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This qualitative research study was designed to follow-up with ten participants in a relapse prevention program at an inpatient psychiatric unit with a diagnosis of major depression for the purpose of determining their experiences post-discharge in practicing relapse prevention and in pursuing and maintaining wellness in their mental health. It relied upon narrative theory, theories of self-efficacy, and theories of depression to guide the research process as well as the field of knowledge about rehospitalization, relapse prevention, depression, and self-efficacy. Participants described depression associated with loss, feeling helpless, powerless, overwhelmed and suicidal. They increased in their confidence of depression management as their depression got better and they actively managed it. During the interviews participants expressed themes of connection, with participants feeling disconnected from themselves and others, wanting to be listened to, but feeling unheard or hiding their own voice, a loss of self with healing occurring through use of self, learning cognitively and experientially to manage their depression using specific self-efficacy skills and identifying the things that interfered with depression management. A relational theory of depression management, based on attachment theory is proposed and several suggestions for research and treatment are made. / Ph. D.

The current study examined direct and indirect influences of romantic attachment processes, marital adjustment, and the coparenting relationship on family functioning. Data was collected from a community sample of 86 heterosexual couples with a child aged eight to eleven living in the home. Both spouses completed a demographic questionnaire, the Experiences in Close Relationships Scale, the Dyadic Adjustment Scale, the Coparenting Scale, and the Self-Report Family Inventory as part of a larger study on family processes in middle childhood. Data analysis included multilevel modeling, utilizing the actor-partner interdependence model. Results indicated that marital adjustment mediated the association between attachment processes and family functioning, suggesting that a healthy marital relationship is an important variable that helps explain links between attachment security and the family functioning. Findings also highlighted the benefit of conceptualizing adult romantic attachment, marital, and coparental subsystems within a systemic framework.

The current study aimed to examine current diabetes outcomes within the context of past and present relationships for type 1 diabetics. To qualify for the study, participants had to have been diagnosed with type 1 diabetes prior to the age of 18 and reported that they were currently in a committed romantic relationship. Relationships have been known to impact diabetes management practices; however, the impact of the long-term impact of shared management for adolescents with their parents has never been examined. Additionally, the current romantic relationship has been shown to have an impact, as well, so romantic relationships were also included in the study. Family systems theory suggests that relationships across the lifespan have a significant impact on across the lifespan. Within the context of diabetes management, family systems theory suggests that the role of the parent in shared management in adolescence may have a long-term effect on diabetes management in adulthood. Therefore, it was hypothesized that the parent-child relationship dynamics related to diabetes in adolescence would be associated with current diabetes management outcomes in adulthood. Further, it was hypothesized that this relationship would remain when current romantic relationship dynamics were considered. The current study recruited n = 123 adult participants with type 1 diabetes who were currently in a committed romantic relationship. Participants completed an online survey focused on their relational experiences related to diabetes in adolescence and in the context of their current romantic relationship. The survey assessed the diabetes outcomes of general blood sugar management, the HbA1C (A1C), and emotional distress related to diabetes management. A series of multiple linear regression analyses revealed that, for the most part, a collaborative parent-child diabetes management relationship and parent-child diabetes management conflict were not associated with A1C in adulthood. However, greater parent-child conflict during adolescence was associated with greater diabetes emotional distress in adulthood. In terms of the partner relationship, unsupportive romantic partner behaviors were associated with poorer A1C and greater diabetes emotional distress, even when the parent-child variables (i.e., collaborative parent involvement, diabetes responsibility, and diabetes specific conflict) were also included in the analysis. All regressions are controlled for age. Romantic relationship quality was controlled for within the regressions that included the romantic relationship constructs. There were two notable outcomes from these analyses: 1) arguments related to diabetes management in adolescence may be related to diabetes emotional distress in adulthood, and 2) unsupportive partner behaviors may be related to worse A1C and diabetes emotional distress outcomes. Implications for future research and practice are also addressed within the study. / Doctor of Philosophy / The current study looked at how type 1 diabetes (T1D) outcomes may be related to current romantic partner relationships and the relationship dynamics in adolescence with the participant's parent. Participants in the study were diagnosed with T1D prior to the age of 18 and were currently in a committed romantic relationship. Other research has found that relationship dynamics are related to diabetes outcomes, such as the HbA1C (A1C) and emotional distress related to diabetes. Therefore, this study looked at both the family of origin experiences and the current partner relationship dynamics, as related to T1D specifically. In the current study, n = 123 participants reported on their experience managing diabetes in adolescence with their parents. To examine this, participants completed surveys related to how collaborative their parents were in adolescence, whether they or their parents carried the responsibility for different tasks, and how many topics related to diabetes they would argue about. Next, they reported on their partner's current supportive and unsupportive behaviors. The role of the parent and partner relationship were then both examined to determine if they were related to the A1C or emotional distress in adulthood. Based on these results, it was found that more arguments in adolescence were related to more diabetes specific emotional distress in adulthood. Meanwhile, it was also found that unsupportive behaviors from partners were also related to more diabetes specific emotional distress and worse A1C.

Doctor of Philosophy / Department of Family Studies and Human Services / Walter R. Schumm / Abstract This study seeks to clarify a controversy in the literature about which characteristics of families are most responsible for facilitating the development of empathy in children. The study utilized a correlational research design and self-report questionnaires. The Balanced Emotional Empathy Scale measured the criterion variable, subjects’ levels of emotional empathy. The Circumplex Model of Marital and Family Systems’ accompanying questionnaire, the fourth version of the Family Adaptability and Cohesion Evaluation Scales (FACES IV) measured the two key predictor variables, levels of family cohesion and family flexibility, in the subjects’ families of origin. The central hypothesis of the Circumplex Model is that healthy family functioning would be predicted by balanced functioning on both of these key dimensions of family life. The first predictor variable, family cohesion, appears to encompass those factors emphasized by researchers who have asserted that positive family affective bonds would be the family characteristic most predictive of higher levels of empathy in children. The second predictor variable, family flexibility, appears to encompass those factors emphasized by researchers who have asserted that the style of parental discipline would be the family characteristic most predictive of higher levels of empathy in children. Participants in this study were all students at a mid-size, public, Midwestern university. A purposive convenience sample was utilized. Correlational statistics and multiple regression analyses were used to test hypotheses. The results suggested several conclusions. Balanced levels of family cohesion were positively associated with higher levels of emotional empathy, as predicted. The prediction that balanced levels of family flexibility would also be positively associated with higher levels of emotional empathy was not supported. Instead, higher levels of empathy were associated with a somewhat strict or rigid style of parental discipline. Various alternative explanations for these results are discussed, as are limitations of the study, recommendations for future research, and implications for practitioners.