In this study, exercise adherence levels were examined from archival data collected from 2004 to 2006 to determine if an association existed with the levels of depression among individuals over 49 in 3 rural community centers. Abundant research has shown that exercise is effective in alleviating depression but has not shown how levels of exercise adherence may impact the efficacy of exercise in the treatment of depression. The focus of the study was to determine if an increase in exercise adherence may be associated with a decrease in the symptoms of depression. An ANCOVA was used to determine if differences in levels of depression were significantly associated between low and high exercise adherence. The results did not provide evidence that a high level of exercise adherence is associated with lower symptoms of depression. An independent samples t test was used to determine if gender makes any difference in exercise adherence. The results did not provide evidence that gender made any difference in exercise adherence. An ANOVA was used to determine if the type of exercise was associated with exercise adherence. The results provided significant evidence that select exercises were adhered to more than others. A new study comparing varying levels of exercise adherence, not merely low exercise adherence and high exercise adherence, would allow for a more precise measurement of the association between exercise adherence and depression. It is hoped that providing further insight into an adjunct treatment of depression will result in an increased efficacy of treatment and a positive social change for society.

Deaf students have unique linguistic and cultural needs that are cultivated in social settings; however, these needs have received minimal consideration from school administrators and policy makers when designing and implementing educational programs. Inquiry regarding how Deaf people learn in social situations and whether these processes are present in formal educational settings is necessary to understand how to better serve this population in school. Observations were used to provide insight on how deaf people teach and learn from one another in social/informal settings. Individual interviews with 11 Deaf people ages 18 to 40 provided insight regarding personal experiences in formal and informal educational settings. Constructivism, sociocultural theory, and multiple intelligences theory were the conceptual frameworks for this study. Trustworthiness was established using member checking and detailed accounts of participants' experiences in their educational placements. The findings revealed that deaf people value facets of Deaf culture in all aspects of their lives, including education. Participants expressed the need for school staff and administrators to understand cultural nuances that are important for deaf students, the need for barrier-free communication, the importance of self-identity, and the need for Deaf mentors and or role models in school. In social settings, deaf people use visual communication and require clear sightlines for communication, use expansion techniques unique to ASL, use scaffolding to support and mentor one another, and use repetition for clarity, understanding, and emphasis. The knowledge gained from this study can help actualize educational curricula that improve literacy and increase job and educational opportunities for deaf people.

Professionals who work with victims of sexual trauma frequently experience emotional and psychological stressors that affect their everyday life. Vicarious traumatization is an occupational risk among helping professionals, but it is not known how this phenomenon can be identified and minimized among professionals who work with victims of sexual trauma. The purpose of this qualitative narrative study was to explore the personal experiences of licensed and nonlicensed professionals who work with female victims of sexual trauma. Constructivist self-development theory and the traumagenic dynamics model provided the framework for the study. The research questions focused on the evidence of vicarious trauma among participants, the skills and techniques used to minimize the risk of vicarious trauma, and the influence of vicarious traumatization on helping professionals. Data were collected through semistructured interviews with 8 helping professionals in the Southern United States. Findings from data coding and theme analysis indicated that (a) professionals experience psychological and emotional risks in trauma work, (b) establishing boundaries and implementing self-care techniques can minimize vicarious trauma, and (c) consistent training and ongoing discussions about vicarious trauma are essential to professionals who commit their lives to helping sexual trauma victims. Findings may be used to increase awareness and education about vicarious trauma among professionals who work with victims of sexual trauma, and to develop techniques to minimize the risk of vicarious trauma.

Mediation analysis is built to answer not only if one variable affects another, but how the effect takes place. However, it lacks interpretable effect size estimates in situations where the mediator (an intermediate variable) and/or the outcome is categorical or otherwise non-normally distributed. By integrating a powerful approach known as average marginal effects within mediation analysis—termed Marginal Mediation Analysis (MMA)—the issues regarding categorical mediators and/or outcomes are, in large part, resolved. This new approach allows the estimation of the indirect effects (those effects of the predictor that affect the outcome through the mediator) that are interpreted in the same way as mediation analysis with continuous, normally-distributed mediators and outcomes. This also, in turn, resolves the troubling situation wherein the indirect plus the direct effect does not equal the total effect (i.e., the total effect does not equal the total effect). By offering this information in mediation, interventionists and lawmakers can better understand where efforts and resources can make the greatest impact. This project presents the development and the software of MMA, describes the evaluation of its performance, and reports an application of MMA to health data. The approach is successful in several aspects: 1) the software works across a wide variety of situations as the MarginalMediation R package; 2) MMA performed well and was statistically powered much like other mediation analysis approaches; and 3) the application demonstrated the increased amount of interpretable information that is provided in contrast to other approaches.

Late-life depression is a major public health concern, associated with poor health outcomes, including doubling of dementia risk. Psychiatric evaluation is impractical in large epidemiological studies, which instead typically rely on self/informant reports, which are subject to various biases (stigma, recall). Few studies have addressed level of agreement between sources. This study examined associations between these sources and assessed whether subject and informant variables moderated these associations. In a population-based study of dementia in Cache County, Utah (2002-5), 1,480 subjects completed an in-depth clinical assessment (CA). Major depression was assessed via the self-report Patient Health Questionnaire-9 (PHQ-9) and informant-rated Neuropsychiatric Inventory (NPI-CA). One hundred forty-eight subjects with cognitive impairment also completed a psychiatrist’s examination, including the self-report Geriatric Depression Scale (GDS), the informant-rated NPI (NPI-MD), and the physician’s clinical rating (PCR). Bivariate correlations were modest: NPI-CA versus PHQ-9 (r = .26), NPI-MD versus GDS (r = .20), GDS versus PCR (r = .22), NPI-MD versus PCR (r = .45). Kappa statistics and logistic regression models indicated that the NPI-CA predicted the PHQ-9 moderately (ϰ = .08, p <.001; OR = 3.1, 95% CI: 1.5 to 6.1). Results also indicated that the GDS did not significantly predict the PCR (ϰ = .10, p > .05; 95% CI: 0.7 to 11.2) nor the NPI-MD (ϰ = .01, p > .05; 95% CI: 0.6 to 6.3), and that the NPI-MD predicted the PCR moderately well (ϰ = .35, p < .001; OR= 11.1, 95% CI: 2.6 to 48.3). CA-NPI predicted the PHQ-9 for cognitively normal subjects (ϰ = .13, p < .001; OR = 10.1, 95% CI: 1.9 to 52.6) but not for subjects with mild impairment (ϰ = .01, p > .05; 95% CI: 0.4 to 4.3) nor dementia (ϰ = .14, p > .05; 95% CI: 0.9 to 7.8). No other variables moderated these associations. Results suggest the importance of cognitive assessment when measuring late-life depression via self-report.

abstract: Statistical inference from mediation analysis applies to populations, however, researchers and clinicians may be interested in making inference to individual clients or small, localized groups of people. Person-oriented approaches focus on the differences between people, or latent groups of people, to ask how individuals differ across variables, and can help researchers avoid ecological fallacies when making inferences about individuals. Traditional variable-oriented mediation assumes the population undergoes a homogenous reaction to the mediating process. However, mediation is also described as an intra-individual process where each person passes from a predictor, through a mediator, to an outcome (Collins, Graham, & Flaherty, 1998). Configural frequency mediation is a person-oriented analysis of contingency tables that has not been well-studied or implemented since its introduction in the literature (von Eye, Mair, & Mun, 2010; von Eye, Mun, & Mair, 2009). The purpose of this study is to describe CFM and investigate its statistical properties while comparing it to traditional and casual inference mediation methods. The results of this study show that joint significance mediation tests results in better Type I error rates but limit the person-oriented interpretations of CFM. Although the estimator for logistic regression and causal mediation are different, they both perform well in terms of Type I error and power, although the causal estimator had higher bias than expected, which is discussed in the limitations section. / Dissertation/Thesis / Masters Thesis Psychology 2019

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Although there is a wealth of research knowledge related to risk behavior engagement of the general student population, there is less specifically reported about honors students. To address this gap in research, non-honors and honors students were surveyed to determine possible differences in risk behavior engagement. Students were recruited through the East Tennessee State University psychology subject pool and via direct email messages to an honors student-specific listserv. We hypothesized that honors students would have differences in terms of GPA and number of credit hours, endorse more substance use and have more perceived stress compared to non-honors students. The survey sample was majority non-honors students (90.5%; n = 383), with 9.5% (n = 40) honors undergraduate students. After conducting chi-square tests of independence and independent t-tests we determined that there were no significant differences in substance use, life events, or emotional dysregulation between groups. However, upon analyzing demographic information honors students reported significantly higher GPAs (M = 3.77, SD = 0.32) than non-honors students (M = 3.53, SD = 0.53), t(404) = -2.72, p = .007. Additionally, honors students reported a higher number of credit hours than non-honors students, t(403) =-4.26, p < .001, with non-honors students taking an average of 14.67 (SD = 2.63) credit hours and honors students an average of 16.53 (SD = 1.81) credit hours. No other significant demographic differences were observed. Our findings did not show significant differences within populations, but rather, that honors students likely encounter stress and engage in risk behaviors just as much as non-honors students.