Doctor of Philosophy / Department of Family Studies and Human Services / Joyce Baptist / The purpose of the current study is to examine what factors contribute to how marriage and family therapy (MFT) programs address multicultural competency training and to understand the support mechanisms of the training process. A sequential explanatory mixed-method design was utilized to evaluate MFT training programs. First, a Multicultural Survey, adapted from the Multicultural Competency Checklist (Ponterotto, Alexander, & Griegor, 1995), was used to gain a preliminary understanding of the masters MFT field regarding multitcultural competency training. Out of the 70 MFT program directors contacted, 39 program directors or program representatives responded to the survey (55.71% response). Qualitative interviews from 8 participants (program directors, n = 7; program representative, n = 1) representing each geographical region (Northeast, n = 2; South, n = 2; Midwest, n = 2; West, n = 2) were used to examine programs’ multicultural competency training content, program context and training processes. Five themes emerged from the data: 1) internal program dynamic, 2) external program factors, 3) stakeholders, 4) faculty recruitment, and 5) cross-program collaboration. General systems theory, process theory and the logic model were utilized to conceptualize the results (Kellogg, 2004; Rossi, Lipsey, & Freeman, 2004; White & Klein, 2002).

Master of Science / Department of Family Studies and Human Services / Karen S. Myers-Bowman / Young women are influenced by a variety of different messages as they are transitioning from being viewed as little girls to being viewed as young women. While women of all ages can experience dissatisfaction with their bodies and appearance, this is especially common during the time when girls are entering into adolescence, adjusting to their changing bodies, and trying to develop a sense of who they are as an individual. Our society today has placed a significant importance on thinness and young women are bombarded with messages presenting them with an unattainable level of thinness as society‘s ideal. This paper describes adolescent development, looks at the sociocultural influences (family, peers, and media) that impact young women‘s body image, presents prevention and intervention programs that have been used with young women, and provides recommendations for family life educators on how to educate parents on the messages their daughters are being sent and provides them with suggestions on how to talk with their daughters about these messages.

Master of Science / Department of Family Studies and Human Services / Briana S. Goff / Homophobic hate crimes against lesbians and gay men represent a significant social problem that has important psychological consequences for survivors. Because the nature of these crimes is, by definition, against someone for his or her intrapersonal traits, it has even more potential to be damaging to a victim and in turn potentially detrimental to the development and/or maintenance of close personal relationships. The impact of trauma has long been studied from the view of the trauma survivor or any secondary traumatization of those around the primary survivor. The impact of hate crime victimization has also been examined, and it, too, has also been examined from the primary survivors perspective. Only in recent years has the impact of trauma on interpersonal relationships been examined. Additionally, there is currently little to no literature on the impact of trauma or traumatic events on gay or lesbian relationships. The types of hate crime victimization experiences range from verbal abuse to severe physical assault to death. While hate crime victimization is not specifically identified in the DSM – IV – TR as a potentially traumatic event, physical assault, which is found commonly in hate crimes, is identified. Therefore, hate crime victimization could be a potentially traumatic event. However, this has not been addressed in the traumatic stress field. This report is intended to address the gaps in the current body of literature in both the traumatic stress field and the gay and lesbian literature. This overwhelming lack of literature has the potential to be very detrimental to professionals working with this population and in turn detrimental to the population and society. Evidence suggests that there may be a difference in how or if the potentially traumatic hate crime victimization experience manifests itself internally or in other forms because of the nature and severity of the victimization in one or both partners. Evidence also suggests, similarly to heterosexual couples, the impact of trauma has repercussions throughout the couple relationship. This report provides a preliminary start to continue and expand the work with the gay and lesbian community.

Doctor of Philosophy / Department of Family Studies and Human Services / Anthony Jurich / This qualitative research study explored how mothers reacted to sibling sexual abuse disclosures while investigating the treatment and supportive services they engaged in to help them cope with this family trauma. Previous research focused on the role mothers played in intrafamilial sexual abuse cases, indicating that mothers were collusive and aware that the sexual abuse was occurring and did not intervene or protect their daughters. This research study’s purpose was to begin the foundational process of filling the gap in the literature concerning mothers and sibling sexual abuse disclosures. Qualitative data from the interviews conducted with mothers of sibling sexual abuse cases were utilized for this study. Participants were asked to reflect upon their early childhood experiences, characteristics of relationships in their families, how they handled the sibling sexual abuse disclosure, their level of functioning after the abuse disclosures, and any treatment strategies utilized, as well as their perceived effectiveness. The study shared the lived experiences of mothers who had sibling sexual abuse disclosures occur within their immediate families. The results revealed that the participants’ immediate reactions were not indicative of the action they took, following the disclosure, to protect their daughters from further abuse. Also indicated was a connection between mothers’ ability to cope with the abuse disclosure over time and their daughters’, the victims’, ability to make progressive steps towards improved functioning, following the abuse disclosure. This research can assist clinicians in understanding the importance of the therapeutic relationship and being sensitive to the delicate role mothers of perpetrators and victims have to play in these cases. In addition, clinicians must assist these mothers in transitioning through their numerous emotions, in order to return to a functional level of interaction in their lives.

Cognitive impairment in coronary artery disease (CAD) patients can predict poorer quality of life, dementia, and increased mortality. This study aimed to determine the association between long-term cortisol elevations and cognitive function in CAD patients. Participants were recruited at the beginning of a 1 year cardiac rehabilitation program and followed forward. Composite Z-scores were computed from tests measuring memory and executive function at baseline and 1 year. Cortisol deposition (3 months) was measured from a 20 mg, 3 cm hair sample. Analyses of covariance showed less improvement in memory function (F1,50=4.721, p=0.035) but not executive function (F1,49=0.318, p=0.575) in patients dichotomized into a high cortisol group based on a previously established reference range. Prolonged cortisol elevation may be associated with cognitive changes in subjects with CAD.

This cross-sectional study examined neurobiologic correlates of depression in ischemic stroke patients. Depression severity was measured with a standardized scale (Center for Epidemiologic Studies Depression Scale; CES-D). Eighty-two patients (53.1% male, mean (± SD) age 71.9 ± 14.2 years, mean (± SD) National Institutes of Health Stroke Scale (NIHSS) score 4.6±4.7, mean (± SD) CES-D score 12.6 ± 10.8) were recruited. A linear regression controlling for age and stroke severity (NIHSS) determined that the kynurenine to tryptophan ratio (β= -0.105, p=0.369) was not significantly associated with CES-D (primary hypothesis) (overall model R2=0.069, F3,73=1.805, p=0.154). Secondary analyses suggested one instance of cytokines favouring inflammatory states in mild depressive symptomatology; IFN-Ɣ/IL-10 (OR, 2.17; 95% CI, 1.02-4.64, p=0.045). For the most part however, inclusion of cytokines and neuroimaging correlates such as atrophy, lesion location and white matter changes were non-significant. Longitudinal studies are necessary to identify the possible neurobiologic correlates of depressive symptoms post-stroke.

Cognitive impairment in coronary artery disease (CAD) patients can predict poorer quality of life, dementia, and increased mortality. This study aimed to determine the association between long-term cortisol elevations and cognitive function in CAD patients. Participants were recruited at the beginning of a 1 year cardiac rehabilitation program and followed forward. Composite Z-scores were computed from tests measuring memory and executive function at baseline and 1 year. Cortisol deposition (3 months) was measured from a 20 mg, 3 cm hair sample. Analyses of covariance showed less improvement in memory function (F1,50=4.721, p=0.035) but not executive function (F1,49=0.318, p=0.575) in patients dichotomized into a high cortisol group based on a previously established reference range. Prolonged cortisol elevation may be associated with cognitive changes in subjects with CAD.

This cross-sectional study examined neurobiologic correlates of depression in ischemic stroke patients. Depression severity was measured with a standardized scale (Center for Epidemiologic Studies Depression Scale; CES-D). Eighty-two patients (53.1% male, mean (± SD) age 71.9 ± 14.2 years, mean (± SD) National Institutes of Health Stroke Scale (NIHSS) score 4.6±4.7, mean (± SD) CES-D score 12.6 ± 10.8) were recruited. A linear regression controlling for age and stroke severity (NIHSS) determined that the kynurenine to tryptophan ratio (β= -0.105, p=0.369) was not significantly associated with CES-D (primary hypothesis) (overall model R2=0.069, F3,73=1.805, p=0.154). Secondary analyses suggested one instance of cytokines favouring inflammatory states in mild depressive symptomatology; IFN-Ɣ/IL-10 (OR, 2.17; 95% CI, 1.02-4.64, p=0.045). For the most part however, inclusion of cytokines and neuroimaging correlates such as atrophy, lesion location and white matter changes were non-significant. Longitudinal studies are necessary to identify the possible neurobiologic correlates of depressive symptoms post-stroke.

Resilience and post trauma responses often coexist, however, for the past decades, the trauma paradigm has served as the dominant explanatory framework for human suffering in post-conflict environments, while the resilience of individuals and communities affected by mass violence has not been given equal prominence. Consequently, mental health interventions in post-conflict zones often fail to respond to local realities and are ill equipped to foster local strengths. Drawing primarily from trauma, feminist and structural violence theories, this study strengthens understanding of adult resilience to traumatic exposure by examining the resilience of Quechua women in the aftermath of the political violence in Peru (1980-2000), and their endurance of racially and gender-targeted violence. The study uses a cross sectional survey to examine the resilience and posttraumatic responses of 151 Quechua women. Participants were recruited from an urban setting and three rural villages in Ayacucho, Peru. The study examines the associations between resilience, past exposure to violence, current life stress and post-trauma related symptoms as well as the individual and community factors associated with the resilience of Quechua women. In doing so, this study makes a unique contribution by simultaneously examining posttraumatic responses and resilience in a post-conflict society, an area with a dearth of research. Results indicate that resilience was not associated with overall posttraumatic stress related symptoms, but instead higher resilience was associated with lower level of avoidance symptoms and therefore with lesser likelihood of chronic symptoms. Findings also demonstrate that enhanced resilience was associated with women’s participation in civic associations, as well as being a returnee of mass displacement. Lower resilience was instead associated with lower levels of education, absence of income generated from a formal employment and the experience of sexual violence during the conflict. These results were triangulated with qualitative findings, which show that work, family, religion, and social participation are enhancing factors of resilience. The study highlights the courage and resilience of Quechua women despite persistent experiences of everyday violence. The importance to situate trauma and resilience within historical processes of oppression and social transformation as well as other implications for social work practice and research are discussed.

Among several difficulties associated with immigration, acculturation process has been recognized as one of the main stressors and one of the major risk factors associated in the incidence of mental disorders. The strategies adopted by individuals to deal with the acculturation process appear to be predictive of different mental health outcomes. This exploratory study investigated the relationship between acculturation strategies and the occurrence of symptoms of depression in the context of the Brazilian immigrant community living in the Greater Toronto Area. The results demonstrated that Separation and Assimilation were the predominant strategies for this sample and that acculturation strategies failed to serve as significant predictors of depression scores. However, participants with Separation as their predominant acculturation strategy exhibited higher depressive symptom endorsement. The significance of these findings in the context of previous research as well as its implications for future research and critical multicultural practice in mental health are discussed.