5 resultados para COGNITIVE BEHAVIORAL INTERVENTION

em DRUM (Digital Repository at the University of Maryland)


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Children who have experienced a traumatic brain injury (TBI) are at risk for a variety of maladaptive cognitive, behavioral and social outcomes (Yeates et al., 2007). Research involving the social problem solving (SPS) abilities of children with TBI indicates a preference for lower level strategies when compared to children who have experienced an orthopedic injury (OI; Hanten et al., 2008, 2011). Research on SPS in non-injured populations has highlighted the significance of the identity of the social partner (Rubin et al., 2006). Within the pediatric TBI literature few studies have utilized friends as the social partner in SPS contexts, and fewer have used in-vivo SPS assessments. The current study aimed to build on existing research of SPS in children with TBI by utilizing an observational coding scheme to capture in-vivo problem solving behaviors between children with TBI and a best friend. The current study included children with TBI (n = 41), children with OI (n = 43), and a non-injured typically developing group (n = 41). All participants were observed completing a task with a friend and completed a measure of friendship quality. SPS was assessed using an observational coding scheme that captured SPS goals, strategies, and outcomes. It was expected children with TBI would produce fewer successes, fewer direct strategies, and more avoidant strategies. ANOVAs tested for group differences in SPS successes, direct strategies and avoidant strategies. Analyses were run to see if positive or negative friendship quality moderated the relation between group type and SPS behaviors. Group differences were found between the TBI and non-injured group in the SPS direct strategy of commands. No group differences were found for other SPS outcome variables of interest. Moderation analyses partially supported study hypotheses regarding the effect of friendship quality as a moderator variable. Additional analyses examined SPS goal-strategy sequencing and grouped SPS goals into high cost and low cost categories. Results showed a trend supporting the hypothesis that children with TBI had fewer SPS successes, especially with high cost goals, compared to the other two groups. Findings were discussed highlighting the moderation results involving children with severe TBI.

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While a variety of crisis types loom as real risks for organizations and communities, and the media landscape continues to evolve, research is needed to help explain and predict how people respond to various kinds of crisis and disaster information. For example, despite the rising prevalence of digital and mobile media centered on still and moving visuals, and stark increases in Americans’ use of visual-based platforms for seeking and sharing disaster information, relatively little is known about how the presence or absence of disaster visuals online might prompt or deter resilience-related feelings, thoughts, and/or behaviors. Yet, with such insights, governmental and other organizational entities as well as communities themselves may best help individuals and communities prepare for, cope with, and recover from adverse events. Thus, this work uses the theoretical lens of the social-mediated crisis communication model (SMCC) coupled with the limited capacity model of motivated mediated message processing (LC4MP) to explore effects of disaster information source and visuals on viewers’ resilience-related responses to an extreme flooding scenario. Results from two experiments are reported. First a preliminary 2 (disaster information source: organization/US National Weather Service vs. news media/USA Today) x 2 (disaster visuals: no visual podcast vs. moving visual video) factorial between-subjects online experiment with a convenience sample of university students probes effects of crisis source and visuals on a variety of cognitive, affective, and behavioral outcomes. A second between-subjects online experiment manipulating still and moving visual pace in online videos (no visual vs. still, slow-pace visual vs. still, medium-pace visual vs. still, fast-pace visual vs. moving, slow-pace visual vs. moving, medium-pace visual vs. moving, fast-pace visual) with a convenience sample recruited from Amazon’s Mechanical Turk (mTurk) similarly probes a variety of potentially resilience-related cognitive, affective, and behavioral outcomes. The role of biological sex as a quasi-experimental variable is also investigated in both studies. Various implications for community resilience and recommendations for risk and disaster communicators are explored. Implications for theory building and future research are also examined. Resulting modifications of the SMCC model (i.e., removing “message strategy” and adding the new category of “message content elements” under organizational considerations) are proposed.

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African American women account for a disproportionate burden of cervical cancer incidence and mortality rate when compared to non-Hispanic White women. Cervical cancer is one of the most preventable types of cancer, and women can be screened for it with a routine Pap test. Given that religion occupies an essential place in African American lives, framing health messages with important spiritual themes and delivering them through a popular communication delivery channel may allow for a more culturally-relevant and accessible technology-based approach to promoting cervical cancer educational content to African American women. Using community-engaged research as a framework, the purpose of this multiple methods study was to develop, pilot test, and evaluate the feasibility, acceptability, and initial efficacy of a spiritually-based SMS text messaging intervention to increase cervical cancer awareness and Pap test screening intention among African American women. The study recruited church-attending African American women ages 21-65 and was conducted in three phases. Phases 1 and 2 consisted of a series of focus group discussions (n=15), cognitive response interviews (n=8), and initial usability testing that were conducted to inform the intervention development and modifications. Phase 3 utilized a non-experimental one-group pretest-posttest design to pilot test the 16-day text messaging intervention (n=52). Of the individuals enrolled, forty-six completed the posttest (retention rate=88%). Findings provided evidence for the early feasibility, high acceptability, and some initial efficacy of the CervixCheck intervention. There were significant pre-post increases observed for knowledge about cervical cancer and the Pap test (p = .001) and subjective norms (p = .006). Additionally, results post-intervention revealed that 83% of participants reported being either “satisfied” or “very satisfied” with the program and 85% found the text messages either “useful” or “very useful”. 85% of the participants also indicated that they would “likely” or “very likely” share the information they learned from the intervention with the women around them, with 39% indicating that they had already shared some of the information they received with others they knew. A spiritually-based SMS text messaging intervention could be a culturally appropriate and cost-effective method of promoting cervical cancer early detection information to African American women.

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Stressful life events early in life, including symptoms of mental disorders or childhood maltreatment, may increase risk for worse mental and physical health outcomes in adulthood. The purpose of this dissertation was to examine the effects of childhood Attention Deficit Hyperactivity Disorder (ADHD) symptoms and maltreatment experience on two adult outcomes: obesity and alcohol use disorder (AUD). Mediational effects of adolescent characteristics were explored. This dissertation used Waves I, III, and IV of the National Longitudinal Study of Adolescent to Adult Health. In Paper 1 (Chapter 3), we investigated the association between multiple types of child maltreatment and adult objective (body mass index; BMI) and subjective (self-rated) obesity, as well as mediating effects by adolescent characteristics including depressive symptoms and BMI. Results showed that after adjusting for sex, race/ethnicity, and maternal education, physical maltreatment was moderately associated with adulthood obesity as measured by BMI and self-reported obesity, while sexual maltreatment was more strongly associated with the objective measure but not the subjective measure. The indirect effects of mediation of adolescent BMI and depressive symptoms were statistically significant. In Paper 2 (Chapter 4), the objective was to examine mediation by adolescent depressive symptoms, alcohol consumption, peer alcohol consumption, and delinquency in the relationship between ADHD symptoms and adult AUD. The indirect effects of mediation of adolescent delinquency, alcohol consumption, and peer alcohol consumption were statistically significant in single and multiple mediator models. In Paper 3 (Chapter 5), the objective was to assess the joint effects of maltreatment/neglect on adult AUD. After adjusting for sex, race/ethnicity, child maltreatment, and parental AUD, ADHD symptoms were significantly associated with increased odds of AUD. There was no strong evidence of multiplicative interaction by maltreatment. This association was stronger for males than females, although the interaction term was not statistically significant. This dissertation adds to the literature by examining relationships between several major public health problems: ADHD symptoms, childhood maltreatment, AUD, depressive symptoms, and obesity. This project has implications for understanding how early life stress increases risk for later physical and mental health problems, and identifying potential intervention targets for adolescents.

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The present study employed a cross-sectional design to test a model of coping with acculturative stress in an international student sample. Drawing from Lent’s (2004) social cognitive model of restorative well-being, several direct and mediated paths were hypothesized to predict (negatively) acculturative stress and (positively) life satisfaction. Behavioral acculturation and behavioral enculturation (Kim & Omizo, 2006) were also examined as predictors of coping with acculturative stress among international students. Using a self-report survey, participants’ ratings of acculturative stress, life satisfaction, social support, behavioral acculturation, behavioral enculturation, and coping self-efficacy were assessed. The results revealed that the variables of the model explained 16% of the variance in acculturative stress and 27% of the variance in life satisfaction. A final model, including the use of modification indices, provided good fit to the data. Findings also suggested that coping self-efficacy was a direct predictor of acculturative stress, and that behavioral acculturation and coping self-efficacy were direct predictors of students’ life satisfaction. Limitations, future research, and practical implications are discussed.