Clinical Psychology Commons^™

The Relationship Between Psychotherapist Personality And Therapeutic Alliance, Michael Finlay

Loma Linda University Electronic Theses, Dissertations & Projects

Time-limited effective psychotherapy is a topic that is frequently addressed in clinical therapy research. Though a wide range of therapeutic factors, expectancy effects, techniques, and extratherapeutic have all been demonstrated to be related to outcome, researchers have consistently identified the therapeutic alliance as one of the strongest factors in predicting psychotherapy outcomes. Researchers are beginning to measure the effectiveness of therapy by evaluating improvements in outcome measures, and client reported therapeutic alliance. Researchers have recently began investigating the common personality profiles among psychotherapists, and have hypothesized that there is a relationship between psychotherapist personality and therapeutic alliance. The goal of …

An Empirical Examination Of Doctoral Training Models In Clinical Psychology In The United States, Katherine E. Dautenhahn

Loma Linda University Electronic Theses, Dissertations & Projects

Since as early as 1908, psychology as a discipline has grappled with how to integrate research and practice into the field’s professional identity. To further define the area of expertise of a psychologist, three main models of clinical training have been proposed: the scientist-practitioner model, the practitioner-scholar model, and the clinical scientist model. Despite clinical psychology’s universal claim for empirical moorings, the debate about the foundation of training in clinical psychology has remained primarily theoretical. The purpose of this study is to expand upon the limited research exploring the differences between training models to empirically determine which factors significantly predicted …

Sociocultural Attitudes Towards Appearance Questionnaire-4-Revised In Asian Americans, Dean Lim

Loma Linda University Electronic Theses, Dissertations & Projects

Prior research has indicated that the prevalence of eating disorders, which are recognized as one of most lethal psychological disorders with an approximately 20% mortality rate, are increasing among Asian Americans with rates comparable to those of the general population in the United States. However, research has also suggested that Asian Americans may not be fully reporting symptoms related to eating disorders because of sociocultural stigma and the desire to uphold cultural values, such as interdependence, harmony within the community, humility, and emotional restraint. The SATAQ-4R is a widely-used measure of sociocultural influences on body image and eating disturbance, which …

Neurocognitive And Psychosocial Effects Of Repeated Concussions In Children And Adolescents, Shina Halavi

Loma Linda University Electronic Theses, Dissertations & Projects

In the United States, an estimated 1.7 million people sustain a traumatic brain injury (TBI) annually. About 75% of these TBIs are mild, which are referred to as “concussions.” This study assessed the neurocognitive and psychosocial effects of repeated concussions in children and adolescents and their interactions with age and gender. It also assessed the correlation between psychosocial functioning and neurocognitive functioning. Given the paucity of research on the effects of concussion in the developing brain, the current study characterized the neurocognitive and psychosocial effects of concussion in young populations. The overarching hypothesis stated that repeated concussions would induce more …

Effects Of Emotional Content On Working Memory Updating: Proactive Interference And Resolution, Maria Guadalupe Corona

Loma Linda University Electronic Theses, Dissertations & Projects

The working memory (WM) system refers to the structures and processes supporting the encoding, maintenance, manipulation, and retrieval of information to be used for goal-directed behavior. Proactive interference (PI) is often experienced when information to be processed shares physical properties with information that is no longer relevant. The working memory system may then process such information less efficiently (i.e., slower processing time) and less accurately, and control processes involved in interference resolution become triggered in order to maintain performance. The current study investigated the effects of emotional content on interference resolution by using a working memory updating paradigm. Specifically, an …

Evaluating Cognitive Changes In Patients Receiving Outpatient Alcohol Treatment, Michelle Mcdonnell

Loma Linda University Electronic Theses, Dissertations & Projects

Chronic alcohol use has been linked to various physical health concerns, neurological changes, and cognitive deficits. Research has shown that some of these neurologic and cognitive deficits can improve over time following detoxification and abstinence; however, the exact nature or timeline of this recovery process has not been established. The aim of the current study is to identify cognitive deficits and changes present in the alcohol addiction treatment population, the influence of cognitive deficits on treatment completion, and the effect of previous engagement in treatment (which is indicative of previous relapse) on cognitive functioning at both treatment onset and treatment …

Consequences Of Attributions For Unfair Healthcare Treatment Among Culturally Diverse Patients, Nathalie Serna

Loma Linda University Electronic Theses, Dissertations & Projects

Ethnic minority and lower SES populations report less positive healthcare encounters and worse health outcomes as compared to higher SES and mainstream populations. In Chile, the prevalence of type 2 diabetes (T2D) is one of the highest in South America and among the indigenous Mapuche population it has quadrupled over the last decade (Perez-Bravo et al., 2001). Research suggests that Mapuches have been historically discriminated in everyday life as well as in healthcare (Alarcon, et al., 2004). Based on Weiner’s attribution theory of motivation and emotion (1986, 1995, 2006) and guided by Betancourt’s integrative model of culture, psychological factors, and …

Parenting Stress And Emotion Dysregulation In Children With Dd: The Role Of Parenting Behaviors, Neilson Chan

Loma Linda University Electronic Theses, Dissertations & Projects

Parents of children with developmental delays (DD) report higher levels of parenting stress compared to parents of typically developing children. High levels of parenting stress have been associated with negative outcomes for their children, including higher levels of emotion dysregulation. However, this relationship between parenting stress and child emotion dysregulation has rarely been examined in families of children with DD. Additionally, the mechanisms through which parenting stress influences child emotion dysregulation remain unclear; it may be that parenting stress impacts parenting behaviors (i.e., sensitive and intrusive parenting), which in turn influence the development of the child’s emotion regulatory abilities. In …

Coping As A Mediator Between Symptom Burden And Distress In Lung Cancer Patients, Spring F. Gehring

Loma Linda University Electronic Theses, Dissertations & Projects

Lung cancer is considered the leading cause of cancer death worldwide. An estimated 224,390 new cases of lung cancer are expected to be diagnosed and 158,080 Americans are expected to die from lung cancer in 2016 (National Institutes of Health, 2016; Siegel, Miller, & Jemal, 2016). Lung cancer patients also report the highest levels of psychological distress and symptom burden than any other forms of cancer (Linden, Vodermaier, MacKenzie, & Greig, 2012). Given the prevalence and impact of lung cancer, it is imperative to address the emotional toll this diagnosis can have on those suffering with the disease to develop …

An Examination Of The Moderating Effect Of Proactive Coping In Nicu Nurses, Britan M. Moore

Loma Linda University Electronic Theses, Dissertations & Projects

The NICU environment is unique in that the patient population consists of critically ill neonates. Research has revealed that there are increased levels of depression, secondary traumatic stress, and burnout in nurses. Problem solving and support seeking coping strategies have been shown to be associated with lower levels of burnout and increased patient and job satisfaction in general staff nurses. Multiple linear regression and a hierarchical stepwise technique was used to conduct moderator analyses assessing whether the use of problem solving or support seeking strategies moderated the relationship between secondary traumatic stress levels and burnout as well as between depressive …

Neuropsychological Effects Of Pomegranate Supplementation Following Ischemic Stroke, John A. Bellone

Loma Linda University Electronic Theses, Dissertations & Projects

Polyphenols are compounds found in fruits and vegetables that have antioxidant and anti-inflammatory properties. Mounting evidence suggests that dietary polyphenol intake can reduce the detrimental effects of various disease processes, and pomegranates have frequently been examined because of their particularly high polyphenol content. Since stroke induces both oxidative stress and inflammation and is currently the leading cause of long-term disability in the U.S., we sought to determine whether dietary supplementation with polyphenols could enhance cognitive recovery in individuals who had suffered an ischemic stroke. We administered polyphenols via 2 POMx pills containing polyphenols derived from pomegranates equivalent to the content …

Stereotypes About Healthcare Professionals, Emotions, And Mammography Compliance, Kayla M. Kinworthy

Loma Linda University Electronic Theses, Dissertations & Projects

Rates of mammography screening are particularly low for minority women, with only 42% of Latin American (Latino) women in the U.S. reporting having a mammogram in the last year as compared to 53% of non-Latino White (Anglo) women [1]. Minority patients are more likely to report negative healthcare encounters with their health professionals [2; 3], which may result in less favorable cultural stereotypes about healthcare professionals and more negative emotional reactions. Guided by Betancourt’s Integrative Model of Culture, Psychological Processes, and Health Behavior [4] and the Stereotype Content Model [5], the aim of the present research was to examine the …

Simpatia And Negative Interpersonal Emotions In Continuity Of Health Care, Andres Gilberto Mendez

Loma Linda University Electronic Theses, Dissertations & Projects

Past research has demonstrated that continuity of care has positive outcomes for patients. Continuous care has been shown to have positive outcomes for the patient, including increased patient satisfaction, decreased hospitalizations, decreased emergency department visits, and improved receipt of preventive services. Guided by Betancourt’s Integrative Model for the Study of Culture, Psychological Processes, and Health Behaviors, the aim of this research was to examine the role of cultural scripts and mistreatment related negative interpersonal emotions on continuity of care among Latin American (Latino) and Non-Latino White (Anglo) women. Specifically, this study examined the effect of simpatía, a cultural script that …

Lateralization Of Emotion, Reaction Time, And Skin Conductance Responsiveness, Kimberley Erin Rose

Loma Linda University Electronic Theses, Dissertations & Projects

Bilateral presentations of brief (250 ms), unmasked emotional and neutral stimuli were examined in two experiments with primarily female samples. Reaction time and accuracy data were used to measure perception of emotion and skin conductance response (SCR) was used to measure experience of emotion. Both words and pictures were used to account for hemispheric differences in language and visuospatial dominance. Response time was faster to emotional pictures than words. Reaction time and speeded accuracy data did not support right hemisphere hypothesis (RHH) or valence hypothesis (VH) in the expected manner. Data suggested emotion caused greater interference under speeded conditions in …

Client/Therapist Feedback And The Role Of The Alliance On Psychotherapy Outcomes, Elizabeth Preston Cisneros

Loma Linda University Electronic Theses, Dissertations & Projects

Through a system of patient-focused outcomes research which has employed a quality assurance system for tracking client progress in therapy, there has been consistent evidence that utilizing the system to identify those who are not responding to treatment and warning their therapist about the client’s risk significantly improves client outcomes in psychotherapy. Although outcomes have been improved, significant proportions of clients have treatment failures or see no improvement in therapy. Moreover, feedback to therapists appears to be most effective in improving outcomes for the minority of clients who are already at risk of treatment failure.

Attempts to augment the feedback …

Body Image Satisfaction In Infant And Pediatric Cardiac Transplant Recipients As Adolescents, Danusia Nedilskyj

Loma Linda University Electronic Theses, Dissertations & Projects

With the long-term survival rate of infant and pediatric heart transplant recipients reaching as high as 85%, there is now a significant number of these youths entering adolescence. Although psychological factors thought to be associated with pediatric heart transplant have reached clearer delineation in the literature, few studies have been conducted. Given the emphasis on development typically seen in adolescence combined with the unique experience of receiving a heart transplant, factors such as body image, self-perception, stress and mood have emerged from the literature. As such, this study assessed psychosocial variables of body image satisfaction, self-concept, depression, and social stress …

The Development Of An Advanced Filial Therapy Model, Amy Cathleen Wickstrom

Loma Linda University Electronic Theses, Dissertations & Projects

This study sought to develop an advanced filial therapy model by examining the experiences of seven parents who participated in a preliminary advanced filial therapy intervention. These parents had previously completed a 10-week basic filial therapy model called Child Parent Relationship Therapy. A phenomenological qualitative design was employed, wherein data was obtained from parent playtime notes, researcher field notes, group process transcriptions, and focus groups. Parent experiences of the intervention were examined from a systems-relational lens, and four categories emerged, which include relational epiphanies, enhanced understanding of the playtimes, model format, and skill development. Additionally, a variety of themes were …

Neurodevelopmental Outcome & Mr Spectroscopy Of Therapeutic Hypothermia After Pediatric Drowning, Sharon Mieras Perugini

Loma Linda University Electronic Theses, Dissertations & Projects

Despite advances in medical treatment and technology, outcome following pediatric drowning can vary widely from mild to severe impairments and death. Prognosis is often difficult to predict given a number of contributing factors. As such, this study examined the relationship between clinical indicators including submersion duration, initial GCS and PRISM scores, and waking time with outcome as well as metabolite ratios based on magnetic resonance spectroscopy. Research stemming from the area of cardiac arrest as well as anecdotal case study reports of cold water drownings suggests that lowering the body temperature may be helpful and protective. As such, the use …

Comparison Of Rationally-Derived And Empirically-Derived Methods For Predicting Failure In Residential Treatment, Jennifer Pester Grattan

Loma Linda University Electronic Theses, Dissertations & Projects

Patient-focused research methods have been used in adult mental health treatment to improve outcomes by tracking individual treatment response and comparing it with expected recovery patterns. One such approach has used rationally- and empirically-derived methods to analyze data from the OQ-45 and identify patients who are not responding as expected to treatment. Treatment is then adjusted, improving outcomes and lowering overall costs.

Similar but less extensive research has shown analogous methods can be used with children and adolescents. This would be particularly useful in residential treatment, which is an expensive and inadequately researched approach. This study used archival data gathered …

Study Of The Four Factor Theory Of Women’S Sexual Function, Julie M. Merrell

Loma Linda University Electronic Theses, Dissertations & Projects

Tiefer, Hall, and Tavris (2002) described factors comprising four categories of female sexual function. They suggested that unique factors need to be examined to understand sexual function in women. Socio-cultural, political, or economic factors, partner and relationship factors, psychological factors, and medical factors were described as aspects of women’s lives that can be the source of sexual dysfunction. In a previous study, Merrell (2007) utilized Tiefer et al’s (2002) four factor model of sexual functioning to examine female sexual functioning looking specifically at body shame, relationship satisfaction, positive and negative affect, sexual self-schema, and overall health. Based on the results …

Profiles Of Drug Endangered Children: Investigation In A Clinical Sample, Imanie Samanmali Wijayaratne

Loma Linda University Electronic Theses, Dissertations & Projects

Despite the increase in children born prenatally exposed to methamphetamine, little is known about the cognitive and neuropsychological outcomes of these children. Research specific to prenatal-methamphetamine exposure is extremely limited and has been primarily restricted to rat studies. This research combined with the few studies examining children prenatally exposed to methamphetamine suggests that methamphetamine-exposure is associated with various cognitive and neuropsychological delays and is impacted by both biological and environmental factors. Given the scarcity of research in this area, the current study used archival data from a psychological assessment clinic to (1) describe the frequency of prenatal methamphetamine-exposure cases, (2) …

A Psychoeducational Group Intervention For Fibromyalgia Patients, Derek O. Bacchus

Loma Linda University Electronic Theses, Dissertations & Projects

This study examined the effect of a multidisciplinary psychoeducational treatment group on Fibromyalgia Syndrome (FMS) pain, depression, catastrophizing, and quality of life. The Short-Form McGill Pain Questionnaire (SF-MPQ), Center for Epidemiologic Studies Depression Scale (CES-D), Coping Strategies Questionnaire (CSQ), and the World Health Organization Quality of Life Assessment—Abbreviated Version were used to assess these constructs in 15 participants. The sample was composed entirely of female participants and was predominantly middle aged, which is typical of the FMS population. Two separate groups of FMS patients—seven in Group 1, eight in Group 2—completed a 10-week psychoeducational intervention where they were presented with …

Ethical Decision-Making Regarding Multiple Relationships Between Therapist And Client, Diana Jochai

Loma Linda University Electronic Theses, Dissertations & Projects

The current study examined a new conceptual model of factors critical to a therapist’s decision-making process when faced with the potential of a nonsexual multiple relationship with a client. This new model was founded on the conceptual framework proposed by Street, Douglas, Geiger, & Martinko (2001) and integrated the components of the decision-making process and the individual and situational factors influencing those components identified in existing general conceptual models and specific behavioral guidelines. For the ethical decision-making process to begin, a practitioner must be able to recognize the presenting problem as an ethical dilemma (Brazerman, 1986; Jones, 1991; Street et …

Breast Cancer Screening Disparities In Japanese-American Women, Theodora Stratis

Loma Linda University Electronic Theses, Dissertations & Projects

Cancer screening disparities in ethnic minority women have received much research attention in the last several years due to a marked increase in ethnic minority cancer incidence and poor survival rates (Miller, Kollnel, Bernstein, Young Swanson, West et ah, 1996). Breast cancer is the leading cause of death for Asian American women (Asian American Network for Cancer Awareness, Research & Training, 2002) and, although their incidence and mortality rates are lower than Caucasian women, these rates continue to increase every year. This increasing mortality rate is likely due to the underutilization of breast cancer screening by Asian American women. Asian …

Memory For Emotional Images : Recognition And Temporal Contexts, George E. Devore

Loma Linda University Electronic Theses, Dissertations & Projects

Negative emotional stimuli are usually better remembered than neutral emotional stimuli. Previous examination of binding theory found no differences in recall for homogeneous lists of taboo and neutral words. The current study expands on binding theory using negative and neutral visual stimuli in homogeneous lists. A rapid serial visual presentation paradigm and recognition and temporal memory item-discrimination tasks were used. Binding theory predicts no differences between negative and neutral images for recognition and temporal memory. Results were consistent with the assumptions of binding theory and no significant differences were found. This result suggests that binding theory generalizes for visual stimuli …

Predictors Of Emotional Reactions In Women Treated For Breast Cancer, Erin E. Ramirez

Loma Linda University Electronic Theses, Dissertations & Projects

Breast cancer can be a devastating disease that impacts a woman in all spheres of her life (Ingram, 1989). Previous studies have examined the impact of breast cancer on body satisfaction, as well as the impact on emotional well-being. Studies have also examined the role of the coping style that a woman engages in response to the diagnosis and treatment of breast cancer in the woman's psychological adjustment to the disease. However, to date, no research has introduced and tested a multifaceted model.

The purpose of this study was to develop a model predicting psychological maladjustment in women treated for …

Predictors Of Emotional Reactions In Women Treated For Breast Cancer, Erin E. Ramirez

Loma Linda University Electronic Theses, Dissertations & Projects

Breast cancer can be a devastating disease that impacts a woman in all spheres of her life (Ingram, 1989). Previous studies have examined the impact of breast cancer on body satisfaction, as well as the impact on emotional well-being. Studies have also examined the role of the coping style that a woman engages in response to the diagnosis and treatment of breast cancer in the woman's psychological adjustment to the disease. However, to date, no research has introduced and tested a multifaceted model.

The purpose of this study was to develop a model predicting psychological maladjustment in women treated for …

Emotional Stroop Effects: Eating Disorders And Obesity, Kristy Anne Kuehfuss

Loma Linda University Electronic Theses, Dissertations & Projects

This study addresses the effects of emotional valence on selective processing of body-shape related words in young women who suffer from anorexia, bulimia, or obesity, and non-clinical controls. Research in the area of emotional Stroop interference has indicated that persons with eating disorders, particularly anorectics, show elevated latencies in naming colors of words related to food or body-shape, in contrast to either neutral words, or to non-clinical control groups. One intriguing issue regarding the emotional Stroop interference among various clinical populations relates to the question of whether the interference is due to the emotionality of the relevant words or to …

Pnes: Neuropsychological Impairments & Psychological Symptomatology, Adriana Macias

Loma Linda University Electronic Theses, Dissertations & Projects

The present study utilized a standardized neuropsychological evaluation and self report measures to compare 52 female patients, 18 years of age and older with a video-electroencephalogram (V-EEG) confirmed diagnosis of psychogenic non-epileptic seizures (PNES) (n₁=29) to a group of left temporal lobe epilepsy (L-TLE) demographically matched patients (n₂=23). In an attempt to overcome methodological confounds of previously reported studies, participants were chosen based on stringent exclusion criteria, which barred mixed etiologies. The purpose of this study was to investigate possible differences in neuropsychological functioning, mood, and personality characteristics between individuals with PNES and those with L-TLE. …

Ethnic Identity And Body Ideal In Adolescent Girls, Erin E. Ramirez

Loma Linda University Electronic Theses, Dissertations & Projects

Adolescence is a period characterized by physical growth and maturation (Cobb, 1995). This normal biological process moves most American girls away from the thin ideal body shape that is dominant within the United States. Ethnic differences in ideal body size have in fact been found in several studies; but they have been shown based on ethnic group membership, not ethnic identification. The specific relationship of ethnic identity and body ideal for Mexican American, African American, and Anglo American adolescent females has not been clearly defined; Lopez, Blix, and Blix (1995) have hinted at the role of ethnic identification (through the …