Clinical Psychology Commons^™

Addressing Mental Health Issues And The Effectiveness Of Cognitive Behavioral Therapy And Mindfulness-Based Interventions Among Athletes, Shelby Jones-Stachnik

Dissertations

This literature review identifies mental health concerns among competitive athletes and evaluates psychological interventions to address these challenges. Specifically, the review explores the mental health concerns experienced by athletes engaged in high-level sport. It examines whether cognitive behavioral therapy and mindfulness-based interventions are effective approaches for improving psychological outcomes in this population. A systematic review of peer-reviewed research was conducted, and findings were synthesized to evaluate the effectiveness of cognitive behavioral therapy and mindfulness-based interventions. The review included randomized controlled trials, quasi-experimental studies, and meta-analyses examining psychological interventions in athletic populations. Findings across the literature indicate that both cognitive behavioral …

Trends Of Pediatric Psychotropic Polypharmacy In Massachusetts Before And During The Covid-19 Pandemic, Gianna D'Ambrozio

Graduate Doctoral Dissertations

Youth in the U.S. and internationally are increasingly being diagnosed with depression and related psychiatric conditions (Murthy, 2021) many of whom are being subjected to non-evidence-based, or what has been termed irrational, psychotropic polypharmacy (Barnett & Concepcion Zayas, 2019). Psychotropic polypharmacy can be defined as “the use of 2 or more psychiatric medications in the same patient,” (Zito et al., 2021) though definitions can vary. Using data from the Center for Health Information Analysis’ Massachusetts All-Payer Claims Database, this study examined the sociodemographic factors associated with high rates of polypharmacy, a hypothesized increase in pediatric psychotropic polypharmacy rates in Massachusetts …

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

The Impact Of Translated Phq-9 And Gad-7 Scales On Treatment Recommendations In An Adult Vietnamese Population: A 3-Month Primary Care Evaluation, Vivienne Bui

Doctor of Nursing Practice Final Manuscripts

Depression and anxiety are prevalent yet underdiagnosed in limited-English-proficient (LEP) populations due to language barriers, cultural stigma, and provider bias. Vietnamese-speaking patients are particularly vulnerable to under-recognition in primary care. This quality improvement project evaluated whether implementing Vietnamese-translated Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) tools would improve mental health diagnosis and referral rates. Guided by the Johns Hopkins Evidence-Based Practice Model, a pre–post design was conducted at a San Diego clinic from March 26 to June 26, 2025. Vietnamese-speaking adults (≥18 years) completed translated PHQ-9 and GAD-7 forms during intake. Providers used scores in conjunction with clinical …

“There Was Nothing Left To Give”: Experiences Of Compassion Fatigue Among Former In-Patient Psychiatric Clinicians, Katie Ladner

Counseling and Psychology Dissertations

Compassion Fatigue (CF) is a state of emotional and physical exhaustion resulting from prolonged exposure to stressful or traumatic experiences, specifically among healthcare workers, and it negatively impacts their ability to provide care to their patients and perform their jobs effectively (Singh et al., 2020). The purpose of this qualitative study is to explore the lived experiences of compassion fatigue in mental health clinicians who previously worked in in-patient psychiatric hospitals and their subsequent resignations. This phenomenological research explored participants' understanding and descriptions of their CF experiences in their roles within psychiatric hospitals and how CF contributed to their leaving …

Barriers And Bridges: Exploring Factors That Shape Mental Health Service Utilization In Rural America, Margaret Wiwuga

Educational Specialist, 2020-current

Despite disproportionately higher suicide mortality rates and comparable prevalence of mental illness across urban and rural communities in the United States, rural populations across the nation experience significantly lower access to and utilization of mental health services, naturally leading to worse comprehensive outcomes. This literature review examines multifaceted factors shaping mental health service use in rural America, taking note of both barrier and enabling factors that impede or enable these unique populations’ willingness and ability to access and use mental health services. Ten articles published prior to September 9, 2025, were selected from the James Madison University Libraries’ Psychology and …

What’S Behind The Mask: The Diagnostic Divide In The Female Autism Phenotype, Shelley Gies Alston

Educational Specialist, 2020-current

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by differences in social communication and restrictive, repetitive behaviors; however, women are diagnosed at significantly lower rates than men. This study examined whether DSM-5-TR diagnostic practices may contribute to the underdiagnosis and delayed identification of ASD in individuals assigned female at birth (AFAB), with attention to masking behaviors, gendered social expectations, and clinician interpretation of symptoms. Grounded in the Female Autism Phenotype (FAP), a retrospective mixed-methods study surveyed 12 AFAB individuals aged 18–24 who self-identified or were formally diagnosed with ASD. Participants completed a 44-item online survey including Likert-scale and open-ended …

Co-Active Therapeutic Filmmaking: A Methodology Pilot Project, Blair Webber

Expressive Therapies Theses

This pilot project examined the intersection of drama therapy and filmmaking. Drawing on the Co-Active Therapeutic Theater model from drama therapy and digital storytelling and participatory video methods from social work research, this methodology designed and delivered a co-created filmmaking intervention at a residential treatment center for adult men with co-occurring mental health and substance use disorder. Four participants made a seven-minute-long short fictional film based on their definition of active recovery and a theme of recovery they wished to share with an audience. It was screened at the treatment center for staff and their fellow residents. Data collection was …

Big Feelings, Fast Decisions: Emotion Regulation As A Moderator Of Impulsivity In Binge And Emotional Eating, Emma G. Folk

Graduate Theses and Dissertations (2019 - present)

Emotion-driven impulsivity and difficulties with emotion regulation are both associated with maladaptive eating behaviors, including binge eating and emotional eating. However, it remains unclear whether broader emotion regulation difficulties intensify the influence of impulsive responses to emotional states on these behaviors. This study examined whether emotion dysregulation moderates the relationship between emotion-driven impulsivity and maladaptive eating behaviors. Participants were 266 adults (ages 18–65) who completed measures of impulsivity, emotion regulation difficulties, binge eating, and emotional eating. Moderation analyses were conducted using PROCESS in SPSS, controlling for body mass index (BMI) and gender. Negative and positive urgency were significantly associated with …

From Invisible Injury To Measurable Impact: Exploring Associations Between Peripheral Biomarkers Of Neuroinflammation And Mental Health Outcomes After Mtbi, Lauren Leggett Smith

Psychology Theses & Dissertations

Mild traumatic brain injury (mTBI), often referred to as a “silent epidemic,” accounts for the majority of traumatic brain injuries worldwide and is increasingly linked to persistent psychiatric outcomes. Despite its prevalence, mTBI remains understudied due to diagnostic challenges, underreporting, and misperceptions of its clinical significance. The present study examined whether peripheral biomarkers of neuroinflammation and astroglial injury—tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and glial fibrillary acidic protein (GFAP)— mediate associations between mTBI history and psychiatric symptom severity, including depression, anxiety, and posttraumatic stress disorder (PTSD). Participants were 138 traumaexposed adults recruited from an urban university and surrounding community, with …

How Does Cognitive Behavioral Therapy (Cbt) And Antipsychotics Compare To Antipsychotics Alone Impact Inpatient Length Of Stay: A Scoping Review, Morgan E. Johnson, Hailey M. Wade, Y'Esha V. Williams-Click, Rocquell Duncan, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap

Doctor of Nursing Practice Projects

Background

Psychosis in adults is a serious psychiatric condition that often necessitates inpatient hospitalization for stabilization and the initiation of medication. Untreated psychosis can lead to poor outcomes, including longer hospital stays, loss of occupational functioning, and a decreased quality of life. While antipsychotic medications are typically the first line of treatment, they can have severe side effects, which may lead to patients discontinuing their use. Cognitive Behavioral Therapy (CBT) for psychosis is an evidence-based intervention that targets maladaptive behaviors associated with the condition. CBT may improve treatment responses when used alongside antipsychotic medication. However, there is limited research on …

Examining The Psychometric Properties Of The Big Three Perfectionism Scale–Short Form (Btps-Sf) Among Malaysian Chinese Students At A Private University, Kam-Fong Lee, Ashraf Sadat Ahadzadeh, Shin Ling Wu

Makara Journal of Health Research

Background: Perfectionism is increasingly prevalent among young adults and is a significant predictor of pathological and behavioral outcomes. Despite its relevance, validated and reliable measures of perfectionism tailored to university students, particularly within the Malaysian cultural and academic context, are lacking. This study addresses this gap by examining the psychometric properties of the BTPS-SF among Chinese students at a private university in Malaysia.

Methods: Data were collected using a cross-sectional design with convenience and snowball sampling from 380 students aged 18–25 years, predominantly from a Chinese student population.

Results: The results of the exploratory factor analysis, conducted …

Questionnaire For Eudaimonic Well-Being: Psychometric Validation Among Malaysian Youth, Mohd Ahsani A. Malek, Nurulwahida Saad, Suzana Mohd. Hoesni, Muhamad Ariff Ibrahim, Nurul Shafira Adi, Mohd Nazir Mohd Nazori

Makara Journal of Health Research

Background: The rising prevalence of mental illness underscores the need to understand how individuals can live and flourish under such conditions. In Malaysia, research has largely emphasized diagnosis and treatment, with limited focus on positive psychology and few validated instruments. This study aimed to translate and validate the questionnaire for eudaimonic well-being (QEWB) among Malaysian youth.

Methods: The QEWB was translated into Malay using back-to-back translation and administered to undergraduates from four public universities through a cross-sectional survey design. Convenience quota sampling was used, resulting in 229 respondents completing the online form to measure sociodemographic characteristics, eudaimonic well-being, …

Heroes Of Medicine In The Rio Grande Valley: Documentary Interview With Dr. Cynthia Cavazos Gonzalez, Cynthia Cavazos Gonzalez, Raquel Elena Orellana

Heroes of Medicine in the Rio Grande Valley

Cynthia Cavazos Gonzalez PhD is an Associate Professor of Clinical Practice at UTRGV in Edinburg, Texas and she is the clinic director of the UTRGV Psychology training clinic. She completed a doctoral degree in Clinical Psychology from California School of Professional Psychology in Fresno, California. Her doctoral degree is in Clinical Psychology with a major specialization in Neuropsychology and minor specialization in Health Psychology. She completed an APA-accredited pre-doctoral internship at UTMB in Galveston with a major emphasis in hospital consultation, outpatient psychotherapy, and psychological and neuropsychological evaluations with diverse populations. She completed an informal neuropsychology post-doctoral residency in Texas …

Ptsd Symptoms And Cannabis Use Among College Students: Examining The Role Of Trauma-Related Cannabis Use To Cope, Christopher T. Latourrette

Psychology Theses & Dissertations

Individuals with posttraumatic stress disorder (PTSD) are more than four times as likely to develop cannabis use disorder (CUD) as those without PTSD. This common co-occurrence is often interpreted through a self-medication framework in which cannabis is used to manage PTSD symptoms. Prior work has relied heavily on veteran samples, includes measures of cannabis coping that are not specific to PTSD, and has most commonly examined total PTSD symptom severity, limiting precision in understanding how discrete symptom clusters relate to cannabis outcomes. The present study sought to examine associations between individual PTSD symptom clusters and cannabis use severity and to …

Adaptations Of Collaborative/Therapeutic Assessment With Survivors Of Torture: Clinical Insights From Shareback Conversations, Samantha Correa

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Survivors of Torture (SoT) experience disproportionately high rates of PTSD, depression, and anxiety (Steel et al., 2009). Many SoT treatment programs use brief assessments to monitor symptoms (McFarlane & Kaplan, 2012). However, research on integrating feedback into treatment had been limited until Colpas et al.'s 2024 study on Sharebacks, a novel approach where clients review their progress with their clinician in structured feedback sessions. Given the therapeutic potential of assessment feedback (Tarocchi et al., 2013; Smith & George, 2012; Poston & Hanson, 2010) and Colpas et al.'s findings on Sharebacks' importance, this study explores how practitioners can most effectively incorporate …

Hallucinogens For Mood And Anxiety Disorders: A Critical Review Of Psychedelic-Assisted Therapies, Georgia Chlebek

The Cardinal Edge

In quite a few people worldwide, there are several mental disorders that prevent the brain from operating in the “proper” way, depression, anxiety, and post-traumatic stress disorder (PTSD) being among the most common. Luckily, there are several medications that are produced and used to treat these disorders, but some medications are hard to access, and others simply don’t help the patient. Firstly, these medications take time to study and prove safe for public use, though in some cases time is not readily available. In other cases, these medications are going through shortages and becoming increasingly difficult for patients to access …

Assessment Perception: Delivery Matters, Nicole Marie Arcuri Sanders, Chelsey Simmons

Journal of Counselor Preparation and Supervision

Perception shapes how individuals experience the world and guides their actions toward personal goals. In counseling, clients’ accurate understanding of assessment results is essential for informed decision-making and effective treatment engagement. Mental health clinicians have an ethical responsibility to communicate findings in ways that safeguard client welfare and empower both clients and stakeholders to collaborate in care. This conceptual manuscript introduces the BRIEF (Brief, Relevant, Interpretive, Empathetic, and Factual) Feedback Integration Framework, a structured model for delivering assessment feedback ethically and accessibly. Integrating cognitive, developmental, and cultural considerations. BRIEF provides counselors, supervisors, and educators with a practical strategy for improving …

Utility Of The Wasi–Ii 2-Subtest Full Scale Iq For Identifying Impaired Cognitive Functions, Joseph J. Ryan, David S. Kreiner, Samuel T. Gontkovsky

Archives of Assessment Psychology

This study focused on how accurately the WASI–II 2FSIQ predicts the 4FSIQ. If two subtests can identify intellectual disability, a low score might prompt a switch to the WAIS–IV or WISC–V prior to completing the four WASI–II subtests. Participants were 94 individuals with psychiatric or neurological disorders (age M = 49.04 yrs, education M = 13.48 yrs) seem for clinical evaluation. The correlation between the 2FSIQs and 4FSIQs in the total sample was high, r(92) = .96, p < .001, but the former cannot be relied upon to predict 4FSIQs. It overestimated 4FSIQs in 69.1% of the cases, with only 50% of the 2FSIQs falling within + 3 points of the 4FSIQs. However, classification accuracy statistics indicated that the 2FSIQ effectively screened for the presence of intellectual disability. A 2FSIQ standard score cutoff of ≤ 79 yielded a high probability that the 4FSIQ was also at or below the cut score.

Humanity Is Evolving Its Consciousness: The Role Of Archetypal Energies As Guides During An Unfolding Weeding Out And Alignment Process, Carroy U. Ferguson

Psychology Faculty Publication Series

Humanity is evolving its consciousness at individual and collective levels.  Given these seemingly tumultuous times, as of this writing (January 2026), to make such a statement may sound like a strange thing to say.  However, I suggest that if you are alive today and if you are reading these words, these are the very times for which you were born—to assist Humanity as it evolves its consciousness with your unique gifts, whatever they may be.  That is, this period of our individual and collective human being-ness may be characterized as an unfolding period of weeding out and alignment with the …

Pilot Study: Role Of Social Support And Stress On Anxiety In First-Year College Students, Erin N. Smith, Deven L. Dancy, Lauren E. Nee, Kali Rebuck, Stephanie J. Shirk

Journal of Applied Disciplines

Research indicates worsening mental health, especially anxiety, in college populations; yet few studies have investigated anxiety and related factors in this population. This study examined the impacts and interrelations among anxiety, stress, and social support in first year, first semester college students. In a sample of 119 students, the following models of the impact of social support in the stress-anxiety relation were tested: 1) a direct impact of social support, 2) a moderating effect of social support, and 3) an indirect impact of social support. Results indicated that the indirect model of the influence of social support best fit the …

The Role Of Isotocin In Female Zebrafish (Danio Rerio) Reproductive Behavior And Its Implication For Intranasal Oxytocin Therapy In Humans, Katelynn M. Benge

Masters Theses

In the past several decades, oxytocin has been colloquially termed the “cuddle hormone,” due to its role in pair-bonding and monogamy (Carter et al., 1992). In addition to being used experimentally for psychological disorder, it has also been used in couple’s counseling settings (Anagnostou et al., 2014; Domes et al., 2016). The outcomes of this research reveal mixed results, creating a need for further research in the topic to understand the exact mechanisms by which oxytocin works in the brain to induce this prosocial response. This study sought to address this deficit through the zebrafish animal model. The zebrafish serves …

Fear Of Falling: A Collaborative Approach To Treatment, Alexandra Uhren, Celeste Delap, Kate Jansen

Journal of Interprofessional Practice and Collaboration

Purpose: Physical Therapy (PT) and Behavioral Health (BH) often overlap in patient care; however, collaborative treatment is always not utilized by providers. This case study details the interdisciplinary treatment of a 69-year-old female with a fear of falling; emphasizing the importance of interprofessional collaborative care in treating Fear of Falling (FOF) in individuals at risk for fall-related injury with Cognitive Behavioral Therapy (CBT) and PT interventions.

Problem: FOF is common among older adults and can result in physical, psychological, and social consequences (Lee & Tak, 2023; MacKay et al., 2021). Patients at risk of fall-related injury experience decreased self-confidence in …

Culturally Responsive Dialectical Behavior Therapy With Chinese Sexual And Gender Minority Individuals: A Qualitative Study, Weiyi Liao M.S.

Selected Full Text Dissertations, 2011-

Professional guidelines emphasize the importance of adapting evidence-based treatments to the cultural and contextual needs of minoritized populations. Although substantial research has examined lesbian, gay, bisexual, transgender, and queer (LGBTQ+) mental health, comparatively little is known about the psychotherapy experiences of Chinese sexual and gender minority individuals or how dialectical behavior therapy (DBT) may be delivered responsively with this population. DBT is an evidence-based treatment for emotion dysregulation, self-harm, and suicidal behavior that explicitly addresses the effects of invalidating environments. Because Chinese cultural contexts and LGBTQ-related minority stress may both shape emotional expression, help-seeking, and treatment experiences, this qualitative study …

The Use Of Virtual Reality In Ptsd Research And Practice, Kenneth B. Abrams, Lindsay Okindo, Marta E. Bacon, Yiking Skylar Yu, Sofia Santamaria Germani, Malvika Malhotra, Nancy A. Cullen

Psychology Faculty Work

In the aftermath of traumatic events such as combat, sexual violence, or a natural disaster, individuals may develop posttraumatic stress disorder (PTSD). Technological advancements in virtual reality (VR) over the past few decades have opened new avenues for improving the assessment, treatment, and understanding of PTSD. VR allows users to be immersed in interactive, computer-generated environments that simulate real-world scenarios, such as a warzone or assault location, that would be difficult or unsafe to reproduce using traditional methods. The present paper offers an overview of how VR technology has been employed in both clinical and research settings related to PTSD. …

Visual Aids And Numeracy In Healthcare: Leveraging The Drawing Effect, Zephyr J. Markley

Capstone Showcase

Healthcare decisions often require patients to interpret numerical risk information under stress, yet many struggle with low numeracy, which can distort comprehension and undermine informed consent. Well-designed visual aids can improve diagnostic inference, calibrate confidence, and support better choices, especially for patients with limited numeracy, but their impact depends on whether users can actually interpret the format accurately. Drawing may further enhance these tools by adding a tactile, generative layer that engages visual, semantic, and motoric processing while helping patients organize information into concrete models.

Passive visual aids appear useful but limited because they often position patients as observers rather …

Emotion Regulation Difficulties And Substance Use: The Role Of Conscientiousness, Caitlyn M. Donnelly

Theses and Dissertations

Difficulties in emotion regulation have been consistently linked to substance use among college students. However, individual differences may influence this relationship. Conscientiousness, a personality trait characterized by self-control, planning, and goal-directed behavior, has been proposed as a potential protective factor. The present study examined associations among difficulties in emotion regulation, conscientiousness, and substance use behaviors, as well as whether conscientiousness moderates the relationship between emotion regulation difficulties and substance use. Using a quantitative, cross-sectional, correlational design, data was collected from college students recruited through a university participant pool. Participants completed self-report measures of emotion regulation difficulties, conscientiousness, and substance use …

Parental Behavior, Attachment, And Sibling Outcomes In Asd Families, Bridget W. Mwaura

Theses and Dissertations

Neurotypical siblings of individuals with Autism Spectrum Disorder (ASD) often experience unique challenges, including increased familial stress and differences in parental treatment, which may affect the sibling bond. Grounded in the Attachment Theory and Siblings Embedded Systems Framework, this study examined relationships among attachment security, parenting behaviors and sibling relationship quality. It was hypothesized that secure parental attachment and helpful parenting behaviors would predict greater sibling closeness and lower conflict, and that attachment security would mediate the relationship between parenting behaviors and sibling relationship quality. Results from a sample of emerging adults (N=91) partially supported these hypotheses. Bivariate …

Understanding The Progression Of Borderline Personality Disorder During Adolescence: A Clinical Case Study, Anjali Chandak, Megha Sadashiv, Bhawna Sharma, Bhargav Mulpuru

Digital Journal of Clinical Medicine

Borderline Personality Disorder (BPD) often emerges during adolescence, but remains relatively understudied in this population. This case report explores the sociobiological factors shaping symptom expression in an adolescent girl. Longitudinal clinical evaluation revealed hallmark features, including affective instability, identity disturbance, interpersonal relations, and self-harming behaviour. Early attachment disruptions, emotional regulation difficulties, and heightened sensitivity to relational stressors were identified as key developmental risk factors. Diagnostic and therapeutic considerations are presented, highlighting the need for prompt, developmentally informed, and evidence-based interventions. The case further emphasises how prognosis and chronicity may be significantly influenced by an adopting developmental approach, providing insight into …

Survivors Of Historical Intergenerational And Familial Trauma Scale For Black American Descendants Of Enslaved People: A Development And Initial Validation Study, Loryn Chás Kimbrough

Graduate Research Theses & Dissertations

Despite extensive research documenting cultural and racialized trauma, no validated assessment tool had previously captured the intrafamilial mechanisms of trauma transmission specific to the BADEP population, whose trauma lineage is rooted in slavery. The present study addresses this gap through the development and initial validation of the Survivors of Historical Intergenerational and Familial Trauma Scale (SHIFTS), a culturally grounded instrument designed to measure the transmission of historical trauma (HT) and ongoing intergenerational trauma (IGT) among Black American Descendants of Enslaved People (BADEPs). The SHIFTS examines how HT gives rise to the continued transmission of two interrelated legacies: survival-based and trauma-rooted …