Theses and Dissertations from UMD
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New submissions to the thesis/dissertation collections are added automatically as they are received from the Graduate School. Currently, the Graduate School deposits all theses and dissertations from a given semester after the official graduation date. This means that there may be up to a 4 month delay in the appearance of a give thesis/dissertation in DRUM
More information is available at Theses and Dissertations at University of Maryland Libraries.
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Item The relationship of early social, mental, and behavioral experiences with adult obesity and Alcohol Use Disorder(2016) O'Neill, Allison Hunt; Lee, Sunmin; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Stressful life events early in life, including symptoms of mental disorders or childhood maltreatment, may increase risk for worse mental and physical health outcomes in adulthood. The purpose of this dissertation was to examine the effects of childhood Attention Deficit Hyperactivity Disorder (ADHD) symptoms and maltreatment experience on two adult outcomes: obesity and alcohol use disorder (AUD). Mediational effects of adolescent characteristics were explored. This dissertation used Waves I, III, and IV of the National Longitudinal Study of Adolescent to Adult Health. In Paper 1 (Chapter 3), we investigated the association between multiple types of child maltreatment and adult objective (body mass index; BMI) and subjective (self-rated) obesity, as well as mediating effects by adolescent characteristics including depressive symptoms and BMI. Results showed that after adjusting for sex, race/ethnicity, and maternal education, physical maltreatment was moderately associated with adulthood obesity as measured by BMI and self-reported obesity, while sexual maltreatment was more strongly associated with the objective measure but not the subjective measure. The indirect effects of mediation of adolescent BMI and depressive symptoms were statistically significant. In Paper 2 (Chapter 4), the objective was to examine mediation by adolescent depressive symptoms, alcohol consumption, peer alcohol consumption, and delinquency in the relationship between ADHD symptoms and adult AUD. The indirect effects of mediation of adolescent delinquency, alcohol consumption, and peer alcohol consumption were statistically significant in single and multiple mediator models. In Paper 3 (Chapter 5), the objective was to assess the joint effects of maltreatment/neglect on adult AUD. After adjusting for sex, race/ethnicity, child maltreatment, and parental AUD, ADHD symptoms were significantly associated with increased odds of AUD. There was no strong evidence of multiplicative interaction by maltreatment. This association was stronger for males than females, although the interaction term was not statistically significant. This dissertation adds to the literature by examining relationships between several major public health problems: ADHD symptoms, childhood maltreatment, AUD, depressive symptoms, and obesity. This project has implications for understanding how early life stress increases risk for later physical and mental health problems, and identifying potential intervention targets for adolescents.Item Racial/Ethnic Differences in Depression During the Transition to High School: Findings from the National Longitudinal Study of Adolescent to Adult Health(2015) Woodall, Ashley Marie; Chae, David H; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)This study investigates racial/ethnic differences in the change in depressive symptoms during the transition to high school. Weighted multivariable linear regression was used to assess the change in depressive symptoms from eighth grade to ninth grade using data from Wave I and Wave II of the National Longitudinal Study of Adolescent to Adult Health (Add Health). Analyses revealed that non-Hispanic Black adolescents had a significantly greater increase in depressive symptoms compared to non-Hispanic White adolescents (b = 1.39, p < 0.01). Moreover, biracial/multiracial adolescents showed the greatest increase in depressive symptoms compared to non-Hispanic Whites; however this was not statistically significant (b = 2.38, p = 0.15). These findings suggest that the transition to high school is a difficult period in psychological adjustment, particularly for non-Hispanic Black and biracial/multiracial adolescents. Furthermore, these findings highlight the need for more research concerning racial identity development and the mental health of biracial/multiracial populations.Item THE EASE PROGRAM: THE DEVELOPMENT OF A DISTRESS TOLERANCE INTERVENTION FOR MIDDLE SCHOOL ADOLESCENTS(2012) La Touche-Howard, Sylvette Antonia; Daughters, Stacey B.; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Although many middle school adolescents consider the middle school grades to be an exhilarating time of momentous change in their lives, others struggle not only with academic challenges but also with the inability to handle negative emotional states. Middle school adolescents often seek ways to cope with the distress they experience. Evidence indicates that adolescents are rarely adequately equipped with the necessary skills to deal with these stressful situations. Moreover, studies indicate that their distress tolerance, defined as the ability to persist in goal directed activity while experiencing emotional distress, is associated with increased risk behavior. Given preliminary evidence that low distress tolerance is associated with risky health behavior amongst adolescents, the overall goal of this study was to develop an adolescent appropriate intervention for improving distress tolerance skills, drawing on techniques from Dialectical Behavior therapy, with four main objectives: (1) to enable adolescents to understand the relationship between their emotions and behavior; (2) to educate adolescents on how to identify and label their emotions; (3) to teach skills to adolescents that will enable them to cope with their difficult emotions; and (4) to provide adolescents with skills that will enable them to avoid engaging in later risk behavior. To aide in the development of this intervention, a multi-method approach was employed using focus groups (n=20), in depth interviews (n=15) and a 3 round Delphi method (n=12). Results from this study were used to develop, modify and finalize a distress tolerance intervention (EASE- Empowering Adolescents to deal with Stress and Emotions) for middle school adolescents.