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

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Subject: search.filters.subject.Mental Health

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Now showing 1 - 10 of 21
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    Exploring Young Bi+ Women's Intersecting Mental Health and Sexual and Reproductive Health Experiences in Context: A Multi-Analytic Method Qualitative Study
    (2023) Robinson, Jennifer Lynn; Aparicio, Elizabeth M; Butler, James; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Young bi+ women report worse mental health and sexual and reproductive health (SRH) outcomes compared to gay, lesbian, and straight young adults. They experience intersecting threats to their health and well-being due to their sexuality, gender, and stage of development. There is a lack of research on bi+ women’s unique mental health and SRH experiences, and often bi+ women are overlooked due to bi-erasure and biphobia. Regressive policies related to LGBTQ+ and women’s rights, including increased restrictions to reproductive healthcare after the Dobbs v. Jackson Women’s Health Organization decision overturning abortion protections, further threaten bisexual women’s health. This dissertation used a multi-analytic method qualitative approach to explore the intersecting mental health and SRH experiences of young bisexual women in the current socio-political context. Semi-structured in-depth interviews were conducted over Zoom with 16 young bi+ women from across the U.S. A narrative inquiry approach was used to explore young bi+ women’s mental health experiences and coping strategies. In addition, thematic analysis was used to investigate how young bi+ women describe their mental health as intersecting with their SRH in the current socio-political context. The study yielded rich and nuanced information about challenges these young bi+ women experienced throughout their lives that affected their mental health and SRH. Experiencing trauma had far-reaching negative effects on their mental health. Participants discussed the challenges of forming their identity within the social context, particularly as bi+ women in a society that often invalidates bisexual identities and subjugates women. They also discussed the joys along with difficulties of navigating young adulthood. They further described coping with challenges in a variety of adaptive (e.g., therapy, exercise) and maladaptive (e.g., substance use, self-injury) ways. They discussed relying on social support such as partners, friends, family, therapists, and teachers. Participants desired more support with sexuality-related issues, particularly in early adolescence. These bi+ women described their mental health and SRH as intertwined and discussed how bodily autonomy and agency were essential to their well-being. The socio-political context, including social norms, rhetoric, and federal- and state-level policies, influenced participants’ well-being. The current study shows that young bi+ women face unique threats to their mental health and SRH. Practice implications include improving access to affordable and LGBTQ+-affirming healthcare and developing interventions attuned to the needs of young bi+ women. Policies are needed that uphold the choice and agency of young women in their reproductive health decision-making. Future research should continue to explore the needs and experiences of young bi+ women concerning their mental health and SRH including demographic differences along with potential mechanisms resulting in poorer health.
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    INVESTIGATING THE EFFECTS OF COMMUNICATION CHANNELS AND INTERGROUP CONTACT ON COLLEGE STUDENTS’ MENTAL HEALTH
    (2022) Wang, Xiaojing(Romy); Joyce, Nick; Communication; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    The prevalence and severity of mental health issues among students have increased on college campuses in recent years. Online counseling can provide a good way to improve college students’ mental health, but the amount of social presence of online counseling types may impact its effectiveness. Moreover, communication challenges may arise when the counselors and clients are from different racial groups, and these challenges may in turn be impacted by the characteristics of the communication channel. Using an experiment with 292 participants, this study investigated how counseling channels and inter/intragroup contact, as well as their interaction, affect counseling effectiveness (state anxiety, self-disclosure, satisfaction, and working alliance) and intergroup outcomes (intergroup prejudice and intergroup anxiety) as well as the moderation effects of communication competence and stigma. The results indicated that videoconferencing counseling had a higher satisfaction than online synchronous chat counseling. Intergroup counseling significantly reduced intergroup prejudice and intergroup anxiety. Participants’ self-disclosure, satisfaction, working alliance, reduced intercultural prejudice, and reduced intercultural anxiety significantly decreased their state anxiety. Implications of these findings for intergroup communication in online counseling are discussed.
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    Moderating Effects of Critical Consciousness and Acculturative Stress on the Relation Between Racism and Low-Income Asian Americans’ Mental Health
    (2022) Lee, Eunmyoung Alice; Shin, Richard; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Anti-Asian racism has been a pervasive challenge for Asian American communities (Sue et al., 2007), which has increased by nearly 150% from 2019-2020 post the onset of the COVID-19 pandemic (Yam, 2021). An expansive body of research has found that racism is significantly related to an array of negative mental health outcomes among Asian Americans (Hahm et al., 2010). However, there remains a dearth of research specifically examining mental health outcomes among low-income Asian Americans, who may be at greater risk for stress due to exposure to both racism and classism. The present study examined the relation between racism and psychological outcomes amongst low-income Asian American adults. Critical consciousness and acculturative stress were examined as potential moderators in that relation. A sample of low-income Asian American adults (N = 365) participated in an online survey to respond to measures on demographic information, racism, psychological distress, psychological well-being, critical consciousness, and acculturative stress. Results showed that racism was a significant predictor of psychological distress and psychological well-being while controlling for age and subjective social status among low-income Asian Americans. The moderation analyses found that acculturative stress was a significant moderator in the association between racism and psychological well-being whereas critical consciousness was not a significant moderator in the association between racism and psychological well-being nor distress. Clinical implications and recommendations for future research are also discussed.
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    WHAT HAPPENS WHEN STUDENTS KNUCK AND BUCK SYSTEMS OF INJUSTICE? A MULTIMETHOD STUDY EXPLORING THE RELATIONSHIP BETWEEN STUDENT ACTIVISM AND EMOTIONAL WELL-BEING
    (2022) Smith, Samantha Alyce; Arria, Amelia M; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    In recent years, college students' declining mental health status has garnered the attention of public health and educational professionals. Mental health is a complex construct influenced by biological, behavioral, social, and environmental factors. One critical dimension of mental health is emotional well-being, representing the positive and negative emotions one experiences. Little research exists regarding the relationship between activism, a possible social influence, and mental health. This multimethod dissertation study focuses on the relationship between college student participation in activism and contemporary social movements, including the Black Lives Matter movement, and different dimensions of emotional well-being, including depressive and anxiety symptoms, level of optimism, and sense of belonging. Framed by the Transactional Theory of Stress and Coping, the qualitative portion of the research involved in-depth interviews among 18 students aged 18-25 who participated in 2020 Black Lives Matter protests. The purpose of these interviews was to examine the short-term impact of protest participation on student emotional well-being and how activism was related to coping. Findings revealed that the sociopolitical climate negatively impacted student emotional well-being, and those associated negative emotions acted as a motivator to participate in protests. Conversely, participating in protests garnered sense of belonging and empowerment. Protest participation appeared to serve as an emotion-focused coping strategy among these students. The quantitative analyses conducted in this dissertation utilized secondary data from the 2019 Wake Forest Well-being Assessment to investigate the motivators (Aim 2) and emotional well-being correlates (Aim 3) of activism participation. For both analyses, two forms of activism were studied – disruptive (e.g., protests) and persuasive tactics (e.g., digital activism). Civic morals identity centrality and discrimination were examined as possible motivators. Multivariate and multinomial logistic regression models developed for Aim 2 held constant other potential confounding variables (i.e., gender, sexual orientation, parental education and race/ethnicity) and revealed positive associations between discrimination experiences and civic moral identity centrality and disruptive activism (p<.001) and persuasive tactics (p<.001). Regression models for Aim 3 that examined the relationship between activism participation and emotional well-being revealed that disruptive activism tactics were positively associated with depressive symptoms (p<.001), anxiety symptoms (p<.001), and sense of belonging (p<.05). A negative association was observed between disruptive activism and optimism (p<.05). All of these associations were robust to the inclusion of demographic covariates. Coping did not appear to moderate any of the relationships observed. Taken together these finding begin to elucidate the nuanced and complex relationship between activism and emotional well-being. Given that a significant proportion of college students studied participated in some form of activism, our understanding of the impact of activism on student emotional well-being is an important area that warrants additional investigation in future studies. The findings of this study can be used to support ongoing intervention development that addresses the mental health needs of college students, specifically those engaged in activism work. Additionally, these findings can be used to support mitigating health disparities that are the result from sociopolitical factors such as racism and discrimination.
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    YO SOY PAZ (I AM PEACE): PILOT STUDY OF A TRAUMA-INFORMED, COMMUNITY AND MINDFULNESS-BASED PROGRAM FOR LATINO IMMIGRANTS IN MARYLAND.
    (2022) Munoz, Juliana; Green, Kerry M; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Background: One in three Latinos in the US is an immigrant. Immigrants face particular stressors that are heightened by previous traumatic experiences before, during, and after migration. Latino populations report the highest level of stress of all racial/ethnic groups in the US and the second-highest prevalence of mental health illness. Mindfulness-Based Interventions (MBIs) have shown to be successful at reducing stress and strengthening mental health in diverse populations, yet little is known about the effects of these interventions on this particular population.Methods: The pilot study tested the Yo Soy Paz (I am Peace) online synchronous program, an evidence and trauma-informed mindfulness-based intervention that was adapted for immigrant Latina mothers and the community staff members that work with them in a community setting. The eight session pilot intervention was delivered to three cohorts for a total of 41 participants, including staff and parents of youth receiving services at a local community-based organization that serves Latino immigrants. The study used the Consolidated Framework for Implementation Research (CFIR) to examine the feasibility, acceptability, appropriateness, and fidelity of the Yo Soy Paz online program. The study also examined the initial effects of the program on stress, mindfulness, mind-body connection, and subjective well-being. Qualitative and quantitative data were collected through self-reported pre-post questionnaire, fidelity checklists, and focus groups with parents and staff. Results: Acceptability, feasibility, fidelity and appropriateness scored high on the quantitative measures. Inner compatibility with the organization’s mission and vision, clients’ needs and the organization’s receptivity to implement the intervention scored in the medium range. Mothers’ and promotoras’ self-reported mean scores for subjective wellbeing and perceived physical and mental health increased significantly from baseline- to post-test. No significant changes were observed in surveys completed by the staff, even though focus group participants reported meaningful improvement. Discussion: Overall the pilot feasibility study was well received and relevant for the organization and the population they serve. MBIs for Latino immigrants and the staff that works with them have the potential to improve well-being and overall mental and physical health. The study’s findings provide guidance to others in implementing online mindfulness practices with Latino immigrants and the staff that works with them.
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    Generalizable Depression Detection and Severity Prediction Using Articulatory Representations of Speech
    (2022) Seneviratne, Nadee; Espy-Wilson, Carol; Electrical Engineering; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Major Depressive Disorder (MDD) is a mental health disorder that has taken a massive toll on society both socially and financially. Timely diagnosis of MDD is extremely crucial to minimize serious consequences such as suicide. Hence automated solutions that can reliably detect and predict the severity of MDD can play a pivotal role in assisting healthcare professionals in providing timely treatments. MDD is known to affect speech. Leveraging on the changes in speech characteristics that occur due to depression, a lot of vocal biomarkers are being developed to detect depression. However, the study into changes in articulatory coordination associated with depression is under-explored. Speech articulation is a complex activity that requires finely timed coordination across articulators. In a depressed state involving psychomotor slowing, this coordination changes and in turn modifies the perceived speech signal. In this work, we use a direct representation of articulation known as vocal tract variables (TVs) to capture the coordination between articulatory gestures. TVs define the constriction degree and location of articulators (tongue, jaw, lips, velum and glottis). Previously, correlation structure of formants or mel-frequency cepstral coefficients (MFCCs) were used as a proxy for underlying articulatory coordination. We compute the articulatory coordination features (ACFs) which provide details about the correlation among time-series data at different time delays and are therefore rich with information about the underlying coordination level of speech production. Using the rank-ordered eigenspectra obtained from TV based ACFs, we show that depressed speech depicts simpler coordination relative to the speech of the same subjects when in remission which is inline with previous findings. By conducting a preliminary study using a small subset of speech from subjects who transitioned from being severely depressed to being in remission, we show that TV based ACFs outperform formant based ACFs in binary depression classification. We show that depressed speech has reduced variability in terms of reduced coarticulation and undershoot. To validate this, we present a comprehensive acoustic analysis and results of a speech-in-noise perception study to compare the intelligibility of depressed speech relative to not-depressed speech. Our results indicate that depressed speech is at least as intelligible as not-depressed speech. The next stage of our work focuses on developing deep learning based models using TV based ACFs to detect depression and attempts to overcome the limitations in existing work. We combine two speech depression databases with different characteristics which helps to increase the generalizability which is a key objective of this research. Moreover, we segment audio recordings prior to feature extraction to obtain data volumes required to train deep neural networks. We reduce the dimensionality of conventional stacked ACFs of multiple delay scales by using refined ACFs which are carefully curated to remove redundancies and using the strengths of dilated Convolutional Neural Networks. We show that models trained on TV based ACFs are more generalizable compared to its proxy counterparts. Then we develop a multi-stage convolutional recurrent neural network that performs classification at the session-level. We derive the constraints under which this segment-to-session level approach could be used to boost the classification performance. We extend our models to perform depression severity level classification. The TV based ACFs outperform other feature sets in this task as well. The language pattern and semantics can reveal vital information regarding a person's mental state. We develop a multimodal depression classifier which incorporates TV based ACFs and hierarchical attention based text embeddings. The fusion strategy of the proposed architecture enables segmenting data from different modalities independently (overlapping segments for audio and sentences for text), in the most optimal way for each modality, when performing segment-to-session level classification. The multimodal classifier clearly performs better than the unimodal classifiers. Finally, we develop a multimodal system to predict the depression severity score, which is a more challenging regression problem due to the quasi-numerical nature of the scores. Multimodal regressor achieves the lowest root mean squared error showing the synergies of combining multiple modalities such as audio and text. We perform an exhaustive error analysis that reveals potential improvements to be made in the future. The work in this dissertation takes a step forward towards the betterment of humanity by exploring the development of technologies to improve the performance of speech based depression assessment, utilizing the strengths of the ACFs derived from direct articulatory representations.
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    THE STATE OF GRADUATE STUDENT MENTAL HEALTH IN THE UNITED STATES: ELEVEN YEARS AND 200,000 STUDENTS
    (2020) DeYoung, Kathryn Alyce; Leslie, Leigh A; Shackman, Alexander J; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Graduate students are an essential part of the academic enterprise. Converging lines of evidence suggests that many graduate students experience high levels of emotional distress. Yet the true depth and breadth of this public health “crisis” has remained unclear. The present study used survey data collected from 187,427 American graduate students between 2008 and 2019 as part of the ACHA-NCHA II to demonstrate that moderate-to-severe emotional distress, psychiatric illness, and suicidality are common among graduate students. Remarkably nearly 1 in 3 students were diagnosed with or treated for one or more psychiatric disorders. Notably, every indicator of emotional distress and illness increased over the past decade, in some cases substantially, above and beyond contemporaneous shifts in demographic and institutional characteristics. This study represents the most comprehensive assessment to date, provides crucial information for refining research and policy, and sets the stage for efforts aimed at developing effective intervention strategies.
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    Understanding Secondary Educators’ Knowledge of Mental Health and Their Perceptions of Their Role in Addressing Student Mental Health
    (2019) Ross, Ana-Sophia; Wang, Cixin; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Adolescents have significant unmet mental health needs and schools represent the most common place for youth to receive mental health services. Teachers are primarily responsible for recognizing and working with students with mental health needs. Scholarship has investigated teachers’ knowledge pertaining to signs and symptoms for mental illness and found that teachers report little confidence in their knowledge, and have difficulty accurately identifying students struggling with mental illness. Research has provided some insight into how teachers can promote positive mental health amongst their students but little is known about classroom educators’ perceptions about how they can address student mental health concerns. Thus, this qualitative study utilized thematic analysis to investigate 27 teacher/classroom educators’ perceptions about how they can help students who struggle with mental health problems. Five main themes emerged from the analysis: 1) school collaboration, 2) student support, 3) family involvement/family-school partnership, 4) school reform/systematic change, and 5) teacher professional development training. Additionally, the study also investigated educator’s knowledge of signs and symptoms of depression, anxiety, and eating disorders. Eighty-five percent of teachers were able to correctly identify depression from a vignette while all participants were able to identify an eating disorder from a vignette. This study provides insights about how to improve school-based mental health efforts, with specific attention to classroom-based educators’ role in the provision of services.
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    Secondary Traumatic Stress, Financial Stress, and the Role of Coping in Understanding Southeast Asian American Mental Health
    (2019) Truong, Nancy Nguyen; Miller, Matthew J; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    This study advances the literature by jointly examining two stressors (secondary traumatic stress and financial stress) hypothesized to impact the mental health of the Southeast Asian American (SEAA) community and focused on the experiences of generational stress with SEAAs. This study also examined how coping moderated the relationship between stress and mental health. Hierarchical multiple regression analysis was used to test whether secondary traumatic stress, financial stress, direct and indirect coping (entered in Step 1), and the interactions between stress and coping (entered in Step 2) predicted mental health. Participants included 134 self-identified 1.5-generation and second-generation SEAA adults who completed an online survey. Consistent with emerging research, increased financial stress and secondary traumatic stress significantly predicted poorer mental health. Further, indirect coping significantly predicted poorer mental health. Contrary to expectations, none of the moderation effects were significant. Post-hoc analyses were also conducted. Limitations and implications for future research and practice are addressed.
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    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.