Master of Science / Department of Family Studies and Human Services / Anthony Jurich / Adolescent pregnancy has been an ongoing concern in society for many years. This concern is even greater among the African American community. Girls who experience a pregnancy or childbirth during adolescence often experience difficulties in school and future careers, as well as financial and mental instability. This report will examine how the pregnancy and childbirth experiences of African American teens influence their younger female siblings.

Doctor of Philosophy / School of Family Studies and Human Services / Joyce Baptist / Sexual violence is pervasive in the lives of women across the globe. Survivors commonly experience a range of mental health conditions following sexual trauma, rendering the development and examination of effective treatments to be critical. Preliminary research supports the use of adjunct exercise interventions for the treatment of trauma. In order to explore the impact of exercise interventions for the treatment of sexual violence, specifically, it is necessary to first come to understand survivors’ experiences of exercise. To better understand the experience of exercise among women survivors of sexual violence, a phenomenological study, informed by a feminist perspective, was conducted with survivors of sexual violence receiving services at a rape crisis center. Data analysis uncovered four themes that capture the survivors’ experience: exercising (and avoiding exercising) fosters safety, exercising is risky, past trauma restricts exercise choices, and exercising is beneficial. Survivors’ choices related to exercise were found to be conscious and deliberate and were impacted by their stage of recovery. Implications for future research and practice are discussed.

Doctor of Philosophy / Department of Family Studies and Human Services / Rick J. Scheidt / Alzheimer's disease (AD) is a chronic illness that has the capacity to impact several domains of a person's life. The purpose of this qualitative study was to explore four particular domains of meaning of an AD diagnosis to gain a systemic understanding of couples' experiences when one spouse had recently been diagnosed with Alzheimer's disease. A social constructionist framework was used in conjunction with the biopsychosocial-spiritual model, to explore the biological, psychological, social, and spiritual factors which inform and possibly influence couples' experiences in relation to an AD diagnosis. The interview guide was constructed using the underlying biopsychosocial-spiritual framework for the purpose of exploring couples' experiences in a systemic manner. Four couples were interviewed in their homes, no more than two months following a formal diagnosis of AD. This particular time frame captured the raw experience couples went through when receiving an AD diagnosis. All interviews were recorded, transcribed, and analyzed according to a modified version of Moustakas' phenomenological method of analysis. A family medicine physician served as the co-interpreter throughout the entire analysis process. Results consisted of unique descriptions for each couple's case and a composite description of the cross-case analysis, highlighting similarities and differences among cases. The biopsychosocial-spiritual model was found to be a significant tool for elliciting a systemic understanding of each couple's experience, and recognizing unique aspects of couples' experiences. Analysis across cases revealed 14 common themes that emerged across the four (five biological, four psychological, four social and two spiritual) domains. Results revealed that of the 14 common emerging themes, five themes were shared by all cases: Recognizing a Problem, Experience of Diagnosis Process, Experience of Symptoms, Social Support, and Social Activities. The overall analysis illustrated many more similarities among biological experiences than any other domain of experience. One case, #3, displayed a particularly unique psychological experience, as well as a significant spiritual foundation. Overall, this study emphasized the importance of using a systemic framework, such as the biopsychosocial-spiritual model, to gain a rich, in-depth understanding of how different couples experience the diagnosis process of AD.

Cette thèse poursuit un double objectif. D’une part, mesurer et situer le niveau de la condition physique, de la performance motrice et de la participation aux activités physiques chez des enfants ayant un TDAH. D’autre part, apprécier l’impact d’un programme structuré en activité physique sur la condition physique, la performance motrice, certains comportements cibles ainsi que sur les fonctions cognitives propres à ces enfants. Pour vérifier l’atteinte de ces objectifs, trois études expérimentales ont été complétées et ont fait l’objet d’articles soumis pour publications. Dans le premier article, on évalue la condition physique et la performance motrice chez des enfants ayant un TDAH prenant ou non de la médication. Les résultats obtenus démontrent que la condition physique, comprenant ici des variables reliées à la composition corporelle, l’endurance musculaire et la flexibilité de ces enfants, ne diffèrent pas de celle des membres d’un groupe témoin. Seul l’indice de masse corporelle est significativement moins élevé chez les enfants ayant un TDAH prenant de la médication. Aucune différence n’est observée entre les groupes en ce qui a trait à la capacité aérobie telle que mesurée lors d’une épreuve de tapis roulant. Par contre, lorsqu’évaluée à partir d’un test navette, la performance aérobie de tous les participants est significativement moins élevée, d’où l’importance du choix de l’instrument de mesure. Finalement, les enfants ayant un TDAH ont significativement plus de problèmes de motricité globale que les enfants du groupe témoin. Ces difficultés sont particulièrement importantes pour la locomotion. Dans le cadre d’un programme d’activités physiques structurées et supervisées, le deuxième article porte, d’une part, sur l’évaluation de l’intensité de la participation aux exercices proposés chez des enfants ayant un TDAH. D’autre part, l’impact potentiel de facteurs comme les problèmes de poids et la présence de difficultés motrices sont également pris en considération. Les résultats obtenus suggèrent que ces enfants atteignent une intensité et une durée d’exercice qui ne diffèrent pas de celles des enfants du groupe témoin. Quant aux enfants qui ont un problème de poids ou des difficultés motrices, l’intensité et la durée de leur participation ne diffèrent pas de celles des participants témoins. Sur la base des données obtenues, les enfants ayant un TDAH peuvent parvenir à un degré de participation aux exercices qui permet de bénéficier des bienfaits de la pratique d’activités physiques. Le troisième article traite de l’impact potentiel d’un programme d’activités physiques sur la condition physique, la performance motrice, certains comportements ainsi que sur les fonctions cognitives des enfants ayant un TDAH. Sur la base des résultats obtenus, il est possible de faire valoir que la participation à un tel programme permet d’améliorer les capacités musculaires, les habiletés motrices, certains comportements observés par les parents et les enseignants ainsi que la capacité d’attention. Cela pourrait produire un impact significatif dans l’adaptation fonctionnelle de ces jeunes. Ces résultats soulignent le besoin de continuer la recherche dans les domaines de l’activité physique et du TDAH. La discussion générale présente les liens existants entre les manuscrits en fonction du modèle de l’engagement dans les activités physiques. Le déficit de la motricité globale ainsi que l’impact clinique potentiel de l’activité physique dans le traitement du TDAH sont les deux axes de recherche qui semblent le plus propices à des travaux futurs. / The first purpose of this thesis is to describe fitness and gross motor performance of children with ADHD taking medication or not, in addition with the description of their participation in structured physical activity sessions. The second objective is to evaluate the impact of a physical activity program on fitness, gross motor performance, behaviour and cognition of those children. Three manuscripts are presented. The purpose of the first study is to assess fitness and gross motor performance of children with ADHD, including users and non-users of methylphenidate medication. Fitness level of children with ADHD using medication or not, including body composition, flexibility and muscular endurance, is similar to that of a control group. The only difference is observed for body mass index, which was lower in children with ADHD using medication. Aerobic capacity is also similar when measured by a treadmill test. However, a lower performance is observed when aerobic capacity was estimated using a field shuttle test, suggesting that the methodology used is important. Finally, both groups of children with ADHD present significantly lower scores for locomotion skills. The objectives of the second manuscript are to assess the participation of children with ADHD in structured physical activity sessions and to explore the impact of variables such as weight and motor problems on this participation level. Results suggest that children with ADHD can have an intensity and duration of participation similar to children without the disorder, with a simple behavioural management system for negative behaviours. Furthermore, the intensity of participation is not different for children with ADHD having weight problems or motor skills difficulties. This highlights the fact that children with ADHD can attain effective physical activity participation when they are included in a structured supervised program. Finally, the objective of the third study is to assess the effects of a moderate- to high-intensity physical activity program on fitness, gross motor skills, cognitive functions and ADHD-related behaviour in children with ADHD. Results show that participation in a physical activity program improves muscular capacities, motor skills, behaviour reports by parents and teachers and attention capacity. The results suggest that a structured physical activity program may have clinical relevance in the functional adaptation of children with ADHD. This highlights the need for further research in the area of physical activity with this population. The general discussion presents the links between the three studies using the physical activity engagement model. Gross motor skills difficulties and the clinical impact of physical activity programs in ADHD treatment are proposed as promising research avenues.

Les fuseaux de sommeil sont des ondes électroencéphalographiques reflétant les mécanismes électrophysiologiques de protection du sommeil. Les adultes autistes ont un sommeil léger et moins de fuseaux de sommeil que des adultes neurotypiques. L’étude vérifie si les enfants autistes montrent également moins de fuseaux de sommeil que les enfants neurotypiques et documente leur évolution avec l’âge. Nous avons enregistré le sommeil de 34 adultes (16 autistes) et 26 enfants (13 autistes) et comparé la quantité de fuseaux de sommeil enregistrés aux électrodes préfrontales (Fp1, Fp2) et centrales (C3, C4). Les deux groupes montrent une diminution similaire des fuseaux en vieillissant. Le groupe d’enfants autistes montre moins de fuseaux que le groupe témoin aux électrodes Fp2 et C4; les adultes autistes montrent significativement moins de fuseaux que les adultes contrôles aux deux électrodes centrales. Le mauvais sommeil des autistes pourrait être causé par une faible protection du sommeil déjà présente en bas âge. / Autism is characterized by poor sleep maintenance. Sleep spindles are electroencephalographic markers representing a sleep protective mechanism. Autistic adults display less spindles than matched controls. This study investigates sleep spindle activity in children and adults with and without autism. The sleep of 34 adults (16 autistics) and 26 children (13 autistics) was recorded. Sleep spindles were counted and compared between groups at prefrontal (Fp1, Fp2) and central (C3, C4) electrodes. Both diagnostic groups showed a similar decrease in sleep spindle with age. Autistic children had significantly less spindles than controls at Fp2 and C4; adults with autism had significantly less spindles than controls at the two central electrodes. Poor sleep in children and adults with autism may be due to impaired protective mechanisms. The developmental pattern of sleep spindle topography suggests an atypical maturational course of the thalamo-cortical loop in autism.

Des études animales ont montré que l’exposition du foetus à l’adversité affecte le développement cérébral et la régulation d’émotions plus tard. Cette régulation serait reliée aux changements structurels cérébraux, particulièrement au circuit fronto-limbique. Cependant, ces résultats n’ont pas été entièrement répliqués chez l’humain. Le but de cette étude était de tester si l'adversité précoce conduit à des altérations structurelles des régions (orbitofrontal, préfrontal, cingulaire) fronto-limbiques, identifiées comme régions-clés dans la (de)régulation d’émotions. Les mesures principales de l’adversité étaient un poids léger à la naissance et l’hostilité maternelle puisqu’ils étaient parmi les plus prédictifs des résultats développementaux et comportementaux chez l’humain. Les mesures secondaires, incluant le tempérament difficile d’enfant et l’impulsivité en adolescence, étaient utilisées du à leur lien avec le développement cérébral et émotionnel. Les participants étaient des jumeaux identiques, membres de l’Étude des Jumeaux Nouveau-nés du Québec (ÉJNQ, N = 650 paires) suivis depuis 5 mois à 15 ans, leur âge actuel. Ceci a permis de mieux contrôler le facteur génétique et ainsi mieux isoler les effets d’environnement. Trente-sept paires ont été recrutées. La structure cérébrale de chacun, obtenue avec l’imagerie par résonance magnétique, a été analysée avec la régression linéaire. Le poids à la naissance n’a eu aucun effet. L’hostilité maternelle a prédit une réduction de l’aire du gyrus cingulaire postérieur. Tempérament difficile a prédit une réduction de l’aire du cortex orbitofrontal. L’impulsivité était associée avec l’aire et volume du cortex préfrontal réduits. Ces résultats soulignent l’importance des interventions précoces afin d’empêcher des altérations menant à la psychopathologie. / Animal studies have shown that fetal exposure to adversity affects brain development and emotion regulation later on. Emotion regulation would be related to a structural change in the brain, particularly the fronto-limbic circuitry. However, results have not been entirely confirmed in humans. The purpose of the present study was to test whether early adversity leads to structural changes in the fronto-limbic (prefrontal, orbitofrontal and cingulate) regions, previously identified as key areas in emotion (dys)regulation. Main measures of adversity were low birth weight and maternal hostility because these were among the best predictors of developmental and behavioral outcomes in humans. Secondary measures, including difficult child temperament and adolescent impulsivity, were used because of their link with brain and emotion development. Participants were identical twins part of Quebec Study of Newborn Twins (QSNT, N = 650 pairs), followed from 5 months to 15 years, their current age. Using identical twins allowed to better control the genetic factors and, thus, to better isolate the specific effects of early environment. Thirty-seven pairs have been recruited. Each twin’s brain structure was assessed with magnetic resonance imaging and analyzed using linear regression. Birth weight showed no effect on brain structure. Maternal hostility predicted a reduction in cortical area of posterior cingulate gyrus. Difficult child temperament predicted a reduction in cortical area of orbitofrontal cortex. Impulsivity was associated with smaller cortical area and volume in prefrontal cortex. These results highlight the importance of the early interventions in order to prevent the alterations leading to development of psychopathology.

Doctor of Philosophy / School of Family Studies and Human Services / Jared R. Anderson / Using a representative sample of married, active duty Air Force service members (N= 29,254), a theoretical model of community functioning was tested to examine the association between community functioning and three family outcomes (i.e., parent-child relationship satisfaction, family coping, and marital satisfaction). Tests of indirect relationships included measures of psychological resilience, depression, and PTSD, while rank and gender were examined as potential moderators. Results using structural equation modeling indicated that there was a direct, positive relationship between community functioning and all three family outcome variables and an indirect relationship through both psychological resilience and depression. In addition, there was a direct, negative relationship between community functioning and depression, as well as an indirect relationship through psychological resilience. Moderation was supported for rank only. These results demonstrate the importance of community functioning and resilience as they relate to service member’s mental health and family relationships. They suggest a potential framework in which community functioning and resilience may lead to reductions in individual and family risk factors.

Master of Science / Department of Journalism and Mass Communications / William Adams / Mental illness and suicide present vexing challenges for journalists who seek to elevate public understanding of public health issues and remedies. Using the theoretical frameworks of media agenda setting and issue framing, content analysis was used to examine a nationwide sample of newspapers stories for evidence of media familiarity with prevailing norms for community mental health care and suicide prevention. Stories examined showed little evidence of such expertise, leaving questions about the ability of journalists — and their readers — to differentiate between standard and substandard mental health care systems. Long-term change in public policy about mental illness and suicide prevention will likely depend on the ability of special interests to capture and keep media attention as well as media management decisions to assign mental health coverage to general assignment reporters or place it in the hands of journalists with specialized training.

Doctor of Philosophy / Department of Family Studies and Human Services / Joyce A. Baptist / Sickle cell disease (SCD) is a prevalent, pervasive chronic illness. It is a hereditary condition that affects those of African, Mediterranean, Indian, Middle Eastern, and Hispanic/Latino descent. It causes extreme pain for patients and a myriad of other symptoms and complications. The medical issues associated with and the very nature of SCD has the potential to cause psychological distress and related problems for patients. Parents, caregivers, significant others, and family members are similarly affected by a family member with SCD. Applying the Vulnerability-Stress-Adaptation Model, this qualitative study used heterogeneous sampling and explored the experience of three families with SCD. Three main themes emerged from the data, analyzed using thematic analysis: Stress and Challenges, Adapting to and Coping with the Demands of SCD, and Individual and Family Strengths. The pervasiveness and unpredictability of SCD as well as the strengthening effects of having experienced SCD were shared across families, despite their heterogeneity. Clinical implications for families with SCD are discussed.

Master of Public Health / Department of Human Nutrition / Sandra B. Procter / Family meals and meals with caregivers can be sources of social support. Current literature indicates that social support is important for physical and psychological health and well-being. There has been no published research looking at the role of communal meals in collegiate dining centers as sources of social support. This study investigated the possibility that communal meals in a collegiate dining center and eating with other people in these settings may be related to perceived social support, academic success, frequency of family meals, and/or degree of involvement in college extracurricular activities. To investigate these relationships, first-year Kansas State University students living in the residence halls of the Derby Complex (Ford, Haymaker, Moore, and West Halls) were administered a survey about dining center usage habits. The survey included the previously tested Interpersonal Relationship Inventory Short Form by V.P. Tilden (n.d.) as a measure of perceived social support. Participants granted access to their first semester Kansas State University grade point average and semester dining center usage data. Surveys were completed online (n=216) and in paper format (n=89) for a total of 303 participants. There was no significant difference between the demographics of those that completed the online versus paper formats of the survey. Therefore, the online and paper formats of the survey were analyzed together. The data were analyzed for all participants and for males (n=94) and females (n=209) separately. Results revealed multiple significant relationships (p<0.05). Results related to grade point average and perceived social support revealed a significant positive relationship between frequency of eating in the dining center and grade point average for all participants combined. This relationship was also noted for males and females analyzed separately. Frequency of eating with others was found to be significantly positively correlated to perceived social support score for all participants combined, and for males and females analyzed separately. Frequency of eating with others was significantly positively correlated with grade point average for males alone and females alone, but not all participants combined. Further research is needed to determine if the relationships are causal and if so, the direction of causality in the relationships.