Rozprawy doktorskie na temat „Psychology in literature”

Chronic pain is a prevalent disorder that is difficult to treat and has the potential to be stigmatizing for individuals with chronic pain. An exploratory literature review was conducted to examine chronic pain stigma. The review specifically investigated studies that addressed individuals’ experiences of chronic pain stigma, identified sources of chronic pain stigma, and chronic pain stigma’s impact on treatment adherence. The following key terms were used to search 15 computerized databases (i.e. chronic pain AND stigma OR stigmatization OR disbelief OR stereotype OR invisible OR misconception). Studies were reviewed if they were relevant to chronic pain stigma, were conducted in the United States, the majority of participants were adults with a chronic pain condition, chronic pain condition was non-malignant, chronic pain was defined as persistent or intermittent for at least 3 months, and stigma was defined as being labeled, stereotyped, devalued, or discredited. The final review included 18 qualitative and quantitative studies from 1989-2015 that examined chronic pain and stigma. The findings of the study included twelve key themes that shed light on the experiences of stigma, sources of stigma, and impact on treatment adherence. Experiences of stigma included: estrangement, self-stigmatization, invisibility, medication stigma, and disbelief. The participants in the studies identified three sources of stigma: doctors, public, and family. Four themes emerged from the few studies that addressed treatment adherence: difficulty communicating about pain, management strategies, to seek care or not seek care, and to not take medications due to fears of addiction and stigma. The findings are further discussed in relation to the United State’s societal values, beliefs, and culture. A cultural shift is suggested in how we view chronic pain and illness. Additionally, recommendations are made for the role of psychologists addressing chronic pain stigma from a multi-systems level approach. Keywords: Chronic pain, stigma, disbelief, diagnostic uncertainty, illegitimacy

The cultural movement toward abbreviation and multitasking detracts from the desire and also, potentially, the ability to begin engaging in deep reading. This is problematic, considering that the deep reading of narrative fiction has many potential benefits. Through the use of both heuristic and hermeneutic methodology, this thesis takes a look at the psychological and scientific literature that explores the relationship between reading narrative fiction and an increase in both empathy and theory of mind skills; how the art of reading narrative fiction can be viewed from a depth psychological perspective; and the author’s personal experience with reading narrative fiction. This information is then utilized to explore how these components can be applied within the psychotherapy process through the use of bibliotherapy, as well as how it can be a valuable tool for one’s own personal growth and exploration outside of a therapy setting.

Psychotherapy interns often report feeling traumatized by the process that attempts to match them with an internship site. Once placed, feeling unsupported in one's supervisory relationship may lead to burnout, which contributes to high rates of attrition. A supportive relationship between supervisors and interns appears significant to the development of their early professional resilience. This integrative literature review asks, "How do therapists at all stages of their career achieve and maintain professional resilience?" and "What is inherent in the supervisory relationship that influences such growth and resilience in interns?"

Literature on psychotherapy supervision, professional trauma, compassion fatigue, and resilience was selected from the psychodynamic, psychoanalytic, and existential-humanistic traditions as well as from relational neuroscience. This literature was integrated in such a way as to define, compare and contrast these concepts.

Psychotherapists report a variety of historic traumas that contribute to their choice of psychotherapy as a profession. Therapists also identify as falling on a dynamic spectrum of resilience, reporting both personal and professional protective and risk factors. Psychodynamic, psychoanalytic, and existential-humanistic training and professional models continue to highlight the value of the supervisory and consultant relationship in support of recovery from professional overwhelm toward lasting personal and professional resilience. Therapists at all stages of their career report achieving and maintaining professional resilience by practicing individualized self-care, engaging in dynamic personal psychotherapy, and through supportive relationships in supervision and consultation. The primary element in the supervisory relationship that promotes growth and resilience in interns is the ability of the empathic supervisor to privilege the supervisee's experience in the supervisory relationship as well as with their mutual clients.

A supervisory model emerged that (a) elevates personal history and awareness of an intern's preexisting risk and protective factors, (b) promotes in-session self-awareness, and (c) draws on existential-humanistic theory, leading to the development of resilience. This model serves to support the humanity of the intern and supervisor as evolving professionals while respecting and perhaps enhancing the orientation of the training site.

The present study is a critical analysis of the literature about motivation in the treatment of anorexia nervosa. This dissertation provides a comprehensive overview of the theoretical and empirical literature on motivation to change in the treatment of anorexia nervosa, including discussion of the support for factors hypothesized to be associated with treatment motivation as well as identification of factors that require additional study. It will also provide conceptual clarity of motivation as a construct in anorexia nervosa treatment research. Current literature reveals how differences in the way motivation is conceptualized, studied, and assessed may limit our understanding of its role in anorexia nervosa treatment. Recommendations are therefore made regarding the adoption of a more consistent and shared understanding of the construct.

Chronic over-activity of the body's endocrine stress response system is detrimental to overall health and, over time, may have a negative impact on the structure and function of the hippocampus, a key brain area involved in episodic memory consolidation. Yoga is becoming an increasingly popular mind-body therapy used to reduce and prevent the harmful effects of stress on the body. This review presents a summary of the research investigating yoga as a therapeutic intervention to reduce both perceived and physiological stress in healthy adults. Studies looking at the effects of yoga on hippocampal-dependent memory function in children, adults, and elderly populations were also reviewed. Research investigating the stress-reducing effects of yoga has indicated that yoga may hold therapeutic value in reducing both perceived and physiological stress in healthy populations. In children, yoga has been shown to improve spatial, but not verbal, memory. In adults and elderly individuals, studies indicate improvements in both short and long-term verbal recall following yoga intervention. Elderly individuals also showed increased hippocampal volume following long-term yoga practice. Due to the shortage of empirical evidence, along with several shared methodological limitations, further investigation is still needed to fully determine the efficacy of yoga as a beneficial mind-body therapy for decreasing both perceived and physiological stress-response, improving memory, and preventing stress and age-related hippocampal volume loss.

Depression is a serious condition experienced by many individuals diagnosed with coronary heart disease (CHD). Depression after CHD diagnosis has been associated with poor cardiac prognosis, cardiac mortality, and is postulated to influence adherence to physician recommendations, including attendance at cardiac rehabilitation programs. Cardiac rehabilitation (CR) is an empirically supported secondary intervention for cardiac patients and is recommended by the American Heart Association (AHA) and the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) to reduce disease progression, however many CR participants do not complete. A number of studies have investigated depression and phase II CR programs. The goal of the current systematic literature review and meta-analysis was to explore the association between depression and phase II CR completion. A literature search cross-referenced three electronic databases (PsycINFO, MEDLINE, Dissertation Abstracts International) up through December 2014. Studies quantifying an association between depression and phase II CR completion were reviewed. After duplicate studies were removed and study inclusion criteria applied, 17 observational studies with 19 independent samples consisting of 30,586 cardiac patients remained for meta-analysis. A random-effects model found a moderate inverse relationship between depression and phase II CR completion (g = -.44, 95% CI -.59 to -.29), indicating that depressed CR patients were significantly less likely to complete their program. A minor amount of publication bias was detected with a funnel plot and trim-and-fill analysis. No significant moderator variables were detected.

This critical analysis of the literature is a comprehensive collection and review of the literature on the strengths-based perspective as it is applied to the treatment of substance use disorders. Literature was collected, analyzed, and critically evaluated to consolidate the existing research on strengths-based treatment approaches, identify ways in which the strengths-based perspective is congruent with culturally competent practice, and to identify strengths, weaknesses, and gaps in the literature. Analyses reveal that there are numerous components of the strengths-based perspective that are congruent with culturally competent practice and that strengths-based treatment approaches may serve as an effective adjunct or alternative to traditional treatment approaches for substance use disorders. While additional research is needed to further our understanding of the effectiveness of this approach, preliminary results indicate that there are numerous therapeutic advantages associated with the strengths-based perspective and its use with substance abusing populations.

Throughout the United States are institutions abundant with violent offenders who have been found not guilty by reason of insanity (NGI). The decision to release these insanity acquittees into the community is a vital one, both for the patient and the larger community. While these decisions should be informed by evaluations that combine clinicians’ opinions with validated tools of assessment, no standard of care regarding such evaluations exists. Forensic specialists are thus often left to base discharge decisions on clinical judgment alone. This dissertation assumed a critical review of the theoretical and empirical literature relevant to conditional release decisions of NGI patients, including the research on structured assessment of risk of future violence. Based on this critical review, the author proposed recommendations for five standards to enhance conditional release decision-making for violent offenders in forensic settings: (a) Adherence to professional and ethical conduct; (b) documentation of patient progress; (c) incorporation of empirically-validated risk assessment tools; (d) creation of a comprehensive release plan; (e) verification of patient’s commitment to successful reintegration. This dissertation additionally examined the strengths and limitations of the critical review strategy, as well as delineated areas for research to empirically evaluate the recommended standards and promote improved quality of conditional release evaluation for NGI acquittees.