Clinical Psychology Commons^™

Behavioral Health Among Asian American And Pacific Islanders: The Impact Of Acculturation And Receipt Of Behavioral Health Services On Depression And Anxiety, Mari E. Yamamoto

Clinical Psychology Dissertations

Behavioral health models improve access to mental health care by integrating psychology and medicine. While integrated care is supported among the general population, less research focuses on the model with Asian American and Pacific Islanders (AAPIs). AAPIs are low treatment-seeking due to various barriers (e.g., limited English proficiency, stigma, insurance) and acculturation stressors. Using hierarchical linear modeling, this study examined longitudinal depression (PHQ-9) and anxiety (GAD-7) growth trajectories among AAPIs within a behavioral health model and the moderating impact of acculturation and frequency of behavioral health visits. The best fitting model was from a sample who (N = 354; …

Risk Factors Associated With Depression And Anxiety In Older Adults Of Mexican Origin, Raquel Estrada Gonzalez

Walden Dissertations and Doctoral Studies

Older adults of Mexican origin are often underserved, especially those residing in nursing homes. Their number has increased in the past 4 years. There is a gap in the research literature on Hispanic elders, specifically those of Mexican origin, residing in nursing homes along the Texas-Mexico border. Because Texas has one of the fastest growing populations of Mexican elders, it is important to better understand this population. This nonexperimental study evaluated the relationship among risk factors' such as gender, marital status, family support, activities of daily living (ADLs) and participation in nursing home activities. These relationships were evaluated with a …

Using Structural Equation Modeling To Understand The Role Of The Family In Pediatric Asthma Contexts, Nour Al Ghriwati

Theses and Dissertations

Family factors have long been associated with the psychosocial adjustment of children with chronic illnesses, such as asthma (Minuchin, 1975; Rapee, 1997). Research indicates that negative family factors may also contribute to child disease severity, via bio-behavioral mechanisms of effect (Wood et al., 2006); however, these pathways have yet to be examined with a comprehensive focus on more positive family factors. This study sought to examine whether factors such as family cohesion, problem solving abilities, and communication influence asthma symptom severity in children via their effects on child depression and anxiety symptoms. Using structural equation modeling, we identified significant indirect …

Therapist Adherence To Cognitive Behavioral Therapy For Anxious Youth Across A Case, Julia R. Cox

Theses and Dissertations

The field has developed many evidence-based treatments (EBTs); the integrity of EBTs being delivered, however, has been studied less than rigorously. Because many treatment manuals are developed to be delivered session-by-session, one way to assess treatment adherence, specifically, is across the course of the case: do therapists deliver treatment components in the order prescribed? The goals of this study were to characterize how therapists deviate from prescribed order and how adherence to order relates to child characteristics. Therapy process data were collected from a subsample of children (N = 33, aged 7-15) that received cognitive behavioral therapy (CBT) to address …

Adherence To And Competence In Cognitive Behavioral Therapy For Youth Anxiety: Psychometric Evaluation, Cassidy C. Arnold

Theses and Dissertations

Treatment integrity—the extent to which a treatment is delivered as it was intended—has long been recognized as critically important in treatment evaluation research, but has garnered increased attention in recent years within the context of dissemination and implementation science. However, the field’s development has been hindered by inadequate measurement tools. This project is focused on developing and evaluating the psychometric strength of two measures of treatment integrity. To evaluate the psychometric strength of the Cognitive-Behavioral Therapy for Youth Anxiety Therapist Adherence Scale (CBAY-A)and the Cognitive-Behavioral Therapy for Youth Anxiety Therapist Competence Scale (CBAY-C), 954 psychotherapy sessions from two treatment evaluation …

The Relation Between Adiposity And Anxiety In Youth: Analysis Of Peer Victimization, Teasing, Sociocultural Influences, And Internalization Of Appearance Ideals As Explanatory Variables, Natasha L. Burke

USF Tampa Graduate Theses and Dissertations

The purpose of the current study was to examine putative mediators and moderators in the association between adiposity and anxiety in a sample of overweight and obese youth. In addition, anxiety was examined as a potential moderator between adiposity and health-related quality of life (HRQOL). Participants were youth (N = 137) between 8 and 17 years old (M = 13.09, SD = 2.61) and their legal caregivers recruited from four medical clinics affiliated with the University of South Florida. Youth were primarily overweight (28.5%) or obese (64.2%) and ethnically diverse. Data were analyzed by path analysis. Weight-related teasing significantly mediated …

Cognitive Processes And Moderators Of Willingness In Individuals With Social Anxiety Disorder And Non-Anxious Controls In Response To A Social Performance Task, Lauren P. Wadsworth

Graduate Masters Theses

The present study investigated differences between individuals with social anxiety disorder (SAD) and non-anxious controls (NAC) on measures of thought processes and anxiety responses surrounding an anxiety-provoking situation. Participants gave a spontaneous speech to an audience and reported their anxiety throughout. Measures of trait decentering and anxiety, situational anxiety, negative thoughts and believability, and willingness to repeat the task were administered. Compared to NAC, individuals with SAD reported a higher prevalence of negative thoughts, found the thoughts more believable, reported lower levels of trait decentering, and reported less willingness to repeat an anxiety-provoking task. Collapsing the groups, we found an …

Oppositional And Anxiety Behavior Profiles In A Clinical Sample Of Youth With Selective Mutism, Rachele Diliberto

UNLV Theses, Dissertations, Professional Papers, and Capstones

Children with selective mutism often present as a very heterogeneous population, with both anxious (APA, 2000; 2013; Kristensen 2000; Manassis et al., 2007; Steinhausen & Juzi, 1996; Yeganeh et al., 2003) and oppositional symptoms (APA, 2013; Andersson & Thomsen, 1998; Kolvin & Fundudis, 1981; Krohn, Weckstein, & Wright, 1992). This study sought to identify anxiety and oppositional behavior profiles in a clinical sample of children with selective mutism. Also, this study sought to determine both discriminant and concurrent validity for these profiles and examine their association with family expressiveness, conflict and control. Participants (n=57) included youth receiving treatment at the …

Parenting Dimensions And Internalizing Symptoms Among Low-Income Latino Adolescents: Cultural Values As Moderators, Crystalia Sulaiman

College of Science and Health Theses and Dissertations

Among ethnic minority youth, Latino adolescents disproportionately report higher levels of depression and anxiety than their peers of other ethnic backgrounds. The purpose of the present study is to better understand the familial and sociocultural factors that impact mental health among Latino adolescents. Specifically, the present study examines how youth cultural values (i.e., family obligation and affiliative obedience) moderate the relation between parenting dimensions (i.e., parental acceptance and parental psychological control) and youth internalizing symptoms (i.e., depression and anxiety) cross-sectionally and longitudinally. Latino adolescents (n = 115) from a Chicago public school categorized as "lowincome" participated in a survey and …

Mental Health Referral In Primary Care: Influence Of A Screening Instrument And A Brief Educational Intervention, Michael T. Miesner

Electronic Theses and Dissertations

Although less than half of all patients with mental disorders seek mental health treatment per se, approximately 80% of all people will visit their primary care physician (PCPs) within a year (Strosahl, 1998). However, it is not well understood how to best handle patients presenting with mental health issues in primary care practices. The purpose of this project was to implement an intervention involving a screening measure for anxiety and mood disorders in a primary care setting to increase the volume of anxiety and mood disorder screening, to increase the accuracy of disorder detection, and to also enhance PCPs patterns …

Savor The Memory: A Reminiscence Exercise To Increase Positive Emotions And Reduce Depression Risk In Anxious Individuals, Bethany Morris

USF Tampa Graduate Theses and Dissertations

A growing literature suggests that experiencing positive emotions provides psychological benefits (e.g., Coifman et al. 2007), and interventions increasing positive emotions may reduce depression risk (Geschwind et al., 2011). The present study tested whether reminiscence, a method of positive emotion savoring (Quoidbach et al., 2010), can mitigate depression risk by increasing positive emotions in an unselected sample and a subsample of at-risk anxious individuals. Female participants (n=336) were randomized to a reminiscence or control condition and asked to complete daily mental imagery exercises focusing on a positive memory (reminiscence) or a neutral laboratory memory (control) for one week. As expected, …

Differential Extinction Of Disgust And Anxiety Among Victims Of Sexual Traumatization, Christal Badour

Graduate Theses and Dissertations

Emerging evidence suggests that in addition to fear, traumatic event-related disgust reactions may be integral to understanding the sequelae of sexual traumatization. Importantly, evidence broadly suggests compared to fear, disgust may be resistant to extinction. As such, conditioned disgust reactions may not evidence the same pattern of extinction observed with fear-based reactions. This may have important implications for the treatment of posttraumatic stress disorder (PTSD). As such, the current study sought to fill an important gap in the existing literature by examining specific processes and mechanisms that are likely to affect outcomes of exposure-based interventions following sexual traumatization. Specifically, 72 …

Co-Worry In Friendship Dyads, Michelle H. Goldstein

Honors Scholar Theses

Anxiety disorders increase in prevalence from childhood into adulthood. Although cognitive theories are prominent in the etiology and maintenance of anxiety, peer relationships are emerging as salient interpersonal risk factors. This study investigates the effects of specific interpersonal interchanges on anxiety symptoms in college students. 60 undergraduates attended the experiment with a same-sex best friend, and were randomly assigned to the co-worry or neutral conversation condition. Each person completed self-report measures of state anxiety, negative affect and positive affect prior to and following an 8-minute conversation about self-generated worry topics such as exams or neutral topics such as the weather. …

Traumatic Life Events And Symptoms Of Anxiety: Moderating Effects Of Adaptive Versus Maladaptive Coping Strategies, Alishia Foster

Electronic Theses and Dissertations

The experience of trauma is prevalent among young adult college students and is often associated with poor mental health outcomes such as symptoms of anxiety. Not all individuals who have experienced trauma, however, develop anxiety, perhaps due to individual-level adaptive characteristics, such as use of adaptive rather than maladaptive coping strategies. Yet, little research has examined the interrelationships between the experience of trauma, specific types of coping strategies, and subclinical anxiety symptoms. A sample of 915 undergraduate students completed self-report measures of trauma, coping strategies, and anxiety symptoms. We hypothesized that traumatic life events would be associated with anxiety symptoms, …

A Longitudinal Study Of The Bidirectional Relations Between Internalizing Symptoms And Peer Victimization In Urban Adolescents, Tess Drazdowski

Theses and Dissertations

The purpose of this study was to examine the bidirectional relations between anxious and depressive symptoms and two forms of peer victimization (i.e., overt and relational) within a sample of 358 predominantly African-American adolescents living in low-income urban areas across four years. Longitudinal path analyses tested progressively complex models for each type of victimization. For both overt and relational victimization the autoregressive model where only previous levels of each construct predicted future levels of the construct was the most parsimonious explanation. The best fitting model for both types of peer victimization suggested that internalizing symptoms helped to further explain future …

Toward A Conceptualization Of Emetophobia: Examining Intolerance Of Uncertainty As A Unique Predictor Of Symptoms, Mimi Zhao

Electronic Theses and Dissertations

Emetophobia, a poorly understood disorder, is a specific phobia characterized by an irrational and persistent fear of oneself vomiting or others vomiting. Though research on the disorder is sparse, previous investigations have reported interference in social, occupational, and health domains in the lives of individuals with emetophobia (Lipsitz et al., 2001; McFayden & Wyness, 1983; Veale & Lambrou, 2006). To this end, the current study examined whether individual differences in Anxiety Sensitivity (AS), Disgust Sensitivity (DS), and Intolerance of Uncertainty (IU) are associated with symptoms of emetophobia, whether AS predicts symptoms of emetophobia above and beyond DS, IU, and expected …

Follow-Up Evaluation Of Treatment For Anxiety And Depression Provided In A University-Based Primary Care Clinic, Renée M. Grinnell

Theses and Dissertations

Although integrated primary care psychology services are becoming increasingly common, the literature lacks adequate research support for the longitudinal durability of treatment effects following the conclusion of brief primary care interventions. This study served as a follow-up program evaluation of psychological services for depression and anxiety provided at the Medical College of Virginia’s Ambulatory Care Center in Richmond, Virginia. Data were collected on 47 adult primary care patients who received treatment for depression and/or anxiety between six and 18 months prior to the follow-up telephone call. Data were collected on the trajectory of depression scores throughout and following treatment, treatment …

Evaluation Of Psychological Services For Anxiety And Depression Provided In A University-Based Primary Care Clinic, Elizabeth J. Sadock

Theses and Dissertations

Primary care clinics are increasingly integrating psychological services into their service programs, however few studies have used a comparison group to demonstrate the effectiveness of these services. This study evaluated the psychological services provided at the Ambulatory Care Clinic (ACC) at the Virginia Commonwealth University Health System (VCUHS) by comparing changes in 147 patients’ PHQ-9 depression scores and GAD-7 anxiety scores over time to the scores of 139 patients at the Hayes E. Willis Health Center, a comparison clinic with demographically similar patients but no integrated psychological services. Assessment data were collected from participants in the ACC at VCUHS during …

How Individual Differences In Self- And Other-Focused Co-Rumination Relate To Internalizing Symptoms And Friendship Quality, Heather Smith-Schrandt

USF Tampa Graduate Theses and Dissertations

Co-rumination involves friends spending a great deal of time encouraging each other to excessively discuss problems, with content being largely negative (Rose, 2002). Co-rumination appears to strengthen the bonds between best friends, while ironically exacerbating internalizing symptoms. Co-rumination is conceptualized as a mutual dyadic process, but little is known about the reciprocity of excessive problem discussion. The balance of college students' (N = 601) self- and other-focused co-rumination with their best friend was assessed via an online survey. Contrary to expectations, inconsistent and weak evidence was obtained for differentiating self- and other-focused co-rumination, and their balance. Specifically, self- and other-focused …

The Development Of A Self-Report Questionnaire To Measure Problematic Video Game Play And Its Relationship To Other Psychological Phenomena, Anatol Tolchinsky

Master's Theses and Doctoral Dissertations

Problematic video game play is becoming a more frequent clinical presentation, and currently there is no standard way of measuring this phenomenon. This study operationalized this construct in a way that accurately reflects the existing literature and attempted to construct a valid measure based on this information. This new assessment instrument was evaluated by analyzing its factor structure on both 375 college-age participants and 314 online participants who endorsed being a regular video game player.

This area of research is still in its infancy, especially in regard to comorbid psychopathology. Consequently, this study surveyed participants’ subjective experience of depression and …

Social Affiliation: A Model Of Anxious Avoidance In Women, Milena Stoyanova

Department of Psychology: Dissertations, Theses, and Student Research

There is substantial evidence demonstrating that women experience greater anxiety and fear compared to men. However, our understanding of specific factors accounting for women’s greater vulnerability remains rather limited. Taylor and colleagues (2000) proposed that women may have a different biobehavioral response to stress, which has evolved to protect and nurture offspring. The tend-and-befriend model provides new opportunities to explore underlying processes that may contribute to women’s greater anxiety and fear.

The present study examined women’s stress response combined with the absence of positive social contact as it relates to the presentation of fear and anxiety. One hundred and seven …

Pornography Addiction And Mental Health Disorders, Tabitha Cassidy

Senior Honors Theses

This study aims to understand the differences between mental health disorders in a sample of pornography users, addicts, and non-users. Participants in the study included males and females who visited a paraprofessional counseling center on a college campus (n=1048). Between non-users and users of pornography, one-way analysis of variance planned comparison results indicated that participants significantly differed in scores of Depression, Anxiety, and Global Severity Index as measured by the Brief Symptom Inventory 18 (BSI 18). Non-Suicidal Self-Injurious behaviors as measured by the Ottawa Self-Injury Inventory; and Grandiosity/Narcissism as measured by the Spiritual Assessment Inventory. Independent sample t-test scores indicated …

Stress, Anxiety, And Somatic Symptoms: A Comparison Of Biomarkers In A Clinical Sample, David J. Finitsis

Master's Theses

Anxiety disorders are the most prevalent class of mental disorders, often characterized by a chronic course and comorbid psychopathology. The anxiety-stress literature utilizing cortisol as a biomarker of the hypothalamus pituitary adrenal (HPA) axis has been inconsistent. The establishment of salivary alpha-amylase (sAA) as a biomarker of sympathetic nervous system (SNS) activation allows researchers an opportunity to examine the stress response more fully. This study sought to explore relationships between trait anxiety and salivary stress biomarkers in an outpatient sample attending a specialized anxiety treatment center. Multiple regression and moderator analyses were conducted to examine associations between psychosocial and physiological …

Attentional Processes Associated With Victimization History And Posttraumatic Symptomatology In Women Exposed To Intimate Partner Violence, Ryan B. Matlow

Electronic Theses and Dissertations

Exposure to intimate partner violence (IPV) puts women at risk for severe and chronic physical and mental health consequences, including elevations in IPV-related psychopathology and increased risk for future victimization. Previous research has examined attention as one of the key information processing mechanisms associated with elevated psychopathology and risk for victimization; however, the nature of attentional processing in response to IPV-related information in women exposed to IPV is poorly understood. Therefore, the current study aimed to further understanding of associations between attentional processing, IPV exposure, and related distress using measures of eye movement and subjective interpretations of IPV-related information. A …

Differences Between Core And Animal Reminder Disgust Elicitation On A Core Disgust Avoidance Task--A Replication With Modifications, Matthew Schumann

All Graduate Theses, Dissertations, and Other Capstone Projects

Compred to other emotions, there has been a lack of research on disgust as it relates to psychopathology. Of the extant research, disgust has been shown to be implicated in various anxiety disorders and consist of three domains: core, animal-reminder, and contamination disgust. There is evidence that these domains are correlated with disgust-relevant anxiety disorders, and this sensitivity to specific disgust domains have different topographical presentations. This study aims to determine if priming participants with different domain-specific videos (core, animal-reminder, neutral) and then completing a disgust-related behavioral avoidance task that is specific to the core domain, will lead to greater …

Does Virtual Reality Elicit Physiological Arousal In Social Anxiety Disorder, Maryann Owens

Electronic Theses and Dissertations

The present study examined the ability of a Virtual Reality (VR) public speaking task to elicit physiological arousal in adults with SAD (n=25) and Controls (n=25). A behavioral assessment paradigm was employed to address three study objectives: (a) to determine whether the VR task can elicit significant increases in physiological response over baseline resting conditions (b) to determine if individuals with SAD have a greater increase from baseline levels of physiological and self-reported arousal during the in vivo speech task as opposed to the VR speech task and (c) to determine whether individuals with SAD experience greater changes in physiological …

Adult Adhd And The Relationship Between Self-Reported Frequency Of Cognitive Distortions, Anxiety, And Depression, Craig Strohmeier

PCOM Psychology Dissertations

Cognitive-behavioral therapy for adults with ADHD often includes strategies to address cognitive distortions. Although identifying cognitive distortions as part of a causal chain related to disorders such as anxiety and depression has been well studied, limited research has focused on the relationship between ADHD and cognitive distortions. The goal of this study was to determine the nature of the relationship between ADHD, cognitive distortions, anxiety, and depression within a group of adult outpatients from an ADHD treatment center (N = 30). Results indicated that the severity of ADHD symptomatology, identified through a self-report scale, was significantly related to the self-reported …

Play And Treatment Outcomes In A Cognitive-Behavioral Program For Children With Anxiety: The Role Of Child Involvement And Collaboration, Enid S. Flagg

PCOM Psychology Dissertations

This study examined a mediation model of the relationship between play, process variables (child involvement and collaboration), and treatment outcome in a randomized clinical trial (RCT) of CBT for childhood anxiety disorders. Additionally, it explored the use of play in CBT for children. Participants (N=43; M age = 10.09) took part in a RCT which evaluated the effectiveness of an individual cognitive-behavioral treatment (ICBT) versus a family cognitive-behavioral treatment (FCBT), for childhood anxiety disorders. Archival data (videotaped treatment sessions) at a university based clinic for childhood anxiety disorders was coded for treatment interventions (play and cognitive-behavioral) and process variables (child …

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, …

The Influence Of Parent Factors On Child Perfectionism: A Cross-Sectional Study, Lisa Caitlin Cook

UNLV Theses, Dissertations, Professional Papers, and Capstones

Perfectionism is a multidimensional construct that affects adults and children and is associated with psychological problems such as depression, anxiety, and obsessive compulsiveness. Studies regarding risk factors for perfectionism are scarce but extant research and theories suggest parents may be involved in the development of perfectionism in children. The present study included 160 children aged 8-17 years (67 males, 93 females) and their parents. The study examined child perfectionism across five age groups (8-9 years, 10-11 years, 12-13 years, 14-15 years, 16-17 years) as well as relationships between parent and child perfectionism and between parent psychopathology and child perfectionism. Self-oriented …