Master of Public Health - MPH / Background: The repercussions of being HIV positive coupled by the complications of antiretroviral therapy are likely to cause distress, emotional and psychological problems particularly among children infected by the virus. The limited support services for children experiencing distress intensify the urgency to address this challenge. Despite the availability of social workers and nurses' interventions currently in place, the number of children in need of psychological care continues to increase. This is particularly true at Deborah Retief Memorial (DRM) hospital, one of the main antiretroviral therapy facilities in Kgatleng district, Botswana. Method: The purpose of this study was to explore and describe the perceptions of social workers, nurses and caregivers on key factors contributing to psychological distress of HIV positive children. A descriptive, exploratory qualitative study design that employed the use of in-depth interviews was used to conduct this study. Participants included four caregivers of HIV positive children who seek antiretroviral therapy at DRM hospital Infectious Diseases Control Clinic, together with five nurses and two social workers who worked in the same clinic. Conventional content analysis was used to analyse the in-depth interview transcripts. Results: Perceived psychological stressors for HIV positive children included disclosure of HIV status, orphanhood, social problems, lifelong treatment, stigma, poor caregiver-child relationship and lack of caregiver‟s love, care and support. However the caregivers did not fully understand the psychological distress the HIV positive children were experiencing, hence were unable to recognize it in these children. The study highlighted that major challenges faced by the health-workers included lack of qualified personnel, lack of adequate knowledge and skills, and a non-conducive working environment required to effectively assist children with psychological distress. The findings also indicated the need for education and support of caregivers and HIV positive children by the educators, family and health-worker systems. Conclusion: The profile of key stressors of psychological distress, the challenges and support needs suggested by the participants in this study can provide a framework for improving the existing services for HIV positive children with psychosocial problems. This information is important for use in training nurses and social workers involved with children with psychological behaviours.

The purpose of the study is to explore the psychological profile of South African police trainees. A literature study highlighted three important pretrauma variables that can influence an individual’s resilience when stressful circumstances occur. These variables include coping behaviour, personality characteristics and psychological distress. The primary goal of the research was to explore whether a relationship exists between these pretrauma variables and if demographic differences occur. Police officers in South Africa are exposed to violent circumstances, which can have a negative impact on their psychological functioning; it is therefore important to explore which psychological profiles are more likely to result in resilience. Studies such as this one can be used to facilitate the selection of resilient police officers in South Africa. A quantitative research investigation was conducted using three instruments namely, the Ways of Coping Questionnaire (WOC), Temperament and Character Inventory (TCI) and the Symptom Checklist-90-R (SCL-90-R). As a secondary aim, the psychometric properties of these instruments were briefly explored. A sample of 150 police trainees was selected to take part in the research study during their first six months in training, before entering the field. The selected sample size yielded a total of 142 completed tests. The participants were selected using a method of stratified random sampling, which resulted in an equal distribution of male and female trainees. The results confirm that the trainees are more likely to use adaptive coping mechanisms, and are generally psychologically healthy. As expected, significant relationships exist between the three pretrauma variables under investigation. / Dissertation (MA)--University of Pretoria, 2008. / Psychology / unrestricted

Thesis advisor: Sean Clarke / In the popular press and in the public imagination there has been much interest in the concept of generational differences—the idea that one’s experiences might vary as a function of the timing of one’s birth and other key life events relative to historical markers or periods. While research findings on generational differences in the workplace, including occupational health, have been limited and inconsistent, nurse administrators have noted important occupational health differences in work-related experiences of the nurses they supervise. This secondary analysis of cross-sectional data on 1,146 direct care staff registered nurses in non-administrative roles enrolled in the Boston Hospital Workers Health Study (BHWHS) in 2014 examined the relationships between being a member of one of three generationally-defined age groups (Baby Boomers, Generation X and Millennials) and indicators of three major categories of health. Physical (measured by body mass index, pain presence and severity, absences and limitations related to pain, and occupational injury), psychological (measured by psychological distress), and overall work-related (measured by work limitations) health variables were analyzed using regression modeling controlling for individual and work-related characteristics. Overall, this sample of nurses from two major teaching hospitals in a single city, which was relatively homogeneous in terms of gender, race, and ethnicity, reported generally good health and serious symptoms or limitations were rare. With a few notable exceptions, poor physical health was more common in older age groups and psychological symptoms were worse in the younger age groups in this cohort. However, the findings should be interpreted cautiously and may reflect a number of selection and survivor biases. Further research is needed to replicate these findings before drawing broader conclusions about age or generation as influences on nurse occupational health. As the empirical literature stands, it appears that energy would best be focused on nurturing a culture of health, emphasizing risk factors for various health problems, across all age groups, rather than in tailoring health promotion efforts for nurses by age or generation. / Thesis (PhD) — Boston College, 2020. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Objectives: To examine changes in planning, selecting, and preparing healthy foods in relation to personal factors (time, money, stress) and social distancing policies during the COVID-19 crisis. Methods: Using cross-sectional online surveys collected in 38 countries worldwide in April-June 2020 (N = 37,207, Mage 36.7 SD 14.8, 77% women), we compared changes in food literacy behaviors to changes in personal factors and social distancing policies, using hierarchical multiple regression analyses controlling for sociodemographic variables. Results: Increases in planning (4.7 SD 1.3, 4.9 SD 1.3), selecting (3.6 SD 1.7, 3.7 SD 1.7), and preparing (4.6 SD 1.2, 4.7 SD 1.3) healthy foods were found for women and men, and positively related to perceived time availability and stay-at-home policies. Psychological distress was a barrier for women, and an enabler for men. Financial stress was a barrier and enabler depending on various sociodemographic variables (all p < 0.01). Conclusion: Stay-at-home policies and feelings of having more time during COVID-19 seem to have improved food literacy. Stress and other social distancing policies relate to food literacy in more complex ways, highlighting the necessity of a health equity lens. / Agentschap Innoveren en Ondernemen / Revisión por pares

Thesis advisor: Rocio Calvo / Racial choice, an aspect of racialization via racial categorization, may position Latinx individuals into differential pathways to well-being or distress. The psychological distress rates of Latinxs differ by ethnic group, racial choice and Medicaid coverage. However, little is known about how these factors relate to one another to impact psychological distress. The three studies of this dissertation use nine years of pooled data (N=34,201) from the National Health Interview Survey (NHIS), 2010-2018. The NHIS is a national and annual survey that is telephonically administered to track the health and mental health status of individuals living in the United States. Study 1 examined the relationship between racial choice (Black, Other vs. White) and psychological distress (moderate, serious levels vs. low) among panethnic and ethnic group (Mexican, Cuban, Puerto Rican, Dominican) samples of Latinx individuals. Findings revealed that Black racial choice is significantly related to higher levels of distress for Mexicans and Cubans, but not for Puerto Ricans and Dominicans. Study 2 examined the moderating role of ethnic group in the relationship between Medicaid coverage, racial choice and psychological distress. Findings revealed that Medicaid coverage decrease the odds of distress for Black-Puerto Rican and -Dominican respondents compared to Black-Mexicans and -Cubans. Study 3 examined whether immigrant status and socioeconomic status (SES) are significant correlates to racial choice. Findings revealed that immigrant status and low SES have significant but different associations with choosing Black as a race over White. These findings show that racial choice matters in the lives of Latinxs and may create pathways to different levels of distress. Special attention on the reasons behind Latinx racial choice is needed to further understand the impact of racialization on Latinx mental health. The findings of each study are further discussed in their corresponding chapters. / Thesis (PhD) — Boston College, 2020. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

Sustainable development efforts frequently focus on understanding and promoting the factors that influence health and wellbeing. Urban environments have received attention in recent years as spaces which can increase psychological distress. Despite hypothesized reports of urban environments being less conducive to good mental health then natural environments, few studies have investigated the effects of urban form characteristics (size, density, nuisances, transportation, and housing characteristics) and mental health measures at the city level. Using 2014 data from the 500 largest cities in the United States, this thesis evaluates the relationship between urban form and aggregate self-report scores of poor mental health. Results suggest that elements of the built environment have a direct influence on mental health status. The aim of this study is to test the association of urban form characteristics and psychological distress using a cross-sectional analysis of individual health survey responses. Mental health data were collected for a study of Center for Disease Control health characteristics in the 500 largest cities in the United States. Urban form data was collected from both United States Census and GIS datasets such as the Center for Neighborhood Technology’s Housing and Transportation Affordability Index (H+T Index). Linear regression analysis and factor analyses were used to estimate the relationship between psychological distress and urban form characteristics. Results suggest that urban density is negatively associated with mental health status at city level. This finding is logical and confirms earlier research. While measures of housing cost and diversity were slightly negatively associated with mental health, measures of transportation cost and employment access were slightly positively associated.

Autism poses many internal challenges, from increased sensory overwhelm and cognitive inflexibility to navigating co-occurring conditions like depression and anxiety. In addition, Autistic persons may use different internal working models to transact with other agents in the world. These population differences may result in empathy gaps. How do scientists minimize the resulting psychological distress associated with these challenges and empathy gaps? A psychoeducational program for global cognition was developed that attempts to integrate psychological research to design a prosthetic internal working model. The result is EM-Theory (Elemental Model), a 4x4 (sixteen elemental module) psychoeducational matrix called the Skew Metric. EM-Theory may evoke increased psychoeducational insight into the mechanics of cognitive architecture in a manner that is always accessible because it is optimized for limited capacity visuospatial working memory. It is hypothesized that an increased understanding of cognitive mechanics may increase capacities to self-regulate psychological distress. Emphasis was placed on four reportable elemental modules as a significant cause of psychological distress. A small conceptual study was conducted with 10 participants with autism spectrum differences (ASD) and ten participants from the typically developing population (TD). Measures were taken to capture attributes of psychological distress from four reportable elemental modules (worry, rumination, distraction from mindfulness, and loss of mental vigilance), as well as measures designed to capture each ASD participant’s relationship with internalized narratives implicating their autism. General conclusions were not drawn from this small sample study. However, individual differences were described as a proof of concept on how a quantitative test may be further developed to provide accurate and meaningful feedback to assist beyond introspection. / Graduate

Workplace stress has been found to be a causal agent of psychological distress consequences in employees. Chronic stressors have been well researched, in particular, role conflict, role ambiguity, and work overload have been extensively studied. A meta-analysis was conducted in order to aggregate past research to gain a better understanding of the impact these stressors have on the psychological distress consequences of depression, tension/anxiety, somatic complaints, and generalized feelings of stress. Only role ambiguity was found to be a significant contributor to psychological distress, in particular to feelings of depression and stress. In general, however, effect sizes for all three stressors were moderate to large. While chronic stressors have been well researched, acute stressors have been widely overlooked. Since research in this area is limited, the Daily Work Hassles Survey was developed and validated in order to analyze the role daily hassles play in the workplace. The survey yielded two factors, Interpersonal Hassles and Task Hassles. The former of which was found to be significantly related to the distress consequences of depression, tension/anxiety, somatic complaints, and general feelings of stress. The ultimate goal of this project was to compare chronic and acute stressors. Results from the daily hassles study were contrasted to the results of the aforementioned meta-analysis. It was found that the chronic stressors of role ambiguity, role conflict, and overload are significantly greater predictors of selected distress consequences than the acute factors of Interpersonal Hassles and Task Hassles. However, when somatic complaints was employed as the dependent variable, no significant differences were found between chronic and acute stressors.

Caregiving, specifically caregiver burden, is commonly related to decreased psychological well-being. Conversely, marital quality is positively related to psychological well-being, though existing literature presents mixed findings as to whether or not a gender difference exists in this relationship. The current study examined the relationship between objective and subjective spousal caregiver burden and psychological distress with marital quality as a moderator. Gender differences in this relationship were also explored. 1,066 spousal caregivers from the National Study of Caregiving (NSOC) were used to estimate cross-sectional moderation models and plot significant interactions in Mplus. Results indicated a significant positive relationship between subjective caregiver burden and psychological distress, and higher marital quality protected against psychological distress in this relationship. The connection between objective caregiver burden and psychological distress was not significant, and no gender differences were found in the moderation of marital quality. These findings suggest that perceptions of caregiver burden are important for the psychological health of spousal caregivers, and higher marital quality may be an effective buffer of this relationship regardless of gender. Spousal caregivers who perceive caregiving to be highly burdensome may benefit from improving their marital quality to protect against negative psychological health outcomes.

Background: Stroke remains a major public health burden. Few studies have focused on the age differences in the associations of behavioral and psychosocial factors with stroke while no study focusing on the effect of severe psychological distress (SPD) on stroke has been conducted. The aim of this study was to examine the age differences in these risk factors for stroke as young (18-44 years), middle aged (45-64 years), and elderly (65 years or older). Methods: A total of 1,258 adults with stroke and 39,985 controls were selected from the 2005 California Health Interview Survey. Multiple logistic regression analyses were used to estimate the associations of the factors with stroke at different ages. Results: The prevalence of SPD was 10% in cases and 3.6% in controls, respectively. Overall, current smoking, lack of physical activity, alcohol consumption, SPD, type II diabetes, male, older age, and unemployment were all associated with a higher prevalence of stroke. Practically, we found that smoking and SPD were associated with the prevalence of stroke in young adults, lack of physical activity was associated with the prevalence of stroke in middle-aged adults, and lack of physical activity and SPD were associated with the prevalence of stroke in the elderly. Conclusions: Appropriate intervention for reducing stroke and eliminating its disparities may be developed separately at each age.