Master of Arts / Department of English / Elizabeth C. Dodd / At the age of 12, I developed a condition that caused me to hyperventilate, black out, and on occasion, experience horrific visions. Though the visions were sparse at first, they quickly increased in number as weeks progressed. In the eighth grade, they became a daily occurrence. Though at the time I knew there was something wrong with me, I had no idea what was causing my symptoms. Because the episodes caused many inconveniences and embarrassments, I withdrew from social activities and stopped attending school altogether. Believing that my problems were the result of a physical illness, my parents had my blood tested for diseases such as mononucleosis. I also underwent an MRI, which checked for any tumors or abnormalities in my brain. When all of my tests came back negative, I was referred to a psychiatrist. I told the psychiatrist about my inclination to avoid social activities, but refrained from telling her about the hallucinations. Despite my withheld information, she determined I had an extreme case of clinical depression and agoraphobia. Though I was comforted by the notion that I had been granted a diagnosis, I still found it impossible to leave my bedroom without having the strange episodes. As my symptoms of depression increased, my interest in living decreased. But with the help of family and close friends, I was able to persevere and accept my circumstances despite the discomfort they created in my world.

Doctor of Philosophy / Department of Family Studies and Human Services / Briana S. Goff / The purpose of this study was to review state disaster mental health response plans and actual disaster mental health responses to examine not only adherence to identified disaster mental health best practices, but also to highlight procedures being performed during deployment of disaster mental health response teams. This research study was developed to gain a thorough understanding of disaster mental health response in both the planning and implementation phases. Interviews with three state disaster mental health officials were completed and a review of each state’s disaster mental health state plan was completed. The study investigated the conclusiveness of state plans and their adherence to published best practices in three post 9/11 disasters: 2005 Hurricane Katrina response in Mississippi; 2007 Greensburg, Kansas tornado; and 2008 Indiana flooding. A phenomenological approach was used to identify themes in disaster mental health response that should be considered for future disaster mental health planning. Each state’s disaster mental health plan varied in compliance to identified best practices; however, it was noted that all states were more compliant to best practices in their response than in the written state disaster mental health state plan. Several themes for disaster mental health responses were identified that were not previously fully addressed in the published best practices. Such themes addressed issues in disaster mental health teams and training, local disaster mental health response, communication, research and data collection, relationships with external organizations, and long-term recovery. This research may serve as a guide for those developing disaster mental health plans and encourage further considerations in disaster mental health response.

Master of Science / Department of Family Studies and Human Services / Candyce S. Russell / As the number of Americans aged 60 and over increases substantially in the coming years, so is the incidence of depression among this age group. The purpose of this report is to explore the mental health needs of older Americans, the ways in which they are undiagnosed or under-diagnosed for depression, the clinical challenges associated with treating depression in the elderly, and the barriers that are in place due to social, psychological, financial and governmental factors. With the “Baby Boom” generation (those born between 1946-1964) entering their senior years, there will be an increased need for Marriage and Family Therapists to be cognizant of the rise in depression and familiar with the treatment options and limitations. Marriage and Family Therapists adhere to the Systems Theory and thus are uniquely qualified to act as a bridge between the medical and mental health communities. This report will promote the collaborative approach to healthcare and the way in which Marriage and Family Therapists can contribute to the treatment of depression in the aged.

Doctor of Philosophy / Department of Family Studies and Human Services / Briana S. Goff / The purpose of the current study is to understand the lived experiences of military couples regarding the effects of war-related trauma and deployment on couple functioning. An interpretive phenomenological perspective was utilized during data analysis. This type of phenomenological perspective suggests that human phenomena can only be understood in a situated context (Packer & Addison, 1989). This is to suggest that a person’s emotions, behaviors, and experiences cannot be separated from the context in which they occur. For the purpose of this study, the “context” under consideration was the Army culture and customs in which each of the participant couples was embedded. The Couple Adaptation to Traumatic Stress Model (CATS; Nelson Goff & Smith, 2005) offers a constructive step forward in systemically understanding and treating the impediments created by war-related trauma and deployment. The current study utilized the core terms included in the CATS Model (Nelson Goff & Smith, 2005) as sensitizing concepts to guide the qualitative analysis process. This includes the CATS Model couple functioning variables of attachment, satisfaction, stability, adaptability, support/nurturance, power, intimacy, communication, conflict, and roles. Using qualitative interviews from 90 participants (n = 45 couples), five themes were identified as salient, including communication, conflict management, roles, support/nurturance, and post-traumatic growth. Participants were divided into subgroups (n = 15 couples, 30 total participants) according to their scores on the Purdue Post-Traumatic Stress Disorder Scale – Revised (PPTSD-R; Lauterbach & Vrana, 1996) and the Dyadic Adjustment Scale (DAS; Spanier, 1976). This subsample was selected to examine differences in themes among couples with high and low levels of marital satisfaction, as well as those with high and low levels of post-traumatic stress symptoms. Many similarities were found among the couples with high marital satisfaction and those with low levels of post-traumatic symptoms. Likewise, similarities were also discovered among the couples with lowest levels of marital satisfaction and those with highest levels of post-traumatic stress symptoms. From the current study, there is clear evidence in support of the CATS Model elements of communication, conflict, roles, support/nurturance, and satisfaction. A new contribution to the CATS Model can be made from the current study, which is the inclusion of post-traumatic growth.

Master of Science / Department of Family Studies and Human Services / Sandra M. Stith / Sexual violence, and sexual coercion in particular, is an understudied field, but research is beginning to show that males and females alike are perpetrators of sexual violence. Research has looked at predictors of sexual violence in males, but little research has looked at predictors of sexual violence in females. Similarly, little research has examined predictors of sexual violence in the context of dating relationships; therefore, this study examined predictors of sexual coercion in males and females within dating relationships. Using a sample of 305 male and 363 female undergraduate students’ self-report surveys, hierarchical regression analyses were utilized to test the nature of the sexual coercion predictors. Seven variables (problems with alcohol, past child abuse, anger management skills, relationship satisfaction, acceptability of violence towards wives, acceptability of violence towards husbands, and sexual coercion victimization) served as the independent variables with sexual coercion perpetration as the dependent variables in all of the regression analyses. Using the Revised Conflict Tactics Scale (CTS2; Straus, Hamby, Boney-McCoy, & Sugarman, 1996) to assess sexual coercion perpetration, male and female students were found to exhibit a different set of significant predictor variables in the regression analyses; however, sexual coercion victimization was a significant predictor in both data. Sexual coercion victimization predicting sexual coercion perpetration in males and females suggests that sexual coercion is bilateral and part of a systemic cycle of violence. Clinical implications and recommendations for future research are provided.

Master of Science / Department of Family Studies and Human Services / Briana S. Goff / Homophobic hate crimes against lesbians and gay men represent a significant social problem that has important psychological consequences for survivors. Because the nature of these crimes is, by definition, against someone for his or her intrapersonal traits, it has even more potential to be damaging to a victim and in turn potentially detrimental to the development and/or maintenance of close personal relationships. The impact of trauma has long been studied from the view of the trauma survivor or any secondary traumatization of those around the primary survivor. The impact of hate crime victimization has also been examined, and it, too, has also been examined from the primary survivors perspective. Only in recent years has the impact of trauma on interpersonal relationships been examined. Additionally, there is currently little to no literature on the impact of trauma or traumatic events on gay or lesbian relationships. The types of hate crime victimization experiences range from verbal abuse to severe physical assault to death. While hate crime victimization is not specifically identified in the DSM – IV – TR as a potentially traumatic event, physical assault, which is found commonly in hate crimes, is identified. Therefore, hate crime victimization could be a potentially traumatic event. However, this has not been addressed in the traumatic stress field. This report is intended to address the gaps in the current body of literature in both the traumatic stress field and the gay and lesbian literature. This overwhelming lack of literature has the potential to be very detrimental to professionals working with this population and in turn detrimental to the population and society. Evidence suggests that there may be a difference in how or if the potentially traumatic hate crime victimization experience manifests itself internally or in other forms because of the nature and severity of the victimization in one or both partners. Evidence also suggests, similarly to heterosexual couples, the impact of trauma has repercussions throughout the couple relationship. This report provides a preliminary start to continue and expand the work with the gay and lesbian community.

Doctor of Philosophy / Department of Family Studies and Human Services / Anthony Jurich / This qualitative research study explored how mothers reacted to sibling sexual abuse disclosures while investigating the treatment and supportive services they engaged in to help them cope with this family trauma. Previous research focused on the role mothers played in intrafamilial sexual abuse cases, indicating that mothers were collusive and aware that the sexual abuse was occurring and did not intervene or protect their daughters. This research study’s purpose was to begin the foundational process of filling the gap in the literature concerning mothers and sibling sexual abuse disclosures. Qualitative data from the interviews conducted with mothers of sibling sexual abuse cases were utilized for this study. Participants were asked to reflect upon their early childhood experiences, characteristics of relationships in their families, how they handled the sibling sexual abuse disclosure, their level of functioning after the abuse disclosures, and any treatment strategies utilized, as well as their perceived effectiveness. The study shared the lived experiences of mothers who had sibling sexual abuse disclosures occur within their immediate families. The results revealed that the participants’ immediate reactions were not indicative of the action they took, following the disclosure, to protect their daughters from further abuse. Also indicated was a connection between mothers’ ability to cope with the abuse disclosure over time and their daughters’, the victims’, ability to make progressive steps towards improved functioning, following the abuse disclosure. This research can assist clinicians in understanding the importance of the therapeutic relationship and being sensitive to the delicate role mothers of perpetrators and victims have to play in these cases. In addition, clinicians must assist these mothers in transitioning through their numerous emotions, in order to return to a functional level of interaction in their lives.

Background. Because there have been few studies examining resilience associated with postnatal (PN) depression, this study aimed at formulating and testing a theory-based model integrating both traditional resilience paradigms and non-traditional factors including existential beliefs about life, motherhood and religion. Method. Study hypotheses addressed prediction of PN depression, stress and resilience, and the confounding influence of negative affectivity (neuroticism). Study variables included PN depression (Edinburgh PN Depression Scale, EPDS), stress, neuroticism, self-esteem, mother's distress and ambivalence, purpose/meaning, religious belief, parity, age, marital and social status. They were assessed with standardized self-report instruments and, following a pilot, administered to a probability sample of women four months postpartum in a one-wave, community, postal survey. Because the overall response rate was so low (49%) only the Europeans were included in the study (N = 225; response-rate = 78%). Statistical hypothesis-testing included linear and logistical multivariate model-twilding techniques, and principal components analysis. Results. Sixteen percent scored in the major depression range (EPDS > 12), and 14% in the minor depression range. Depression was associated with stress, neuroticism, purpose/meaning, mother's distress and (marginally) religious belief, but not with self-esteem, mother's ambivalence, age, parity or social class. Although neuroticism was strongly associated with depression, and also overlapped with most psycho-social variables, nonetheless stress, purpose/meaning, and mother's distress maintained significant relationships with depression after neuroticism was statistically controlled. Stress was associated in part with the perception of losing one's freedom in the motherhood role (neuroticism controlled). When resilience was defined as high stress coupled with low depression, it was associated with low levels of neuroticism and mother's distress. When resilience was defined in terms of high levels of maternal satisfaction, it was associated with high purpose and low ambivalence. Principal components analyses revealed that (1) stress scores reflected two dimensions suggestive of distress and self-efficacy; and (2) depression, stress, neuroticism, self-esteem and purpose were markers for the same underlying component, whereas mother's distress and ambivalence were markers for another (unrelated) component. Conclusion. This study underlines the relevance of temperament, self-efficacy, self-transcendence, existential beliefs and motherhood-related cogniitions to the understanding of PN depression and stress. / Subscription resource available via Digital Dissertations only.

Background. Because there have been few studies examining resilience associated with postnatal (PN) depression, this study aimed at formulating and testing a theory-based model integrating both traditional resilience paradigms and non-traditional factors including existential beliefs about life, motherhood and religion. Method. Study hypotheses addressed prediction of PN depression, stress and resilience, and the confounding influence of negative affectivity (neuroticism). Study variables included PN depression (Edinburgh PN Depression Scale, EPDS), stress, neuroticism, self-esteem, mother's distress and ambivalence, purpose/meaning, religious belief, parity, age, marital and social status. They were assessed with standardized self-report instruments and, following a pilot, administered to a probability sample of women four months postpartum in a one-wave, community, postal survey. Because the overall response rate was so low (49%) only the Europeans were included in the study (N = 225; response-rate = 78%). Statistical hypothesis-testing included linear and logistical multivariate model-twilding techniques, and principal components analysis. Results. Sixteen percent scored in the major depression range (EPDS > 12), and 14% in the minor depression range. Depression was associated with stress, neuroticism, purpose/meaning, mother's distress and (marginally) religious belief, but not with self-esteem, mother's ambivalence, age, parity or social class. Although neuroticism was strongly associated with depression, and also overlapped with most psycho-social variables, nonetheless stress, purpose/meaning, and mother's distress maintained significant relationships with depression after neuroticism was statistically controlled. Stress was associated in part with the perception of losing one's freedom in the motherhood role (neuroticism controlled). When resilience was defined as high stress coupled with low depression, it was associated with low levels of neuroticism and mother's distress. When resilience was defined in terms of high levels of maternal satisfaction, it was associated with high purpose and low ambivalence. Principal components analyses revealed that (1) stress scores reflected two dimensions suggestive of distress and self-efficacy; and (2) depression, stress, neuroticism, self-esteem and purpose were markers for the same underlying component, whereas mother's distress and ambivalence were markers for another (unrelated) component. Conclusion. This study underlines the relevance of temperament, self-efficacy, self-transcendence, existential beliefs and motherhood-related cogniitions to the understanding of PN depression and stress. / Subscription resource available via Digital Dissertations only.

Background. Because there have been few studies examining resilience associated with postnatal (PN) depression, this study aimed at formulating and testing a theory-based model integrating both traditional resilience paradigms and non-traditional factors including existential beliefs about life, motherhood and religion. Method. Study hypotheses addressed prediction of PN depression, stress and resilience, and the confounding influence of negative affectivity (neuroticism). Study variables included PN depression (Edinburgh PN Depression Scale, EPDS), stress, neuroticism, self-esteem, mother's distress and ambivalence, purpose/meaning, religious belief, parity, age, marital and social status. They were assessed with standardized self-report instruments and, following a pilot, administered to a probability sample of women four months postpartum in a one-wave, community, postal survey. Because the overall response rate was so low (49%) only the Europeans were included in the study (N = 225; response-rate = 78%). Statistical hypothesis-testing included linear and logistical multivariate model-twilding techniques, and principal components analysis. Results. Sixteen percent scored in the major depression range (EPDS > 12), and 14% in the minor depression range. Depression was associated with stress, neuroticism, purpose/meaning, mother's distress and (marginally) religious belief, but not with self-esteem, mother's ambivalence, age, parity or social class. Although neuroticism was strongly associated with depression, and also overlapped with most psycho-social variables, nonetheless stress, purpose/meaning, and mother's distress maintained significant relationships with depression after neuroticism was statistically controlled. Stress was associated in part with the perception of losing one's freedom in the motherhood role (neuroticism controlled). When resilience was defined as high stress coupled with low depression, it was associated with low levels of neuroticism and mother's distress. When resilience was defined in terms of high levels of maternal satisfaction, it was associated with high purpose and low ambivalence. Principal components analyses revealed that (1) stress scores reflected two dimensions suggestive of distress and self-efficacy; and (2) depression, stress, neuroticism, self-esteem and purpose were markers for the same underlying component, whereas mother's distress and ambivalence were markers for another (unrelated) component. Conclusion. This study underlines the relevance of temperament, self-efficacy, self-transcendence, existential beliefs and motherhood-related cogniitions to the understanding of PN depression and stress. / Subscription resource available via Digital Dissertations only.