Clinical Psychology Commons^™

Casualties Of Racism: Racial And Ethnic Discrimination And Suicidal Thoughts And Behaviors Among Racial And Ethnic Minority Emerging Adults, Lillian Anais Polanco

Dissertations, Theses, and Capstone Projects

The evidence demonstrating that experiences of racial/ethnic discrimination is detrimental to the mental health of racial/ethnic minority youth is unequivocal. What remains unclear, however, is whether racial/ethnic discrimination increases vulnerability for suicidal thoughts and behaviors in particular, and if so, what are the underlying mechanisms to explain this relation. Drawing upon the Race-based Traumatic Stress Theory (Carter, 2007), which suggests that some individuals may experience racial/ethnic discrimination as a traumatic stressor, and thus, eliciting a traumatic stress response, the present study examined posttraumatic stress reactions (i.e., posttraumatic stress, depression, dissociation, stress sensitivity) as mediators in the relation between racial/ethnic discrimination …

Linking Hostile/Helpless Maternal Representations In Pregnancy And Later Child Protection Involvement: A Pilot Study, Madeleine Terry

Dissertations, Theses, and Capstone Projects

The present pilot study examined whether there are reliable indices in the narratives of pregnant women that can be used to identify child abuse and neglect potential before the birth of the child. The Hostile/Helpless (HH) Classification system (Lyons-Ruth et al., 1995-2005), which detects mental states associated with trauma, disturbances in early attachment, and severe pathology, was adapted for use with the Pregnancy Interview (PI), a semi-structured clinical interview (Slade, 2003) that assesses a woman's emotional experience of pregnancy, and quality of her developing relationship with her baby. The study sample was drawn from a replication study of the Minding …

Detecting Cognitive, Functional And Behavioral Response To Donepezil In Alzheimer’S Disease: The Role Of Attention Tasks, Clara Vila-Castelar

Dissertations, Theses, and Capstone Projects

Introduction: Cholinesterase Inhibitors (ChEIs) used in Alzheimer’s Disease (AD) have modest effects, heterogeneous treatment response, and it has been difficult to detect treatment response. The standard research and clinical outcome measure, the Alzheimer’s Disease Assessment Scale-Cognitive subscale (ADAS-Cog) aggregates multiple cognitive domains, and has limited sensitivity. We propose that because acetylcholine is directly linked to the cognitive domain of attention, and ChEIs increase available acetylcholine, measures of attention under high-load conditions could predict long-term cognitive, functional and behavioral response, and thus, unlike global measures, could be sensitive to treatment efficacy.

Method: We conducted a longitudinal, open label donepezil trial …

Subthreshold Ptsd And Associated Psycholgical Distress In Trauma Exposed Male And Female Veterans, Matthew A. Southard

Dissertations, Theses, and Capstone Projects

Post-Traumatic Stress Disorder (PTSD) represents the upper end of a stress-response continuum to traumatic events, rather than a discrete pathological syndrome (Ruscio, et al., 2002). Individuals with PTSD report higher levels of anxiety, depression, anger, aggression, and adjustment difficulties compared to non-traumatized individuals (Ginzburg, Ein-Dor, & Soloman, 2009; Thompson et al, 2011; Novaco and Chemtob, 2002; Kotler et al, 2001; Orth & Wieland, 2006). Subthreshold PTSD represents a less severe range on the stress-response continuum and these individuals may experience similar rates of symptoms of anger, aggression, and depression as those with full-PTSD (Jakupcak, et al., 2007; Mylle & Maes, …

Bias-Motivated Homicides: Toward A New Typology, Lindsey Sank Davis

Dissertations, Theses, and Capstone Projects

Despite significant progress towards equal protection under the law for women, LGBT individuals, and people of color in the United States, hate crime remains a pervasive problem, and rates appear to have increased in recent years. Bias-motivated homicide – arguably the most serious form of hate crime – is statistically rare but may have far-reaching consequences for marginalized communities. Data from the Uniform Crime Reports and the National Crime Victimization Survey have suggested that, on average, fewer than 10 bias-motivated homicides occur in the United States per year; however, data from open sources indicate that the rate of bias-motivated homicide …

A Qualitative, Phenomenological Study Of Psychotherapists’ Perception Of Ethnic Identity Shifts In Immigrant Patients, Ricardo Corbetta

Dissertations, Theses, and Capstone Projects

This qualitative phenomenological paper investigates ethnic identity shifts in immigrant patients by interviewing nine psychotherapists who work with immigrant patients in New York City. It takes into consideration the privileged and biased perspective of the therapist’s subjective experience of their patient’s ethnic identity shifts. The study argues that ethnic identity affiliation is relevant and worth investigating during the psychotherapeutic work, as it can shed light on crucial aspects of one’s emotions, thoughts and behavior.

The Prediction Of Personal Narrative On Features Of Recovery Among People With Schizophrenia-Spectrum Disorders, Beth Vayshenker

Dissertations, Theses, and Capstone Projects

Among individuals with schizophrenia, research has demonstrated that in addition to the positive and negative symptoms characteristic of schizophrenia, the diminishment of the self also represents an important aspect of the illness (Lysaker & Lysaker, 2010). Research has confirmed that the self-experience, particularly as measured by the telling of one’s life story through the Scale to Assess Narrative Development (STAND), is linked to a variety of subjective and objective recovery outcomes from schizophrenia. While this association has been documented in different research studies, less is known about the ways in which personal narrative functions to predict recovery outcomes in a …

Multimodal Depression Detection: An Investigation Of Features And Fusion Techniques For Automated Systems, Michelle Renee Morales

Dissertations, Theses, and Capstone Projects

Depression is a serious illness that affects a large portion of the world’s population. Given the large effect it has on society, it is evident that depression is a serious health issue. This thesis evaluates, at length, how technology may aid in assessing depression. We present an in-depth investigation of features and fusion techniques for depression detection systems. We also present OpenMM: a novel tool for multimodal feature extraction. Lastly, we present novel techniques for multimodal fusion. The contributions of this work add considerably to our knowledge of depression detection systems and have the potential to improve future systems by …

The Nature Of Defenses Used By School-Aged Children With Adhd, Laurie G. Slodounik

Dissertations, Theses, and Capstone Projects

This study sought to develop a more nuanced clinical picture of children with ADHD by examining the relationship between their emotional dysregulation and their use of defense mechanisms—the unconscious mental processes that guard against strong emotions. Children’s responses to the Thematic Apperception Test (TAT) were examined for evidence of defense mechanisms using an empirically validated scale, the Defense Mechanism Manual. The study employed a mixed between-within nonequivalent group design to examine the responses of 37 children ages 7-10. It was hypothesized that children with ADHD would use more frequent and more immature defenses than their peers without the disorder. Additionally, …

Neural Hypervigilance In Trauma-Exposed Women, Seungyeon A. Yoon

Dissertations, Theses, and Capstone Projects

Trauma-exposed people often experience hypervigilance, which is a tonic condition of elevated alertness and excessive scanning for potential threat. A cardinal feature of hypervigilance is that no actual threat is needed to evoke or maintain the over-alertness and heightened affective response. However, most neuroimaging research in trauma to date has only focused on reactivity to an actual threat. Thus, the overarching aim of this dissertation was to investigate neural signatures and salivary markers of post-trauma hypervigilance in the absence of threat that can cause impairment in daily functioning and contribute to developing other trauma-related symptoms such as heightened threat reactivity. …

The Development Of Affect And Defense In Childhood And Adolescence, Kari Gray

Dissertations, Theses, and Capstone Projects

The purpose of this study is to further determine the nature of the relationship between how defense mechanisms affect and are affected by the ways in which feelings are modulated and regulated in children and adolescents. This study has been built upon an IRB-approved research project conducted under primary investigator Steven Tuber, Ph.D. at the Psychological Center and the City College of New York (From Child Assessment to Child Treatment; A Preliminary Investigation). The study data are pre-existing, collected from 5 – 16 year old children and adolescents presenting for treatment and/or assessment at the Psychological Center, a …

The Relationship Among Reflective Functioning, History Of Childhood Trauma, And Symptoms Of Depersonalization And Derealization In Patients With Panic Disorder, Sarah J. Kay

Dissertations, Theses, and Capstone Projects

This exploratory study examined the relationship among reflective functioning (RF), history of childhood trauma, and symptoms of depersonalization and derealization in an attempt to provide a more nuanced clinical picture of panic disorder.

All analyses were conducted using baseline data collected as part of the “Dynamic therapy vs. CBT for Panic Disorder” study at Weill Cornell Medical College and the University of Pennsylvania. The study participants were 201 patients with a primary DSM-IV diagnosis of panic disorder with or without agoraphobia who completed the parent study.

While there was a significant relationship found between trauma and panic severity at one …

Impact Of Neurodevelopmental Genes On The Trajectory Of Adhd Severity: A Pilot Study, Agnieszka Mlodnicka

Dissertations, Theses, and Capstone Projects

Attention-deficit/Hyperactivity Disorder (ADHD) is a chronic neurodevelopmental disorder characterized by symptoms of inattention and hyperactivity, and is associated with delays in neural development. To assess the association of genes involved in neurodevelopment with symptoms and trajectory of ADHD, saliva was collected and genotyped from 145 participants from a longitudinal study of preschoolers who were followed annually for 7 years. We examined four single nucleotide polymorphisms (SNPs) in genes associated with neurodevelopment: neuregulin-1 (NRG-1; SNP rs3924999), neurotropin-3 (NT-3; SNP rs6489630), brain-derived neurotrophic factor (BDNF; rs6265), and regulator of G protein signaling 4 (RGS4; rs951439). Hierarchical linear modeling revealed that neuregulin-1 and …

Cortical Thickness Abnormalities Within The Salience And Reward Networks In Older Depressed Adults With Apathy, Monique A. Pimontel

Dissertations, Theses, and Capstone Projects

Background and Significance: Apathy is a common comorbidity in late-life depression. Among older depressed adults, apathy is associated with a number of adverse outcomes, including increased disability, comorbid illness, and mortality. The etiological substrates of apathy in late-life depression nonetheless remain poorly understood, and little is known about its optimal treatment. To this end, the aim of the current study was to examine cortical abnormalities within the salience (SN) and reward networks (RN), two brain systems involved in the processing of incentive salience that may underlie the syndrome of apathy in older depressed adults.

Methods: We examined the association between …

Preventing Sexual Violence Where It Most Often Occurs: An Investigation Of The Situational And Structural Components Of Child Sexual Abuse In Residential Settings, Nicole Colombino

Dissertations, Theses, and Capstone Projects

Given that sex offenders tend to perpetrate crimes against people they know (e.g., Greenfield, 1997) and first encounter victims in residential locations (Colombino, Mercado, Levenson, & Jeglic, 2011), it is important that research examine the circumstances of sexual offenses within residential settings. Although previous research has examined the perpetration patterns of sexual offenses against children, especially related to grooming tactics (e.g., Conte, Wolf, & Smith, 1989) and situational factors (e.g., Wortley & Smallbone, 2006), there are few studies that specifically examine the correlates of child sexual abuse within residential settings. This type of data would allow for the development of …

Women’S Sexual Fantasies In Context: The Emotional Content Of Sexual Fantasies, Psychological And Interpersonal Distress, And Satisfaction In Romantic Relationships, Sarah Constantine

Dissertations, Theses, and Capstone Projects

Background: Psychoanalytic thinkers propose that aspects of an individual’s sexual fantasies are related to her psychological and interpersonal functioning. The present study aims to elucidate the significance of sexual fantasies with respect to women’s emotional and interpersonal lives. The study evaluated a model, which hypothesized that internal representations of self and others (e.g. attachment security, maturity of object relations) along with psychological and interpersonal factors would predict both the emotional content (guilt, fear, affection) of written sexual fantasy narratives, and overall romantic satisfaction in heterosexual women. Methods: Five hundred and thirty four women completed self-report questionnaires online. Subsequently, the sexual …

The Relationships Among Different Traits Of Masculinity And Intimate Partner Violence, Jennifer E. Loveland

Dissertations, Theses, and Capstone Projects

Research has shown that distinct yet overlapping concepts of dominance, hostility towards women, and sexism—all indices of masculinity—influence the occurrence of intimate partner violence (IPV), although the mechanisms are unclear. This paper seeks to explore the relationship between these individual-level trait measures of masculinity and two aspects of IPV, physical violence and coercive control. With inconsistent findings and the limited study of clinical populations, further examination of these concepts may provide increased understanding of the mechanisms behind IPV perpetration. Results will provide a greater understanding of the complexity of this violence in order to better assist individuals experiencing IPV.

The Effects Of Childhood Irritability On Adolescent Outcomes And Treatment Response In Children With Attention-Deficit/Hyperactivity Disorder, Estrella Heber

Dissertations, Theses, and Capstone Projects

Childhood irritability has received considerable attention in recent research due in part to the highly impairing consequences of severe irritability and its association with poor long-term outcomes (Leibenluft, Cohen, Gorrindo, Brook, & Pine, 2006; Stringaris, Cohen, Pine, & Leibenluft, 2009; Stringaris & Goodman, 2009a). While the frequency and severity of irritability typically declines with age, there are individuals who continue to display irritability at stable or increasing levels (Wiggins, Mitchell, Stringaris, & Leibenluft, 2014). Regardless of whether it persists or remits, the effects of childhood irritability resonate for many years and it remains a potent predictor of poor outcomes across …

Mental Illness Stigma And Community Integration: Linking Perceived Experiences With Reported Behavior, Lauren L. Gonzales

Dissertations, Theses, and Capstone Projects

This study examines the relationship between individual and neighborhood characteristics, stigmatizing experiences, and measures of community integration among individuals with mental illness. Surveys were administered to two samples: 608 community member participants and 343 participants with mental health diagnoses. Participants in both samples were recruited from 3 community sites in the New York City metropolitan area: East/Central Harlem in Manhattan, Crown Heights/East Flatbush in Brooklyn, and Yonkers and Mt. Vernon in Southern Westchester. Negative symptoms and perceived level of community microaggressions were strong predictors of community integration for participants with mental illness. Prior contact with mental illness predicted less stigmatizing …

An Examination Of Therapeutic Alliance During Prolonged Exposure In The Treatment Of A Comorbid Ptsd And Sud Population, Annelisa Pedersen

Dissertations, Theses, and Capstone Projects

Prolonged exposure has emerged as a highly effective method of treating PTSD (Foa, Hembree, & Rothbaum, 2007; Ruzek et al., 2014), yet for some individuals it has proven to be anxiety-arousing to the point of being contraindicated (Morris, 2015). As a treatment, prolonged exposure can be a challenging procedure to implement given the high levels of avoidance, fear, and resistance that often accompany a diagnosis of PTSD (Arntz, Tiesema, & Kindt, 2007; Hoffart et al., 2013; McLaughlin et al., 2014). When it is used to treat individuals who carry an additional diagnosis of SUD, further complications may arise with respect …

Minding The Baby®: Maternal Adverse Childhood Experiences And Treatment Outcomes In A Mother-Infant Home Visiting Program, Jessica G. Albertson

Dissertations, Theses, and Capstone Projects

This study examined Adverse Childhood Experiences (ACEs) in a sample of women participating in Minding the Baby® (MTB), a mother-infant home-visiting intervention known to have positive effects on mother-infant attachment. In addition to documenting maternal childhood trauma exposure within the sample, this study explored whether such exposure affected the intervention outcome or service delivery. We looked specifically at whether maternal childhood trauma exposure affected mother-child attachment or frequency of contact with home-visitors. We also examined the relationship between maternal early childhood trauma exposure and reflective functioning capacity (RF), a potential resiliency-promoting factor.

Methods: The study’s participants were 29 first-time …

A Conceptualization Of The Body In Psychodynamic And Body-Based Psychotherapies: Areas Of Overlap And Possibilities For Integration, Aleksandra Rayska

Dissertations, Theses, and Capstone Projects

The distinction between verbal and nonverbal psychotherapies is clearly visible in theory and clinical practice. Moreover, this duality of approaches promotes a split between the body and the mind, defining them as separate from each other. This dissertation helps bridge the divide between the literature in body-based therapies and verbally-based psychotherapy by (i) exploring the conceptual frame used to understand the body in psychodynamic therapy (ii) identifying the areas of overlap between psychodynamic theory and theories that underlie body-based psychotherapies, and (iii) proposing ways in which psychodynamic and body-based theories can inform one another. A clinical case was used to …

Physiological Correlates Of Affective Decision-Making In Anxiety And Depression, Louisa I. Thompson

Dissertations, Theses, and Capstone Projects

Improving our understanding of cognitive and physiological profiles in anxiety and depression has the potential to reveal novel ways to target and improve treatments for these prevalent mental health conditions. The present study examined the impact of self-reported anxiety and depression symptoms on three established decision-making measures, the Iowa Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson, 1994), Balloon Analogue Risk Task (BART; Lejuez et al., 2002), and Game of Dice Task (GDT; Brand et al., 2005), in a diverse sample of 100 college students (age 18 to 35). Physiological measures of tonic heart rate variability and galvanic skin response …

The Transgenerational Transmission Of Emotion Regulation: The Effect Of Maternal Coping On Child Executive Functioning, Devon J. Harrison

Dissertations, Theses, and Capstone Projects

There is a recognized link between maternal trauma history and adverse child outcomes, however the mechanisms underlying this intergenerational relationship are less clearly understood. Maternal emotion regulation, as measured by coping style, may help explain this cross-generational transmission, implicating the role of a mother’s coping in her child’s capacity to plan, attend, and self-inhibit. Objective: The purpose of this study is to examine the association between maternal coping style and child executive functioning (EF) in a sample of 188 urban mothers and their pre-adolescent and adolescent children. Data was analyzed from a larger cross-sectional and cross-generational study of maternal difficulties …

Cognitive And Affective Control Deficits In Adults With Autism Spectrum Disorder, Melissa-Ann Mackie

Dissertations, Theses, and Capstone Projects

Cognitive control constrains mental operations to prioritize information that reaches conscious awareness and is essential to flexible, adaptive behavior under conditions of uncertainty. However, cognitive control can be compromised by neurodevelopmental disorders such as autism spectrum disorder (ASD), which is characterized by the presence of social and communicative deficits, and restricted interests/repetitive behaviors. Although prior investigations have attempted to elucidate the nature of cognitive control deficits in ASD, whether there is an underlying deficit in cognitive and affective control associated with the symptom domains of ASD remains unclear. The present series of eight experiments presents an information theoretic framework for …

Examining The Concurrent And Predictive Relations Of Working Memory In Childhood Attention-Deficit/Hyperactivity Disorder, Ashley N. Simone

Dissertations, Theses, and Capstone Projects

Attention-deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by developmentally inappropriate levels of inattention and/or hyperactivity/impulsivity which lead to impairment in multiple settings (American Psychiatric Association, 2013). Childhood ADHD has been concurrently associated with various neurocognitive deficits and one in particular that has been under examination over the past several years is working memory (WM). WM is a temporary storage system that is responsible for maintenance and/or manipulation of information in order to complete complex cognitive and behavioral tasks. Researchers have postulated that WM is one of several potential endophenotypes of ADHD (Castellanos & Tannock, 2002) and/or that WM is …

Activation And Habituation Of The Cingulate Cortex During Emotion Processing In Healthy Controls, Borderline, And Schizotypal Personality Disorder, Emily Balevich

Dissertations, Theses, and Capstone Projects

Disturbances in emotional functioning are central features of the clinical profiles of both borderline and schizotypal personality disorder (BPD and SPD, respectively). BPD is characterized by a high sensitivity to emotional stimuli and unusually strong and long-lasting reactions, indicative of impaired habituation to emotional stimuli (Linehan, 1993). Previous research suggests that SPD patients demonstrate limbic hyper-reactivity to unpleasant stimuli, at least initially, but intact habituation to repeated presentation of unpleasant stimuli (Hazlett et al., 2012). The cingulate cortex supports various aspects of emotion processing and regulation, and abnormalities of this region have been related to emotion dysfunction in SPD and …

The Impact Of Spirituality And Trauma On Appraisals Of Psychotic-Like Experiences, Kathleen Isaac

Dissertations, Theses, and Capstone Projects

Background: A substantial portion of the general population (2.5% to 31.4% internationally) reports psychotic-like experiences, which are paranormal, psychic or bizarre perceptual experiences such as voice hearing, or holding strong beliefs (i.e. superstitions) that are neither experienced as pathological nor indicative of a psychotic disorder. Cognitive models of psychosis suggest that the cognitive appraisal (i.e. personal interpretation) of the experience may help distinguish non-clinical psychotic-like experiences from clinical psychotic symptoms. This dissertation attempted to add to cognitive models by assessing whether cultural and personal factors such as spirituality and trauma inform the appraisals of anomalous experiences. This study used a …

Making Sense Of Missing Sessions: Attendance Patterns In Posttraumatic Stress Disorder And Substance Use Disorder Treatments, Margaret Rauen

Dissertations, Theses, and Capstone Projects

The current study examined the diverse ways individuals with co-occurring Posttraumatic Stress Disorder and Substance Use Disorders (PTSD-SUD) attend treatment. The study was a secondary analysis of a randomized controlled trial for PTSD-SUD (Ruglass et al., 2017), in which participants meeting criteria for both PTSD and SUD (N=82) were randomized to either Concurrent Treatment of PTSD and SUD using Prolonged Exposure (COPE: n=39) or Relapse Prevention Therapy (RPT: n=43). Latent class growth analysis (Muthén & Muthén, 2000) revealed three distinct classes of attendance as the model of best fit. Diagnostic, but not demographic, variables were significantly associated with treatment attendance …

Who Posts Selfies And Why?: Personality, Attachment Style, And Mentalization As Predictors Of Selfie Posting On Social Media, Nancy Adler

Dissertations, Theses, and Capstone Projects

This study examines the phenomenon of selfie posting on social media and its relationship to narcissism, the Dark Triad, impulsivity, attachment style, rejection sensitivity, and reflective functioning. The sample was made up of 499 participants who completed an online survey consisting of personality measures and open- and closed-ended questions about selfie posting behavior. Data were analyzed using a negative binomial regression model.

Results: The study found that individuals with high levels of the Dark Triad trait of psychopathy post more selfies on social media than do individuals with low levels of the trait. The Dark Triad trait of narcissism was …