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Therapist (Dis)Continuity, Therapeutic Relationship, and (Premature) Termination in a Psychology Training Clinic

Description: Premature termination is a substantial problem with significant adverse effects for clients, therapists, and treatment organizations. Unfortunately, it is also a relatively common phenomenon within mental healthcare settings. Across varied mental healthcare settings, rates of premature termination have reportedly ranged from 19.7 % to 40 %. Perhaps not surprisingly, the rate of premature termination in training clinics is substantially higher than in community mental health settings and private practice, with 75 to 80 % of clients ending treatment services prematurely. The purpose of this study was to explore the combined effect of intake therapist continuity or discontinuity, and quality of the therapeutic relationship on premature termination. Intake therapist continuity, measures of working alliance, and termination outcome from 524 clients at the University of North Texas Psychology Clinic were utilized for adults receiving individual therapy services between August 2008 and August 2013. Results of the study suggest intake therapist continuity did not predict subjective termination status (X2(2, n = 524) = 1.61, p = 0.45), nor did it predict change in symptomology status (X2(3, n = 453) = 1.14, p = 0.77). Additionally, working alliance predicted subjective termination status (X2(6, n = 212) = 21.17, p < 0.01), but not change in symptomology status (X2(9, n = 208) = 6.27, p = 0.71). The findings of the current study are discussed, as well as suggestions for further research related to client, therapist, treatment, and procedural variables and their impact on premature termination.
Date: August 2015
Creator: Al-Jabari, Rawya M.
Partner: UNT Libraries

The Effects of Attributional Styles on Perceptions of Severely Mentally Ill Offenders: a Study of Police Officer Decision-making

Description: Police officers are allowed considerable discretion within the criminal justice system in addressing illegal behaviors and interpersonal conflicts. Broadly, such resolutions fall into two categories: formal (e.g., arrest) and informal outcomes. Many of these interventions involve persons who have historically faced stigmatization, such as those who have mental disorders, criminal histories, or both (i.e., mentally disordered offenders). On this point, stigma generally includes discriminatory behavior toward the stigmatized person or group and can be substantially influenced by internal and external attributions. In addition, researchers have suggested that internal attributions lead to punishing behaviors and external attributions lead to helping behaviors. The current study examined attributions about offender behavior made by police officers in an effort to evaluate the effectiveness of Corrigan’s model. Specifically, this study investigated the effects of officer attributions on their immediate decisions in addressing intentionally ambiguous and minor offenses. Officers provided one of two vignettes of a hypothetical offender who was either mentally disordered or intoxicated and provided their anticipated resolution of the situation. Encouragingly, disposition decision differed by offender condition, with a substantially higher rate of arrests for the intoxicated offender (i.e., the external condition). Corrigan’s model was initially successful for both offender conditions, but was overall more successful for the mentally disordered condition. Results are discussed within the broader context of police policy, such as crisis intervention training, and identification of officers who could benefit from additional mental health trainings.
Date: August 2015
Creator: Steadham Jennifer A.
Partner: UNT Libraries

Attachment Theory Within Clinical Supervision: Application of the Conceptual to the Empirical

Description: Attachment theory has established itself as applicable to many types of relationships, encompassing caregiver-child, romantic, interpersonal, and psychotherapeutic interactions. This project sought to investigate the application of attachment theory to clinical supervision. Using suggestions put forth in previous work by Watkins and Riggs, this study examined the dyadic interactions inherent in both supervision and attachment. Using the working alliance as determination of the quality of supervision, attachment styles, leader-follower attachment, and attachment-based expectations were explored as predictors for supervisor-trainee dyad outcome in a training clinic for doctoral psychology students. The study design is longitudinal and prospective. Findings indicate the necessity of measurement of supervisory-specific attachment rather than general attachment, the stability of working alliance over time, and the large contribution of the leader-member attachment framework to the understanding of supervisory attachment. Implications include the importance of maintaining hierarchical, evaluative boundaries within supervisory relationship, consistent with a leader-follower dynamic.
Date: August 2015
Creator: Wrape, Elizabeth R.
Partner: UNT Libraries

Relationship Centrality and Expressive Writing: Understanding Post-breakup Distress

Description: When a romantic relationship ends in dissolution, the ex-partners may experience distress similar to post-traumatic stress or complex grief (i.e., dysphoric mood, feelings of loss, intrusive memories, negative rumination regarding the relationship, and a loss of self-esteem). Interventions designed to reduce post-breakup distress have historically attempted to foster integration of the breakup into the self-narrative through techniques such as expressive writing. Recent research indicates centrality, or heightened integration of an event or concept into an individual’s identity, predicts heightened levels of distress in the case of negative life events, including romantic relationship dissolution. Given the role romantic relationships themselves play in identity formation, exploration is warranted of the potential distress resulting from over-identification with a romantic relationship itself, or relationship centrality, after a breakup has occurred. Furthermore, if an individual has overly-integrated a relationship into their identity, the effectiveness of interventions focusing on further integration of the breakup is called into question. This study explored the centrality of participants’ previous romantic relationships, the distress resulting from the dissolution of those relationships, and the role of expressive writing as a distress reduction tool when centrality is taken into account.
Date: December 2015
Creator: Nowlin, Rachel B.
Partner: UNT Libraries

The Role of Values in Psychotherapy Process and Outcome

Description: Given the importance of client characteristics and preferences, and therapist expertise to evidence-based practice in psychology, the current study sought to contribute to the literature concerning the role of values in psychotherapy. Personal values of clients and trainee therapists in 29 dyads were examined for relationships between client and therapist values and associations with working alliance and outcomes. Although previous literature in this area has suggested that successful therapy is characterized by an increase in similarity of client and therapist values, the current study did not replicate this finding. However, client perceptions of therapist values were found to be important to working alliance and outcome. Findings are discussed in terms of suggestions for future research as well as implications for clinical practice, including the importance of discussing expectations and preferences with clients.
Date: August 2015
Creator: Hogan, Lindsey R.
Partner: UNT Libraries

Self-definition and College Adaptation in Students From the Ronald E. McNair Postbaccalaureate Achievement Program

Description: While a great deal of psychological research is conducted on college students, less has been done on their adaptation to college. These young adults, as they develop ego identity and differentiate themselves from parents and families, must adjust to the social and academic environment of college. Psychosocial adjustment predicts college retention better than academic predictors do. First generation college students face greater than typical challenges adapting to college. The Ronald E. McNair Post-Baccalaureate Achievement Program exists to aid first generation, lower income undergraduate student who wish to pursue a doctoral degree. Self-definition scored from thematic apperceptive technique stories reflects an individual’s relative freedom from social role constraint. This study examined the role of self-definition and familial understanding and acceptance in this population as predictors of successful adaptation to college. While neither was found to be a significant predictor, family understanding and acceptance was found to be a more defining characteristic of this sample than was self-definition. This suggests that when social support is sufficient, individuals do not need to rely on self-definition.
Date: December 2015
Creator: Vance, Jeffrey Michael
Partner: UNT Libraries

Conceptualizing Quality of College Life

Description: The objectives of this study were to mathematically model the quality of college life (QCL) concept and to study the associations between attachment style, emotion regulation abilities, psychological needs fulfillment and QCL via structural equation modeling. Data was collected from 507 undergraduate students (men = 178, women = 329; age M = 21.78 years, SD = 4.37). This data was used to provide evidence for the validity of the College Adjustment Scales (CAS) as a measure of quality of college life. The CAS demonstrated good convergent validity with the World Health Organization Quality of Life measure (WHOQOL), Subjective Well-being and Psychological Well-being Scales. Results: Students who were insecurely attached were as likely to feel adequate in their academic and professional endeavors as securely attached students. However, insecurely attached students had lower QCL levels, lower fulfillment of psychological needs and more emotion regulation difficulties than securely attached students. The results also indicated that Anxious Attachment and Avoidant Attachment were positively and strongly associated. Nonetheless, Anxious Attachment and Avoidant Attachment affected QCL through different mechanism. Emotion regulation mediated the path between Anxious Attachment and QCL while the fulfillment of psychological needs mediated the path between Avoidant Attachment and QCL. The fulfillment of psychological needs also mediated the path between emotion regulation and QCL. The described pattern of results was found for three separate models representing 1) the student’s attachment with their romantic partner, 2) best friend and 3) mother. Additionally, the study’s findings suggest a change in primary attachment figure during the college years. Emotion regulation, the fulfillment of psychological needs and QCL were all affected more strongly by the student’s attachment style with their romantic partner and best friend compared to their attachment style with their parents.
Date: August 2014
Creator: Cardona, Laura A.
Partner: UNT Libraries

An Exploration of the Criterion and Construct Validity of the Self-Compassion Scale

Description: Past research indicates that self-compassion has positive implications for psychological health and functioning. However, as a newly specified construct, the literature regarding self-compassion could benefit from a more thorough validation of the primary scale used in this area of research, the Self-Compassion Scale. In the present study, structural path analysis (using Amos) was used to explore the criterion validity of the SCS with four variables which have been theorized to be relevant to self-compassion (caregiver emotional responsiveness, fear of emotion, internalized spirituality, and achievement goal orientation). Initial hypothesis testing indicated support for the path model, with the exception of achievement goals which were not significantly associated with self-compassion. Trimming these paths in a subsequent analysis improved model fit. Interestingly, further analyses of the model indicated that the pairing of participant and parent gender produced substantial differences in path coefficients. Next, correlational and factor analytic methods were used to test the construct validity of the SCS. Correlational analyses found adequate convergent construct validity but some lack of divergent validity between SCS dimensions and conceptually similar constructs (i.e., fear of emotion, social connectedness and self-criticism). Confirmatory factor analysis indicated that a two-factor model fit the data better than the one-factor model proposed by the author of the SCS. The incremental validity of the two-factor model was supported by incorporating a two-factor SCS in the path analysis. In sum, these findings generally support the criterion validity of the SCS through meaningful associations with theoretically relevant variables but cautions that these associations are strongly influenced by gender. It is also strongly recommended that a two-factor model of the SCS be explored in further research to ascertain its incremental utility for understanding self-compassion’s positive effects on psychological health.
Date: August 2014
Creator: Farnsworth, Jacob K.
Partner: UNT Libraries

Development and Validation of a Measure of Religious and Spiritual Flexibility

Description: Religion and spirituality are vital aspects of many people’s lives both in the United States and across the globe. Although many constructs and measures exist to describe and assess the experience of pursuing the sacred, the complexity of religious and spiritual experience leads to mixed results in relation to well-being and psychopathological traits. However, in broad terms, the relationship appears positive. Over the past 30 years the need for more refined and useful approaches to the study of religious and spiritual behavior has been repeatedly acknowledged. Although authors wisely caution development of further measures without due cause, extant constructs and measures do not provide clear and consistent results for understanding the influence of one’s relationships to religion and spirituality upon behaviors of clinical interest. The present project drew from the functional contextual concept of psychological flexibility, which provides clarity to understanding the encouragement and maintenance of psychological well-being. A new construct of religious and psychological flexibility is explicated as a functional approach to understanding religious and spiritual behavior in a manner that is useful in research and clinical settings alike. The development and evaluation of the Measure of Religious and Spiritual Flexibility (MRSF) is described. The MRSF evidenced adequate internal consistency and test-retest reliability. Confirmatory factor analysis results were positive, but indicate further refinement. Analyses suggested good construct validity of the MRSF in relation to psychological well-being and psychopathology; construct validity in relation to extant constructs in the psychology of religion was varied. Implications and future directions are discussed.
Date: August 2014
Creator: Schmalz, Jonathan E.
Partner: UNT Libraries

Effects of Religious Attendance on Suicidal Ideation: Examining Potential Mediators of Social Support, Locus of Control, and Substance Abuse

Description: Religion has a well-documented relationship with mental health benefits and has consistently demonstrated an impact on several specific mental health concerns, including suicide, generally finding various religious facets to be inversely associated with suicidal thoughts and behaviors. More specifically, religion has been found to be associated with suicide in a number of ways, including decreased acceptance of suicide, decreased likelihood of suicidal thoughts, decreased likelihood of suicidal attempts, fewer suicide attempts, lower relative risk of suicide, lower suicide rate, and increased reasons for living. Several studies have proposed potential mediators (e.g., social support, locus of control, and substance abuse) of the relationship between religion and mental health, usually in non-clinical samples. The current study sought to examine the association between religious attendance and suicidal ideation using archival data of a clinical sample collected from the University of North Texas Psychology Clinic. Results from this sample revealed no evidence of mediation, instead suggesting a direct effect of religious attendance on suicidal ideation. Two mediation models demonstrated the effects of external locus of control and social support on suicidal ideation. These models are discussed in terms of their directionality, considering the extant research on these associations. Findings of the current study have implications for welcoming the incorporation of salient religious topics throughout treatment in mental health settings, including discussion of religious attendance among those clients who have identified religion as a personal value.
Date: August 2014
Creator: Price, Samantha Danielle
Partner: UNT Libraries

Explaining the Relationship Between Borderline Personality Features and Suicidal Ideation

Description: Researchers have previously identified substance use and borderline personality disorder as factors that increase risk for suicidal thoughts and behaviors. This study explored the relationship between these factors in samples of students and individuals seeking outpatient treatment. Supplemental data collected via the internet (MTurk) also looked at experiential avoidance (EA) with the Avoidance and Fusion Questionnaire for Youth. The Structured Clinical Interview for the DSM-IV, Alcohol Use Disorders Identification Test, Scale for Suicide Ideation, and Personality Assessment Inventory- Borderline Features Scale elicited information regarding severity and/or frequency of substance use, suicidal thoughts, and borderline features respectively. Additionally, the Psychiatric Diagnostic Screening Questionnaire was administered to the UNT sample. The UNT sample analyses indicate substance use moderates, strengthening, the relationship between borderline features and current suicidal thoughts. However, severity of suicidal thoughts was lower for individuals high in both borderline features and substance use disorder symptoms compared to those low in borderline features and high in substance use symptoms. The MTurk sample analyses suggest substance use functions as a mediator. A robust relationship existed between substance use severity and EA, showing substance use as a behavioral marker for EA. In conclusion, concurrent treatment of substance use and borderline personality features would be beneficial in reducing risk for suicidal thoughts. Further investigation into the role and utility of addressing EA is warranted.
Date: August 2014
Creator: Nichols, Erica
Partner: UNT Libraries

The Process of Ritual: a Twenty-Year Survey of Literature

Description: Use of the term "ritual" in PsycLit from 1975-1995 was examined through an archival study. Abstracts identified as including any form of the term were coded for valence, target population, study type, and differential area of interest. Valence was predominantly positive, consistent across time, with a growing negative trend. Interest in ritual has increased. Key elements of adaptive ritual were identified as recurrence across time, shared symbolism and volitional participation. A Dynamic Process of Ritual is proposed which includes the individual, society, and chaos in a fluctuating relationship, all operating within an additional dimension of a continuum of ritualization in which the individual's position is determined by personal and societal complexity and individual response to crisis.
Date: August 1998
Creator: Emmett, Gloria J.
Partner: UNT Libraries

Violent and Nonviolent Juvenile Offenders : An Assessment of Differences in Object Relations Functioning Using the Thematic Apperception Test

Description: TAT stories and demographic information of 30 violent and 30 nonviolent juvenile delinquents were obtained. Institutional assessment records at Dallas County Juvenile Department (DCJD) served as the data base for this study. TAT stories and demographic information of 30 violent and 30 nonviolent juvenile delinquents were obtained. Institutional assessment records at Dallas County Juvenile Department (DCJD) served as the data base for this study. Differences with respect to object relations functioning between juveniles charged with two categories of index offenses: property offenses and aggravated assault were examined. Object relations were assessed utilizing a scoring system designed for use with the Thematic Apperception Test (TAT). The scoring system encompasses a psychoanalytic perspective and consists of four dimensions representing separate but interrelated aspects of object relations. It was hypothesized that juvenile delinquents who commit violent crimes would exhibit lower object relations functioning as compared to juvenile delinquents who commit nonviolent crimes.
Date: December 1994
Creator: Cox, Randall J. (Randall Judd)
Partner: UNT Libraries

Stress in Parents of Children with ADHD vs Depression: a Multicultural Analysis

Description: Parents of children with Attention Deficit Hyperactivity Disorder (ADHD) are often reported as experiencing more stress than parents of normal children. The bulk of this research has been conducted primarily on a Caucasian population, however, providing little information regarding multicultural aspects of parenting stress. Research has also been lacking in attention given to the stress related to parenting a child with internalizing disorders. The purpose of this study was 1) to compare parenting stress reported by mothers of children with ADHD to parenting stress reported by mothers of children with depressive disorders, and 2) to compare parenting stress as reported by Caucasian, African American, and Hispanic mothers. Results indicated that mothers of ADHD children experienced more parenting stress related only to their children's hyperactive and distracting behaviors. Contrary to previous research, Caucasian mothers reported significantly more overall and parent-related parenting stress than African American mothers.
Date: August 1998
Creator: Walker, Cyndi D. (Cyndi Dianne)
Partner: UNT Libraries