CU Dissertations

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CU Dissertations

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CU Dissertations contains all the electronic dissertations since October of 2009 Graduation. Some dissertations can be accessed by Catholic University users only.

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: Collaborative Assessment and Management of Suicidality (CAMS): Adherence to a Flexible Clinical Framework; Degree awarded: Ph.D. Psychology. The Catholic University of America, The Collaborative Assessment and Management of Suicidality framework (CAMS; Jobes, 2006) has amassed more consistent empirical support to date than most other suicide-focused psychosocial approaches for actively treating adult patients. This support has led to multiple variations of CAMS training being delivered to mental health practitioners across several settings. However, no research has examined the extent to which such training impacts participants' self-reported adherence to the CAMS therapeutic philosophy and recommended CAMS practice behaviors, or whether adherence varies as a function of contextual variables (i.e., the type of training received, therapist factors, and primary work setting/agency support). The present study was designed to address this gap, using an online survey of 120 practitioners who completed some form of CAMS training or read the CAMS manual with the intention of applying it in clinical practice. Results indicated moderate to high adherence to the CAMS therapeutic philosophy, which is comparable to other studies gauging the impact of suicide-focused training. Similarly, participants reported relatively high adherence to CAMS practice, in line with other suicide-focused training studies and, in fact, higher than findings on adherence to interventions for other psychiatric issues. Older and more experienced clinicians, those with doctoral degrees, and those whose work was guided more from a CBT perspective had higher adherence to the CAMS therapeutic approach. Additionally, adherence to CAMS philosophy as measured by comfort using CAMS-consistent statements was higher for men, those with more of a CBT orientation, clinicians who received more intensive training, and those working in outpatient or Veterans Administration medical centers as opposed to counseling centers. Finally, therapist confidence in using CAMS with patients was positively related to both adherence types. On the whole, adherence to philosophy and practice did not vary consistently as a function of any contextual variable, which suggests that practitioners receiving CAMS training can successfully subscribe to the CAMS therapeutic philosophy and implement CAMS-specific practices regardless of their broader contexts. Future investigations of CAMS training should assess self-reported CAMS-related attitudes and beliefs before and immediately after training, as well as actual behavior change in clinical practice., Made available in DSpace on 2014-06-20T15:48:49Z (GMT). No. of bitstreams: 1 Crowley_cua_0043A_10515display.pdf: 773733 bytes, checksum: f36b07d1936a3a2c9297326c68ff36f6 (MD5)

: The Collaborative Assessment and Management of Suicidality (CAMS) with Adolescents: An Empirical Investigation; Nearly one-fifth of U.S. high school students have seriously considered suicide (YRBS 2019), and 2,797 adolescents died by suicide in 2020 (Drapeau & Macintosh, 2021). There are limited options for suicide-specific treatments that address the developmental needs of adolescents, and many adolescents struggling with thoughts of suicide receive no mental health treatment beyond a visit to an emergency department for an acute suicidal crisis (Asarnow et al., 2022). Preliminary research suggests that the Collaborative Assessment and Management of Suicidality (CAMS, Jobes, 2016) is effective at reducing suicide ideation among adolescents (Adrian et al., 2021). Given the low rate of engagement in mental health services in this population, further research is needed to determine the feasibility and utility of CAMS as a treatment for complex, high-risk adolescents. This quasi-experimental mixed-methods study used an archival dataset to compare differences in service use outcomes for adolescents who received CAMS and for a matched sample of adolescents who received standard treatment. Propensity score matching (PSM) was used to create the matched sample. In order to further inform the development of CAMS-4Teens, qualitative responses from the Suicide Status Form (SSF-4, Jobes, 2016) were explored to describe the frequency and context in which adolescents mentioned their parents in relation to their suicidality. There were no differences between groups in the number of emergency department visits or inpatient admissions, but adolescents who received CAMS had a significantly higher rate of outpatient services than those in the comparison group, including more specific or more intensive services beyond their CAMS treatment. The qualitative data revealed that fewer than one-third of adolescents mentioned a parent on the SSF, but those who did were likely to mention a parent as a reason for living. The lack of a parent mention was associated with significantly higher ratings of suicide risk by clinicians. The results of this pragmatic comparison trial suggest that CAMS may facilitate ongoing engagement in mental health services after a suicidal crisis. They also highlight the important of ongoing assessment and of incorporating each individual patient’s perspective in order to provide patient-centered individualized treatment. , Psychology, adolescent, CAMS, service use, suicide, treatment, Psychology, Degree Awarded: Ph.D. Psychology. The Catholic University of America

: Collaborative Assessment and Management of Suicidality--Integrated Training Model: Impact on Clinician Competency; Effective implementation of evidence-based practices is vital in clinical suicide prevention. Multiple factors influence the implementation of evidence-based practices (EBPs), including mental health care clinicians’ access to training as well as the quality of training they receive. This study investigated the impact of a multi-modal training program for a suicide-specific evidence-based practice: The Collaborative Assessment and Management of Suicidality – Integrated Training Model (CAMS – ITM). Survey data was used to assess the effectiveness of CAMS – ITM in increasing clinical competency to treat suicidal patients, as measured by improvements in clinicians’ self-report of skill in treating suicidal patients, knowledge of suicide-specific best practices, and attitude toward the treatment of suicidality. Pre-training survey responses compared to post-training survey responses were analyzed across groups of clinicians receiving CAMS training in the states of Oklahoma, Ohio, Colorado, and Alaska. The findings of this exploratory study showed good support for CAMS – ITM, as analyses showed improvements in attitude, knowledge, and skill by the end of training. Moreover, there was evidence that the first training, an online video course, was effective in improving competency in and of itself. This study adds to the extant literature on EBP training for mental health clinicians and adds to the body of evidence in support of CAMS as a tool for the dissemination and implementation of suicide specific best practices. , Clinical psychology, CAMS, clinical competency, clinician training, implementation, suicide-specific EBP, training outcome, Psychology, Degree Awarded: Ph.D. Psychology. The Catholic University of America

: Comfort as Experienced by Thai Older Patients with Advanced Cancer; Degree awarded: Ph.D. Nursing. The Catholic University of America, your words, Made available in DSpace on 2011-03-01T11:47:06Z (GMT). No. of bitstreams: 1 Tanatwanit_cua_0043A_10165display.pdf: 15872978 bytes, checksum: 8b9c912761df91d98f089ffbc697f0e5 (MD5)

: Coming to Terms with Complexity: A Lens for the Human Sciences in the Twentieth Century

: Communication, Communion and Conflict in the Theologies of Gregory Baum and Patrick Granfield; Degree Awarded: Ph.D. Systematic Theology. The Catholic University of America, Communion, communication, and conflict are interrelated realities of great importance for the life and mission of the church. These realities themselves and the relationships between them are in need of theological refinement and assessment, because conflict necessarily affects the church's ability to communicate the message of salvation, and to experience communion.Within a North American and Roman Catholic context, Canadian theologian Gregory Baum (b.1923) and U.S. theologian Patrick Granfield (1930-2014) present ways of perceiving the relationships between these three realities. Through an analysis of the salient dimensions of their respective theologies, this dissertation explores their respective understandings of the church, and identifies ways in which their approaches complement each other, with particular attention paid to the themes of communion, communication and conflict.Baum reflected on these three realities with respect to the church's life and mission to the world, articulating an ecclesial spirituality. Granfield did so primarily with respect to the church's institutional life. Considering their works together offers a means to deepen the church's experience of the mystery of communion via a renewed approach to its communication of the divine promise, while acknowledging conflict as a force which need not be destructive, but which can be harnessed for creative growth.The works of both men show that the implementation of an ecclesiology of communion in the church today requires an awareness that communion is more than simply a theological notion of union with God, that communication in the church is more than speech alone, and that conflict in the church need not be divisive or destructive. Rather, communion in the church must always be concretely expressed in order to be experienced, communication is the sharing of the whole person, and conflict can be attended to in a way which strengthens communion and does not undermine it. By their attention to these three realities in the church, both Baum and Granfield have provided important reflections, not only on how the church lives and functions, but on how it can remain faithful to its divine calling and mission in a continually challenging and complex era.

: A Communication Enrichment Retreat for Catholic Korean-American Couples Employing the Trinitarian Mode of Communication; Degree awarded: D.Min. Pastoral Studies. The Catholic University of America, AbstractGood communication, as the ability to exchange precise meanings, leads couples to a deeper mutual understanding and works as a key to enhancing marital intimacy and satisfaction. Communication has been a fundamental issue, particularly for first generation Korean-American couples who have been challenged by the pressure of adapting to the new cultural situation of living in the United States. While still constrained by a strong tendency to maintain Confucian paradigm of marital communication and thereby avoid dialogue, these couples have felt the growing need both for effective communication that deals with tensions and conflicts among themselves and for real dialogue that results in a healthier marriage. The Trinitarian mode of marital communication, which is derived from the marriage analogy of the Trinity, could serve as a Catholic ideal of marital communication. As characterized by the triple interaction of silence, listening, and dialogue in conformity with God's Trinitarian communion of love among God, the Son, and the Holy Spirit, it will help Catholic Korean-American couples share their life and love together "in the Lord" at a deeper level and enhance mutual understanding and intimacy in the Second Vatican Council's vision of marriage as "the intimate community of life and love." A Trinitarian Couple Communication that employs "reflection, validation, and empathy" and involves the perspective of silence, of listening, and of dialogue may function as a workable model for daily use to help couples reduce misunderstanding and unnecessary conflicts among themselves and gain more satisfaction and intimacy in marital relationships.This Project in Ministry was carried out in two parts. Accordingly, Part One laid the theoretical foundation for the Project by researches in Catholic Theology of Marriage, Marriage in Traditional Korean Confucianism, Korean-American Marriage in the Challenge of Cultural Transition, and a Catholic Ideal of marital Communication. Upon this foundation, Part Two designed, implemented, and evaluated through surveys the actual retreat program. This Project in Ministry may serve as an effective and workable educational model to enrich marital communication, particularly for Catholic Korean-American couples who have alienated themselves from the existing marriage programs because of the language and cultural barrier., Made available in DSpace on 2011-02-24T20:47:15Z (GMT). No. of bitstreams: 1 Jung_cua_0043D_10016display.pdf: 617000 bytes, checksum: 5dbd8534ed6a9ee049683f0e5728c787 (MD5)

: Communication Skills Training for Family Caregivers of Persons with Dementia from Alzheimer's Disease; Experts predict the number of persons with Alzheimer’s disease will steeply rise over the next thirty years as the population of older adults in the United States increases. In Alzheimer’s disease, the accumulation of abnormal protein fragments and inflammatory processes in the brain causes a variety of symptoms, including a gradual diminishing of a person’s capability to understand and rationally respond to others. Family caregivers of persons with dementia from Alzheimer’s disease (DAT) experience stress due to changes in their loved one's ability to communicate. Researchers recommend communication skills training for family caregivers in order to help the caregivers optimally interact with their relative that has dementia. Evidence suggests that communication skills training for family caregivers may result in positive outcomes for caregivers and persons with DAT. The purpose of this project was to determine if an evidence-based communication skills training program for family caregivers of persons with DAT improved caregiver self-efficacy, well-being, and stress level, and increased the frequency of the use of evidence-based dementia communication skills. A mixed-method design was employed. The quantitative part of the study included a one-group pre-post measures design at Time 0 and Time 1 (11 weeks) with a variety of validated and non-validated tools. Two qualitative questions explored program helpfulness. The caregiver training program consisted of six short videos, a PowerPoint presentation, four one-hour individual caregiver educational sessions, and a caregiver logbook. Eight caregivers completed the training (mean age=69 years, female=5). All the caregivers reported moderate to high satisfaction, and most would strongly recommend the program. Replies to self-efficacy questions indicated significant improvement in confidence in their ability to communicate with their relative and in controlling negative thoughts about caregiving. Providing better training in communication skills to family caregivers of persons with DAT may contribute to an improved caregiving experience for a rapidly growing dementia caregiver population., Gerontology, Nursing, Health sciences, Alzheimer's Disease, Caregivers, Communication, Dementia, Family, Skills, Nursing, Degree Awarded: D.N.P. Nursing. The Catholic University of America

: Communion and Mission in the Theology of Joseph Ratzinger

: Community values in educational and occupational selection :

: Comparative Responsiveness of the Numeric Rating Pain Scale and the PEG Scale among Adult Chronic Pain Patients in an Ambulatory Setting; Comparative Responsiveness of the Numeric Rating Pain Scale and the PEG Scale among Adult Chronic Pain Patients in an Ambulatory Setting Cynthia Cichanowicz, MSN, ANP-c Director: Dr. Deirdre Doerflinger, PhD, ANP, BC, GNP, BC, FAANP Chronic pain is one of the most common reasons adults seek primary and emergency outpatient care. In 2016, an estimated twenty percent of U.S. adults reported chronic pain and eight percent of U.S. adults experienced high-impact chronic pain causing restrictions in mobility and daily activities, dependence on opioids, anxiety and depression, and poor perceived health or reduced quality of life (CDC, 2018). The significant rise in opioid use and associated adverse outcomes over the past two decades have generated a national and international movement to combat the opioid crisis. Solutions to and quality of healthcare in pain management have been the focus of a worldwide initiative by state and federal governments, the Joint Commission on Accreditation of Healthcare Organizations, and the healthcare industry. It is essential for organizations to develop methods for pain screening and assessment to develop appropriate individualized pain treatment plans. The Numerical Rating Scale (NRS) is one of the most used scales when evaluating pain. However, this scale measures only one characteristic of pain, the intensity. Patients rate their pain on a scale from 0 to 10 where 0 equals no pain and 10 is the worst possible pain (Danise & Turk, 2013). Assessment of pain intensity alone is inadequate when evaluating the chronic pain population. The PEG scale is a short 3-item tool developed in 2009 which stands for P-pain intensity, E- interference with enjoyment in life, and G- interference with general activity (Krebs, et al., 2009). Purpose: The purpose of this project was to compare patient preference for the NRS vs. the PEG scale, assessment of providers utilization and satisfaction of the NRS vs the PEG scale, and patient responsiveness in pain to the pain treatment plan based on these scores. Methods/Design: A quantitative design was used to examine the preferences of chronic pain patients between the use of the Numerical Rating Scale (NRS) and the PEG scale (Pain, Enjoyment, General Activity), in assessing their chronic pain, assessment of providers utilization and satisfaction of the NRS vs the PEG scale, and patient responsiveness in pain to the pain treatment plan based on these scores. Results: The outcomes measured in the project concluded that the majority of both patients and providers preferred the use of a functional pain assessment tool that assessed pain intensity as well as it’s influence on physical and emotional status. Of the patients surveyed 90.9% reported the PEG scale adequately described their pain and 100% reported it was easy to use. Of the providers surveyed, 63.2% reported they were fairly or extremely confident of their patients’ ability to adequately describe their pain using the PEG scale. Conclusion: The use of a functional pain assessment tool is preferred by both patients and providers when assessing and treating chronic pain. , Nursing, Chronic Pain , Functional Pain Scale, Numerical Rating Scale, Opioid, Patient Preference, PEG Scale, Nursing, Degree Awarded: D.N.P. Nursing. The Catholic University of America

: A Comparative Study of Reported and Perceived Driving Behavior in Relation to Road Crashes in Three Different Regions of the Kingdom of Saudi Arabia; Road traffic safety represents the procedures implemented and actualized to inhibit drivers and operators from being killed or significantly wounded. Traffic safety is vital to the enhancement and preservation of economic, social, and environmental aspects of any society. In the Kingdom of Saudi Arabia, road traffic crashes have become to be a very severe issue and the country has already taken steps in resolving this issue. However, previously conducted scientific studies regarding road safety in the KSA were limited to a certain age group.In this dissertation, road traffic crashes were studied in three regions of the KSA (Makkah, Riyadh, and Dammam) based on: driving behavior, locus of control, demographic factors, time of the day, type of road. In addition questionnaire was used to assess driving behavior. Different statistical models such as the random parameters Poisson regression, MANOVA, and logistic binary regression were used to conduct the investigation. The results of the study indicate the following, aggressive behavior increases the chances of both getting into a car crash and being injured in one. Therefore, the KSA should introduce measures in order to control and train drivers who tend to driveaggressively. Furthermore, the programs should include and be adjusted to different demographic groups. The results indicated that the period between 12 am and 6 am is the time of the day when the chances for a road crash are the highest. The dissertation also adapted the DBQ for use in the KSA, and demonstrated its validity by cross-matching the responses on the questionnaire with official reports. This questionnaire could be a useful tool for selecting people to attend road safety programs. This dissertation is a very valuable source of information for the KSA as well as a base for future research., Civil engineering, Transportation, Crashes, Driving Behavior, Poisson, Random Parameters, Civil Engineering, Degree Awarded: D.Engr. Civil Engineering. The Catholic University of America

: A Comparative Study of the Hermeneutics of Henri de Lubac and Hans-Georg Gadamer Concerning Tradition, Community and Faith in the Interpretation of Scripture; Degree Awarded: Ph.D. Systematic Theology. The Catholic University of America, This dissertation investigates and compares the hermeneutics of the French Jesuit theologian, Henri de Lubac (1896-1991), and the German philosopher, Hans-Georg Gadamer (1900-2001). The writings of both Gadamer and de Lubac continue to generate scholarly investigation, including proposals to apply their insights to contemporary biblical interpretation. Although de Lubac and Gadamer were contemporaries, they never directly engaged each other's writings; this dissertation brings their thought into dialogue. Chapter One provides a biographical overview of the lives of both scholars by situating the texts that will be examined within the broader context of each work. Since de Lubac approached the subject of biblical interpretation chiefly as an historian of exegesis, the first step in this comparative investigation is a formulation of de Lubac's hermeneutical principles. Chapter Two, which constitutes the major portion of this dissertation, analyzes de Lubac's works Catholicisme, Histoire et Esprit, Exegese medievale, and La Posterite spirituelle de Joachim de Flore in view of understanding his hermeneutics. An historical account of the formation of de Lubac's theology of the four-fold sense of Scripture is provided, together with a description of its final synthesis. This chapter proposes that de Lubac's later works must be read in light of his writings of the 1930s in order to grasp the scope of his desired integration of traditional interpretation and modern science. It also provides a more detailed analysis of the exegetical import of La Posterite spirituelle than previous literature. Although the writings of Gadamer concern general hermeneutics, he occasionally applied his theories to biblical interpretation. Chapter Three examines Gadamer's Wahrheit und Methode in order to compare his hermeneutics with those of de Lubac that were presented in Chapter Two. The conclusion appraises the similarities between de Lubac and Gadamer in their treatment of the role of tradition and community in interpretation. The conclusion also explores the tension between their views on the role of faith in interpretation and suggests that certain principles of Gadamer's general hermeneutics may provide the philosophical support that de Lubac desired for his theological hermeneutics of Scripture. An appendix analyzes the textual relationship of Histoire et Esprit to its sources.

: A Comparative Study of the Teacher’s Religious Knowledge, Personal Faith Beliefs, and Personal Faith Practices that Impact the Teacher-Perceived Religiosity as Evangelizers in the Catholic Elementary/Middle School Classroom; The teacher’s role as evangelizer in a Catholic elementary school is important since most classroom teachers are expected to teach the content of the Catholic faith and every teacher, Catholic or non-Catholic, is encouraged to share their faith with the students. This study explored the relationship among teachers’ perceptions of their role as evangelizers, and their knowledge of Catholic doctrine and consistency of personal beliefs about Church teachings. A 71- item survey was completed by 593 K-8 teachers in Catholic elementary schools randomly selected from the six NCEA regions. In addition to demographic information, the survey contained items about perceived roles as evangelizers, and questions about knowledge of Catholic doctrine and personal beliefs about such. A factor analysis revealed six components of the evangelizer items, four concerned personal dispositions about their role as evangelizers and two specifically about intentional activities in their teaching. Teachers with more experience in teaching in a Catholic school compared with teachers with less experience reported putting God first in their lives and inviting their students to do the same, see every student as important to God, and strive to integrate Gospel teachings in all aspects of the curriculum. The important predictors of their view of teaching as a ministry were the teachers’ generational cohort, whether they taught religion and the number of years teaching in a Catholic school. Older teachers were also more intentional than younger teachers in efforts to form disciples of Jesus. Catholic teachers answered 74 percent of the doctrinal items consistent with the teachings of the Catholic Church, compared with 60 percent of non-Catholic teachers. Catholic teachers in their personal beliefs answered 71 percent of the doctrinal items consistent with Catholic teachings, as compared to non-Catholic teachers with 52 percent. The results also showed that older teachers had a better understanding of Church doctrine than did younger teachers. This study provides Catholic leaders with a better understanding of how Catholic and non-Catholic elementary school teachers perceive themselves as faith evangelizers in the Catholic elementary classroom. This study also provides information about the importance of faith formation for Catholic elementary/middle school teachers., Elementary education, Middle school education, Religious education, Education, Degree Awarded: Ph.D. Education. The Catholic University of America

: Comparing Judicial Instructions About Confession Evidence in a Criminal Case; Most false confessors will plead, or will be found, guilty at trial in the U.S. DNA exonerations indicate that false confessions are the second leading cause of wrongful conviction. Jurors have an incomplete understanding of the factors that affect confession evidence. This study sought to sensitize mock jurors to factors that can increase or decrease the strength of confession evidence, by way of a novel set of modified (“enhanced”) jury instructions. The enhanced instructions combined best-practice standard (“general”) criminal case instructions with empirical findings about factors occurring before, during, and after an interrogation that impact confession reliability. Participants (N= 314) read a weak or strong murder trial transcript online, followed by general or enhanced jury instructions. The key evidence in the trial was the defendant’s confession, gathered by police using either coercive (weak case) or appropriate (strong case) tactics. The cases differed in 11 key details. For example, in the weak case, police employed coercive tactics, such as lying about the existence of incriminating evidence against the suspect, whereas in the strong case, the police ensured the suspect’s sobriety prior to the interview and recorded the interview in its entirety. Altogether, 64% of the general instruction group convicted the defendant in the weak case and 74% in the strong case—a 10% difference that was not statistically significant. In contrast, 60% of the enhanced group convicted thedefendant in the weak case and 78% in the strong case—an 18% difference that was significant. The enhanced instruction participants were 1.47 times more likely to render a guilty verdict in the strong case than the weak case compared to the general instruction participants. This is the first study to demonstrate that jury instructions can sensitize jurors to confession evidence, without making them more skeptical about confession evidence in general. However, 30% of participants who considered the confession to be involuntary still convicted the defendant, and the enhanced instructions did not lower convictions for involuntary confessions. Implications are discussed for educating jurors and legal professionals about confession evidence., Degree awarded: Ph.D. Psychology. The Catholic University of America

: Comparing Pain in Patients Undergoing Percutaneous Versus Transjugular Techniques of Liver Biopsy; Degree Awarded: Ph.D. Nursing. The Catholic University of America, ABSTRACTNo study was found in the initial review of the literature comparing pain experienced by patients using the medical technique of Percutaneous Liver Biopsy (PLB) as compared to Transjugular Liver Biopsy (TLB). The relevance of this study derives from the general lack of research on this important subject related to the pain liver biopsy patients' experience. In addition, no studies were found in the literature comparing pain experienced during PLB and TLB using both the Numeric Pain Scale (NPS) and the Visual Analogue Scale (VAS). This study compared the experience of pain between patients who had the PLB procedure versus the TLB. This prospective, descriptive, comparative, quantitative study used the NPS and VAS with 32 post-liver biopsy patients to measure their pain prior to the biopsy procedure and at 2, 4 and 6 hours following the biopsy. In this study the NPS and VAS were both found to be reliable pain measures with alpha coefficients of 0.94 for the NPS and 0.91 for the VAS. Using the Grand mean for pain scores over time, the magnitude of the TLB pain was found to be 2.2 times greater than the pain PLB patients reported. Following the computed F value (1,30)=4.43, p<.05 using the NPS and using the VAS, F(1,30)=5.53, p<.03, post-hoc comparisons were used that found a statistically significant higher level of pain for the TLB patient as compared to the PLB patient prior to the biopsy (t[20.5]=2.2, p=0.038) and 2 hours after the procedure (t[24.4]=2.3, p=0.03 for the NPS. Part of being a nurse is to intervene effectively and holistically to relieve pain and prevent its' long-term effects, as anxiety or fear over the possibility of needing another liver biopsy in the future is worrisome to patients. In addition, practicing nurses should use research to guide the effective relief of acute pain in their liver biopsy patients. The findings of this study may help to guide how nurses and physicians can reduce liver biopsy pain. The conclusions of this study are that:1. There was a statistically significant difference in pain during liver biopsy between the TLB and the PLB patient, with the pain being greater in the TLB patient.2. The higher level of pain for the TLB patient as compared to the PLB patient was found to occur prior to the biopsy and 2 hours after the biopsy.3. The NPS and the VAS are reliable tests for measuring pain in liver biopsy patients.

: Comparing Teaching Aids for how to Evaluate Eyewitness testimony in a Criminal Case; Degree awarded: Ph.D. Psychology. The Catholic University of America, Although eyewitness identifications are a common form of evidence presented in criminal trials, analyses of actual cases and studies of mock jurors suggest that people are not skilled at evaluating eyewitness accuracy. Laypeople tend to rely on factors that are not diagnostic of identification accuracy, such as the eyewitness's confidence, and they tend to underestimate factors that are diagnostic of identification accuracy, such as proper interview and lineup procedures. The present study compared the effects of three teaching aids on participants' sensitivity to eyewitness evidence in either a strong or weak eyewitness identification scenario. The interview-identification-eyewitness (I-I-Eye) experimental aid directed participants to first attend to how law enforcement interviewed the eyewitness, second evaluate the identification procedures, and third determine what eyewitness factors during the crime could have impacted the eyewitness's identification accuracy. The Neil v. Biggers control aid presented five criteria that are the current legal standard for evaluating eyewitness evidence. The Jury Duty control aid described aspects of the criminal trial process. The strong and weak transcript scenarios differed on factors relevant to the fairness of the eyewitness interview and the lineup (system variables). Participants were 293 undergraduate students. A 3 (teaching aid) x 2 (trial transcript strength), between-groups factorial design was employed. Participants in the I-I-Eye group rendered significantly more correct verdicts for the strong case and marginally more correct verdicts for the weak case than those in either control group. Importantly, only the I-I-Eye participants demonstrated sensitivity by ruling guilty more often in the strong case (55%) than in the weak case (16%). Thus, the I-I-Eye participants not only learned about eyewitness factors, but were able to integrate this information with other case details so as to reach a correct verdict. Moreover, participants in the I-I-Eye group were more likely to list characteristics of the crime scene (estimator variables) and police procedures (system variables), and less likely to list the lack of forensic evidence in the case, as the reason for their verdict. We discuss how to use the I-I-Eye heuristic to teach laypersons and professionals in the criminal justice system how to evaluate eyewitness evidence., Made available in DSpace on 2011-06-24T17:13:03Z (GMT). No. of bitstreams: 1 Pawlenko_cua_0043A_10201display.pdf: 1032885 bytes, checksum: 90e296418992bf9c1cbf68b945c40db0 (MD5)

: Comparing the Interactive Effects of State and Trait Emotion Regulation on Memory; Cognitive reappraisal and emotion suppression are two common emotion regulation (ER) strategies that have been widely studied in relation to affective, cognitive, and social outcomes. Research on affective and social outcomes of ER yield consistent results, with cognitive reappraisal relating to more adaptive outcomes, and emotion suppression relating to worse outcomes. The findings regarding relationships between ER and cognitive variables, however, are less consistent, particularly for studies examining ER and memory. Potential explanations for these inconsistent findings are differences in 1) the methods of measuring ER strategies, and; 2) the types of memory assessed. The first chapter of this dissertation discusses the rationale for incorporating measurement of ER as both trait and state variables in future research, while the second chapter reviews the existing literature regarding ER and various types of memory. The third chapter presents an original research study examining the relationships between both state and trait ER and two different types of memory (verbal and non-verbal), and testing for potential interactive effects between state and trait ER on memory. Data was collected from 75 Catholic University of America undergraduate students age 18 and older. Participants completed computerized questionnaires (demographics and trait ER) and a computerized task consisting of three state ER conditions (cognitive reappraisal, emotion suppression, no-regulation). Participants were then tested on their memory for information presented during the state conditions. Results showed trend interactive effects of state and trait ER on verbal memory only. Individuals performed better on verbal memory tests while cognitively reappraising and emotionally suppressing emotions when they were high trait cognitive reappraisers, suggesting that, regardless of the state ER strategy used, individuals who typically use cognitive reappraisal tend to have better verbal memory. However, when emotionally suppressing emotions, individuals only performed better on memory tests when they were high trait suppressors, suggesting that habitual use of the instructed strategy may have led to decreased cognitive load. These findings illustrate the importance of including both trait and state ER measures in future research, as the way in which individuals regulate in an experimental setting is likely affected by how they typically regulate emotions., Developmental psychology, Psychology, Degree Awarded: Ph.D. Psychology. The Catholic University of America

: A Comparison of Mindfulness-Based Programs for Stress in University Students; Degree awarded: Ph.D. Psychology. The Catholic University of America, Mindfulness-based stress reduction (MBSR) has demonstrated the ability to reduce stress in various populations, including university students, although a commitment to eight sessions and daily 45-minute formal mindfulness meditations may be a hindrance for some students. Other mindfulness-based interventions (e.g., acceptance and commitment therapy) use brief mindfulness exercises and informal practice without formal meditations. The present study compared a six-session workshop for stress management in undergraduate and graduate students that used formal mindfulness meditations and informal practice (Mindful Stress Management; MSM) to one that focused on brief mindfulness exercises and informal practice (Mindful Stress Management-Informal; MSM-I), as well as to a wait-list control. MSM participants exhibited significant within-group changes on all measures, and when compared to the wait-list control, greater levels of mindfulness, decentering, self-compassion, and lower stress. Students in MSM-I had significant within-group changes on a subset of measures (mindfulness, decentering, self-compassion, stress, depression, rumination, and worry), and greater mindfulness and self-compassion compared to the wait-list. MSM participants showed more improvement in self-compassion, psychological inflexibility, and stress than did those in MSM-I. Mediational analyses on mindfulness and mindfulness-related variables found that increases in one facet of mindfulness (nonreactivity to inner experience) and self-compassion, and decreases in worry mediated reductions in stress for MSM participants, while no mediator reached significance for students in MSM-I. Finally, there was no significant relation between the amount of formal meditation practice (for MSM participants) and informal mindfulness practice (for MSM-I participants) and reductions in psychological distress (stress, anxiety, or depression) or increases in mindfulness. Overall, results suggest that a 6-week program with formal mindfulness meditations and informal practice is a more promising intervention for undergraduate and graduate student stress than one that uses brief mindfulness exercises and informal practice., Made available in DSpace on 2013-11-05T15:05:17Z (GMT). No. of bitstreams: 1 Hindman_cua_0043A_10395display.pdf: 1655667 bytes, checksum: 796c6d4a8507155a013152597232cbf7 (MD5)

: A Comparison of the Effect of Deliberate Practice versus a Task Training Approach on Army Reserve Nurse and Combat Medics' Cognitive Load, Confidence and Competence During Simulated Combat Trauma Hemorrhage Care Training; The increase in the number and longevity of cancer patients receiving care in a traditional ambulatory infusion center (AIC) may diminish patient satisfaction with the care environment and Health Related Quality of Life (HRQL) because infusion centers nationally are overwhelmed with patients, challenged by prolonged wait times, long visit durations, and increased outpatient volume. The purpose of this study was to evaluate adult oncology patients’ self-reported satisfaction and HRQL when receiving chemotherapy and ancillary care services at an AIC as compared to care received in a specific home-based cancer care model (HBCCM), the home cancer model (HCM). A quantitative, prospective, quasi-experimental design was used to examine differences in the groups based on the variables of interest. The independent variables were three comparison patient groups: those receiving usual care in the AIC, those receiving care in the HCM, and those receiving care in both the AIC and HCM. The dependent variables included: patient self-reported HRQL and patient satisfaction. Primary outcome variables included HRQL and patient satisfaction; structural support was assessed as a secondary outcome. The sample (n=213) consisted of adult oncology infusion patients receiving care either via the AIC or the HCM. Eligibility criteria included: adult oncology patients over 18 years of age, receiving at least one prior episode of care in either the HCM or the AIC; ability to read and/or understand English; and ability to complete study instruments with some assistance. Two clinical venues (an AIC and a HCM) within a hospital system in the Northeastern United States make up the research settings. Recruitment included recruitment flyers, as well as recruitment outreach via the secure electronic patient portal, telephone calls, and face-to face. Consent was impliedthrough completion of the study questionnaires and HIPPA authorization was obtained to extract clinical variables from the Electronic Medical Record (EMR). Instruments included: quality of life measurement via the European Organization for Research and Treatment of Cancer (EORTC) 30-item Quality of Life Questionnaire (QLQ-30) (Appendix A); patient satisfaction measurement via the eight item Functional Assessment of Chronic Illness Therapy- Treatment Satisfaction- General (FACIT-TS-G) (Appendix B) and structural support measurement via the eight item Medical Outcomes Study Social Support Survey (mMOS-SS) (Appendix C). Additional demographic and descriptive data was obtained from the patient’s EMR. All questionnaire and EMR data was collected using REDCap protocols, which permit de-identification of data during analysis. Lastly, an close and open-ended survey component with additional questions permitted better understanding of the context of the study HCM and the effect of the home environment on the care model, as well as the qualitative impact on patient satisfaction and HRQL. Instruments were completed directly via REDCap. The results of the study address the gaps in the literature regarding how a dedicated adult HCM impacts patient satisfaction, how a dedicated adult HCM impacts HRQL, and the relationship between structural supports and patient satisfaction and HRQL in the adult HCM. In Research Question 1, this study found participants in the HCM model had better HRQL than participants in the AIC model. Although the results were not statistically significant, they approached statistical significance. Participants whose cancer had metastasized had levels of HRQL that were significantly lower than those whose cancer had not metastasized (p=0.02), and female participants had significantly lower HRQL than male participants (p=0.03). Of the covariates examined in relationship to this model, those participants with a hematologic malignancy had significantly higher levels of satisfaction with treatment in comparison to those whose cancer had not metastasized (p=0.03). Research question 2 indicated that there is a significant relationship between patient satisfaction with treatment and HRQL in patients receiving care in the different models: participants with higher levels of satisfaction with treatment also had increased levels of HRQL; participants with lower levels of treatment satisfaction also had reduced levels of HRQL. Research Question 3 found patients in the hybrid group had significantly lower HRQL as compared to other racial groups (p=0.04). Additionally, the Black/African American group did have a statistically significant reduction in treatment satisfaction (p <0.01). In Research Question 4, the overall model results of the mMOSS-SS indicated that participants with higher mMOSS-SS scores had higher EORTC (p=0.01) and FACIT (p<0.01). In both cases, the overall model results were statistically significant. Research Question 5 explored a qualitative descriptive analysis to better understand the experience of receiving care in the different care models, as well as the reasons there might be differences in HRQL and satisfaction with treatment between care model groups. This research question found that the nursing care near uniformly viewed as safe, responsive, protocolized, and knowledgeable, regardless of care model location. Further, the majority of participants equated feeling safe with good nursing care. In assessing how the location where participants receiving care influenced HRQL or satisfaction, there were significant difference in responses by location. Regional AIC participants described care closer to home relieving stress, being more convenient, improving satisfaction, and decreasing COVID-19 exposure. Downtown hospital AIC participants described excellence being worth the drive, but also long treatment days, frustrations of long commute, traffic, and parking, increased expenses in terms of commute, time, and copays. HCM participants described convenience and comfort of home treatment, decreased expenses, reduced time and travel, and increased flexibility, such as ability to work remotely while getting treatment. While there were both positive and negative descriptions of care model’s impact to satisfaction and HRQL, the HCM patients frequently reported positive contribution of the care model’s impact to patient satisfaction and HRQL. In conclusion, this study found that HRQL was higher in patients receiving care in the HCM, and definitely not inferior to care in the AIC in terms of HRQL. As such, it will be important for the oncology healthcare industry to continue to explore viable HBCCMs. Given the associated positive outcomes, improved convenience, and reduced cost with HBCCMs, providers, nurses, and health systems should consider designing, implementing, and researching patient centered options and pathways to further support the development of oncology care delivery in the home., Nursing, alternative care delivery models, Cancer care at home, infusion center, oncology care at home, patient satisfaction, quality of life, Nursing, Degree Awarded: Ph.D. Nursing. The Catholic University of America