Sixteen women who had had hysterectomies and eighteen women who had had mastectomies were mailed the Oregon Sex Inventory to see if any significant differences in sexual behavior occurred before or after surgery. The mastectomy group showed a greater degree of change in their sexual behavior than the hysterectomy group. The mastectomy group reported a decrease in the importance of the breast during the sexual act after surgery and a decrease in their desire for intercourse after surgery. The hysterectomy group reported lowered sexual satisfaction after surgery. The changes reported in this study although relatively small are statistically significant. The sample, because of the high income and education level may reflect some bias. The questionnaires were randomly sent but the women in both groups who responded seem to represent a definite socio-economic class of our society. It is of interest to note that this is the first research study done on mastectomies that used a control group.

Sexual behavior is a normative part of adolescence and it is important to understand how familial factors influence Latina/o adolescents’ sexual health. The current study examined two structural equation models (SEM) and the associations between familial cultural values (i.e., familismo and filial piety), maternal and paternal monitoring (i.e., disclosure and solicitation) and Latina/o adolescent’s sexual behavior (i.e., intentions to have sex, sexual behavior, sexual responsibility). A hypothesized SEM examined whether paternal/maternal monitoring mediated the relation between familial cultural values and adolescents’ sexual health, while an alternative SEM examined whether familial cultural values mediated the association between paternal/maternal monitoring and adolescents’ sexual health. Participants included 1,024 Mexican adolescents (54% female) between the ages 12-18. Results showed that the overall hypothesized SEM had excellent fit indices. Filial piety was associated with favorable sexual health outcomes and increased parental monitoring. Maternal disclosure was associated with lower intention to have sex and more sexual responsibility, while paternal solicitation was associated higher intention to have sex. Sex differences were found after conducting a chi-square difference tests and partially constraining the model. For Latino adolescents, paternal child disclosure and solicitation was associated with intentions to have sex. For Latina adolescents, familismo was associated with more maternal disclosure. Mediational analysis showed that for Latino adolescents, more reported filial piety was associated with more paternal solicitation and disclosure, which was then associated with lower and higher intentions to have sex, respectively. The alternative SEM had excellent fit indices, however, no sex differences were found. Mediational analyses were conducted with the unconstrained model while controlling for sex. Mediational pathways showed that maternal disclosure was positively associated with filial piety, which was associated with lower intention to have sex sexual intention and more sexual responsibility. Findings indicate that family cultural values and paternal monitoring may influence Latino adolescent’s intention to have sex. Additionally, filial piety should be considered as a protective factor for Latina/o adolescents’ sexual health. These findings can inform prevention programs targeting Latina/o families. Furthermore, a greater emphasis should be placed on the importance paternal monitoring and filial piety given their associations with Latino adolescents’ sexual health.

Many studies reported that childhood abuse and stress play contributory roles in the development and maintenance of disordered eating behaviors. However, these studies made no mentioned efforts to validate their self-report data, and thus failed to separate the effects of actuality versus perception of childhood abuse. Thus, the current study examined how perceptions of childhood abuse and life stress affect binge eating behavior among university students. Participants for the current study included 173 undergraduate students, recruited via Study Board. After giving verbal consent, participants completed a series of surveys and questionnaires that collected demographic data, and measured perception of abuse, perceived stress levels and binge eating activity. Upon completion, participants were given either course credits or extra credits, to be given at the discretion of their professors. Results indicated that all of the hypotheses were supported. There were significant differences between the perception of abuse and the perceived life stress conditions (respectively). Furthermore, both of the independent variables were shown to be predictive of binge eating behavior. However, there was no interaction effect between the two independent variables. Moreover, these two variables did not moderate each other in terms of predicting binge eating behavior among university students. Findings from this study indicated that perceptions of childhood abuse and recent life stress are both predictive of binge eating activity among university students, which was highest among individuals with a perceived history of childhood abuse. While findings from this study showed a correlation between perception of abuse and binge eating behavior, they did not show a correlation between reporting of actual incidents of childhood abuse and binge eating behavior. There were a number of limitations to the study, including limited generalizability of the findings, limited reliability of self-report measures, and any confounding of analyzed data due to order effect. Future studies are encouraged to further explore the relationship between perception and actuality of childhood abuse.

<p> Surveillance and epidemiological studies over the last number of years show that HIV incidence has remained relatively stable, and even increased in some populations. Ironically, some of the most substantial increases have been seen in the very populations that have been most heavily targeted for HIV prevention interventions. This suggests that current prevention models, which primarily emphasize rational thought process, may be neglecting some important mechanisms that influence or cause high-risk sexual behavior. This study examines how non-rational thought processes may relate to high-risk sexual behavior in the face of social stressors. Grounded in Carver&rsquo;s &amp; Scheier&rsquo;s (1996, 1998) Self-Regulatory Failure Model, which suggests that under certain circumstances, individuals may shift from abstract goals to more immediate sensory oriented goals. I explored a model that includes gay-related discrimination, hate crimes, and social stressors as predictors of high-risk sexual behavior, mediated by negative affect. I also explore whether the putative link between negative affect and high-risk sexual behavior is moderated by sensation seeking and avoidant coping personality styles. Lastly, I conducted exploratory analyses on the role alcohol may play in this model. The study employed a two stage purposive sampling procedure: First, 20 different U.S. media markets were selected at random; and next, individuals were recruited from within those media markets to participate in an online survey about these topics. Because the outcome data were counts of sexual behavior with a large proportion of zero responses, I employed Zero Inflated Poisson regression modeling. This modeling procedure allows one to examine if different variables predict initiation of behavior versus frequency of behavior. The results show partial support for the hypothesized model. Interpersonal stressors and discrimination appear to be consistent predictors of high-risk sexual behavior in this sample; however, the relationship to the outcomes differ for initiation of behavior as opposed to frequency of behavior, and further by type of sexual behavior. Hate crime rates showed little ability to predict high-risk sexual behavior outcomes. There is tentative evidence for distancing forms of coping as moderators of the relationship between negative affect and high-risk sexual behavior. Negative affect did not emerge as a mediator in the primary model examined in this study; although, negative affect was independently related to some sexual behavior outcomes. When alcohol use during sex was added as part of the exploratory analyses, negative affect emerged as a mediator for some high-risk sexual behavior outcomes. Exploratory analyses also revealed relationships between alcohol with sex, discrimination, and social stressors that suggest a strong interplay between all four variables and the sexual behavior outcomes. Hate crimes, however, were still mostly unrelated to high-risk sexual behavior in the exploratory analyses. Overall, these results point to a dynamic, complex, and non-linear set of relationships between interpersonal stressors, affect, sexual behavior, and alcohol use. Larger sample sizes, longitudinal study designs, and more granular measures of affect may help to clarify the causal relationships between these constructs. These results have implications for prevention interventions that emphasize emotional self-regulation at the individual level and address discrimination and stigma at a structural level.</p>

<p> Every year approximately 17,000 adolescents ages 15-19 become pregnant in New York City. Most of these pregnancies are unintended and only a small percent of adolescents use effective contraception, with wide disparities by race/ethnicity and poverty level. While many studies have identified factors associated with contraceptive use, most research has focused on individual level factors, with little attention to the contribution of the school environment to sexual risk behavior and contraceptive use. This study investigates the effect of school-level factors on contraceptive use among adolescents in NYC public high schools before and after controlling for individual-level factors, and whether this effect varies with race/ethnicity. Using a cross-sectional design, the NYC Youth Risk Behavior Survey (YRBS) individual-level datasets for 2007, 2009 and 2011 were linked to a school-level dataset. Variables were selected based on empirical findings on factors associated with sexual behaviors, including contraceptive use, by adolescents. The analytic sample included all YRBS respondents aged 14 or older who reported having sexual intercourse in the past three months and had complete responses to the YRBS questions on contraceptive use at last sex (N=8,054). The chi square test of significance was used to evaluate significant associations between independent variables and contraceptive use in bivariate analyses; variables with a p value &lt; 0.1 were included in the multivariable analyses. Binary and multinomial logistic regression analyses were conducted to estimate the strength of the associations of school-level factors with contraceptive use among sexually active adolescents. Findings included that use of any contraception and/or hormonal contraception at last sexual intercourse was associated with attending schools with a higher six-year graduation rate, higher percent of students strongly agreeing they were safe in their classrooms, higher percent of teachers at the school for over two years, and having a School-Based Health Center (SBHC) in the building. No known study has examined the contribution of school-level effects to contraceptive use in a dataset linking YRBS and school-level datasets. Implications of research findings are that schools providing a supportive, engaging and safe environment can protect students from sexual risk behaviors and increase contraceptive use among sexually active adolescents. &#8195; </p>

<p> The purpose of this study was to determine the impact of group supervision on counseling self-efficacy of master's-level counseling internship students. Larson's (1998a) Social Cognitive Model of Counselor Training (SCMCT) was used as the theoretical framework for the study. SCMCT addresses how counseling knowledge is transitioned to counseling action. The study was a quantitative, causal-comparative research design. The participants were 135 master's-level counseling internship students from a CACREP-accredited, private college in the southeast United States. Data was collected through the administration of online surveys: Counseling Self-Estimate Inventory (COSE; Larson et al., 1992), Group Supervision Impact Scale (GSIS; Getzelman, 2003), Supervisory Styles Inventory (SSI; Friedlander &amp; Ward, 1984), and a demographics survey. Group supervisor impact (r = .227, p = .008), peer supervisee impact (r = .240, p = .004), and group supervision environment impact (r = .358, p &lt; .001) were significantly correlated with counseling efficacy. Group supervision environment impact was the best predictor variable of counseling self-efficacy, b = .773, t(127) = 3.210, p = .002. There was no significant difference in counseling self-efficacy between participants with master's-level group supervisors and participants with doctorate-level group supervisors, t(133) = .586, p = .559. There was no significant difference in counseling self-efficacy between participants who had a group supervisor licensed in professional counseling and participants who had a group supervisor licensed in a different field, t(133) = .125, p = .901.</p>

<p> The purpose of this study was to identify potential predictors of alcohol screening and brief intervention outcomes for severe-risk drinkers. Specifically, age, gender, race, blood alcohol level, counseling intervention type, type of injury, hazardous alcohol use, symptoms of alcohol dependence and harmful alcohol use were examined to see whether the variables were able to predict reduction to low-risk levels among severe-risk participants. A total of 101 participants were included in this research study. The variables were collected at baseline via the screening process of the alcohol screening and brief intervention (ASBI) procedures. The AUDIT (Babor et al., 2001) instrument was utilized to gather the hazardous alcohol use, symptoms of alcohol dependence, and harmful alcohol use variables. The other variables were gathered from participant self report. </p><p> Two logistic regression analyses were conducted to analyze the data in SPSS. The analysis indicated that one variable was statistically significant, blood alcohol level. The odds ratio of .993 suggested that for every one unit increase in blood alcohol level, a severe-risk participant was .993 times as likely to reduce their drinking to low-risk at six month follow-up. These findings show little support for the individual predictors examined within this analysis, which were all completed during the screening phase of the ASBI process. This lack of significance for individual predictors emphasizes the need for future research to examine the components of a successful brief counseling intervention.</p>

<p> Multidisciplinary scholars have argued the importance of nature in human health for the past several decades (Kellert &amp; Wilson, 1993; Roszak, 1992), and numerous researchers have identified the positive effects of nature on human wellness (Brymer, Cuddihy, &amp; Sharma-Brymer, 2010; Kuo, 2010). The profession of counseling is based on the philosophy of human wellness (Myers, 1992), although the current multidisciplinary wellness models (Myers &amp; Sweeney, 2008) seem to overlook the wellness benefits of nature. As a way to begin the systematic exploration of nature in professional counseling, Reese and Myers (2012) developed the construct of EcoWellness and described the construct as the missing link in holistic wellness models in counseling. They recommended that the next step in exploring the construct included the development of an instrument operationalizing EcoWellness and its underlying constructs. Thus, the purpose of this study was to develop and assess the initial validity and reliability of the Reese EcoWellness Inventory (REI). </p><p> The researcher utilized a six-step instrument development method that included the pilot testing of an initial 111-item instrument with a convenience sample of college students (<i>N</i> = 264). After modification of the REI, a revised 62-item instrument was tested and evaluated with a simple random sample recruited from Researchmatch.org (<i>N</i> = 853). Participants completed the REI, the Five-Factor Wellness Inventory (Myers &amp; Sweeney, 2005b), and the Marlowe-Crowne Social Desirability Scale Short Form (Strahan &amp; Gerbasi, 1972) in testing the initial validity and reliability of the REI. Results of confirmatory and exploratory factor analyses and the associated univariate tests demonstrated a mixed picture of the instrument's validity and reliability. A lower-level factor model was tested and it was found to possess adequate model fit. It was determined that the second-order factor of EcoWellness dictated the relationships between the lower-level factors. The development and testing of the REI provides an initial empirical foundation for the integration of nature into professional counseling and counselor education. Further research is needed to replicate and extend the study findings through utilizing samples more inclusive of national distributions of demographic characteristics such as age, gender, and ethnicity.</p>

<p> Throughout history, experiencing auditory hallucinations has been described as highly complex and personal. Although early research was conducted in attempts to understand the process and phenomenology of auditory hallucinations, in more recent years the ontological understanding of auditory hallucinations has evolved into inconclusive neural explanations, cognitive models of pathology and psychopharmacological treatments. Despite their importance, these avenues of inquiry attempt to ameliorate auditory hallucinations as a symptom rather than understand the experience for the hearer. In order to re-visit the experiential importance, this qualitative and phenomenological dissertation explored a deeper understanding of the lived experience of auditory hallucinations in the schizophrenic individual using a psychoanalytic (i.e. Lacanian) framework.</p>

<p> Physicians require discipline, determination, a tolerance for delayed gratification, and brainpower to navigate college, medical school, postgraduate education, and their personal and professional careers. A high degree of resilience is needed for this journey. Adding to research on the concept of resilience, this thesis recognizes two factors beyond one&rsquo;s control that influence one&rsquo;s capability for resilience: infant attachment pattern and adverse childhood experiences. Alchemical hermeneutic methodology was employed to examine the influence of these factors on the development of resilience and to explore the vulnerability of medical students and physicians to a failure of resilience. A heuristic approach taken to incorporate the author&rsquo;s experience and observations as a physician provides evidence of the pressures and potential pitfalls in physician lives. The author proposes changes in medical training and the structure of medical practice that take into account individuals&rsquo; strengths and limitations in regard to their capacity for resilience.</p>