Clinical Psychology Commons^™

Service Engagement And Serious Mental Illness: The Obstacles And Barriers To Attendance In A Post-Treatment Recovery Outpatient Setting, Marisa Jeanne Friedman

PCOM Psychology Dissertations

This qualitative study examined the factors that affect treatment adherence and service engagement in individuals with serious mental illnesses (SMI). A semistructured interview was used to collect data from treatment adherent and treatment nonadherent adults with SMI. What factors make one more or less likely to disengage from treatment? What boundaries stand in the way of quality mental-health care, and how do adults with SMI overcome these barriers? Service engagement in the population with SMI in the study was explained according to three healthcare behavioral models, the health belief model, the network episode model, and the demoralization framework model. Data …

Improving Cognitive-Behavioral Therapy Homework Adherence With Change Talk And Commitment Language: A Cognitive Dissonance Perspective Of Behavioral Change, Robert J. Brecher

PCOM Psychology Dissertations

Adherence to homework assigned during cognitive-behavioral therapy (CBT) is an important factor contributing to positive outcomes. However, rates of adherence are poor, limited evidence supporting methods to improve adherence is limited. The current study aimed to develop and test an intervention designed to promote CBT homework adherence based on cognitive dissonance theory. Patients participating in outpatient CBT were randomly assigned to either an experimental or a control condition. In the experimental condition, participants engaged in an induced-compliance procedure eliciting change talk targeting the recommended homework activity. The control condition consisted of treatment as usual. Owing to limited sample size (n …

In Their Own Words: Perceived Experiences And Family Functioning Of Suicide Survivors Before And After Suicide Loss, Wendy Shallcross Lam

PCOM Psychology Dissertations

This research explored the unique experiences of relatives of individuals who have died by suicide, termed suicide survivors, in an in-depth fashion using qualitative methods. Through a semi-structured interview, the present study explored how families dealt with general stress prior to the experience of suicide loss, how they handled the loss of a family member to suicide, and what has been used to cope in the aftermath. A major focus was to explore whether or not the event of suicide dramatically altered family dynamics or if families continued a pre-existing interaction pattern established prior to the loss. The results revealed …

Adult Adhd And The Relationship Between Self-Reported Frequency Of Cognitive Distortions, Anxiety, And Depression, Craig Strohmeier

PCOM Psychology Dissertations

Cognitive-behavioral therapy for adults with ADHD often includes strategies to address cognitive distortions. Although identifying cognitive distortions as part of a causal chain related to disorders such as anxiety and depression has been well studied, limited research has focused on the relationship between ADHD and cognitive distortions. The goal of this study was to determine the nature of the relationship between ADHD, cognitive distortions, anxiety, and depression within a group of adult outpatients from an ADHD treatment center (N = 30). Results indicated that the severity of ADHD symptomatology, identified through a self-report scale, was significantly related to the self-reported …

Play And Treatment Outcomes In A Cognitive-Behavioral Program For Children With Anxiety: The Role Of Child Involvement And Collaboration, Enid S. Flagg

PCOM Psychology Dissertations

This study examined a mediation model of the relationship between play, process variables (child involvement and collaboration), and treatment outcome in a randomized clinical trial (RCT) of CBT for childhood anxiety disorders. Additionally, it explored the use of play in CBT for children. Participants (N=43; M age = 10.09) took part in a RCT which evaluated the effectiveness of an individual cognitive-behavioral treatment (ICBT) versus a family cognitive-behavioral treatment (FCBT), for childhood anxiety disorders. Archival data (videotaped treatment sessions) at a university based clinic for childhood anxiety disorders was coded for treatment interventions (play and cognitive-behavioral) and process variables (child …

Religious Cognitive Belief, Emotional Attachment, And Behavioral Commitment And Its Relationship With The Self-Regulation Of Adolescents, Leslie M. Chaundy

PCOM Psychology Dissertations

Research indicates that religion has played a vital role in the founding of the American nation as well as the American education system. However, over the years, religion has been taken from the educational realm and is no longer considered an important variable in impacting educational outcomes. This study examined the National Study of Youth & Religion dataset to further explore what was the most important component of religiosity (religious cognitive beliefs, emotional attachment, or behavioral commitment) in impacting academic and behavioral success. This study found that religious cognitive beliefs (belief in God and belief in moral absolutes) did not …

Youth Treatment Adherence At A Rural Community Mental-Health Clinic, Asma S. Ali

PCOM Psychology Dissertations

This study examined the relationships between youth and adult psychopathology, and sociodemographic factors and treatment adherence for youth attending outpatient treatment at a rural community mental-health clinic. “Adherence” was defined as attending more than five sessions, while “non-adherence” was defined as attending fewer than or equal to five sessions. Results revealed no significant differences between youth adhering or not adhering to treatment depending on the relation of caregiver to youth or the mode of transportation taken to the clinic. Furthermore, caregiver and youth psychopathology and caregiver’s estimated travel time to the clinic did not predict treatment adherence. Incidentally, examination of …

Examining Levels Of Posttraumatic Stress Disorder Symptoms And Treatment Attendance Amongst Children Living In Different Caregiver Settings, Danika S. Perry

PCOM Psychology Dissertations

This study examined symptoms of posttraumatic stress disorder (PTSD) and treatment attendance rates amongst a sample of children and adolescents who engaged in treatment for PTSD. The purpose was to determine if there was a difference in the level of PTSD symptoms or the number of sessions attended between those children living in foster care and those living with their primary non-foster caregiver(s). In addition, the treatment attendance rates of foster care children were examined to determine if there was a relationship between the level of the PTSD symptoms and the child’s treatment attendance rates. Results revealed that there was …

Cognitive Distortions As A Mediator Between Early Maladaptive Schema And Hopelessness, Keith Milligan

PCOM Psychology Dissertations

The purpose of the current study was to examine cognitive distortions as a mediator between maladaptive schema and hopelessness. With hopelessness and suicidal behavior so strongly correlated, an examination of hopelessness is critical. It was expected that this study would shed light on the role of distorted thinking as it relates to beliefs shaped from early maladaptive experiences and hopelessness. First, distorted thinking was not found to partially mediate the relationship between early maladaptive schema and hopelessness. This was likely a consequence of multicollinearity due to the use of a very proximal mediator. Second, a linear combination of the cognitive …

A Single Case Study Of Cognitive Remediation Therapy With An Adolescent With Disordered Eating, Carol Lynn Galiano

PCOM Psychology Dissertations

Picky eating is currently not included in the diagnostic classification system DSM-IV TR as a distinct category of eating disorders in childhood. It can reach clinical significance requiring intervention when it results in chronic nutritional inadequacies and/or harmful impact on social development or family functioning. Studies have shown that patients with eating disorders have difficulties with executive functioning. These findings have been used to develop an intervention based on cognitive remediation therapy (CRT) which targets thinking skills and their role in the development and maintenance of an eating disorder. To further investigate, this study assessed the efficacy of an 8-week, …

The Relation Between Self-Compassion, Body Image, And Mood: How Do Women Internalize Weight-Related Feedback?, Nicole Helverson

PCOM Psychology Dissertations

Objective: Body dissatisfaction has been identified as a risk factor for depression and eating pathology, whereas, self-compassion has been associated with higher quality of life. This study sought to examine the relationship between negative body image and self-compassion as risk or protective factors for weight and body composition related feedback mood changes.

Method: This deception study used a true-experimental, pre- and post-test design in a sample of 117 female graduate and medical students and college staff, aged 18 to 45 years; women diagnosed with eating disorders were excluded. After completing baseline questionnaires (including mood, body image, and self-compassion), …

Parents' Coping With Children's Newly Diagnosed Long-Qt Syndrome: A Qualitative Study Of The Function And Utilization Of An Online User Group, Allison Burns-Pentecost

PCOM Psychology Dissertations

Long QT syndrome is a sudden death syndrome that occurs in about 1 in 2,000 births. LQTS is caused by genetic mutations that affect the electrophysiology of the heart, resulting in a prolonged QT interval and possible cardiac arrhythmia, syncope or sudden death. Treatments include medications, implantable cardioverter defibrillators and activity restrictions. Little research exists regarding the psychosocial factors of the illness or the ways in which families cope with diagnosis and management of the chronic illness. The current study used archival data from an online user group. Participants were members of the group who discussed concerns related to LQTS. …

A Self-Regulated Learning Approach For The Remediation Of Behavioral Issues In Children With Attention Deficit Hyperactivity Disorder, Richard G. Allen

PCOM Psychology Dissertations

Behavioral-based interventions have long been demonstrated to be effective for
addressing behavioral difficulties for children with ADHD; however, such interventions do not always include explicit procedures to develop self-regulated learning. This is surprising, considering the strong evidence-based literature related to behaviorally-based self-management interventions. Considering the neurocognitive basis of ADHD, current assessment and intervention practices should emphasize the identification of self-regulatory deficits and evidence-based interventions to build such capacities. The current outcome study examined archival data from 12 cases to determine the clinical effectiveness of a function-based self-management intervention model for children diagnosed with ADHD in a community behavioral health program. …

Hope And Explanatory Style: A Study Of Outcomes In Inpatient Headache Sufferers, Angela L. Borsuk

PCOM Psychology Dissertations

Chronic daily headache (CDH) imposes significant burden on sufferers, among which are impaired quality of life, physical suffering, and financial cost. Psychological factors are known to play a considerable role in headache onset, maintenance, progression, and treatment outcome. Furthermore, headache-related disability cannot be accounted for by biological factors alone; both headache symptoms and psychological variables contribute to headache-related disability (Nicholson et al., 2007). Hope is an important predictor of improved health-related quality of life and has been linked with better outcomes for many diseases, disorders, and also in managing pain. Explanatory style, an individual’s style of making sense out of …

Predictors Of Attrition And Success In A Weight Management Program For Patients With Type 2 Diabetes, Kevin O'Leary

PCOM Psychology Dissertations

Aim: To examine the factors that lead to attrition and success in a weight management program for patients diagnosed with type 2 diabetes. The current study specifically examines the effect of quality of life, expected weight loss, self-esteem, and early weight loss on attrition and success rates. Methods: Archival data from a study conducted at the University of Pennsylvania Center for Weight and Eating Disorders were used. Seventy-nine overweight and obese subjects with type 2 diabetes participated in a lifestyle modification program over 40 weeks. Logistic regression analyses were performed to explore the relationship between early weight loss, expected …

Predictors Of Vicarious Trauma And Secondary Traumatic Stress Among Correctional Officers, Bertee Thomas Jr

PCOM Psychology Dissertations

The correctional setting is often dangerous and unpredictable. Correctional officers have the unique and often dangerous charge of overseeing a very volatile population. The job of a correctional officer can be very stressful and often contributes to emotional, physiological, and psychological distress. Correctional officers may be exposed to violence either directly or indirectly. One of the psychological reactions most commonly associated with violence is the development of trauma. This type of traumatic response may be triggered by direct or indirect exposure to traumatic stimuli. The focus of this study was to identify variables associated with secondary traumatic responses among correctional …

The Relationship Between Cognitive Distortions And Risk To Sexually Re-Offend In Adolescents: Comparing Three Levels Of Treatment, Christina D. Haldaman

PCOM Psychology Dissertations

This study examined the relationship between cognitive distortions, risk to sexually re-offend, and length of time in treatment, and psychopathy. This study investigated differential treatment effects across three different treatment modalities to gain a better understanding of cognitive distortions in the treatment of adolescent sexual offenders. Literature has theorized that a fundamental aspect of sex offender treatment is addressing these cognitive distortions. Archival data from an existing database were collected from 99 adolescent males between the ages of 12 and 18. Of these adolescents, 51.5% were Caucasian; 28.3% were Latino; 10% were African American; 8.1% were Bi-racial, and 2% were …

The Relationship Between Parental Stress, Cognitive Distortions, And Child Psychopathology, Daniel Kennedy

PCOM Psychology Dissertations

While there are a number of factors that may contribute to maladaptive parenting behaviors, parental stress has consistently been related to the increased risk of child maltreatment and, ultimately, the development of childhood. The question then is what drives parental stress and what are those key factors? Based on previous research, there are multiple parental, child, and environmental factors that lead to parental stress, but there is not a clear understanding of what initially drives parental stress. Based on cognitive behavioral models of stress and Abidin’s theory of parental stress, it is theorized that parental cognitions play an important role …

Clinician Factors In Psychotherapy Disparities For People With Intellectual Disabilities And Co-Occurring Mental Illness, Timothy Barksdale

PCOM Psychology Dissertations

An estimated 4.5 million Americans with intellectual disabilities (ID) have lived in the community for over twenty years now, following the closing of institutions that once isolated them from the public (Scott, Lakin & Larson, 2008). It has since become evident that this group has the same and more vulnerabilities of developing mental illness than the general public but often lack access to therapeutic service (Whitaker & Read, 2005). Unfortunately society’s lack of interaction with and education about this population has contributed to a number of misconceptions and fears. The hypothesized variables for the behavioral health disparity included: level of …

A Qualitative Study Of Recovery-Oriented Services In Inpatient Forensic Settings, Deanna Pecora Mellie

PCOM Psychology Dissertations

Recovery principles are currently guiding the transformation of mental health practice and policy in the United States (Anthony, 2000; Davidson et al., 2005; Davidson et al., 2006; Ralph & Corrigan, 2007). Although principles of recovery have become the focus of mental health care reform, they have just begun to enter the forensic system (Hillbrand & Young, 2008). This is important because the forensic state hospital population has experienced a significant growth, reportedly approximating 50 % of all beds in given states, while the general civil state hospital population continues to decline (Salzer et al., 2006). Furthermore, Hillbrand and Young (2008) …

Attention To Psychosocial Concerns Related To Lqts: A Survey Of Medical Providers, Elizabeth Conlin

PCOM Psychology Dissertations

Long QT Syndrome (LQTS) is a heritable condition characterized by syncopal episodes, arrhythmias, and sudden cardiac death in otherwise healthy individuals. Current research, although underrepresented, on the quality of life and psychosocial stressors indicate that some individuals experience depression and anxiety as a result of this chronic medical illness. A survey was created and administered to cardiologists and allied professionals, who offer medical services to LQTS patients, and belong to the Pediatric Arrhythmia and Congenital Electrophysiology Society (PACES). A Likert scale survey was developed for selfadministration and posted in an email for PACES members to complete voluntarily. This survey study …

Acculturation, Psychological Distress, And Family Adjustment Among Russian Immigrants In The United States, Eugene Dunaev

PCOM Psychology Dissertations

The purpose of this research was to investigate the effect of acculturation differences on psychological distress and family functioning in non-Jewish Russian immigrant families. Potential mediating effects of social support and parenting style and moderating effect of the child’s gender were investigated using regression analysis. The sample consisted of 80 Russian immigrant mother-child dyads residing in the northeast region of the U.S. The study included independent assessment of acculturation to American and Russian cultures. Results confirm the presence of associations between acculturative differences, psychological distress, and family problems. A mediational role of social support and parenting style on the impact …

An Evaluation Of A Group Nutritional Program In A Population Of Obese Individuals With Psychiatric Disabilities, Jamie Via

PCOM Psychology Dissertations

Individuals with serious mental illnesses are at high risk for obesity. The increased risk of obesity and comorbid medical conditions among individuals with serious mental illnesses has increased the need to seek and utilize effective treatments to address obesity in this population. In efforts to address the need for effective treatment, Eli Lilly and Company developed the Solutions for Wellness program. The aim of this study was to examine if the Solutions for Wellness nutritional program was effective in increasing wellness knowledge and increasing healthy lifestyle choices within a small sample of obese individuals with serious mental illnesses. The nutritional …

An Examination Of The Interactive Effects Of Mindfulness And Stress On Negative Health Habits In A Primary Care Population, Christina J. Dichiara

PCOM Psychology Dissertations

The overarching goal of this study was to better understand relationships between health habits, stress, and mindfulness. In doing so, this research examined the interaction of mindfulness with responses to stress as it affects negative health habits. There was also a psychometric development study conducted, using confirmatory factor analyses (CFA) to test the applicability of the two-factor model of the PHLMS to a primary care population. Data were collected from 198 adult patients in a primary care medical practice. Participants ranged in age from 18 to 89 years old, were 51% female, and 92% Caucasian. For CFA analyses, three fit …

Understanding The Thoughts And Attitudes Related To Participation In Youth Sports, Jeanine A. Johnson

PCOM Psychology Dissertations

The present study was designed to examine the thinking and attitudes that may be associated with elementary and middle school students participating in youth sports. Girls benefit physically, socially, and educationally from ongoing participation in sports. However, compared to boys, girls tend to start later, quit sooner, and participate less often in sports, despite the numerous advantages that athletics provides. The external barriers that contribute to girls’ decreased involvement in sports as they increase in age and grade are well researched. However, there is a lack of information about the possible cognitive variables related to a girls’ decision to play …

Interpersonal Difficulty, Affective Problems, And Ineffectiveness As Predictors Of Eating Disordered Attitudes And Behavior, Paige L. Marmer

PCOM Psychology Dissertations

The goal of this study was to better understand the relationships between psychological variables (i.e., interpersonal problems, affective problems, and ineffectiveness) and factors (i.e., previous hospitalizations, self-harm, and length of stay) related to disordered eating. A set of psychological variables and ED-related symptoms from the EDI-3 were examined within an inpatient eating disorder treatment center. Data were analyzed from an existing dataset consisting of 1,331 female participants, ranging in age from 14-65. Multiple linear regression analyses were conducted to test the hypothesis that the independent variables would predict ED-related symptoms (i.e., bulimia, body dissatisfaction, and drive for thinness). Regression models …

Factors Associated With A Longer Length Of Stay And Minimal Improvement In An Inpatient Headache Unit, Kristen Wenrich

PCOM Psychology Dissertations

The purpose of the present study is to identify psychological factors that predict a longer length of stay (LOS) and minimal improvement in a headache inpatient unit. Research shows that some psychological factors associated with headache disorders, such as anxiety, depression, and maladaptive coping skills, can complicate the disorder. The present study theorized that psychological factors that complicate the headache disorder would predict a longer LOS and minimal improvement. The present study used a quasiexperimental, prospective, cross-sectional survey research design, with multiple regression analyses. There was a total of 51 completed protocols. Of those completed protocols, 78% of participants were …

The Effects Of Cultural Competence And Racial Identity Development On The Working Alliance In African-American And Caucasian Counseling Dyads: A Preliminary Analysis, Peter J. Scoma

PCOM Psychology Dissertations

Multicultural considerations in behavioral healthcare rightfully remain a point of interest for practitioners, administrators and educators alike. Attention to culturally sensitive practice as a core competency for mental health practitioners has become rooted in academic curriculum and clinical trainings (Bussema & Nemec, 2006; Schottler et al., 2004). Despite this increased awareness of culturally competent practice, the results of these efforts are unclear as minority utilization of behavioral healthcare services continues to decline (Flaskerud, 2007). Racial biases and prejudice are still apparent in administrative and institutional settings that aspire to integrate cultural competencies into their organizations (Sue & Sue, 2007). Literature …

Traumatic Stress Responses In Mothers And Fathers To Pediatric Intensive Care Treatment: The Role Of Beliefs, Carla Cirilli

PCOM Psychology Dissertations

The aim of this study was to examine the prevalence of traumatic stress responses in parents of children treated in a pediatric intensive care unit, specifically parental beliefs about their child’s illness and their own coping self-efficacy as related to the severity of parental acute and posttraumatic stress. Archival data from a study conducted August 2004 through July 2005 in the Children’s Hospital of Philadelphia PICU were used. Two hundred and forty-five parents were assessed at 48 hours after admission, and 180 parents were assessed 3 months postdischarge. At Time 1, parents completed a screening measure assessing psychosocial factors and …

The Role Of Cognitive Insight, Hope, Self-Stigma, And Symptomatology In Predicting Treatment Engagement In Individuals Diagnosed With Serious Mental Illnesses, Patrick D. Boyle

PCOM Psychology Dissertations

Adherence to and engagement with treatment is a complex and multifaceted issue encountered throughout many medical and helping professions, particularly in the fields of psychology and psychiatry. Adherence to treatment/service engagement is especially an issue in the treatment of serious mental illnesses; studies have shown that up to 80% of individuals do not adhere to their treatment (Tait et al., 2003). This study investigated if cognitive insight, as measured by the Beck Cognitive Insight Scale ([BCIS] Beck et al., 2004), and clinical insight are related to the recovery concepts of hope and self-stigma as well as symptomatology in predicting treatment …