Thèses sur le sujet « Social sciences -> psychology -> clinical psychology »

Objective: The primary goal of the current study was to characterize perceived social support (PSS) and isolation longitudinally among people with chronic pain (CP) who were and were not receiving group psychosocial interventions for CP. The second goal of the study was to describe how PSS and isolation variables are associated with quality-of-life (QOL) variables over time for those same participants.

Background: Previous research has demonstrated that positive social support can predict better outcomes for people with CP and negative social support can predict poorer outcomes. Furthermore, CP is associated with decreased social support and greater isolation. Despite the knowledge that PSS can be an important coping resource for people with CP, research on the longitudinal patterns of PSS and isolation and their relationships to QOL variables over time is lacking, especially among people with CP.

Method: Social health and QOL data from 290 participants from the Learning About My Pain study (Eyer & Thorn, 2015) were used to examine longitudinal PSS and isolation with piecewise linear growth models using multilevel modeling. Participants were randomly assigned to participate in group cognitive-behavioral therapy (CBT), group pain psychoeducation (EDU), or medical treatment-as-usual (TAU) for 10 weeks followed by a 6-month post-treatment follow-up period. Participants were assessed pre-, mid-, and post-treatment, as well as at follow-up.

Results: PSS was relatively stable over the treatment and follow-up periods except for small decreases in emotional and informational support among TAU and social isolation among EDU during the follow-up period. Companionship was associated with decreasing pain interference, disability, and depression, and emotional support was associated with decreasing pain interference and depression, whereas instrumental support and isolation were associated with worsening QOL. The Buffering Hypothesis of PSS was not supported in the current sample.

Conclusions: A potential benefit of participating in psychosocial group treatments for CP appears to be the lack of deterioration of emotional and informational support for CBT and EDU and decreasing isolation for EDU participants. Social health was predictive of QOL. Future research and treatment of CP should account for PSS and isolation and the ways in which they interact with pain and QOL.

The present study examined the influence of attachment style, social support, and family resiliency on levels of stress, depression, and anxiety in parents who have children with autism. The study concentrated on investigating the impact of attachment anxiety, attachment avoidance, social support from family and friends, and family resiliency on stress, depression, and anxiety in parents who have children with autism. One hundred and eighty-nine participants, who were parents of children with autism and belonged to various local and national parent support organizations, filled out an online survey provided to them via email, newsletter, or group forum. Results showed that attachment avoidance, social support from friends, and family resiliency are significant predictors of stress. Furthermore, attachment anxiety, attachment avoidance, and family resiliency were indicated as being significant predictors of anxiety and depression. The findings from this study suggest that attachment style, family resiliency, and social support outside the family are important factors to consider in the psychological well-being of parents who have children with autism.

Obesity is a chronic and debilitating medical condition that results from a complex mix of genetic, physiological, psychological, and social factors. Despite a recognized consensus regarding the complexity of obesity, little is known about how various demographic, medical, and cognitive performance variables interact in this population, especially in relation to factors which may contribute to the maintenance of obesity over time. Research has supported that one key aspect of this process is eating in response to psychological rather than physiological cues. Given the increased prevalence of psychopathology, particularly mood disorders, in obese individuals, the question arises as to whether there exists an underlying impairment in emotion recognition.

The current study sought to examine the associations among demographic and medical variables as well as performance on cognitive tests of memory, attention, executive function, sensory-motor, and verbal skills. Contrary to the hypothesis that BMI would be inversely related to performance on tests of emotion recognition, results indicated that as BMI increases, reaction time to complete these tasks decreases. This finding was noted even after the effects of age, gender, estimated pre-morbid IQ, pre-existing medical conditions, and performance in all neurocognitive domains was removed. In addition, when examined across BMI categories, it was observed that participants with BMIs greater than 40 kg/m2 showed the fastest reaction times. Overall, these findings provide support for contemporary theories of emotion which generally agree that emotions evolved to facilitate adaptation to environmental threat.

Gatekeeper Suicide Prevention Trainings such as Question Persuade and Refer (QPR) are used to increase suicide awareness and teach participants basic suicide intervention skills. Previous researchers showed that QPR training increases knowledge of suicide risk factors and increases participants' willingness to intervene with individuals at risk of suicide. It was hypothesized that completion of QPR would also increase positive attitudes toward the utilization of mental health services and that this outcome would be more pronounced among male participants. The examination of attitudes was rooted in the theoretical framework of Ajzen's theory of planned behavior. The Inventory of Attitudes toward Seeking Mental Health Services (IASMHS) was the instrument used for the study. The study occurred in a rural community college in southern Oregon. Student attitudes were assessed prior to completion of a 1-hour QPR presentation followed by a 3-week post assessment. Analysis of Variance revealed significant effects of QPR training. IASMHS scores were significantly higher at post QPR training. A significant interaction between gender and QPR training showed that women scored significantly higher than men only at pre QPR training. There was no statistical gender difference in attitudes measured by the IASMHS at post QPR training. QPR increased help seeking attitudes in both men and women with the increase being more pronounced in men. Increasing positive attitudes toward help seeking can contribute to positive social change. Practitioners in the field of men's health should consider using gatekeeper suicide prevention training such as QPR as a means of increasing male help seeking.

Mental health stigma, while common, leads to harmful consequences. There is some evidence to show that education reduces stigma. The reduction, however, is short term and only observed in those who are relatively open and flexible with their beliefs. Emerging research suggests that variables such as empathy, perspective taking, and psychological flexibility may be key processes in stigma reduction. Relational Frame Theory (RFT) provides a framework for understanding the development of stigma, the role of inflexibility in maintenance of stigma, and how education that targets flexibility might facilitate reduction in stigma. Applications of RFT have resulted in the development of the Implicit Relational Assessment Procedure, a tool that can be applied for assessment of not only implicit stigmatizing attitudes, but also the flexibility with which they are held. The current study examined the impact of divergent educational experiences on mental health stigma using college students with various levels of formal education relevant to psychological difficulties both implicitly with self-report measures and explicitly with the IRAP. Also examined were empathy and psychological flexibility as moderators of the relationship between education and stigma. Data suggest that mental health bias is a function of education, but that didactic and experiential education may have differential effects. Increases in education and empathy factors were associated with reduced stigma measured explicitly; however, these variables did not correlate with the measure of implicit stigma. Additionally, when empathy moderated the relationship between education and implicit stigma, high levels of empathy were associated with increases in implicit stigma. Inconsistencies in results from implicit and explicit measures indicate a clear need for continued research in this area to more fully understand mental health stigma and to develop reduction interventions.

This dissertation is a phenomenological analysis of the lived experiences of adult daughters who perceive their mothers to have struggled with a mental illness throughout their childhood, adolescence, or even into adulthood. An extensive review of the literature showed a noticeable dearth in the existing literature regarding the lived experiences of adult daughters who experienced maternal mental illness first-hand. Qualitative face-to-face interviews were conducted with eight female participants in an effort to obtain a more comprehensive understanding of their retrospective account of living with a mother who is mentally ill. Of particular interest was creating a space for the women to re-tell their stories and to identify ways in which their own relationship with their mothers has had a trans-generational effect on the relationship and parenting styles with their own children. Several thematic patterns were obtained from the interviews including parentification (mothering the mother), minimization of the mother's mental illness, and feelings of anger, sadness, embarrassment that came up as the daughters dealt with the impact of maternal psychopathology. The stories told by these women will hopefully contribute to the existing literature on attachment, maternal mental illness, and the subsequent impact on parenting practices.

Although there is an extensive literature on women who are overweight, obese, or suffer from eating disorders, less is known about women who are at a healthy weight yet who are attempting to lose weight. To learn more about the psychological characteristics and behavioral patterns of such women, this study analyzed data from the American College Health Association's National College Health Assessment (ACHA-NCHA-II). We compared these women with two groups of women: (a) those who are at a healthy weight but who are not attempting to lose weight and (b) overweight women who are attempting to lose weight. We employed numerous variables including BMI, depression, anxiety, academic performance, exercise, and diet strategies in these comparisons. In terms of psychological health and weight-related behavior, healthy women attempting weight loss are more similar to overweight women who are attempting weight loss than they are to healthy women who are not attempting to lose weight. We found comparatively high rates of depression, anxiety, and academic difficulty among our target population. Based on our findings and the relevant literature, we recommend that university health officials provide weight-related educational information to female students in an effort to promote psychological well-being and healthy weight practices.

Psychological struggle seems to be an inherent part of the human experience. Unfortunately, the public attitude towards the obese focuses more on negative stereotypes (e.g., undisciplined, ugly, stupid, and lazy) than on the underlying psychological components that lie at the heart of the struggle. Negative stereotypes like these have an affect upon the way the obese think about themselves and may lead to self-stigmatization, which in turn may interfere with a person's attempt to gain control of their health and emotional well-being when eating is used to relieve the associated distress. Many people who struggle with their weight are found to be very rigid in their thought processes regarding food. Perhaps it is not the content of food and body-related cognitions that is important, but the inflexibility with which they are held.

The current study will investigate the relationships among avoidant eating behavior, perceived stigmatization, self-stigmatization, and psychological flexibility. Participants will be recruited from a population of obese individuals who are seeking help at a bariatric clinic, and from Facebook. Participants will initially complete a packet of questionnaires on psychological flexibility, perceived stigmatization, self-stigmatization, and eating behavior online. Then for seven days they will receive four text messages a day for seven days, three of which will provide them with a link to the Periodic Assessment of Stigmatizing Experiences, and one text message providing a link to the Daily Eating Survey. It is hypothesized that 1) Perceived stigmatizing experiences (i.e., a fear of enacted stigma from society) will predict disordered eating 2) Weight- and food-related psychological inflexibility will moderate the relationship between perceived stigmatizing experiences and disordered eating 3) Self-stigma (i.e., self-devaluation due to perceived stigmatization from society) will moderate the relationship between perceived stigmatizing experiences and disordered eating 4) Psychological inflexibility will predict increased perceived self-stigma.

One commonly accepted protective factor, social support, is hypothesized to be both helpful and harmful following exposure to traumatic events (Bonanno, 2008; Ellis, Nixon, & Williamson, 2009; Lyons, 1991). Although at least 10 theoretical models have been proposed to explain the relationship between social support and post-traumatic responses, existing theories do not adequately capture the multidimensional experience of social support, which is comprised of several constructs and structures (e.g., received and perceived support; support functions and content). Moreover, existing social support theories have not been studied in research related to therapy with traumatized clients. The present study, therefore, examined how clients who experienced trauma expressed social support in psychotherapy. A qualitative content analysis was conducted using a directed coding system developed for this study that was based on the constructs and structures commonly discussed in psychology literature on post-traumatic experiences, namely: (a) received support, (b) perceived support, (c) extended support, (d) social support functions, and (e) social support contents.

The current study observed that clients who have experienced trauma are likely to mention social support in sessions but that salient factors related to the benefits and harms associated with social support were discussed less. Although many expressions of social support fell into "not otherwise specified" categories because the quality or type of support experienced was not clearly stated, inductive analysis identified the following salient factors: support needs, relationship elements, planned future support activities, past perceived support, and past support that did not occur. The study also provided support for some existing models of social support and trauma (i.e., network orientation, stress-buffering, erosion, social-cognitive processing, and COR models).

Clinical implications related to social support discussions in individual therapy include the need to examine and potentially change therapists' views of social support. Psychotherapists are encouraged to explore the support relationships identified by clients, as well as the quality and types of support experienced and perceived, in order to understand the role and impact of social support and address the benefits and risks associated with support. Clinicians should also recommend that clients engage in adjunctive mutual aid and affiliative support groups.

The experience of anxiety and depression can have detrimental effects on the body, especially that of a developing fetus. Depression and anxiety have been linked to the experience of greater pregnancy symptoms, miscarriage, poorer birth outcomes and difficult deliveries. Despite their detrimental effects, depression and anxiety may be common during the prenatal period. A history of miscarriage may heighten normally occurring symptoms, adding a layer of difficulty to an already stressful time period.

Mind-body practices have been linked to a number of health benefits, including attenuation of psychiatric symptoms and improved pregnancy outcomes. While many of these practices have received increasing attention in popular literature, lacking are studies utilizing large, randomized clinical trials empirically validating the efficacy of these interventions.

The purpose of the original study was to examine whether miscarriage status and the engagement in mind-body practices were associated with lower levels of depression and anxiety in pregnant women. Forty-three (N=43) pregnant women in the second and third trimesters were recruited and questioned about their pregnancy, their engagement in mind-body practices (past and present) and were asked to complete the Center for Epidemiological Studies Depression Scale (CES-D) and the State Trait Anxiety Inventory (STAI). It was anticipated that women with a miscarriage history would report higher levels of anxiety and depression and that women engaging in mind-body practice, past or present, would report lower levels of depression and anxiety. When statistical analyses failed to yield significant results, this author chose to explore the process of generating new knowledge through autoethnography. This dissertation moved from an empirical study to a qualitative, autoethnographic exploration of pregnancy loss in which the themes of meaning making, personhood and the expression of feelings were explored through the literature, the author's personal experience and through participation in an online pregnancy loss support group.

This interpretative phenomenological analysis research study illuminates the experience of involuntary commitment for individuals diagnosed with schizophrenia in order to better understand the patient's perspective of forced hospitalization and the effects of that experience as related to future treatment. Data analyses led to the emergence of several themes regarding participants' experience during the period of involuntarily commitment: Stigmatization, Treatment by Professionals, Experience While Committed, Facilities, Effectiveness of Treatment, and Improving Treatment. Findings indicated a need to improve the practice of execution of involuntary commitment, as all participants indicated that benefits of commitment were marginal and resulted in an iatrogenic influence of commitment. However, in spite of symptomatological exacerbation, participants were able to identify various means of improving treatment, which generally entailed more compassionate care, illuminating a need for a treatment model reflective of moral care. Participants also expressed a desire for therapeutic services with an entrusted practitioner, indicating that therapy could be efficacious for treatment. Participants explicitly conveyed a desire only to see a clinician not associated with their psychiatrist, as all participants expressed mistrust of their psychiatrists. Given that participants had a desire for therapy, utilizing therapeutic modalities deemed effective for treating individuals diagnosed with schizophrenia is essential. Accordingly, depth and humanistic psychological modalities have been empirically validated as efficacious in treating individuals diagnosed with schizophrenia. Research further indicates that client-centered and object-relations therapeutic approaches, with modifications, are most efficacious in order to adaptively treat individuals diagnosed with schizophrenia.