School of Public Health
Permanent URI for this communityhttp://hdl.handle.net/1903/1633
The collections in this community comprise faculty research works, as well as graduate theses and dissertations.
Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.
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Item Couples Coping with Li-Fraumeni Syndrome: A Mixed-Methods Study of Family Strengths(2018) Young, Jennnifer Louise; Epstein, Norman B; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Using mixed methodology involving qualitative and quantitative data, this dissertation fills gaps in knowledge regarding psychosocial implications for families living with the genetically-transmitted Li-Fraumeni cancer susceptibility syndrome, specifically targeting couple dyads. An initial review of the existing literature on couples coping with heritable cancer syndromes identified gaps in knowledge, and pointed to future directions for research in this area. The three papers that comprise this dissertation provide multiple perspectives on the levels of distress, coping styles, and social support patterns of couples in which one partner is at high risk of cancer. The first paper investigates spousal distress and coping styles in relation to cancer worry for individuals with Li-Fraumeni Syndrome, using quantitative data from one of the largest existing collections of Li-Fraumeni Syndrome cases. The second paper identifies couples’ coping and communication processes regarding cancer stressors, using semi-structured qualitative interviews of individuals with Li-Fraumeni Syndrome and their partners. The third paper utilizes a social network approach to illustrate shared patterns of emotional, tangible, and informational support that couples report accessing. The integrated findings from these three studies indicate that these subjects are low in general distress but high in cancer-specific worry. Couples cope with this worry by balancing multiple roles, exercising flexibility in family dynamics, and utilizing extensive social support networks. This research provides significant information that can aid in development of effective interventions for couples as they face their ongoing threat of cancer. Recommendations for clinical work with this population include an integrated blend of couple therapy, genetic counseling, and oncology practice that is sensitive to the unique needs of individuals with heritable cancer syndromes and their partners.Item EXPLORING THE EXPERIENCES OF WOMEN WITH ANOREXIA NERVOSA IN COMMITTED ROMANTIC RELATIONSHIPS: A QUALITATIVE STUDY(2018) Krenz, Natalie; Epstein, Norman B; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Eating disorders (EDs) significantly affect an individual’s quality of life and have the highest mortality rate of all psychological disorders. Therefore, understanding EDs is imperative for researchers and treatment professionals. EDs have a systemic impact; however, previous research largely focused only on impacts with adolescents and their families. The present study fills a gap in research on how Anorexia Nervosa (AN) influences adults within their romantic relationships. Qualitative data analysis was conducted by interviewing 9 adult women who ranged in age from 21 to 32, had been diagnosed with AN, and were in committed relationships for at least 6 months during some point in their recovery. Using grounded theory, their perceptions of how their ED symptoms and recovery interact with the functioning of their relationships were investigated. The results provide insight on the interaction between AN and romantic relationships and can aid in development of more effective couple therapy for individuals with AN.Item African American Couples' Provider Role Attitudes as a Function of Income, Relative Income, Education, and Age(2018) Walton, Tariiq Omari; Epstein, Norman B.; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)This study investigated characteristics that are associated with the provider role attitudes of African Americans being seen for couple therapy at a university-based family therapy clinic in a major metropolitan region, the Center for Healthy Families at the University of Maryland, College Park. It was predicted that income, relative income, education, age, and gender would be associated with the degree of traditional provider role attitudes of members of African American couples being treated at the CHF between 2000 and 2015. Contrary to the predictions, no relationship between education, age, and relative income and the provider role attitudes of the study’s participants was found. However, the results did show a significant relationship between gender and income and provider role attitudes. The implications for future research and clinical applications are discussed.Item Comparing Members of Interracial and Same-Race Clinical Couples: Conflict and Steps Toward Leaving the Relationship(2014) Young, Jennnifer Louise; Epstein, Norman B; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Past research on marital divorce rates indicates that interracial couples are more likely to divorce than same-race couples. There has been speculation that this higher rate of relationship dissolution stems from larger differences in partners' backgrounds, values, and culture. These differences may contribute to higher levels of conflict in interracial relationships. The present study compared conflict levels reported by members of interracial and same-race couples in a clinical sample, using secondary data from couples receiving treatment at the Center for Healthy Families, a clinic at the University of Maryland, College Park. Members of interracial couples reported higher overall conflict, and higher conflict in specific areas, as well as more steps taken toward leaving their relationships than those in same-race couples. Higher conflict mediated group differences in steps taken to leave the relationship. Constructive couple communication did not moderate the association between couple type and level of conflict.Item The Influence of the Interaction Between Trust and Cognitions on Aggressive and Withdraw Communication Behavior Between Members of Clinical Couples(2012) Ross, Donald Bruce; Werlinich, Dr. Carol A.; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The purpose of this study was to examine the moderation effect of avoidance and aggressive cognitions on the relationship between levels of trust and levels of negative communication behavior, within a clinical sample of 60 heterosexual couples who had experienced mild-to-moderate conflict or abuse in the relationship. Results were found separately for males and females. For males, a non-significant positive trend was found suggesting avoidance cognitions have an effect on the relationship between trust and avoidance communication behavior. Females showed a significant association between avoidance cognitions and withdraw communication behaviors. The level of trust and the level of aggressive cognitions were significantly predictive of aggressive communication behavior in males. And the level of trust and the level of avoidance cognitions were significantly predictive of withdraw communication behavior in females. Implications for clinical interventions are discussed.Item The Role of Provider-Role Ideology and Consistency in Couple Communication(2010) Brenneman, Jessica Lynn; Leslie, Leigh A; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)This study investigated how problem solving and conflict in couples' communication is affected by their beliefs about provider role ideology, and the consistency between their beliefs and their actions. It was predicted that couples who have the same provider-role ideology and couples who are consistent in their behavior and beliefs will use more problem solving and less hostile conflict behaviors than couples who are unmatched in their beliefs or inconsistent in beliefs and behavior. Contrary to predictions, no relationship between ideology, consistency, and communication was found. However, the results did show a significant relationship between women earning a large portion of the household income and greater amounts of hostile conflict in the couple communication. The implications for future research and clinical applications are discussed.Item Attachment and Demand/Withdraw Behavior in Couple Interactions: The Moderating Role of Conflict Level(2008-05-05) Opel, Katelyn Cogan; Epstein, Norman; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)This study examined the relations between clinical couples' secure, preoccupied, dismissive, and fearful avoidant attachment styles and their constructive, demanding, and withdrawing dyadic conflict resolution communication behavior. It also tested whether overall level of relationship conflict moderated the relation between attachment style and communication. The study was a secondary analysis of preexisting data, using a sample of 72 couples who completed assessments at the Center for Healthy Families at the University of Maryland, College Park. The subset of assessment material used for this study included the Relationship Questionnaire, Dyadic Adjustment Scale and Communication Patterns Questionnaire. Results indicated that attachment style was related to types of conflict communication behavior. Also, couples reporting low levels of conflict used more mutual constructive communication than those reporting high levels of conflict. Implications of the study's findings for therapeutic work with couples and suggestions for future research are discussed.Item DETERMINANTS AND BEHAVIORAL CORRELATES OF STATE-LEVEL ANXIETY IN CLINICAL COUPLE INTERACTIONS(2005-08-19) Dezfulian, Taryn Marie; Epstein, Norman E.; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Extant research demonstrated that clinically diagnosable disorders such as depression and anxiety have detrimental effects on dyadic satisfaction in couple relationships, but studies have focused almost exclusively on trait-level emotional responses. Consequently, little is known about state-level emotional responses, including factors influencing negative emotional states during couple interactions, and associations between emotional states and the partners' subsequent communication behavior. This study investigated the associations between: (a) each partner's attachment security and negative attributions about the other's malicious intent for them; (b) the degree of state-level anxiety partners experience immediately before engaging in a discussion about a conflictual relationship issue; and (c) partners' use of constructive and destructive behaviors during the discussion. State-level anxiety mediated the relationship between partners' pre-existing attachment security and negative attributions about the partner and each partner's use of constructive and destructive communication. Implications for clinical assessment and intervention with state-level anxiety responses in distressed couples are discussed.