Clinical Psychology Commons^™

Perceived Barriers And Facilitators To Mental And Behavioral Health Screening And Treatment In Primary Care For Women In Northeast Tennessee, Sarah K. Hill

Electronic Theses and Dissertations

Between one quarter and one third of all primary care patients meet criteria for at least one mental disorder. However, many women are not screened for mental disorders as recommended by the literature. Some studies suggest even lower rates of screening and treatment in rural areas. This researcher sought to identify barriers and facilitators to mental and behavioral health screening and treatment for women in primary care and solicit feedback on how to ameliorate perceived barriers. Given the limited extant data describing rural Appalachian women’s perceptions of barriers and facilitators to receiving mental health services an exploratory qualitative analysis was …

Human Action Switching In Hiv, Chinonyere Nzerem

Loma Linda University Electronic Theses, Dissertations & Projects

We evaluated switching in human action/verb fluency to examine how it associates with other measures of executive functioning and with difficulties in the performance of IADLs in a HIV+ sample. Our sample was comprised of 29 HIV+ participants. All the participants completed measures of phonetic fluency (FAS) and semantic fluency [Animals, Human Actions (HA)] in addition to the Paced Auditory Serial Addition Test (PASAT), Stroop Color-Word Test (Stroop), Trail-making Test Part B (TMT B), Letter-Number Sequencing (LNS), Wisconsin Card Sorting Test, and the Boston Naming Task (BNT). The first regression model with phonetic and semantic switching produced R2 = .260, …

Examining The Inner Experience Of Four Individuals With Bipolar Disorder Using Descriptive Experience Sampling, Johanah Kang

UNLV Theses, Dissertations, Professional Papers, and Capstones

Bipolar disorder is a lifelong mood disorder with diagnostic criteria that provide a description of expected experiences of individuals diagnosed with BD (e.g., elevated mood, sadness, difficulty concentrating). Despite these criteria, the inner experience of these individuals is largely unknown. Understanding the inner experience of individuals diagnosed with BD may prove essential in understanding and treating BD. The present study examined the inner experience of four individuals diagnosed with BD using the Descriptive Experience Sampling (DES) method (Hurlburt 1990, 1993, 2011). Results revealed all our participants had clear and prevalent experiences of sensory awareness. They also had difficulties apprehending and …

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 …

Ideal Dating And Sexual Partners For Low-Income Heterosexual African American Adolescents, Darnell Nathaniel Motley

College of Science and Health Theses and Dissertations

Dating and sexual relationships among adolescents have been identified as both normative and beneficial. However, the research examining the dating and sexual relationships of African American adolescents has been narrow in scope, focusing primarily on risks of intimate partner violence, pregnancy, and STI/HIV transmission. This myopic focus has left a gap in the literature as it relates to the normative aspects of dating and sexual relationships for these youth.

The present study sought to better understand the dating and sexual partner preferences of 51 African American adolescents (male = 32, female = 19) recruited from Chicago and San Francisco. The …

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 …

An Exploratory Study Of Recovery And Recovery Maintenance For Victims Of Childhood Sexual Abuse Who Completed Faith-Based Residential Treatment Programs, Ann Kerlin

Doctoral Dissertations and Projects

This interpretive phenomenological analysis of the experience of recovery and recovery maintenance for women with a history of childhood sexual abuse and its sequelae included interviews and a non-standard questionnaire. Ten women with this history who had completed a faith based treatment program for substance abuse and/or eating disorders described recovery. Themes that emerged related to the process of change included: Changes in Relationships with Others, to Self, to God, and lastly, Forgiveness as a Catalyst for Change. Six practices emerged in the exploration of maintenance recovery. This research highlighted the need for thorough bio-psycho-social-spiritual assessment and areas of concern …

Slope Of Change Through D-Cycloserine Facilitation Of Exposure Therapy In A Social Anxiety Population, Christina M. Sheerin

Dissertations

The present study sought to add to a growing base of research investigating approaches that facilitate the therapeutic effects of exposure-based therapy for social anxiety disorders. In particular, the approach involves the use of medication adjuvants that work in conjunction with therapeutic learning. This work translates findings from preclinical work to further our understanding of the neurobiological mechanisms that impact extinction learning. Among others, a promising method has been found with the use of D-cycloserine (DCS), a partial NMDA receptor agonist. Evidence of its positive impact in preclinical work has led to its application to clinical populations who suffer from …

Impact Of Co-Occurring Psychiatric Disorders And Traumatic Brain Injury On Speech-Language Treatment: Speech-Language Pathologists’ Perspectives, Janis Whitney Neal

Master's Theses and Doctoral Dissertations

Previous studies have associated traumatic brain injury (TBI) with higher rates of psychiatric disorders. This study investigated speech-language pathologists’ (SLPs) perspectives on the prevalence of co-occurring psychiatric disorders in the TBI population and its impact on speech-language treatment. Interviews were conducted with twelve SLPs working with a TBI population. Results revealed a lack of standard measures to assist SLPs in distinguishing between the symptoms of psychiatric disorders versus the neuropsychiatric symptoms of TBI. Also, results indicated the heavy reliance on a multidisciplinary team to provide comprehensive and individualized treatment for the TBI clientele, and the negative consequences of untreated psychiatric …

Randomized Clinical Trial Examining Duration Of Voucher-Based Reinforcement Therapy For Cocaine Abstinence., Kimberly C Kirby, Carolyn M Carpenedo, Karen L Dugosh, Beth J Rosenwasser, Lois A Benishek, Alicia Janik, Rachel Keashen, Elena Bresani, Kenneth Silverman

College of Science & Mathematics Departmental Research

BACKGROUND: This is the first study to systematically manipulate duration of voucher-based reinforcement therapy (VBRT) to see if extending the duration increases abstinence during and following VBRT.

METHODS: We randomized cocaine-dependent methadone-maintained adults to Standard (12 weeks; n=62) or Extended (36 weeks; n=68) VBRT and provided escalating voucher amounts contingent upon urinalysis verification of cocaine abstinence. Urinalysis was scheduled at least every 2 weeks during the 48-week study and more frequently during VBRT (3/week) and 12 weeks of Aftercare (2/week).

RESULTS: Extended VBRT produced longer durations of continuous cocaine abstinence during weeks 1-24 (5.7 vs 2.7 weeks; p=0.003) and proportionally …

Peer Support For Consumers With Psychosis, Elizabeth Ann Cook

Department of Psychology: Dissertations, Theses, and Student Research

The purposes of this project were: 1) to collaboratively adapt an existing cognitive-behavioral intervention for consumers with serious mental illness (SMI) so that it could be provided by peers, and 2) to evaluate the feasibility of the resulting group intervention and perform a preliminary analysis of its effectiveness. Focus groups consisting of 7 consumers with SMI and 9 peer providers assisted in the determination of group content and structure. Results from the focus groups suggested significant overlap between topics covered and educational strategies utilized in traditional psychosocial interventions and preferences for the peer-based group. However, participants expressed a preference for …

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). …

Effects Of Anger Awareness And Expression Training Versus Relaxation Training On Headaches: A Randomized Trial, Olga Slavin-Spenny, Mark A. Lumley, Elyse R. Thakur, Dana C. Nevedal, Alaa M Hijazi

Psychology Faculty Research Publications

Background and purpose: Stress contributes to headaches, and effective interventions for headaches routinely include relaxation training (RT) to directly reduce negative emotions and arousal. Yet, suppressing negative emotions, particularly anger, appears to augment pain, and experimental studies suggest that expressing anger may reduce pain. Therefore, we developed and tested anger awareness and expression training (AAET) on people with headaches.

Methods: Young adults with headaches (N = 147) were randomized to AAET, RT, or a wait-list control. We assessed affect during sessions, and process and outcome variables at baseline and 4 weeks after treatment.

Results: On process measures, …

Neuropsychological Correlates Of Anosognosia In Mci And Dementia, Krystle Dina Barrera

Loma Linda University Electronic Theses, Dissertations & Projects

Anosognosia is a general term used to describe a lack of awareness of a disability and is well documented in various disorders associated with neurological compromise. While anosognosia is well documented as part and parcel to Alzheimer's dementia, less research has focused on determining the presence of anosognosia in what has come to be viewed as the subclinical precursor to dementia, mild cognitive impairment. In addition, a number of different methodologies and instruments are employed in quantifying and assessing anosognosia in various populations, which make comparison across studies and diagnoses difficult. Research commonly employs a paradigm that uses the discrepancy …

Cerebral Metabolic And Neuropsychological Outcomes Following Mild Traumatic Brain Injury, Julia L. Evans

Loma Linda University Electronic Theses, Dissertations & Projects

Traumatic brain injury (TBI) in adolescents and adults can result in cognitive, emotional, behavioral and neurological deficits that can persist more than a year after an injury. The current preliminary study used 3D magnetic resonance spectroscopic imaging (MRSI) and comprehensive neuropsychological assessment to determine if prolonged cerebral metabolic and cognitive alterations occur in individuals with persistent neurocognitive deficits following a mild TBI (mTBI). The current study evaluated the potential interactions between cerebral metabolism and neuropsychological performance, coping style, mood, and perceived quality of life in mTBI subjects with chronic post-concussive symptoms. The mTBI subjects performed worse than controls on neuropsychological …

Adolescent Participation In Traditional Martial Arts: Effects Of Training On Risk Behaviors And Psychological Wellbeing, Stephanie Anne Devore Goldsmith

Loma Linda University Electronic Theses, Dissertations & Projects

Adolescence is the period of lifetime development in which many youth begin to make health and lifestyle choices that have a significant impact on overall wellbeing as they transition from childhood into young adulthood. Physical activity appears to be linked to making other healthy lifestyle choices including non-engagement in risk behaviors and improvement in mood and self-concept. The current study sought to examine the effect participation in traditional martial arts training has on overall psychological wellbeing in adolescents. This study administered two widely used and validated scales, the CDC's Youth Risk Behavior Surveillance System (YRBSS) and the Piers Harris-2 (PH-2) …

Acculturation As A Mediating Factor Between Ethnic And Self-Identities, Judith A. Hotvedt

Loma Linda University Electronic Theses, Dissertations & Projects

Is acculturation a mediating factor in self- and ethnic identity among ethnic minority emerging-adults? A conceptual model was tested examining links between self and ethnic identity and acculturation. An association was proposed between perceived social support, affirmation and belonging, and EOM self-identity statuses (diffusion, foreclosure, moratorium, achievement) as mediated by VIA mainstream and heritage acculturation. A second association was proposed between out-group orientation, interpersonal variables, and ethnic identity as mediated by VIA mainstream and heritage acculturation. This study did not provide full support for acculturation as a mediating variable; rather, the ‘interpersonal variable’ was an intervening variable in the association …

Predictors Of Neuropsychological Status In Cardiac Patients, Joel E. Kamper

Loma Linda University Electronic Theses, Dissertations & Projects

Heart Disease is one of the leading causes of death and disability in the United States. Disease processes such as Coronary Artery Disease (CAD) and Chronic Heart Failure (CHF) account for the majority of cases, and are responsible for Myocardial Infarctions (MI), Coronary Artery Bypass Grafting (CABG) surgery, and other common disease sequelae and treatment paradigms. While the fact that heart can negatively impact cognitive functioning is well documented, the factors that drive changes in cognition have not been studied in depth. Additionally, while many heart patients choose to enter cardiac rehabilitation (CR) programs designed to decrease morbidly and mortality, …

Implications Of Tailoring Emotional Expression Within An Expressive Writing Paradigm, Eric R. Hanson

Loma Linda University Electronic Theses, Dissertations & Projects

This dissertation uses the theoretical perspective that both emotion and emotional processing theories could greatly enhance feedback messages given in a linguistic writing paradigm. The measurement of emotional expression is briefly reviewed along with the basic expressive writing paradigm, outcome of this expressive writing paradigm, and the tailoring literature. Reference is made to the single study (Owen, et al., 2011), which has utilized tailoring in an expressive writing paradigm; the present study is a modification of this original study. This dissertation used clinically minded feedback which utilized both emotion and emotional processing theory. For the experimental design, three tailoring conditions …