Psychology
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Item Bias versus Context Models for Integrating Multi-Informant Reports of Youth Mental Health(2021) Makol, Bridget A; De Los Reyes, Andres; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Best practices in youth mental health assessment entail collecting reports from multiple informants. However, multi-informant reports commonly yield different estimates of youth mental health (i.e., informant discrepancies), resulting in various clinical decision-making challenges and necessitating strategies for integrating them. Two leading theoretical models exist for interpreting informant discrepancies. Whereas one model posits that informant discrepancies reflect rater biases and thus depress measurement validity (i.e., bias models), the other posits that they reflect meaningful variations in behavior across social contexts (e.g., home, school) and thus enhance measurement validity (i.e., context models). Although greater empirical support exists for context models relative to bias models, measurement models extending from both bias (i.e., Trifactor Model [TFM]) and context (i.e., Trait Score Satellite Model [TSSM]) models have been developed. Across two studies, I rigorously compared the TFM and TSSM. In Study 1, a systematic review of TFM and TSSM research (n = 47) revealed that, relative to TFM studies, TSSM studies were more likely to include (a) informants who varied in where they observe behavior (e.g., parent [home] vs. teacher [school]) and (b) more informants. In Study 2, I subjected these models to validation testing using a sample (n = 134) that included three informants’ reports of adolescent social anxiety and independent ratings of adolescent behavior within peer interactions. I found satisfactory fit for both models when integrating all three informants’ reports. However, when predicting well-established, independent criterion variables (i.e., observed behavior, referral status), the primary score derived from the TSSM outperformed each individual informant’s report, a composite of informants’ reports, and the primary TFM-derived score. Relative to the TFM, the TSSM (a) more closely aligns with best practices in evidence-based assessment of youth mental health, and (b) more effectively integrates multi-informant reports in data conditions where informant discrepancies reflect valid information. When using measurement models designed to integrate multi-informant reports, users of these models must subject them to rigorous validation testing to discern their applicability to the data conditions in which they will be applied. In turn, integrating multi-informant reports requires explicitly linking theory, quantitative methodology, and empirical support observed within relevant data conditions.Item Stress, Mental Health, and Self-Care among Refugee Teachers in Malaysia(2020) Gosnell, Nicole; O'Neal, Colleen; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The mental health of post-conflict refugee teachers is understudied, yet critically important given the current refugee crisis which has displaced more than 70 million people (UNHCR, 2019). Teachers in hidden refugee schools are often refugees themselves, have little teacher education, and are faced with overwhelming classroom demands and other unique stressors. This study utilizes a mixed method design to examine stress, mental health (i.e., depression, and anxiety), and self-care among teachers in hidden refugee schools in Kuala Lumpur, Malaysia. Quantitative data are archival, collected in Malaysia in 2013. Quantitative study participants included 97 primarily Burmese refugee teachers and 26 non-refugee teachers living in Malaysia. Quantitative measures included (a) Depression, Anxiety, and Stress Scales (DASS); (b) a self-care strategies questionnaire, and (c) a demographic questionnaire. Quantitative results suggest that refugee teachers have significantly higher rates of mental health and stress, but lower rates of self-care as compared to their non-refugee peer teachers. In addition, higher rates of self-care are associated with lower rates of mental health symptoms and stress rates; the association is moderated by age. Qualitative data were collected in June 2018 via individual interviews with eleven Burmese refugee teachers working in Malaysia. Qualitative results shed light on the unique definitions and experiences of stress, mental health, and self-care among refugee teachers in the context of macrolevel factors. Overall, this dissertation found that macrolevel factors unique to being a refugee impact refugees’ rates, experiences, and definitions of microlevel mental health symptoms, stress, and self-care.Item Appealing to Masculinity or Empathy?: Educating Men to Recognize Warning Signs of Dating Violence(2018) Kearney, Monica Sherri; O'Brien, Karen M; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Dating violence continues to be a social concern for young adults (Barrick, Krebs, & Lindquist, 2013). Dating violence occurs often on college campuses, with between 16% and 50% of college women reporting experiences of dating violence prior to graduation (Knowledge Networks, 2011; Murray & Kardatzke, 2007). However, over half of college students reported that it is difficult to identify warning signs of dating violence (Knowledge Networks, 2011). Moreover, one study determined that undergraduate, heterosexual men have more difficulty recognizing warning signs of dating violence than undergraduate heterosexual women (Kearney & O’Brien, 2016). Thus, the purpose of this study was to assess multiple strategies to increase recognition of warning signs of dating violence and engagement in an online dating violence intervention with a sample of heterosexual college men. Participants were assigned randomly to one of four conditions: (1) the appeal to masculinity condition, (2) the appeal to empathy condition, (3) the combined appeal to masculinity and empathy condition, or (4) the control condition. Participants were instructed to watch the first component of STOP Dating Violence (O’Brien et al., 2016), a short online video intervention developed to educate college students about dating violence. Participants in the control condition received the standard intervention, while participants in the experimental conditions viewed a brief (one minute) introduction before beginning the intervention. Results indicated that all participants demonstrated an increase in ability to recognize warning signs of dating violence after participating in the intervention. Moreover, there was an interaction of time and condition for three dimensions of dating violence warning signs. However, condition did not have an effect on engagement with the intervention material. The results and future directions for research are discussed.Item Intersectional experiences, stigma-related stress, and psychological health among Black LGB communities(2018) Jackson, Skyler; Mohr, Jonathan J; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Contemporary theories of stigma-related stress (Hatzenbuehler, 2009; Krieger, 2014; Meyer, 2003) suggest that marginalized populations face chronic experiences of prejudice and discrimination due to their minority statuses—and that these stressful events undermine psychological health. Research based on this perspective typically (a) focus on one aspect of identity (e.g., sexual orientation) in isolation from other salient aspects of identity (e.g., race), (b) test temporal theories of discrimination and health using cross-sectional study designs, and (c) focus on experiences of stigmatization, overlooking the potential role of positive, identity-supportive experiences in mental health. The present study uses daily diary methods to explore the prevalence and day-to-day correlates of intersectional experiences (IEs) in a sample of 131 Black lesbian, gay, and bisexual (LGB) individuals. Every evening for one week, participants reported both negative and positive IEs from the last 24 hours, and completed measures of identity conflict, rumination, and affect. Across 849 combined study days, participants described 97 negative IEs (11.4% of days) and 263 positive IEs (31.0% of days). Multilevel regression was used to test concurrent and temporal relations between daily IEs and mood—as well as the mediating roles of identity conflict and rumination—at the within-person and between-person levels. Negative IEs were associated with identity conflict and negative affect at both the within- and between-person levels, and negative rumination at the within-person level only. Positive IEs predicted positive rumination and positive affect (but not identity conflict) at the within- and between-person levels. Results indicated that identity conflict mediated the concurrent association between negative IEs and negative affect (but not between positive IEs and positive affect) at both levels of analysis. Negative rumination mediated the concurrent association of negative IEs and negative affect at the within-person level (but not the between-person level). The study also produced a significant indirect path from positive IEs to positive affect, mediated through positive rumination, at both levels of analysis. No direct or indirect lag-effects were demonstrated in which IEs predicted next day outcomes. This microlongitudinal investigation is among the first to quantitatively capture the prevalence and day-to-day correlates of intersectional experiences among LGB people of color.Item MENTAL HEALTH AND EMOTION REGULATION AMONG REFUGEE STUDENTS IN MALAYSIA(2016) Gosnell, Nicole; O'Neal, Colleen R; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The global refugee crisis has propelled over 65.3 million refugees into flight, including 33 million children (UNHCR, 2016). This study utilizes a mixed-methods design to examine mental health and emotion regulation among post-conflict Southeast Asian refugee children. To understand stressors that may cause mental health challenges, this study explores themes raised in qualitative interviews addressing oppression in Burma, flight to Malaysia, and life in Malaysia. Quantitative study participants included 90 refugee children in Malaysia aged 10-19 years (M = 14.22, 74.4% Burmese, 51.1% female). Measures included the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) and the Emotions as a Child (EAC) Qualitative participants included four refugee boys who participated in a group interview about their individual experiences. This study examined: rates of PTSD and MDD among refugee students, the relation between emotion regulation and mental health, and the unique post-conflict stressors experienced by refugee children.Item Childhood Attention Problems and the Development of Comorbid Symptoms at the Transition to High School: The Mediating Role of Parent and Peer Relationships(2015) LeMoine, Kaitlyn Ashley; Chronis-Tuscano, Andrea; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are at increased risk for the development of depression and delinquent behavior. Children and adolescents with ADHD also experience difficulty creating/maintaining high quality friendships and parent-child relationships, and these difficulties may contribute to the development of co-morbid internalizing and externalizing symptoms in adolescence. However, there is limited research examining whether high quality friendships and parent-child relationships mediate the relation between ADHD and the emergence of these co-morbid symptoms at the transition to high school. This study examines the mediating role of relationship quality in the association between ADHD and depressive symptoms/delinquent behaviors at this developmentally significant transition point. Results revealed significant indirect effects of grade 6 attention problems on grade 9 depressive symptoms through friendship quality and quality of the mother-child relationship in grade 8. Interventions targeting parent and peer relationships may be valuable for youth with ADHD to promote successful transitions to high school.Item A Longitudinal Examination of the Relationship between Childhood Emotional Abuse and Anxiety among Youth: Distress Tolerance as a Mediating and Moderating Factor(2014) Banducci, Anne Nicole; Lejuez, Carl; MacPherson, Laura; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Background: Anxiety is the most common psychological problem experienced by youth. A number of factors are associated with the emergence of anxiety, including individual and environmental factors. Two such factors include childhood emotional abuse (CEA) and low distress tolerance (DT). The current study aimed to understand how more severe CEA and lower DT impacted anxiety symptoms among community youth. Specifically, we examined low DT both as a moderator and mediator in the relationship between CEA and anxiety. Methods: Participants were two cohorts of community youth. Cohort 1 included 244 youth (54% male, 50% White, 35% Black, 3% Hispanic, 11% mixed/other) with a mean baseline age of 12.01 years (SD = 0.82) assessed annually over five years. Cohort 2 included 109 youth (60% male, 11% White, 79% Black, 10% mixed/other) with a mean baseline age of 10.87 years (SD = 1.28) assessed annually over three years. Measures included the Revised Child Anxiety and Depression Scale, Childhood Trauma Questionnaire, and Behavioral Indicator of Resiliency to Distress. Results: In cohort 1, more severe CEA was associated with higher anxiety at baseline and with sharper decreases in anxiety over time. Lower DT was associated with higher anxiety at baseline, but did not predict changes in anxiety over time. Distress tolerance significantly moderated the relationship between CEA and anxiety, such that youth with both low DT and more severe CEA had the highest anxiety across all five assessments. Results using data from cohort 2 were not significant. Conclusions: These findings suggest lower DT amplifies the relationship between CEA and anxiety, such that youth with lower DT, who have been abused, are less likely to experience normalization in anxiety symptoms over time compared to youth with higher DT. These findings are in line with diathesis-stress models common to developmental psychopathology.Item The Valuation of Social Reinforcement in Schizophrenia(2015) Catalano, Lauren Theresa; Blanchard, Jack J; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Facial affect perception impairments impede social functioning in schizophrenia. What remains unknown is how individuals with schizophrenia assign value to pleasant facial expressions that typically motivate social affiliation. The current study adapted a matching pennies game (Shore & Heerey, 2011) to assess the subjective value of social feedback in terms of money. Individuals with schizophrenia and controls were instructed to choose the same side of a coin as six computerized partners, each of whom provided different rates of monetary feedback and types of social feedback. In a later test phase, participants chose which partner to play from amongst pairs of partners. Among participants who appropriately learned task contingencies, individuals with schizophrenia failed to use genuine smiles to motivate choices to the same extent as controls; however, money was equally valued. These findings suggest that there is a reduced sensitivity to social rewards in schizophrenia.Item The relationship of internalized stigma with symptoms, social behavior, and emotional responding in schizophrenia(2013) Park, Stephanie Grace; Blanchard, Jack J; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Internalized stigma refers to the process by which affected individuals endorse stereotypes about mental illness, expect social rejection, apply these stereotypes to themselves, and believe that they are devalued members of society (Corrigan et al., 2005; Corrigan et al., 2006; Ritsher & Phelan, 2004). Studies in clinical populations have found that internalized stigma is associated with a host of negative psychosocial variables, including decreased self-esteem and self-efficacy, hopelessness, demoralization, poor quality of life, and reduced motivation to work towards recovery goals (e.g., Livingston & Boyd, 2010; Ritsher, Otilingam, & Grajales, 2003). However, the relationship between internalized stigma and symptoms in schizophrenia is still unclear. Further, though evidence suggests that individuals with schizophrenia who are high in internalized stigma tend to actively avoid others, have reduced social contact, and maintain insular support networks (e.g., Yanos, Roe, Markus, & Lysaker, 2008), actual behavior and emotional responding during social interactions have not been explored. Thus, the current study examined 50 outpatients with schizophrenia or schizoaffective disorder on a battery of self-report measures, clinician-administered interviews, and a social affiliation interaction task to examine the associations between internalized stigma and symptoms, functioning, and emotional responding. Results showed that lower levels of Stigma Resistance were significantly correlated with greater deficits in clinician-rated experiential but not expressive negative symptoms. The present study replicated previous findings of a significant relationship between internalized stigma and other psychiatric symptoms, including depression. Using a multi-method approach to assess functioning, this study found that individuals with higher levels of internalized stigma and lower Stigma Resistance demonstrated impairments in communicative functional capacity and immediate social network relationships. Further, individuals lower in Stigma Resistance were rated as less affiliative and less overall socially skilled during a social affiliation interaction task. However, internalized stigma was not associated with positive or negative affect after the interaction controlling for affect before the task, and there were no differences in willingness to interact or reactions to partner. Importantly, these findings may ultimately contribute to the further development of psychosocial interventions that target internalized stigma.Item BRIEF BEHAVIORAL ACTIVATION TREATMENT FOR DEPRESSION IN SPANISH-SPEAKING LATINOS: ACCEPTABILITY AND PRELIMINARY EVALUATION(2012) Collado-Rodriguez, Anahi D.; MacPherson, Laura; Lejuez, Carl W; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Although depression is highly treatable, disparities in mental health treatment in the US have prevented Latinos who lack English language proficiency from accessing efficacious interventions. Reasons cited for these disparities include language barriers, high cost of services, lack of culturally sensitive treatments, and stigma toward mental health treatment. A direct Spanish translation of the Brief Behavioral Activation Treatment for Depression (BATD) may be well-equipped to address the existing barriers through its focus on individual and cultural values, its efficiency and straight-forward nature, itsfocus on developing existing and new strengths, and conceptualization of depression as a consequence of clients' environments and not of cognitive processes, which may serve to decrease stigma associated with care. Using this translation, the current study sought to establish preliminary efficacy and acceptability of BATD in a group of depressed Spanish-speaking Latinos (N=10) . Results showed that over time there was a significant decrease in self-reported depression and a significant increase in activation as indicated by multiple self-report measures. Further, increases in activation corresponded to decreases in depression. Sustained clinical gains through a one-month follow-up were observed. Taken together, these results provide preliminary support for BATD as an efficacious treatment for depression. Consideration of the results combined with interview-based feedback obtained from participants provide several domains for modification of this treatment for future studies, and suggest that the next logical step is to include a treatment control group and a larger sample size in future investigations.