Clinical Psychology Commons^™

Youth With Adhd : The Impact Of The Clinical Anxiety On Neuropsychological Functioning, Elisabeth Jeanne O'Rourke

Legacy Theses & Dissertations (2009 - 2024)

Children with ADHD demonstrate significant deficits in certain executive functions (EFs), including visual and verbal working memory, inhibitory control, cognitive flexibility, and sustained attention. Similar deficits have been observed in children with anxiety, however there is less evidence that inhibitory control is worse in these youth. More recently, research has examined the EF of children with comorbid ADHD and anxiety (ADHD + ANX). There is evidence that suggests that anxiety can play both a protective as well as harmful role for EF in these children. The current study sought to explore whether the performance of children with ADHD + ANX …

Statistical Fit And Factor Structure Of The Food-Life Questionnaire In Emerging Adult Undergraduate Students, Arielle Wolinsky

Legacy Theses & Dissertations (2009 - 2024)

The Food-Life Questionnaire (FLQ) is a psychometrically sound measure of beliefs and attitudes towards food that was initially developed and validated for use with a general adult population; however, the psychometric properties of the measure have yet to be examined in an emerging adult population. The constructs captured by the FLQ are particularly relevant in emerging adulthood, because it is a time of increased risk for the development of disordered eating attitudes and behaviors. Using data from a large, demographically diverse sample of emerging adult undergraduate students (n = 679), the current study evaluated the fit of the original five-factor …

Developing A Clinician Self-Report Fidelity Measure For A Transdiagnostic, Evidence-Based Protocol At A Residential Eating Disorders Treatment Center, Jennifer M. Oswald

Legacy Theses & Dissertations (2009 - 2024)

Objective: Fidelity monitoring is a vital component of successful evidence-based practice implementation in routine treatment settings. However, resource-intensiveness and low clinician buy-in pose barriers to traditional observer-report monitoring, highlighting a need to explore the practical utility of self-report approaches. This study used a mixed-methods approach to (a) develop a self-report fidelity measure of a transdiagnostic evidence-based protocol in a residential eating disorders treatment center; (b) tailor the measure for optimal accuracy, acceptability, and ease of use; and (c) assess measure validity via convergence with observer ratings. Methods: N = 10 clinicians participated in cognitive interviewing to refine an initial draft …

The Evocative Effects Of Child Temperament On Parenting Stress And Behaviors, Laura Welch

Legacy Theses & Dissertations (2009 - 2024)

Despite recognition that parents contribute to child development, much remains to be clarified about ways child characteristics shape parents’ behaviors. For example, temperamental characteristics such as negative affectivity elicit more parenting stress (Oddi, Murdock, Vadnais, Bridgett, & Gartstein, 2013) and less effective parenting behaviors (Laukkanen, Ojansuu, Tolvanen, Alatupa, & Aunola, 2014). On the other hand, children’s effortful control is known to reduce psychological risks associated with negative affectivity (Gartstein, Putnam, & Rothbart, 2012) yet no studies have investigated whether this may consequently reduce parenting stress. Furthermore, stressed parents are more likely to engage in harsh parenting strategies (Martorell & Bugental, …

Coping With Medically Unexplained Physical Symptoms: The Role Of Illness Beliefs And Behaviors, Lisa M. Mcandrew, Nicole Sullivan, L. Alison Phillips, Wilfred R. Pigeon, Karen S. Quigley, Fiona Graff, David R. Litke, Drew A. Helmer, Joseph F. Rath

Educational & Counseling Psychology Faculty Scholarship

Background: Medically unexplained syndromes (MUS) are both prevalent and disabling. While illness beliefs and behaviors are thought to maintain MUS-related disability, little is known about which specific behavioral responses to MUS are related to disability or the way in which beliefs and behaviors interact to impact functioning. The purpose of the present study was to examine the relationship between illness beliefs and disability among patients with MUS, and assess the extent to which behaviors mediate this relationship. Methods: The study examined data from the baseline assessment of a multi-site randomized controlled trial (RCT). Participants were 248 veterans with MUS. Illness …

Ayahuasca's Antidepressant Effects Covary With Behavioral Activation As Well As Mindfulness, Maha N. Mian

Legacy Theses & Dissertations (2009 - 2024)

Ayahuasca, a plant-based hallucinogen that serves as a spiritual medicine in South America, has improved depression in at least one placebo-controlled clinical trial. Case studies suggest that dramatic behavioral changes often follow the Ayahuasca ceremony, but most explanations of antidepressant effects focus on observed changes in mindfulness. The present study investigated if both mindfulness and behavioral activation might also contribute to these anti-depressant effects. We surveyed individuals (N = 152) about their changes in depressive symptoms, Behavioral Activation, and mindfulness after an Ayahuasca experience. Mindfulness was strongly associated with reduced depression severity (r = -.670, p < .001), while behavioral activation was moderately linked (r = -.474, p < .001). Changes in depressive symptoms (Center for Epidemiological Sciences Depression Short Form [CES-D-10]) covaried with subscales from the Five Facet Mindfulness Questionnaire [FFMQ] and Experiences Questionnaire [EQ], confirming previous findings (beta = -.57, [95% CI (- 5.70) - (- 3.25)], p < .001). In addition, a modification of the Behavioral Activation for Depression Scale-Short Form [BADS-SF] accounted for significant unique variance in the improvements in depression (beta = -.16, [95% CI (-6.32) - (-0.08)], p < .05). These results suggest that changes in behavioral activation likely serve as an important mechanism underlying Ayahuasca’s antidepressant effects. Future clinical trials could benefit from tracking behavioral activation. In addition, a concerted focus on increasing valued, positive activities might enhance Ayahuasca’s anti-depressant effects.

Examining How Lesbian, Gay, And Bisexual Christian Clients' Perceptions Of Therapists' Cultural Humility Contribute To Psychotherapy Outcomes, Kelsey Anne Kangos

Legacy Theses & Dissertations (2009 - 2024)

Understanding the intersection between sexual and religious identity has important implications for mental health. The lesbian, gay, and bisexual (LGB) community is at high risk for major depression, generalized anxiety disorder, panic disorder, eating disorders, substance abuse issues, and poor self-esteem. Religious culture can further these risks when they create homophobic environments, resulting in LGB individuals‘ struggle to integrate religious and sexual identities (Sherry, Adelman, Whilde, & Quick, 2010).

Evaluating The Cognitive Profile Of Autism Spectrum Dsorder, Cortney Janicki

Legacy Theses & Dissertations (2009 - 2024)

Previous research on the cognitive functioning of individuals with autism spectrum disorder has mixed findings. It is generally understood that individuals with autism have a unique cognitive profile compared to their typically developing peers; however, capturing the special features of this cognitive profile has been difficult. The present study examines the cognitive profile of individuals with autism from multiple angles including overall Nonverbal and Verbal IQ score differences, differences in age, and differences in sex. The study evaluated data gathered from diagnostic evaluations for autism spectrum disorder performed in the Capital Region of New York. A total of 178 children …

An Examination Of The Relationship Between Cognitive And Metacognitive Factors And Bulimic Symptoms In Undergraduate Women, Lauren Eileen Ehrlich

Legacy Theses & Dissertations (2009 - 2024)

Rumination, a passive, perseverative, self-focused style of thinking about negative emotions and events, is a cognitive factor that has been empirically linked to a variety of harmful outcomes, particularly negative affect and depression. Recently, rumination has been proposed as a transdiagnostic risk factor that predicts numerous mental health conditions, including eating disorders. Taking into consideration the potential harm of rumination, researchers have sought to explain why individuals continue to ruminate. Metacognitive theories posit that negative and positive beliefs about rumination influence how frequently an individual ruminates and the consequences of repetitive, negative thinking. However, there is a dearth of evidence …

The Effect Of Social Support On Physiological Stress Reactivity In Youth Exposed To Community Violence, Rachel Clegg

Legacy Theses & Dissertations (2009 - 2024)

Research indicates that asymmetry between biological stress response systems is associated with psychological and physiological problems, which negatively affect child development. Asymmetry between these systems is common following childhood exposure to adversity. Furthermore, research shows that social support may act as a buffer against negative effects of stress, specifically for girls. The present study examines the role of social support in the relationship between biological systems among a sample of 49 youth (ages 9-12) with high levels of exposure to community violence. We measured perceived social support within the youth and exposed them to an in-lab psychosocial stressor. Hypothalamic-pituitary-adrenal axis …

Stress And Support In Health Service Psychology Students : Predictors Of Burnout And Vigor, Dylan Alexander Corp

Legacy Theses & Dissertations (2009 - 2024)

Students in health service psychology (HSP) training programs (i.e., doctoral programs in clinical, counseling, or school psychology) have reported experiencing greater burnout (i.e., energetic exhaustion) and lower vigor (i.e., energetic arousal) than typical workers. Given that greater burnout and lower vigor are associated with negative outcomes like poor health and client care, the purpose of the present study was to understand burnout and vigor in HSP students. Specifically, the present study sought to test the Conservations of Resources theory of stress (CORT) by replicating previous findings that threatening work-related stress and the supervisory working alliance (SWA) predicted HSP students’ burnout …

The Cognitive And Contextual Underpinnings Of Food Cravings : A Multi-Method Exploration, Martha Niemiec

Legacy Theses & Dissertations (2009 - 2024)

The notion of addiction pervades Western vernacular. While firmly established in the substance and drug literature, the concept of addiction is now increasingly associated with other ingested substances (coffee, chocolate, highly processed foods) and a range of compulsive behaviors (gambling, sex, online social networking, gaming). Addiction is associated with substantial morbidity and mortality, and a greater understanding of its etiology has significant public health implications. The physiological mechanisms thought to contribute to the development and maintenance of addiction (tolerance, withdrawal, and, possibly, craving) are widely considered hallmark features and primary treatment targets, while psychological and contextual factors are often underappreciated …

Longitudinal Relationship Between Onset Of Physical Symptoms And Functional Impairment, Lisa M. Mcandrew, Drew A. Helmer, Shou-En Lu, Helena K. Chandler, Sarah Slotkin, Karen S. Quigley

Educational & Counseling Psychology Faculty Scholarship

Patients with chronic physical symptoms (e.g., chronic pain) often have significant functional impairment (i.e., disability). The fear avoidance model is the dominant theoretical model of how the relationship between chronic physical symptoms and functional impairment develops and proposes a cyclical/bidirectional relationship. There has never been a definitive test of the proposed bi-directional relationship. The current study followed 767 Operation Enduring Freedom/Operation Iraqi Freedom soldiers from pre-deployment, when they were relatively healthy, to one year after deployment, when it was anticipated that symptoms would increase or develop. Over the four assessment time points, physical symptom severity consistently predicted worse functional impairment …

Concordance Of Illness Representations: The Key To Improving Care Of Medically Unexplained Symptoms, Lisa M. Mcandrew, Myrna L. Friedlander, L. Alison Phillips, Susan L. Santos, Drew A. Helmer

Educational & Counseling Psychology Faculty Scholarship

How can effective patient-provider relationships be developed when the underlying cause of the health condition is not well understood and becomes a point of controversy between patient and provider? This problem underlies the difficulty in treating medically unexplained symptoms and syndromes (MUS; e.g., fibromyalgia, chronic fatigue syndrome), which primary care providers consider to be among the most difficult conditions to treat.¹ This difficulty extends to the patient-provider relationship which is characterized by discord over MUS.¹ In this article, we argue that the key to improving the patient provider relationship is for the patient and provider to develop congruent …

Examining Types Of Motivation For Exercise In Relation To Pathological Exercise In Eating Disorders, Christina Scharmer

Legacy Theses & Dissertations (2009 - 2024)

Exercise can serve adaptive and maladaptive functions among individuals with elevated eating disorder (ED) pathology; however, little is known about how best to distinguish healthy and problematic exercise within this population. The present study aimed to inform this distinction by examining associations between intrinsic and extrinsic motivations for exercise, problematic exercise, and ED pathology in a sample of undergraduate students (N=347, 70% female) with threshold or sub-threshold EDs. All participants completed the Eating Disorder Examination Questionnaire (EDE-Q), the Exercise Motivation Inventory-2 (EMI-2), the Compulsive Exercise Test (CET), and the Exercise Dependence Scale (EDS). Preliminary exploratory factor analysis of the EMI-2 …

Examining The Role Of Impulsivity And Expectancies In Predicting Marijuana Use : An Application Of The Acquired Preparedness Model, Rachel Luba

Legacy Theses & Dissertations (2009 - 2024)

Impulsivity and substance use covary. Smith’s acquired preparedness model

Barriers To The Implementation Of Effective Transition Services For Adolescents With Autism Spectrum Disorder, Laura Corona

Legacy Theses & Dissertations (2009 - 2024)

In the years following high school, young adults with autism spectrum disorder (ASD) report lower rates of employment, post-secondary education, and independent living than do individuals with other disabilities (Newman et al., 2011). Though evidence-based practices exist to support individuals with disabilities generally during the transition from high school to post-school education or employment, little research has focused on evidence-based practices specifically targeting high school students with ASD (Test, Smith, & Carter, 2014). The present study utilized a mixed methods approach to investigate barriers to the implementation of effective transition services for adolescents with ASD. In Phase 1, parents, school …

Feasibility And Acceptability Of A Novel Tool For The Study Of Interpersonal Processes In Psychotherapy, Carly Max Schwartzman

Legacy Theses & Dissertations (2009 - 2024)

Psychotherapy process research methods often require extensive time and resources. Technology innovations have the potential to increase the efficiency of data collection and processing. A technology with potential applications for psychotherapy research is the Sociometric Badge (SB), which is a portable, palm-sized device that can simultaneously record session audio and data on social signals (e.g., speech patterns, body movement) in real-time and in varied contexts. This pilot study examined the feasibility and acceptance of these assessment devices in comparison with traditional audio recording equipment. Undergraduate students (N = 308; Mage = 19.16 years [SD = 1.4]; 50.3% female) were randomly …

Psychological Reactance Theory And Marijuana Craving, Melissa Nicole Slavin

Legacy Theses & Dissertations (2009 - 2024)

Psychological Reactance Theory (Brehm, 1966) asserts that people experience reactance (a retaliatory motivational state characterized by negative affect and resistant attitudes) when they perceive their autonomy is threatened. Reactance may lead to “boomerang effects”, where the individual is drawn toward the restricted object or behavior. Anti-marijuana (MJ) messages designed to discourage use might heighten reactance and inadvertently lead to greater craving for MJ and stronger intentions to use. The current online experiment determined that a message discouraging use of MJ evoked greater reactance in student and community member participants than a harm-reduction message. Additionally, reactance was associated with participants’ indirect …

Perseverative Thinking In Eating Pathology : Do Rumination Patterns Differ According To Symptom Type?, Lauren Eileen Ehrlich

Legacy Theses & Dissertations (2009 - 2024)

Rumination, defined as repetitive, negative, self-referential thinking, is strongly associated with the development and maintenance of many internalizing disorders. Although rumination was first examined within the depression literature, it is now considered a transdiagnostic risk factor that underlies many psychological disorders. Despite the negative consequences of engaging in these thought processes, rumination is a common cognitive process, perhaps due to positive metacognitive beliefs about the function of rumination. Recent work has demonstrated a link between eating pathology and a tendency to ruminate on eating disorder relevant themes, as well as beliefs about the usefulness of rumination. Our understanding of this …

High Healthcare Utilization At The Onset Of Medically Unexplained Symptoms, Lisa M. Mcandrew, L. Alison Phillips, Drew A. Helmer, Kieran J. Maestro, Charles C. Engel, Lauren M. Greenberg, Nicole Anastasides, Karen S. Quigley

Educational & Counseling Psychology Faculty Scholarship

Objective: Patients with medically unexplained syndromes (MUS) often do not receive appropriate healthcare. A critical time for effective healthcare is the inception of MUS. The current study examined data from a prospective longitudinal study of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans to understand the relationship of increasing physical symptom burden to healthcare utilization.

Methods: Data was examined from a prospective study of OEF/OIF veterans assessed before and one year after deployment (n=335). Physical symptom burden was measured with the Patient Health Questionnaire (PHQ-15). Analyses were conducted with polynomial regression and response surface analysis (RSA).

Results: Increases in physical symptom …

Telephone-Based Versus In-Person Delivery Of Cognitive Behavioral Treatment For Veterans With Chronic Multisymptom Illness: A Controlled, Randomized Trial, Lisa M. Mcandrew, Lauren M. Greenberg, Donald S. Ciccone, Drew A. Helmer, Helena K. Chandler

Educational & Counseling Psychology Faculty Scholarship

Background:The goal of this randomized clinical trial was to examine the efficacy of a cognitive behavioral stress reduction treatment for reducing disability among veterans with chronic multisymptom illness (CMI).Method: Veterans (N=128) who endorsed symptoms of CMI were randomized to: usual care (n=43), in-person (n=42) or telephone-delivered cognitive behavioral stress management (n=43). Assessments were conducted at baseline, three months, and twelve months. The primary outcome was limitation in roles at work and home (i.e., ‘role physical’). Reductions in catastrophizing cognitions were evaluated as a mechanism of action. Results: Intent-to-treat analyses showed …

The Common Sense Of Counseling Psychology: Introducing, Lisa M. Mcandrew, Jessica L. Martin, Myrna L. Friedlander, Katherine Shaffer, Jessica Y. Breland, Sarah Slotkin, Howard Leventhal

Educational & Counseling Psychology Faculty Scholarship

The goal of therapy is typically to improve clients’ self-management of their problems, not only during the course of therapy but also after therapy ends. Although it seems obvious that therapists are interested in improving client’s self-management, the psychotherapy literature has little to say on the topic. This article introduces Leventhal’s Common-Sense Model of Self-Regulation, a theoretical model of the self-management of health, and applies the model to the therapeutic process. The Common-Sense Model proposes that people develop illness representations of health threats and these illness representations guide self-management. The model has primarily been used to understand how people self-manage …

Less Engagement In Pleasure Activities Is Associated With Poorer Quality Of Life For Veterans With Comorbid Post-Deployment Conditions, Lisa M. Mcandrew, Held F. Rachel, Abbi Bhavna, Karen S. Quigley, Drew A. Helmer, Radhika V. Pasupuleti, Helena K. Chandler

Educational & Counseling Psychology Faculty Scholarship

Objective: The presence of multiple comorbid conditions is common after combat deployment and complicates treatment. A potential treatment approach is to target shared mechanisms across conditions that maintain poorer health-related quality of life (HRQOL). One such mechanism may be decrements in pleasurable activities. Impairment in pleasurable activities frequently occurs after deployment and may be associated with poorer HRQOL.

Method: In this brief report, we surveyed 126 Veterans who had previously sought an assessment at a Veterans Affairs post-deployment health clinic and assessed pleasurable activities, HRQOL, and post-deployment health symptoms.

Results: Forty-three percent of Veterans met our criteria for all three …

The Use Of A Gambling Accelerator To Reduce Risky Wagering In Problem Gamblers, James Broussard

Legacy Theses & Dissertations (2009 - 2024)

We evaluated an intervention based on a digital gambling accelerator to ascertain whether the accelerator is equally effective as brief Motivational Interviewing (MI) to change gambling behavior compared to a control group. Frequent scratch-off lottery gamblers recruited from the community (42 at-risk and 45 probable pathological gamblers) were randomly assigned to either a digital gambling accelerator intervention, brief MI, or a control task. After the interventions, participants were offered the opportunity to purchase authentic scratch-off tickets using a portion or all of their participant remuneration ($30). Neither of the two active interventions reduced the purchasing of scratch-off tickets. However, changes …

Repetitive Negative Thinking And The Maintenance Of Social Appearance Anxiety : An Experimental Manipulation Using Psychophysiological And Subjective Measurement, Erin Elizabeth Reilly

Legacy Theses & Dissertations (2009 - 2024)

Social appearance anxiety (SAA), which refers to fear of having one’s appearance negatively evaluated by others, has been posited to be a risk factor for the development of both eating pathology and social anxiety, but the processes through which this factor is maintained over time remain unclear. The current study aims to evaluate repetitive negative thinking (RNT) as a process through which SAA is maintained over time. Undergraduate females (N = 126) attended an appointment during which they were asked to complete self-report measurements, make an impromptu speech task related to appearance to induce SAA, were randomized to either engage …

Intra-Exposure Levels Of Anxious Arousal In A Lab-Based Exposure Intervention For Fear Of Public Speaking, Matteo Bugatti

Legacy Theses & Dissertations (2009 - 2024)

Background. Exposure therapy is effective for addressing social anxiety and public speaking fears, yet there are differences in suggested exposure strategies among empirically supported, manualized treatments. Manualized exposure strategies differ in the relative theoretical emphasis that underpins the specific procedural approach. Some approaches rely more heavily on the principle of habituation and formal cognitive restructuring; alternative approaches emphasize inhibitory learning and the individual's response to his/her own negative emotions, while promoting present-focused awareness. Innovative process methods can shed light on the similarities and differences between these approaches. Objectives. The goal of this study was to examine differences in anxious arousal …

Does What You Think You Feel, Impact What You Actually Eat? : An Examination Of Alexithymia, Interoceptive Awareness, And Loss Of Control Eating In Young Women, Lisa Marie Anderson

Legacy Theses & Dissertations (2009 - 2024)

Affect regulation theories posit that loss of control (LOC) and binge eating are maintained via an emotion regulation process, through which eating relieves negative affect and aversive mood states. LOC has been identified as a key binge eating characteristic associated with psychopathology and poor psychological outcomes. As such, maladaptive emotion regulation has been identified as a central risk factor for binge eating, as theories posit that individuals binge eat in response to negative mood states. However, empirical studies testing the link between induced negative mood and subsequent food intake in people with LOC and binge eating have yielded inconsistent findings. …

Eating Pathology In Sexual Minority Men : Evaluating An Objectification Theory Framework And The Role Of Identity Acceptance Concerns, Joseph Michael Donahue

Legacy Theses & Dissertations (2009 - 2024)

Research supports objectification theory as providing a framework for understanding how eating disturbances can develop in females. However, research among men—specifically sexual minority men who are disproportionally affected by such issues—is deficient. The current study sought to further assess whether the relations hypothesized by objectification theory were significant among sexual minority males. In addition, the current study explored the role of sexual orientation acceptance concerns as a moderating variable. To evaluate the current study’s aims, sexual minority males (N=208) were recruited online and asked to complete self-report measurements related to the objectification theory, eating pathology, and sexual orientation identity. Results …

A Brief Motivational Intervention For Marijuana Use In College Students, Vivian S. Hwang

Legacy Theses & Dissertations (2009 - 2024)

The prevalence of marijuana use has risen among young adults, and marijuana is