This study investigates the relation between emotion regulation problems and clinical depression. One goal of the present study was to bring increased clarity and parsimony to how emotion regulation is presently measured by consolidating three widely used instruments. In addition, of interest was an investigation of whether particular emotion regulation problems and management strategies interact with gender to predict either severity of overall depression symptoms or the presence of a formal mood disorder diagnosis. The results clearly showed that irrespective of a person's gender, particular emotion regulation indicators, both singly, and in combination, are, indeed, more strongly related to the severity of depression symptoms. Specific to the severity of self-reported depression within these 17 emotion regulation subscales are: (a) Difficulty Identifying Feelings (TAS-20 subscales); (b) Limited Accessed to Emotion Regulation Strategies (DERS subscale); (c) Positive Refocusing (CERQ subscale); (d) Self-Blame (CERQ subscales); and (e) Refocus on Planning (CERQ subscales). According to results, the two emotion regulation constructs specifically distinguish DSM mood disordered from nondisordered subjects: Factor 2: Loss of Control over Behavior and Perceived Helplessness; and Factor 6: Assuming, Accepting Blame or Responsibility. These two constructs are also included in the five subscales that form a linear combination accounting for maximum variance in BDI-II. When considered together, the results of the present study suggest that these two emotion regulation factors seem to be the most important in predicting not only severity of depression, but also in helping to provide diagnostic information of clinical depression (differentiating people with DSM Major Depressive Episode and Mood Disorder NOS, versus those without a mood disorder).

Background: Prior studies have shown a strong association between disturbing dreams and suicidal ideation and behaviors, but the pathways connecting them have not been well characterized. The systemic desensitization theory of dreams would suggest that the acquired capability for suicide, specifically the fearlessness about death component, could further explain these pathways. Hypothesis: More intense suicidal ideation will lead to more severe suicidal behaviors through a three-step mediation of more severe nightmares and greater acquired capability for suicide. However only for those with lower levels of anxiety sensitivity will the more severe nightmares lead to greater acquired capability for suicide and suicidal behaviors. Methods: Mediation and moderation regression analysis were completed through secondary analysis of data for two studies, and primary data collection and analysis was done through a third study. 647 participants filled out self-report questionnaires as part of intake data at a southeastern university’s psychology clinic for the first study (mean age 27.4, 62.1% female). 1143 participants from various branches of the military filled out the self-report questionnaires as part of the Military Suicide Research Consortium for the second study (mean age 29.34, 16.6% female). 251 participants were recruited through Amazon MTurk and filled out the self-report questionnaires (mean age 34.0, 38.6% female). Mediation and moderation regression analysis were then completed for a third online study, which tested additional mediators and moderators. Results: The hypotheses were partially supported across the various studies. Within the sample collected for the sake of this project, the effects were the strongest. There was evidence that dreams involving death specifically were related to higher fearlessness about death from suicide, although not higher fearlessness about death more generally. Ruminative thinking patterns moderated this interaction, such that less rumination strengthened the relationship between dreams about death and fearlessness about death from suicide. Limitations: Limitations include the inability to detect causality due to a cross-sectional design, as well as the lack of generalizability to older or suicidal samples. Conclusions: These findings further explain the pathways linking disturbing dreams to suicidal ideation through adding in fearlessness about death and acquired capability with rehearsal for suicide as mediators. They also establish the moderating role of ruminative thinking as an explanatory mechanism between dreams and fearlessness about death. / A Thesis submitted to the Department of Psychology in partial fulfillment of the requirements for the degree of Master of Science. / Spring Semester 2019. / April 1, 2019. / Includes bibliographical references. / Thomas E. Joiner, Professor Directing Thesis; Jesse R. Cougle, Committee Member; Colleen M. Ganley, Committee Member.

Latina/o emerging adults living in southern states may be especially at risk of being disproportionately affected by HIV. In 2015, Latina/os aged 20 to 24 accounted for 14.7% of all 20-24-year old’s living with HIV in southern states, despite the fact that 20 to 24-year-olds make up 3.7% of the region’s overall population of individuals living with HIV (CDC, 2016; U.S. Census Bureau, 2017). Specifically, there continues to be groups of Latina/o emerging adults who do not use condoms when they are sexually active and who are not using condoms consistently. Condom use literature suggests that relationship factors, such as power dynamics and dating violence (DV) victimization, can play an essential role in Latina/o emerging adults' attitudes towards condoms and condom use behaviors. Hence, there is a continued need for studies focused on identifying factors that serve as barriers to and supports for southern-residing, Latina/o emerging adults’ condom use behaviors. To this end, 196 Latina/o emerging adults (59 males, 137 females) completed a survey that asked questions about their sexual attitudes, behaviors, intentions, cultural factors, and DV. This study sought to examine the inter-relations among Latina/o emerging adult’s DV experiences (i.e., victimization, perpetration), cultural factors (i.e., acculturation, traditional gender roles (TGRs), familismo), and condom use outcomes (i.e., attitudes toward condoms, condom use efficacy, condom use negotiation efficacy). Second, it sought to investigate whether biological sex and cultural factors moderated the relationship between DV experiences and condom use outcomes. Bivariate correlations revealed a number of associations between the variables and regressions analyses suggest that adherence to TGRs significantly affected whether or not females had perpetrated or experienced DV. Further, biological sex was found to moderate the relationship between DV perpetration and condom use negotiation efficacy and DV perpetration and Attitudes towards condoms such that the effect is stronger for Latinos compared to Latinas. Lastly, familismo beliefs was identified as an exacerbator, such that the positive relationship between DV victimization and condom use efficacy is particularly strong for individuals who possess higher familismo beliefs than those with lower familismo beliefs. This study’s finding of Latina’s increasing condom use negotiation efficacy among Latina’s that perpetrate DV sheds insight into the possibility of Latinas utilizing physical violence as a method of achieving a balance of power and sexual control in a romantic relationship to protect themselves against STIs. Given this, future researchers should longitudinally investigate the nuances in DV perpetration and victimization behaviors among emerging adults with an emphasis on relationship power dynamics in heterosexual relationships among Latina/os.

Although reducing recidivism among juvenile offenders is an important goal of the criminal justice system and diversion programs are known to reduce recidivism, little is known about the risk factors associated with participation in diversion programs or recidivism. The purpose of this quantitative study was to identify the juvenile offender risk factors associated with participation in diversion programs and recidivism. Social learning theory was the theoretical framework. The key research questions focused on how juvenile offenders'€™ demographic characteristics, risk factors, and participation in different types of diversion programs were associated with recidivism. Archival data from a large juvenile justice agency were analyzed using chi-square tests and binary logistic regression to examine the associations between the characteristics of N = 4,656 juvenile offenders (age at the referral date, gender, race, size of family, guardian involvement, and offense type); participation in a 90-day program (DP90) or a 180-day program (P180); and recidivism (referral within 1 year). The overall rate of recidivism was 15.3% per year, but recidivism varied significantly between groups of offenders. The strongest predictor of recidivism was dropping out of the DP180 program. Offenders who did not drop out of the DP90 program were the least likely to recommit a crime. The findings of this study suggest that likely steps for positive social change be implemented through policy changes to expand the role of guardians in diversion participation process. Further research to explain how and why the level of parental/primary guardian involvement and the type of diversion program may moderate the behavior of juvenile offenders in diversion programs is recommended. The use of family-based support strategies may improve the completion rate of diversion programs and may ultimately help to reduce the rate of recidivism for juvenile offenders.

The dynamics of the modern blended family is a topic of considerable interest in family research. The purpose of this quantitative study was to understand how parental stress, perceived parental regard, and depressive symptoms affect nonresidential and residential stepmothers. Family Systems Theory provided an appropriate lens for this research study. An analysis of covariance was used to determine whether differences existed between nonresidential and residential stepmothers in terms of parental stress, perceived parental regard, and depressive symptoms. The second goal was to determine whether the covariates of age, ethnicity, household income, time spent stepparenting, and the number of biological and stepchildren affected the variables in a meaningful way. The participants selected for the study were both nonresidential and residential stepmothers, 18 years and older. Participants completed a web-based survey that administered three different instruments: The Perceived Child Regard Questionnaire, the Parental Stress Scale, and the Center for Epidemiologic Studies Depression Scale-Revised. A total sample size of 94 nonresidential stepmothers and 79 residential stepmothers completed the survey. Results indicated no significant differences in parental stress and depressive symptoms due to custody status. However, there was a significant effect noted between nonresidential and residential stepmothers pertaining to perceived child regard. These findings provide a valuable direction for researchers who wish to further explore stepfamily concepts especially concerning variables that may attribute to the differences in custody status and perceived child regard. As well as provide psychoeducation for stepfamilies and their community.

Using systems theory, the purpose of this qualitative study was to explore the perspectives of service providers about the psychiatric experiences of hospitalized adolescents, their coping strategies and the aftercare services they used following discharge. The goal was to learn about their experiences as they transitioned into mainstream culture. This study was conducted for psychiatric policy makers to assist with implementing therapeutic programs that teach adolescents coping strategies that help them make a smooth transition. The technique used to recruit 21 participants (psychiatrists, psychologists, social workers, psychiatric nurses, and direct care workers) was snowballing. The participants involved in face-to-face or phone interview. The NVivo coding system identified the following four themes from the service providers' responses: (1) Coping strategies is the core of the teaching process for inpatient psychiatric adolescents, (2) The coping strategies learned in the hospital are assessed at discharge, and used for integration and stability in mainstream society, (3) Adolescent patients who correctly used prescribed medication along with other coping strategies in and outside the hospital and were linked to aftercare programs were better able to handle their experiences of stigmatization and integrate into the community, (4) The role of the service providers is vital for ongoing communication among family, adolescent, inpatient hospital, and aftercare personnel. The most common coping strategies taught to adolescents were asking for help, avoiding conflicts, following instructions, and medication compliance. The likelihood of recidivism increased with inconsistencies within these coping strategies. The findings can initiate positive social change by guiding policy makers and service providers with the development of appropriate psychiatric care to accommodate adolescents' needs for a smooth transition back into school, work, and community.

The purpose of this qualitative phenomenological research study was to determine the psychological and emotional effects of female deployment on male spouses. The current research was designed to study the emotional and psychological experiences of male spouses of deployed women. The research question was focused on understanding the lived experience of the male spouses of their deployed active duty wives. The intent was to describe male spouses' lived experiences, focusing on mental health, physical health, marital problems, caregiving, and other reintegration related problems as well as the role transfer stress experienced by these male spouses of deployed wives. Gender role theory was the theoretical framework chosen for this study to understand role transfer issues faced by the male spouse of a deployed woman. Fifteen male spouses were interviewed in 1-on-1 interviews to gain knowledge of their emotional and psychological stressors related to spouse deployment. The interview data were analyzed for common themes of their lived experiences. The results of the data were greater understanding of the male spouses lived experiences of being a spouse of an active duty deployed spouse, as well as how better to help this population. The study highlights the understanding that the experiences of the spouse of a deployed service member is critically important for the government and society alike. Civilian husbands of deployed military women have unique gender-specific needs which are poorly addressed, leading to unnecessary marital tension for all parties. Implications for positive social change included findings that provided insight needed to assist the male spouse of a deployed woman.

To improve how healthcare is being provided, many states have focused on enhancing patients' health experiences and outcomes and reducing the per capita cost of care. Even though appointment follow-up is an important part in outpatient treatment programs, not much is known about practical methods to help individuals with mental illnesses into ongoing treatment. The purpose of this quantitative study was to determine to what extent patient appointment follow-up adherence at a family health center in New York predicts negative health outcomes and hospitalizations among patients receiving psychological treatment. The theoretical foundation that framed this study was the theory of planned behavior. Two research questions measured whether there was statistically significant difference between the dependent variable (number of emergency room visits) and the independent variables (number of follow-up appointments and caseworker status). A causal-comparative research design was used to examine archival data, and multiple linear regression analysis was done to analyze the data. Findings indicated that the number of mental health visits and having a caseworker are important factors in appointment follow-up. The findings of this study have organizational and societal implications for social change. Government agencies as well as mental health advocates may benefit from the findings of this study, which can encourage more attention on the quality of care for those with mental health diagnoses. Thus, the findings may lead to developing improved care.

No description available.

Bladder antimuscarinic medications (BAMs) are commonly used among the aged population to manage urinary incontinence (UI), which is a frequent health problem among nursing home (NH) residents. However, a number of BAMs produce anticholinergic effects in the central nervous system (CNS), and may thereby cause delirium and lead to antipsychotic medication (APM) use. This study examined the associations of BAMs and delirium incidence, and the associations of BAMs and APM initiations in NHs in Iowa. The main data sources were Medicare data, Minimum Data Set (MDS), and the Online Survey Certification and Reporting (OSCAR) or Survey Provided Enhanced Reporting (CASPER) from 2011 to 2014. Propensity score (PS) matching was used to balance baseline covariates between groups. Proportional hazard models with stratification on matched sets were used to analyze time to the study outcomes with 90-day, 183-day, 365-day, and the entire follow up. The study found out that compared with those without BAM use, residents with new BAM use had a non-significant higher risk for delirium incidence during the entire follow up, with a hazard ratio (HR) of 1.12, and 95% confidence interval (95% CI) of 0.92-1.36. New BAM users also had a non-significant higher risk for APM initiation (HR: 1.07, 95% CI: 0.78-1.49). Compared to residents who had new use of other BAMs, those who had new use of bladder-selective BAMs (darienacin and solifenacin) or quaternary-amine BAM (trospium) had a lower risk (HR: 0.83, 95% CI: 0.49-1.38) for delirium incidence and APM initiation (HR: 0.85, 95% CI: 0.36-2.03). However, none of the differences was statistically significant. APM prescribing rate at the facility level was not random in Iowa geographically. There were spatial variations in the associations between BAM prescribing rate and APM prescribing rate across the state.