<p> Self-esteem, viewed for decades as psychology&rsquo;s Holy Grail, has proved to be an elusive and surprisingly barren destination. One of the oldest concepts in psychology, self-esteem likely ranks among the top three covariates occurring in personality and social psychology research. Propelled by the self-esteem movement of the 1970s, it was popularly believed that self-esteem played a significant causal role in determining a wide range of both positive and negative social behaviors. However, the results of a 2003 large-scale literature review showed that it is actually not a major predictor of almost anything, with the exception of positive feelings (happiness) and possibly greater initiative. With over a decade passing since that publication, the current investigation sought to review, synthesize and critically analyze the more recent literature. Results confirmed a similar dearth of meaningful relationships connected to self-esteem, the only exceptions being some modest correlates to happiness, narcissism, and self-perceived attractiveness and intelligence. However, the literature continues to be plagued with myriad conceptual and methodological problems. This study utilizes specific critical thinking principles to advance understanding in this area, to address why the self-esteem obsession still persists, and to propose a new theoretical model, one that accounts for the construct&rsquo;s heterogeneous and multidimensional nature. Self-esteem is defined as the appraisal of one&rsquo;s own personal value, including both emotional components (self-worth) and cognitive components (self-efficacy). The multiple forms of self-esteem are a function of how accurately or closely it matches an individual&rsquo;s measureable reality, composed of the objective outcome of one&rsquo;s behavior (actual achievements, measurable capabilities) as well as one&rsquo;s interpersonal interactions (i.e., the level of congruence between how one thinks he or she is perceived and how he or she is actually perceived). Self-esteem also varies in terms of its level of stability, or the degree to which it is influenced by evaluative events or the need to match external standards across time and situation. The permutations of these sorting variables yield eight types of self-esteem: Optimal High, Fragile High, Accurate Low, Fragile Low, Non-compensatory Narcissism, Compensatory Narcissism, Pessimal, and Disorganized. Specific recommendations for clinicians and researchers are provided.</p>

<p> This qualitative study examines the situation when an individual is in psychotherapy and twelve-step recovery for compulsive overeating at the same time. Although both are common approaches, controversy exists concerning the relationship between compulsive overeating and addiction, the optimal treatment approaches for compulsive overeating, and the widespread use of twelve-step recovery by consumers and clinicians. This work describes issues related to the integration of psychotherapy and twelve-step programs in the treatment of compulsive overeating and establishes recommendations for psychotherapists who are treating compulsive overeaters who are making or may make use of twelve-step programs. This study utilizes interpretative phenomenological analysis, informed by conceptualizations from Jungian psychology, to analyze the interviews of eight participants in order to generate phenomenological description of the nature and elements of change when these two approaches are concurrent, and the ways in which the two approaches interact, making use of the participants&rsquo; understandings of their own experiences to inform clinical practice.</p><p> Keywords: psychotherapy, twelve step, compulsive overeating, addiction, phenomenology, Jungian, Overeaters Anonymous.</p>

<p> This study explores what happened that led a woman with long-term recovery from a severe substance use disorder back into active addiction. Recovery over the long term requires ongoing personal development and involves awareness and interaction between both conscious and unconscious aspects of the psyche. Long-term recovery was likened to C. G. Jung&rsquo;s concept of individuation and it can be imagined that relapse occurs when a woman&rsquo;s commitment to abstinence cannot withstand the alchemical pressures involved in moving through a difficult period. A method of Interpretive Phenomenological Analysis was employed as a means to explore the themes and patterns which emerged in narratives obtained through interviews and writings of six women who relapsed after more than 10 years abstinence and had been previously active in 12-step based recovery. Patterns expressed in the narratives suggested that an initially insufficient understanding or limited personal investment in the recovery process, as well as, undertreated co-occurring disorders were factors that facilitated a return to active addiction. These dynamics seemed to reduce resiliency and allowed the women to justify a pharmaceutical solution when intense life stressors manifested and the participant became isolated. Relapse is a reality that may benefit from re-conceptualization and for some can be an indispensable continuation of the recovery process. The experience of failure seemed necessary and though the experience was painful and perilous, each of the women reported that their recovery was ultimately strengthened from it. Key words: substance use disorders, relapse, women, long-term recovery, and individuation</p>

<p> Volunteerism has been relied upon by many organizations. Unfortunately, for communities that rely on volunteers to run a fire department, the rate of volunteering has declined significantly. Previous researchers have suggested that psychological burnout leads to a decrease in desirable behaviors, however, there has been no data examining burnout in volunteer firefighters. Researchers have suggested there are relationships between personality traits and volunteering behavior, as well as personal values and volunteering behavior. </p><p> The current study was designed to identify relationships between response rates to fire calls and personality traits, as well personal values. Also, the present study examined the efficacy of an Acceptance and Commitment Therapy (ACT) focused values intervention to increase the response rates of volunteer firefighters to fire calls as well as decrease burnout. Volunteers from multiple fire departments across Long Island, NY were recruited for participation (n = 40). Subjects completed a demographics questionnaire, the Portrait Values Questionnaire, the Big Five Inventory, and the Maslach Burnout Inventory-General Survey. Subjects participated in an activity aimed at clarifying their personal value of being a volunteer firefighter. The data were analyzed to determine the efficacy of the values intervention. </p><p> It was hypothesized that volunteers who participated in the values intervention would have an increase in response rate, as well as a decrease in burnout as measured by the Maslach Burnout Inventory. The researcher also investigated whether or not personality traits have a mediational effect on burnout and response rate. </p><p> Results demonstrated that following ACT-focused values intervention response rate to fire calls significantly increased and scores on the Cynicism and Exhaustion subscales of the Maslach Burnout Inventory significantly decreased. Also, results showed significant relationships between the personality traits of Extraversion, Agreeableness and Conscientiousness and response rates, however, failed to show a relationship between personal values and response rates. </p><p> Future research could examine the efficacy of a more comprehensive ACT intervention on response rates and burnout in various first responders. Future researchers might consider the development of a protocol to decrease burnout among first responders. Also, future research should examine the predictive ability of personality traits on first responder behavior.</p>

<p>Reflection of feeling (ROF), a component of empathy, has been widely theorized as a technique that can benefit clients and enhance the therapeutic relationship, but scant research has been conducted on it. The current study aimed to fill a gap in the literature by being the first to examine how often novice therapists utilized reflections of feeling in actual psychotherapy sessions with clients who experienced trauma. </p><p> A deductive and inductive qualitative content analysis was employed to investigate the use of ROF by four therapist-client pairs in 12 psychotherapy sessions at a university&rsquo;s community counseling clinics. For each therapist-client pair, three recorded sessions representing the beginning, middle, and end of treatment were selected, transcribed and analyzed. </p><p> Results indicated that the ROF technique was used infrequently (11.6%). When ROF was used, simple reflections were more prevalent than complex reflections, and were the most frequently coded reflection type (18 out of 31 ROF codes) in both trauma and non-trauma discussions. Inductive analyses revealed that the most common codes observed throughout psychotherapy sessions included acknowledgements (e.g., &ldquo;mm hmm;&rdquo; &ldquo;yeah&rdquo;; 50.56%) and follow-up questions (25.1%). </p><p> Future research regarding ROF in a naturalistic setting appears needed to study whether clients find this technique useful or not, how it impacts the therapeutic relationship, what training conditions enhance its use, and whether it differentially affects different populations (e.g., trauma and nontrauma survivors). Researchers who aim to study ROF could replicate and enhance the coding scheme developed in the present study. </p>

<p> Despite the momentum towards using EBTs in clinical practice, there are still significant barriers to implementing EBTs for children who have experienced maltreatment. Research has examined predictors of EBT utilization, such as clinician factors and attitudes toward EBTs, and the results are inconsistent. There is also no qualitative research on clinicians&rsquo; training in and utilization of EBTs and barriers to training in and utilization of EBTs. The present study used a mixed-methods approach to examine clinicians&rsquo; knowledge, training, and utilization of evidence-based treatments (EBTs) for child maltreatment in a national sample of 157 clinicians who provide psychotherapy to children and adolescents who have experienced maltreatment. Quantitative methods found that clinician factors (i.e., graduate training in EBTs, educational background, and theoretical orientation) did not predict EBT utilization. In addition, clinicians&rsquo; attitudes toward EBTs did not moderate the relationship between training in and utilization of EBTs. However, the number of EBTs clinicians received training in significantly predicted EBT utilization, even when statistically controlling for variability in attitudes toward EBTs. Qualitative methods examined clinicians&rsquo; barriers to training in and utilization of EBTs, as well as the solutions to the implementation of EBTs. The qualitative results suggest that a comprehensive response from agencies is needed to provide more opportunities for training in EBTs, as well as ongoing supervision and consultation. Specific solutions to the implementation of EBTs were also discussed. </p>

<p> 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&rsquo; experiences of chronic pain stigma, identified sources of chronic pain stigma, and chronic pain stigma&rsquo;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&rsquo;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</p>

published_or_final_version / Community Medicine / Master / Master of Public Health

<p>The following study explored the relationship between emotion regulation in children with and without externalizing behavior problems and their caregivers. The study examined emotion regulation in both clinical and comparison samples. The main research question for the study was determining if there was a link between parent and child emotion regulation in both clinical and comparison samples. Sixty families were collected from two rural populations in the United States. Families referred for parent training with children ages 2 through 8 were recruited for a clinical sample (n = 34) along with a nonclinical comparison group (n = 26). A blocking design was used. The sample was largely Caucasian (73.3%), boys (71.7%), aged 4.62 years. Parents completed measures related to child behaviors, parenting stress, and child and parent emotion regulation at a single time point. Family behaviors were also coded during structured behavioral observations. Analyses indicated higher rates of problem behaviors in the clinical group, higher rates of parenting stress, higher levels of parental emotion dysregulation, and higher levels of child emotion dysregulation. Parents of children in the clinical sample also used more negative verbalizations with their children. Parent emotion regulation was found to be correlated with child emotion regulation, parenting stress, child behavior problems, and parental use of negative speech toward their child during play situations. Findings from this research indicate a need to target and measure outcomes for emotion regulation in both parents and their children when working with families who are referred for treatment of child behavior problems.

This study partially replicates previous findings that Alzheimer's disease (AD) patients overpredict their performance on memory tasks. Higher functioning AD patients generally overpredicted their performance as compared to their caregivers' predictions of the patients' abilities across four memory tasks. There was only one significant difference between the lower functioning AD patients' and their caregivers' predictions of the patients' performance. Higher functioning AD patients had no difficulty in providing estimations of their caregivers' abilities on the same memory tasks, while the lower functioning AD patients generally overestimated their caregivers' performance. The second part of this study evaluated AD patients' performance on two temporal order tasks. There was no significant difference between the patients' and the control subjects' temporal order judgments. Results are discussed in terms of the role of frontal cerebral systems and methodological problems inherent to research with dementia patients.