Clinical Psychology Commons^™

The Effect Of Youth Diabetes Self-Efficacy On The Relation Among Family Conflict, Disease Care And Glycemic Control, Kathryn Maher

Theses and Dissertations

The aim of the current study was to examine the associations among youth diabetes self-efficacy, family conflict, disease care and glycemic control via a comprehensive path model. Data were from a baseline assessment of a longitudinal RCT of 257 adolescent/parent dyads (adolescents aged 11–14). Each member of the dyad separately completed the Self-efficacy for Diabetes Self-Management Scale, Family Environment Conflict subscale, Diabetes Family Conflict Scale, Diabetes Behavior Rating Scale, and 24-hr Diabetes Interview Blood Glucose Frequency subscale. Additionally, a biological marker of glycemic control, or HbA1c, and relevant demographic variables were collected. A mediation model found higher youth diabetes self-efficacy …

Family Processes As Moderators Of The Impact Of Peer, School, And Neighborhood Influences On Adolescent Aggression, Alison Kramer-Kuhn

Theses and Dissertations

Despite theoretical support for the role of the family in providing a foundation to protect youth against risks for aggression, there is little published literature examining a protective influence. This study examined family functioning and perceived parental messages about fighting and nonviolence as moderators of the relation between risk factors and adolescent aggression. The specific risk factors included affiliating with a delinquent group of peers, attending a school with norms that support aggression, and witnessing violence within the community. Secondary analyses were conducted on data collected from a high-risk sample of 537 adolescents in 2 cohorts from 18 schools. Adolescents …

Clarifying The Direction Of Effects Between Alliance And Client Involvement In Treatment For Child Anxiety In Community Settings, Nadia Islam

Theses and Dissertations

Alliance and client involvement are thought to be important therapy process factors in child psychotherapy; however, few studies have investigated them over the course of treatment. The present study examined change in alliance, client involvement, and the relationship between the two over time in an effectiveness study comparing cognitive behavioral therapy (CBT) and usual clinical care (UC) for child anxiety disorders. The sample included 40 clinically-referred children (57.50%, female, mean age = 10.81, SD = 2.11, 35.00% Caucasian, 32.50% Latino/Hispanic, 5.00% African-American, 7.50% mixed ethnicity, 20.00% not reported) and 39 therapists employed by community clinics. Two doctoral-level students comprised the …

Heart Rate Variability As A Moderator Of Trauma Writing Outcomes, Alison Eonta

Theses and Dissertations

Writing about personal traumatic experiences is associated with beneficial effects on physical and psychological symptoms compared with writing about emotionally neutral events. However, not everyone benefits from trauma writing to the same extent. The present study hypothesized that the effectiveness of trauma writing may be moderated by emotion regulation, as indexed by respiratory sinus arrhythmia (RSA). Research also shows that greater physiological reactivity is predictive of better trauma writing outcomes. Given the importance of physiological output in emotional processing, response training was developed and found to increase appropriate physiological reactivity. Because higher RSA is thought to indicate a more flexible …

Effectiveness Of A Cbt Intervention For Persistent Insomnia And Hypnotic Dependency In An Outpatient Psychiatry Clinic, Hannah Taylor

Theses and Dissertations

Previous research supports the efficacy of cognitive-behavioral therapy for insomnia (CBT-I) in patients with comorbid psychiatric diagnoses; however, questions remain about the effectiveness of CBT-I due to the fact that previous studies excluded patients with significant psychiatric symptoms and comorbid diagnoses. This study begins to address this gap in the insomnia literature by testing a five-session CBT-I intervention in a diverse sample of patients receiving mental health treatment in an outpatient psychiatry clinic (N=23) who continue to experience chronic insomnia despite receiving pharmacological treatment for sleep. Participants were randomized to CBT-I (n=13) or a treatment as usual control group (n=10). …

The Role Of Pain-Related Catastrophizing In Outcomes And Recovery From Minimally Invasive And Surgical Procedures For Treating Temporomandibular Disorders, Aaron Martin

Theses and Dissertations

The current study examined the ability of pain-related catastrophizing to predict outcomes following non-surgical and surgical intervention for temporomandibular disorders (TMDs). The interpersonal context of pain-related catastrophizing, referred to as the communal coping model, was also examined to determine if patient perceptions of punishing and solicitous responses from significant others would moderate or mediate relations between pain catastrophizing and outcomes. The role of pain duration as a moderator of the relation between pain-related catastrophizing and perceived significant other responding was also examined. A total of 94 patients were identified for which 65 had follow-up outcomes that could be examined. Patient …

Risk Assessment In Corrections: An Analysis Of Variables Related To Suicide Attempts And Self-Mutilation, Melissa Ann Fine

Theses and Dissertations

Suicide and self-mutilation risk assessment is a complicated process, especially within a correctional setting. According to the Bureau of Justice Statistics, over 50% of incarcerated individuals have a mental health illness, further reinforcing the need for concise, evidence-based risk assessment practices. The Virginia Department of Corrections collected data on suicide attempts, completed suicides, and incidents of self-injurious behavior for 17 months with a measure created to assess risk factor found in the community. Results indicated that numerous factors were related to suicide attempts, however only having made prior suicide attempts, the presence of a major depression diagnosis, and placement in …

The Relation Between Patterns Of Beliefs About Fighting And Social Information-Processing: Differences In Cognitions, Goals, And The Response-Decision Process In Adolescents, Denicia Titchner

Theses and Dissertations

Beliefs about aggression play a key role in how youth interpret and respond to social situations and are related to aggressive behavior. Adolescents may report beliefs supporting aggression and engage in aggression due to reinforcement within their environment, rather than due to maladaptive social information-processing (SIP) biases. The purpose of this study was to examine adolescents’ patterns of beliefs about aggression and how these patterns relate to SIP. This study used latent class analysis (LCA), the Articulated Thoughts in Simulated Situations paradigm, and a Problem Solving Interview to examine differences in SIP between adolescents with varying patterns of beliefs about …

Evaluating The Effects Of A Group Cognitive Behavioral Therapy For Veterans With Posttraumatic Stress Disorder And Insomnia: A Pilot Study., Laurin Mack

Theses and Dissertations

Combat and war zone veterans are particularly vulnerable to developing Posttraumatic Stress Disorder (PTSD) due to the increased risk of experiencing trauma inherent in military service. Insomnia and nightmares are core symptoms of PTSD and can be factors in the development, maintenance, and exacerbation of PTSD. However, sleep disturbance has received relatively little attention from a treatment point of view until recently. Recent research has demonstrated that cognitive behavioral therapy for insomnia (CBT-I) and imagery rehearsal therapy (IRT) for nightmares are effective stand alone and combination treatments for sleep disturbance in civilian and veteran populations. Although group interventions are lower …

The Role Of Family Organization In Family Health History Communication About Cancer, Vivian M. Rodríguez

Theses and Dissertations

Family health history (FHH) has been recognized as an important tool in cancer prevention and health promotion. To date, literature on FHH discussions about cancer have largely focused on patient-physician communication or the dissemination of cancer-specific genetic tests results within the family. Fewer studies have sought to identify family factors that may promote FHH discussions, yet this type of information could be used to identify families needing support in having these conversations. Thus, the present study examined relations between family organization (cohesion and flexibility), communication openness, and FHH communication about cancer within a diverse group of women recruited from an …

A Qualitative Analysis Of Latina Adolescents' And Their Mothers' Perspectives On Adolescent Dating Violence, Carla Shaffer

Theses and Dissertations

Adolescent dating violence is a prevalent and disconcerting reality for many adolescents. Communication with others (e.g., parents, older siblings, friends) about dating violence may buffer some negative outcomes associated with experiencing dating violence. Although researchers are attending more to this public health problem, what we know about the messages that adolescents receive about dating violence is limited, especially for Latina teens. To address this gap in the literature, 18 Latina adolescents (14-17 years) and their mothers participated in semi-structured interviews to explore their beliefs about what dating violence means to them, messages that are shared about dating violence with mothers …

Antisocial Behavior From Adolescence To Early Adulthood: Heritability, Stability, And Correlates Using A Longitudinal Twin Sample, Ashley Dibble

Theses and Dissertations

The purpose of this study was to examine the heritability, stability, and outcomes of antisocial behavior from adolescence into adulthood in a longitudinal twin sample. Specifically, the genetic and environmental influences on conduct disorder, adult antisocial behavior, and alcohol dependence were examined. The influence of genes and environment on the relationship between these disorders was also examined. The study utilized a subset of FinnTwin12, a population-based twin study that consists of five consecutive birth cohorts. The subsample consisted of 1035 twin pairs (N = 2070) and of that 2070, 1854 completed the intensive interview at age 14. At age 22, …

The Ticking Of The “Biological Clock”: Worry About Future Fertility In Nulliparous Women, Karen E. Kersting

Theses and Dissertations

Abstract

Title: The Ticking of the “Biological Clock”: Worry about Future Fertility in Nulliparous Women

By: Karen Kersting, M.A., M.S.

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University.

Virginia Commonwealth University, 2013.

Major Director: Kathleen M. Ingram, J.D., Ph.D.

Associate Professor of Psychology

Department of Psychology

Modern women are waiting until later in their lives to have children than women of previous generations, a trend influenced by a number of factors including financial stability, dating norms, and career goals and responsibilities. As women age, their fertility may decline …

Bereavement In Emerging Adulthood: The Influence Of Religion And Type Of Loss, Elizabeth Collison

Theses and Dissertations

Bereavement is an important area of research as it may result in grief reactions that lead to serious psychological and health consequences (Stroebe, Schut, & Stroebe, 2007). Positive outcomes, such as personal growth or spiritual well-being, may also transpire post-loss (Hogan & Schmidt, 2002; Paloutzian & Ellison, 1982). Though research on bereavement has grown, few studies have focused on the at-risk group of emerging adults (Hardison, Neimeyer, & Lichstein, 2005; Arnett, 2000). The current study aims to add to the bereavement in emerging adulthood literature through analyzing descriptive data and assessing the impact of type of loss (i.e., nonviolent vs. …

State Anxiety And High-Risk Developmental Influences On Laboratory-Provoked Aggression Among College Men, Samantha L. Chase

Theses and Dissertations

Recent literature has identified a subtype of anxious people who appear to be at risk for aggression as opposed to inhibited and withdrawn as might otherwise be predicted among anxious individuals. While physical aggression is not typically associated with anxiousness, the current study examined the effect of both state and trait anxiety and other development factors on laboratory-provoked aggression in males.

Participants (N = 56) were randomly assigned to anxiety induction and control groups. An attempts was made to induce anxiety using a videotapes speech procedure. Several self-report measures were completed to gather developmental information such as history of aggressiveness, …

Effects Of Imagery Training On Language In Expressive Writing, Therese Verkerke Cash

Theses and Dissertations

Research examining language in written and oral trauma narratives indicates that exposure and cognitive processing are important processes responsible for therapeutic change. Bio-informational theory, which defines emotions as the activation of response, stimulus, and meaning units in memory, provides a meaningful structure for evaluating language in traumatic and neutral essays. This study examined the effects of imagery training procedures designed to prime activation of response or stimulus units on word usage. The effect of writing instructions on activation of meaning units was also investigated. Unscreened undergraduates (n=246) were randomly assigned in a 2 writing condition (traumatic or neutral) x 3 …

Stakeholder Views On Children’S Mental Health Services, Adriana Rodriguez

Theses and Dissertations

Identification of evidence-based treatments (EBTs) has been an important development; however recently, some shortcomings of the approach have been highlighted. These complexities have led to a surge in transportability research in mental health services science with goals of identifying needed strategies to encourage the adoption of innovations. The mental health system ecological (MHSE) model is an approach necessary to assist with closing this gap effectively as it integrates mental health contexts: client-level, provider-level, intervention-specific, service delivery, organizational, and service system characteristics. The aim of this study is to use the MHSE model to examine perspectives of mental health stakeholders on …

Assessing Parental Involvement In Type 1 Diabetes Management During Adolescence, Elizabeth M. Robinson

Theses and Dissertations

Type 1 diabetes is one of the most common pediatric chronic illnesses. Adolescents are at risk for poorer glycemic control; however, youth whose parents remain involved in diabetes care are in better control. The current study examined parental involvement (PI) using a multi-method, multi-source approach in a sample of 255 youth (Age M = 12.83). The Diabetes Family Responsibility Questionnaire, Parental Monitoring of Diabetes Care Scale, and 24-Hour Diabetes Interview assessed two types of PI, parental responsibility and parental monitoring. Global and specific assessment served to cross-corroborate indicators of PI related to HbA1c. Higher levels of monitoring related to lower …

Disclosure And Health: Enhancing The Benefits Of Trauma Writing Through Response Training, Andrea Konig

Theses and Dissertations

Writing about a personal traumatic event has been found to have psychological and physical health benefits. Focusing on traumatic memories in writing may be a form of exposure. In imagery exposure and trauma writing, greater physiological reactivity was predictive of better outcomes. Given the importance of physiological output in emotional processing, response training was developed and found to be effective in increasing appropriate physiological reactivity in imagery exposure. If response training amplifies physiological reactivity and the benefits of writing, the hypothesis that writing is a form of exposure would be strengthened, and training may be a valuable tool to improve …

Efficacy Of A Cognitive-Behavioral Treatment For Insomnia Among Afghanistan And Iraq (Oef/Oif) Veterans With Ptsd, Margolies Skye Ochsner

Theses and Dissertations

Sleep disturbances are a core and salient feature of PTSD and can maintain or exacerbate associated symptoms. Recent research demonstrates that cognitive-behavioral sleep-focused interventions improve sleep disturbances as well as PTSD symptoms. The present study is a randomized controlled trial comparing Cognitive Behavioral Therapy for Insomnia (CBT-I) to a waitlist control group. Conducted at a Veterans Affairs Medical Center, the study: 1) compared subjective outcome measures of sleep amongst veterans assigned to either a treatment group (CBT-I) or a waitlist control group; (2) examined the influence of the intervention on measures of PTSD, general mood and daytime functioning, comparing veterans …

The Development Of The Common Factor Therapist Competence Scale For Youth Psychotherapy, Ruth Brown

Theses and Dissertations

In order to continue to improve the effectiveness of psychotherapy, researchers must identify key change processes. Unfortunately, there are disparate views in the field about the relative importance and potency of specific techniques versus relationship factors. Few measures have been developed to examine the relative contribution of these factors, particularly for child-focused treatment. The Common-Factor Therapist Competence Scale for Youth Psychotherapy (COMP-CF) was developed to address this deficit. For this study, 142 video-taped sessions of child CBT for anxiety were observed and rated by independent coders using the COMP-CF. The measure demonstrated good reliability and internal consistency. Significant between-therapist and …

The Interpersonal Process And Predictors Of Consent In Tissue Donation Requests, Lindsey Dorflinger

Theses and Dissertations

The present study examined the interpersonal process during tissue donation requests and evaluated demographic and interpersonal/behavioral predictors of consent or refusal to donate. One hundred and two audiorecordings of tissue donation requests were evaluated using several different observer measures of interpersonal behavior and decision making. Results showed that tissue requesters (TRs) and next-of-kin (NOKs) tended to match one another’s level of affiliation, and complemented one another on interpersonal dominance. TRs infrequently used negative or disapproving statements during the request, but when they did NOKs were less friendly, more disapproving, and more likely to express concern. Overall there were few differences …

Parent-Child Communication About Substance Use: Experiences Of Latino Emerging Adults, Kathryn Reid-Quiñones

Theses and Dissertations

The purpose of the current studies was to identify messages that Latino parents communicate to their offspring about the use of legal and illegal drugs and to determine associations between parental messages and substance use outcomes. Previous research has identified parent-child communication as protective against tobacco, alcohol, and other drug use. However, most of these studies have failed to examine the specific messages communicated and those that have focused almost exclusively on non-Hispanic Caucasians. Study 1 identified messages that Latino parents communicate to their offspring regarding legal and illegal drugs through two focus groups with Latino college students (N = …

The Impact Of Overt And Relational Victimization On Adolescents' Well Being: Moderating Effects Of Ethnicity At The Individual And School Level, Krista Mehari

Theses and Dissertations

The sociocultural influence of ethnicity on peer victimization among youth has received little attention in the research literature. Individual ethnicity within school ethnic composition may influence the frequency of victimization and the effect of victimization on adolescents’ well being. The current study investigated these issues using a data set of 5,581 sixth grade students attending 37 schools located in four sites. Multilevel models examined the extent to which individual ethnicity within school ethnic composition influenced the frequency and impact of overt and relational victimization on changes in life satisfaction. Ethnic differences were found in the frequency of victimization, but these …

The Influence Of Family Structure And Transitions On Parenting, Income, Residential Mobility, And Substance Initiation In Early Adolescence: A Comparison Of Caucasian And African American Youth, Sally Mays

Theses and Dissertations

The effect of family structure on youth adjustment has received increasing attention as historical trends in single parenting, divorce, remarriage, and cohabitation with partners and extended family members have produced a diverse constellation of structures. African American youth are less likely than Caucasian youth to live in an “intact” family. Links between family structure and a variety of indices of youth adjustment have been established, although a relatively understudied outcome is that of substance initiation, despite its association with dependence and other negative sequelae. The dynamic effect of transitions has additionally been less studied than the static effect of structure. …

Developmental Trajectories Of Physical And Relational Aggression And Their Relation To Delinquency And Substance Use In Adolescence, Denicia Titchner

Theses and Dissertations

Although researchers studying adolescent aggression have proposed a conceptual distinction between physical and relational aggression, there is contradictory evidence regarding the degree to which they differ in their trajectories and relations to other outcomes. This study explored the importance of differentiating between these two forms of aggression based on comparisons of their trajectories, relation with each other, impact on delinquency and substance use, and gender differences. Data were collected as part of the Multisite Violence Prevention Project, conducted at 19 middle schools from four sites with a predominantly low-income, minority sample of students (N = 2,822). Growth curves showed significant …

Adapting Evidence-Based Treatments For Youth In A Community Mental Health Setting: Single Case Design, Alexis Quinoy

Theses and Dissertations

This single-case design study examined the effectiveness of adapting evidence-based treatments (EBTs) for children in a community clinic through a university-community partnership. Community clinic therapists treated eight youths (five males), ages 10 to 14, of whom four were Caucasian, two were Latino, one was African-American, and one was Caucasian/African-American. Youths presented with a primary diagnosis of a DSM-IV (American Psychiatric Association, 1994) internalizing disorder (plus multiple comorbidities). An adapted treatment combining multiple elements based on two primary treatment manuals: Coping Cat (Kendall et al., 1990) and PASCET (Weisz et al., 1999) was used. Youths with comorbid externalizing symptoms were also …

Do Body Image And Gender Role Attitudes Mediate The Relationship Between Media Exposure And Sexual Risk Behavior In College Students?, Vivian Rodriguez

Theses and Dissertations

Despite growing awareness of the HIV/AIDS pandemic and educational efforts to provide accurate information about sexually transmitted diseases (STD), young adults continue to engage in risky sexual practices that increase their vulnerability of acquiring an STD, including inconsistent condom use. Research has gathered ample evidence to suggest that the media, in particular television consumption, is directly linked with sexual risk, yet less is known about the potential mechanisms that may be driving this link. The present study examines body image and gender role attitudes as two potential mediators of this relationship. Three-hundred and four undergraduate students (73% female; 64% White) …

The Discrepancy Between Subjective And Objective Measures Of Sleep In Older Adults Receiving Cbt For Comorbid Insomnia, Hannah Lund

Theses and Dissertations

Clinical research on insomnia has observed that many individuals with this sleep disorder exhibit a significant discrepancy between their subjective reports of symptom severity and objective measures of the same parameters. This study sought to more closely examine this discrepancy by comparing sleep diary estimates with polysomnography data in a population of 60 older adults with comorbid insomnia. Consistent with previous research, results show that participants significantly underestimated sleep efficiency and total sleep time and significantly overestimated sleep onset latency. Participants receiving CBT-I exhibited significantly reduced discrepancy at post-treatment, particularly with regard to sleep latency, compared to those in a …

The Alliance-Outcome Association In Cbt And Usual Care For Youth Depression Delivered In Community Settings, Shelley Avny

Theses and Dissertations

The child-therapist alliance is believed to be a critical ingredient of successful psychotherapy for youth depression. However, only a few studies have examined the association between the alliance and clinical outcomes in the treatment of youth depression. The present thesis examined the alliance-outcome association in two treatments for youth depression: cognitive-behavioral therapy (CBT) and usual clinical care (UC). Data were from an effectiveness trial conducted in six community clinics (see Weisz et al., 2009). Forty-one youth were randomly assigned to receive CBT or UC from community clinicians. The observed early alliance, alliance shifts, and self-reported alliance did not significantly predict …