In this thesis, I explore the cultural traumas and memories that shape Arab American identity in the US, and how such events influence their interactions and relationships with other Arab and non-Arab Americans. Drawing on memory and trauma literature, this study highlights the impact of collective memory and cultural trauma on individual and collective Arab American identity formation. Through 11 in-depth interviews, I found that trauma affected the respondents in two particular ways, through enduring traumas from their countries of immigration and the continuing impact of 9/11. Specifically, I found that the traumas of immigrating from a country where respondents had experienced direct violence through war or oppression, or where they lacked socio-economic stability, deeply impacted how they understand and utilize their Arab American identity as a tool to uplift the voices of other Arabs. Additionally, I found although the participants did not explicitly consider 9/11 as a personal trauma, they saw it as a significant cultural event that influenced their self-perception as Muslims and their sense of belonging in U.S. society. Specifically, the profiling of Arabs post-9/11 caused the respondents to constantly self-surveil as well as had negative effects on the community. 9/11 also resulted in the respondents becoming more supportive of Arab American organizations through intra-country donations, as well as becoming more accepting of alternative ways to practice and understand Islam. This study contributes to the social science literature by examining how collective trauma affects the daily lives and identities of Arab Americans. It underscores the importance of inclusivity in research, recognizing the significance of Arab American voices and the need for a comprehensive understanding of the Arab American community. / M.S. / This study explores how cultural trauma and collective memory have shaped the identity of Arab Americans in the U.S. I found that Arab Americans were affected in two ways. First, the enduring trauma of war, violence, and oppression from their countries of origin impacted how they understood their Arab American identity and used it to advocate for fellow Arabs. Second, the continuing impact of 9/11 resulted in racial/ethno-religious profiling and constant self-surveillance, which affected the community’s acceptance of alternative ways to practice and understand Islam. These experiences strengthened their sense of collective identity.

The research presented in this thesis investigates eye injuries caused by blunt impacts and blast overpressure. This research represents part of an ongoing investigation to accurately quantify and predict eye injuries and injury mechanisms for various loading schemes. It has been shown that blunt trauma can cause severe eye injuries but it remains undecided whether blast overpressure alone can cause eye injury. Presented herein are four experimental studies that quantify eye injuries and implement a technique for predicting injury risk. Isolated porcine or human eyes were subjected to various loading conditions consisting of blunt projectiles, water streams, remote control helicopter blades, and blast overpressure. All eyes were prepared in a similar manner that required the insertion of a miniature pressure sensor into the globe through the optic nerve. This sensor measured intraocular pressure throughout each event. Using previously published injury risk curves, this intraocular pressure data was used to predict the injury risk for four eye injuries: hyphema, lens damage, retinal damage, and globe rupture. Injuries sustained were quantified upon direct inspection of the globe following testing. No serious eye injuries were observed for any of the tests and all tests resulted in low predicted injury risks consistent with the lack of observed injury. The research presented in this thesis provides a robust low injury level dataset for eye injuries. This data could be useful for designing and validating computational models and anthropomorphic test device eyes, and serves as a basis for future work with more dangerous projectiles and higher pressure levels. / Master of Science

Ecological interventions hold promise for meeting the needs of post-disaster communities, yet little systematic quantitative evidence is available about such programs. This study evaluated the short-term outcomes of participants in the Strategies for Trauma Awareness and Resilience (STAR) program, a novel and exemplar ecological intervention for helpers working in post-disaster settings. It is a one week training and support program for helpers working in disaster-affected communities. Changes in the psychological distress of 42 STAR participants, across four STAR sessions, were assessed and identified as primary outcome variables. Knowledge, attitude, and intended practice changes were also assessed, along with perceived support, using a pre (T1)/post (T2) design. These indicators were then tested as possible predictors of participants' changes in distress. An integrity check was conducted on a sample of the seminar modules to assess fidelity to the program manual. Qualitative data were also gathered from follow up visits conducted with two participants. These data were used to help interpret quantitative findings, as well as to plan for future studies of how STAR effects might extend out from helpers into their home communities. Results showed that participants exhibited significant changes in knowledge, attitudes, and intended practices from the beginning of the seminar to the end. Results also showed significant decreases in psychological distress over the STAR week. Regression analyses showed that changes in knowledge, attitudes, and practice, as well as perceived social support during the seminar, explained significant amounts of variance in self reported trauma symptoms at T2. Variance in T2 burnout and compassion fatigue explained by these predictors was notable but not statistically significant due to lack of power. Results suggest that STAR can change knowledge and attitudes of helpers from disaster communities and that participants in this program experience decreases in distress during their stay. The lack of a valid comparison group makes causal interpretations of these findings premature. Findings also suggest that changes in distress are not caused by, or even significantly related to, learning that takes place during the STAR week. The mechanism for distress reduction during the STAR week is an unresolved question. Other significant unresolved questions remain regarding the STAR intervention and ways the present findings can be generalized to ecological interventions more broadly. For example, while the current study suggests important changes occur in helpers during the STAR week, it is of central importance to explore how these changes translate into the disaster-affected home communities. Discussion also focuses on the difficulties involved in conducting systematic research with organizations and helpers whose primary goals are practical or clinical, not scientific. Despite the questions that remain, taken together, results point to the promise of STAR to address the mental health needs of helpers and perhaps eventually disaster communities. / Ph. D.

Interpersonal Violence in the form of school shootings is prevalent in American society and can negatively impact the mental health of survivors. Black, Indigenous and People of Color (BIPOC) tend to bear the worse outcomes following such events due in part by effects of complex trauma (e.g., minority stress). Using the Andersen Model of Behavioral Healthcare Use within a sample of 4,627 students who were enrolled at the time of the Virginia Tech 4/16 shooting, the current thesis sought to: (1) examine predisposing factors as a mediator of the relationship among racial identity and help seeking, (2) to examine enabling factors as a mediator of the relationship among racial identity and help seeking and (3) to examine need factors as a mediator of the relationship among racial identity and help seeking. Using negative binomial regressions within a mediational framework, the relationships among racial identity and help seeking were assessed, with variables capturing predisposing, enabling, and need components of the Andersen Model of Behavioral Healthcare Use entered as mediators. The results showed that predisposing factors mediated the relationship among racial identity and help seeking behavior in Asian, Black, and White students, but not Latinx students. Enabling factors mediated the relationship among racial identity and help seeking in Asian and Latinx students, but not Black and White students. Need factors mediated the relationship among racial identity and help seeking behavior in White students, but not in Asian, Black or Latinx students. Clinical implications of these results and future directions are discussed. / M.S. / Mass shootings in educational settings negatively impact the mental health of survivors, especially Black, Indigenous and People of Color (BIPOC) who often bear the worst outcomes to these events. Individuals who are survivors of mass shootings don’t often utilize mental healthcare services despite their effectiveness in trauma exposed populations. This study uses the Andersen Behavioral Model of Healthcare Use to examine the help seeking behavior of students following the Virginia Tech 4/16 shooting. The results of this study indicated that Asian, Black and White students’ functioning in several areas of their life (e.g., social life, academic life) prior to the event explained the relationship between racial identity and help seeking behavior. Social support factors also explained the help seeking behavior of Asian and Latinx students. Lastly, students’ need as measured by their posttraumatic stress symptoms explained the relationship among racial identity and help seeking behavior in White students. Clinical implications stressing the importance of widened outreach following mass trauma are discussed.

Yes / Microbial keratitis can arise from penetrating injuries to the cornea. Corneal trauma promotes bacterial attachment and biofilm growth, which decrease the effectiveness of antimicrobials against microbial keratitis. Improved therapeutic efficacy can be achieved by reducing microbial burden prior to antimicrobial therapy. This paper assesses a highly-branched poly(N-isopropyl acrylamide) with vancomycin end groups (HB-PNIPAM-van), for reducing bacterial attachment and biofilm formation. The polymer lacked antimicrobial activity against Staphylococcus aureus, but significantly inhibited biofilm formation (p = 0.0008) on plastic. Furthermore, pre-incubation of S. aureus cells with HB-PNIPAM-van reduced cell attachment by 50% and application of HB-PNIPAM-van to infected ex vivo rabbit corneas caused a 1-log reduction in bacterial recovery, compared to controls (p = 0.002). In conclusion, HB-PNIPAM-van may be a useful adjunct to antimicrobial therapy in the treatment of corneal infections. / Medical Research Council and the Department of Biotechnology, India under grant number, MR/N50188/2.

Thesis (M.S.M.) PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / OBJECTIVE: To examine the association between maternal trauma exposure and children's social skills in preschool. METHODS: We nested a prospective cohort study within an ongoing randomized controlled trial of a maternal depression prevention intervention. Each participating mother had a three to five year-old child in Head Start. Maternal trauma history was assessed at baseline. Six months later, Head Start teachers (masked to both study arm and mothers' depression status) completed the Social Skills Rating system (SSRS) to assess children's social skills and problem behaviors. SSRS scores of children of mothers with and without a trauma history were compared using t-tests for bivariate comparisons. To evaluate for potential effect measure modification and confounding, we conducted a stratified analysis by the variables of interest. We evaluated for effect measure modification by comparing stratum-specific estimates to each other. we then evaluated for confounding by comparing the standardized to the crude estimates. Finally, we conducted a multivariate analysis, adjusting for potential confounders. RESULTS: Eighty-two mother-child pairs completed the baseline and follow-up evaluations. Sixty mothers (73%) reported a history of trauma. The most common traumatic exposures included emotional abuse (58%), the violent death of a close contact (53%), and physical assault (43%). In the bivariate analysis, children of mothers with a history of trauma had lower overall social skills scores when compared to children of mothers without trauma [101.48 (54th percentile) vs. 109.18 (66th percentile), p. 0.04]. When adjusted for multiple potential confounders, mean social skills scores were 10.01 points lower (95% CI -18.88, -1.14) for children of mothers with a history of trauma. There was no evidence of effect measure modification by study group assignment, ethnicity single parenthood, or depression score. CONCLUSIONS: Among urban Head Start mothers, trauma exposure is common and is associated with lower child social skills. Because social skills are a critical aspect of kindergarten readiness, specifically addressing maternal trauma in preschool programs that serve high-risk populations may be important. / 2999-01-01

Despite the growing presence of trauma and abuse narratives in young adult literature (YAL), adolescent traumatic memory has largely been left out of the conversation. To better understand how contemporary memory scholarship is manifested in YAL, the following essay will offer a close reading of Staying Fat for Sarah Byrnes (1993) by Chris Crutcher and Speak (1999) by Laurie Halse Anderson in conjunction with adolescent memory research. The accuracy of traumatic memory representation in these novels confirms the value of YAL as a means for youth to interact with and learn about traumatic memory, its processes, and its effects.

Although the negative consequences of traumatic exposure across various domains of functioning have been well-documented, gaps and discrepancies continue to exist in the understanding of the impact of complex trauma, such as interpersonal violence (IPV), and how outcomes may vary across diverse populations and identities. In this cross-sectional study investigating the impact of traumatic exposure on physiological domains of functioning, a sample of female-identifying college students completed a number of self-reported measures (assessing past and present trauma exposure, complex posttraumatic stress disorder [CPTSD] symptoms, racial-ethnic minority status, and age of onset of first traumatic exposure) and provided resting high-frequency heart rate variability (hfHRV) data, which served as a biomarker for the potential impact of trauma exposure on physiological domains. Correlational and multiple regression analyses were conducted to determine the strength of relationships between variables and the predictive value of the models. Results indicated endorsement of IPV trauma was significantly associated with earlier age of onset, more severe levels of CPTSD symptoms, and higher hfHRV, but not racial-ethnic minority status. Racial-ethnic minority status was significantly related to more severe CPTSD symptoms. Type of trauma exposure was the only variable that emerged as having predictive value for changes in hfHRV. These findings suggest that experiencing IPV may have unique implications for trauma symptomatology and functioning above and beyond other forms of traumatic exposure, but that continued research must be conducted in order to draw more robust conclusions about the effects of exposure on physiological regulation across various racial-ethnic identities. / M.S. / Research has highlighted the consequences that extremely negative, stressful experiences, also called traumatic events, can have on the way humans think, emote, behave, and physically react. It can be more difficult to draw conclusions about the effects of interpersonal violence (IPV), or violence that occurs at the hands of another (i.e., family, partner, or community violence), due to the complex, severe, and long-term nature of symptoms that survivors experience. There is also limited research about what complex trauma looks like across diverse populations. This study aimed to investigate the impact of traumatic exposure on physiology, which falls under biology and broadly includes the functions of living things. A sample of female-identifying college students completed a number of self-reported measures (assessing trauma exposure, complex posttraumatic stress disorder [CPTSD] symptoms, racial-ethnic minority status, and age of onset of first traumatic exposure) and provided resting high-frequency heart rate variability (hfHRV) data, which measures variation in time between beats and served as a measure for the potential impact of trauma exposure on physiology. Results suggested that IPV exposure was associated with earlier age of first traumatic experience, more severe levels of CPTSD symptoms, and higher hfHRV. Racial-minority status was significantly related to more severe CPTSD symptoms. Type of trauma exposure significantly predicted changes in hfHRV. Findings suggest that experiencing IPV may uniquely influence trauma symptoms and functioning above and beyond other forms of traumatic exposure. Continued research will allow for stronger conclusions about the effects of traumatic exposure on physiology across various racial-ethnic identities.

Early-onset torsion dystonia (DYT-TOR1A, DYT1) is an inherited hyperkinetic movement disorder caused by a mutation of the TOR1A gene encoding the torsinA protein. DYT-TOR1A is characterized as a network disorder of the central nervous system (CNS), including predominantly the cortico-basal ganglia-thalamo-cortical loop resulting in a severe generalized dystonic phenotype. The pathophysiology of DYTTOR1A is not fully understood. Molecular levels up to large-scale network levels of the CNS are suggested to be affected in the pathophysiology of DYT-TOR1A. The reduced penetrance of 30% - 40% indicates a gene-environmental interaction, hypothesized as “second hit”. The lack of appropriate and phenotypic DYT-TOR1A animal models encouraged us to verify the “second hit” hypothesis through a unilateral peripheral nerve trauma of the sciatic nerve in a transgenic asymptomatic DYT-TOR1A rat model (∆ETorA), overexpressing the human mutated torsinA protein. In a multiscale approach, this animal model was characterized phenotypically and pathophysiologically. Nerve-injured ∆ETorA rats revealed dystonia-like movements (DLM) with a partially generalized phenotype. A physiomarker of human dystonia, describing increased theta oscillation in the globus pallidus internus (GPi), was found in the entopeduncular nucleus (EP), the rodent equivalent to the human GPi, of nerve-injured ∆ETorA rats. Altered oscillation patterns were also observed in the primary motor cortex. Highfrequency stimulation (HFS) of the EP reduced DLM and modulated altered oscillatory activity in the EP and primary motor cortex in nerve-injured ∆ETorA rats. Moreover, the dopaminergic system in ∆ETorA rats demonstrated a significant increased striatal dopamine release and dopamine turnover. Whole transcriptome analysis revealed differentially expressed genes of the circadian clock and the energy metabolism, thereby pointing towards novel, putative pathways in the pathophysiology of DYTTOR1A dystonia. In summary, peripheral nerve trauma can trigger DLM in genetically predisposed asymptomatic ΔETorA rats leading to neurobiological alteration in the central motor network on multiple levels and thereby supporting the “second hit” hypothesis. This novel symptomatic DYT-TOR1A rat model, based on a DYT-TOR1A genetic background, may prove as a valuable chance for DYT-TOR1A dystonia, to further investigate the pathomechanism in more detail and to establish new treatment strategies. / Früh beginnende Torsionsdystonie (DYT-TOR1A, DYT1) ist eine genetisch bedingte hyperkinetische Bewegungsstörung, die aufgrund einer Mutation im TOR1A Gen verursacht wird, welches für das TorsinA-Protein codiert. DYT-TOR1A wird als zentrale Netzwerkstörung bezeichnet und betrifft hauptsächlich die kortiko-striatothalamo-kortikale Funktionsschleife, welches schließlich zu einem schweren generalisierten dystonen Phänotyp führt. Die Pathophysiologie von DYT-TOR1A ist nicht vollständig verstanden, man geht jedoch davon aus, dass Ebenen im Zentralnervensystem von molekularer Basis bis hin zu ganzen Netzwerken betroffen sind. Die reduzierte Penetranz von nur 30% bis 40% deutet auf eine Gen-UmweltInteraktion hin, im Sinne einer „2-Treffer-Hypothese“. Auch das Fehlen eines adäquaten DYT-TOR1A Tiermodelles hat uns dazu veranlasst, die „2-TrefferHypothese“ zu verifizieren, indem eine unilaterale periphere Quetschläsion des Nervus ischiadicus in einem transgenen, asymptomatischen DYT-TOR1A Rattenmodell (∆ETorA) durchgeführt wurde, welches das humane mutierte TorsinA-Protein überexprimiert. Das Tiermodell wurde phänotypisch und pathophysiologisch auf verschiedenen Analysenebenen charakterisiert. ∆ETorA Ratten mit Quetschläsion entwickelten Dystonie-ähnliche Bewegungen (DLM) mit teilweise generalisiertem Phänotyp. Erhöhte Theta-Oszillationen im Globus pallidus internus (GPi) sind bezeichnend für die humane Dystonie, welche auch im Nucleus entopeduncularis (EP), dem Äquivalent zum humanen GPi, von ∆ETorA Ratten mit Quetschläsion nachgewiesen wurden. Veränderte oszillatorische Muster wurden auch im primären Motorkortex gefunden. Hochfrequenz-Stimulation (HFS) des EP konnte das klinische Erscheinungsbild verbessern und hatte zudem auch einen modulatorischen Effekt auf die veränderte oszillatorische Aktivität des EP und des primären Motorcortex von ∆ETorA Ratten mit Quetschläsion. Auch das veränderte dopaminerge System erwies sich als ein pathologisches Merkmal in ∆ETorA Ratten. Es fand sich eine erhöhte striatale Ausschüttung von Dopamin und ein erhöhter Dopaminumsatz. In der Transkriptomanalyse kamen die zirkadiane Uhr und der Energiemetabolismus als weitere potentielle Signalwege in der Pathophysiologie der DYT-TOR1A Dystonie zum Vorschein. Zusammengefasst konnten DLM in genetisch prädisponierten, asymptomatischen ΔETorA Ratten mittels peripheren Nerventraumas ausgelöst werden, welches zu neurobiologischen Veränderungen in verschiedenen Ebenen des zentralen motorischen Netzwerk führte. Somit konnte die „2-Treffer-Hypothese“ bestätigt werden. Dieses neue symptomatische DYT-TOR1A Rattenmodell, fundiert auf der genetischen Grundlage von DYT-TOR1A, kann sich als wertvolle Möglichkeit für die DYT-TOR1A Dystonie erweisen, um Pathomechanismen genauer zu untersuchen und neue Behandlungsstrategien zu entwickeln.

In 2020, instances of anti-Black racism and racial injustice became increasingly prevalent and garnered widespread public attention. Simultaneously, the COVID-19 pandemic contributed to experiences of stress and elevated risk of exposure to maladaptive health outcomes. Black communities were disproportionately affected by these intersecting events, leaving them more vulnerable to increased stress and trauma, differential access to healthcare, and adverse mental health outcomes (Hooper et al., 2020; Schmitt et al., 2014; Vindegaard and Benros, 2020). In a sample of trauma-exposed Black adults residing in southwest Virginia, this mixed methods investigation examined the associations between psychopathology and exposure to COVID-19 and racial discrimination stressors, as well as between resilience/coping factors and psychological difficulties. Open-ended questions related to stressors, coping strategies, and mental health care perceptions and barriers were posed. Results indicated racial discrimination associated significantly with posttraumatic stress disorder (PTSD), depression and anxiety, and shame symptoms, whereas pandemic-related stress associated only with PTSD symptoms. Afrocentric worldview emerged as the most salient resilience factor negatively associated with psychopathology, followed by social support and resilient coping. Common barriers to care included a dearth in Black providers, feasibility factors, and limited availability of services, though the majority of the sample expressed a belief in mental health services as helpful. Future implications of this work include implementation of accessible, community-based resources, support for increased racial-ethnic representation among mental health providers, and incorporation of culturally-appropriate and client-centered strategies in existing evidence-based treatments. / Doctor of Philosophy / Shortly after the first declaration of COVID-19 as a global health pandemic, instances of racial injustice and police brutality captured national public attention. These intersecting stressors resulted in disproportionately elevated rates of poor health and economic outcomes, increased exposure to potentially traumatic events, and increased risk of mental health difficulties for Black Americans (Hooper et al., 2020; Schmitt et al., 2014; Vindegaard and Benros, 2020). In this investigation, 84 Black adults who reported living in southwest Virginia and had experienced at least one traumatic event in their lifetime completed an online survey. This survey included measures of exposure to traumatic events, COVID-19, and racial discrimination, psychological symptoms, and levels of coping and resilience. Participants also responded to a series of open-ended questions about stress, coping, and use of mental health services. Results of the investigation indicated that higher levels of racial discrimination were significantly associated with more posttraumatic stress disorder (PTSD), depression and anxiety, and shame symptoms, whereas higher COVID-19 stress only associated with greater PTSD symptoms. Of the resilience variables, having a stronger alignment with an Afrocentric worldview was most associated with lower psychopathology, followed by higher social support and resilient coping. This sample reported several barriers to accessing formal mental health care such as low rates of Black providers in their area, cost, stigma, and a limited availability of services. Despite identified barriers, participants generally reported an ability to access services and believed therapy could be helpful. Implications of these results include support for accessible, community-based resources designed to bolster mental health, the need for increased recruitment and retention of diverse racial-ethnic mental health workers, particularly in rural areas, and the use of culturally-sensitive strategies within existing evidence-based clinical services.