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.
Browse
11 results
Search Results
Item Associations between Classical Music, Physical Activity and Symptoms of Depression in Older Adults during the COVID-19 Pandemic(2023) Arnold-Nedimala, Naomi A; Smith, J Carson; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Background: The initial lockdown in March 2020 due to COVID-19 rattled the residents of North America as normalcy came to a standstill, freedom was stripped away, and people were forced to adapt to new restrictions and regulations, simply to survive. The elderly population was greatly affected by the lockdown as it prohibited those living in assisted living facilities to physically interact with family and friends highlighting the need to identify protective behaviors against mental health and depression. The neurological benefits of listening to classical music is an emerging area of research. A few studies suggest the positive outcomes of listening to classical music in reducing symptoms of depression. Additionally, while the cardiovascular benefits of exercise are well known, the impact of exercise on affect continues to be an emerging area of research. Purpose: The purpose of this study is to understand the efficacy of listening to classical music in attenuating symptoms of depression in older adults (50 – 90+) utilizing data collected from 3 separate time points during the COVID-19 pandemic, and to determine if physical activity is associated with providing additional benefit to lowering symptoms of depression Methods: A survey including the Geriatric Depression Scale (GDS), the Physical Activity Scale for the Elderly (PASE), and questions about listening to music (classical, Broadway, Christian music), and the frequency of listening to music was generated and distributed to people living in the United States and Canada immediately following the initial COVID-19 lockdown in April 2020. Informed consent was obtained prior to completing the survey, and participants who were interested in receiving a follow-up survey were asked to provide their email addresses. The follow-up surveys were generated 4-months (August 2020) and one year (April 2021) after the initial survey. Results: At the initial onset of the COVID-19 lockdown in April 2020, significant associations were observed between classical music listening (CML) and lower symptoms of depression, physical activity (PA) and lower symptoms of depression, music listening frequency, and lower symptoms of depression. In August 2020 and April 2021, significant associations were found between physical activity and lower symptoms of depression. However, no associations were observed between classical music listening and lower symptoms of depression, and music listening frequency and lower symptoms Additionally, significant associations were observed between age and lower symptoms of depression, sex, and lower symptoms of depression at all three time points. Conclusion: The results from our study suggest that there is an association between classical music listening and symptoms of depression, physical activity and symptoms of depression, music listening frequency and symptoms of depression in older adults (50+) during the early stages of the COVID-19 pandemic (April 2020). Additionally, the association between physical activity and symptoms of depression was maintained throughout the first year of the pandemic as supported by the data collected in August 2020 (4 months) and April 2021 (12-months).Item 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.Item Depression and Perception of Family Cohesion Levels and Social Support from Friends in Emerging Adulthood at a University Mental Health Clinic(2020) Roc, Sabrina; Barros, Patricia; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Emerging adulthood is identified as a period of transition and uncertainty that occurs between the stages of adolescence and adulthood, often from ages 18-25. During this period, mental health issues are quite prominent, especially symptoms of depression. Previous research has explored what can ease the stress of depressive symptoms, and social support has had resounding effects. The present study used secondary analysis of data from 372 therapy-seeking individuals at a university-based family clinic to evaluate how perceived levels of familial cohesion and social support from friends are associated with depressive symptoms during emerging adulthood and whether or not age moderated the association. The results of this study show significant associations between familial cohesion as predicted, and social support from friends but in an unexpected direction. Age did not appear to have any significant associations. Potential future research as well as clinical implications are discussed.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 The Effect of Depression on Women's Contraceptive Behaviors and Teenage Pregnancy(2018) Vafai, Yassaman; Steinberg, Julia R.; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Objective: The overall objective of this dissertation was to investigate the effect of depression on women’s contraceptive behaviors and teenage pregnancy. Methods: In the first study, the relationship between pre-abortion depressive symptoms and effectiveness level of contraceptive method chosen (low, moderately, or highly effective) after contraceptive counseling was examined using multinomial logistic regression in a group of women seeking abortion services. In the second study Cox proportional hazards models were used to estimate the hazard of contraceptive method discontinuation and unintended pregnancy among women experiencing any current and past elevated depressive symptoms in reproductive health settings. The third study examined the association between first depressive episode relative to age at first sex, and the hazard of first teenage pregnancy among girls participating in the National Comorbidity Survey–Adolescent Supplement. Results: More pre-abortion depressive symptoms were associated with higher odds of choosing a low contraceptive method than a moderately or a highly effective contraceptive method. Compared to non-depressed women, women exposed to baseline and a history of elevated depressive symptoms and those exposed to a history of elevated depressive symptoms had 39% and 12% increased hazards of contraceptive method discontinuation respectively; though the associations were not statistically significant when examining all contraceptive methods together. These associations were significant among patch and the injectable users. Finally, adolescent girls whose first depressive episode occurred at the same age as their sexual debut had a higher likelihood of experiencing first teenage pregnancy (HR: 2.73, 95% CI 1.07, 6.97) than those experiencing no depression onset. Conclusion: This dissertation provides evidence for the critical role of timing of depression in determining women’s contraceptive behaviors and reproductive decisions. The findings collectively suggest that not only the presence or absence of depression, but also the time the condition manifests itself during the course of women’s live can predict women’s decisions surrounding contraceptive method choice, continuation, and pregnancy. Implications: The integration of mental and reproductive health as well as a more effective patient-physician communication are warranted in an effort to optimize pregnancy outcomes in women at risk for depression.Item THE SYNDEMIC EFFECT OF PSYCHOSOCIAL AND STRUCTURAL FACTORS ON HIV TESTING AMONG BLACK MEN AND THE MODERATING EFFECT OF SEXUAL IDENTITY(2018) Turpin, Rodman Emory; Dyer, Typhanye; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Black populations experience the highest incidence and prevalence of HIV in the United States. It has been posited that numerous structural and psychosocial factors contribute to HIV disparities among Black populations, these factors can have an adverse effect on healthcare utilization, including HIV testing. Given the burden of HIV rates among Black men, especially Black gay and bisexual men, it is important to consider possible barriers to HIV testing in this population. Syndemic theory posits a mutually reinforcement of social and structural conditions that cumulatively affects disease outcomes. While syndemic theory has been applied to HIV acquisition, this framework has not been utilized for HIV testing. We tested for a syndemic of depression, poverty, and a lack of healthcare access impacting HIV testing and tested sexual identity as a moderator of healthcare access in a nationally representative sample of Black men. Participants with 2 or 3 syndemic factors were significantly more likely to have never been HIV tested compared to those with 0 or 1 (49.2% to 31.7%). Having 3 syndemic factors was associated with greater prevalence of never having been HIV tested (aPR=1.46, 95% CI 1.09, 1.95). Gay/bisexual identity moderated the association between health insurance and ever having been HIV tested in adjusted models (aPR=4.36; 95% CI 1.40, 13.62), with not having health insurance being associated with HIV testing among gay/bisexual participants only (aPR=4.84, 95% CI 1.19, 19.70). Using latent class analysis, four syndemic classes were identified as significant predictors of having never been HIV tested. In adjusted log-binomial models, compared to the class with the lowest proportion of syndemic factors, the highest prevalence of never having been HIV tested was among the class with the highest proportions of syndemic component factors (aPR=2.27, 95% CI 1.83, 2.82). Overall, there is evidence of a syndemic of depression, poverty, and a lack of healthcare access that negatively affects HIV testing among Black men, with a lack of healthcare access being a significantly greater barrier to HIV testing among gay/bisexual men compared to heterosexual men.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 Association of Life Events with Depressive Symptoms among Puerto Rican Youth(2014) Jaschek, Graciela; Carter-Pokras, Olivia D.; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)BACKGROUND: Early onset depressive symptoms have amplifying effects on the course of later depression, and serious personal, social and economic consequences throughout the life course. Little has been published regarding socio-demographic determinants of depression and possible mechanisms for the development of depressive symptoms among Puerto Rican youth. This study aims to examine the extent to which life events are associated with the development of depressive symptoms, and how place of residence, parental support, youth self-esteem and youth coping modify that association. METHODS: Secondary analyses were performed of data from the longitudinal Boricua Youth Study (three annual waves between 2000-2004). The sample consisted of 10-13 year old Puerto Rican youth living in New York and Puerto Rico with no depressive symptoms at wave 1, and complete information on depressive symptoms (DISC Predictive Scale which includes 9 significant predictors of depression)at waves 2 and/or 3. RESULTS: Depressive symptoms increase across waves with an increase in total, negative, or positive life events in general; and social adversity, death, and family environment life events specifically. Youth with low coping consistently had a higher number of depressive symptoms than youth with high coping regardless of number of total, negative or positive life events. Youth support from parents was found to be a significant confounder for all types of life events. Parent coping was a significant confounder for social adversity events. DISCUSSION: This study identifies various kinds of life events as risk factors that contribute to the development of depressive symptoms. Early onset depressive symptoms have amplifying effects on the course of later depression, and serious personal, social and economic consequences throughout the life course. Preventing the development of depressive symptoms at an early age should be a priority if we want to optimize the mental health and well-being of youth so that they can reach their full potential. Our findings could inform the development of a first-stage screening tool for youth at risk of developing depressive symptoms in community settings.Item Low-Income Mothers' Mental Health in the Context of Family Comorbidity(2013) Schroeder, Allison Lee; Roy, Kevin; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The present study utilized longitudinal ethnographic data from the Welfare, Children, and Families: A Three-City Study to analyze how low-income mothers construct meaning of and cope with mental health problems. The study focused on a subsample of 20 mothers with one or more mental health problems. Findings demonstrated the importance of family relationships and family comorbidity. Mothers often attributed mental health problems to problematic family relationships. Mothers also emphasized their children's health and well-being in assessing their own health. Their ability to care for their children shaped how they viewed themselves. A related feature of mothers' experience of mental health was cumulative disadvantage. Almost all of the mothers linked their mental health to one or more aspects of poverty. Finally, mothers employed a multiple strategies to cope with mental health problems, with mental health treatment being one strategy. Implications for research, policy, and clinical work were discussed.Item Couples' Depression Symptoms, Partners' Demand/Withdraw Communication, and Steps They Have Taken to End their Relationship, within a Clinic Population(2013) Ehlert, Nicole; Epstein, Norman B; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Research has consistently demonstrated an association between an individual's experience of depression and distress within their romantic relationship. Demand/withdraw communication has been identified as one possible mediator of this association, as depression has been shown to increase the likelihood that couples engage in this pattern, and this pattern has been shown to be destructive to a couple's relationship. Using the principles of family systems theory, this study examines whether depression may be associated with the dissolution of romantic relationships, using an Actor Partner Independence Model (APIM) analysis. The sample included couples who had sought therapy at the Center for Healthy Families at the University of Maryland. Results indicated both direct and indirect significant pathways between a partner's experience of depression and both partners taking steps toward leaving the relationship, with perceptions of demand / withdraw patterns as mediators. The study's findings have implications for clinical practice.