Research has found that adverse childhood experiences (ACEs) are associated with changes in both parenting stress and cortisol. Resilience-building interventions may be able to help diminish the effects of ACEs, thus impacting parenting stress and cortisol reactivity. This study aims to examine how two resilience-building interventions (emotion-based and behavior-based) will impact parenting stress and cortisol reactivity in mothers with ACEs. This project is in the preliminary stages of data collection; as such, this honors thesis will review the relevant literature, describe current methodology and proposed analyses, and discuss possible implications and future directions. Participants (goal N=100) undergo a pre-assessment where parenting stress and cortisol reactivity are measured. Participants are then randomly assigned to receive an emotion-based curriculum (goal n= 50) or behavior-based curriculum (goal n=50) for 8 weeks. After completing their curriculum, participants’ parenting stress and cortisol reactivity will be reassessed. Participants from both resilience-building interventions are hypothesized to have a reduction in parenting stress and cortisol reactivity, but participants who received the emotion-based curriculum are predicted to have greater reductions. Additionally, it is hypothesized that changes in parenting stress will be correlated with changes in cortisol reactivity, so participants with greater reductions in parenting stress are anticipated to have greater reductions in cortisol reactivity.

Adverse Childhood Experiences, also known as ACEs, are a major public health concern. ACEs are defined as stressful or traumatic events in early life that range from parental separation to all forms of abuse and neglect, as well as household dysfunction (e.g., living in a home with substance misuse). The current body of scholarly literature shows that ACEs have long lasting effects on both physical and mental health through a person’s life. Research also illustrates a dose-response relationship between the number of ACEs and the number of risk behaviors, such as substance misuse, that a person may exhibit. Quality of life refers to a person’s self-perceived well-being and includes mental, emotional, physical, and sexual health. Quality of life, synonymous with well-being is associated with numerous health benefits including reduced risk of disease, better immune function, and increased life expectancy. This study seeks to determine if quality of life is a protective factor against substance misuse in adults who report ACEs. In line with the current body of knowledge, we hypothesize that adults within the study sample with a higher number of ACEs will exhibit higher rates of tobacco use, alcohol use, and drug use. We also hypothesize that participants with ACEs who rate a higher quality of life score will be less likely to use alcohol, tobacco, or drugs; as compared to those who rate a lower quality of life. Participants (N=766, age 18-55) were recruited through the REACH (Religion, Emotions, and Current Health) survey study. Data on ACEs will be collected from the Adverse Childhood Experiences (ACEs) Questionnaire which measures the number of traumatic experiences during the first eighteen years of life. Data on substance use will be collected via the Tobacco Questionnaire dichotomously (yes or no), the AUDIT scale on alcohol use which measures the frequency and quantity of consumption, and the Drug Abuse Screening Test (DAST) which measures drug use in the last twelve months. Quality of Life will be measured using the World Health Organization Quality of Life WHOQOL-BREF. Quality of life will also be examined using two subscales, overall quality of life and perceived social support. All data was collected via self-reporting. Bivariate and multivariate analyses will be conducted using SPSS. To examine the potential moderating effect of quality of life, a hierarchical multiple regression will be conducted, specifically the simple moderation from the PROCESS macro for SPSS. We predict that those who perceive a higher quality of life, despite early life adversity, will report less frequency in alcohol, tobacco, and drug consumption. Conversely, we predict that those who perceive a lower quality of life will exhibit higher rates of health-related risk behaviors, specifically substance misuse.

Adverse Childhood Experiences (ACEs) affect numerous outcomes in adulthood, but relatively few studies examine their implications for adolescents. Understanding the effects of ACEs is important since adolescent behaviors affect subsequent life course milestones and transitions. One area of the ACEs research that is deficient involves adolescent substance use. In addition, there is a paucity of studies addressing whether the association between ACEs and substance use differs by race/ethnicity. Using data from the Fragile Families and Child Wellbeing Study, this study aims to fill these gaps by (a) examining whether adolescents who experience more ACEs tend to be at higher risk of alcohol and marijuana use; and (b) whether the association between ACEs and these forms of substance use differs among White, Black, and other racial/ethnic youth. The results show that, among Black youth, ACEs tend to affect alcohol and marijuana use at high levels (four or more). Among White youth, this association is limited to marijuana use. Nonetheless, age and peer substance use appear to have more consequential effects on the odds of alcohol and marijuana. The findings suggest that additional research is warranted, but that ACEs should be a focus of research on adolescent substance use.

The therapeutic alliance is a core element of successful treatment in therapy. Recent literature has explored variables that predict the alliance at various time points during therapy, but few studies have explored how the alliance develops over time and the factors that influence its rate of change. The current study addresses these questions by estimating latent growth-curve models to analyze how male and female partners' alliance scores develop over time and how adverse childhood experiences (ACEs) impact the development of the alliance during the first six sessions of therapy. Results from these analyses show that neither men nor women's ACEs had a significant effect on the rate of change in the alliance. A discussion of the attachment implications of these findings, as well as the limitations of this study and potential directions for future research are then presented.

This thesis evaluated the Trauma-Informed Child Advocacy Certificate (TICA) at Mississippi State University which is hosted in the School of Human Sciences, specifically in the area of Human Development and Family Science (HDFS). HDFS students (N = 94) enrolled in coursework during Spring 2021 participated in the evaluation. Students were grouped by enrollment in TICA courses, with 43 students having participated in TICA coursework and 51 students having only participated in general HDFS courses. Assessments included a perceived knowledge survey and 10 application-based scenarios. Independent samples T-tests indicated TICA students perceived themselves to have more trauma-informed knowledge, and frequency analyses showed they were more effective at applying that knowledge than HDFS students who have not taken any TICA courses. Data were used to highlight strengths of the TICA program and make recommendations on ways to enhance the TICA coursework to promote knowledge of trauma-informed professional practices.

Survivors of complex childhood trauma (CCT) tend to develop distinctive mental health challenges later on in adulthood, which may be exacerbated by the ongoing coronavirus pandemic. CCT survivors often struggle with self-regulation, making it difficult to tolerate the distress associated with “gold-standard” trauma-processing therapies for survivors of single-incident and adult-onset trauma. Yoga can enhance self-regulation, through physical movements, breathing techniques, meditative focus, and ethical guidelines of behaviour. This dissertation encompasses the creation of a new approach for teaching yoga to trauma survivors, called TIME yoga. This approach is based on a neuropsychological understanding of the bio-psycho-social alterations that CCT survivors undergo. Chapter 1 details the methods employed in this series of dissertation studies. A randomized controlled trial (RCT) was conducted with 26 adult survivors of CCT. Mental health, emotional functioning, resilience, and cognitive functioning were assessed via subjective and objective measures at two time points (i.e., pre- and post- participation in the online yoga program or waitlist). Chapter 2 is a retrospective and cross-sectional study describing survivors’ pre-intervention psychological and cognitive functioning during the pandemic, and evaluating the impact of trauma at particular developmental stages. Regression analyses revealed particular implications of adolescent and young-childhood trauma. Chapter 3 presents a manual of TIME yoga and feasibility data from the initial RCT, supporting both feasibility and safety of the program. Chapter 4 underscores yoga-related improvements in depressive symptoms, interoceptive awareness, and executive functioning. Using both repeated-measures ANOVAs and clinically meaningful indicators of change, this study illustrates how TIME yoga effectively improved survivors’ self-regulation during the global health crisis. Future directions for program development and evaluation are discussed. / Graduate / 2023-04-11

Substance Use Disorder (SUD) has plagued families of rural Appalachia for many years, perpetuating involvement in the criminal justice system as well as generational trauma for people diagnosed with SUD and their children. This points to the necessity of a trauma-informed, restorative-justice based framework for rehabilitative services to most effectively heal families, address trauma, and re-integrate people diagnosed with SUD into society. A restorative justice-based program would provide health care services for addiction and any comorbid mental health disorders as well as teach parents how to properly provide for themselves and their families, manage finances, obtain employment, and further education. Current rehabilitative program structures were evaluated in the literature, and it was found that typically, rehabilitative programs provide either strictly addiction services or mental health services, but not both. It was also found that the criminal justice system tends to sentence to 28-day inpatient rehabilitative services, which provides people diagnosed with SUD an opportunity to achieve sobriety and establish some stability; however, with little or no follow up, these people are significantly more likely to relapse. These findings were compared with the structure of Ballad Health STRONG Futures, an outpatient addiction services and behavioral health clinic located in Greeneville, TN; Red Legacy Recovery, a recovery initiative serving incarcerated women in Elizabethton, TN; and Families Free, a 501(c)3 organization providing outpatient services to Northeast Tennessee through the Tennessee Department of Mental Health and Substance Abuse Services. It was found that rehabilitative care structures that addresses trauma, addiction, and aspects of daily living such as parenting, finances, education, and employment provides clients with the tools and stability needed to be successful in their respective recovery journeys. This work will provide significant insight for the creation and implementation of other substance use clinics and initiatives across the country and encourage them to address mental health and aspects of daily living to promote clients' success and break cycles of generational trauma.

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