Thesis advisor: Ann W. Burgess / Purpose: The purpose of this descriptive phenomenological study was to understand the lived experience of Black emerging adults with psychotic disorders who have community violence exposure (CVE). The aims included understanding how Black emerging adults with psychotic disorders described the experience of community violence in their lives. A secondary aim was to understand how these individuals described how their experience of community violence has impacted their ability to attain goals that are consistent with emerging adulthood.Background: CVE is a public health crisis. Black emerging adults are at an increased risk of CVE and having a psychotic disorder. CVE and psychotic disorders can cause an increased burden on life. While there is research examining the impact of CVE on mental health and research examining the effects of trauma on psychotic disorders, there is limited qualitative work in Black emerging adults with psychotic disorders and CVE. Method: This study was guided by Husserl's descriptive phenomenology philosophy, and Giorgi's descriptive psychological phenomenological approach guided data collection and analysis. Eleven participants were recruited through purposive sampling. Participants had to have a psychotic disorder, report CVE, identify as Black or African-American, and be between 18 and 29. Interviews were conducted individually with each participant to understand their experiences of CVE. Using bracketing, the data was coded and analyzed. Rigor and trustworthiness were ensured by using Lincoln and Guba's criteria for credibility, confirmability, dependability, and transferability. Results: The sample consisted of eleven participants, ranging in age from 21 to 28, with an average age of 24.6. Six identified as male, four identified as female, and one participant identified as transgender and non-binary/non-conforming. All participants identified as non-Hispanic Black/African-American and had a primary psychotic disorder. Four themes were identified: (1) CVE results in a range of emotional responses, (2) CVE results in a range of behavioral responses, (3) CVE causes disruptions in life and relationships, and (4) participants aspire for a better life without a clear pathway. These four themes represent the lived experiences of CVE in these Black emerging adults who have psychotic disorders in Boston, MA. The themes shed light on the consequences CVE had in their lives. Conclusion: Utilizing descriptive phenomenology created a comprehensive understanding of the experience of the phenomenon of CVE in Black emerging adults with a psychotic disorder. The results illuminated the complex nature CVE has on their life and mental health. Future research should focus on quantitative studies to explore the impact of CVE on various health, social, and psychological outcomes. / Thesis (PhD) — Boston College, 2024. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Epidemiological research indicates that parents report lower levels of youths’ exposure to violence than youth self-report, and theory suggests that such discrepancies reflect parents’ lack of knowledge of youth victimization and impaired ability to help children cope with victimization. This study extends prior research examining the implications of parent-youth informant discrepancies on ratings of victimization. Latent class analysis (LCA) was employed to identify groups of dyads distinguished by patterns of parent and youth report of victimization, uncovering heterogeneity based on patterns of parent-youth ratings of victimization. Analyses examined how latent classes reflecting parent-youth agreement on victimization were related to adjustment (i.e., depression, aggression, and delinquency) concurrently and over time. Participants were youths ages 10-15 years and their mothers (N=1,339 dyads) from the Project on Human Development in Chicago Neighborhoods (PHDCN). Parent and youth reports of six victimization events were used as the observed indicators in latent class analysis. Youths and parents completed parallel measures of adjustment (anxiety/depression and delinquency subscales of the Child Behavior Checklist and Youth Self Report) concurrently and at follow-up assessment (~2.5 years). This study compared three classes of youths: (a) Low Victimization (77.0%), (b) Youth > Parent (13.5%), and (c) Parent > Youth (8.1%). Concurrently, the class in which youths reported more victimization than parents (Youth > Parent) demonstrated higher levels of youth-reported depression, delinquency, and aggression. Longitudinally, however, this was not the case. In fact, the Parent >Youth class was more likely to show increased maladjustment, relative to the Youth > Parent class. Specifically, these youths showed increases in both youth- and parent- reported delinquent behavior, as well as parent-report of youth anxious/depressed behavior. In the absence of a gold standard to determine which informant is over- or under- reporting victimization, a person-centered approach can offer a unique framework for integrating informant reports. Moreover, discrepant perspectives can offer useful information for understanding the effects of victimization, as well as implications for prevention and intervention.

The current study examines associations between community violence exposure (CVE) and internalizing and externalizing symptoms. The emotional desensitization hypothesis states that moderate levels of CVE will be associated with increased internalizing symptoms, whereas high levels of CVE will be associated with decreases in internalizing distress. The current study extends prior research by examining whether patterns of emotional desensitization differ based on the route of exposure – either being personally victimized or witnessing community violence. Further, associations examined the influence of interpersonal proximity to the victims of violence – that is, whether individuals are victims themselves (most proximal), witness violence against known individuals, or witness violence against strangers (least proximal). Participants include 714 undergraduate students (Mage = 20.5 years, SD = 3.9) who completed an online survey of CVE, internalizing and externalizing outcomes, and cognitions supporting aggression. Results revealed significant moderation by interpersonal proximity. Specifically, curvilinear associations between CVE and internalizing symptoms, reflecting emotional desensitization, were stronger at lower levels of proximity, whereas positive linear associations emerged at higher levels of proximity. Associations between CVE and more externalizing behaviors were stronger at low, compared to high, levels of proximity. Internalizing symptoms and cognitions supporting aggression partially mediated the association between CVE and externalizing behaviors. Further, latent profile analysis revealed that distinct groups of individuals were classified based on cumulative frequency of CVE and types of violent experiences. Thus, route of exposure, relationship to the victims of violence, and type of violence are each salient characteristics of CVE that may relate differentially to adjustment.

<p>The main aim of the current study is to examine the relationship between community violence exposure and the development of psychopathology and examine the relationship between community violence exposure and other types of trauma, that is, childhood trauma and stressful life events. It was hypothesised that exposure to community violence will have a high correlation with development of psychological disorders such as mood and anxiety and psychotic disorders. The main study employed a quantitative research design in order to determine the relationship between PTSD in children and adolescents. The current study used secondary data to measure the correlation between exposure to community violence and the development of psychopathology. The data for this study was collected from 132 consecutive referrals between the ages of 13 to 19 (mean age = 15.4, SD = 1.6) from a youth stress clinic at a university in the Western Cape. Findings indicated that community violence prevalence was higher than previous South African studies but lower compared to American studies. There was generally a high prevalence of PTSD and major depressive disorder (MDD) in this sample compared to previous South African studies. An unexpected outcome was that even though there was a high prevalence of PTSD, there was no relationship between community violence exposure and PTSD in this sample, rather, community violence exposure was related to MDD. Furthermore, MDD and not PTSD was related to experiences of childhood trauma. Stressful life events were related to acute stress disorder (ASD).</p>

<p>The main aim of the current study is to examine the relationship between community violence exposure and the development of psychopathology and examine the relationship between community violence exposure and other types of trauma, that is, childhood trauma and stressful life events. It was hypothesised that exposure to community violence will have a high correlation with development of psychological disorders such as mood and anxiety and psychotic disorders. The main study employed a quantitative research design in order to determine the relationship between PTSD in children and adolescents. The current study used secondary data to measure the correlation between exposure to community violence and the development of psychopathology. The data for this study was collected from 132 consecutive referrals between the ages of 13 to 19 (mean age = 15.4, SD = 1.6) from a youth stress clinic at a university in the Western Cape. Findings indicated that community violence prevalence was higher than previous South African studies but lower compared to American studies. There was generally a high prevalence of PTSD and major depressive disorder (MDD) in this sample compared to previous South African studies. An unexpected outcome was that even though there was a high prevalence of PTSD, there was no relationship between community violence exposure and PTSD in this sample, rather, community violence exposure was related to MDD. Furthermore, MDD and not PTSD was related to experiences of childhood trauma. Stressful life events were related to acute stress disorder (ASD).</p>

Magister Artium (Psychology) - MA(Psych) / Given that numerous research studies have established the important role that attachment plays in the development of internalizing disorders in children, it is important to ensure that the clinical psychologists working within this population and within this category of disorders are aware of this link. This will help ensure that they intervene adequately and appropriately. Although there is some emerging research on psychologists' perceptions and practices regarding the assessment of internalizing disorders, there is very little available information to date specifically addressing clinical psychologists' perceptions and understandings regarding the influence of attachment on the development of internalizing disorders in children. This study aimed to explore how clinical psychologists operationalize internalizing disorders in children and how they understand the link between infant-caregiver attachment and internalizing disorders in children. Parents/caregivers from low income, high violence communities are a vulnerable group in South Africa, and as a result, it is becoming increasingly important to explore how clinicians understand the development of children growing up in conditions where the nature of parenting is taking place under conditions of pervasive adversity. As such, this study explored the perceptions of clinical psychologists working in low income, high violence communities within Cape Town. This research was conducted using a qualitative research approach that makes use of in-depth individual interviews. Semi-structured interviews were conducted, and then transcribed and analysed using thematic analysis. A sample size of eight participants was recruited using a purposive, snowball sampling technique. All ethical considerations were adhered to and appropriate ethical clearance was obtained from all relevant ethical committees. Object relations theory provided the theoretical framework through which data was interpreted. A specific focus on attachment theory was incorporated. Findings suggest that although clinicians acknowledge and accept the important influencing factor of infant-caregiver attachment on the development of internalizing disorders in children, very few clinical psychologists make use of attachment theory as their primary theoretical or therapeutic orientation. Participants highlighted the importance of an integrative approach to the understanding of childhood pathology and made reference to the fact that the impact of attachment relationships needs to be considered in conjunction with other risk factors that predispose children to the development of internalizing disorders. Given the importance that participants placed on systemic and contextual factors influencing the attachment relationship, future research could investigate the role of a multi-disciplinary approach to the treatment of internalizing disorders in children. Further research also needs to be conducted that examines the efficacy of attachment-based conceptualizations and interventions in diminishing internalizing problems in children, and the way that these are perceived by the clinical psychologists working with these behaviours.

Magister Psychologiae - MPsych / The main aim of the current study is to examine the relationship between community violence exposure and the development of psychopathology and examine the relationship between community violence exposure and other types of trauma, that is, childhood trauma and stressful life events. It was hypothesised that exposure to community violence will have a high correlation with development of psychological disorders such as mood and anxiety and psychotic disorders. The main study employed a quantitative research design in order to determine the relationship between PTSD in children and adolescents. The current study used secondary data to measure the correlation between exposure to community violence and the development of psychopathology. The data for this study was collected from 132 consecutive referrals between the ages of 13 to 19 (mean age = 15.4, SD = 1.6) from a youth stress clinic at a university in the Western Cape. Findings indicated that community violence prevalence was higher than previous South African studies but lower compared to American studies. There was generally a high prevalence of PTSD and major depressive disorder (MDD) in this sample compared to previous South African studies. An unexpected outcome was that even though there was a high prevalence of PTSD, there was no relationship between community violence exposure and PTSD in this sample, rather, community violence exposure was related to MDD. Furthermore, MDD and not PTSD was related to experiences of childhood trauma. Stressful life events were related to acute stress disorder (ASD). / South Africa

Children in the United States are exposed to considerable community violence that has been linked to child functioning. However, not all those exposed, experience negative outcomes. Recent research has focused on factors that "buffer" or protect children from negative consequences of violence exposure. The purpose of this investigation was to examine the potential buffering or moderating role of maternal acceptance in the relationship between community violence exposure and internalizing and externalizing problems. Subjects were 268 urban African American first graders. Community violence exposure was significantly related to symptoms of post-traumatic stress, but did not correlate with either internalizing or externalizing problems for all children, after control for demographics, maternal mental health, and general life stress. However, children's perceptions of maternal acceptance moderated the relationship between violence exposure and internalizing and externalizing problems which included being withdrawn, anxious-depressed, and demonstrating delinquent behavior. Children with the lowest levels of self-reported maternal acceptance were most impacted by community violence. In this sample of urban first graders, low levels of maternal acceptance placed children at greater risk for adverse outcomes associated with community violence exposure compared to moderate and high levels of maternal acceptance.