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Racial/ethnic Differences in Hospital Utilization for Cardiovascular-related Events: Evidence of a Survival and Recovery Advantage for Latinos?
Evidence continues to demonstrate that racial/ethnic minority groups experience a disproportionate burden of disease and mortality in cardiovascular-related diseases (CVDs). However, emerging evidence suggests a health advantage for Latinos despite a high risk profile. The current study explored the hospital utilization trends of Latino and non-Latino patients and examined the possibility of an advantage for Latinos within the context of CVD-related events with retrospective data collected over a 12-month period from a local safety-net hospital. Contrary to my hypotheses, there was no advantage for in-hospital mortality, length of stay or re-admission in Latinos compared to non-Latinos; rather, Latinos hospitalized for a CVD-related event had a significantly longer length of stay and had greater odds for re-admission when compared to non-Latinos. Despite data suggesting a general health advantage, Latinos may experience a relative disparity within the context of hospital utilization for CVD-related events. Findings have implications for understanding the hospital utilization trends of Latinos following a CVD-related event and suggest a call for action to advance understanding of Latino cardiovascular health.
Date:
May 2014
Creator:
García, James J.
System:
The UNT Digital Library
Daily-collected Sleep Diaries Compared to Weekly-collected Sleep Diaries Via Actigraph Concordance
Both sleep diaries and actigraphy have been recommended to assess sleep in research and clinical settings. Investigators have traditionally used sleep diaries that were completed daily by participants and collected weekly but have recently begun using sleep diaries that are both completed and collected daily. No research had previously assessed the agreement between daily-collected sleep diaries and actigraph data over one week. Undergraduate students were randomly assigned to use daily- or weekly-collected sleep diaries. Sleep parameters obtained from these measures were compared to each other via concordance with concurrent actigraph data. It was hypothesized that daily-collected sleep diaries would have greater concordance with actigraphy than weekly-collected sleep diaries. Results indicated that daily-collected sleep diaries provided more reliable data than weekly-collected sleep diaries, but the differences were not statistically significant. Additional aims examined self-reported sleep diary adherence, the participation day number, and day of the week. There were trends for the Daily group to have better adherence. Overall concordance did not change based on the day number or day of the week. Both sleep diaries yield comparable sleep parameter data, suggesting that clinicians and researchers can use either method to estimate sleep parameters.
Date:
May 2014
Creator:
Francetich, Jade M.
System:
The UNT Digital Library
Lipodystrophy, Body Image and Depression in Hiv Positive Black Women
Human immunodeficiency virus (HIV) seropositive men on highly active antiretroviral therapy treatment (HAART) who experience lipodystrophy syndrome (LD), a side effect of HAART, rate themselves as more depressed than those who did not experience LD(Crane et al., 2008). Furthermore, men who rated their LD symptoms as more severe also scored higher on depression measures than men who experienced less severe symptoms. It is unknown these findings can be generalized to other groups of HIV positive individuals. The current study seeks to fill this gap in the literature by exploring the associations between LD, body image, and depressive symptoms in an archival sample of HIV positive Black women. This study aims to describe the body changes associated with HAART in a Black female sample and explore the relationships between LD, body image, depression, and quality of life. Findings supported past research indicating a correlation between depression and poor body image but did not indicate that body image quality of life moderated the relationship between perceived body changes and depression. Results expanded on the literature by indicating that perceived body changes may be more distressing to Black women with HIV than objective changes. Lastly, findings suggested that Black women may have inaccurate …
Date:
May 2014
Creator:
Carr, Jarice N.
System:
The UNT Digital Library
Diabetes Status of Mexican Americans: Impact of Country of Birth
In order to better tailor treatment to specific populations, factors which contribute to health disparities among different racial/ethnic groups must be examined. Among Mexican American individuals, the high rate of diabetes represents a significant contributor to overall health. The present study focuses on factors affecting diabetes status among Mexican Americans born in either Mexico or the United States using the 2007 – 2008 NHANES data set. Comparisons were made between diabetes status based on self-report and clinical classification using HbA1c. Results indicated that within the diabetic subsample, Mexican Americans born in Mexico were twice as likely to be incorrectly classified as non-diabetic, when they actually were diabetic, when using a self-report method. In contrast, nativity did not result in differences in diabetes incidence using the HbA1c clinical cut-score diagnostic classification. Age, BMI, gender, nativity, and health insurance coverage were found to have varying relationships to diabetes prevalence and HbA1c levels, but time in the U.S. for Mexico-born individuals was not found to uniquely predict diabetes incidence. Analyses also demonstrated that Mexico-born males, as compared to the other groups, had significantly higher HbA1c levels. Further research is necessary to better understand the relationships among these factors. However, findings do demonstrate a …
Date:
December 2014
Creator:
Douglas, Megan E.
System:
The UNT Digital Library
Effects of Religious Attendance on Suicidal Ideation: Examining Potential Mediators of Social Support, Locus of Control, and Substance Abuse
Religion has a well-documented relationship with mental health benefits and has consistently demonstrated an impact on several specific mental health concerns, including suicide, generally finding various religious facets to be inversely associated with suicidal thoughts and behaviors. More specifically, religion has been found to be associated with suicide in a number of ways, including decreased acceptance of suicide, decreased likelihood of suicidal thoughts, decreased likelihood of suicidal attempts, fewer suicide attempts, lower relative risk of suicide, lower suicide rate, and increased reasons for living. Several studies have proposed potential mediators (e.g., social support, locus of control, and substance abuse) of the relationship between religion and mental health, usually in non-clinical samples. The current study sought to examine the association between religious attendance and suicidal ideation using archival data of a clinical sample collected from the University of North Texas Psychology Clinic. Results from this sample revealed no evidence of mediation, instead suggesting a direct effect of religious attendance on suicidal ideation. Two mediation models demonstrated the effects of external locus of control and social support on suicidal ideation. These models are discussed in terms of their directionality, considering the extant research on these associations. Findings of the current study have …
Date:
August 2014
Creator:
Price, Samantha Danielle
System:
The UNT Digital Library
Discrimination and Perceived Stress in Sexual and Gender Minorities: Self-esteem As a Moderating Factor
Sexual and gender minorities are subjected to discrimination and stigmatization which increase vulnerability to psychological co-morbidities (Mays & Cochran, 2001). The mechanisms through which discrimination contributes to distress in lesbian, gay, bisexual and transgender (lgbt) communities can be partially elucidated through the minority stress model. The minority stress model argues that minorities are subjected to negative societal attitudes and discrimination that results in excessive psychosocial stress related to their minority position, which is distinct from daily stress. Meyer’s minority stress model is supported by social stress theoriesand data linking discrimination to stress in lgb samples. Researchers suggest that self-esteem buffers the negative effects of adverse experiences but tests of the moderating effect of self-esteem on the discrimination-distress relationship in ethnic and gender minorities yielded mixed results. Szymanski found that self-esteem moderates the relationship between discrimination and psychological distress in a male sexual minority sample, but this has never been tested in a gender-balanced sexual minority sample. We hypothesized that higher levels of self-esteem are associated with lower overall perceived stress in lgbt adults, and that self-esteem acts differentially in lgbt populations to moderate perceived discrimination. We found that discrimination, self-esteem and the interaction effect between discrimination and self-esteem accounted for …
Date:
August 2014
Creator:
Wike, Alexandra Elizabeth
System:
The UNT Digital Library
Psychosocial Mediators of the Fitness-depression Relationship Within Adolescents
Adolescence is a developmental period during which boys and girls are at high risk of developing major or minor depression. Increases in fitness have been associated with lower levels of depressive symptomatology and improvements in psychological well-being, yet the mechanisms that underlie this relationship have not been thoroughly examined. Three such psychosocial variables (i.e. body satisfaction, social physique anxiety, and physical activity self-efficacy) have been identified as possible mechanisms and although they have theoretical support, additional research is needed to demonstrate empirically the potential effects of these variables. Self-report measures were used to assess the psychosocial variables and the Progressive Aerobic Cardiovascular Endurance Run (PACER) in conjunction with age, Body Mass Index [BMI], and sex was used to determine an estimate of aerobic capacity (VO2max). Path analyses were used to test the proposed model using version 6.2 EQS Multivariate Software. Results of study revealed that the boys’ and girls’ depressive scores were determined based on the extent that their fitness levels improved their satisfaction with their bodies and lowered the anxiety they experience in relation to real or imagined judgments of their physique. Although all pathways in the model were significant, with the exception of physical activity self-efficacy to depression, …
Date:
August 2014
Creator:
Sheinbein, Shelly T.
System:
The UNT Digital Library
Personality and Mental Health Attitudes Among US Army ROTC Cadets
With the current military mental health crisis, it is important to understand the role of the leader in military mental health. First, the impact of military leader behaviors on the well-being of military personnel is reviewed. Next, the role of leader attitudes as a precursor to leader behaviors is discussed. The relation of leader behaviors to leader personality using the NEO Five Factor Model (FFM) is reviewed, as well as the relation of prejudicial attitudes to the NEO FFM personality factors. A research project is described that attempted to draw these concepts together, assessing the NEO FFM personality dimensions and mental health attitudes of US Army ROTC cadets, the future leaders of the US Army. No significant relations were observed between NEO FFM personality traits and mental health attitudes, even after controlling for Impression Management. Also, the predicted positive correlation between positive mental health attitudes and Impression Management was not found. These results suggest that more research and more refined measures are needed in the area of leader attitudes toward soldier mental health problems, and how those attitudes might impact the soldiers.
Date:
August 2014
Creator:
Holtz, Pamela M.
System:
The UNT Digital Library
Factors That Influence Athletic Trainers’ Ability to Recognize, Diagnose, and Intervene: Depression in Athletes
Athletic trainers (ATs) are professionals who are most directly responsible for athletes’ health care in a sport environment. ATs work with athletes on prevention, diagnosis, and treatment of athletic injury; it is through these interactions that put ATs in an ideal position to recognize the psychological and emotional distress that athletes may suffer. Consequently, the National Athletic Trainer’s Association (NATA) has called for ATs to be competent in implementing psychosocial strategies and techniques (e.g., goal-setting, imagery, positive self-talk), recognizing basic symptoms of mental disorders, and identifying and referring athletes in need of psychological help. I explored ATs’ ability to recognize, diagnose, and provide a referral for collegiate athletes who were presenting with symptoms of depression across three different scenarios. The study examined factors that may impact ATs’ abilities in these areas, including AT gender, athlete gender, and type of presenting problem (e.g., athletic injury, romantic relationship, or sport performance issue). Overall, female ATs were better at recognizing depressive symptoms than male ATs, though both were equally proficient at diagnosing depression. Regardless of gender of the AT, gender of the athlete, and presenting problem, ATs were most likely to refer the athletes to a counselor/psychologist, and to a lesser extent sport …
Date:
August 2014
Creator:
Nguyen, Thomas TN
System:
The UNT Digital Library
The Influence of Perceived Stress on Insulin Resistance in Adults with Type 2 Diabetes
Objective: To identify whether perceived stress is a risk-factor for higher cortisol levels and greater insulin resistance in Type 2 diabetic patients, using data from participants with and without diabetes in the National Survey of Midlife Development in the United States (MIDUS), specifically MIDUS II, Project 4. The following hypotheses were tested: (H1a) greater perceived stress would be associated with higher cortisol for Type 2 diabetic participants, (H1b) the perceived stress/cortisol relationship would be stronger for people with Type 2 diabetes than for those without it, (H2) greater perceived stress would be associated with higher Homeostatic Model Assessment-Insulin Resistance (HOMA-IR, insulin-resistance) for Type 2 diabetic participants, (H3a) subjective well-being would moderate the perceived stress/insulin resistance relationship for Type 2 diabetic participants, and (H3b) depression would moderate the perceived stress/insulin resistance relationship for Type 2 diabetic participants. Method: MIDUS, a longitudinal study of over 7,000 American adults, explores biopsychosocial factors that could contribute to variance in mental/physical health. Only complete data were utilized. Type 2 participants (n=115) consisted of 54 males and 62 females ranging in age from 36 to 81 years. Non-diabetic participants (n=1097) consisted of 470 males and 627 females ranging in age from 34 to 84 years. Results: …
Date:
August 2014
Creator:
Phillips, Amanda S.
System:
The UNT Digital Library
Psychopathic Traits and Insecure Attachment Patterns in Community-based Subgroups
There is a growing body of research on psychopathic traits in non-clinical populations. This emerging research has documented the prevalence of psychopathic traits in the general population and demonstrated that psychopathy has a similar latent structure as well as similar correlates (e.g., violent behavior, alcohol abuse, and lower intelligence) to forensic/offender samples. Relatedly, there is strong evidence insecure attachment patterns in adulthood are associated with many personality disorders, including psychopathy, but only a few studies have examined the relationship between attachment and psychopathic traits in non-clinical samples (albeit, convenience samples of college students). Thus, two aims of the current study are to: 1) describe and explore the manifestation and expression of psychopathic traits in a large, community-based sample and 2) examine associations between adult attachment disturbances and psychopathic traits in diverse sociodemographic subgroups. Using a cross-sectional design, results showed mean-level psychopathy factor score differences existed only when considering single sociodemographic factors (e.g., age), not an interaction of those factors. Psychopathy factor profiles were also consistent across groups, with higher levels of lifestyle followed by interpersonal, affective, and antisocial traits reported. Regarding the second aim, findings indicated support for the positive association between disturbed attachment patterns in adult relationships and psychopathic …
Date:
August 2014
Creator:
Carter, Rachel M.
System:
The UNT Digital Library
Is Mindfulness Just Another Ego Depletion Exercise?
Given increasing interest in the therapeutic benefits of mindfulness, limitations of its treatment utility are frequently questioned. As such, the purpose of the study was to examine the effects of mindfulness on a subsequent self-control task in a sample of college students. A total of 67 participants were randomly assigned to one of three conditions: a control condition, an experimental mindfulness-only condition or a comparison expectancy-plus-mindfulness condition to investigate the utility of mindfulness practice when motivated by an outcome of increased self-control. Results did not indicate a difference in persistence on a difficult task between conditions, regardless of the manipulation. Conceptual and experimental limitations of current study’s findings, as well as future directions, are discussed.
Date:
May 2014
Creator:
Connally, Melissa Londoño
System:
The UNT Digital Library
Sexual and Nonsexual Boundary Violations Between Sport Psychology Professionals and Their Client-athletes
Sexual attraction (SA), as well as sexual (SBVs) and nonsexual boundary violations (NSBVs), have been identified as matters of ethical concern, being viewed as harmful within mental health or counseling relationships. Much of the literature in the area of SA and SBVs has focused on the counselor-client relationship, but it has been investigated only minimally in the field of sport psychology and specifically with regard to sport psychology professionals (SPPs). Because SA, SBVs, and NSBVs between SPPs and their client-athletes seem to be potentially problematic concerns in need of empirical investigation and practical scrutiny, the aim of this study was to examine: (a) the incidence of SBV and NSBV beliefs and behaviors among SPPs; (b) SPPs' feelings regarding SA for and from client-athletes; and (c) SPPs' willingness to seek supervision to manage their SA beliefs and behaviors towards client-athletes. SPPs (n = 365) completed the Survey of Applied Sport Psychologists (SASP) via e-mail or regular mail. As expected, SPPs experienced SA (40.6%) and generally did not experience strong feelings as a result of the SA. However, of the SPPs experiencing SA, 13.5% of males and 13.8% of females engaged in a SBV with a client-athlete. NSBV behaviors and beliefs are …
Date:
May 2014
Creator:
Moles, Troy
System:
The UNT Digital Library
Apology and Forgiveness in Couples
Following a transgression, interpersonal forgiveness is one strategy used to restore harmony between the victim and offender. Research also suggests that forgiveness can promote psychological and physical health. Research has shown that an apology from the offender may facilitate the forgiveness process. The majority of studies suggest that when a victim receives an apology, they experience higher levels of forgiveness toward their offender. The purpose of this thesis was to explore the association between apology and forgiveness in a sample of adults and undergraduate students (N = 803). The results are organized in three sections. First, I found a positive relationship between apology and forgiveness, replicating prior research. Second, I created a new measure of transgression severity, and provided evidence of internal consistency, construct validity, and criterion-related validity for this measure. Third, I tested two variables hypothesized to moderate the association between apology and forgiveness. First, there was some evidence that perceived offender humility moderated the association between simple apology and forgiveness. Offenders who were perceived as being more humble when providing a simple apology were granted more forgiveness than their less humble counterparts. Second, there was some evidence that transgression severity moderated the association between a complete apology and …
Date:
August 2014
Creator:
Reyna, Samuel H.
System:
The UNT Digital Library
Athletic Trainers and Sport Psychology: Knowledge, Experience and Attitudes
Certified athletic trainers (ATCs) play a unique role in sport environments as the primary medical staff available to athletes. Thus, ATCs are well positioned to oversee athletes’ physical and psychological well-being. Although sport psychologists (SPs) have been identified as a potential resource for ATCs, previous studies have reported a lack of collaboration between SPs and ATCs. This study aimed to (a) examine ATCs’ views regarding professional roles for both ATCs and SPs, (b) explore ATCs’ referral behaviors, (c) evaluate ATCs belief in the credibility of sport psychology across demographic (i.e., gender, age) and experiential variables (i.e., access to SPs), and (d) examine ATCs’ involvement in sport psychology. Four hundred ninety-six ATCs (265 men, 231 women) completed and returned the questionnaire. ATCs viewed assisting in the psychological recovery of athletes as the most acceptable professional role for fellow ATCs; aiding in the psychological recovery of injured athletes and teach mental skills were identified by ATCs as the most appropriate roles for SPs. In considering an athlete experiencing interpersonal difficulties (e.g., relationship problems), a mixed design ANOVA revealed a ATC sex by referral option interaction; female and male ATCs indicated they would likely refer the athlete to a counselor/therapist, followed by a …
Date:
May 2014
Creator:
Ramaeker, Joseph P.
System:
The UNT Digital Library