Doctorate in Social Work (DSW) Dissertations
This series contains dissertations from Penn's Doctorate in Social Work program. For more information about University of Pennsylvania dissertation requirements and guidelines, please consult the dissertation manual.
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Publication EXAMINING THE RELATIONNSHIP BETWEEN DISCRIMINATION, RESILIENCE AND PSYCHOLOGICAL WELL-BEING OF SUB-SAHARAN AFRICAN HIJABI WOMEN IN THE UNITED STATES(2025-05-19) Kofoworola OwonikokoABSTRACT Objective: This study examined the psychological well-being of women of sub-Saharan African ancestry who wear the Islamic head covering, called hijab (so-called hijabi women) in the United States. The study focused on perceived discrimination, resilience, and psychological well-being of this group. The population under study faced distinctive challenges in the context of intersectionality amidst rising anti-Muslim and anti-immigrant sentiments in the US. Methods: The study is quantitative research, with cross-sectional design. The number of participants is N=155. Data were collected using Google Forms from women 18 years old and above, using the Anti-Muslim Discrimination Scale, Transcultural Resilience Scale and the Psychological (Distress and psychological) Scale. Employing network and convenience sampling approaches, diverse experiences were captured within this demographic group. Data analysis was performed using SPSS 21 and SPSS-Amos for structural equation modeling. Descriptive, bivariate, and multiple regression analyses were used to evaluate the relationships between variables. Results: This study demonstrated that perceived discrimination (Interpersonal and Societal) negatively impacted psychological well-being (Life satisfaction and Distress). The study found a substantial link between societal and interpersonal discrimination (r =0.53, p=0.01). Transcultural resilience mediated between societal discrimination and life-satisfaction. Resilience across cultures was shown to be positively correlated with life satisfaction (B = 0.33, p <.001) but insignificant in predicting distress. As not all hypotheses were proven, the conclusion is that this study was partially supported. Implication: This study filled a critical research gap and provided important objective data and insights to assist in combating discriminatory policies and also identified culturally responsive interventions. The adoption and implementation of the findings will promote equitable and fair practices that uphold human dignities, leading to improved well-being of sub-Saharan African hijabi women living in the United States.Publication Examining the Impact of Intrafamilial Adversity on Emotion Regulation in Sexual and Gender Minority People in Southwest Alabama(2025) Mary Barrett SmithThis dissertation explores the relationship between general childhood adversity, identity-based invalidation, and emotional dysregulation among sexual and gender minority (SGM) individuals in Southwest Alabama. Grounded in the Minority Stress Model (Brooks, 1981; Meyer, 2003), the Traumatic Invalidation Framework (Cardona et al., 2022), and the Transactional Model of Emotion Dysregulation (Fruzetti et al., 2005), the study tests three primary hypotheses: (1) a positive association between adverse childhood experiences (ACEs) and identity-based adversities (ID-Adversities), (2) an association between ACEs and emotional dysregulation, and (3) an association between ID-Adversities and emotional dysregulation. This study is a secondary analysis of cross-sectional data collected through the Southwest Alabama Inclusion Project’s LGBTQ+ Community Needs Assessment. Participants (N = 488), ranging in age from 13 to 82 and representing a wide spectrum of sexual and gender identities, completed a survey that included measures of Adverse Childhood Experiences (ACEs), identity-based adversity (ID-Adversity), and emotional dysregulation using the DERS-SF. One-way ANOVA confirmed that ACEs were positively associated with ID-Adversity; multiple linear regressions confirmed that both ACEs and ID-Adversity independently predicted higher levels of emotional dysregulation. Post hoc analyses revealed developmental variation: identity-based adversity had the strongest effect among adolescents (13–17), ACEs were most predictive among emerging adults (18–24), and for adults 25 and older, lower household income emerged as the most robust predictor of dysregulation. Transgender boys and men reported significantly more ACEs than their cisgender peers, highlighting compounded risk among multiply marginalized subgroups. Findings underscore the cumulative, shifting nature of adversity across development and point to the embeddedness of psychological risk in structural and socioeconomic contexts. Policy and clinical implications include the need for trauma-informed, identity-affirming mental health services; caregiver education programs; and systemic reforms to reduce stigma, poverty, and exclusion of SGM individuals across the life course. Key words: sexual and gender minority, mental health, emotion regulation, parenting, identity-based adversity, adverse childhood experiencesPublication Examining the Impact of Intrafamilial Adversity on Emotion Regulation in Sexual and Gender Minority People in Southwest Alabama(2025-01-01) Mary Barrett SmithThis dissertation explores the relationship between general childhood adversity, identity-based invalidation, and emotional dysregulation among sexual and gender minority (SGM) individuals in Southwest Alabama. Grounded in the Minority Stress Model (Brooks, 1981; Meyer, 2003), the Traumatic Invalidation Framework (Cardona et al., 2022), and the Transactional Model of Emotion Dysregulation (Fruzetti et al., 2005), the study tests three primary hypotheses: (1) a positive association between adverse childhood experiences (ACEs) and identity-based adversities (ID-Adversities), (2) an association between ACEs and emotional dysregulation, and (3) an association between ID-Adversities and emotional dysregulation. This study is a secondary analysis of cross-sectional data collected through the Southwest Alabama Inclusion Project’s LGBTQ+ Community Needs Assessment. Participants (N = 488), ranging in age from 13 to 82 and representing a wide spectrum of sexual and gender identities, completed a survey that included measures of Adverse Childhood Experiences (ACEs), identity-based adversity (ID-Adversity), and emotional dysregulation using the DERS-SF. One-way ANOVA confirmed that ACEs were positively associated with ID-Adversity; multiple linear regressions confirmed that both ACEs and ID-Adversity independently predicted higher levels of emotional dysregulation. Post hoc analyses revealed developmental variation: identity-based adversity had the strongest effect among adolescents (13–17), ACEs were most predictive among emerging adults (18–24), and for adults 25 and older, lower household income emerged as the most robust predictor of dysregulation. Transgender boys and men reported significantly more ACEs than their cisgender peers, highlighting compounded risk among multiply marginalized subgroups. Findings underscore the cumulative, shifting nature of adversity across development and point to the embeddedness of psychological risk in structural and socioeconomic contexts. Policy and clinical implications include the need for trauma-informed, identity-affirming mental health services; caregiver education programs; and systemic reforms to reduce stigma, poverty, and exclusion of SGM individuals across the life course. Key words: sexual and gender minority, mental health, emotion regulation, parenting, identity-based adversity, adverse childhood experiencesPublication From Classical and Patriarchal to Relational and Queer: Histories and Theories of Psychoanalysis(2025-05-19) Nugent, JeanneAbstract This two-paper study investigates the historical and conceptual contexts of psychoanalytic psychotherapy, focusing on queer identity, sexuality, and gender. It examines the historiography and metapsychology of psychoanalysis to highlight the marginalized status of lesbian, gay, transgender, and gender non-conforming (LGBTGNC) people within the structure of the discipline itself. Part one explores the transmission of Freud’s foundational concepts through the leading histories of the movement over the past 125 years. It begins with Freud’s historical narratives about the movement and then traces the conditions that shaped the post-Freudian schools through subsequent chronicles. These historiographic sources document the impact of the end of the Victorian era, the World Wars, migration, Cold War politics, and social change movements within both progressive and regressive developments. Notably, most canonical texts ignore queer identity, gender, and sexuality within the overarching narrative. Part two evaluates the contributions of post-Freudian schools to metapsychology, starting with Freud’s Topographic and Structural models and tracing subsequent contributions from Ego psychology, Relational psychoanalysis, and Self Psychology. These schools decentered sexuality, leaving questions of queer (and non-queer) identity, gender, and sexuality under-theorized. The study concludes with a reconsideration of psychosexuality, dual-drive theory, innate polysexuality, and oedipal complexity as keys to a renewed psychoanalysis with queer people in mind, useful for the formulation of a new metapsychology relevant to a more fluid analysis of identity, gender, and sexuality today. Keywords: queer psychoanalysis, psychotherapy, LGBTQ+, metapsychology, Oedipus complex, Freud, Ego Psychology, Self Psychology, Relational Psychoanalysis, history of psychoanalysisPublication WHEN THE COUCH IS NOT JUST THE COUCH—GAY MEN THERAPISTS’ EXPERIENCES IN THE EROTIC TRANSFERENCE/COUNTER TRANSFERENCE MATRIX: A REFLEXIVE THEMATIC ANALYSIS(2025-04-25) Burner, Christopher A.Minimal research has explored the erotic transference-countertransference matrix when both therapist and client identify as the same gender and sexual orientation (Davies, 1994; Sherman, 2002). In an effort to interrogate how therapist and client might be interacting in the intersubjective space, the purpose of this study was to explore the following question: What are the experiences of therapists who are gay men in working with erotic transference-countertransference dynamics with gay men patients of a different race? I conducted a reflexive thematic analysis (RTA)—within the relativist variation of TA—typified by a recursive and iterative process and composed across six phases for seven (n=7) participant interviewees. In answering the research question, the findings show that homoerotic transference and counter transference dynamics serve a function, that racialized transferences and counter transferences were harder to reconcile than those of the erotic, how Whiteness creates impasses in the therapeutic relationship through racialized fetishizations and direct prejudicial attacks, and how the participants navigate a process of using their own anxiety to construct dyadic boundaries, in addition to sublimating the racialized and erotic into more socially acceptable modes of positive counter transferences. This study’s results suggest that social workers engage in advocacy and social justice efforts for those voices that are absent, discouraged, rejected, and even contested, for it is precisely these voices that help generate knowledge that informs our practices, teaching, and research. Key words: erotic counter transference/transference, limit consent, normative unconscious processes, minority stress theory, sexual racism, intersectionalityPublication Validation of the Chinese Version of the Perinatal Anxiety Screening Scale (PASS-C) among Perinatal Chinese Immigrant Women(2025) Su, Grace ShixinObjective: Despite the prevalence of perinatal anxiety and the maternal health crisis, underdiagnosis is an ongoing issue as women are not being properly screened for anxiety at their perinatal health visits. Asian immigrant mothers may be at higher risk for untreated perinatal mental health issues, including perinatal anxiety, due to the lack of perinatal screening tools developed specifically for this population. The Perinatal Anxiety Screening Scale (PASS) has been shown to be an acceptable measure for detecting anxiety disorder symptoms. While the PASS had been translated into Simplified Chinese and validated against a group of perinatal mothers in China, it had not been tested for validity and reliability for perinatal Chinese immigrant mothers in the U.S. The current study examined the validity and reliability of the adapted Chinese version of the PASS (i.e., PASS-C) when used among Chinese-speaking perinatal mothers aged 18-45. Methods: This study used a combination of cross-sectional and longitudinal designs. Data was collected twice, two weeks apart (Time 1 and Time 2), through participant self-reporting via an online survey through Qualtrics. A sample of N = 255 completed Time 1 survey and n = 85 completed Time 2 survey. All participants were U.S.-based first-generation and 1.5-generation ethnic Chinese immigrant women between 18 to 45 years of age, able to read either Simplified or Traditional Chinese, and between 20 completed weeks of gestation and up to 1 year after childbirth. The Time 1 survey included the adapted PASS-C, a set of sociodemographic questions, and additional measures, including translated Chinese versions of the Depression, Anxiety and Stress Scale (DASS-21) for convergent validity and the Hypomania Checklist 32 (HCL-32) for discriminant validity. The Time 2 survey included only the PASS-C and was used to assess the scale's test-retest reliability. Results: Findings showed the PASS-C to be an acceptable measure in identifying perinatal anxiety symptoms among Chinese-speaking perinatal mothers. The PASS-C demonstrated very good test-retest reliability in both antenatal and postnatal mothers and across both Traditional and Simplified Chinese language versions. Results demonstrated good internal reliability of the PASS-C in both Traditional Chinese (Cronbach’s alpha = 0.95) and Simplified Chinese (Cronbach’s alpha = 0.97) language versions. Further, the PASS-C and its Acute Anxiety and Adjustment subscale demonstrated very good convergent validity with the overall DASS-21 and DASS Anxiety scores. Results demonstrated acceptable convergent validity with the remaining PASS-C subscales: Excessive Worry and Specific Fears; Perfectionism, Control and Trauma; and Social Anxiety. The PASS-C also demonstrated good discriminant validity with the HCL-32 across all its subscales. Conclusion: The development and validation of culturally and linguistically responsive mental health screening tools are necessary to address mental health disparities and increase access to care for Asian immigrant mothers and their families. The validation of the PASS-C is a step toward increasing health equity and resources for Chinese immigrant mothers who may be at risk of underdiagnosis and untreated perinatal anxiety.Publication Friendship in Transition: An Interpretative Phenomenological Analysis of the Role of Peer Support on Student Service Members and Veterans(2025-05-19) Moore, Dylan AnthonyFriendship serves as a vital pillar of academic success, providing crucial support and fostering resilience among college students. For student service members and veterans (SSM/V), the transition to college life presents unique challenges that can hinder their ability to form these vital connections. While the importance of friendship is well-documented for traditional college students, there is limited research on how SSM/V experience friendship during their academic transition. This qualitative investigation aims to explore the role of friendship in SSM/V journey from military service to college life through semi-structured interviews with 10 participants. An interpretative phenomenological analysis, informed by the theoretical framework of Self-Psychology and Veteran Critical Theory, was conducted to interpret these narratives. The findings reveal four key themes: a) friendships as a valuable support system in the transition to college life, b) friendship dynamics and experiences within the college environment, c) navigating unique considerations when establishing friendships, and d) barriers to friendship-building. The study highlights how friendships contribute to SSM/V adaptation to college life and academic success. Recommendations include fostering collaboration among faculty, staff, administrators, and veteran resource centers to develop targeted programs that facilitate friendship-building, such as social events and peer mentoring initiatives. Additionally, universities should prioritize creating inclusive environments that encourage interaction between SSM/V and their civilian peers. This research also calls for further studies on the unique experience of SSM/V in building and maintaining meaningful relationships.Publication Psychosocial Predictors of Disordered Eating in Adolescents with Celiac Disease: Body Image Dissatisfaction, Anxiety, Depression, and Family Eating Environment(2025-05-19) Rowen, KaitlinPurpose/Objective: Research suggests a high prevalence of disordered eating in adolescents with celiac disease, however research on vulnerability factors is limited. To address this gap, this study tested the hypothesis that a higher level of body image dissatisfaction, greater severity of anxiety symptoms, greater severity of depression symptoms, and poorer quality of family eating environment predicts greater disordered eating behaviors, attitudes, and feelings in U.S. adolescents with celiac disease. Methods: A correlational design with a nonprobability convenience sample of N = 187 was used. Participants were U.S. adolescents, 13 to 18 years old, with celiac disease. Data was collected via a one-time, online survey. Measures included Celiac Dietary Adherence Test, Eating Attitudes Test-26, Appearance and Weight subscales of the Body Esteem Scale for Adolescents and Adults, Depression and Anxiety subscales of the Revised Child Anxiety and Depression Scale-25, and Family Eating Habits survey. Multiple and logistic regression analyses were used to test hypotheses. Results: Findings partially supported the hypothesis, indicating a higher level of body image dissatisfaction (measured as weight dissatisfaction), greater severity of depression symptoms, and poorer quality of the family eating environment (measured as atmosphere) predicted greater disordered eating behaviors, attitudes, and feelings when measured as 1. dieting; 2. bulimia and food preoccupation; and 3. composite of behaviors, attitudes, and feelings about dieting, bulimia and food preoccupation, and oral control. No differences in disordered eating were found among groups defined by race, body mass index, or co-occurring diet and health related conditions. Post-hoc analysis indicated that transgender males scored significantly higher than cisgender males on disordered eating behaviors, attitudes, and feelings regarding dieting. However, no other gender group differences were significant under Bonferroni cutoff. Conclusions: Filling a research critical gap, results enhanced understanding of potential psychosocial vulnerabilities for disordered eating in adolescents with celiac disease. Clinical recommendations are made for targeted assessments and individual and family-based interventions that allow for early detection, treatment, and prevention of disordered eating in this high-risk population.Publication An Officer and a Therapist: How Active-Duty Social Workers Navigated the Ethical Hazards of Their Dual Agency(2025-05-19) Dickinson, SamuelActive-duty LCSWs bear a simultaneous legal obligation to two entities that often have conflicting values and requirements for them to satisfy (the National Association of Social Workers and the Department of Defense), and this concurrent commitment routinely forces them to prioritize one side of their dual agency as both an officer and a therapist. The experience of having to navigate the ethically hazardous “mixed-agency dilemmas” that result from these competing prioritizations has been left unexamined in academic social work research. To respond to this gap in the literature, this qualitative pilot study examined the stories of seven formerly active-duty LCSWs using a reflexive thematic analysis. Common participant experiences included being subject to military medicine’s prioritization of DoD obligations over the NASW code of ethics, experiencing unavoidable dual relationships resulting from the intimate and boundaryless practice settings of operational medicine, and secondary gain issues of service members seeking mental health treatment as a way out of the military. While analyses of participants’ interviews revealed that LCSWs were often pressured to resolve mixed-agency dilemmas by favoring the officer side of their dual agency, participants overwhelmingly recommended navigating the mixed-agency dilemmas of their positions by prioritizing their identities as social workers, and by using the values and ethics of their licensure as a guiding heuristic while seeking out peer support and practicing self-care. This study recommends that MSW programs, the NASW, and military officer development schools increase their efforts to educate social workers on the reality of mixed-agency dilemmas in active-duty settings.Publication “I don’t belong to either side. I lost my identity”: A Thematic Analysis Study on Chinese International Students’ Interpersonal Experiences During the COVID-19 Pandemic(2024-11-19) Fan, LinlinBackground and Purpose: The COVID-19 pandemic has had tremendous impacts on everyone’s life globally. However, Chinese international students (CIS) are not only susceptible to challenges brought about by COVID-19 but also endure stigma and discrimination for being “virus carriers” due to their Chinese nationality. As international students, they face additional challenges because of travel restrictions and visa issues, which exacerbate their social isolation and precipitate psychological distress. This study aims to inform practice to promote anti-discriminatory and culturally competent interventions that support this population’s mental health. Research Questions: What are CIS’s interpersonal experiences during the COVID-19 pandemic? Does CIS face stigma and discrimination related to COVID-19 in their interpersonal encounters with the non-Chinese population? How do they cope with mental health challenges during the pandemic? In what ways do family and ethnic/national identity shape CIS’s experiences? Methods: Ten in-depth, semi-structured interviews were conducted with CIS (aged 20 to 28) who resided in the United States for at least 10 months during the COVID-19 pandemic (March 2020 to May 2022). Purposive sampling was employed, recruiting participants through social media advertisements, including a Chinese students’ association WeChat group in a university and Facebook. Interviews were conducted in Mandarin Chinese via Zoom. Reflective thematic analysis, following Braun and Clarke's (2012, 2013, 2014, 2020) framework, was employed using NVivo for coding and analysis. Findings: The findings suggest that CIS employed mostly active coping strategies to address the challenges they faced during the pandemic. They struggled to deal with discrimination because of their ethnic and national identity, with some participants coping with direct confronting and providing information to counter stereotypes, whereas others resorting to secrecy and withdrawal. The findings also shed light on the emergence of Chinese nationalism among some participants, spurred by perceived discrimination by the non-Chinese population in the host country and satisfaction with their home country’s government's handling of the pandemic. Conversely, others expressed a loss of national identity, stemming from marginalization experienced both in their home country (othered Chinese-ness) and the host country. Conclusions and Implications: This study highlights the complex challenges faced by CIS during the pandemic, including the experiences of stigma, discrimination, mental health struggles, and issues related to national and ethnic identity. Most participants employed active coping strategies, such as self-care and seeking support from others. Among different types of support, peer support emerged as particularly crucial, while family support was more nuanced—sometimes highly beneficial but at other times counterproductive due to high expectations and cultural values that discourage giving up. Despite their active coping efforts, the combination of social isolation, experiences of discrimination and stigma, and confusion surrounding their identity significantly impacted their overall well-being and triggered mental health crises. These findings underscore the importance of creating inclusive, anti-racist campus environments to address discrimination and racism within academic settings. The findings also suggest that the Yin and Yang philosophy, with its emphasis on dialectical thinking and a process-oriented worldview, can serve as an effective coping mechanism for managing crisis and pandemic-related stress.