influenced the association of felt pressure to conform to gender norms with mental health and quality of life outcomes. Specifically, I hypothesized that greater pressure to conform to gender norms would be directly related to worse mental health and quality of life outcomes, and that gender dysphoria and body dissatisfaction would indirectly mediate this relationship. Furthermore, I hypothesized that participants' gender identity would moderate this relationship, such that transgender individuals would show stronger associations on all pathways as compared to cisgender individuals. The sample consisted of 211 individuals – 109 being transgender and 102 being cisgender. Participants completed a 15-minute online survey including a consent form. Results indicated partial support of hypotheses – pressure to conform to gender norms directly predicted outcomes of compromised mental health (i.e., depression, anxiety, and stress), but did not predict well-being or quality of life. Furthermore, gender dysphoria (but not body dissatisfaction) mediated the relationship between felt pressure for gender conformity and compromised mental health outcomes for cisgender participants, but unexpectedly not for transgender participants. Post hoc analyses suggest that perceived discrimination mediated the relation between felt pressure and all mental health measures and quality of life measures for both transgender and cisgender participants.
ContributorsKlennert, Victoria Elizabeth (Author) / Mickelson, Kristin (Thesis advisor) / Hall, Deborah (Committee member) / Nelson-Coffey, Katherine (Committee member) / Arizona State University (Publisher)
Created2023