Education Commons^™

Examining Processes Of Change For Acceptance And Commitment Therapy And Cognitive Behavioral Therapy Self-Help Books With Depressed College Students, Carter H. Davis, Michael P. Twohig, Michael E. Levin

Psychology Faculty Publications

Given the prevalence of depression, it is worthwhile to consider a variety of treatment approaches to reach as many sufferers as possible, including highly accessible formats such as self-help books. Books based in acceptance and commitment therapy (ACT) and cognitive behavioral therapy (CBT) propose to treat depression through distinct processes of change, though the degree to which these treatments are distinguishable in this format is unclear. Furthermore, it is possible that some individuals may respond better to therapeutic processes from one approach over the other based on personal preferences. We tested the effects of ACT and CBT self-help books on …

Predictors Of Adherence To A Publicly Available Self-Guided Digital Mental Health Intervention, Mercedes G. Woolley, Korena S. Klimczak, Carter H. Davis, Michael E. Levin

Psychology Faculty Publications

Low adherence to self-guided digital mental health interventions (DMHIs) have raised concerns about their real-world effectiveness. Naturalistic data from self-guided DMHIs are often not available, hindering our ability to assess adherence among real-world users. This study aimed to analyze 3 years of user data from the public launch of an empirically supported 12-session self-guided DMHI, to assess overall program adherence rates and explore predictors of adherence. Data from 984 registered users were analyzed. Results showed that only 14.8% of users completed all 12 modules and 68.6% completed less than half of the modules. Users who were younger, had milder depression, …

Efficacy Of Patient Education And Duloxetine, Alone And In Combination, For Patients With Multisystem Functional Somatic Disorder: Study Protocol For The Edulox Trial, Cecilia Pihl Jespersen, Heidi Frølund Pedersen, Maria Kleinstäuber, Per Fink, Kaare Bro Wellnitz, Eva Ørnbøl, Andreas Schröder, Johanne Liv Agger, Lene Vase, Nanna Brix Finnerup, Lise Kirstine Gormsen

Psychology Faculty Publications

Background

Multisystem functional somatic disorder is characterized by specific patterns of persistent physical symptoms with a complex biopsychosocial etiology. The disorder can lead to disability and personal suffering. Current treatment options require specialized settings, therefore patients often wait a long time to receive specific treatment.

Patient education is considered important in most treatment programs, but has only been investigated sparsely as a stand-alone treatment. Pharmacological treatment is limited to tricyclic antidepressants in low doses with not antidepressant properties. Duloxetine has been found effective in single organ functional disorders. As a treatment for multisystem functional somatic disorder, duloxetine could reduce symptoms …

Discussing Patient Emotions In Audiology: Provider Experiences With The Implementation Process Of Hearing Loss Psychological Inflexibility Screenings, Sydnee Grigsby, Karen Muñoz, Guadalupe G. San Miguel, Michael P. Twohig

Psychology Faculty Publications

Purpose: This study aimed to investigate barriers and facilitators experienced by clinical educators and graduate students when talking with patients about difficult emotions and thoughts related to their hearing.

Method: A longitudinal observational design was used, and an Implementation Research Logic Model guided the process. Five clinical educators and five graduate students participated in the study. Participants completed pre- and post-measures and attended individual debriefing sessions during the eight-month study period.

Results: Four themes emerged from the debriefing sessions: (1) learning process, (2) confidence (3) barriers, and (4) supervision. Participants described that the Acceptance and Action Questionnaire-Managing Child Hearing Loss …

Establishing The Temporal Relationship Between Religious Commitment, Sexual Identity Struggles, And Religious Struggles Among Sexual Minorities, G. Tyler Lefevor, Samuel J. Skidmore

Psychology Faculty Publications

Objective: Conclusions about the temporal relationship between religiousness and both religious and sexual identity struggles are frequently made in the absence of longitudinal data. The present study examines the temporal relationship between religious identification, sexual identity struggles, and religious struggles.

Methods: Participants were 132 Latter-day Saint sexual minorities who provided data at two timepoints, two years apart. We employed two cross-lagged panel models, one focusing on religious struggles and religious commitment and the other focusing on sexual identity struggles and religious commitment, to understand the temporal relationships between these variables.

Results: Cross-lagged panel models suggested that interpersonal religious struggles and …

Diminished Adolescent Social Well-Being During The Covid-19 Pandemic, Michael J. Furlong, Mei-Ki Chan, Erin Dowdy, Karen Nylund-Gibson

Psychology Faculty Publications

Managing the COVID-19 pandemic involved implementing public health policies that disrupted students' lives, creating conditions that substantially influenced their mental health and well-being. Subsequently, research focused don the mental health sequelae of increased depression and anxiety, but the possible impacts on adolescents' social well-being have been largely unexamined. Social well-being is essential to youth's overall mental health and can be diminished even without symptoms of depression and anxiety. This report explored heterogeneities in changes in adolescents' social well-being from pre-COVID-19 to post-restrictions using longitudinal data from adolescents attending middle and high schools in California (N = 1,299; 49.9% female). …

An Examination Of Psychological Flexibility As A Mediator Between Mental Health Concerns And Satisfaction With Life Among Autistic Adults, Ty B. Aller, Heather H. Kelley, Tyson S. Barrett, Benjamin Covington, Michael E. Levin, Maryellen Brunson Mcclain

Psychology Faculty Publications

Background: Experiencing mental health concerns (e.g., depression, anxiety, stress) can have negative effects on satisfaction with life (SWL) for autistic adults. Current mental health supports that may promote SWL do not effectively meet the needs of autistic adults, often due to deficits-based approaches. Methods: To begin addressing the gap in research surrounding mental health supports among autistic adults, we designed a preregistered longitudinal study that used structural equation modeling to assess 289 autistic adults from the Simons Powering Autism Research (SPARK) program to determine if progress toward ones values, a strengths-based component of psychological flexibility, is a potential …

Response To Commentary: The Framework For Systematic Reviews On Psychological Risk Factors For Persistent Somatic Symptoms And Related Syndromes And Disorders (Psy-Pss), Paul Hüsing, Abigail Smakowski, Bernd Löwe, Maria Kleinstäuber, Anne Toussaint, Meike C. Shedden-Mora

Psychology Faculty Publications

Persistent somatic symptoms (PSS) are common in all fields of medicine. Current classification systems for mental disorders in this field, i.e. Somatic Symptom Disorder (SSD; DSM-5) or Bodily Distress Disorder (BDD; ICD-11), now stress the relevance of psychological features associated with the physical complaints. It is well known that psychological criteria are among the relevant risk factors for the development and/or worsening of persistent physical symptoms, however, the selected diagnostic criteria remain subject to debate. Numerous psychological concepts have been studied and discussed in the scientific field. However, empirical evidence remains scattered, individual factors have not been reviewed systematically, and …

Increasing Transcultural Competence In Clinical Psychologists Through A Web-Based Training: Study Protocol For A Randomized Controlled Trial, Selina Studer, Maria Kleinstäuber, Ulrike Von Lersner, Cornelia Weise

Psychology Faculty Publications

Background In mental health care, the number of patients with diverse cultural backgrounds is growing. Nevertheless, evaluated training programs for transcultural competence are missing. Barriers for engaging in transcultural therapy can be identified in patients as well as in therapists. Besides language barriers, clinical psychologists report insecurities, for example, fear of additional expenses when involving a language mediator, ethical concerns such as power imbalances, or fear of lack of knowledge or incorrect handling when working with patients from other cultures. Divergent values and concepts of disease, prejudices, and stereotyping are also among the issues discussed as barriers to optimal psychotherapy …

Reach, Adoption, And Maintenance Of Online Acceptance And Commitment Therapy At A University: An Implementation Case Study, Carter H. Davis, Korena Klimczak, Ty B. Aller, Michael P. Twohig, Michael E. Levin

Psychology Faculty Publications

College students are undergoing a mental health crisis and existing clinical resources at universities may be inadequate to meet their needs. One solution to this problem could be the use of self-guided, online programs for mental health that can be easily distributed to students. A persistent issue, however, is the transition from program development to implementation of a self-guided program at campus-wide scale. We describe, in a self-narrative format, the steps taken to translate an online program we developed based in acceptance and commitment therapy (ACT), called ACT Guide, from a research context to a campus-wide service at our university. …

Act-Enhanced Behavior Therapy For A Hispanic Adult With Trichotillomania: A Case Report, Marissa L. Donahue, Michael P. Twohig

Psychology Faculty Publications

Trichotillomania, also known as Hair-Pulling Disorder, is characterized by recurrent pulling out of one’s hair over brief episodes or sustained periods of time and results in hair loss. ACT-enhanced behavior therapy (A-EBT) has been shown to be an effective approach in the treatment of trichotillomania by promoting psychological flexibility around hair pulling urges and teaching stimulus control and habit reversal training. However, there is limited support of A-EBT for clients with an ethnic minority identity. This case report focuses on an adult, Hispanic female client, Luna (pseudonym), who received eight sessions of A-EBT for the treatment of trichotillomania. At post-treatment, …

Merging Acceptance And Commitment Therapy With Exposure Exercises To Treat Social Anxiety In A Teen, Caleb D. Farley, Michael P. Twohig

Psychology Faculty Publications

Social anxiety disorder (SAD) often develops during teenager years, and it is important to conceptualize developmentally appropriate interventions. Exposure therapy framed from a perspective of acceptance and commitment therapy (ACT) shows promise for decreasing pathology and increasing wellbeing. This case illustrates the process through which exposure therapy was integrated with ACT to elicit meaningful outcomes in a case of SAD with a 16-year-old female. Treatment outcomes assessed included engagement in values-based activities as well as assessments of depression, social anxiety, separation anxiety, generalized anxiety, experiential avoidance, and contextually targeted school-based wellbeing. Intervention centered on learning ACT principles through relatable metaphors …

Pediatric Hearing Aid Management: Experiences And Perspectives Of Spanish-Speaking Parents, Karen Muñoz, Diego Guillen, Carlos Muñoz, Michael P. Twohig

Psychology Faculty Publications

Purpose: The purpose of the study was twofold: (a) to explore hearing aid management experiences of Spanish-speaking parents who have young children using hearing aids and (b) to explore parents' access to the Internet and perceptions about remote audiology services.

Method: The study used a mixed methods design. Data were collected through a phone interview.

Results: Eleven mothers of children aged 14-60 months participated. Most of the children (9/11) had a bilateral hearing loss, and two had an additional disability. Three themes emerged for hearing aid management experiences: audiology services, routines, and emotional challenges/supports. Parents had variable levels of confidence …

Religion/Spirituality, Stress, And Resilience Among Sexual And Gender Minorities: The Religious/Spiritual Stress And Resilience Model, G. Tyler Lefevor, Chana Etengoff, Edward B. Davis, Samuel J. Skidmore, Eric M. Rodriguez, James S. Mcgraw, Sharon S. Rostosky

Psychology Faculty Publications

Although many sexual and gender minorities (SGMs) consider themselves religious or spiritual, the impact of this religiousness or spirituality (RS) on their health is poorly understood. We introduce the religious/spiritual stress and resilience model (RSSR) to provide a robust framework for understanding the variegated ways that RS influences the health of SGMs. The RSSR bridges existing theorizing on minority stress, structural stigma, and RS-health pathways to articulate the circumstances under which SGMs likely experience RS as health promoting or health damaging. The RSSR makes five key propositions: (a) Minority stress and resilience processes influence health; (b) RS influences general resilience …

The Impact Of Changes In Religion On Health Among Sexual Minority Mormons, G. Tyler Lefevor, Samuel J. Skidmore, Kiet D. Huynh, James S. Mcgraw

Psychology Faculty Publications

The current study presents data from the first longitudinal examination of sexual minority (SM) Mormons (n = 132). Over the course of 2 years, SM Mormons reported decreased psychological (e.g., orthodox beliefs), behavioral (e.g., service attendance), and social (interpersonal religious commitment) religiousness. Analyses revealed that, at baseline, service attendance was related to lower levels of meaning in life and higher levels of depression at time 2, while interpersonal religious commitment at baseline was related to higher levels of meaning in life and lower levels of depression. Latent change scores of religiousness suggested that decreases in interpersonal religious commitment over …

Choosing Act Or Cbt: A Preliminary Test Of Incorporating Client Preferences For Depression Treatment With College Students, Carter H. Davis, Michael P. Twohig, Michael Levin

Psychology Faculty Publications

Background

Depression is a significant concern among college students, who suffer at higher rates and with greater severity than the general population. Online self-help could reduce the burden currently placed on college counseling centers, and programs based in cognitive behavioral therapies (CBTs) have a strong evidence base. However, online CBTs for depression often suffer from low adherence rates. An understudied method for improving adherence in this population is offering students a choice between various CBTs.

Methods

We conducted a randomized trial with 142 students with high levels of depression, with a subset of participants randomly receiving either traditional cognitive behavioral …

Differential Effects Of Mindful Breathing And Loving Kindness Meditations: A Component Analysis Study, Sarah J. Bolognino, Tyler L. Renshaw, Mary L. Phan

Psychology Faculty Publications

Objective: Mindful breathing meditation (MBM) and loving-kindness meditation (LKM) are common components of effective mindfulness-based interventions (MBIs). This study examined the differential effects of MBM and LKM on purported therapeutic process variables and mental health outcomes via component analysis.

Method: The research design was a randomized controlled trial with four conditions: MBM, LKM, combined (MBM + LKM), and a relaxation control. All conditions consisted of 10-min. audio-recorded guided meditations that were self-implemented over the course of two weeks. Participants were college undergraduates (N = 52).

Results: Findings indicated statistically significant and very large main effects of time, regardless of …

Girls Are Good At Stem: Opening Minds And Providing Evidence Reduce Boys' Stereotyping Of Girls' Stem Ability, Emily N. Cyr, Kathryn M. Kroeper, Hilary B. Bergsieker, Tara C. Dennehy, Christine Logel, Jennifer R. Steele, Rita A. Knasel, W. Tyler Hartwig, Priscilla Shum, Stephanie L. Reeves, Odilia Dys-Steenbergen, Amrit Litt, Christopher Lok, Taylor Ballinger, Haemi Nam, Crystal Tse, Amanda L. Forest, Mark Zanna, Sheryl Staub-French, Mary Wells, Toni Schmader, Stephen C. Wright, Steven J. Spencer

Psychology Faculty Publications

Girls and women face persistent negative stereotyping within STEM (science, technology, engineering, mathematics). This field intervention was designed to improve boys' perceptions of girls' STEM ability. Boys (N = 667; mostly White and East Asian) aged 9-15 years in Canadian STEM summer camps (2017-2019) had an intervention or control conversation with trained camp staff. The intervention was a multi-stage persuasive appeal: a values affirmation, an illustration of girls' ability in STEM, a personalized anecdote, and reflection. Control participants discussed general camp experiences. Boys who received the intervention (vs. control) had more positive perceptions of girls' STEM ability, d = 0.23, …

Changes In Mental Health As A Predictor Of Cannabis Coping Motives And Consequences: Examining The Impact Of Covid-19 Among College Students, Rebecca Dunaief, Adrian Jorge Bravo, James Henson

Psychology Faculty Publications

Objective: Cannabis use is common among college students and many students use cannabis to cope with negative affect. The COVID-19 pandemic was a particularly stressful time for college students. Subsequently, the present study compared college students who reported increases in anxiety/depression symptoms since COVID-19 stay at home orders to those who reported no change in anxiety/depression symptoms on cannabis coping motives, use frequency, and negative consequences. Specifically, we examined whether self-reported changes (i.e., group that indicated increases) in poor mental health during COVID-19 were associated with problematic cannabis use via higher cannabis coping motives. Method: College students (analytic n = …

Social Information Processing Theory Indicators Of Child Abuse Risk: Cultural Comparison Of Mothers From Peru And The United States, Christina M. Rodriguez, Patricia Bárrig Jó, Enrique Gracia, Marisol Lila

Psychology Faculty Publications

Much of the research conducted on social information processing (SIP) factors predictive of child abuse risk has been conducted in North America, raising questions about how applicable such models may be in other cultures. Based on the premise that the parents’ child abuse risk is affected by both risk and protective factors, the current study considered how specific SIP socio-cognitive risk factors (acceptability of parent–child aggression as a discipline approach; empathic ability; frustration tolerance) as well as social support satisfaction as a resource related to child abuse risk by comparing a sample of mothers in Peru (n = 102) with …

Navigating Identity Uncertainty: Identity Distress During The Covid-19 Pandemic, Alan Meca, Kelsie K. Allison, Julia Passini, Taryn Veniegas, Bethany Cruz, Linda G. Castillo, Seth J. Schwartz, Byron L. Zamboanga, Minas Michikyan, Melissa Bessaha, Pamela C. Regan, Kaveri Subrahmanyam, John Bartholomew, Brandy Piña-Watson, Miguel Ángel Cano, Charles R. Martinez Jr.

Psychology Faculty Publications

The long-term effects of the COVID-19 pandemic have only recently begun to be explored. Among college students, who were faced with sudden and unprecedented changes and challenges, it is likely that COVID-19 detrimentally impacted the establishment of a sense of self, a key developmental task of the college years. However, no research has examined the relationships among COVID-19 related worries, identity distress, and psychological and academic adjustment. To address these gaps in the current study, we examined the prevalence of identity distress, the relationship between COVID-19 related worries and identity distress, and the direct and indirect associations between COVID-19 related …

The Impact Of Covid-19 Pandemic Experiences On College Drinking Via Mental Distress: Cross-Sectional Mediation Moderated By Race, Abby L. Braitman, Rachel Ayala Guzman, Megan Strowger, Jennifer L. Shipley, Douglas J. Glenn, Emily Junkin, Alina Whiteside, Cathy Lau-Barraco

Psychology Faculty Publications

Background: The COVID-19 pandemic has been linked to stress, anxiety, and depression among college students, with heightened distress tied to greater drinking for some individuals. Emerging research suggests that these associations may differ across race, but few studies use adequate samples to examine this, particularly among college students, an at-risk population for both heavy drinking and mental distress. Specifically, pandemic-related stressors and mental distress may be higher among Black students than White students. The current study examined: (1) whether mental distress cross-sectionally mediates the association between pandemic-specific stressors and drinking and (2) whether race (Black or White) moderates these associations. …

Correlates Of Christian Religious Identification And Deidentification Among Sexual And Gender Minorities: A U.S. Probability Sample, G. Tyler Lefevor, Lauren J. A. Bouton, Edward B. Davis, Samuel J. Skidmore, Ilan H. Meyer

Psychology Faculty Publications

Using a U.S. nationally representative sample of 1,529 sexual and gender minorities (SGMs), we examined the demographic and developmental correlates of Christian religious deidentification. We found that SGMs who were older, Black, cisgender men, and/or lived in the American South were more likely to identify as Christian in adulthood, relative to other SGMs. Those who were never Christian reported being more out to family and friends at earlier ages than those who were raised Christian. SGMs who were raised Christian, but did not identify as Christian in adulthood reported, more adverse childhood experiences and bullying than other SGMs. Sexual minorities …

Temporal Expectations In Delay Of Gratification, Jeremy M. Haynes, Mariah E. Willis-Moore, D. Perez, Devanio J. Cousins, Amy L. Odum

Psychology Faculty Publications

We examined how temporal expectations influence preference reversals in a delay of gratification task for rats based on a hypothesis of Rachlin (2000), who suggested that preference for a larger-later reward may shift in favor of a smaller-immediate reward as a result of changes in when that larger reward is expected. To explore Rachlin’s hypothesis, we pre-exposed two groups of rats to the delays associated with a larger-later reinforcer from a delay of gratification task. One group experienced the delays as a function of their choices in an intertemporal choice task and the other group experienced delays yoked from the …

“I Just Wanted Support”: Examining How Lds Clergy May Effectively Minister To Sexual And Gender Minority Congregants, Samuel J. Skidmore, G. Tyler Lefevor, Adlyn M. Perez-Figueroa, Kristen A. Gonzalez

Psychology Faculty Publications

This study explored why members of the Church of Jesus Christ of Latter-day Saints (LDS) who identify as sexual or gender minorities (SGM) speak with clergy regarding their SGM identities, as well as what LDS SGMs find helpful and unhelpful in these conversations. A sample of 25 current or former LDS SGMs participated in semi-structured interviews, which were analyzed using thematic analysis. Participants reported six overarching reasons for talking with clergy, including church procedures, seeking guidance, seeking emotional comfort, seeking repentance, seeking openness, and other people’s initiation. Participants reported several ways clergy were helpful, including empathic listening, openness, and affirmative …

Unpacking The Internalized Homonegativity–Health Relationship: How The Measurement Of Ih And Health Matter And The Contribution Of Religiousness, G. Tyler Lefevor, Eric R. Larsen, Rachel M. Golightly, Maddie Landrum

Psychology Faculty Publications

Internalized homonegativity (IH) is widely recognized to negatively influence the health of lesbian, gay, bisexual, and queer/questioning (LGBQ +) individuals. It is not clear, however, the role that religiousness may play in the relationship between IH and health or how differing conceptualizations of IH or health may influence this relationship. We conducted a multi-level meta-analysis of 151 effect sizes from 68 studies to examine the relationship between IH and health as well as what may moderate this relationship. Results suggested that IH was consistently and negatively related to health (r = − .28). Analyses suggest that IH was most …

“I Come Out Because I Love You”: Positive Coming Out Experiences Among Latter-Day Saint Sexual And Gender Minorities, Samuel J. Skidmore, G. Tyler Lefevor, Adlyn M. Perez-Figueroa

Psychology Faculty Publications

Background:

Coming out conversations are pivotal and stressful experiences for sexual and gender minorities (SGMs). Coming out can lead to more affirmation, safety, confidence, and improved relationships. However, adverse coming out experiences can lead to damaged relationships and ostracization, which may be more likely in conservative religious contexts.

Purpose:

The purpose of the current study was to explore what leads to positive coming out experiences for SGM members of the Church of Jesus Christ of Latter-day Saints.

Method:

A sample of 25 current or former Latter-day Saint (LDS) SGMs participated in semi-structured interviews, which were analyzed using thematic analysis.

Results: …

Parent–Child Recurring Conflict: A Mediator Between Parental Anger Management And Adolescent Behavior, Erin Donohue, Linda C. Halgunseth, Sarah M. Chilenski, Daniel F. Perkins

Psychology Faculty Publications

Guided by social learning theory, this longitudinal study examined whether parent–child recurring conflict mediated the association between parental anger management, an understudied antecedent to parent–child recurring conflict, and adolescent deviant and problem-solving behaviors in 415 rural families. Parental use of anger management in 6th grade was associated with less parent–child recurring conflict in 9th grade, which was associated with more adolescent problem-solving behavior in 11th grade. Family practitioners seeking to promote adolescent problem-solving behaviors may consider teaching families strategies for reducing parent–child recurring conflict and fostering parental anger management.

Does Internalized Stigma Change The Way That Religiousness Relates To Depression For People With Minoritized Sexualities?, G. Tyler Lefevor, Chana Etengoff, Samuel J. Skidmore

Psychology Faculty Publications

Drawing on minority stress and intersectionality theories, we examine whether the relationship between religiousness and depression among people with marginalized sexualities changes as a function of their experience of internalized stigma. Analyses of a sample of 260 people with marginalized sexualities suggested that the relationship between religiousness and depression was moderated by internalized homonegativity. Simple slopes analyses revealed that when people with marginalized sexualities reported higher degrees of internalized homonegativity, the relationship between religiousness and depression was positive. Conversely, when people with marginalized sexualities reported lower degrees of internalized homonegativity, religiousness was negatively related to depression. Dismantling analyses using subscales …

Sexual Complexity: A Comparison Between Men And Women In A Sexual Minority Sample Of Members Of The Church Of Jesus Christ Of Latter-Day Saints, William S. Bradshaw, John P. Dehlin, Renee V. Galliher

Psychology Faculty Publications

We report here some of the results from an online survey of 1612 LGBTQ members and former members of the Church of Jesus Christ of Latter-day Saints (CJCLDS, Mormon). The data permitted an exploration of diversity—individual similarities and differences within and between the sexes. Men and women were compared with respect to sexual identity self-labeling and behavior (i.e., identity development, disclosure, activity), orientation change efforts, marital relationships, and psychosocial health—these variables in the context of their religious lives. More women than men self-identified in the bisexual range of the sexual attraction continuum. Both men and women had engaged in extensive …