Clinical Psychology Commons^™

Moderators Of Subjective Distress And State Body Image During Open And Blind Weighing, Danielle E. Peters

Electronic Theses & Dissertations (2024 - present)

Objective: Body image disturbances are central to eating disorder (ED) pathology and are often addressed through exposure-based methods, such as open weighing. Open weighing is recommended in evidence-based ED treatments, but many clinicians and patients prefer blind weighing. It may be that pre-treatment patient characteristics may influence how distressed they feel by open and blind weighing. As such, the present study aimed to 1) compare how open and blind weighing impact subjective distress and state body image, and 2) examine whether self-weighing tendencies, body avoidance, body checking, body checking-related beliefs, intolerance of uncertainty, and ED psychopathology moderate the relationship between …

Well-Being Despite Adversity: A Portfolio Approach To Understanding Resilience Among Autistic Adults, Krista Rose

Electronic Theses & Dissertations (2024 - present)

Autistic individuals, across the lifespan, face increased exposure to stressful, adverse, and potentially traumatic experiences. These experiences pose a negative impact on well-being and quality of life. Prevailing risk-based models are anchored in deficit-focused conceptualizations and provide limited insight into autistic individuals’ experiences afteradversity, highlighting the important shift towards strength-based models within resilience. Although resilience is a crucial topic to promote positive outcomes and well-being among autistic individuals, existing research is limited, lacks an integrated framework, and has not yet been investigated in the context of stressful, adverse, or potentially traumatic experiences, despite the deleterious effect these experiences pose …

Weighing The Costs: Understanding How Eating Disorder History And Motivation For Use Impacts Experience On A Glucagon-Like Peptide-1 Receptor Agonist And Interest In Future Use, Kimberly M. Gauert

Electronic Theses & Dissertations (2024 - present)

Glucagon-Like Peptide-1 receptor agonist (GLP-1 RA) medications have become popular tools due to their effectiveness regarding weight loss and chronic disease management. The drastic increase in demand for these medications has led to widespread availability and an increase in “off-label” use for cosmetic purposes. Although GLP-1 RA medications have the potential to positively impact overall health and wellbeing, there is also concern regarding potential misuse of these medications by those with a history of eating disorder behaviors. However, few studies to date have examined the relationship between a history of eating disorder pathology, reason for GLP-1 RA use, and current …

Academic Satisfaction Of Graduate Students In Mental Health Professions: Mediating Roles Of Burnout And Engagement, Yu Ying Li

Electronic Theses & Dissertations (2024 - present)

Academic satisfaction for students is as critical to their retention and well-being as job satisfaction for working adults; however, it has received limited empirical attention particularly among graduate students in mental health-related programs. One of the barriers to mental health trainees’ satisfaction with their academic training is burnout. The current study evaluated the applicability of Study Demands-Resources (SD-R) framework (Lesener et al., 2020) to trainees. Specifically, this study examined the relations between study demands (i.e., perceived stress), study resources (i.e., supervisory alliance and social support), student burnout, student engagement, and academic satisfaction. It also tested if student burnout and engagement …

The Relationship Between Interoceptive Awareness And Eating Disorder Symptomatology, Madelyn G. Johnson

Electronic Theses & Dissertations (2024 - present)

Interoceptive awareness (IA; e.g., the ability to perceive and interpret internal bodily sensations) is increasingly recognized as central to eating disorder (ED) psychopathology, yet findings remain mixed regarding whether heightened IA is protective or maladaptive. Across two studies using a sample of 654 college students (Mage = 18.74, SD = 1.56; 46% White; 58% female) from a large northeastern U.S. university, we examined (1) how specific IA facets relate to ED symptom severity, and (2) whether anxiety sensitivity (AS) helps explain these associations. In Study 1, linear regressions predicting Eating Disorder Examination Questionnaire–7 (EDE-Q7) scores showed that nearly all MAIA-2 …

Disentangling Exercise Motivation From Eating Disorder Symptom Severity: A Dominance Analysis Of Compulsive Exercise Predictors, Sarah E. Siegel

Electronic Theses & Dissertations (2024 - present)

Compulsive exercise (CE) appears frequently in eating disorder (ED) samples but also occurs in nonclinical populations, raising the possibility that different motivational processes drive the behavior, perhaps depending on ED pathology. This study examined the relative contribution of exercise motives to CE while separating motivational variance from ED symptom severity. Undergraduate women (N = 376; 38.3% White, 28.8% Black) completed the Exercise Motivations Inventory–2 (EMI-2), the Compulsive Exercise Test (CET), and the 7-item Eating Disorder Examination Questionnaire (EDE-Q7). An exploratory factor analysis of EMI-2 subscales yielded four factors: Affective Well-being (Enjoyment, Revitalization, Stress Management), Health/Function (Ill-health Avoidance, Nimbleness, Positive Health, …

Improving Clinical Decision-Making: Reducing The Affect Heuristic In Substance Use Treatment, Corey M. Monley

Electronic Theses & Dissertations (2024 - present)

Therapists are at risk for engaging in the affect heuristic, which occurs when automatic emotional reactions influence clinical decision-making more than objective data about clients. Emotional reactions are common when treating clients using substances (CUS), but the influence of the affect heuristic on therapists’ clinical decision-making with CUS has yet to be quantified. This study investigated (1) the extent to which therapist trainees engage in the affect heuristic with CUS and (2) whether it can be reduced through brief cognitive science training. Graduate-level therapists (n = 130) were randomized to one of two conditions: brief online training involving …

Family Routines And Cognitive Emotion Regulation: The Role Of Harsh Parenting And Family Activities, Vidhi Jain

Electronic Theses & Dissertations (2024 - present)

Cognitive emotion regulation (CER), consisting of adaptive and maladaptive strategies, is a critical developmental process linked to various well-being outcomes across the lifespan. Family contexts such as daily routines, parenting, and engagement shape the development of emotion regulation. Existing literature generally links family routines to better CER outcomes (Selman & Dilworth-Bart, 2023), but has not yet investigated the impact of routines in adverse family environments. The present study examined whether harsh parenting and the frequency of shared family activities jointly moderate the relationship between family routines and adaptive and maladaptive CER. A sample of emerging adults (N = 210; …

Understanding The Intergenerational Transmission Of Risk And Resilience In Black Birthing Parent-Infant Dyads: Physiological Coregulation & Cultural-Contextual Factors, Annabelle Armah

Electronic Theses & Dissertations (2024 - present)

Symptoms of postpartum depression (PPD) are common, particularly for Black birthing parents who may face increased psychosocial risk during the perinatal period. Previous work has demonstrated that PPD can have significant ramifications not only for maternal wellbeing but for infants’ regulatory development. PPD may influence the concordance or mutual influence of biological states between parents and children (i.e., physiological synchrony). Physiological synchrony is thought to be implicated in the development of self-regulation and may be a mechanism through which PPD undermines infants’ emerging regulatory capacities. In Black families, cultural-contextual factors, like racism or cultural practices, may additionally shape birthing parent …

Investigating The Effects Of Values Clarification And Self-Compassion On Mental Health Self-Stigma And Willingness To Seek Psychological Help, Sara V. White

Electronic Theses & Dissertations (2024 - present)

Mental health self-stigma, or the harmful beliefs that one holds about his or her mental illness, is associated with psychological distress and acts as a significant barrier to help-seeking. Yet, self-stigma is notoriously resistant to change when targeted directly. To address such concerns, the present study examined the effects of two brief writing interventions, self-compassion and values clarification relative to a control condition, in reducing self-stigma and improving willingness and intentionality to seek psychological help. Additionally, the present study also explored the contributions of two theoretically relevant mechanisms—state self-compassion and psychological (in)flexibility—on self-stigma, and whether resistance to self-compassion negatively impacted …

Examining Ketamine's Differential Impact On Posttraumatic Stress Disorder Symptoms Using The Ptsd Checklist For Dsm-5, Samantha G. Gomez

Electronic Theses & Dissertations (2024 - present)

Posttraumatic stress disorder (PTSD) can be a debilitating and chronic condition. Current gold standard treatments are effective but face high dropout rates. Ketamine therapy is a promising and alternative treatment for those struggling with PTSD symptoms. Prior research has indicated significant reductions in overall PTSD symptoms. However, research regarding symptom-specific changes following ketamine therapy is limited. The present study aimed to extend previous work by MacConnel and colleagues (2025) regarding significant decreases in total PTSD Checklist for DSM-5 (PCL-5) scores following ketamine treatment at an outpatient ketamine center, as well as examine potential symptom-specific changes. A final sample of 142 …

Racial Bias In Collateral Report Of Adhd Symptom Endorsement, Teresa Mejia

Electronic Theses & Dissertations (2024 - present)

Attention-Deficit/Hyperactivity Disorder (ADHD) is the most frequently diagnosed mental health condition among children in the United States. However, prevalence rates in the diagnosis and treatment of ADHD are unequal across populations. Specifically, the literature has demonstrated consistent variability in symptom endorsements and diagnosis dependent on a child’s demographic factors (i.e., race, gender, age). A diagnosis of ADHD requires that the diagnostic criteria be met in at least two aspects of a child's life, usually the school and home environments. As such, teacher reports are commonly used in the assessment of ADHD for children and adolescents. Given the challenges in obtaining …

Perceptions Of Psilocybin-Assisted Psychotherapy And Standard Interventions For Nicotine Cessation, Philip Kamilar-Britt

Electronic Theses & Dissertations (2024 - present)

Clinical trials suggest potential therapeutic utility of psilocybin-assisted psychotherapy (PAP) for nicotine cessation. In response to promising outcomes, research into PAP for nicotine dependence is growing. However, attitudes towards PAP among the general public, especially daily nicotine users, remains understudied. To address this knowledge gap, we recruited daily nicotine users (N=534) to complete an anonymous online survey with questions on demographics, nicotine use, prior history with psychedelics, and attitudes towards PAP and standard interventions for nicotine cessation. As hypothesized, daily nicotine users were more familiar with standard interventions and rated them more favorably than PAP. Despite differences in treatment attitudes, …

Development And Validation Of The Mealtime Behaviors Self-Report Questionnaire, Taylor Rae Perry

Electronic Theses & Dissertations (2024 - present)

Disturbances in eating are a hallmark feature of eating disorders (EDs). However, these disturbances extend beyond dietary patterns, as clinicians have long observed aberrant mealtime behaviors in individuals with EDs. Despite these observations, research on aberrant mealtime behaviors has been limited to a small case study of individuals with anorexia nervosa. Clinically, however, individuals across all ED diagnoses appear to exhibit these behaviors. Notably, there is currently no existing measure designed to assess aberrant mealtime behaviors. Developing such an assessment could provide clinicians with valuable information to inform mealtime interventions. Therefore, the present study aimed to examine the prevalence of …

Integration Of Theoretical Frameworks For Problematic Exercise: Toward A Comprehensive Model Of Maladaptive And Adaptive Exercise, Christina M. Sanzari

Electronic Theses & Dissertations (2024 - present)

Exercise can promote health and well-being, and yet a proportion of individuals who exercise develop a maladaptive relationship with physical activity. Problematic exercise is often associated with significant impairment and psychological distress, yet a consensus has not been reached regarding how problematic exercise should be conceptualized. The literature distinguishes between primary exercise dependence, or excessive exercise driven by its intrinsic reinforcement, and secondary exercise dependence, or excessive exercise driven by compensatory motivations related to weight and shape concerns. However, to date, little is known about the prevalence and nature of exercise dependence in the absence of eating pathology. This incongruity …

Risk Factors For Executive Functioning Development In Preschool Children With Type 1 Diabetes, Victoria L. Ledsham

Electronic Theses & Dissertations (2024 - present)

Links between Type 1 diabetes (T1D) and decreased cognitive functioning in children are well documented, but research on executive functioning (EF) in this population is more limited. Multiple T1D-related risk factors (e.g., hypoglycemia, hyperglycemia, glycemic variability, diabetic ketoacidosis) for EF have been established throughout the literature, but their individual effects have been difficult to determine given their interrelated nature. In result, cumulative risk has been proposed as a more robust predictor of EF differences in children with T1D. Moreover, despite the importance of early T1D onset as a risk factor for EF impairment, no studies have previously investigated EF in …

Concurrent Parasympathetic Synchrony In Romantic Couples Exposed To Childhood Maltreatment Subtypes, Kate L. Senich

Electronic Theses & Dissertations (2024 - present)

Early responsive caregiving hones children’s physiological systems and subsequently supports social interactions (Feldman, 2007; Porges 2001; Steelman et al, 2002). Conversely, mis-attuned interactions with caregivers, such as exposure to maltreatment subtypes, might hinder social engagement capacities at both behavioral and biological levels (Kim & Cicchetti, 2004; Sheridan & McLaughlin et al., 2014). These early adverse influences endure across development and can affect behavioral and physiological interactions with romantic partners (Mayo et al., 2021; River et al., 2020; Zamir, 2022). Specifically, temporally coordinated patterns of physiological responses between partners (i.e., synchrony) are linked with important relationship behaviors, including conflict behaviors …

Does Type Of Metta Phrase Impact The Acceptability And Utility Of Loving-Kindness Interventions: An Experimental Evaluation, Shannon B. Underwood

Electronic Theses & Dissertations (2024 - present)

Loving-kindness (metta) meditation (LKM) is a widely utilized self-compassion intervention with numerous biopsychosocial benefits. Yet a smaller, emerging body of evidence suggests that LKM is difficult and various barriers impact its accessibility and effectiveness. Relational Frame Theory provides a behavioral and contextual perspective of language and cognition that may help clarify how LKM may yield receptivity or rejection of the practice itself. Prior research examining the role of language in LKM identified specific metta phrases more likely to evoke a coordinated (i.e., sameness/agreement) or oppositional (i.e., rejection/lacking) response, and found that indices of psychological suffering predicted oppositional responding (Underwood, 2023). …

Social Communication Skills Moderate The Relationship Between Family Quality Of Life And Parenting Stress, Hanna Kent

Electronic Theses & Dissertations (2024 - present)

Parents of newly diagnosed autistic children face elevated levels of parenting stress due to the unique demands associated with raising an autistic child and the challenges of navigating the early intervention systems which often impact their family functioning (Rivard et al., 2023). This study aimed to investigate how autistic traits and demographic variables are associated with parenting stress and family quality of life (FQOL) in caregivers of recently diagnosed autistic children. Data were obtained from 118 caregivers enrolled in a family education program within one year of their child’s autism diagnosis. Measures included the Parenting Stress Index, Short Form, The …

Relational Mechanisms In Residential Eating Disorder Treatment: A Moderated Mediation Analysis, Bethany Ah Crawford

Electronic Theses & Dissertations (2024 - present)

Background. Eating Disorders (ED), previously described as a “disease of disconnection,” appear to have differing trajectories of treatment and behavior change based, in part, on feelings of connectedness to others during and outside of treatment. Patient experience of Relational Connectedness is not well-explored in ED treatment compared to other diagnoses but may be a valuable mechanism of change. Interpersonal problems are also known to impact outcome trajectories. Patients high in interpersonal and relational difficulties exhibit negative compensatory behaviors such as avoidance and hostility, which can deleteriously affect building a trusting relationship. Individual difference variables likely play a role in relationship-outcome …

A Strength-Based Approach To Understanding The Impact Of Experiences Of Discrimination Related To Identity-Based Stressors On Disordered Eating Among A Sample Of Sexual And Gender Diverse Individuals, Susana Cruz Garcia

Electronic Theses & Dissertations (2024 - present)

Empirical research investigating eating disorder (ED) behaviors among sexual and gender minorities has grown substantially in recent decades, though notable gaps call for further work to clarify mixed findings regarding the experiences of this heterogeneous population. This study sought to add to our understanding of disordered eating behaviors in LGBTQIA+ participants, with a specific focus on differences between lesbian and gay (LG) versus bisexual, transgender, queer, intersex, asexual, and other identities (BTQIA+), with the latter group remaining especially underrepresented in the literature. Study aims were firstly, to quantify ED incidence and the frequency of experiences of identity-based discrimination in sexual …

Contributions Of Birthing People’S Prenatal Parasympathetic Nervous System Functioning And Postnatal Sensitivity On Infant Temperament, Amanda M. Flagg

Electronic Theses & Dissertations (2024 - present)

Grounded in developmental psychobiology, this research aimed to elucidate how birthing people’s physiological regulation during pregnancy may shape the early emergence of socioemotional development in early infancy. The present study examined how birthing people’s prenatal parasympathetic nervous system (PNS) activity, specifically baseline high-frequency heart rate variability (HF-HRV) and HF-HRV withdrawal, and postnatal sensitivity contributes to infant temperamental reactivity at six months of age. The study aimed to clarify early developmental mechanisms through which birthing people’s PNS shapes emerging infant temperament. Data were drawn from a longitudinal cohort of Black and African American birthing people, a population underrepresented in psychophysiological research, …

Clinical Experiences In Conducting Empirically Supported Treatments For Insomnia, Sondra S. Tiab

Electronic Theses & Dissertations (2024 - present)

Controlled research shows that cognitive-behavioral therapy (CBT) is an effective treatment for insomnia, yet clinician experiences with applying CBT in routine settings has received limited attention. This study replicated and extended upon the Two-Way Bridge initiative (Goldfried et al., 2014), which aimed to establish a dialogue between researchers and clinicians on the identification of variables that promote and interfere with the effectiveness of evidence-based therapies. This survey study asked clinicians to identify variables they have encountered that make it challenging to implement CBT and related interventions for insomnia. N = 182 clinicians completed an online survey on typical assessment practices, …

A Laboratory-Based Experimental Evaluation Of The Effects Of Values Clarification And Valued Contingencies On Problematic Smartphone Use Behavior, Max Roberts

Legacy Theses & Dissertations (2009 - 2024)

Problematic smartphone use (PSU) is a growing problem in need of effective interventions. The psychological inflexibility (PI) model of Acceptance and Commitment Therapy (ACT) provides a transdiagnostic framework through which PSU can be conceptualized and intervention processes identified. One sub-process of the PI model – values clarity – is theoretically important in maintaining and ameliorating addictive behaviors like PSU. The present study tested the acute impact of values clarification on PSU behavior. Undergraduates (N = 130; 50% female) who self-identified as having problems with their smartphone use and valued helping children in need were randomized into one of three conditions …

Clarifying The Relationship Between Weight Suppression And Eating Psychopathology: The Role Of Fear Of Weight Gain And Intolerance Of Uncertainty, Danielle Elizabeth Peters

Legacy Theses & Dissertations (2009 - 2024)

Objective: Weight suppression (WS), the discrepancy between a person’s highest and current body weight, is largely associated with eating pathology in clinical and non-clinical samples. WS may put individuals in a biobehavioral bind: biological factors may drive the body toward weight regain, which in turn drives eating disorder (ED) behaviors in an attempt to prevent weight regain. However, few studies have examined psychological factors that may play a role in the biobehavioral bind of WS. As such, the present study aimed to (1) whether WS was associated with fear of weight gain (FOWG) and intolerance of uncertainty (IU) and (2) …

Feasibility And Acceptability Of A Self-Paced, Online Workshop Targeting Self-Compassion Skills For Emerging Adults With Disordered Eating, Arielle Wolinsky

Legacy Theses & Dissertations (2009 - 2024)

The present paper includes two studies that explored the relevancy of self-compassion to emerging adults, expectancies of having a self-compassion mindset on disordered eating, and the prospective and concurrent acceptability and feasibility of a self-paced, online workshop targeting self-compassion skills for emerging adults with disordered eating. Study 1 was a cross- sectional study examining emerging adults’ understanding of self-compassion, expectancies of having a self-compassion mindset on disordered eating, and the feasibility and prospective acceptability of a proposed self-paced, online workshop targeting self-compassion skills for emerging adults with disordered eating. Study 1’s findings were incorporated into the design and implementation of …

Social Determinants Of Health As A Correlate Of Patient And Clinical Characteristics In Community Mental Health Care, Syed Aajmain

Legacy Theses & Dissertations (2009 - 2024)

Background: Social determinants of health (SDOH) are conditions in the environment in which people live and work that influence health risks and outcomes. These include a range of social, economic, psychosocial, and behavioral factors such as food insecurity, hazardous housing, and financial resource strain. Such factors account for variance in numerous health outcomes, including life expectancy and quality of life. Studies on university student populations also demonstrate that unmet SDOH needs are associated with poorer self-assessed general health as well as higher anxiety and depression symptom severity. However, little is known about SDOH in the context of routine outpatient psychotherapy …

Outcome-Based Patient-Therapist Matching Implementation: A Study Of Clinician Beliefs And Attitudes, Ashleigh Smith

Electronic Theses & Dissertations (2024 - present)

Background. Implementation science aims to identify methods that support the adoption of evidence-based practices (EBPs), including measurement-based care (MBC) and MBC-informed patient-therapist matching. Examining clinician attitudes can elucidate potential barriers to implementing EBPs, and attitudinal differences may exist across groups of therapists. In the context of a patient-therapist matching implementation project, this multi-method study investigated the relationship between clinician characteristics, attitudes toward EBPs/MBC, and implementation climate. Method. A sample of N = 72 therapists completed measures of demographic and clinical characteristics, attitudes toward EBPs, perceptions of implementation climate, and attitudes toward monitoring and feedback. A subset of N …

The Transdiagnostic Role And Measurement Of Cognitive Inflexibility Across Understudied Eating Disorder Groups: A Multi-Method Investigation, Mckenzie Miller

Electronic Theses & Dissertations (2024 - present)

Cognitive inflexibility is an established transdiagnostic executive function deficit that maintains a wide array of psychiatric conditions. Eating disorders (ED) are serious, life-threatening conditions that remain underdiagnosed and understudied across diverse demographic groups. There is growing evidence for a role of cognitive inflexibility in driving hallmark ED symptoms, particularly in anorexia nervosa. Treatments targeting cognitive inflexibility may improve the currently poor outcomes of these conditions. To date, the role of cognitive inflexibility remains to be examined across demographically and diagnostically diverse ED groups. The first two studies presented here examine associations between cognitive inflexibility and symptom presentation in two relatively …

Development And Initial Validation Of The Supervisor Responsiveness Scale, Ramon Garcia

Electronic Theses & Dissertations (2024 - present)

Theoretically, responsiveness to the emergent needs of supervisees and clients is the primary means by which clinical supervisors help trainees become effective psychotherapists (Friedlander, 2012). To advance understanding and research on this aspect of supervision, the Supervisory Responsiveness Scale (SRS) was developed and assessed psychometrically.

First, 35 items reflecting trainees’ perceptions of their supervisor’s responsiveness, as defined by Friedlander (2012), were developed and rated for clarity, face and content validity by a panel of 12 experienced supervisors. After the item pool was refined based on these ratings, 216 supervisees representing all training levels rated each item on a 1 ( …