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Proximal risk factors including household chaos, parenting and maternal distress can have a broad impact on multiple domains of child development and functioning. Using multiple methodologies including a meta-analysis and structural equation modeling with an empirical, cross-sectional design from a larger longitudinal research study; in this dissertation, I examine the impact of household chaos on child executive functioning, socioemotional and physiological stress outcomes, the role that parenting plays in this association, and how maternal distress predicts chaos in the home. In study 1, I conduct a meta-analysis examining the direct association between household chaos and child executive functioning, as well as multiple potential moderators (e.g. child age, sex and race/ethnicity). It incorporates 26 studies, with 27 independent effect sizes with a total sample of 8,944 children. Overall, I found a significant effect of r = .22 between household chaos and child executive function. Among the moderators assessed, only measurement approach of executive functions (informant-completed questionnaire versus direct assessment) was significant, with informant-completed questionnaires yielding an effect of r = .27 compared to direct assessment, r = .16. I conducted a series of separate moderation analyses for questionnaire and direct assessment effects. No significant moderators emerged from the questionnaire analyses, despite heterogeneous effect sizes. Direct assessment analyses revealed that both household chaos dimensions (disorganization and instability) were significantly related to child executive functions, however instability was a stronger correlate (r = .21) than disorganization (r = .09). Composition of the sample was also a significant moderator with effects increased with the proportion of minorities, and with parents with lower levels of education. Building on this work, in studies 2 and 3, I used cross-sectional empirical data from a sample of 137 mothers and their school-aged (5-year old) children. During home visits, mothers completed questionnaires assessing their mood, stressful experiences, the home environment and their child’s socioemotional functioning. Mothers also completed a video tour of the home. Mother-child interactions were videotaped and later coded for parenting. Both mothers and children independently completed behavioural assessments of executive function. Also, hair samples were collected from mothers and children from which the stress hormone, cortisol, was extracted as a biomarker of chronic stress. In order to empirically test the findings from the meta-analysis, in my second study, I used structural equation modeling to examine the indirect effect of household chaos on child executive functioning via parenting. I found that household chaos was directly and indirectly (via maternal cognitive sensitivity and emotional availability) associated with a latent variable of child executive functioning. Furthermore, instability, but not disorganization, significantly predicted child executive functioning directly and indirectly via parenting. Finally, sex-based analyses indicated that the effect of chaos on child executive functioning was significant through indirect effects only for boys. In the third study, in order to elucidate potential contributing factors to household chaos, I used a structural equation model to examine the indirect effects of a linear regression-weighted composite variable of maternal distress (depression, negative affect and physiological stress) on child hair cortisol levels and externalizing and internalizing behaviour problems via household chaos. I found that maternal distress had both direct and indirect effects (via household chaos) on child hair cortisol levels; however, only indirect effects were significant for externalizing and internalizing behaviour problems. Also, the indirect effect was only significant for household disorganization, but not instability, for child hair cortisol and externalizing and internalizing behaviour problems. Taken together, the findings from my dissertation demonstrate that: 1) household chaos has a direct, negative effect on child executive functioning and an indirect effect via parenting; and 2) maternal distress plays an important role in predicting the levels of chaos within the home which has implications for child chronic stress levels and behavioural problems. Collectively, these findings highlight the need to take a multi-method approach to measuring executive functioning in children and further, to develop and evaluate interventions that aim to support mothers, improve parenting and promote order and stability within the home in order to foster healthy developmental trajectories for children. / Dissertation / Doctor of Philosophy (PhD) / Children exposed to household chaos may experience adverse outcomes across multiple domains. Parenting can also be negatively affected by household chaos which may impact the quality of parent-child interactions. Further, the physical and psychological health of the mother may regulate the levels of chaos in the home which has implications for child outcomes as well. This dissertation seeks to examine the influence of household chaos on child executive functioning, stress levels and socioemotional functioning, and the roles that parenting and maternal distress play. I address three primary objectives: 1) using meta-analytic techniques, I examine the magnitude of effect of household chaos on child executive functioning based on existing literature as well as potential factors that may modulate the strength of the linkage between household chaos and child executive functioning; and using cross-sectional data, I examine 2) how household chaos impacts parenting and subsequently, how parenting impacts child executive functioning; and 3) how maternal distress influences the level of chaos in the home and how this chaos impacts child stress levels and socioemotional functioning. Collectively, the results from this dissertation indicate that household chaos has a broad negative impact on child outcomes, and both parenting and maternal distress play important roles in understanding this impact. Further, it demonstrates the need for intervention research aimed at supporting the physical and psychological health of mothers, improving parenting and creating order and stability in homes for children.

In his classic book, Experiencing Architecture, Rasmussen (1959) noted that architects inspired by addressing problems in built environments created buildings with a special spirit: a distinctive stamp. Recent problems in healthcare facilities, specifically those related to reducing stress and anxiety, have inspired designers to create positive, uplifting distractions to redirect a patient's attention from a sterile environment and/or noxious event. In doing so, healthcare facilities have become special environments with a caring spirit. This study examined a specific aspect of creating a caring environment: determining whether or not a positive distraction, a child's art-light mosaic movie developed by the researcher, would lower pain and distress in children 4, 5, and 6 years old during an immunization procedure. The researcher conducted a randomized controlled study in two locations using a child's self-report pain scale, heart rate, parent/guardian report, and nurse report measures. After collecting and analyzing data from 76 well-participants receiving one to five immunizations, the researcher found no statistically significant difference between the conditions for any of the measures. Thus, the null hypothesis, the art-light mosaic image would not assist in lowering pain and distress in pediatric patients, 4 to 6 years old, during an immunization procedure, was not rejected. From these results, the researcher recommended future studies incorporate training the parent and child on how to use the distraction, combine the distraction with a topical analgesic, provide a clear understanding of pain and distress from the child's point of view, and develop more sensitive self-report measures of pain for children. / Ph. D.

The immigrant paradox is the empirical trend that immigrants have better mental health than second and subsequent generations. Mossakowski (2007) found that Filipinos follow this trend, and using the same data this study builds upon the previous research by examining the relationship between cultural (ethnic identification, native language) and structural (nativity, age at immigration, and poverty in city of birth) variables. The results indicate that cultural variables are important in understanding psychological distress among Filipino Americans. Relative deprivation was not associated with psychological distress, and the effect of selective migration is explained away when language and ethnic identification are controlled. Use of native language benefits U.S. born and adult immigrant Filipinos, but is damaging to child immigrants with low ethnic identification. Suggestions for future research are discussed. / Master of Science

Emerging adulthood is a developmental period associated with increased engagement in health risk behaviors, particularly in college students with attention-deficit/hyperactivity disorder (ADHD), a disorder characterized by low distress tolerance and significant difficulty managing emotions. However, research has not examined how these factors impact propensity to engage in health risk behaviors in college students with ADHD. Thus, this study examined the independent and joint effects of ADHD status, emotion regulation, and distress tolerance on the propensity of college students to engage in health risk behaviors (alcohol use, impulsive eating, and drug behaviors). Participants included 143 undergraduate students (81.8% female; 44.1% with ADHD) who completed an online questionnaire via REDCap. Individuals with ADHD reported significantly higher use of maladaptive emotion regulation strategies and lower levels of distress tolerance than the comparison sample. Moderation models using the PROCESS macro for SPSS examined whether the associations between emotion regulation abilities and distress tolerance with health risk behavior engagement were moderated by ADHD diagnostic history. The relation between distress tolerance and engagement in drug use behaviors was moderated by ADHD status, such that for individuals with ADHD, poorer distress tolerance was associated with more drug use. ADHD status also moderated the association between maladaptive emotion regulation strategies and cognitive restraint in eating. For individuals without ADHD, more maladaptive emotion regulation was marginally predictive of less engagement in cognitive restraint around food, but this relation, was not significantly for college students with ADHD. Findings from this study provide insight into intervention targets for college students with ADHD, ultimately resulting in significantly decreased societal and personal health costs. / M.S. / Emerging adulthood is a developmental period associated with increased engagement in health risk behaviors, particularly in college students with attention-deficit/hyperactivity disorder (ADHD), a disorder characterized by low distress tolerance and significant difficulty managing emotions. However, research has not looked at how these factors impact odds of engaging in health risk behaviors in college students with ADHD. Thus, this study examined the independent and combined effects of ADHD status, emotion regulation, and distress tolerance on the propensity of college students to engage in health risk behaviors (alcohol use, impulsive eating, and drug behaviors). Participants included 143 undergraduate students (81.8% female; 44.1% with ADHD) who completed an online questionnaire via REDCap. Individuals with ADHD reported higher use of maladaptive emotion regulation strategies and decreased ability to tolerate distress than the comparison sample. The relation between distress tolerance and engagement in drug use behaviors was moderated by ADHD status, such that for individuals with ADHD, poorer ability to tolerate distress was associated with more drug use. ADHD status also moderated the association between maladaptive emotion regulation strategies and cognitive restraint in eating. For individuals without ADHD, more maladaptive emotion regulation was slightly predictive of less cognitive restraint around food, but this relation was not significant for college students with ADHD. Findings from this study provide insight into intervention targets for college students with ADHD, ultimately resulting in significantly decreased societal and personal health costs.

In this thesis, I propose an argument against the possibility of moral dilemmas, which I construe as situations in which moral wrongdoing is inescapable. The first chapter addresses some terminological matters and attempts to sort out the main issues of contention between proponents and opponents of moral dilemmas. The second chapter lays out my argument, which I dub the "Argument from Action-Guidingness," against proponents of moral dilemmas. Negative moral judgments of the sort "X is wrong" typically carry with them the implication that X ought not to be done. If judgments of wrongness always have this action-guiding force, then moral dilemmas, which say that all courses of action available to the agent are morally wrong, threaten morality with incoherence. To avoid this problem, proponents of dilemmas will be forced to abandon the action-guiding implications of negative moral judgments when dilemmas arise. But this move is not without its own difficulties, which I elucidate. The final chapter identifies flaws in two prominent arguments in favor of dilemmas: the argument from moral distress and the argument from incommensurable values. The latter half of the chapter examines Sayre-McCord's "fairness argument" against dilemmas, and contrasts it with the argument from action-guidingness. / Master of Arts