Family Science Theses and Dissertations
Permanent URI for this collectionhttp://hdl.handle.net/1903/2770
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Item VICTIM DEPRESSION, POSITIVE PARTNER BEHAVIOR, AND TYPE OF PARTNER AGGRESSION AS DETERMINANTS OF WOMEN’S STEPS TOWARD LEAVING AN ABUSIVE RELATIONSHIP(2019) Thomas, Jannel; Epstein, Norman B; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)This study investigated factors associated with the degree to which victims of partner violence take steps toward leaving the relationship. It was a secondary analysis of clinic data from pre-therapy couple assessments of demographic characteristics; physical, psychological, and sexual partner aggression; victim depression; perpetrator positive partner behavior; and steps the victim took toward leaving. Females’ income and education were not associated with steps toward leaving. Physical, psychological, and sexual aggression were all associated with steps toward leaving. Greater depression was associated with more steps toward leaving and more positive partner behavior was associated with fewer steps toward leaving. Neither depression nor positive partner behavior moderated the association between physical or psychological aggression and steps toward leaving. The association between sexual aggression and steps toward leaving was positive when positive partner behavior was higher, but non-significant when positive partner behavior was lower. Clinical implications and suggestions for future research are discussed.Item RACE AND IMMIGRATION STATUS AS MODERATORS OF THE RELATIONSHIP BETWEEN FAMILY ACCEPTANCE/FAMILY REJECTION AND DEPRESSIVE SYMPTOMS FOR LGBTQ+ YOUTH(2019) Levin, Emma R; Leslie, Leigh; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Research consistently demonstrates that LGBTQ+ youth, when compared to non-LGBTQ+ youth, are at significantly greater risk for depression, anxiety, substance use, and suicidality as a result of stressors related to belonging to a minority group (Russell & Fish, 2016). Family acceptance is an important protective factor against these negative mental health outcomes, and family rejection has been demonstrated as an important risk factor. Research on LGBTQ+ youth has been criticized for regarding all LGBTQ+ youth as the same and not accounting for the intersection and interaction with other identities such as race or immigrant status. The research questions posed by this study are 1) to what extent do race and immigrant status, separately and combined, moderate the established relationship between family acceptance and depressive symptoms?, and 2) to what extent do race and immigrant status, separately and combined, moderate the established relationship between family rejection and depressive symptoms? Results of the present study show that race significantly moderated the relationship between family acceptance and depression for LGBTQ+ youth, but did not moderate the relationship between family rejection and depression. Immigrant status moderated neither relationship. Three-way interactions with race and immigrant status moderated both the association among family acceptance, family rejection, and depression. Clinical implications and implications for future research are discussed.Item Clerical Conduct Related to the Perpetuation of Child Sexual Abuse in Pennsylvania Catholic Dioceses: A Developing Framework(2019) Britto, Crystel; Roy, Kevin; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Throughout his papacy, Pope Francis reiterated that clericalism played a major role in the global Catholic sexual abuse crisis. Research has not been able to back this claim due to lack of data on cultural and structural elements that have contributed to the various crises. The present study aims to fill this gap in research by examining narratives regarding clerical sexual abuse and seeks to explore themes contributing to a framework of abuse. Qualitative data analysis was conducted by examining the 40th Statewide Investigating Grand Jury Report of Pennsylvania, focusing on correspondence between various actors regarding 12 priests in Pennsylvania and their involvement in child sexual abuse. Using grounded theory with elements of narrative analysis, the study seeks to explore themes of belief, behavior and emotion of clergy between 1930-2016. The results provide insight into the nature of the Catholic Church’s involvement in the perpetuation of child sexual abuse.Item FAMILY-CENTERED PEDIATRIC CARE: PREDICTORS OF ACCESS AND ASSOCIATIONS WITH CHILD WELL-BEING(2019) Fife, Julie Marie; Lewin, Amy B; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Despite widespread recognition that family-centered care (FCC) is a critical component of quality pediatric health care, not all children receive FCC. This study builds on previous work by: (1) examining the extent to which socioeconomic resources are associated with the receipt of FCC after implementation of the Affordable Care Act, (2) exploring whether healthcare workforce shortages interfere with the delivery of FCC, and (3) extending previous research on the role of FCC in child well-being by measuring well-being across multiple domains and including children without special health care needs. Using data from the 2016 National Survey of Children’s Health (n=50,212), this study found a graded relationship between the odds of receiving FCC and multiple indicators of family-level socioeconomic resources, indicating that socioeconomic resources, beyond health insurance, are important factors in accessing quality pediatric health care. Healthcare workforce shortages may also play a role in the availability of FCC. Results from this study found consistent and significant associations between FCC and positive child well-being among healthy and typically developing children, and these associations were found across all domains of development. Findings indicated that FCC is particularly beneficial for young children (0-5 years), and children in households with low to moderate socioeconomic resources, making it a potentially meaningful tool to help reduce health disparities for children from households with more limited socioeconomic resources. Future research, and policies and practices aimed at increasing the delivery of FCC should include and emphasize the experiences of Hispanic families and families with limited socioecnomic resources.Item Trangender-Inclusive Health Care Services Among College Health Centers in the United States(2019) Messman, Jenna Beckwith; Leslie, Leigh A.; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Research demonstrates that transgender people face significant health disparities compared to their cisgender peers, experience harassment and mistreatment in health care settings, and that many health care facilities are ill-equipped to competently treat them. While there has been some evaluation of trans-inclusive services provided in large health care facilities, there has been no formal assessment of the competencies of college health care facilities to meet the needs of transgender students. A 43-item survey tool operationalizing the American College Health Association’s (ACHA) Guidelines for Trans-Inclusive College Health Programs was developed and sent to representatives of ACHA’s membership (n=1,005). The degree to which college health centers are meeting these 32 recommended guidelines was assessed. The data show that college health centers are overwhelming providing some degree of trans-inclusive health care and that the provision of such services varies greatly based on six institutional characteristics: control of institution (public vs. private); religious affiliation (yes vs. no); transgender-inclusive laws and policies by state (low inclusion vs. high inclusion); size of institution (<1000, 1000-4999, 5000-9999, 10000-19999, 20000+); locale (city, suburban, town, rural); and region (Northeast, Midwest, South, West). These findings are notable in that many college health centers are providing more trans-inclusive care than most large health care facilities and are positioned to be leaders in trans-inclusive health care. Despite the provision of such services on college campuses, transgender students still face significant health disparities compared to their cisgender peers and more research is needed to better understand what colleges and communities can do to improve their health outcomes.Item THE MEDIATING ROLE OF PARENTING BEHAVIOR IN THE ASSOCIATION BETWEEN PARENTAL AND CHILD PSYCHOLOGICAL FUNCTIONING(2019) Gheorghiu, Stefania; Epstein, Norman B; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The aim of the present study was to broaden the investigation of the intergenerational association of psychological functioning by examining the role of parenting behavior (harsh parenting and parental acceptance) as a mediating factor in the association between maternal and youth psychological functioning (i.e., severity of anxiety and depression symptoms). Measures of psychological distress, harsh parenting, and parental acceptance were administered to a community sample of 309 Latino youth (ages 9-15) and their mothers. Results from a path analysis, controlling for monthly family income, mother’s age at baseline assessment, and the number of children in the household, showed support for the mediating role of parental acceptance but not harsh parenting in the association between parent and youth psychological functioning. However, harsh parenting had an indirect association with child psychological distress, mediated by lower child perceptions of parental acceptance. Implications for future research and clinical practice are discussed.Item THE PHYSICAL AND MENTAL HEALTH EFFECTS OF ADULT CHILDREN ON FATHERS: A LONGITUDINAL STRUCTURAL EQUATION ANALYSIS(2019) Blick, Ryan; Anderson, Elaine; Roy, Kevin; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Men are entering the later stages of life at an unprecedented rate. As fathers and their children age, a gradual transition in the hierarchy of their relationship occurs, eventually resulting in fathers being recipients, rather than providers, of care. Unfortunately, little is known about the effect that adult children (children ages 19 years old and above) have on fathers’ physical and mental health in the middle-to-late stages of life. Using a sample of 588 fathers who were between the ages of 50- and 80-years-old and who had at least one adult child, a series of structural equation models using a cross-lagged panel design were conducted to increase our understanding of 1) the nature of the associations among fathers’ physical health, mental health, relationship quality with their spouse, and relationship quality with their adult children over time in middle-to-late adulthood, and 2) how these associations change as fathers age in middle-to-late adulthood. The findings indicate that fathers’ mental health is strongly correlated with their physical health, marital relationship quality, and relationship quality with their focal child across all age groups of fathers between 57- and 80-years-old. However, a transition seems to occur for fathers between 63- and 68-years-old that increases the within-time salience of fathers’ relationship quality with their focal child. In spite of the strong bivariate correlations, the structural equation models revealed high levels of within-trait stability and a lack of cross-trait predictive power among each of these aspects of fathers’ lives across age groups. The lone exception to this was in the emergence of a significant effect from father’s mental health between the ages of 69- and 74-years-old to their father-child relationship quality six years later, suggesting the possibility of a final transition in father-child relationship dynamics late in fathers’ lives.Item Life Course Events and Reproductive Function: Examining the Long-Term Influence of Stress on Women's Fertility and Reproductive Health Over the Life Course(2019) Gleason, Jessica L; Thoma, Marie E; Moser Jones, Marian; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Over the last decade, infertility, or the inability to achieve pregnancy after 12 months of trying, has risen to a place of public health prominence, with links being made to cardiovascular disease, diabetes, cancer, and other chronic disease. The mechanisms linking infertility to later-life morbidity are unclear, but are most likely due to shared physiologic pathways, such as chronic perturbation of the stress response axes. This investigation had three primary aims: understanding the current state of the research on psychosocial factors as precipitants of infertility by conducting a systematic scoping literature review; exploring associations between infertility-related conditions, endometriosis and uterine fibroids, and chronic inflammation and telomere attrition; and, examining the temporal influence of early life stress on infertility. For the first aim, few studies were identified that directly explored a temporal association between psychosocial factors and infertility, though these studies support the plausibility of this association. For the second aim, women with endometriosis had higher odds of having elevated levels of the inflammatory biomarker, C-reactive protein, and their telomeres shortened at a rate of 1% for every year of diagnosis of their condition. Black women with endometriosis had 13.6% shorter telomeres than those without endometriosis. For the third aim, the experience of stressful life events (SLEs) was associated with elevated odds of infertility, which increased with each increasing event, such that women reporting three and four or more events had 1.68 (CI: 1.16, 2.42) and 1.88 (CI: 1.38, 2.57) higher odds, respectively. Maternal responsiveness moderated this association, such that those with lower responsiveness had higher increasing odds of infertility with the experience of two, three, or four or more events (OR=1.98, CI: 1.01, 3.93; OR=2.63, CI: 1.18, 5.89; OR=3.07, CI: 1.53, 616). The results of this investigation indicate that there may be a temporal association between stress and infertility. Additionally, given their associations with reproductive function, inflammation and stress may be part of the shared mechanisms linking infertility to poor overall health, as well as future health outcomes.Item Operation Pedro Pan Over the Life Course(2019) Pakstis, Allyson; Moser Jones, Marian; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)This dissertation examines the short- and long-term psychosocial effects of unaccompanied childhood migration over the life course of individuals who participated in Operation Pedro Pan. This program, in which over 14,048 unaccompanied Cuban children migrated by plane to the U.S. between 1960 and 1962 to flee the Fidel Castro regime, resulted in the separation of thousands of Cuban families for periods ranging from a few months to permanent separation. Operation Pedro Pan, a singular historical event, serves as a case study for investigating the implications of unaccompanied child migration on families over the life course. In this study, individual semi-structured interviews were conducted with 25 participants in Operation Pedro Pan, and thematic analysis was used to systematically identify meaningful patterns across participant responses. The main research questions, framed by life course perspective and family resilience framework, investigated the influence of this event on the migrants’ family roles and expectations, family decision-making, parenting style, family communication, family transition, and integration into the U.S. as unaccompanied immigrant minors. This is the first study to examine Operation Pedro Pan from an outsider perspective. This dissertation is also unique in that it utilized the life course perspective and family resilience framework to investigate the experience of unaccompanied immigrant minors. The principal finding of this study is that shared Cuban family values were crucial to participants’ families’ ability to adapt to their new circumstances in the U.S. after separation of several months to several years. These shared family values likely allowed participants, their siblings and parents to be flexible in their roles and successfully adapt to living in a new country after an unexpected migration. Additionally, this research provides further evidence that the local community and the different types of support that it can provide to a newly arrived immigrant or refugee family can be essential to their acculturation process.Item Parenting stress and associated pathways to health outcomes in Latino parents: An investigation of longitudinal latent change(2019) Kim, HaeDong; Epstein, Norman B; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Prior parenting stress studies have been limited due to a primary focus on how parenting stress is associated with the well-being of children, use of samples consisting of predominately White parents, and reliance on cross-sectional data. Using longitudinal data collected from a randomized control trial of a parenting intervention for Latino parents with early adolescents, the present study investigated how changes in relational variables (parent-child conflict and parenting stress) were associated with changes in the parents’ psychological well-being across four months and ten months. Confirmatory and exploratory factor analyses were conducted on the study measures, and measurement invariance was subsequently tested for all of the study variables across the two time periods. Latent change models were imposed for the time periods of four months and ten months while controlling for treatment group membership (intervention vs. control), income, parent’s enculturation, and number of children in the family. The results from latent change analysis showed that across a period of four months, change in parent-child conflict was positively associated with changes in parenting stress and parent’s psychological distress, whereas across ten months, change in parent-child conflict was only associated with change in psychological distress. Examination of the control variable regarding group membership (intervention vs. control) showed that being assigned to the parenting intervention had protective indirect effects on change in parenting stress through its association with change in parent-child conflict across four months, and on change in psychological distress through change in parent-child conflict across ten months. The present findings showed that changes in parent-child relationships are related to changes in parenting stress and psychological distress of Latino parents with early adolescents. It seems that change in parent-child conflict may affect change in parenting stress in the shorter term but affect the parent’s individual psychological well-being in the longer term, and that community-based parenting interventions have the potential to protect and increase the well-being of Latino parents of early adolescents.