Clinical Psychology Commons^™

Stressful Life Events And Ocd Treatment: A Thematic Analysis Of Patient Perspectives, Emily E. Fenlon

Theses and Dissertations--Psychology

Trauma exposure, including interpersonal violence (IPV), is associated with increased risk and severity of obsessive-compulsive disorder (OCD). Exposure and response prevention (ERP) is the treatment of choice for OCD, yet research suggests a history of trauma and comorbid PTSD may adversely impact treatment outcomes. No studies have yet evaluated patient perspectives on the relationship between trauma, IPV and related sequelae and OCD treatment. The present study applies reflexive thematic analysis to interviews from individuals with a history of IPV who received exposure-based therapy for OCD. Interviews explored the influence of posttraumatic distress, impairment, and psychopathology on the treatment of OCD, …

The Relationship Between Estradiol And Progesterone Concentration Levels, Alcohol Consumption, And Inhibitory Control, Layne Elizabeth Robinson B.S.

Theses and Dissertations--Psychology

Alcohol use is increasing among women, with estimates for binge drinking having risen to levels similar to those seen in men. Despite this trend, sex differences regarding mechanisms of alcohol consumption have seldom been investigated. Our group and others have found evidence to suggest that ovarian sex hormones are associated with alcohol consumption and mechanisms that might be related to alcohol consumption, such as executive function deficits. The current study sought to extend this prior research in a larger sample with higher drinking rates and more rigorous methods, and to explore inhibitory control associations with drinking. Across the two samples …

Patient Perspectives Of Psychotherapy Duration And Treatment Outcomes, Doug Terrill

Theses and Dissertations--Psychology

The duration of psychotherapeutic treatment is a longstanding and clinically consequential question in psychotherapy research. Premature dropout from therapy is common, indicating some patients do not receive adequate benefit. On the other hand, some patients remain in treatment beyond the point at which they receive significant benefit, which may delay care for those on patient waitlists. Researchers have proposed two contemporary models of the relation between treatment duration and symptom improvement; 1) the dose-effect (DE) model, which posits that patients improve at similar rates following a negatively accelerated symptom curve, suggesting treatment should end when sessions no longer provide significant …

Effects Of Transcranial Direct Current Stimulation On Urge During Cue-Exposure To Body-Focused Repetitive Behaviors, Hannah Rebecca Wild

Theses and Dissertations--Psychology

Body-focused repetitive behaviors (BFRBs) are unnecessary, repetitive grooming behaviors linked to abnormalities in sensory and reward processing, as well as top-down inhibition. The left dorsolateral prefrontal cortex (dlPFC) is implicated in these processes and plays a key role in cravings among individuals facing addiction. Transcranial direct current stimulation (tDCS) targeting the left dlPFC shows promise in reducing craving for addictive substances. Despite phenomenological similarities between BFRBs and addictive disorders, no controlled studies have examined tDCS’s effect on BFRBs. This study used a randomized, double-blind design to examine whether a single session of anodal multifocal tDCS targeting the left dlPFC reduced …

Comparing Domain- And Facet-Based Models Of Personality Disorder: Incremental Predictive Validity And Model Fit, Alexandra Hines

Theses and Dissertations--Psychology

Personality disorders (PDs) have historically been conferred using a categorical diagnostic framework (i.e., present versus absent). However, recent research supports a transition toward dimensional models of PDs wherein personality traits are measured along a continuum. Some dimensional models contain personality domains only, whereas other models contain both personality domains and facets of each of those domains. The leading models of each type are the PD model in the eleventh edition of the International Classification of Diseases (ICD-11) and the Alternative Model of Personality Disorders (AMPD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), respectively. …

Resilience After Prenatal Substance Exposure: Exploring The Role Of Cumulative And Specific Protective Factors In Predicting Toddlerhood Temperament Profiles, Anjeli Elkins

Theses and Dissertations--Psychology

Objective

Prenatal exposure to common substances, including nicotine, marijuana, cocaine, methamphetamine, opiates, and alcohol, has been linked to a wide range of psychiatric disorders and neurodevelopmental impairments. Identifying protective factors that may improve temperament profiles in toddlers who have experienced prenatal substance exposure may protect against these adverse outcomes and is crucial for developing targeted early interventions.

Methods

Participants (n=92; Mage = 28.7 years; 47.0% White) were biological mothers of toddlers (Mage = 22.6 months) with prenatal substance exposure. Mothers responded to an online survey that gathered information on substance use during pregnancy, proposed perinatal protective factors, and child temperament. …

Responses To Tobacco Use Screening And Tobacco Cessation Assistance Offers Among Rural And Ubran Cancer Survivors At An Nci-Designated Comprehensive Cancer, Abigayle Feather

Theses and Dissertations--Psychology

Smoking after cancer diagnosis is associated with poor outcomes while smoking cessation can improve quality of life and promote survival. Although there are calls for equitable tobacco treatment delivery in cancer and other healthcare settings, disparities in tobacco-related disease burden persist. In the context of an outpatient cancer center’s population-based tobacco treatment program, this study examines the association between cancer survivors’ rural and Appalachian residence and 1) current tobacco use status, 2) decision to decline cessation assistance, and 3) reason for declining assistance. A cross-sectional, retrospective analysis was conducted using electronic health record data from 16,839 adults (64.04% female, 88.49% …

Associations Between Queer Parent Family Socialization And Adolescent Outcomes Among Diverse Lgbtq+ Parent Families In The U.S., Nita U. Kulkarni

Theses and Dissertations--Psychology

Queer parent family socialization refers to the way LGBTQ+ parents talk with their children about what it means to be queer in society, how to handle discrimination, and ways to have pride in their family’s identity. This construct has been linked with positive well-being outcomes in children, and this study used a strengths-based, mixed- methods framework informed by Minority Stress Theory and intersectionality to examine how queer parent family socialization related to several adolescent well-being outcomes, namely internalizing behaviors, social competence, and adaptive coping. Participants recruited across two projects were 191 queer parents with an adolescent and 114 adolescents with …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Talking About Cancer And Tobacco (Tact) Study With Lgbtq Patients And Their Care Providers, William Bowling

Theses and Dissertations--Psychology

Due to multilevel factors, including a high prevalence of tobacco use, the burden of some cancers is disproportionately higher in the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community than the general population. Evidence-based tobacco treatment delivery with high rates of tobacco cessation would be a powerful tool for secondary cancer prevention in the LGBTQ community, yet few studies have explored this issue. The current study aimed to 1) uncover both positive and negative aspects related to the lived experience and treatment of LGBTQ cancer survivors who use tobacco, 2) elucidate barriers and facilitators of tobacco treatment and cessation, and …

Exploring The Effects Of Transcranial Direct Current Stimulation Of The Right Inferior Frontal Gyrus On Inhibitory Control In Posttraumatic Stress Disorder, Colton Rippey

Theses and Dissertations--Psychology

Background: The right inferior frontal gyrus (rIFG) is implicated in stop signal reaction time (SSRT) performance – a common measure of inhibitory control – and emotional expression and control. Individuals with posttraumatic stress disorder (PTSD) exhibit poorer stop SSRT performance, which is associated with rIFG hypoactivity. Neuromodulation of the rIFG with transcranial direct current stimulation (tDCS) can significantly improve inhibitory control and reduce fearful responding to threatening stimuli. Research has yet to test the effects of multifocal tDCS targeting the rIFG on inhibitory control or emotional reactivity in individuals with PTSD.

Methods: The current study aims to examine the impact …

Global Sleep Quality, Emotion Regulation Difficulties, And Ptsd Symptom Severity In Trauma-Exposed College Women, Grace M. Seymour

Theses and Dissertations--Psychology

Sleep problems are common among college women and may contribute to PTSD symptoms. Those with emotion regulation difficulties may have increased difficulty managing distress worsened by poor sleep, though it is unclear which specific facets of emotion regulation are most relevant. This study examined interactions between sleep quality and facets of emotion regulation difficulties on PTSD symptoms among college women (N = 1,037) using self-report measures: the Pittsburgh Sleep Quality Index (PSQI), PTSD Checklist for DSM-5 (PCL-5), and Difficulties in Emotion Regulation Scale (DERS-18). Two significant interactions emerged. Sleep disturbance interacted with difficulties engaging in goal-directed behavior (b …

Putative Mechanisms Of Personality Change In Treatment, Hannah Croom

Theses and Dissertations--Psychology

BPD Compass was designed to engage the BPD-relevant traits from the Alternative Model of Personality Disorders in the DSM-5 by targeting putative mechanisms associated with these personality domains: aversive reactivity to engage negative affectivity, attachment insecurity to engage antagonism, and self-efficacy to engage disinhibition. The goal of the present study was to test the associations between putative mechanisms and respective personality traits. We used multilevel structural equation modeling to test if personality domains and putative mechanisms changed in treatment, if changes in putative mechanism were associated with changes in respective personality domain, and if within-person changes in putative mechanisms predicted …

Examining Values In The Treatment Of Borderline Personality Disorder: A Single-Case Experimental Design, Nicole Stumpp

Theses and Dissertations--Psychology

Borderline personality disorder impacts roughly 1.6% of the general population yet only a quarter of people with BPD are able to access treatment. Understanding the mechanisms that promote behavior change in treatment is crucial for improving care for this population. Experiential avoidance has been linked to risky behaviors, a prevalent and debilitating symptom observed in BPD. Values identification may be a fruitful avenue for engaging experiential avoidance in treatment. The goal of the present study is to understand the unique and combined effects of values identification and behavior change skills (i.e., opposite actions, exposure) on experiential avoidance (target), maladaptive behavior …

Randomized Controlled Trial Of A Single-Session Mechanism-Focused Intervention For Suicidal Thoughts And Behaviors, Martina Fruhbauerova

Theses and Dissertations--Psychology

Suicide remains a critical public health concern, with increasing rates and millions experiencing suicidal ideation annually. Although evidence-based treatments exist, many are time-intensive, underutilized, and often inaccessible to high-risk individuals, especially those recently discharged from inpatient psychiatric care. Brief, scalable interventions targeting core psychological mechanisms implicated in suicidal thoughts and behaviors (STBs) are needed. This study evaluated a novel Single Session Mechanism-Focused Intervention (SSMFI) designed to reduce hopelessness and negative perceptions of social relatedness among adults hospitalized for STBs. In a randomized controlled trial (N = 38) conducted on two inpatient psychiatric units, participants were assigned to either the SSMFI …

Characterizing Resting Cerebral Blood Flow In Obsessive-Compulsive Disorder With Arterial Spin Labeling, Hannah R. Wild

Theses and Dissertations--Psychology

Obsessive-compulsive disorder (OCD) is a condition characterized by intrusive thoughts (obsessions) and ritualistic behaviors (compulsions) profoundly impacting daily functioning and quality of life. Neuroimaging studies using various techniques have revealed inconsistent resting cerebral blood flow (rCBF) patterns in OCD patients, particularly within the cortico-striatal-thalamo-cortical (CSTC) circuit and sensorimotor network. Arterial Spin Labeling (ASL) MRI offers a promising, noninvasive method for directly measuring rCBF. This study, using data from the Yale HCP Trio study, analyzed unmedicated OCD patients and healthy controls, who underwent two consecutive resting pulsed-ASL scans. OCD patients with lower obsessional severity exhibited higher perfusion in the pre- and …

Gender Differences In Preschool Conduct Disorder Symptoms Across One-Year, Madeline K. Petersen

Theses and Dissertations--Psychology

Conduct disorder is a childhood disruptive behavior disorder that exhibits striking gender differences in prevalence, comorbidities, and associated outcomes. These gender differences, particularly symptomology, remain understudied in conduct disorder despite the growing prevalence in females. This paper seeks to examine gender differences in parent rated conduct disorder symptoms in preschoolers overrecruited for disruptive behavior problems at three different timepoints across one-year. It is hypothesized that males will exhibit higher levels of physical aggression symptoms at the initial timepoint with declining rates across a one-year period compared to females, while females will exhibit lower levels of conduct problems at the first …

Relationship Of Criterion A Level Of Personality Functioning With Borderline Personality Disorder Over The Course Of Brief Treatment, Michelle M. Smith

Theses and Dissertations--Psychology

The Alternative Model of Personality Disorders (AMPD) housed within DSM-5 Section III posits that impairments in personality functioning, operationalized by the Level of Personality Functioning Scale (LPFS) “constitute the core of personality psychopathology” (APA, 2013, p. 762). If this is the case, there should be strong associations between LPFS and DSM personality disorders, including borderline personality disorder (BPD). BPD Compass is a comprehensive CBT-based treatment for BPD which aims to reduce BPD symptoms over the course of 18 weekly sessions. This study examined if a) LPFS would be associated with changes in BPD symptoms, b) whether LPFS has incremental validity …

The Experience And Regulation Of Posttraumatic Shame Among Women With Interpersonal Trauma Histories, Jordyn M. Tipsword

Theses and Dissertations--Psychology

Posttraumatic shame – an emotion stemming from harsh attitudes about the self after trauma – is central to PTSD for many women following physical or sexual assault or abuse (interpersonal trauma [IPT]). However, knowledge of the frequency, intensity, and stability of shame in the daily lives of women post-IPT is lacking. Additionally, while some work has explored shame-specific emotion regulation (ER), or processes aimed at changing emotional responses, it remains unclear which ER strategies are effective in reducing shame, and the role of PTSD severity in shame regulation also remains unexplored. This project explored daily experiences and regulation of posttraumatic …

Development Of The Trait Response To Emotion Dimensional Measure For Use In Minoritized Populations, Anita Adams

Theses and Dissertations--Psychology

Trait responses to emotion (TREs) are personality traits that develop from how one consistently responds to and copes with emotions. TRE development is influenced by demographic factors, such as age, gender, and early life adversity, and TREs can influence how one copes with a variety of stressors. TRE theory and measurement is relatively new, and although TREs have been validated in majority race samples, TRE theory and measurement have not been validated in minority race samples, particularly in African American populations. This dissertation is taking the first preliminary steps for the development of a cross-cultural trait response to emotion dimensional …

Hormonal Effects On Adhd Symptoms In Adolescents Across The Menstrual Cycle, Ashley G. Eng

Theses and Dissertations--Psychology

Background: Females with attention-deficit/hyperactivity disorder (ADHD) become particularly impaired during adolescence, experiencing increased rates of depression and anxiety, as well as important public and personal health outcomes like increased suicide attempts, risky sexual behavior, and substance use. However, female-specific risk factors for ADHD have been vastly understudied despite this increased impairment and comorbidity. One particularly understudied risk factor is the dramatically rising and fluctuating levels of ovarian hormones during late puberty that begin cycling monthly. In adult women, rapid decreases in estrogen levels increase risk for ADHD symptoms across the menstrual cycle, particularly for those with high trait impulsivity. Preliminary …

A Mixed-Methods Study Exploring Free Nicotine Replacement Therapy As A Strategy To Promote Tobacco Treatment Equity At Cancer Center Cessation Initiative Sites, Marguerite A. Webster

Theses and Dissertations--Psychology

Nicotine replacement therapy (NRT) is a safe, efficacious smoking cessation treatment for cancer patients; however, equitable access is limited due to insurance gaps. Offering free NRT to patients with cancer has potential to increase tobacco treatment engagement and promote equity. This mixed-methods study aims to describe how some Cancer Center Cessation Initiative (C3I) sites implemented free NRT within their tobacco treatment programs (TTPs) to inform future development of equitable TTPs. Participating sites’ (N=9) TTP and patient population characteristics were assessed via survey and analyzed with descriptive statistics. Semi-structured interviews were conducted with 16 individuals and analyzed using directed …

Fluctuations In Alcohol Impairment Of Working Memory Across The Menstrual Cycle, William Mcgarrigle

Theses and Dissertations--Psychology

Behavioral endocrinology studies in women suggest that higher circulating levels of the ovarian sex hormone estradiol (E2) may be linked to better working memory performance, especially under conditions of cognitive impairment (e.g., age-related cognitive decline). Phases of the menstrual cycle characterized by different levels of E2 may therefore influence the degree to which women are vulnerable to alcohol impairment of working memory. The current thesis used a within-subjects design to test the hypothesis that women are less sensitive to acute alcohol-induced impairment of working memory when E2 is elevated during the menstrual cycle. A sample of 75 premenopausal women completed …

Power Of Perception: The Role Of Perceived Caregiver Mindset Beliefs On Undergraduate Student Academic Engagement, Katherine R. Tanaka

Theses and Dissertations--Psychology

Promoting academic engagement is vital for college student success. Researchers have explored factors like growth mindset, the belief that intelligence can improve with effort, as a driver of academic engagement. Beyond personal mindset, students’ perceptions of key social influences, such as caregivers, also play a role. This study examined how undergraduate students’ own mindsets and perceptions of their caregivers’ mindsets relate to four components of academic engagement: behavioral and emotional engagement, and behavioral and emotional disaffection. Data from undergraduates (N = 1417) were analyzed using surveys, descriptive statistics, hierarchical regression, and exploratory moderation. Students generally reported both a personal …

Menstrual Cycle Phase And Hormonal Effects On Emotional Eating In Females With Attention-Deficit/Hyperactivity Disorder, Urveesha Nirjar

Theses and Dissertations--Psychology

Previous research has shown that cyclical fluctuations in ovarian hormones can predict changes in ADHD symptoms as well as eating behaviors, particularly emotional eating across the menstrual cycle. Previous studies have so far only examined the effects of estrogen (E2), progesterone (P4) and cycle phase in predicting individual symptoms or disorders such as ADHD or eating disorders or related behaviors separately. The aim of this study is to examine how emotional eating is influenced by naturally occurring hormonal and cycle changes in a sample overrecruited for ADHD. Seventy-eight individuals (assigned female at birth) with menstrual cycles overrecruited for ADHD provided …

The Role Of Maladaptive Emotion Socialization In Risk For Urgency And Problem Drinking In Adolescents, Emily Atkinson

Theses and Dissertations--Psychology

Negative urgency (NU; the tendency to act rashly when experiencing negative emotions) is a robust risk factor for a number of problem behaviors, including early adolescent drinking. Little is known about the factors that precede the development of NU, and hence the full etiology of this component of risk. The current study aimed to investigate the possibility that childhood maladaptive emotion socialization (MES; the tendency for children’s expressions of emotions to be met with punishment, minimized, or invoke a reaction of distress from their parents/caretakers) increases risk for the development of NU. Secondarily, the study tested whether MES predicts increased …

Bipolarity Of Maladaptive Personality Traits In The Alternative Model Of Personality Disorders, Alexandra Hines

Theses and Dissertations--Psychology

It has been posited that extremely high or extremely low levels of any personality trait in the Five Factor Model of Personality can be maladaptive. However, the Alternative Model of Personality Disorders (AMPD) in Section III of the DSM-5 is composed almost exclusively of unipolar maladaptive traits. The lack of maladaptively low neuroticism and high extraversion fails to fully cover psychopathy; the lack of maladaptively high extraversion fails to cover histrionic personality disorder (HPD); the lack of maladaptively high agreeableness fails to cover dependent personality disorder (DPD); and the lack of maladaptively high conscientiousness fails to cover obsessive-compulsive personality disorder …

The Sport Concussion Assessment Tool: A Multidimensional Symptom Model For Detecting Elevated Post-Concussion Symptoms, Eric Ingram

Theses and Dissertations--Psychology

Following sport-related concussions, a multidimensional symptom interpretation may identify athletes with domain-specific problems when beginning to return-to-play (RTP). This study investigated whether a four-factor model of post-concussion symptoms (i.e., cognitive, physical, affective, and sleep-arousal) would identify student-athletes with persistent concerns not reflected by their total symptom score. Collegiate student-athletes (N=24,696) from the Concussion Assessment Research and Education consortium completed the Sport Concussion Assessment Tool – 3rd edition Symptom Evaluation at baseline and two post-injury follow-ups (i.e., beginning RTP and 6-month). Confirmatory factor analysis was used to compare one- and four-factor models of post-concussions symptoms. Normative reference data were …

Personalized Longitudinal Network Models Of Alcohol Use: A Mechanistic Approach, Stephen Semcho

Theses and Dissertations--Psychology

AUD and high-risk drinking are significant public health concerns, and prevailing diagnostic models fail to account for the within-person variability in AUD presentation and the role of functional mechanisms that maintain drinking outcomes. The ETOH Framework highlights the importance of three primary superdomains that maintain and characterize AUD – reward salience, cognitive dyscontrol, and negative emotionality. The current study was the first attempt to investigate the role of the primary ETOH mechanisms, along with positive and negative affect, on alcohol use outcomes, using a novel approach to model individual-level networks of relations over time. This study gathered twice-daily diary data …

The Condom Use Outcomes And Sexual Functioning Of Young Adult Latinas: The Roles Of Intimate Partner Violence, Posttraumatic Stress Disorder, And Marianismo Beliefs, Jessica Flores

Theses and Dissertations--Psychology

Intimate partner violence (IPV) has been linked to poorer condom use outcomes and sexual functioning in women broadly. Limited studies have examined these associations in Latina samples through a culturally sensitive, trauma-informed lens. A sample of 383 U.S. Latina/Latinx/Hispanic women (Mage = 25.29 years; SD = 4.44) who had a past-year intimate relationship completed a cross-sectional online survey of IPV history, posttraumatic stress disorder (PTSD) symptoms, marianismo beliefs (i.e., traditional Latina gender role expectations), condom use outcomes (i.e., condom use attitudes, efficacy, negotiation efficacy, and behaviors) and sexual functioning. Linear regression models found that past-year IPV was positively related …