Psychology

In psychological research, positive developmental outcomes in young adulthood are often conceptualized as the absence of psychological symptoms. However, positive outcome may be better understood as high levels of subjective wellbeing and adaptive interpersonal, occupational, and educational functioning. Nevertheless, a comprehensive model that takes into account multiple facets of youth behavior and transactional relations between youth and their environments as predictors of adjustment in young adulthood is lacking. Prior evidence implicates internalizing and externalizing behaviors in the development of subjective wellbeing, and emotion regulation as a reliable predictor and/or correlate of both internalizing and externalizing behaviors. Parenting behaviors in childhood and youth substance use represent other shared risk or resilience factors that likely contribute to internalizing and externalizing behaviors, as well as subjective wellbeing and adaptive functioning outcomes in young adulthood. The current study examined an existing sample of youth who were recruited at ages 10-12 and were assessed again at ages 16 and 25. Analyses aimed to (a) identify subgroups of youth who vary in frequency and quality of internalizing and externalizing symptoms and emotion regulation at ages 10-12 and 16 using latent class analyses, (b) examine stability of and transitions in class membership from classes at ages 10-12 to classes at age 16 using latent transition analysis, (c) investigate parenting behaviors as predictors of stability and transitions among classes, and (d) investigate whether classes differ in cross-sectional and prospective levels of substance use, as well as subjective wellbeing and adaptive functioning in young adulthood. Results demonstrated that a 4-class model best fit the data at both time points. Classes of youth with (a) low symptoms and high emotion regulation; (b) low internalizing, moderate externalizing, and high emotion regulation; and (c) moderate internalizing, high externalizing, and low emotion regulation emerged at both time points. The fourth class at ages 10-12 was characterized by high social withdrawal and moderate hyperactivity and emotion regulation, and the fourth class at age 16 was characterized by moderate internalizing, low externalizing, and low emotion regulation. Latent transition analyses revealed transitions from several symptom classes at ages 10-12 into the age 16 Low Symptoms/High Emotion Regulation class, and also stability and transitions to other symptom classes. Predictor analyses indicated that levels of parenting behaviors (maternal and paternal acceptance, child-centeredness, use of guilt and anxiety to control youth, lax discipline, and nonenforcement of rules) were associated with transitions among and stability within classes, but findings were dependent on levels of internalizing and externalizing symptoms among classes. Substance use differed cross-sectionally and prospectively across classes based on the substances considered. Further, subjective…

Psychology

In this study, I tested predictions of the Behavioral Approach System (BAS) model as applied to the course of bipolar spectrum disorders. In this model, when a vulnerable individual experiences a BAS activation-relevant event, the weak regulatory strength of the BAS interacts with pre-event BAS state and is likely to lead to hypomania/mania. In contrast, when a vulnerable individual experiences a BAS deactivation-relevant event, the weak regulatory strength of the BAS interacts with pre- event BAS state and is likely to lead to depression. A secondary goal of this study involved comparing the BAS model to the cognitive-vulnerability stress model of bipolar disorder. Toward this end, data from a sample of 217 individuals (112 individuals with a diagnosis in the bipolar spectrum and 105 demographically similar, normal controls) participating in the Longitudinal Investigation of Bipolar Spectrum Disorders (LIBS) Project, a two-site prospective examination of the role of BAS, cognitive styles, and life events in the course of bipolar disorders among college students, were analyzed. The results of this study suggest that there is some support for both the BAS model and the cognitive-vulnerability stress model. Specifically, BAS-relevant cognitive styles, in interaction with congruent positive life events, predicted hypomanic episodes. There was less support for either model in the prediction of depression. There was some support for BAS sensitivity and BAS-relevant events each predicting the course of bipolar disorder. However, there was no support for the interaction of BAS sensitivity and BAS-relevant events predicting the type and number of mood episodes. As such, this study found more support for a BAS-related cognitive vulnerability-stress model, as compared to the "pure" BAS model, as applied to bipolar spectrum disorders. Following a review of the results, strengths and limitations, as well as clinical implications and potential future research directions are discussed.

Temple University – Theses

Psychology

We assessed the relationship between several therapist variables and treatment outcome by examining the predictive power of therapist training/demographic characteristics, therapist competence and treatment integrity, and therapist style, to child outcome in a sample of 279 youth who participated in the Child and Adolescent Anxiety Multimodal Study (CAMS). All youth participated in 14 sessions of CBT (randomly assigned either with medication or without) delivered by trained therapists. Youth across both treatment conditions experienced significant treatment gains with youth in the CBT+MED and CBT only conditions showing greater gains than those in the placebo group. Therapist (a) prior clinical experience and (b) prior anxiety-specific clinical experience were significant predictors of treatment outcome across both parent- and diagnostician- rated measures. Higher levels of prior clinical experience predicted better outcome; higher levels of anxiety-specific experience were less favorable. Therapist treatment integrity, competence, and a collaborative style were also predictive of outcome. Therapists who were more collaborative and empathic, followed the treatment manual, and implemented it in a developmentally appropriate way, had youth with better treatment outcomes. Clinical implications and recommendations for future research are discussed.

Temple University – Theses

Psychology

Cognitive functioning, particularly executive functioning, is a strong predictor of everyday action impairments in schizophrenia. However, it is unclear if remediating cognitive deficits can lead to meaningful gains in adaptive functioning. Approaches that attempt to improve everyday action performance through bypassing or compensating for cognitive deficits are promising ways to address functional impairments. This study examined whether standardized environmental interventions can compensate for cognitive difficulties and improve action performance in schizophrenia. Forty two individuals were administered two versions of the Naturalistic Action Test (NAT) – a standard version (ST-NAT), and a user-centered version (UC-NAT) that incorporated interventions aimed at streamlining action performance. Individuals with schizophrenia demonstrated enhanced performance on the UC-NAT, demonstrating the beneficial effects of environmental interventions on everyday action. Results indicated that the interventions likely exerted their effect through compensating for global cognitive dysfunction. Additionally, the NAT's reliability and validity for schizophrenia populations, as well as the UC-NAT's utility for addressing the cognitive impairments of a variety of neurological populations were examined.

Temple University – Theses

Psychology

Guidelines for conducting effective exposure treatment with anxious youth emphasize content (e.g., preparation for and processing of the exposure) and process (e.g., collaboration and youth involvement) variables as important elements of exposure task sessions, but there is a paucity of research examining these guidelines. Using multiple regression, this study evaluated the extent to which independent observers' ratings of process (i.e., collaboration and youth involvement) and content variables (i.e., preparation for and processing after the exposure task) were predictive of treatment outcome in a sample of 61 anxiety-disordered youth. Results indicated that collaboration between the youth and therapist significantly predicted improvement in treatment outcome as measured by youth-, parent-, and teacher-reports. Youth involvement in exposure task sessions predicted improved outcome as measured by teacher-report. Contrary to expectation, preparation for exposure did not predict outcome, but post-event processing of the exposure task was significantly predictive of clinician-rated diagnostic outcome. Exploratory analyses suggest that treatment responders were more likely to be assigned between-session exposure tasks as "homework" and were more likely to be rewarded for their efforts in session. Treatment implications and future directions are discussed.

Temple University – Theses

Psychology

Social anxiety disorder is the fourth most prevalent mental disorder in the US. Over the past several decades, psychotherapeutic, specifically cognitive behavioral, and pharmacologic approaches have been found efficacious for social anxiety disorder. A number of meta-analyses have been conducted since 1995 examining the efficacy of cognitive behavioral therapy (CBT) and/or pharmacotherapy for social anxiety disorder. Though there have been numerous trials in the past decade, no meta-analysis examining both psychotherapy and pharmacotherapy for social anxiety disorder has been published since 2001. For the present study, a comprehensive literature search produced 93 publications featuring 94 controlled trials (N = 11,503), which were included in the final analyses. We found a moderate to large effect size for all active treatments compared to control conditions. Significant heterogeneity among treatment effects was evident, largely accounted for by true variation between effects, versus standard error. Examination of potential study characteristic moderators indicated that treatment type (CBT, medication, combination), analysis type (intent-to-treat vs. completer), funding source, type of screening interview, type of treatment clinic (academic or private), version of diagnostic criteria, type of social anxiety sample (generalized social anxiety disorder only vs. mixed sample of generalized and specific social anxiety disorder) and type of inclusion/exclusion criteria related to other anxiety disorders were significant moderators. Publication type, inclusion/exclusion criteria related to depression and substance abuse/dependence, and full sample comorbidity with another disorder were not. Treatment type was no longer a significant moderator once control condition was accounted for. In psychotherapy trials, self-exposure (as compared to all other types of CBT) and psychotherapist training were significant moderators, whereas variables corresponding to treatment modality and delivery were not. Medication class and specific drug type were significant moderators for pharmacotherapy studies comparing an active treatment to a control condition. Head-to-head comparisons, which included trials comparing active treatments, indicated no differences between psychotherapy, medication, and the combination of the two. Further, social anxiety treatment had moderate to large effects on depression and quality of life.

Temple University – Theses

Psychology

Objective: Conduct a meta-analysis of school-based interventions for anxious and depressed youth to evaluate the findings according to QUORUM guidelines. Method: A search of the literature was conducted using PubMed, PsycINFO, and manual searches, supplemented by contact with leading researchers. The present meta-analysis used 63 studies and investigated 8,225 participants receiving CBT and 6,986 participants in comparison conditions. Results: Mean pre-post effect size estimates indicate that anxiety-focused school-based CBT was moderately effective at improving symptomatology of anxiety (Hedge's g = 0.501) and depression-focused school-based CBT was mildly effective at improving depression symptomatology (Hedge's g = 0.298) for youth receiving active interventions as compared to those in anxiety intervention control conditions (Hedge's g = 0.193) and depression intervention controls (Hedge's g = 0.091). Moderators and mediators of treatment outcome were explored. Conclusions: School-based CBT interventions for youth anxiety and for youth depression hold considerable promise, though further investigation is still needed to identify features that optimize service delivery and outcome.

Temple University – Theses

Psychology

A core feature of GAD, excessive and uncontrollable worry, may be indicative of poor attentional control and difficulty disengaging attention from threatening or emotional information (e.g., Fox, 2004; Mathews, Fox, Yiend, & Calder, 2003; Yiend & Mathews 2001). The current study examined the performance of college students with and without self-reported GAD (N = 63) on measures of attentional control and a spatial cueing task designed to assess engagement-disengagement processes from emotionally valenced (aversive, pleasant) and neutral picture stimuli. Attentional control abilities were examined using the Stroop Color-Word Association Test (SCW Test) and Trail-Making Test (TMT). Separate analyses of variance (ANOVAs) demonstrated that GAD participants performed more poorly on the Stroop Color subtest and the TMT: Part B than non-GAD participants. Mixed ANOVAs of response times measured during the spatial cueing task revealed significant main effects for Cue Valence and Cue Validity, as well as several significant interactions of these variables with GAD status. The significant Cue Valence x Cue Validity x GAD status interaction indicated that GAD participants were slower to disengage their attention from aversive stimuli, relative to pleasant or neutral stimuli, than non-GAD participants who did not exhibit this bias. This interaction effect, however, did not remain significant upon covarying for depression. Together, these findings suggest that individuals with GAD evidence poorer attentional control and demonstrate difficulties disengaging from threatening stimuli compared to persons without the disorder. Impairment in these attentional processes may, therefore, contribute to the etiology and maintenance of GAD.

Temple University – Theses

Psychology

Individuals high in social anxiety report higher interpersonal dependency (e.g., Darcy et al., 2005), lower satisfaction with their sexual communication with their intimate partners (Montesi et al., 2009), less self-disclosure (e.g., Sparrevohn & Rapee, 2009), and less emotional expression (e.g., Spokas et al., 2009) than non-anxious individuals. In comparison to non-anxious individuals, socially anxious individuals also report lower satisfaction with various aspects of their intimate relationships including lower sexual satisfaction (Bodinger et al., 2002), less social and emotional intimacy (Schneier et al., 1994), and lower overall relationship quality (Sparrevohn & Rapee, 2009). The primary aim of the present investigation was to better understand the lack of satisfaction and fulfillment reported by socially anxious individuals in intimate relationships. Data were collected from 135 undergraduate students in committed, heterosexual, monogamous, sexually active partnerships of at least three months duration. Structural equation modeling was used to examine variations of a partially latent structural regression model in which higher social anxiety and higher interpersonal dependency were predictive of higher sexual communication reluctance and, in turn, lower overall relationship satisfaction and higher sexual dissatisfaction. Based on an examination of overall model fit statistics, chi square difference statistics, parameter coefficients, and correlation residuals, two models (one including fear of damaging the relationship and one without this variable) were retained. Both of the retained models, which included direct paths from social anxiety to satisfaction in addition to indirect paths from social anxiety and interpersonal dependency to the outcome satisfaction variables, had excellent fit (Model 1D:X²M=3.48,df=8,p=.90,RMSEA=0.00,CFI=1.00; Model 2D: X²M =15.07,df=14,p=.3, RMSEA=0.02,CFI=0.99). Exploratory hypotheses were examined. Results are discussed in terms of the benefits of open communication between intimate partners about specific areas of the sexual relationship (e.g., sexual fantasies). Future directions of study are proposed.

Temple University – Theses

Psychology

Objective: This study examined (a) the distribution of physical symptoms in youth with specific primary anxiety disorders (i.e. separation anxiety disorder [SAD], generalized anxiety disorder [GAD], and social phobia [SP]) and (b) their response to treatment with cognitive-behavioral therapy (CBT; 14 sessions of CBT over the course of 12 weeks), medication, combination therapy (CBT + medication), or pill placebo in a sample. Method: Anxiety disordered youth (N = 488, age 7-17) who met criteria for a primary diagnosis of GAD, SAD, and/or SP as part of the Child/Adolescent Anxiety Multimodal Study (CAMS; Walkup et al. 2008) were included in this study. The sample was diverse and included children with comorbid secondary diagnoses. Results: The most common somatic complaints were headache, stomach pain or aches, feeling drowsy or too sleepy, head cold or sniffles, and sleeplessness. The distribution of these complaints did not differ across diagnostic groups. The number and severity of physical symptoms decreased over the course of treatment. Treatment condition, including placebo, was unrelated to the number and severity of physical symptoms posttreatment. Conclusions: Treatment of anxiety leads to a decrease in the number and severity of physical symptoms experienced in anxiety-disordered youth, irrespective of treatment type.

Temple University – Theses

Psychology

Schizophrenia is a debilitating disorder with an array of affective, cognitive, and behavioral consequences. In addition to these impairments, research suggests that there is a distinct pattern of hedonic functioning in schizophrenia that may contribute to some of the most intractable symptoms of the disorder, the negative symptoms. Specifically, individuals with schizophrenia appear to experience deficient levels of pleasure during anticipation of a pleasurable stimulus, while experiencing typical levels of pleasure while directly engaged with a pleasurable stimulus. Despite these findings, it is unclear whether hedonic functioning deficits occur in individuals with subthreshold levels of psychotic symptoms and/or in individuals at clinical high risk for the disorder. The purpose of this study was to examine hedonic functioning in relation to the continuum of psychotic symptoms in a college undergraduate student sample, and in those at clinical risk for schizophrenia. Participants were 679 students who completed self-report measures of current psychotic-like experiences, and trait-like components of hedonic functioning (i.e., anticipatory and consummatory pleasure). Consistent with study hypotheses, deficits in anticipatory pleasure, but not in consummatory pleasure, were significantly associated with increased clinical risk for schizophrenia. However, this relation was found exclusively among women in the sample, whereas men did not show a significant relation between anticipatory pleasure deficits and clinical high-risk. Furthermore, anticipatory pleasure deficits were not significantly associated with increases in the number of positive psychotic symptoms endorsed. Moreover, consummatory pleasure was not associated with increases in the number of subthreshold positive psychotic symptoms, nor was there a relation with the number of distressing positive psychotic symptoms or clinical risk status. The present study provides the first examination of the relation between hedonic functioning and subthreshold psychotic symptoms, as well as the relation with clinical high-risk for psychosis. These findings suggest that anticipatory pleasure deficits may be more closely related to increased clinical risk for psychosis among women rather than increases in psychotic symptoms in the general population. Anticipatory pleasure deficits may be a useful target for intervention and prevention techniques among those at clinical risk for psychosis, especially in female at risk populations. Additional longitudinal studies will be essential for testing whether anticipatory pleasure deficits predict the occurrence of future psychotic disorders among those at high risk for the disorder in order to improve early identification and early intervention efforts in this population.

Temple University – Theses

Psychology

Many people experience a romantic breakup at some point in their lives, but people's reactions can vary considerably. A common way of coping with the dissolution of a romantic relationship is to seek support and opportunities to talk with close others. Although talking with social network members may prove helpful for some, the Social-Cognitive Processing (SCP) model posits that interpersonal interactions can hinder emotional recovery and adjustment if the disclosers feel the social network members are responding in a socially constraining way. As a result of perceiving social constraints, individuals may try to avoid thinking and talking about the breakup altogether, which, in turn, may interfere with the cognitive processing necessary to move forward from the breakup. The current research marked the first time the SCP model was explored with regards to the dissolution of romantic relationships, and it evaluated the utility of the SCP model in potentially explaining the variable nature of adjustment to a romantic breakup. One hundred and seventy-four eligible participants completed this online study. Participants completed various questionnaires pertaining to their previous relationship and subsequent breakup, their feelings and experiences following the romantic dissolution, their tendencies to think about the breakup, and the degree to which they discussed the relationship dissolution with others and the reactions they received during these conversations. In support of the SCP model, the results indicated that social constraints were associated with greater psychological distress. Furthermore, avoidance partially mediated the relation between social constraints and psychological distress as levels of social support decreased. This suggests that higher levels of social support might help buffer against engaging in avoidance in response to social constraints. In an initial attempt to examine whether the extent of avoidance displayed varied as a function of a dispositional variable (i.e., self-monitoring), no support was found. Future research should continue to investigate additional factors that may moderate the relation between social constraints and psychological distress through avoidance.

Temple University – Theses

Psychology

A wealth of research indicates that depression is a serious global health issue, and that it is often characterized by a complicated and varied course. The ability to predict depressive course would be tremendously valuable for clinicians. However, the extant literature has not yet produced an accurate and efficient means by which to predict the course of depression. Research also indicates that cognitive variables - and cognitive vulnerability factors in particular - are related to the course of depression. In examining data provided by participants in the Temple-Wisconsin Cognitive Vulnerability to Depression Project (N = 345), the current study aimed to elucidate the relationship between cognitive vulnerability and depressive course using an actuarial statistical method. Results indicated that several cognitive measures predicted aspects of the onset and course of depression at rates significantly better than chance; foremost among these was the Cognitive Style Questionnaire (CSQ; Alloy et al., 2000). The CSQ was found to be the variable that best differentiated between participants who developed an episode of depression and those who did not. Furthermore, in comparison to participants who did not develop an episode of depression, the CSQ was found to differentiate between participants who recovered from a given depressive episode and those who did not, as well as between participants who experienced a single episode and those experiencing a recurrent course of the disorder across the prospective phase of the study. Conceptual and clinical implications of these results are discussed, as are directions for future research.

Temple University – Theses

Psychology

Research has supported the efficaciousness of mindfulness-based interventions on depression and general psychological well-being (Teasdale et al., 2000). Thus, researchers are beginning to examine the specific mechanisms of mindfulness's salutary effects (Shapiro, Carlson, Astin, & Freedman, 2006). As mindfulness has been increasingly linked to enhanced emotional awareness and emotion regulation (Nielsen & Kaszniak, 2006; Chambers Gullone, & Allen, 2009), the specific act of objectively labeling affective experience has been proposed as an emotion regulation mechanism of mindfulness. Research has linked emotion regulation pathways in the brain with experimental tasks of affect labeling in individuals with high trait mindfulness (Creswell, Way, Eisenberger, & Lieberman, 2007). The aim of this study was to examine affect labeling as an emotion regulation mechanism of mindfulness in the context of well-established cognitive models of depression. Specifically, the study investigated whether individuals asked to label facial stimuli with affective labels recovered from a negative mood more quickly, and with more emotional granularity, than those in a control condition. One hundred and forty-nine Temple University undergraduates completed measures of mood, emotion regulation, and cognitive style prior to a negative mood priming task and were randomly assigned to one of two labeling conditions: affect labeling or gender labeling (control). Emotion dysregulation proved to be an important predictor of affective response to the mood induction. Specifically, emotion dysregulation was positively associated with negative affect, and negatively associated with positive affect, preceding and following the mood induction. However, contrary to study hypotheses, HLM analyses indicated that speed and specificity of affective recovery did not differ across experimental condition; thus, affect labeling was not associated with more adaptive emotional regulation. In addition, cognitive styles and mindfulness failed to moderate the relationship between affect labeling and affective recovery in the expected direction. However, greater trait mindfulness was associated with less negative affective responses to the mood induction. Implications of study findings, strengths and limitations of the study, as well as future directions are discussed.

Temple University – Theses

Psychology

Two Studies investigated the relationship between verbal behavior and short-term mate selection. The first study, an observational traditional speed-dating study, collected audio and video recordings of dyadic interactions between men and women in addition to self-report data on whether the participant would like to talk to each date in the future. The second study, a true experiment, employed the use of a researcher confederate to manipulate verbal behavior and attractiveness level of the speed-date partner. Participants were led to believe they were being "matched" with three other undergraduates based upon online profiles. Verbal behavior manipulations included varying valence-based autoclitics (neutral or high) and self-other referential autoclitics in two sequential orders (based on I , you , I /you in relation to one another, and dyadic we frames of reference). During traditional speed-dating, a wide variety of verbal operants were used. In general, dyadic we was not frequently used by participants, imprecise tacting tended to be characteristic of no ratings, and successful speed-daters tended to modify their verbal behavior as appropriate to the specific listener. For online-dating, among the findings concerning the observed relationships between autoclitics, physical attractiveness, and various outcomes in short-term romantic interest, were confederate use of I-to-we sequential progressions with neutral valence tended to best predict longer times spent chatting, as chosen by participants when given the choice to chat more than the five-minute minimum. Additionally, confederate use of I and you in relation to one another was positively correlated with participant interest ratings of the confederate for medium-attractiveness confederates and was negatively correlated with interest ratings for low- and high-attractiveness confederates. Autoclitics moderated the relationship between physical attractiveness of the confederate and yes ratings for both low- and high- attractiveness confederates. Findings from the current projects are discussed in context of general dissemination of verbal behavior and in context of other populations.

Temple University – Theses

Psychology

The training literature suggests that ongoing support (e.g., consultation) following initial training enhances training outcomes, yet little is known about the critical components of ongoing support and the lasting effects of ongoing support. The present study examined components of consultation calls that were provided to 99 community clinicians following training in the delivery of cognitive-behavioral therapy (CBT) for youth anxiety. The 104 recorded consultation calls were coded for content and consultative methods present. A subset of the training sample (N = 50) completed a 2-year follow-up interview during which they reported on their implementation rates of CBT since ending consultation. They also completed measures assessing CBT knowledge and attitudes toward evidence-based practices (EBPs). It was hypothesized that active learning (i.e., role-plays) would predict therapist adherence, skill, self-efficacy, and satisfaction at postconsultation, but regression analyses found no significant relation. However, level of clinician involvement during consultation calls significantly positively moderated the relation between active learning and clinician skill. Analyses of the follow-up data indicated (a) high implementation rates of CBT and (b) maintenance of overall attitudes toward EBPs, willingness to implement EBPs if mandated, views regarding the appeal of EBPs, and beliefs regarding the clinical utility of EBPs. A significant decline in CBT knowledge and openness toward EBPs was observed. Consultation call attendance positively predicted therapist CBT knowledge, overall attitudes toward EBPs, and attitudes regarding the appeal and clinical utility of EBPs at the 2-year follow-up. Implications, strengths and limitations, and future directions are discussed.

Temple University – Theses

Psychology

Eating disorders involve the inability to appropriately regulate a behavioral response to food due to impaired reward sensitivity, affect regulation and cognitive control, resulting in deleterious effects on the individual's physical and mental well-being. In this way eating disorders may be analogous to addictive disorders (e.g. alcoholism). Furthermore, eating and addictive disorders co-occur at very high rates and appear to have similar contributing mechanisms (impaired reward sensitivity, impaired affect regulation and impaired cognitive control). Overvaluation of weight and shape concerns appears to be one unique characteristic of eating disorders, not shared with addiction. The current study examined the relationship between impaired reward sensitivity, impaired affect regulation and impaired cognitive control with addiction vulnerability. Furthermore, weight and shape concerns were examined as a potential moderator of the relationship between addiction vulnerability and binge eating. A total of 1000 undergraduate students completed self-report measures examining the three posited mechanisms for addiction vulnerability and disordered eating. A subset of 101 students (50 binge-eaters and 51 non-binge eaters) also completed behavioral measures of the three posited mechanisms. The results of this study support the proposed model that weight and shape concerns moderate the relationship between addiction vulnerability and binge eating. Results also demonstrated on a behavioral task that individuals who endorsed binge eating were more likely to act impulsively and quit the PASAT-C task faster than control subjects. Furthermore, they demonstrated a greater increase in irritability while completing the task which may have resulted in their desire to quit the task earlier. No differences were found on behavioral measures of reward sensitivity (delay discount task) or cognitive control (stop signal task). Future studies should continue to examine the construct of addiction vulnerability to provide additional validity for the construct as well as examine it in the context of all forms of disordered eating.

Temple University – Theses

Psychology

Social anxiety disorder (SAD) is one of the most prevalent psychological disorders and one that is particularly disruptive of social relationships. Socially anxious individuals often have trouble forming and maintaining intimate relationships, as evidenced by a high divorce rate and low relationship satisfaction within existing relationships. However, little is known about the specific reasons why relationships involving socially anxious individuals suffer. Initial research suggests that such relationships may be characterized by lower levels of emotional intimacy and difficulties managing and resolving conflict. The current study aimed to detect specific problems socially anxious individuals have communicating with their partners during conflict and support-seeking conversations. Male (n = 50) and female (n = 57) undergraduates ("actors") and their intimate partners ("partners") completed two videotaped conversations in our laboratory. One conversation featured a topic of conflict within the relationship, whereas the other focused on a personal problem experienced by the actor. Outcomes of interest included level of engagement and expressiveness of the actor, presence of positive (e.g., humor) and negative (e.g., withdrawal) communication behavior by the actor, feelings of satisfaction and closeness of both partners, and emotions experienced by both partners. We hypothesized that social anxiety would be associated with lower levels of engagement and expressiveness overall, but especially during conflict. Further, we hypothesized that those higher on social anxiety would demonstrate more negative communication behavior (such as expressing hostility toward their partners) during conflict. Results provided some evidence that socially anxious individuals were less engaged and expressive when speaking with their partners. However, there was no evidence that they used more negative communication behaviors. Our hypothesis that social anxiety would be associated with greater difficulty during conflict had minimal support; rather, conversations in which the actor elicited support appeared to be the most difficult for socially anxious individuals, particularly when emotional experience was considered. Clinical implications and ideas for further research are explored.

Temple University – Theses

Psychology

Sexual minority men are at an increased risk for negative outcomes, including mental health disorders, suicide, substance abuse, and sexual risk behaviors. Internalized Homophobia (IH), roughly defined as sexual orientation-related self-hatred among gay men, has been linked to these outcomes. Since its publication in 1983, the predominant measure of IH used in psychological research has been the Nungesser Homosexual Attitudes Inventory (Nungesser, 1983). The scale is potentially dated, and there is a relative paucity of investigation into its psychometric properties; findings derived through its use may be in question. The current effort describes two studies designed to address these concerns. Study I includes a principal components analysis of the scale using data obtained from an internet sample (N = 486), resulting in suggested revisions for the broader scale, and proposed brief versions of the Self and Disclosure subscales. Study II used data obtained from a second internet sample (N = 884) to further evaluate scale structure and properties. Analyses include confirmatory factor analyses of the original scale, Shidlo's revised version (1994), the suggested alternative, and the Brief Self and Disclosure scales proposed in Study I. Of the three versions of the overall scale, the suggested alternative proposed in Study I exhibited the most favorable fit and highest item loadings. Internal consistency for the suggested alternative was equal to that of the larger NHAI and Shidlo-revised scales. External validity was evaluated through correlations with mental health and suicide, substance use, sexual risk, and orientation-based victimization. Strong results in the expected direction were found only in the instance of mental health, with negative attitudes towards homosexuality being associated with increases in depression and anxiety scores as measured by the Hospital Anxiety and Depression Scale. The suggested scale alternative and Brief Self and Disclosure scales performed similarly to the more extensive NHAI and Shidlo-revised scales, leading to a recommendation for their use in research. Finally, findings from the current effort are discussed in relation to the broader social context impacting the lives and development of sexual minority men.

Temple University – Theses

Psychology

Studies suggest that nearly two-thirds of women fake or have faked orgasm, yet few researchers have explicitly examined this phenomenon. Previous studies have identified some group differences between women who fake orgasm and those who do not on dimensions of sexual experience, emotion regulation, intimacy, relationship status, and sexual functioning. To date, research into this phenomenon has relied solely on variable-centered analyses (e.g., exploratory factor analysis, correlation, and regression). This study used a person-centered approach (i.e., latent class analysis; LCA) to explore differences in women's motives across individuals, using scores from the Faking Orgasm Scale. A 5-class model was determined to be most interpretable and the best fitting to the data. Classes included low, moderate, and high frequency faking orgasm, partner-focused faking orgasm, and pleasure-focused faking orgasm. These classes were then compared on dimensions of sexual functioning, intimacy, and emotion regulation, as well as demographic variables (e.g., age, length of relationship, number of sexual partners). Significant differences were found in sexual desire, sexual activity, and orgasmic consistency, but not in sexual satisfaction. Significant differences were also evidenced in intimacy, general level of emotion dysregulation, and across various dimensions of emotion regulation. No differences across classes were revealed on age, length of relationship, or number of sexual partners. These findings can serve as the foundation for further exploration into understanding women's various styles of interacting sexually with a partner and may have implications for couples therapy, sex therapy, and individual interventions for women struggling with physical and/or emotional intimacy with a partner.

Temple University – Theses

Psychology

The personality disorder known as psychopathy describes a group of individuals that have tended to be persistently antisocial and more prone to violence, and demonstrate deficits in affective and interpersonal functioning. Further, the diagnosis of psychopathy (as defined by the PCL-R) reliably predicts recidivism, treatment nonresponse, and other socially important outcomes. Although a well-validated assessment methodology exits for adult correctional populations, more recent research has focused on assessment among adolescents (forensic and nonforensic) and community-based adult populations. The current study examined the psychometric properties of the most promising self-report measures, including their factor structures. Also explored were the unclear relationship between psychopathy and anxiety and related constructs, and the relatively low reliability of scale factors and subscales assessing callousness, a key component of the psychopathy construct, in the research to date.

Temple University – Theses

Psychology

Non-suicidal self-injury (NSSI) and suicidal behavior are prevalent problems, particularly among young adults. However, previous research on factors that might impact the severity of NSSI is limited, with no studies examining concurrently demographic and psychological risk factors, along with how reasons for engaging in, and emotional states surrounding, NSSI might impact its course. Furthermore, no studies to date have examined how these variables may be associated with laboratory-based behavioral indicators of NSSI severity. Similarly, the relationship between NSSI and suicide has been largely unexplored until recently. The few studies that have been conducted to date have relied primarily on self-report batteries of symptoms, largely neglecting interview and performance-based methodologies. The current study used a multi-method approach to elucidate factors associated with: 1) co-morbid suicidal behavior and 2) NSSI severity among a sample of young adults who engage in NSSI. Finally, the current study sought to develop an algorithm for predicting suicidal behavior among self-injurers by simultaneously examining all study variables to determine which variables best differentiated between those with and without a history of suicidal behavior. Hypotheses: It was hypothesized that: 1) greater endorsement of self-punishment, emotion regulation, sensation seeking, and addiction functions of NSSI, along with decreases in negative affect and increases in positive affect during NSSI, would be independently associated with a history of suicidal behavior after controlling for relevant demographic and diagnostic characteristics, and 2) greater endorsement of self-punishment, emotion regulation, sensation seeking, and addiction functions, along with decreases in negative affect and increases in positive affect during NSSI, each would be independently associated with a more severe course of NSSI as indicated by a greater number of self-reported acts and methods of NSSI, stronger implicit associations with NSSI, and higher levels of behavioral self-aggression. Methods: Participants were 68 undergraduates aged 18-26 who had engaged in at least 5 acts of NSSI, with at least one in the past six months. Twenty-eight participants endorsed little or no previous suicidal ideation and were in the NSSI Only group. Forty participants endorsed clinical levels of suicidal behavior (plans or attempts) in their lifetime and were in the NSSI+Suicidal Behavior group. Participants completed a screening procedure during which they completed self-report measures of lifetime history of NSSI and suicidal behavior, as well as self-report measures of impulsivity and affect regulation. Participants who met inclusion criteria were enrolled in the full study during which they completed diagnostic interviews for Axis I and II psychopathology, structured interviews to assess detailed lifetime self-injurious and suicidal behavior, self-report measures to assess current mood, and behavioral tasks assessing implicit associations with NSSI and…

Psychology

Among those seeking treatment for a substance use disorder (SUD), the prevalence of a concurrent anxiety disorder or posttraumatic stress disorder (PTSD) is surprisingly high, with some estimates placing the comorbidity rate at 33% to 43%. There is evidence that this comorbidity is associated with greater symptom severity, impairment, and substance use relapse than when the disorders present independently. One of the greatest challenges that clinicians face when presented with a patient with an anxiety disorder/PTSD and SUD is deciding how to approach treatment. Though the prevailing approach has been to treat the disorders sequentially, with the SUD receiving initial attention, there is a movement towards developing integrated or concurrent treatment models. The current meta-analytic study examined integrated or concurrent psychotherapies or pharmacotherapies for SUDs and anxiety disorders or PTSD. A meta-analysis on this topic is particularly important given the generally mixed findings of existing randomized controlled trials in this area of research. Our main question of interest was how integrated/concurrent treatments compared to single-target treatments. In addition, we explored whether there were outcome differences between psychotherapy and pharmacotherapy, between anxiety disorders and PTSD, and differences based on treatment setting (e.g., substance use treatment center versus other settings). Our findings suggested that integrated or concurrent treatments were superior in reducing anxiety or PTSD symptoms, compared to treatments that only targeted substance use or anxiety/PTSD. The effect, however, was small. There was no evidence that integrated or concurrent treatments improved substance use outcomes in comparison to stand alone substance use treatment. We also found evidence that treatment studies conducted at substance use inpatient or outpatient programs produced smaller anxiety/PTSD effects. A trend was found suggesting combined psychotherapy-pharmacotherapy interventions may be more effective than psychotherapy alone. No difference was found between treatments targeting PTSD versus anxiety disorders. Implications of our findings are discussed.

Temple University – Theses

Psychology

Over the past decade, a growing body of literature has developed around the construct of co-rumination, defined as the excessive discussion of problems within close relationships at the expense of engaging in other, potentially more productive activities, such as problem solving (Rose, 2002). Past research on co-rumination has sought to elucidate its relationship with increases in depressive symptoms and, to a lesser extent, greater relationship satisfaction in youth and young adults. Although co-rumination is at its core an interpersonal process, there have been no attempts to understand this behavior in light of other long-established interpersonal vulnerabilities to depression. The present study sought to extend the literature in two key aspects at both a macro and micro level. First, the study examined the interrelations among co-rumination, interpersonal vulnerabilities (dependency and excessive reassurance seeking), depressive symptoms, and relationship quality. Using a longitudinal design, the study tested whether co-rumination mediated the relationships between these interpersonal vulnerabilities and depressive symptoms. Second, using a daily diary paradigm, this study explored how daily co-rumination affected not only daily levels of negative affect, but daily relationship satisfaction as well. A sample of 309 university students completed a baseline questionnaire assessing interpersonal vulnerabilities, relationship quality with their closest confidant, and depressive symptoms followed by a seven-day daily diary that measured target participants’ negative mood, levels of co-rumination with their closest confidant regarding a stressor, relationship satisfaction, and interaction quality. One month later, participants completed a measure of depressive symptoms. Partial support for hypotheses was found. Co-rumination was positively related to other measures of interpersonal vulnerability and relationship quality, but was unrelated to depressive symptoms both concurrently and at the one-month follow-up. Co-rumination was not found to be a moderator or a mediator of the relationships between interpersonal vulnerabilities and depressive symptoms. Co-rumination did moderate the relationships between interpersonal vulnerabilities and relationship quality, with a differential pattern of results across gender. At the daily level, co-rumination was related to negative mood and relationship satisfaction; however, no support was found for co-rumination as a mediator of gender differences in negative mood or relationship quality. Overall, these findings suggest that engaging in co-rumination is associated with relationship quality and satisfaction. More research is necessary to determine under which circumstances and for which young adults co-rumination results in elevations in depressive symptoms, findings that have tended to be more consistent in youth samples.

Temple University – Theses

Psychology

Objective: The present study examined the potential roles of externalizing and depressive co-occurring psychopathology on the time-course to anxiety treatment response among youth receiving different treatment conditions. Method: Participants were 488 youth (aged 7-17 years) who received either Cognitive-Behavioral Therapy (CBT) (N = 139), sertraline (SRT) (N = 133), CBT+sertraline (COMB; N = 140), or pill placebo (PLB; N = 76) in the Child/Adolescent Anxiety Multimodal Study (CAMS; Walkup et al., 2008). Results: Findings did not demonstrate a significant relation of comorbid psychopathology with treatment response time-course. Participants in CBT and SRT had significantly different overall treatment response trajectories, though comorbid psychopathology did not significantly relate to the observed treatment response trajectories. Exploratory analyses revealed that parental treatment assignment reaction to CBT was positively associated with more favorable treatment response time course, whereas parental treatment assignment reaction to SRT did not significantly relate to treatment response time course. Conclusions: Our results are consistent with the notion that current interventions (CBT, SRT) produce improvements that generalize across co-occurring depressive and externalizing psychopathology. Clinical implications for the treatment of anxious youth with regard to comorbidity and contextual factors are discussed and suggestions for future research are offered.

Temple University – Theses

Psychology

Conceptualizations of anger have suffered from a lack of research investigating the temporal dynamics of anger episodes. Furthermore, though some studies have provided valuable insights into the time course of anger, no study to date has utilized a standardized laboratory paradigm designed to mimic an interpersonal provocation. The purpose of this study was to characterize the time course of the affective, physiological, and behavioral components of anger in response to a standardized provocation. Our second aim was to assess potential effects of trait anger, trait aggression, trait hostility, and emotion regulation deficits on the time course of the different components of anger. Participants (n = 82) engaged in the Modified Taylor Aggression Paradigm (MTAP), a laboratory measure of anger/aggression in which provocation is manipulated by varying electric shocks selected for the participant by an (unbeknownst to the participant) fictitious opponent. This study utilized a modified version of the classic TAP that simulated an acute interpersonal provocation that one might encounter in the “real world.” Subjective anger, physiological arousal (as evidenced by heart rate [HR], galvanic skin response [GSR], and high-frequency heart rate variability [HF HRV]), and the behavioral expression of anger (aggression) were measured throughout the task before, during and after provocation. Consistent with previous research, results showed that the rise time to peak levels of most outcome variables was significantly faster than the return time from peak back to baseline. Additionally, results showed that the majority of the time course variables were not correlated with one another providing evidence for the idea that different components of anger have independent time courses. Contrary to our hypotheses, trait variables were largely unrelated to time course variables. The current study provides further evidence for the relationship between the rise time and return time in the time course of subjective, physiological and behavioral manifestations of anger using a standardized and ecologically valid provocation task.

Temple University – Theses

Counseling Psychology

Proponents of self-report and projective assessment traditions have approached the assessment of interpersonal dependency quite differently, in ways that are only recently becoming more aligned. The present study aimed to address the increasing convergence between the two sides, administering both self-report measures and a newly developed implicit measure of dependency in an attempt to characterize more precisely the relations between these seemingly disparate approaches. The study was moderately successful in validating the implicit measure using criteria proposed by two independent groups (Asendorpf, Banse, & Mucke, 2002; Bornstein, 2002). The implicit measure was found to be reliable, orthogonal to two self-report dependency instruments, and predictive of external criteria such as other personality constructs and past depression. This success, however, was hampered by the study's inability to replicate prior findings using a task assessing help-seeking, identified as a behavioral indicator of dependency. All implicit and self-report dependency indices were unrelated to all measures of help-seeking, which prevented any further analyses; potential explanations for the failure of this task are proposed in the Discussion. This study also provided an examination of dissociations between participants' scores on self-report and implicit measures of dependency, and has implications for the significance of such dissociations. That is, the possibility that dissociations themselves are pathological was not supported, and it was found that dissociations between self-report and implicit dependency scores were associated with different patterns of responding on a broadband personality instrument. Finally, the present study offered additional evidence for the relation between dependency and depressive sypmtomatology, and further identified implicit dependency as contributing unique variance in the prediction of past major depressive episodes.

Temple University – Theses

Psychology

Cognitive-Behavioral Therapy (CBT) is an empirically supported treatment for anxious youth; however, approximately 30% of youths continue to meet diagnostic criteria for their primary anxiety disorder at posttreatment. Efforts to identify predictors and moderators of outcome in CBT are encouraged in order to enhance treatment efficacy. One potential predictor is youth pretreatment self-disclosure (e.g. Panichelli-Mindel, Flannery-Schroeder, Kendall, & Angelosante, 2005). Using a sample of 101 Anxiety Disordered (AD) youths meeting criteria for a primary diagnosis of Generalized Anxiety Disorder (GAD), Separation Anxiety Disorder (SAD), or Social Phobia (SOP) who were treated with 16-weeks of CBT (individual or family), this study examined (a) youth self-disclosure as a predictor of CBT outcomes, (b) pre- to post-treatment change in disclosure and distress during disclosure task, for responders relative to nonresponders, (c) disclosure and distress while disclosing in anxious youth relative to community volunteers (N=74); and (d) disclosure and distress while disclosing in treatment responders and nonresponders (posttreatment), and community volunteers. Videotaped recordings of a four-minute Youth Speech Sample (YSS) in which the youth was instructed to talk about him/herself were coded by reliable coders who were blind to diagnostic status, using the Youth Self-Disclosure Rating Scale (YSDRS) for each of the variables of interest (Feared Situations, Personal Content, Global Rating of Disclosure, and Distress while Disclosing). Text analysis software was used to measure Disclosure Language. Treatment outcome was measured using posttreatment diagnostic status and severity, youth self-report, and mother- and father-reports. Findings of the present study indicate that pretreatment disclosure does not predict CBT outcomes for anxious youth. Additionally, there were no differences in the pre- to post-treatment change in disclosure and distress for responders and nonresponders; however, a main effect of treatment on disclosure of personal content was observed, such that youths disclosed more at posttreatment relative to pretreatment. Anxious youths appear more distressed in the disclosure task relative to community volunteers, but groups do not differ in their level of disclosure. Similarly, treatment responders and nonresponder at posttreatment were rated as more distressed while disclosing relative to community volunteers, but do not differ in their level of disclosure. Clinical implications and future directions are discussed.

Temple University – Theses

Psychology

Recently, Feldman, Joorman, and Johnson (in press) proposed that differences in the ways individuals respond to positive affect (PA) might impact the length and intensity of PA episodes, perhaps leading to changes in long-term mental and physical health. Feldman et al. (in press) suggested that "positive rumination," repetitive positive self- and symptom-focused responses to positive mood, should enhance PA, whereas "dampening" responses should diminish PA. The Response to Positive Affect Scale (RPA; Feldman et al., in press) was created to measure these constructs. Preliminary research has found that measures of positive rumination and dampening help predict mania and depression symptoms. The current study examined the convergent and predictive criterion validity, and reliability of the constructs of positive rumination and dampening through a combination cross-sectional, experimental, and naturalistic follow-up design. Temple University undergraduates (Phase I N = 1,281, Phase II N = 181, Phase III N = 154) participated in a three-phase study. In Phase I, participants completed the RPA along with a series of positive and negative health and cognition measures. In Phase II, participants were randomly assigned to one of three mood induction groups (negative, neutral, or positive) and completed a series of affect reports over time. One month later, Phase II participants were asked to report on their affect, physical health, mental health, and intervening life events during Phase III. As expected, positive rumination and dampening demonstrated convergent and divergent validity. However, the predictive criterion validity results were mixed, with the constructs predicting some, but not all, responses to mood inductions. The naturalistic follow-up demonstrated that positive rumination interacted with positive life events to predict hypothesized changes in psychological health, but not physical health. The test-retest reliability of the RPA was not acceptable for a trait measure. These results suggest that positive rumination and dampening are important constructs involved in both mental health and illness. Future research should consider alternative strategies for measuring responses to PA, including more realistic experimental paradigms.

Temple University – Theses

Psychology

The two preeminent cognitive behavioral models of social anxiety disorder (Clark & Wells, 1995; Rapee & Heimberg, 1997) indicate attentional bias as a process fundamental to the maintenance of the disorder. They differ, however, on their conceptualization of this process. Clark and Wells suggest that socially anxious persons look only to themselves, their thoughts, and their images during social situations. Although Rapee and Heimberg agree that socially anxious persons become highly self-focused, they also assert that self-focus and vigilance to threat in the environment coexist and interact throughout social situations. This study provides a direct test of this discrepancy, predicting that persons who scored high and low on a measure of communication anxiety would exhibit differences on measures of self-focused attention and environment-focused attention, in support of the model of Rapee and Heimberg. Participants in this study were randomly assigned to speak to audiences of confederates who were trained to demonstrate either mostly negative or mostly positive behaviors. Rapee and Heimberg's predictions were supported, but only on a measure of anxious participants' cognitions and in exploratory correlational analyses. Overall, the evidence was not sufficient to support one model over another. However, the current study is novel in its design, combination of assessment instruments, and examination of attentional processes that have thus far been studied in isolation.

Temple University – Theses