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Feigning ADHD: Effectiveness of Selected Assessment Tools in Distinguishing Genuine from Simulated ADHD

Description: Research indicates that some college students may be strongly motivated to feign AHDD symptoms for desired external incentives, such as stimulant medication or academic accommodations. To date, literature examining feigned ADHD has been primarily focused on ADHD specific self-report measures (e.g., CAARS) and continuous performance tests (e.g., CPTs); however, little attention has been devoted to the use of multi-scale inventories in detecting feigned ADHD. For CPT measures, virtually no literature exists on the effectiveness of the TOVA to identify feigned ADHD, despite its frequent clinical use for establishing this diagnosis. The current study utilized a between-subjects simulation design to validate feigning cut scores on ADHD-specific measures using 66 feigners and 51 confirmed ADHD cases. As prior literature suggested, the results convincingly demonstrated that face-valid ADHD assessment measures were easily faked. Across both TOVA modalities (e.g., Auditory and Visual), the ADHD simulators performed significantly poorer than those diagnosed with ADHD. As an innovative approach, a Dissimulation-ADHD (Ds-ADHD) scale was developed and initially validated. The Ds-ADHD is composed of ten MMPI-2-RF items mistakenly believed to be clinical characteristics associated with ADHD. Requiring cross-validation, Ds-ADHD optimized cut scores and classification of ADHD feigners appears promising. They were clearly distinguishable from ADHD client, as well as those feigning general psychopathology. Recommendations for the utilization of the Ds-ADHD scale, and future directions for research are discussed.
Date: August 2016
Creator: Robinson, Emily
Partner: UNT Libraries

A Comparison of Treatments for Posttraumatic Stress Disorder Symptoms: Memory Specificity Training (MeST) and Cognitive Processing Therapy (CPT)

Description: The effectiveness of memory specificity training (MeST) was compared with standard cognitive processing therapy (CPT) in treatment of individuals with posttraumatic stress disorder. Eighteen adults aged 18-36 were randomly assigned to the MeST intervention (n = 9) or to the active control group (n = 9) of CPT. Both treatments were administered in group format across 6 weeks. MeST consisted of 6 weekly sessions, while CPT consisted of 12 biweekly sessions. The trial was undertaken in the Psychology Clinic of the University of North Texas, with randomization to conditions accomplished via computer random number generator. The primary outcome measure was change in PTSD symptoms post-treatment from baseline. Sixteen individuals (13 women and 3 men; MeST n = 8 and CPT n = 8) completed treatment and their data was analyzed. MeST significantly decreased PTSD symptomology at post-treatment and these results were maintained at 3 months post-treatment. MeST was found to be as effective as the established CPT intervention at reducing PTSD symptomology. Both MeST and CPT significantly increased participants' ability to specify memories upon retrieval at post-treatment, with results maintained at follow-up. There were no significant effects of MeST or CPT in ability to increase overall controlled cognitive processing at post-treatment or follow-up. No individual in either group reported any adverse effects during treatment or at 3 months follow-up. MeST appears to hold promise as an efficacious treatment option for PTSD. MeST was as effective as CPT in reducing symptoms of PTSD, but required only half the number of treatment sessions to accomplish these gains. Replication of these findings in larger samples is encouraged.
Date: August 2016
Creator: Maxwell, Kendal Lynn
Partner: UNT Libraries

Similarities and Differences in Borderline and Other Symptomology Among Women Survivors of Interpersonal Trauma with and Without Complex Ptsd

Description: Women interpersonal chronic trauma survivors are frequently misdiagnosed with borderline personality disorder (BPD) or post traumatic stress disorder (PTSD), which often results in mistreatment. Neither PTSD nor BPD adequately describes the unique character alterations observed among those exposed to prolonged early childhood trauma. Researchers suggest survivors of interpersonal and chronic trauma should be subsumed under complex PTSD (CPTSD)(MacLean & Gallop, 2003). The primary purpose of this study was to test the validity of complex PTSD as a construct. MANOVA, ANOVA, chi- Square, and independent samples t- Tests were utilized to test hypotheses. Results revealed that women who experienced higher frequencies of trauma met more CPTSD criteria and had higher mean base rate scores on the Major Depression, Depressive, Avoidant, Masochistic, Anxiety, PTSD, and Borderline scales of the MCMI- III than women who experienced fewer traumas. Additionally, findings suggest that the Major Depression, Depressive, Anxiety, PTSD, and Borderline scales may highlight differences among women interpersonal trauma survivors who meet five of six CPTSD criteria versus those who meet full CPTSD diagnostic criteria. Lastly, the mean Borderline scale score for women who met full CPTSD diagnostic criteria was below the cutoff for personality traits. Overall, these findings provide evidence and validation for the distinction of CPTSD from BPD and PTSD.
Date: December 2012
Creator: Marchesani, Estee Simpkins
Partner: UNT Libraries

Neurocognitive Effects of Gist Reasoning Training in Student-Athletes with Concussions, ADHD, and Learning Disabilities

Description: Concussions, attention-deficit disorder (ADHD), and learning disabilities can adversely impact learning and academic achievement, particularly with respect to attention, memory, and executive functioning; fortunately, cognitive training can be beneficial and remediating these weaknesses. One such program, strategic memory advanced reasoning training (SMART), utilizes a top-down approach to train individuals in executive, higher-ordered thinking strategies including strategic attention, integration, and innovation to facilitate information synthesis and enhance cognitive efficiency. Thus, the purpose of the study is to examine whether SMART improved performances on various neuropsychological measures tapping into attention, processing speed, memory, and executive functioning for college student-athletes with neurological conditions (e.g., concussions, ADHD, LD). Student-athletes were randomly assigned to the SMART program or a "wait-list" control group and were administered a neuropsychological battery at baseline, immediately following the intervention, and after a four-month delay. Results showed that participants benefited from SMART with respect to working memory immediately following the intervention after controlling for baseline scores. The benefits of working memory also persisted after four months. Additionally, SMART was beneficial for improving attention, but only after four months after the intervention. The findings of the current study were consistent with previous studies which showed positive effects of SMART on working memory with a variety of populations (e.g., children, adolescents, older adults, Veterans, brain-injured patients); however, the current study did not see improved performance on other aspects of executive functioning which contradict prior research. Statistical differences between the present study and prior research regarding SMART may be explained in methodology, participant characteristics, research setting, and/or limitations. Future studies may include combining cognitive training as the intervention and utilizing neuroimaging alongside cognitive training to examine the relationship between structural/functional change with neuropsychological performance.
Date: August 2017
Creator: Nguyen, Thomas
Partner: UNT Libraries

A psychosocial interaction study of adulthood demographics and non-compulsory education participation using the National Household Education Survey.

Description: This report analyses the NHES: 2005 data to present the state of American education in reference to “adult” participation in education. Psychosocial interaction theory is applied to the social event of attaining adulthood to analyze and report the propensity of American adults to participate in non-compulsory adult education. The review of the literature of perceptual demographic variables of adult attainment: age, prior education, subordinate responsibility, child-age dependent care, marital status, job stability, and home ownership. The analysis compares the data of participants and non-participants of non-compulsory adult education using binomial logistic regression analysis with tests, for a 95% confidence level and .05 significance. Included is a discussion of how appropriately aligned development opportunities and experiences may further increase education effectiveness and performance outcomes.
Date: December 2011
Creator: Chillis, Jimmy, L.
Partner: UNT Libraries

Comparing the 2010 and 2011 Appic Match: Applicant Characteristics and Unmatched Applicant Distress

Description: The internship is one of the most important components of doctoral training in professional psychology. Given the serious problem of the internship imbalance, applicant and program characteristics that constitute a good “fit” with internship training programs have become of greater interest as securing an internship becomes a more competitive process. This study surveyed internship applicants from programs part of the Council of University Directors of Clinical Psychology (CUDCP), before and after the 2010 and 2011 match days. Number of interview offers was found to be the factor most consistently associated with successfully matching, and several other applicant characteristics salient to matching and obtaining interview offers were identified, including applicant personality. Additionally, personal accounts, but not empirical evidence, of going unmatched have attested to the psychological distress associated with this event. in the current study, while going unmatched was not found to be equitable to a traumatic stressor, evidence was found to support significant decrease in subjective well-being with respect to immediate distress. Findings are discussed in terms of the predictability of and implications for the match process and internship imbalance, and recommendations are made for future research directions.
Date: May 2012
Creator: Hogan, Lindsey R.
Partner: UNT Libraries

Decentering and the Theory of Social Development

Description: The concept of decentering originated with Piaget, who defined decentering as a feature of operational thought, the ability to conceptualize multiple perspectives simultaneously. Feffer applied Piaget’s concept of decentering to the cognitive maturity of social content. This study used Feffer’s Interpersonal Decentering scoring system for stories told about TAT pictures to investigate the developmental hierarchy of decentering for children and adolescents. The participants originated from the Berkeley Guidance Study, a longitudinal sample of more than 200 individuals followed for more than 60 years by the Institute of Human Development at the University of California, Berkeley. The hypotheses tested were: (1) chronological age will be positively related to Decentering as reflected in Feffer’s Interpersonal Decentering scores obtained annually between ages 10 and 13 and at 18; (2) children born into higher class homes would have higher Age 12 Decentering scores; (3) children born later in birth order will have higher Age 12 Decentering scores; (4) children whose parents were observed to have closer bonds with their children at age 21 months will have higher Age 12 Decentering scores; (5) adolescents with higher scores from the Decentering Q-sort Scale (derived from adolescent Q-sorts) will have higher Age 12 Decentering scores; and (6) participants who have higher Age 12 Decentering scores will self-report higher CPI Empathy scale scores at Age 30. A repeated measures ANOVA tested Hypothesis 1. Pearson product-moment correlation coefficients tested Hypotheses 2-6. Age and Decentering scores were unrelated, as was birth order; social class findings were mixed. Parents’ bonds with child and Age 12 Decentering were negatively correlated (closer bonds predicted higher Decentering), as were Age 12 Decentering and Age 30 Empathy (higher early Decentering predicted lower adulthood Empathy). Girls (age 12) tended to decenter more consistently and had higher Decentering scores than boys.
Date: August 2012
Creator: Fincher, Jennie
Partner: UNT Libraries

Denial of Risk: the Effects of Intentional Minimization on Risk Assessments for Psychopathic and Nonpsychopathic Offenders

Description: Risk assessments for offenders often combine past records with current clinical findings from observations, interviews, and test data. Conclusions based on these risk assessments are highly consequential, sometimes resulting in increased criminal sentences or prolonged hospitalization. Offenders are therefore motivated to intentionally minimize their risk scores. Intentional minimization is especially likely to occur in offenders with high psychopathic traits because goal-directed deception is reflected in many of the core traits of the disorder, such as manipulativeness, glibness, and superficial charm. However, this connection appears to be based on the conceptual understanding of psychopathy, and it has rarely been examined empirically for either frequency or success. The current study examined the connection between psychopathic traits and the intentional minimization of risk factors using a sentenced jail sample. In general, offenders were able to effectively minimize risk on the HCR-20 and SAQ, while the PICTS, as a measure of cognitive styles, was more resistant to such minimization. Psychopathic traits, especially high interpersonal facet scores, led to greater minimization using a repeated measure, simulation design. Important differences in the willingness and ability to use deception were found based on (a) the content of subscales, and (b) the mode of administration (i.e., interview vs. self-report). The important implications of this research are discussed for risk assessment procedures regarding likely areas of deception and its detection. It also informs the growing literature on the connection between psychopathic traits and deception.
Date: August 2013
Creator: Gillard, Nathan D.
Partner: UNT Libraries

A Multi-method Approach to Examining Stress and Anxiety Among Mexican American College Students

Description: United States post-secondary education continues to see an increase in Hispanic enrollment, particularly those of Mexican heritage. The present study was designed to examine this population’s experience of stress, anxiety and academic approach-avoidance conflict. Data were collected at North Texas postsecondary institutions. Participants (N = 197) completed an online survey including a Picture Story Exercise (PSE), open-ended responses to hypothetical scenarios, and self-report measures. The current study utilized a mixed-method approach integrating content analysis measures and self-reports. Results indicated that anxiety symptoms expressed to academic, familial, and minority social situations differed, partial η2=.39; with the academic scenario including the highest and minority social scenario the lowest anxiety. Results suggested that Mexican-American college students may express cognitive and affective symptoms of anxiety more frequently than physical symptoms on scenarios but not on self-report scales (Personality Assessment Inventory Anxiety; PAI Anxiety). PSE responses suggested that Conflict and Drive for Goal Orientation were frequent among this sample. Academic Total Anxiety and Academic Physical Anxiety related positively to PSE Conflict, while Academic Cognitive Anxiety related negatively to PSE Positive Outcomes. Exploratory models predicting PSE variables from Academic Anxiety and PAI Anxiety were inconclusive but suggested that gender accounted for significant variance in PSE scores.
Date: August 2013
Creator: Durón, Kelly M.
Partner: UNT Libraries

Attention and Metacognition in the Elaborated Intrusion Theory of Desire

Description: The elaborated intrusion (EI) theory of desire is a cognitive model that describes the processes involved in craving as intrusive thoughts that are elaborated upon leading to dissonance when desires are not met. While the theory is based on a wide body of research, certain theoretical predictions have not been fully examined. Specifically, EI theory argues that mental imagery has a central role in craving, and predicts that attempts to suppress substance-related intrusive thoughts and mental imagery is related to increased craving. Further, EI theory suggests that elaboration of craving imagery is related to attention and working memory processes, however, there are questions about whether differential performance in these domains is related to craving. The current study examined the relationship between attention/working memory performance and alcohol craving in a sample of 119 young adult males. Additionally, metacognition was examined to clarify the phenomenological aspects of craving within EI theory. Attention and working memory performance did not significantly predict intrusive thought and mental imagery elaboration. Individuals with high craving reported significantly higher levels of anxiety, thought suppression, and greater strength and frequency of craving-related mental imagery. They were also more likely to try to control their own thoughts and make negative judgments on their ability to do so. The strength of craving-related intrusive thoughts, not mental imagery, was the most significant predictor of craving. Implications for the understanding of craving and treatment recommendations based on the findings are discussed.
Date: August 2013
Creator: Yates III, Robert D.
Partner: UNT Libraries

Internalizing-externalizing Psychopathology and Personality Pathology As Predictors of Treatment Rejection in Substance Users

Description: Substance use disorders (SUDs) are often comorbid with other psychopathology such as mood disorders, anxiety disorders, and personality disorders. While some research suggests individuals with comorbid psychopathology are more likely to seek substance use treatment than those with independent disorders, other studies have also shown many individuals with dual diagnoses still never seek treatment. Moreover, few studies have tried to elucidate the underlying structure of SUD treatment rejection, and instead examined it in more simplistic terms. In addition, studies have tended to examine the impact of individual disorders on treatment rejection, but have not incorporated an empirically supported approach to conceptualizing psychopathology in terms of comorbidity between broad latent dimensions referred to as internalizing (e.g., depression, anxiety) and externalizing (e.g., antisocial personality disorder, polysubstance use) psychopathology. Modeling psychopathology in terms of internalizing and externalizing psychopathology is becoming a prominent approach to understanding mental disorders, yet little research to date has investigated the effects these broad dimensions have on SUD treatment rejection. The current study utilized latent variable modeling techniques to (1) determine the latent structure of SUD treatment rejection in a large U.S. sample, and investigate whether treatment rejection is a multidimensional construct; and (2), to explore the ability of internalizing psychopathology, externalizing psychopathology, and personality pathology to predict the SUD treatment rejection factor(s). The current study relied on use of a general population sample of 43,093 individuals from the first wave of National Institute on Alcohol Abuse and Alcoholism's National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) study. Support was found for the hypothesis that SUD treatment rejection would be a multidimensional construct. Exploratory structural equation modeling indicated a three-factor model best fit the data. Operational definitions and clinical implications of these three treatment rejection factors ("Objective barriers," "Psychological barriers," and "Self-focused barriers") are discussed. Among internalizing psychopathology, ...
Date: August 2013
Creator: Lewis, Jonathan James
Partner: UNT Libraries

An Investigation of the Phase Model of Psychotherapy Across Therapeutic Orientations: Are Different Approaches Actually All That Different?

Description: The current study investigated the process of change underlying two different evidence-based treatments that yield similar outcome effectiveness in the treatment of depression: Cognitive Therapy (CT) and Interpersonal Therapy (IPT). The phase model of psychotherapeutic change (Howard et al., 1993) change is used to provide both a theoretical and practical framework in which to assess different patterns of change across the treatment modalities. The phase model posits that recovery from distress occurs in three sequential stages: remoralization, remediation and rehabilitation. CT can be conceptualized as a treatment in which the primary focus is on the treatment of symptoms (remediation), whereas IPT can typically be conceptualized as focusing on interpersonal conflicts and functioning (rehabilitation). The study utilized the TDCRP dataset (Elkin et al., 1985). Survival analysis indicated no significant difference in terms of onset or pattern of improvement across treatment orientations. Chi square analyses indicated individuals treated with IPT spend significantly more time engaged in rehabilitation compared to their CT counterparts. Taken together, these findings represent evidence that the process of therapeutic change is similar, if not virtually identical, across therapeutic orientation. The analyses also indicate that the phases of therapy may not necessarily be mutually exclusive and sequential, but may instead represent co-occurring patterns of improvement which are not sequentially determined.
Date: August 2013
Creator: Herbert, Gregory L.
Partner: UNT Libraries

Posttraumatic Stress and Neurobehavioral Symptoms

Description: The purpose of this study is to examine the structure of neurobehavioral symptoms in service members with physical and/or psychological trauma to determine the diagnostic specificity of these symptoms. Previous literature has demonstrated that orthopedic injured, mild traumatic brain injury (MTBI), and healthy controls shared similar levels of postconcussive symptom complaints, which suggest that postconcussion-like symptoms are not unique to MTBI. To the best of my knowledge, this is the first study examining this phenomenon in a sample of recently redeployed service members. Dimensional analysis of the PCL-C and NSI using SEM did not produce a model that was consistent with previous literature and principle component analyses did not produce a simple solution for posttraumatic stress or neurobehavioral symptoms. Thus, the study does not provide evidence for construct validity for either instrument. Implications for these findings are that clinicians need to be aware that these instruments may not be measuring coherent constructs within this population as purported and should judiciously interpret and report the results of these instruments.
Date: December 2013
Creator: Klein, Robert S.
Partner: UNT Libraries

Correlates Between Adult Romantic Attachment Patterns and Dimensional Personality Pathology

Description: Previous research has suggested that adult attachment disturbance is related to maladaptic interaction patterns and personality disorder constructs. Specifically, research indicates that those with attachment disturbance are significantly more likely to meet criteria for a number of personality disorders, including borderline personality disorder, narcissistic personality disorder, and antisocial personality disorder. The purpose of this study was to investigate the associations between adult attachment and the new dimensional model of personality disorders scheduled to be released in the Diagnostic and Statistical Manual for Mental Health Diosrders (5th ed.) in spring 2013. Participants completed the Schedule for Adaptive and Nonadaptive Personality (SNAP) to measure dimensional personality functioning and the Experiences in Close Relationships (ECR-R) and the Attachment Prototypes to measure adult attachment patterns. Additionally, select scales from the Personality Assessment Inventory (PAI) and the Five Factor Model (FFM) will be utilized as secondary measures of personality patterns. The results suggest strong associations between adult attachment orientations and specific maladaptive personality characteristics.
Date: August 2013
Creator: Ernest, Kimberly Dawn
Partner: UNT Libraries

An Examination of Resnick's Model of Malingering: a Pai Study of Feigned Ptsd

Description: Malingered posttraumatic stress disorder (PTSD) poses a formidable clinical challenge in personal injury and disability cases because of the apparent ease in feigning PTSD and the supposed link (proximate cause) to the claimed damages. The effective assessment of feigned PTSD is particularly challenging because this diagnosis is both easier to fake than other Axis I disorders and more difficult to detect. As an additional confound, some patients with genuine PTSD produce highly variable, elevated profiles on multiscale inventories that are difficult to distinguish from feigned PTSD. The current study examined whether the Personality Assessment Inventory (PAI) can effectively differentiate between genuine and feigned PTSD in 109 inpatients from a trauma unit. The two most effective scales were the MAL and the NDS scales. As a primary focus, the current study was the first empirical investigation of Resnick's model of malingered PTSD that is comprised of three subtypes: pure malingering (pure-M), partial malingering (partial-M), and false imputation (false-I). The primary goal was to evaluate whether each feigning group was able to (a) effectively simulate PTSD symptoms and diagnoses and (b) avoid being classified as feigning. The partial-M group proved to be the best feigning group in achieving these two goals. Furthermore, the use of well-defined groups, including an indeterminate band (i.e., unclassified) around each cut score, was explored. Overall, the use of well-defined groups improved accuracy in classification and reduced the number of false-positives.
Date: August 2013
Creator: Wooley, Chelsea N.
Partner: UNT Libraries

Posttraumatic Growth: Behavioral, Cognitive, and Demographic Predictors

Description: Recent trauma research argues trauma results in distinct positive and negative consequences, however; many trauma variables positively correlate with both outcomes. This study examined posttraumatic growth (PTG) and post-traumatic stress disorder (PTSD) symptoms as positive and negative trauma outcomes. Behavioral, cognitive, and demographic correlates and predictors were assessed to help clarify differences between the two outcomes. While several behavioral factors were common to both PTG and PTSD symptoms, centrality of event and problem focused coping were the strongest PTG predictors, whereas centrality of event and avoidant coping were the strongest PTSD predictors. These findings indicate while greater incorporation of a trauma/stressful event into one’s identity is a key component of both PTG and PTSD development, behavioral response may be a determining factor between growth or debilitation.
Date: August 2011
Creator: Schuettler, Darnell
Partner: UNT Libraries

Eight-Year Course of Cognitive Functioning in Bipolar Disorder with Psychotic Features

Description: The purpose of the current study was to examine neuropsychological functioning in patients with bipolar disorder (BD) with psychotic features. Data from a large, epidemiological study of patients with first-episode psychosis was used to examine verbal learning and working memory 10 years after onset of psychosis in patients with BD relative to patients with schizophrenia (SZ) and patients with psychotic major depressive disorder (MDD). Cross-sectional comparisons of verbal learning and working memory at the 10-year follow-up mirrored findings of relative performance at the 2-year follow-up (Mojtabai, 2000), as patients with SZ performed significantly worse than patients with psychotic affective disorders. When FEP patients' cognitive performance was examined longitudinally, all groups showed non-significant decline over time, with no significant diagnostic group differences after accounting for current symptoms. More frequent hospitalizations and longer treatment with antipsychotics were associated with poorer performance on cognitive testing 10 years after illness onset, but these associations disappeared when controlling baseline cognitive performance. Within the BD sample, current positive and negative psychotic symptoms were associated with poorer performance on cognitive testing. After controlling for baseline cognitive performance, markers of clinical course were unrelated to cognitive performance, consistent with existing literature on longitudinal cognitive functioning in patients with BD. The current findings support a neurodevelopmental model of verbal learning and working memory deficits in patients with bipolar disorder.
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Date: August 2016
Creator: Bain, Kathleen Marie
Partner: UNT Libraries

An Examination of a Framework for Posttraumatic Stress Disorder Correlates: Exploring the Roles of Narrative Centrality and Negative Affectivity

Description: Recent estimates suggest that a large percentage of the population experiences some type of traumatic event over the course of the lifetime, but a relatively small proportion of individuals develop severe, long-lasting problems (e.g., posttraumatic stress disorder; PTSD). One major goal for trauma researchers is to understand what factors contribute to these differential outcomes, and much of this research has examined correlates of posttraumatic stress disorder (PTSD) symptom severity. An important next step in this line of research is the development of conceptual frameworks to foster a deeper understanding of the relationships among these diverse predictors of PTSD and their predictive power in relation to each other. A framework proposed by Rubin, Boals, and Hoyle centers on the influence of narrative centrality (construal of a traumatic experience as central to one's identity and to the life story) and negative affectivity (the tendency to experience negative emotion and to interpret situations and experiences in a negative light), suggesting many variables may correlate with PTSD symptoms via shared variance with these two factors. With a sample of 477 participants recruited from Amazon Mechanical Turk, this dissertation project extended the work of Rubin and colleagues by a) utilizing structural equation modeling techniques to simultaneously examine relationships among variables, b) investigating the utility of the model with a carefully-selected list of PTSD correlates, c) extending the model by including PTSD symptom severity, and d) exploring both direct and indirect effects to assess the roles of narrative centrality and negative affectivity as they relate to known PTSD correlates and PTSD symptom severity. PTSD correlates included social support quality and quantity, peritraumatic dissociation, negative posttraumatic cognitions, perceived injustice, and negative religious coping. Hypotheses were partially supported, and there was some evidence that the model may be effective in distinguishing between variables more and less germane to ...
Date: August 2016
Creator: Southard-Dobbs, Shana
Partner: UNT Libraries

Phases of Change in Psychotherapy Across Levels of Clinician Training

Description: Given the alarmingly high rates of premature termination in training clinics, research aimed at understanding the course of change and treatment outcomes in training clinics deserves considerable attention. Additionally, more research is needed to understand the effectiveness of psychotherapy training and whether more training is actually associated with better client outcomes. Thus, this study sought to investigate whether clinicians' level of training and experience were related to a variety of clients' outcomes (e.g., well-being, symptom reduction, and life functioning) based on the phase model of psychotherapy. Unfortunately, confirmatory factor analysis of the OQ45.2 did not support the three-factor conceptual model paralleling the phase model. Rather, a two-factor model of best fit was identified. Neither clinicians' level of clinical training nor therapeutic orientation were found to be related to client improvements. However, this finding may have been attenuated by limited variance in client outcomes. Implications for clinical training and future outcome research methodologies are discussed.
Date: August 2016
Creator: Connor, Dana R.
Partner: UNT Libraries

Medical Comorbidity in the Course of Bipolar Disorder

Description: Bipolar disorder is a serious illness affecting approximately 2-4% of the population and is one of the world’s leading causes of disability. In individuals with bipolar disorder, medical comorbidity associated with cardiovascular, respiratory and endocrine disorders is related to increased rates of mortality. Recent updates to multi-system inflammatory related conceptualizations of bipolar disorder focus on the unique power that medical illness and biological processes may play as factors associated with course and outcome in bipolar disorder. The current study examined medical comorbidity and its associations with various demographic and psychological variables in individuals with bipolar disorder, schizophrenia, and major depressive disorder with psychotic features followed for 10 years from their first hospital admission. When compared to an age, gender and race-matched control sample from the population, those with bipolar disorder had significantly higher medical comorbidity across a range of medical diagnoses both at 6 months and 10 years after first hospital admission. Ten years following initial hospitalization, individuals in all three diagnostic groups reported increased rates of diabetes (OR: 2.0 – 3.7), stroke (OR: 4.6 – 7.0) and asthma (OR: 1.9 - 3.1), and individuals with bipolar disorder reported increased rates of cancer (OR = 2.1). A number of psychological and demographic symptoms were examined for their ability to predict the development of medical illness across the assessment interval. Overall rates of medical illness were elevated both early in illness course and 10 years after diagnosis, suggesting that broad sequelae of multi-system inflammation are present early and progress over time.
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Date: May 2016
Creator: Smith, Patrick M
Partner: UNT Libraries

Effects of Immaturity on Juveniles’ Miranda Comprehension and Reasoning

Description: Over the last several decades, researchers have documented how impaired reasoning by adult offenders impeded the intelligent waiver of Miranda rights. Logically, it stands to reason that juveniles – who are developmentally less mature and have less life experience than their adult counterparts – would possess even greater impairment, thereby heightening their risk for invalid Miranda waivers. Juvenile Miranda research supports this notion; with some researchers finding that psychosocial maturity, among other factors, affect a juvenile’s understanding of their rights. Yet, relatively few studies have examined its relation to Miranda reasoning and decision-making. Thus, the current study investigated the specific role of maturity in juveniles’ Miranda comprehension and reasoning. Participants included 236 legally-involved juveniles recruited from either a juvenile detention center or a juvenile justice alternative education program. The effects of psychosocial maturity were examined on a variety of Miranda-related measures and assessed a broad range of Miranda abilities. It was found that, in general, immature juveniles performed more poorly on all Miranda measures as compared to their mature counterparts. However, the impact of maturity varied considerably depending on the ability. Specifically, maturity was most important in the context of Miranda reasoning. As a novel addition to the literature, the current study also investigated the effects of developmental timing on maturity (i.e., immaturity-delayed versus immaturity-expected) on Miranda abilities.
Date: August 2015
Creator: Sharf, Allyson J.
Partner: UNT Libraries

Community Gardening: a Novel Intervention for Bhutanese Refugees Living in the USA

Description: Since 2008, the United States (USA) has resettled thousands of Bhutanese refugees, providing brief financial support and pathways to citizenship. Despite the efforts of governing bodies and voluntary agencies which facilitate resettlement, many refugees struggle with adapting to the vastly different lifestyle, economy, language and social structures. In particular, effectively addressing psychological needs of this population is a challenge for service providers operating within an expensive health care system based on Western constructs of mental health. In response to this challenge, refugee resettlement agencies throughout the country use community gardens to promote psychological healing, self-sufficiency, community engagement, and a return of human dignity. Though success of these programs is being shared in the media, there has yet to be empirical data examining their impact. The current study tested whether Bhutanese refugee engagement in a community garden impacts symptoms of depression, anxiety, PTSD and somatic complaints. The study also investigated whether community gardening is associated with perceptions of social support and adjustment to life in the United States. Quantitative and qualitative data was collected from 50 adult Bhutanese refugees in Fort Worth, Texas. Gardening was significantly related to increased social support overall, a key factor in overall functionality within communal cultures; and specifically perceived tangible support was increased. A significant effect of gardening was also found for adjustment. Although a significant effect was not found for psychological and somatic symptoms, there is still evidence of effects on somatic complaints. Varying results from quantitative and qualitative data warrant further investigation into the nuanced work of clinical research and advocacy with refugee populations.
Date: August 2015
Creator: Gerber, Monica M.
Partner: UNT Libraries

An Initial Validation of the Virtual Reality Stroop Task (VRST) in a Sample of OEF/OIF Veterans

Description: Currently, neuropsychologists rely on assessment instruments rooted in century old theory and technology to make evaluations of military personnel’s readiness to return-to-duty or return to their community. The present study sought to explore an alternative by evaluating the validity of a neuropsychological assessment presented within a virtual reality platform. The integration of a neuropsychological assessment into a cognitively and emotionally demanding virtual environment – reminiscent of a combat experience in Iraq – offers a more ecologically valid manner in which to evaluate the cognitive skills required in theater. U.S. military veterans’ (N = 50) performance on the Virtual Reality Stroop Task (VRST) was compared with performance on a paper-and-pencil, a computer adapted version of the Stroop task, and the subtests included in the Automated Neuropsychological Assessment Metrics-4 (ANAM4) TBI-MIL test battery. Results supported the validity of the VRST, indicating it demonstrates the typical Stroop effect pattern. The emotional salience of the VRST resulted in slowed reaction time compared to the ANAM Stroop. Further, the complex interference condition of the VRST offers opportunities for evaluation of exogenous and endogenous attentional processing. In the evaluation of threat, participants were noted to perform more accurately and more quickly in low threat versus high threat zones. Ancillary inquiries found no clinically meaningful findings regarding the role of deployment or post-concussive symptoms, and mixed findings regarding the effect of posttraumatic stress symptoms on neuropsychological performance among the three tested modalities.
Date: August 2015
Creator: Feil Johnson, Stephanie
Partner: UNT Libraries

Assessment of Hot and Cool Executive Functioning Following Trauma Using the Traditional Stroop Task, Emotional Stroop Task, and a Novel Implicit Association Test

Description: Individuals who have experienced a traumatic event and develop Post-Traumatic Stress Disorder (PTSD) frequently show deficits in both primarily “cool” and “hot” cognitive executive functions (e.g., traditional & emotional Stroop tasks, respectively) that can be impacted by high affective salience. Given the dimensional nature of psychopathology, questions remain about individuals within the general population who have experienced trauma but do not meet full criteria for PTSD and yet may manifest problems in these areas, especially areas of hot and cool executive functioning (EF). Thus, the current project was designed to assess hot and cool EF in a relatively large sample of individuals from the general population who have experienced trauma and currently demonstrate sub-clinical levels of post-traumatic symptoms. The Stroop task, Emotional Stroop task, and a novel modified Implicit Association Test were utilized to assess EF across a spectrum of individuals with varying traumatic histories and level of post-traumatic symptoms. Results suggest that a greater frequency of trauma experiences was moderately associated with worse performance on both hot and cool executive functioning measures. Specifically, females within the sample evidenced a close relationship between traumatic experiences, post-trauma symptoms, and executive functioning. Clinical and theoretical implications are discussed.
Date: December 2015
Creator: Sullivan, Erin
Partner: UNT Libraries