Clinical Psychology Commons^™

Evaluating The Effectiveness Of Supervision On Trauma Training Outcomes For Assertive Community Treatment Teams, Sacha Zilkha

Dissertations, Theses, and Capstone Projects

Most individuals receiving mental health care do not have access to evidence-based psychological treatments, regardless of psychological disorder. Despite the development of effective evidence based treatments and available training, clinician uptake and adherence to such treatments has been low. In this study, the effectiveness of a trauma treatment training model was evaluated through a quasi-experimental design to better inform and address the gap between the existence of evidence based care and lack of evidence based treatment options available in the community. Specifically, data from 23 Assertive Community Treatment Teams in NYC that underwent a 1-day ICBT training along with 12-month …

Emotion Regulation In Relation To Cognitive Functioning In The Preclinical Stages Of Dementia, Erica P. Meltzer

Dissertations, Theses, and Capstone Projects

Emotion regulation (ER) is essential for effective functioning in daily life. Research suggests that ER improves in older adulthood despite concomitant declines in cognition and the presumed neural substrates of ER. The current understanding of ER in older adulthood, and particularly of the relationship between ER and cognition in older adulthood, is limited. This is likely because the construct of ER is challenging to operationalize and, therefore, difficult to study.

The current study investigates ER in relation to cognitive functioning, specifically executive functioning and memory, in individuals with varying degrees of cognitive difficulties (i.e., in the preclinical stages of dementia). …

The Remembrance Of Things Past: Does Self-Report Moderate The Impact Of Childhood Sexual Abuse On Long-Term Psychiatric Consequences?, Christina N. Massey

Dissertations, Theses, and Capstone Projects

Research has shown that the relationship between childhood sexual abuse (CSA) and psychiatric symptoms is quite varied, with some victims experiencing severe and lasting symptoms and others appearing well-adjusted. Disclosure of childhood sexual abuse has been associated with reduced psychiatric symptoms. Thus, the current study sought to examine the potential moderating effects of disclosure. It was hypothesized that disclosure of childhood maltreatment would be associated with fewer symptoms of depression, anxiety, PTSD, and alcohol- and drug-related disorders and that this relationship between disclosure and psychiatric symptoms would remain consistent over time. In addition, it was hypothesized that the moderating effects …

Role Of Humor In Emotion Regulation: Differential Effects Of Adaptive And Maladaptive Forms Of Humor, Lindsay Mathews

Dissertations, Theses, and Capstone Projects

Humor is widely believed to be an adaptive method of regulating emotions; however, the empirical literature remains inconclusive. One potential explanation for inconsistent results is that humor may be a multidimensional construct. Correlational research suggests that “adaptive” humor styles (Self-Enhancing and Affiliative) are more beneficial than “maladaptive” humor styles (Self-Defeating and Aggressive). The current study examined the effects of humor styles on positive and negative emotion in a sample of 146 young adults. In Part I of the study, participants were 1) randomly assigned to three conditions (adaptive humor, maladaptive humor, and distraction), 2) instructed to write about life events …

Real Gender: Identity, Loss, And The Capacity To Feel Real, Hannah Wallerstein

Dissertations, Theses, and Capstone Projects

This project concerns gender and feeling real. It begins with a seeming paradox: on the one hand, since Judith Butler (1999; 2011) we can no longer think gender as ontological in any simple sense; on the other, clinical experience and the voices of transgender and gender-queer individuals shows gender to function on the order of reality, and one exceeding the social. In other words, if feeling real depended entirely on being read as such, how would we account for the many who pass easily as “real” men or women and yet feel unreal, or come to feel more real by …

Providing Care For Many In The Context Of Few Resources: Secondary Traumatic Stress, Burnout And Moral Distress Experienced By Healthcare Providers In Rural Uganda, Lauren Michelle Dewey

Dissertations, Theses, and Capstone Projects

In the context of the global nursing shortage, and particularly in low-resource settings, nurses are at an increased risk for work-related stress problems like secondary traumatic stress (STS), burnout, and moral distress. These three work-related mental health consequences, sometimes associated with absenteeism and intent to leave the profession, could potentially contribute further to the shortage of nurses. This two-part study is a longitudinal examination of the work-related mental health consequences experienced by healthcare providers in rural Uganda. In Study 1, participants (n=208; 159 students and 49 experienced health workers) completed self-report, psychosocial measures at baseline and 134 of the students …

Vocal Rhythm Coordination And Preterm Infants: Rhythms Of Dialogue In A High-Risk Nicu Sample, Adrianne E. Lange

Dissertations, Theses, and Capstone Projects

The contemporary bio-psycho-social view of mother-infant relationships holds that early interactions form the foundation of the growing infant’s sense of himself and the world. Prior to the development of linguistically-based communication, nonverbal communication patterns foster the infant’s socio-emotional growth, cognitive capacity and the development of optimal regulatory patterns. Preterm birth significantly alters the typical developmental trajectory on multiple levels and disrupts normal neurobiological and socio-emotional maturational processes, including those that build on early interpersonal experiences with caregivers. The current study of vocal rhythm coordination in preterm mother-infant dyads is the first of its kind. Aspects of infant prematurity (degree of …

Early Relational Experiences And Poor Psychological And Social Outcomes As Mediated By Internalized Heterosexism In Sexual Minority Women: Illustration Of A Theoretical Model, Katharine Williams

Dissertations, Theses, and Capstone Projects

Research has indicated that LGB (lesbian, gay, bisexual) individuals are at elevated risk for psychopathology when compared with their heterosexual peers, a finding that was highlighted in the Institute of Medicine’s report on The Health of LGBT People (Cochran & Mays, 2000; Cochran et al., 2003; IOM, 2011; King et al., 2008). Sexual minorities and sexual minority couples also have been found to have greater romantic relationship difficulties than heterosexual peers (Balsam & Szymanski, 2005; Frost & Meyer, 2009; Mays, Cochran, & Roeder, 2003; Meyer & Dean, 1998; Otis et al., 2006; Spencer & Brown, 2007). Therefore, this study targeted …

Investigating The Construct Of Psychopathy In Lebanese And American Adults, Marie-Anne Issa

Dissertations, Theses, and Capstone Projects

Psychopathy has been primarily investigated in forensic and psychiatric populations in North America. Cross-cultural studies, mainly conducted in Europe, have shown disparities in psychopathy scores and the measures’ psychometric properties, which raise the issue of cultural factors, such as individualism-collectivism, values, and different ways of emotional expression, and the impact of these cultural factors on the construct and its manifestation. Psychopathy has been rarely explored in Arab populations. This dissertation examines the construct of psychopathy among Lebanese adults, to assess its meaning, relevance, and utility among this population and compares the responses of Lebanese to American adults. The design of …

Perceptions Of Money: Relationships Between Remembered Parental Rejection, Extrinsic Life Aspirations And Maladaptive Attitudes Toward Money, Rebecca J. Smith

Dissertations, Theses, and Capstone Projects

This study examined the extent to which maternal rejection, paternal rejection, maternal care, and maternal overprotection predict extrinsic life aspirations as well as maladaptive money attitudes in young adults. Additionally, this study sought to determine if the Adult Parental Acceptance-Rejection Questionnaire correlates with the Parental Bonding Instrument. The variable, extrinsic life aspirations, was examined to determine if it mediates between parental rejection and maladaptive money attitudes. Finally, the present study examined gender differences with regard to parental rejection, extrinsic life aspirations, and maladaptive money attitudes. A multiple regression analysis was conducted in a college sample of 366 participants using self-report …

Feminine Ideology, Relational Self-Concept, And Internalizing Symptoms In Women, Anjali George

Dissertations, Theses, and Capstone Projects

Background: Investigators have theorized that women may experience internalizing disorders such as depression and anxiety more frequently than men in part because of unique socialization processes that women undergo. One aspect of early socialization thought to contribute to women’s propensity for depression and anxiety is the way women are brought up to relate to themselves in relation to others, often placing greater importance on the needs, desires, and value of others, at times at a psychological cost to themselves. This study attempts to elucidate the relationship between gender socialization, relational self-concept, and internalizing symptoms in women.

Methods: Two hundred and …

Maternal History Of Neglect, Mind-Mindedness, And The Cycle Of Neglect, Karin N. Belser

Dissertations, Theses, and Capstone Projects

Although links between history of maltreatment, attachment security, and maltreatment perpetration have been established, support for the intergenerational cycle of maltreatment remains weak due to definitional and methodological issues. In addition, less severe forms of child neglect that do not result in Child Protective Services (CPS) involvement have not been extensively studied. In order to expand our understanding of the cycle of neglect, the present study examined a model linking maternal mind-mindedness, maternal history of neglect, subthreshold neglect and child outcomes (physical, socioemotional, and intellectual).

Methods. The study participants were 96 mother-child dyads assessed at child ages of 4, 8, …

Boundaries And Belonging: Asian America, Psychology, And Psychoanalysis, Natalie C. Hung

Dissertations, Theses, and Capstone Projects

This dissertation addresses a vexing problem. In psychology and psychoanalysis, Asian Americans are more often understood as a collective Other than as individual Selves, more frequently an object of study than a subject. Through two overarching aims, my dissertation sheds light on neglected aspects of Asian American selves, the meanings of the invisibility surrounding them, and implications for clinical practice.

First, the project challenges extant psychological perspectives on Asian Americans, which often implicitly assume a wide gulf of difference between Asian American cultural values and the Western epistemologies of psychology and psychoanalysis. Through the examination of academic research, clinical literature, …

An Exploration Of The Paradox Of Bisexuality In Women: The Dawn Research Study, Anna Levy-Warren

Dissertations, Theses, and Capstone Projects

Research on lesbian, gay and bisexual populations has reported higher levels of emotional distress among bisexual adults than their gay and lesbian peers. Findings also demonstrate substantial variability in distress levels within populations of bisexual adults. Little research has examined reasons for this variability. Theoretical explanations for distress among bisexuals include foundations in Cognitive Dissonance Theory and Minority Stress Theory, though these theories have not addressed the variability across outcomes. The current study proposes a new theoretical model to explain variability in levels of distress across bisexual women. According to this theory, levels of psychological distress in bisexual women are …

The Benefits Of Multicultural Eclectic Service Delivery, Eugena Griffin

Publications and Research

To date, Blacks in America are often misdiagnosed or mistreated due to the failure of mental health practitioners to provide services from a multicultural eclectic purview. It is necessary to attend to the past and present influences of psychosocial variables related to real and perceived discrimination on minority achievement, behavior, and clinically health outcomes. When providers do not take into consideration these factors, they have a limited conceptualization of their clients’ needs. Such psychosocial variables can exacerbate behaviors, symptoms, and at times be the antecedent that onset those symptoms. Thus, it is imperative that health providers learn methods to investigate …

Selective Attention To Threat In People With Posttraumatic Stress Disorder: A Meta-Analysis, Amberle Cusmano

Theses and Dissertations

People with posttraumatic stress disorder (PTSD) show increased attention towards or away from threat in their environment; the current literature is divided on the direction of these effects. This meta-analysis aims to aggregate and examine if people with PTSD display selective attention to threat compared to people without PTSD.

Behavioral Avoidance And The Evaluation, Expression, And Intensity Of Emotions In Generalized Anxiety And Major Depressive Disorders, Laura Lamantia

Theses and Dissertations

Emotion dysregulation manifests in ways, such as behavioral avoidance and differential patterns of emotional reactivity and processing. The current study examined whether behavioral avoidance (i.e., task disengagement and expression suppression) and emotional experience (i.e., intensity and evaluation) are associated differently in those with GAD, MDD, and healthy controls.

Disruptive Behavior Disorders In Childhood And Criminal Justice System Involvement In Adolescence And Emerging Adulthood: Pilot Results Among Puerto Rican Youth, Marjorine Castillo

Theses and Dissertations

The relationship between Disruptive Behavior Disorders (DBD) in childhood and arrest during adolescence and emerging adulthood was explored in a community sample of 162 Puerto Rican children who lived in the South Bronx, NYC when first recruited. Results indicate a significant link between having DBD in childhood and later arrest.

Let Fall: Hysteria And The Psychoanalytic Act, Matthew W. Oyer

Dissertations, Theses, and Capstone Projects

This text proposes to examine the contemporary crisis of psychoanalysis by taking seriously feminist critiques of the theory’s phallocentrism, but arguing that the phallus cannot be metaphorically or metonymically replaced by any substitutive term, as most revisionist theories of psychoanalysis have sought to do. Castration is the central psychoanalytic concept, though the theory always seeks to cover it over. In order to develop a psychoanalysis that can confront this castration that is always repressed and yet, in its persistent return, continuously disrupts the continuity of psychoanalytic theory, a detour is proposed, returning to the origins of psychoanalysis and taking hysteria …

Repetition: A Study In Visual Form Using Selected Artworks By Edward Hopper, Lauren Irwin

Dissertations, Theses, and Capstone Projects

An attempt was made to study the form, function and patterns of repetition as expressed in visual form. A selected series of paintings by the artist Edward Hopper spanning a period of over thirty years served as the data set and was examined using an integrative approach combining both psychoanalytic theory and art criticism. The paper explored firstly, how unconscious fantasies shaped the content of Hopper's selected works, the function of the repetitive form of visual expression, and the possible psychic determinants. It was suggested that early childhood issues remained ongoing areas of conflict that continued to find repeated symbolic …

Ways Of Thinking About Illness Representations Of Cancer, Ian Zachary Pervil

Dissertations, Theses, and Capstone Projects

For people who have illnesses with vague or diffuse symptoms, such as systemic cancers that lack solid masses or tumors (e.g. leukemia), the process of adjustment appears more difficult than for those with clearly-defined symptoms. Dual systems theory attempts to understand this phenomenon by contending that individuals rely upon two modes of cognitive processing when conceptualizing illnesses: implicit, System 1 processes and explicit, System 2 processes. Those with illnesses whose symptoms lack specificity may rely more heavily on System 1 processing and have greater difficulty adjusting.

This study tested whether illness representations mediate the relationship between cancer patients' tumor status …

Delusional Disorder: Treatment And The Restoration Of Adjudicative Competence, Martin Kassen

Dissertations, Theses, and Capstone Projects

Delusional disorder has long been recognized in the psychiatric nomenclature, however, low prevalence rates and prevailing clinical views about the seemingly refractory nature of delusional disorder have restricted data on clinical treatment outcomes for this illness. Similar perspectives have been noted in forensic settings where minimal data is available to guide standards of care for incompetent to stand trial (IST) delusional pretrial defendants. Rationale. While the factors explicated in Sell provide guidelines for the involuntary medication of defendants found IST, numerous questions are left unanswered regarding the restorability of pretrial delusional detainees. The proposed study investigated the competency restoration rates …

The Effect Of Attitudes Towards The Death Penalty On Forensic Clinical Judgments Of Competency For Execution, Eugenia Garcia-Dubus

Dissertations, Theses, and Capstone Projects

Capital punishment has been a part of the American Justice System since colonial times. A brief historical overview reveals a general tendency towards the imposition of restrictions on who is eligible for the death penalty (DP). In a series of decisions, the Supreme Court has held that the execution of an incompetent inmate is unconstitutional, but the topic is controversial among mental health professionals. The likelihood of clinician attitudes towards the DP affecting judgments of competency for execution (CFE) is discussed in the context of existing literature. The vagueness of the current CFE standard is thought to contribute to this …

Burnout Is Associated With A Depressive Cognitive Style, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

We examined whether burnout is associated with a depressive cognitive style, understood as a combination of dysfunctional attitudes, ruminative responses, and pessimistic attributions. A total of 1386 U.S. public school teachers were included—1063 women (M_age: 42.73, SD_age = 11.36) and 323 men (M_age: 44.60, SD_age = 11.42). Burnout was assessed with the Shirom–Melamed Burnout Measure (SMBM). Dysfunctional attitudes were measured with the Dysfunctional Attitude Scale Short Form, ruminative responses with the Ruminative Responses Scale, and pessimistic attributions with the Depressive Attributions Questionnaire. For comparative purposes, depression was assessed using the 9-item depression module of the …

Burnout’S Prevalence Estimations: A House Of Cards?, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Elmariah et al. (2016) found that 65% of the internal medicine residents who were assessed suffered from burnout. We have 3 concerns about the conclusion. First, the authors used a cutoff score on a burnout measure that is problematic because (a) it is devoid of theoretical or clinical grounding and (b) burnout items were formatted in an unorthodox manner, and (c) including residents who responded "neutral" to a symptom item among those identified as burned out. Second, the authors identified as burned out residents who worked on the night float rotation although the data suggest otherwise. Third information on symptom …

On The Dead End Of Current Research On Burnout's Prevalence, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Dimou et al. (2016) concluded that >50% of surgeons experience burnout. For three reasons, we think that such conclusions are unwarranted. First, there are no consensual or binding diagnostic criteria for burnout. Second, recent research (e.g., Bianchi, Schonfeld, & Laurent, 2015) suggests that burnout is actually a depressive syndrome. Finally, we note that researchers’ recommendations about stress-reducing organizational changes often remain incantatory because they insufficiently consider the economic issues and macrosocial power relationships that can hamper the recommendations’ implementation. Current practices in burnout research have led to an accumulation of results, the clinical meaning of which is obscure.

Burnout-Depression Overlap: A Study Of New Zealand Schoolteachers, Renzo Bianchi, Irvin Sam Schonfeld, Eric Mayor, Eric Laurent

Publications and Research

We examined the overlap of burnout with depression in a sample of 184 New Zealand schoolteachers. Burnout and depressive symptoms were strongly correlated with each other (r = .73; disattenuated correlation: .82) and moderately correlated with dysfunctional attitudes, ruminative responses, and pessimistic attributions. All the participants with high frequencies of burnout symptoms were identified as clinically depressed. Suicidal ideation was reported by 36% of those participants. Three groups of teachers emerged from a two-step cluster analysis: “low burnout-depression,” “medium burnout-depression,” and “high burnout-depression.” The correlation between the affective-cognitive and somatic symptoms of depression was similar in strength to the burnout-depression …

Burnout And Depression: Label-Related Stigma, Help-Seeking, And Syndrome Overlap, Renzo Bianchi, Jay Verkuilen, Romain Brisson, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

We investigated whether burnout and depression differed in terms of public stigma and help-seeking attitudes and behaviors. Secondarily, we examined the overlap of burnout and depressive symptoms. A total of 1046 French schoolteachers responded to an Internet survey in November–December 2015. The survey included measures of public stigma, help-seeking attitudes and behaviors, burnout and depressive symptoms, self-rated health, neuroticism, extraversion, history of anxiety or depressive disorder, social desirability, and sociodemographic variables.The burnout label appeared to be less stigmatizing than the depression label. In either case, however, fewer than 1% of the participants exhibited stigma scores signaling agreement with the proposed …

Burnout And Depression In Psychiatric Residents, Irvin Sam Schonfeld, Eric Laurent, Pierre Vandel, Renzo Bianchi

Publications and Research

Kealy et al. (2016) found that 21% of psychiatric residents were suffering symptoms of burnout. A number of problems call that finding into question. First, the writers used a one-item measure to assess burnout. Second, mounting evidence suggests that burnout is a depressive syndrome. Third, unresolvable job stress is related to depression. Given burnout's overlap with depression and the diagnostic blur around burnout, research on the impact of job stress should connect with depression, which is nosologically well characterized and diagnosable using clinically validated instruments.

Burnout And Depression: Label-Related Stigma, Help-Seeking, And Syndrome Overlap, Renzo Bianchi, Jay Verkuilen, Romain Brisson, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

We investigated whether burnout and depression differed in terms of public stigma and help-seeking attitudes and behaviors. Secondarily, we examined the overlap of burnout and depressive symptoms. A total of 1046 French schoolteachers responded to an Internet survey in November–December 2015. The survey included measures of public stigma, help-seeking attitudes and behaviors, burnout and depressive symptoms, self-rated health, neuroticism, extraversion, history of anxiety or depressive disorder, social desirability, and socio-demographic variables. The burnout label appeared to be less stigmatizing than the depression label. In either case, however, fewer than 1% of the participants exhibited …