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This cross-sectional investigation examined characteristics of ecstasy use during college and associations between ecstasy use during college and demographic factors, family functioning, mental health, and stage of change for ecstasy use. In addition a multivariate model was developed to predict characteristics of ecstasy use during college. An electronic survey was sent to all undergraduate students enrolled at a large urban university in the mid-Atlantic region of the United States during the spring of 2007. Demographic factors and characteristics of ecstasy use were examined using standardized measures employed in national drug use surveys and by the World Health Organization. Measures associated specifically with ecstasy use during college were developed for this investigation. Family functioning was measured with the Parent Adolescent Communication Scale. Mental health was measured with the K6 screening instrument for nonspecific psychological distress. Stage of change was measured with a five-stage algorithm. The final sample for analysis consisted of 194 participants who reported ecstasy use during college and 2849 participants who reported no ecstasy use during college. Data were described using conventional descriptive statistics, chi-square statistics and non-parametric statistics. A logistic regression model was used to identify variables associated with ecstasy use during college. Based on the results, the following generalized conclusions were drawn: ecstasy continues to be used by college students at large urban universities in the mid-Atlantic region of the United States; because the majority of college students reported using ecstasy for the first time during college and also reported using ecstasy for up to two years, it appears that the college environment is a contextual factor for ecstasy use; lower family communication is associated with ecstasy use during college; psychological distress is associated with ecstasy use during college; being white (versus non-white), male (versus female) and having low or moderate (versus high) family communication each is independently associated with ecstasy use during college; differences in stage of change for ecstasy use among ecstasy users and the demographic profile of ecstasy users compared to non-ecstasy users suggest that prevention, education and intervention efforts should be designed to match the unique factors associated with ecstasy use during college. / Public Health

Concussions are a common type of traumatic brain injury resulting in a series of physical, emotional, and psychosocial symptoms. Following a concussion, emotional processing is thought to be altered through small functional and structural disruptions that impact information processing pathways, which may eventually manifest as behavioral impairments. Thus, the use of both behavioral and functional outcomes may be effective for assessing the changes in emotional processing that may occur following a concussion. The primary purpose of this study was to examine behavioral and neurocognitive differences in response to emotional face images between individuals with and without a history of concussion. Fifty participants (18 female; 32 male) were recruited and assigned to either the concussed (n = 23; Mage = 24.1 ± 1.0) or non-concussed (n = 27; Mage = 23.2 ± 0.6) group based on medical and self-reported concussion history. Participants completed a modified emotional oddball paradigm where representative positive (smiling), negative (frowning), and neutral faces from the Radboud Faces Database were displayed. Neuroelectric measures of P3 amplitude and latency, as well as behavioral measures of response accuracy and reaction time were assessed during the experiment. The concussion group showed significant reductions in accuracy, but no difference in reaction time compared to the non-concussed group. An increase (i.e., slower) in P3 latency was also found in the concussed group, with no observed group differences in P3 amplitude. Findings suggest that concussions may lead to chronic neuroelectric and behavioral deficits in classifying emotional, facial expressions.

Mental health is an intrinsic capability that constitute an essential component of healthy aging. Mental health is constituted by positive constructs such as happiness and negative constructs (mental disorders) such as depression. As people grow older, they become more prone to developing mental disorders which are linked to poorer quality of life, increased disability, increased utilization and cost of health services, and higher rates of suicide. This dissertation involved three studies that focused on factors that predict change in mental disorders and happiness of older Americans over a period of five years. Two waves of publicly available national representative data from the National Social Life Health and Aging Project (NSHAP) collected in 2010 and 2015 were used. A total of 2210 older adults within the ages 62-90 years were used in the analyses. Mental health measures were CES-Depression scale, HADS anxiety scale, and self-rated happiness. Essay 1 aimed to identify the important aspects of older adults' interaction with their neighborhood that predict the presence of mental disorder and happiness. Essay 2 evaluated the psychosocial factors that predict change in mental disorder and happiness of older adults, whereas essay 3 investigated the multifactorial determinants of change in mental disorder and happiness of older adults. These three essays provide insight into the impact of mental health in old age and the role of environmental, social, and demographic factors in successful aging. It also provides gaps for future research in the field of mental health and aging.

Congenital heart disease is the most common birth defect globally, affecting both children and their families. Twenty –five percent of children experiencing a CHD birth defect are diagnosed with complex CHD (cCHD), signifying critical heart dysfunction requiring one or more open-heart surgeries during the first year of life. With medical advances, cCHD survival rates have almost tripled in the last three decades. This has resulted in an increase in the number of morbidities associated with cCHD, which is drastically impacting the need to support quality of life outcomes for a child with cCHD and their family. The two most prevalent unaddressed risks for quality of life outcomes in the cCHD population are child and caregiver mental health and child's neurodevelopmental disabilities. Congenital heart disease is the most common birth defect globally, affecting both children and their families. Twenty-five percent of children experiencing a CHD birth defect are diagnosed with complex CHD (cCHD), signifying critical heart dysfunction requiring one or more open-heart surgeries during the first year of life. With medical advances, cCHD survival rates have almost tripled in the last three decades. This has resulted in an increase in the number of morbidities associated with cCHD, which is drastically impacting the need to support quality of life outcomes for a child with cCHD and their family. The two most prevalent unaddressed risks for quality of life outcomes in the cCHD population are child and caregiver mental health and child's neurodevelopmental disabilities. The present study sought to address the relationship between caregiver knowledge of cCHD developmental challenges (i.e., outcomes related to neurodevelopmental disabilities, mental health, and provider quality-care approach) and children's and caregiver's quality of life outcomes, inclusive of academic functioning ability of children with cCHD, children with cCHD and their caregivers' mental health functioning, and the overall satisfaction with the nature of the healthcare provider of the child with cCHD. A total sample size of N = 46 participants were included in the current study. Results that caregivers' knowledge of cCHD risks to quality of life outcomes explained a much greater percentage of the variance in caregiver satisfaction with healthcare providers (R2 = 0.350, p < 0.001) compared to number of surgical interventions (R2 = 0.058, p = 0.047). Clinical implications and implementation for use of a holistic, integrated approach are strengthened by the study findings.

The effectiveness of a pre-graduation animal assisted therapy internship site was investigated through an ethnographic, phenomenological methodology with mixed-methods components. A total of 12 participants who fit into either the category of supervisor, intern, or administrator involved in the animal assisted therapy practice, were interviewed. A research team analyzed the qualitative interview data and researcher participant field notes and came to a consensus of eight major themes: ranch environment, ranch modalities, community impact, counselor development, relationships, partnership, sense of purpose, and the COVID-19 pandemic. Past historical client data were analyzed (n = 47) to investigate effectiveness of the AAT internship cite through the lens of the clients. Historical client data was divided into three categories, dependent on the client's age and the assessment taken: Adult Self Report (ASR), Youth Self Report (YSR), and Child Behavior Checklist (CBCL). A paired t-test was run for each assessment group to compare the means of the pre-assessment scores and the means of the post assessment scores for the total problems scale and anxiety problems scale. There was a statistically significant decrease in anxiety problems for the CBCL group. There was a marginally statistically significant decrease in total problems for the CBCL group. There were no significant results found for the YSR or ASR data. Client demographic findings and the statistically significant findings are discussed in relation to the qualitative themes. Implications for future research and counselor education are discussed.

Undergraduate nursing students face tremendous stress in regards to academic and clinical demands while emotional intelligence (EI) is a topic of interest in the nursing field. This study examined whether problem-focused coping methods for stress are related to ability and personality. In this study, EI represented ability and locus of control (LOC) represented personality. Confrontive coping, seeking social support, and planful problem-solving represented the problem-focused coping variables. A survey instrument which represented a combination of the Assessing Emotions Scale, Perceived Stress Scale, Ways of Coping Scale (Revised), and the Rotter Locus of Control Scale was administered to 11 undergraduate nursing schools during the spring semester of 2019. The results indicated that EI had strong and statistically significant correlations with each of the other variables in the study which were LOC, stress, confrontive coping, seeking social support, and planful problem-solving. The results further supported that EI was a statistically significant predictor for each of the three problem-focused coping variables. It was concluded that level of stress did not mediate the relationship between EI and any of the three problem-focused coping methods. In addition, LOC moderated the relationship between EI and stress. The limitations and possibilities for future research are addressed in this study. Specifically, future research should examine specific stressful encounters in addition to the participants' perception on if the stressful encounter was impactful and if the participant had the resources to cope with the stressful encounter. This information would provide insight into each participant's primary and secondary appraisals.

Doctor of Philosophy / Department of Family Studies and Human Services / Anthony Jurich / Ann Murray / Despite the intensified research efforts into the field of Infant Mental Health and Marriage and Family Therapy, a truly systemically designed program has not been developed. This formative evaluation study illuminates the design phase, its developmental process, and the professional staff member’s experience of this newly implemented “Options” program. I focused specifically on Crawford County Community Mental Health Center’s innovative systemic approach to issues related to infant mental health. In this body of work, I describe the process of creating this innovative approach, identified how the program originators made decisions about their approach and how the approach is being operationalized on a daily basis by interviewing the clinicians, who are providing the services and the administrators who created and oversee the program. I utilized a qualitative approach in the design, transcription categorization, and data analysis. This formative evaluation used the “flashback approach” to tell the story of the evaluation findings, this included an Executive Summary. This study’s exploration yielded a clearer understanding of the developmental process of the infant mental health program and its initial implementation. The results of this evaluation revealed that there are a number of core program components (three levels of focus: child and family, program, and community and catchment area) that were organized and clearly disseminated throughout the staff. The interviews revealed that the program has encountered problematic issues including; policy and procedural agreements and mandates, staff turnover, program ownership and funding limitations. It grew increasingly clear that the value of the program’s positive impact on families outweighed the perceived hassle of establishing and implementing the program. This evaluation produced a number of program recommendations for program perpetuation and potential improvements. The program recommendations addressed the challenges facing the “Options Program” are explained. The future research implications of this formative evaluation are enumerated.

Les études sont mitigées sur les séquelles cognitives des commotions cérébrales, certaines suggèrent qu’elles se résorbent rapidement tandis que d’autres indiquent qu’elles persistent dans le temps. Par contre, aucunes données n’existent pour indiquer si une tâche cognitive comme l’imagerie mentale visuelle fait ressortir des séquelles à la suite d’une commotion cérébrale. Ainsi, la présente étude a pour objet d’évaluer l’effet des commotions cérébrales d’origine sportive sur la capacité d’imagerie mentale visuelle d’objets et d’imagerie spatiale des athlètes. Afin de répondre à cet objectif, nous comparons les capacités d’imagerie mentale chez des joueurs de football masculins de calibre universitaire sans historique répertorié de commotions cérébrales (n=15) et chez un second groupe d’athlète ayant été victime d’au moins une commotion cérébrale (n=15). Notre hypothèse est que les athlètes non-commotionnés ont une meilleure imagerie mentale que les athlètes commotionnés. Les résultats infirment notre hypothèse. Les athlètes commotionnés performent aussi bien que les athlètes non-commotionnés aux trois tests suivants : Paper Folding Test (PFT), Visual Object Identification Task (VOIT) et Vividness of Visual Imagery Questionnaire (VVIQ). De plus, ni le nombre de commotions cérébrales ni le temps écoulé depuis la dernière commotion cérébrale n’influent sur la performance des athlètes commotionnés. / The research is mitigated on the cognitive after-effects of a concussion. Some studies suggest the effects disappear rapidly whereas others observe a continuation in their manifestation. However, no research has been done to indicate whether a cognitive task like mental imagery brings out these effects following a concussion. This study will evaluate the effects of sport-related concussions on object and spatial visual mental imagery of athletes. To achieve this goal, we compare the mental imagery capacity between two groups of male football athletes of University level. The first group (n=15) with no history of concussions and the second group (n=15) with one or more concussions. We hypothesize that the non-concussed athletes visualize better than the concussed athletes. Our results invalidate our hypothesis. Both groups have similar results on the three following measures: Paper Folding Test (PFT), Visual Object Identification Task (VOIT) and Vividness of Visual Imagery Questionnaire (VVIQ). Furthermore, the quantity of concussions and the time past since the last concussion seems to have no impact on the visual mental imagery performance of concussed athletes.

Les écrits rapportent qu’entre 10% et 40% des personnes atteintes de troubles mentaux ont présenté des comportements agressifs depuis l’établissement du diagnostic, et qu’entre 50% et 65% de ces comportements sont perpétrés envers les membres de la famille (Estroff et al., 1998). Or, les aidants naturels se sentent fréquemment démunis devant le comportement impulsif et agressif de leur proche atteint d’un trouble de santé mentale (Bonin & Lavoie-Tremblay, 2010) et la majorité des proches aidants ne reçoivent pas de soutien professionnel (Doornbos, 2001). À cet effet, une équipe de chercheurs et d’organismes communautaires ont mis sur pied un projet de formation adaptée par et pour les familles relativement à la gestion des comportements agressifs de leur proche atteint d’un trouble de santé mentale s’appuyant sur l’approche OMEGA communautaire (Bonin et al., 2011). La présente recherche est inspirée du modèle de Fresan et ses collaborateurs (2007), qui inclut les familles et leur proche atteint dans la prévention de la rechute et le rétablissement de ce dernier. Cette étude avait donc pour but de décrire et analyser, par un devis mixte, les perceptions de l’agressivité, du fonctionnement familial ainsi que de l’observance au traitement médical de personnes atteintes de troubles mentaux, suite à une formation de gestion des comportements agressifs adaptée par et pour des membres de familles, et suivie par leur proche aidant. Des questionnaires auto-administrés ont été remis et complétés par 25 personnes atteintes et comprenaient trois instruments qui étaient : 1. un questionnaire sociodémographique; 2. le Basis-24 (Eisen, 2007) permettant d’évaluer la condition mentale de la personne atteinte; 3. l’Échelle de perception de l’agressivité permettant de mesurer la fréquence et le niveau des comportements agressifs (De Benedictis et al., 2011); et 4. l'Échelle du fonctionnement familial permettant de mesurer le fonctionnement familial (Epstein, Baldwin, & Bishop, 1983). Des questions supplémentaires au questionnaire portaient sur l’observance au traitement médical et sur les changements observés. Des analyses descriptives et corrélationnelles bivariées ont été réalisées pour analyser les données quantitatives. Par la suite, des entrevues individuelles ont été réalisées auprès de huit personnes atteintes de troubles mentaux dont le membre de famille avait suivi la formation de gestion des comportements agressifs. La méthode d’analyse classique de Miles et Huberman (2003) a été utilisée pour réaliser l’analyse des données. L’analyse des données a permis de dégager les perceptions des personnes atteintes de troubles mentaux au regard de la formation de gestion des comportements agressifs que leur membre de famille avait suivi. Ainsi, le programme de formation OMÉGA adaptée par et pour les familles permettrait d’une part de diminuer l’agressivité et, d’autre part, d’améliorer le climat familial. De plus, selon les personnes atteintes, leur membre de famille était plus à l’écoute et faisait moins preuve d’intrusion, ce qui diminuaient les conflits et favorisaient une meilleure dynamique familiale. Cette étude a mis en évidence qu’il est nécessaire d’impliquer les familles dans les programmes de prévention de la rechute de la maladie mentale dans les soins de première ligne. Cette étude contribue ainsi à l’amélioration des connaissances sur la dynamique famille-patient et sur le rétablissement des personnes atteintes de troubles mentaux. Aussi, cette recherche propose des recommandations pour la recherche, la pratique, la formation et la gestion en sciences infirmières. / Literature reports that between 10% and 40% of people with mental disorders showed aggressive behavior since establishing the diagnosis, and between 50% and 65% of these behaviors are perpetrated against members of the family (Estroff et al. 1998). However, caregivers often feel helpless in the face of impulsive and aggressive behavior of their loved one with a mental health disorder (Bonin & Lavoie-Tremblay, 2010) and the majority of caregivers do not receive professional support (Doornbos, 2001). For this purpose, a team of researchers and community organizations have established a training adapted by and for families in relation to the management of aggressive behavior of their loved one with a mental health disorder based on Community OMEGA approach (Bonin et al., 2011). This research was inspired by the Fresan and collaborators' model (2007), which includes families and their loved ones achieved in the prevention of relapse and recovery thereof. Using a mixed-design, the study aimed to describe and analyze, perceptions of aggression, family functioning and adherence to medical treatment of people with mental disorders, following a training about aggressive behavior management training adapted by and for family members and to which their caregiver attended. Self-administered questionnaires were distributed and completed by 25 people and included three instruments: 1. a sociodemographic questionnaire; 2) the Basis-24 (Eisen, 2007) to assess the mental condition of the person; 3. the perception of aggressiveness scale (POAS) to measure the frequency and the level of aggressive behavior (De Benedictis et al., 2011; and 4. the family assessment device (FAD) to measure family functioning (Epstein, Baldwin, & Bishop, 1983). Additional questions to the questionnaire focused on adherence to medical treatment and the observed changes. Descriptive correlative analyzes and T-test were performed to analyze quantitative data. Thereafter, individual interviews were held with eight persons with mental disorders whose family member was trained in management of aggressive behavior. The classical method of analysis of Miles and Huberman (2003) was used to perform data analysis. The data analysis allowed to identified the perceptions of people with mental disorders with regard to training in managing aggressive behavior that their family member had followed. Thus, the OMEGA training program adapted by and for family members would help on the one hand reducing aggression and on the other hand, improve family atmosphere. Moreover, according to the persons with mental disorders, their family member was more attentive and less intrusive, which decreased conflict and promoted better family dynamics. This study has highlighted the need to involve families in prevention programs about relapse of mental illness in primary care. This study contributes to the improvement of knowledge on the patient and family dynamics and on the recovery of people with mental disorders. Also, this research provides recommendations for research, practice, education and management in nursing.