The purpose of this study was to explore the factors that help parents to cope with stress and to determine the overall impact that parenting stresses have on satisfaction with child care and overall life satisfaction. The current study utilized a family stress model to determine the overall impact that parenting stresses have on the two dependent variables with influences of parenting stresses, parenting daily hassles, level of family coping, perceived teacher support, and sense of coherence. Two hundred and one parents from one of five selected counties in Florida completed an online survey. The data were analyzed using SPSS 15.0 and AMOS 6.0 and the models fit well with the observed data. The results revealed that the variable with the greatest total effect on satisfaction with child care was sense of coherence followed by parenting stress and perceived teacher support and the reported R2 explained 10.0 percent of the variance. Similar results were found for satisfaction with life. The variable with the greatest total effect on satisfaction with life was sense of coherence, followed by parenting stress and perceived teacher support and the reported R2 explained 33.0 percent of the variance. Parents reported being most stressed with worrying about "doing enough" for their children, with difficulty in balancing different responsibilities because of their children, and by financial burden. / A Dissertation submitted to the Department of Family and Child Sciences in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Summer Semester, 2010. / April 23, 2010. / Parenting Stress, Family Coping, Satisfaction with Child Care, Satisfaction with Life, Sense of Coherence, Teacher Support / Includes bibliographical references. / Carol A. Darling, Professor Directing Dissertation; Nicholas Mazza, University Representative; Marsha Rehm, Committee Member.

This study examines adoptive adolescents and their relationships with their adoptive parents. The adolescents in this study were adopted from the child welfare system and therefore experienced various stressors throughout their lifetime that are uncommon to other adolescents their age. These stressors include being removed from their biological home, having numerous placements, and possibly being separated from their siblings. Due to these stressors, many adopted adolescents may be left without social supports. This study draws upon previous research, presents a Systematic Research Synthesis (SRS) and builds upon a previous stress-coping model in order to further examine specific variables that affect this population. These variables include personal factors, stressors, and adoptive parent-child relationships. The moderating/buffering effect of social supports is also investigated through an examination of the interaction between three forms of social supports (i.e., family, friends, significant others) and stressors. The analyses that were utilized within this study include t-tests and Generalized Estimating Equations (GEE). This study examines 335 adopted adolescents and their adoptive parents. It is based on the first wave of a three-year longitudinal study. The data are drawn from two separate surveys that were completed by adoptive parents and adopted adolescents. The present study found that adolescents adopted when older had significantly more behavioral and educational needs than adolescents adopted when younger. Also, support from family and significant others were found to be significant while support from friends was not. Although these social supports were found to be significant, an interaction effect with the stressors was not found to be significant. Finally, the adolescents' educational and behavioral needs were found to be significant predictors of their relationships with their adoptive parents. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Summer Semester, 2006. / June 26, 2006. / Includes bibliographical references. / Scott D. Ryan, Professor Directing Dissertation; Pamela Perrewé, Outside Committee Member; C. Aaron McNeece, Committee Member.

Lack of health insurance is a significant public health concern in the U.S. Currently more than 45 million Americans do not have any health insurance, and many more are underinsured. Public policy approaches that seek to improve access to medical care for the uninsured and underinsured must be based on an understanding of physician decision-making because physicians are gatekeepers who play an important role in determining the quantity and quality of medical care. This dissertation explores the relationship between physician variables (job satisfaction, decision-making style, social distance and length of time in practice), patient variables (insurance status, race, and ethnicity) and treatment recommendations by physicians for insured and uninsured patients. Survey instruments measuring social distance, job satisfaction, and tacit decision-making were mailed to a random sample of 250 Georgia family physicians. Decision outcomes were measured through the use of four vignettes that depict common, hypothetical scenarios requiring clinical decision-making. The vignettes varied only in the depiction of the patients described as in terms of insurance status, race, and ethnicity. The data indicated that in three of four hypothetical scenarios, physicians' clinical decisions varied depending on combinations of patient characteristics. The data also revealed that lack of health insurance (but not African American race or Latino ethnicity) resulted in lower decision outcome scores. No relationship was found between the set of physician variables (job satisfaction, decision-making style, social distance, and time in practice) and decision outcome scores. Decision-making style was negatively associated with decision outcome in Scenario 1. Time in practice was positively associated with decision outcome in Scenario 2. Time in practice was positively associated with job satisfaction. This study has important implications for health care policy in developing an effective response to the problem of medical indigence. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester, 2006. / March 14, 2006. / Inequality, Access, Medical Care, Social Work, Public Health, Health, Indigent, Health Insurance, Decisions, Physicians, Prejudice, Stereotypes, Health Policy, Health Care Administration, Medical Sociology, Disparities In Health Care, Equity, Race, Ethnicity, Family Physicians, Georgia / Includes bibliographical references. / C. Aaron McNeece, Professor Directing Dissertation; Mary Ellen Guy, Outside Committee Member; Wendy Crook, Committee Member.

This study addressed the impact of the external environmental context of individual organizations on their internal structures and service configurations, as they attempted to adapt to a changing political economy, via an examination of a portion of the Georgia child welfare system's response to the introduction of the principles of managed care. Based, in part, on Hasenfeld's (1992) notion that institutional and political economy perspectives are the most important theoretical approaches to understanding external influence on the service delivery systems of human services organizations, the current study presents conceptual and analytical models, which also includes network theory. In 1995, members of the Georgia Association of Homes and Services for Children (GAHSC) began sculpting a strategy for addressing managed care approaches to child welfare service delivery and funding in their state. This phenomenon provided an excellent context for studying the external environmental factors associated with the adoption or rejection of a controversial new methodology. A survey instrument, based on Dillman's (1978; 1991) Total Design Method, was developed and administered to assess Chief Executive Officers' and Managers' perceptions of the influence of external, political and economic, institutional, and network influences on their organizations' decisions to adopt managed care principles. The sampling frame included all residential child caring agencies licensed by Georgia's Department of Human Resources' Office of Regulatory Services (N=114). The final response rate for the survey was 33% (n = 37). Survey items were grouped according to theoretical constructs (i.e., perceived political and economic pressure, perceived institutional pressure, perceived network pressure, and perceived adoption of managed care principles) via the creation of index scores based on responses to the survey items. Regression analyses on the index scores for these four variables provided limited support for political economy theory and network theory as significant predictors for the adoption of managed care principles. Limitations in the design and implementation of this study are discussed to inform the applicability of these findings to human service organizations. Possible implications are also presented for human services organizations, social work practice, and future research in this area. / A Dissertation submitted to the School of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester, 2003. / March 27, 2003. / Social Welfare Organizations, Organization Theory, Human Service Organizations, Index Scoring, Multiple Regression / Includes bibliographical references. / Wendy P. Crook, Professor Directing Dissertation; Richard Chackerian, Outside Committee Member; Thomas E. Smith, Committee Member.

This study investigated the effectiveness of providing a Gottman-based group therapy using art-based interventions to adjudicated male adolescents ages 14-18. The group provided structured interventions based on Gottman's Sound Relationship House Theory for five consecutive weeks at a Department of Juvenile Justice residential program. The first hypothesis was that by attending the group, the adolescents would experience a change in their communication, social, self-regulatory, and problem-solving skills. If these self-regulatory skills were improved, the adolescents would report a decrease in mental health symptoms. The second hypothesis was that by attending the group and completing art-based interventions, the adolescents would report a change in the parent/child relationship. Two mental health measures were collected at pretest and posttest: the Problem Oriented Screening Instrument for Teenagers (POSIT), which has 10 subscales and the Symptom Checklist-90 (SCL-90), which has nine subscales. Three outcome measures for the parent-child relationship were administered. These were the POSIT, the Parent-Child Closeness (PCC) questionnaire with two scales for mother and father, and the Quality of Relationships Inventory (QRI), which has three subscales for the mother and father. All measures were analyzed utilizing a Wilcoxin Signed Ranks test. Based on the 10 subscales measured by the POSIT, adolescents reported fewer family, vocational, social, and leisure problems. Based on the nine subscales measured by the SCL-90, adolescents reported fewer symptoms of depression, anxiety, and obsessive-compulsive behaviors. Parent-Child Closeness measures for mother and father were significant, indicating a closer parent-child relationship with fewer parent-child conflicts. No statistical significance was found for the QRI measure. The results of the study offer a preliminary finding to support the use of a Gottman relationship-based adolescent group therapy, utilizing art-based interventions within a Department of Juvenile Justice residential program. / A Dissertation submitted to the Department of Family and Child Sciences in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Summer Semester, 2007. / June 28, 2007. / Gottman's Sound Relationship House Adolescent Grou / Includes bibliographical references. / Mary Hicks, Professor Directing Dissertation; David Gussak, Outside Committee Member; Marsha Rehm, Committee Member; Nicholas Mazza, Committee Member.

A basic principle found in attachment theory is that the relationship a young child shares with his or her primary care provider supplies the prototype for later relationships into adulthood and throughout life. Working within the framework of attachment theory and combining a constructivist perspective, this study explored the life story narratives of selected missionary couples. The research questions guiding this study were: How are themes of attachment evident in the life stories of missionary couples? How are patterns of attachment evident in the current relationship? Are self-reported categories of attachment in romantic relationships the same as self-reported attachment to God? Data collection was accomplished by conducting open-ended, semi-structured, in-depth interviews. Interviews focused on life history and lived experiences. Beginning with each participant's earliest memory surrounding family of origin, the life story interview continued through current life experiences as a missionary and on to future goals. Two self-report attachment measures were utilized in the study. These measures assessed romantic attachment and attachment to God. The data was analyzed by fully transcribing participants' audio taped interviews. An interpretive approach was utilized. Life stories evoked rich accounts of participants' attachment relationships, which further reflected individual attachment styles. Some of the themes that were revealed included: significant difficulty in childhood, an individual who encouraged his or her faith and commitment to God, a sense that God was directing, commitment to marriage, and learning a better way. All participants offered suggestions for improved member care, which was found to be the most urgent need of the missionaries in this study. Participants in this study demonstrated that they were able to increase security, from insecure to a more secure attachment, with prolonged secure and committed experiences in marriage. Participants also changed attachment because of attachment to God. All participants found security in their marriage covenant and felt secure that their spouse and God would never leave them. / A Dissertation submitted to the Department of Family and Child Sciences in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester, 2009. / December 5, 2008. / Attachment Theory, Missionary Couples, Life Stories / Includes bibliographical references. / Marsha Rehm, Professor Directing Dissertation; Ralph Brower, Outside Committee Member; Mary Hicks, Committee Member; Christine Readdick, Committee Member.

Over the past four decades, the rate of incarcerated for US women has increased more than 700%. Although the rate of incarceration for US men has also increased dramatically, incarcerated women differ from their male counterparts in several key ways. Incarcerated women are more likely than incarcerated men to have less than a high school diploma (or equivalent), to be under- or unemployed, to have experienced homelessness, to be living in poverty at the time of their arrest, to have custody of minor children, and to come to prison with untreated physical and mental health issues (Bloom et al., 2004; DeHart, 2008). The largest disparities are reported on measures of drug use and drug crimes and experiences of interpersonal victimization (Belknap, 2007). The Gendered Pathways Perspective (GPP) identifies victimization as an important pathway to criminal behavior for women and girls, as approximately half of incarcerated women report being first arrested as juveniles, many of whom were running away to escape abuse. Incarcerated women and girls also indicate that they use drugs and alcohol, in some measure, to cope with their experience of violence (DeHart, 2009; Fuentes, 2014; Messina & Grella, 2006). Incarcerated women report much higher rates of victimization than women in the community, with estimates suggesting that more than two-thirds of incarcerated women have experienced either physical or sexual abuse in childhood (e.g., Kennedy, Tripodi, et al., 2015). However, there is evidence that experiences of victimization are rarely mutually exclusive, but rather that victimization tends to cluster for some individuals and in some environments (Finkelhor et al., 2007b). Although robust relationships between childhood polyvictimization (defined as multiple, cumulative forms of direct and indirect interpersonal violence) and a variety of criminal offending, re-victimization, mental health, and substance misuse outcomes are reported using samples of youth (e.g., Cyr et al., 2012; Ford et al., 2010), our understanding of how polyvictimization relates to these outcomes for incarcerated adult women is less clear. The current project examined polyvictimization and five interpersonal and behavioral health outcomes among a probability sample of 39 incarcerated women held in a state prison in Florida. The outcomes of interest were intimate partner violence victimization (IPVV), current incidence of dissociation, psychosis, and posttraumatic stress, and substance misuse in the year prior to incarceration. These outcomes were chosen because they are associated with women's crime, increase the risk for suicide attempts and interpersonal conflict during custody, and have been linked to recidivism after release (DeHart, 2008, 2009; Dowden & Brown, 2002; Lord, 2008; Salisbury & Van Voorhis, 2009; Wright et al., 2007; Zust, 2009). A cross-sectional survey design was used and all data was gathered via self-report during face-to-face interviews. For women in the sample, an increase in the number of cumulative victimization domains experienced in childhood was statistically significantly associated with increased dissociation and meeting criteria for a substance use disorder in the year prior to incarceration. Further, sexual assault statistically significantly moderated the relationship between polyvictimization and both dissociation and substance misuse for women in the sample. A positive effect was noted when looking at IPVV, psychosis, and posttraumatic stress, although the relationships in the current sample were statistically non-significant. Although the data did not permit precise estimates of the effect, the confidence intervals suggested moderate to strong effects that indicated concern about the relationship between polyvictimization and subsequent challenges. Understanding experiences of polyvictimization for incarcerated women, and how polyvictimization relates to subsequent IPVV, dissociation, psychosis, posttraumatic stress, and substance misuse, is of particular importance to the social work profession, as social workers provide the majority of behavioral health services in the US (Proctor, 2004). Social work is well positioned to lead community-based prevention efforts which address how experiences of violence and victimization can influence a woman's sense of herself in relationships and can serve to alienate her from family, school, and employment. If drugs and alcohol are used to cope with experiences of violence, social work prevention and intervention can highlight how substance misuse perpetuates experiences of victimization for at-risk women and girls, increasing risk for arrest and incarceration. Further, over the past decade, comprehensive mental health services have become increasingly available in women's prisons across the country (e.g., Daroowalla et al., 2005; Teplin et al., 1997; Wright et al., 2007). Social work professionals are well equipped to take a leadership role in therapeutic service delivery. More research is needed to examine polyvictimization among incarcerated adult women and evaluate the predictive utility of polyvictimization on negative outcomes among this population. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester 2016. / April 11, 2016. / Childhood victimization, Incarcerated women, Intimate partner violence, Polyvictimization, Serious mental health, Substance misuse / Includes bibliographical references. / Stephen J. Tripodi, Professor Directing Dissertation; Eric Stewart, University Representative; Tomi Gomory, Committee Member; Lisa Schelbe, Committee Member.

Sexual violence is a major issue among students in college. In the past 20 years, researchers have made great strides contributing to the knowledge base of sexual violence and have begun discussing the myriad of outcomes and associations seen in victims/survivors of sexual violence. The present study, guided by stress and coping theory (Lazarus & Folkman, 1984), adds to the growing body of research attempting to understand the scope of sexual violence in higher education by looking at sexual violence broadly and in a more nuanced way. Further, the present study examined the relationships among specific high-risk behaviors (heavy drinking, purging, suicide attempts, and deliberate self-injury) in a large, national sample of U.S. college men and women who have experienced different types of sexual violence (sexually touched without consent, attempted sexual penetration without consent, and sexual penetration without consent) in the last 12 months. Additionally, the study explored whether sexual violence has a differential impact on male and female college students. Further, acknowledging the history of rape in the U.S. as intertwined with the oppression of black individuals, this study explored the role of race in the associations between sexual violence and high-risk behaviors. A secondary analysis of National College Health Assessment data collected annually from 2011 to 2014, resulted in sample of 96,977 male and female college students. Four research questions (resulting in 32 hypotheses) were examined. A series of analyses (independent samples t-test, ANOVAs, and logistical regression) were conducted to test the hypotheses. The results suggested that students in this sample who reported experiencing broad sexual violence were more likely to engage in high-risk behaviors (i.e., heavy drinking, purging, attempted suicide, and deliberate self-injury) when compared to those who did not report experiencing sexual violence, supporting all related hypotheses. Further, as the degree of sexual violence increased, so did the odds of engaging in three of the four high-risk behaviors (purging, attempted suicide, and deliberate self-injury). The effect of gender was examined to determine whether men and women who experienced sexual violence had similar behavioral associations. It was hypothesized that being male would moderate the relationship between sexual violence and each high-risk behavior. These hypotheses were largely unsupported; however, there were a few instances where the more nuanced definition of sexual violence provided insight into male and female differences. Men who experienced sexual violence were more likely to engage in purging behaviors, and men who experienced severe sexual violence were more likely to engage in suicide attempts. Finally, the effect of race was examined to determine whether black individuals who experienced sexual violence were more likely to engage in high-risk behaviors than white individuals and other racial minorities. It was hypothesized that identifying as black would moderate the relationship between sexual violence and each high-risk behavior. These hypotheses were not supported, suggesting that being black did not significantly increase the odds of any high-risk behaviors compared to other minority and white individuals. The present study adds to the body of literature of sexual violence on college campuses and provides further evidence that examining sexual violence in a more nuanced way has merit. Comparing the outcomes between sexual violence broadly and as the degrees of sexual violence provided insight into the relationships between each high-risk behavior and the impact that different types of sexual violence can have on an individual. Understanding that there are individual differences in reactions to diverse types of sexual violence has clinical implications. Victim advocates working with individuals immediately after and/or in the months to follow the sexual violence incident are in a particularly special position to assist victims in the coping process. This study demonstrated that generally, the likelihood of engaging in problematic coping increased as the severity of sexual violence increased. The study also provided valuable information regarding gender differences in associations between sexual violence and high-risk behaviors. To date, most of the research regarding male victims of sexual violence has a primary focus on documenting its existence. A strength of the present study is that it moved beyond reporting prevalence and demonstrated that male victims of sexual violence also have increased high-risk behaviors. Acknowledging the problem of sexual violence in our society has been the first step. Understanding the specific behavioral associations of individuals who have experienced sexual violence is the second step. This is essential in order to help to effectively and responsibly inform victim advocates, health and mental health professionals, campus police, and Title IX investigators how to respond to victims of sexual violence given their unique needs and vulnerabilities. / A Dissertation submitted to the Department of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester 2016. / April 19, 2016. / heavy drinking, higher education, purging, self-injury, sexual violence, suicide attempt / Includes bibliographical references. / Tomi Gomory, Professor Directing Dissertation; Pamela Keel, University Representative; Dina J. Wilke, Committee Member; Stephen Tripodi, Committee Member.

Youth with disabilities are overrepresented among youth “aging out” of the child welfare system (Hill, 2012), yet few studies specifically examine the needs of youth aging out with disabilities as they transition into adulthood. Addressing this gap, the current study provides a more nuanced account of youth with disabilities’ recent transitions out of the child welfare system. Using two national databases, this secondary data analysis investigates differences in educational and employment outcomes between youth aging out with and without disabilities and across youth aging out with different types of disability (i.e., distinguishing emotional from non-emotional diagnoses). Additionally, this study identifies services that improve these outcomes among youth aging out with disabilities. These lines of inquiry provide information about the experiences and needs of youth aging out with disabilities so that services aimed toward improving educational and employment outcomes can be appropriately tailored to this substantial population of youth aging out of care. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Summer Semester 2016. / June 27, 2016. / child welfare, disabilities, foster care, independent living services, transition to adulthood / Includes bibliographical references. / Karen A. Randolph, Professor Directing Dissertation; Deborah Ebener, University Representative; Melissa Radey, Committee Member; Dina Wilke, Committee Member; Lisa Schelbe, Committee Member.

PROBLEM: Limited understanding of factors that lead to placement disruption and entry into higher levels of care has been a longstanding problem in child welfare research and practice. While prior research has successfully identified some variables that are associated with placement instability, these findings are limited by methodological shortcomings and limited evidence of predictive utility. METHOD: This study attempts to use child, caseworker, and caregiver factors to predict placement type and change in level of care over an 18 month period using random forest modeling. Data from the NSCAW I LTFC sample were used to train and evaluate predictive models. RESULTS: Models predicting placement type performed fairly, while models attempting to predict changes in level of care were unsuccessful. CONCLUSIONS: Future research should continue to consider nonlinear methods for evaluating child welfare outcomes. Consideration of a broader range of variables, localized data, and alternative measurement approaches are suggested. / A Dissertation submitted to the Department of Family and Child Sciences in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester 2017. / March 23, 2017. / child welfare, placement outcomes, random forest, statistical learning / Includes bibliographical references. / Ming Cui, Professor Directing Dissertation; Carter Hay, University Representative; Lenore McWey, Committee Member; Francis Fincham, Committee Member.