It is estimated that US children 2 to 18 years of age spend an average of 5.5 hours, daily, using media of all types. 1 During these years, it is estimated they will have viewed over 200,000 acts of violence just on television. 2 In this issue of the Southern Medical Journal, Dr. Robert DuRant and colleagues reported on their findings that an increased frequency of watching professional wrestling on television was associated with an increase in reported date fighting and other violent behaviors, risky sexual behavior, and smoking cigarettes, among a multistate random sample of adolescents aged 16 to 20 years. 3 In this cross-sectional study, 22.4% of males and 13.6% of females reported watching professional wrestling on television during the 2 weeks before the survey. Prior research, including experimental and longitudinal studies, has consistently demonstrated strong associations between exposure to media violence and desensitization to violence, greater acceptance of violence as a means of solving problems, and violent behavior, as well as depression, anxiety, and sleep disturbance. 4

Aversion therapy has reemerged as a treatment for self-injurious behavior (SIB) but remains unpopular, as it is perceived to be unethical. The purpose of this mixed-methods sequential explanatory study was to investigate the effectiveness of positive therapy and aversion therapy in the treatment of twins with SIB as well as to understand the lived experiences of their caretakers regarding treatment ethics. The frameworks used included classical and operant conditioning as well as utilitarian ethics theory. Quantitative research questions focused on changes in SIB, aggressive and prosocial behaviors with treatment, while the qualitative research question focused on the perceptions of caretakers regarding treatment. The quantitative component used a case study design and archived data from 2 U.S.-based treatment centers. The qualitative component included essay-type questionnaires for family members and caretakers regarding perceptions of the different therapies. The quantitative data that was obtained measured different behaviors that were not comparable. The twin in aversion therapy demonstrated aggressive behaviors that decreased with treatment, while the twin in positive therapy demonstrated positive behaviors that showed little to no change. Caretaker and family reports were consistent with the quantitative data, and family members considered aversion therapy ethical because they perceived it to be effective in treating SIBs. They also perceived it as ethically preferable to the use of large amounts of medication. Findings suggest that aversion therapy may be effective and ethical. Implications for positive social include potential continued research on aversion therapy to enhance treatment outcomes for individuals with SIB, and possible changes in public perceptions of aversion therapies.

The current dissertation consists of three interrelated studies examining the relationship between sleep functioning and adolescent adjustment. Although links between sleep patterns and internalizing problems and externalizing or problem behaviors in children and adolescents have been established in literature, several gaps remain in this research. This dissertation addressed these by: (a) testing sleep problems, quantity, and chronotype in childhood as predictors of internalizing problems in adolescence (Study 1), (b) testing sleep problems, quantity, and chronotype in childhood as predictors of problem behaviors in adolescence (Study 2), and (c) testing sleep problems and quantity as mediators of the chronotype-adjustment link (Study 3). Latent Growth Modeling (LGM) and Half-longitudinal Path Analysis were used to carry out these studies using a large sample of children part of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC). Findings from Study 1 and 2 showed that greater sleep problems in early childhood and their slower decrease during childhood predicted higher levels of internalizing problems and problem behaviors in early adolescence. Furthermore, lower sleep quantity in early childhood predicted higher internalizing problems and problem behaviors in early adolescence and a greater increase in problem behaviors in adolescence. Lastly, greater eveningness in early childhood predicted greater increases in problem behaviors during adolescence. Results of Study 3 provided evidence that evening chronotype longitudinally predicted less favorable sleep patterns, including greater sleep problems and lower sleep quantity. However, only sleep problems significantly predicted measures of adjustment, particularly internalizing problems; no effects of sleep quantity on adjustment were found.

The significance of this research study is to identify if an adolescences family structure impacts their developmental behaviors. The research design for this study was a quantitative design. The data analysis includes the independent variable (IV) and dependent variable (DV). For this study the IV was family structure and the DV in this study was delinquent behaviors. The findings suggest that during the pre-assessment tool researchers found there was no significance between family structure and delinquent behaviors. However, during the post assessment researchers found that there was significance between family structure and delinquent behavior. Although this study did not find significance during the pre-assessment, there were significant findings in the post-assessment that demonstrated that social workers should continue to consider family dynamics when assessing adolescents’ developmental behaviors.

The study explored relationships among discrimination experiences, mental health (i.e., anxiety symptoms, depression symptoms), risky behaviors (i.e., suicidal ideation, illicit substance use), religiosity, and social support in LGBT adults residing in Latin America. First, multiple regression analyses were conducted to identify patterns of connections among discrimination, mental health, suicidal ideation, and illicit substance use in sexual and gender minority adults from Latin American. Harassment/Rejection discrimination, but neither Work/School nor Other discrimination predicted suicidal ideation. None of the three discrimination subscales predicted illicit substance use. Work/School discrimination predicted mental health problems (Anxiety and Depression subscales of HSCL-25 combined), while Harassment/Rejection and Other discrimination did not. Depression predicted suicidal ideation, but failed to predict illicit substance use, and anxiety symptoms alone neither uniquely predicted suicidal ideation nor illicit substance use. Subsequently, separate mediational models were conducted to examine whether depression mediated relationships between Work/School discrimination and suicidal ideation, as well as Harassment/Rejection discrimination and suicidal ideation. Depression was a significant mediator of both of these relationships. To assess whether the relationships among discrimination, depression symptoms, and suicidal ideation varied as a function of religiosity and social support, the two mediation models were expanded to six moderated mediations. Depression symptoms mediated the effects of Work/School and Harassment/Rejection discrimination on suicidal ideation when participants had low to moderate levels of social support, but not high social support. Depression symptoms also mediated the effects of Work/School discrimination on suicidal ideation when participants had low to moderate levels of both Interpersonal and Intrapersonal Religiosity, but not when participants had high levels. Finally, Depression symptoms mediated the effect of Harassment/Rejection discrimination on suicidal ideation when participants had low to moderate levels of Intrapersonal Religiosity, but not when participants had high levels; depression symptoms mediated the effect of Harassment/Rejection discrimination on suicidal ideation at all levels of Interpersonal Religiosity. Limitations to the current study included a homogenous sample with respect to country of residence, education level, and socioeconomic status, with participants primarily residing in Mexico, having high levels of education, and being primarily middle class. These drawbacks limit generalizability of study findings to sociodemographically and demographically diverse samples of LGBT adults in Latin America. Nevertheless, results from this study indicate that high, but not low or moderate levels of social support and religiosity seem to buffer LGBT adults in Latin America against discrimination, specifically by weakening links among discrimination, depression symptoms, and suicidal ideation. Clinical intervention research with LGBT adults in Latin America should focus on increasing social support networks for this population and on helping LGBT adults reconcile conflicts between religious identities and sexual or gender minority identities, as religiosity may serve as a protective factor against mental health problems generally, and suicidal ideation specifically.

The focus of this study was to explore the impact of challenging behaviors on Applied Behaviors Analysis treatment in Autism Spectrum Disorder. The prevalence of ASD is on the rise, so it is important that we understand how patients are responding to treatment. In this study, we cluster patients (N=854) based on their eight observed challenging behaviors using k-means, a machine learning algorithm, and then perform a multiple linear regression analysis to find significant differences between average exemplars mastered. The goal of this study was to expand the research in the area of ABA treatment for ASD and to help provide more insight helpful for creating personalized therapeutic interventions with maximum efficacy, minimum time and minimum cost for individuals.

Dementia, a clinical condition that affects the psychological ability of patients, is distinguished by a significant overall decline in cognitive function that results in distorted perception. Guiding nursing practice in the long-term care (LTC) setting to decrease the unnecessary use of psychotropics is critical because doing so relates to the patients' quality of life and safety. In the LTC facility that served as the practicum site for this study, there was an observed overuse of psychotropic medications in the care of patients with dementia. The practice-focused question guiding this project asked whether a nursing staff development program would decrease the use of psychotropics in dementia patients. The purpose of the project was to inform nursing staff through an educational program on alternative methods to use when dementia patients exhibit increased disturbing behaviors. The conceptual framework for the project was the knowledge-to-action model. The nursing staff development program had a positive effect on the nursing staff as evidenced by a statistically significant improvement in knowledge and attitudes about the use of psychotropics in caring for dementia patients. The use of psychotropic in the dementia patient decreased from 22.32% to 15.77%, the lowest score achieved by the organization in 5 years. The dementia patients benefited from this project and its positive social change implications for nursing practice by decreasing dementia patients use of psychotropics, minimizing their side effects to the patients and providing an overall feeling of well-being.

Over 25 million people in the United States are affected by eating disorders, and understanding children's eating style can help determine maladaptive eating behaviors. This study was an investigation of parents' beliefs about their children's eating behaviors in relation to parental work status. Two theoretical frameworks were used to guide the study. Symbolic interactionism focused on communication between parents and children. Social learning theory focused on adolescents possibly learning their eating behaviors from observing their parents' eating habits. The research questions and hypotheses examined if there was a relationship between the work status of parents and their beliefs about maladaptive eating behaviors in their adolescents. This study used the parent-report measure, Children's Eating Behaviour Questionnaire (CEBQ). A nonexperimental causal-comparative quantitative research method was used. The participants included parents who have children between the ages of 6 and 12, and the sample size for this study was 126. A link between parental beliefs and early precursors of disordered eating in adolescents was not established. If patterns of a relationship between parents' work status and beliefs about children's maladaptive eating behaviors had been found, the patterns may have provided the possibility of serving as a factor of early intervention programs. The social change aspect obtained from this study may be that parents can work outside the home or not, and there may be other variables (such as family time, closeness, communication, stress) that may provide more information on how parents perceive children's eating behaviors.

Social media is a critical and omnipresent component in Millennials' lives. Using social media can lead to significant social change for societies both online and offline. Social media can be used as a tool to combat domestic and foreign terrorism and to protect our society. Prosocial perceptions and behaviors exhibited on a social media platform can transcend online social culture and produce replicas of those behaviors in the real world. Research in social activism portrayed by Millennials via social media is limited, and research regarding social media use and counterterrorism behaviors of Millennials has not yet been attempted. The current quantitative study assessed social media and its potential use for counterterrorism behaviors by Millennials by establishing if there were correlations between Millennials' social media usage and the existence or potential of using social media for counterterrorism behaviors. Reliability, exploratory factor analyses, as well as linear and hierarchical regression analyses were performed on a sample of 178 participants to establish if social media usage is predictive for counterterrorism behaviors while assessing if any variance is attributed to moderating variables. Positive relationships were found between social media preferences, networking power, and preferences for social responsibilities and counterterrorism behaviors. The survey used a modified instrument to address counterterrorism type behaviors in connection to social media usage, due to the inexistence of such instrument insofar. The results of the study contribute to social change by providing information on how to detect and increase counterterrorism behaviors and attitudes through social learning via social media platforms.

Teachers in a southwestern elementary school were struggling to support students who were not meeting proficiency standards in reading. The purpose of this study was to explore teachers' perceptions and experiences of how administrator behaviors and efforts influenced instructional practices and strategies in the classroom. Marzano's leadership evaluation model served as the conceptual framework that guided this study. The research questions focused on teachers' perceptions of how building administrators offered guidance about teaching and instructional activities and how building administrators influenced teaching and instructional activities to improve student performance. A basic qualitative design was used to capture the insights of 7 teachers who taught on the selected campus during the 2015-2016 school year and any number of school years before, after, or both before and after the 2015-2016 school year through semi structured interviews; a purposeful sampling process was used to select the participants. Emergent themes were identified through open coding, and the findings were developed and checked for trustworthiness through member checking and rich descriptions. The findings revealed that teachers believe that instructional guidance, administrator support, and data tracking positively influence student performance. A professional development project was created to provide administrators with strategies and approaches to support and guide classroom teachers more effectively. This study has implications for positive social change, in that the findings may be applied in creating a structure to provide administrators with strategies to improve school leadership behaviors.