Existing research suggests that gay men may be more vulnerable to depression than are heterosexual men, and that gender-related personality traits may be important in understanding this vulnerability. In the present study the association between two gender-related personality traits (agency and unmitigated communion) and depressive symptoms was examined in an Internet sample of 510 gay identified men, aged 18 years or older. Potential mediators of this association were also examined including: recalled peer harassment, interpersonal behavior, and self-discrepancies in the gender-related personality trait of agency. Participants completed the Extended Personal Attributes Questionnaire (EPAQ), the Unmitigated Communion Scale, the victim subscale from the Olweus Bully/Victim Questionnaire Revised (worded retrospectively), the Checklist of Interpersonal Transactions Revised, and the Centre for Epidemiological Studies Depression Scale. Self-discrepancy was calculated by repeating the agency subscale of the EPAQ from the perspective of ideal self and subtracting the actual score from the ideal score. Zero-order correlations indicated that among gay men who were less agentic than their ideal, the gender-related personality traits of agency and unmitigated communion were associated with depressive symptoms, as were recalled peer harassment, interpersonal behavior characterized as unassured and submissive, and self-discrepancies in agency. Two models were tested with half the sample and a respecified model was validated with the second half. The final model indicated that when all variables were considered jointly, agency and unmitigated communion were not directly related to depressive symptoms but rather, the effects of agency and unmitigated communion were mediated by unassured and submissive interpersonal behavior, and the effect of agency was also mediated by self-discrepancies in agency (p < .05). Thus, how the participants interacted with close others, and the extent that they were not as agentic as they wished, were more important in predicting their depressive symptoms than were the gender-related personality traits of agency and unmitigated communion. The final model also indicated that recalled peer harassment has both a direct impact on depressive symptoms and an indirect impact on depressive symptoms through unassured and submissive interpersonal behavior. Implications for future research, anti-bullying initiatives, and interventions with depressed gay men are discussed.

Since Lois Murphy (1937) reported that young preschool children demonstrate sympathetic responses to peers who are in distress, there has been a continuing investigation of two resulting fundamental questions: Are there stable individual differences in sympathetic responsiveness to another person's emotional state? And, by what mechanism do children come to feel the same emotion as another person or act appropriately in response to someone in distress? These questions have been approached by a number of contributors from various theoretical positions which this paper will review. Less represented in the growing body of literature regarding emotion is reference to the study of emotions with specific populations. This research examined the ability of boys with Attention Deficit Hyperactivity Disorder to process three types of emotional tasks which vary in terms of their respective degrees of complexity. Those tasks included the following: Facial Expression Identification; Emotion Statement Identification; and the partial administration of the Children's Apperceptive Story Telling test (CAST; Schneider, 1989). Boys with Attention Deficit Hyperactivity Disorder had significantly more difficulty on all three tasks. On the Facial Expression Identification Task, ADHD participants identified significantly fewer facial expressions than non ADHD participants. Phi Value for Facial Expression Identification was .35. ADHD students were significantly less accurate at Emotion Statement Identification. Moreover, the younger participants, particularly the younger ADHD participants, were significantly less accurate at Facial Expression Identification than their older counterparts. Eta values for group and grade main effects for the Emotion Statement Identification task .32 and .22 respectfully. The Cast Involved three measures, namely Positive Affect, Negative Affect, and Verbosity. The non ADHD group outperformed the ADHD group on all three measures. Eta values for group main effects for Positive Affect and Negative Affect were .84 and .75 respectively. Eta values for group and grade main effects for Verbosity were .67 and .28 respectively. Grade 8 boys with Attention Deficit Hyperactivity Disorder significantly outperformed their grade 4 counterparts on all three CAST tasks.

Despite the important role of effective coping in cognitive-behavioural treatment programs for sexual offenders to reduce sexual recidivism, research that explores changes in coping strategies is lacking. The purpose of this study was to examine the changes in coping strategies identified by child molesters following cognitive-behavioural relapse prevention treatment. Treated incarcerated child molesters were compared to a group of incarcerated child molesters on a waiting list. Groups completed various measures aimed at identifying coping strategies used in specific high-risk situations, general coping styles, and the use of sexual coping strategies. The results indicated that treated child molesters do show evidence of changes in their selected strategies. Compared to a waiting list group, treated child molesters are able to identify more effective coping strategies in specific high-risk situations. As well, changes are noted in their general coping styles, with an increase in the endorsement of task-focused and social diversion strategies. There were no changes in their endorsement of emotion-focused strategies, distraction strategies, or sexual coping strategies. The changes that occurred are encouraging and suggest that treatment has a positive impact on child molesters' choice of strategies. However, it appears that a more concentrated effort may be required to modify the use of emotion-focused strategies.

This thesis examined the social networks and the perceived social support of people who have been receiving case management services from a community mental health program. Specifically, I focused on individuals who have severe and persistent mental illness and who have been living on the streets, in homeless shelters and in other forms of inadequate housing, since there is some evidence that homelessness itself can have important ramifications for the social network. The study had several objectives. Firstly, I described the social networks (including the professional branch of the network) of participants. Next, I looked at the links between their objective social network features (such as total network size, number of professionals, number of 'close confidantes', etc.) and their well being (as measured by life satisfaction and community adaptation). I also examined the relationship between subjective social support and well-being. Finally, a qualitative analysis was conducted using an inductive content analysis approach. Participants were asked to describe the types of changes they would like to make in their relationships with family members, and they were asked about the changes they would like to make in their relationships with unrelated individuals. As expected, participants described abnormally small social networks, and there was an over-representation of mental health professionals. The regression analyses suggested that the objective aspects of the social network may not be as important as participants' beliefs about their relationships and their satisfaction or dissatisfaction with their relationships. After controlling for the effects of gender and level of symptomatology, satisfaction with family relationships stood out as a predictor of overall life satisfaction. The qualitative results supported the quantitative results in some ways, but in other ways, the qualitative results contrasted with the quantitative. Participants were well aware that their social networks are small, and they wanted to have more friends. Importantly, they wanted to have friends who are "normal", i.e. friends who do not have mental health issues, friends who are socially acceptable and friends who look like valued members of society. In describing their family relationships, participants wanted to have more contact with their families and they wanted to feel more accepted by their families. (Abstract shortened by UMI.)

The purpose of this study was to explore the use of Emotionally Focused Therapy for Couples (EFT) with childhood sexual abuse survivors (CSA) and their partners. Ten couples participated in this exploratory study. In assessing outcomes the concept of the reliable change index was utilized to determine whether the treatment did have an impact on couples over the course of the therapy. Qualitative coding strategies were utilized to relate the process of change in couples to the identified outcomes. A case study replication methodology was utilized to examine the use of EFT with these couples thematically. Half of the couples in this study reported clinically significant increases in mean relationship satisfaction over the course of the therapy. Similarly, half of the CSA survivors reported clinically significant decreases in trauma symptoms on a self-report measure and a statistically significant decrease in trauma symptoms was identified on a standardized interview measure of trauma symptoms in the group of survivors. Very little change was identified over the course of therapy on a self-report measure of attachment. Thematic analyses identified numerous areas where trauma survivors were challenged in fully engaging in the therapy process. In particular, trauma symptoms such as affect dysregulation and hypervigilance, shame, anger, emotional numbing and dissociation were identified to play a role in the challenges that survivors experienced in fully engaging in the EFT therapy process. The EFT model and therapist behaviours were also analyzed observationally and results of these thematic analyses yielded clinical recommendations for working with CSA survivors and their partners in EFT for traumatized couples. Recommendations for future study were articulated.

This longitudinal study examined the predictive ability of the Theory of Self-Determination and the Transtheoretical Model of Change with respect to seeking and engaging in adult psychotherapy. Seeking therapy was operationalized by time (days between deciding to seek therapy and contacting a clinic), and difficulty (concerning this decision). Engagement was measured both behaviourally (attending at least three sessions of therapy) and psychologically (client rated alliance and satisfaction, and therapist rated alliance). To facilitate comparison between the models of motivation and change, the measures of these models were scored in identical ways (i.e., continuous full scale index scores, summary scale scores, and subscale scores). Modifications made to these measures and the implications of doing so are described. The study variables were examined with self-report data from 155 clients and 107 therapists at a community mental health clinic. Data were collected before the therapy began and after the third treatment session, providing both prospective and retrospective information. Hierarchical multiple regression (HMR) and sequential logistic regression (SLR) were used to test three sets of hypotheses and their corresponding research questions. Client rated alliance was significantly predicted by the full measure of motivation and by some of its scales (i.e., intrinsic subscale, identified regulation subscale, internal motivation summary scale). It was also predicted by the action subscale and the ready for change summary scale of the measure of change. Finally, client satisfaction was significantly predicted by the intrinsic motivation subscale. Further significant findings included the importance of the referral source and the waiting list. When clients were self-referred, they required less time but experienced more difficulty in seeking therapy. Also, the longer clients spent on the waiting list, the less likely they were to attend at least three sessions of therapy. The hypotheses of this study were generally not supported however several summary and subscales demonstrated predictive ability. Also, the serendipitous findings with respect to type of referral for therapy and length of time on the waiting list are noteworthy. The strengths and limitations of the study and the implications of these results for future research and clinical application are discussed.

Virtual exposure therapy for phobias is a growing field of interest. Studies have begun to demonstrate its efficacy, which is probably equivalent to traditional in vivo exposure. However, although a majority of studies addressed treatment efficacy itself, few have attempted to understand its mechanisms. In the case of traditional therapy for phobias, two models are still the object of strong debate: the information processing model and the perceived self-efficacy model. Interestingly, the debate among the supporters of these models is still fuelled by their attempts to prove the predictive superiority of their own model by using predicted variables that are in fact different. No study has yet compared directly the most likely predictors of change, either for in vivo or for in virtuo exposure. The goal of this thesis was to contrast the predictive value of different treatment mechanisms for specific phobias with a therapy using virtual reality exposure. The hypotheses are the following: general improvement (as measured by the Fear of Spiders Questionnaire) will be significantly predicted by changes in process variables such as perceived self-efficacy, beliefs and the emotional Stroop task, changes in information processing (as measured with the pictorial Stroop task) will better predict changes in anxiety during a Behavioural Avoidance Test (BAT), while changes in perceived self-efficacy will better predict changes in avoidance behaviours during a BAT. Twenty-eight adults suffering from arachnophobia were assessed for standardized inclusion and exclusion criteria. General outcome and specific processes measures included various questionnaires, a pictorial Stroop task and a BAT . The avoidance behaviour was measured by the participants' capacity to approach a live tarantula during the BAT. Anxiety was measured by recording participants' heart rate as they looked at the tarantula during the first minute of the BAT. All measures were completed before treatment (session 1) and at post-treatment (session 7). After explanations about the cognitive-behavioural rationale for the treatment of phobias and an initiation to the virtual reality equipment (session 2), participants went through virtual exposure for five sessions (of 60 minutes each) in various virtual environments with spiders. During the last session, a discussion about relapse prevention took place. (Abstract shortened by UMI.)

As a psychotherapeutic intervention, interpretation has an extensive history dating back to the beginnings of psychotherapy itself. It has been theoretically expounded as the essence of psychotherapy by some theorists, and rejected as unnecessary by others. However, as the major theoretical orientations have begun to converge, interpretation has entered into their contemporary discourses in one form or another. Empirically, interpretation has been addressed extensively, particularly in the psychodynamic and process psychotherapy literatures. However, few qualitative studies have been conducted on the phenomenon as it presents itself in actual therapy sessions, and these qualitative studies have presented with significant limitations. The present dissertation conducted a phenomenological study of interpretation in psychotherapy by examining the manner in which it presents itself through three sessions of self-identified psychodynamic, humanistic-existential, and cognitive behavioural therapists. These sessions were followed by separate interviews with the therapists and the patients regarding their experiences of the interpretations within the sessions. The three sessions and six interviews were analyzed by using the phenomenological method. The resulting general meaning structure indicated that interpretation was a core therapeutic intervention in all three sessions, and presented as a highly complex phenomenon. Its deeply interrelated main features indicated that interpretation is a highly dialogical phenomenon immersed in therapist and patient contexts and intentions, as well as pre-interpretive and post-interpretive contexts. Both the therapists and patients contributed to the evolution of interpretations in the interpretive dialogue, and in fact patients were found to initiate some of the interpretations. The dialogical nature of interpretation also implied that, through their interrelationship, the therapist and patient dialogued with the interpreted material as a presence beyond their relationship, giving rise to the actual interpretations. Interpretive threads interweaved throughout the sessions as the interpretations formed layers of thematic development and increased in complexity. These interpretations involved greater or lesser degrees of intuition or reflection. Intuition and reflection counterbalanced each other; the former reflecting the interpretation's grounding in understanding the patient's experiencing, and the latter reflecting the interpretation's abstraction, complexity, and/or explanatory focus. Through its temporal dimension, interpretation unfolded in the present of the therapeutic dialogue, but reached back into the past and thrust forward into the future, even beyond the session itself. Finally, the present dissertation addressed specific and general patient responses to interpretation, and suggested a novel typology of interpretation.

Cette thèse de doctorat a pour but d'examiner le développement de la compréhension de la dissimulation émotionnelle au cours de l'enfance. Le premier objectif est d'examiner le développement de la justesse et de la complexité du raisonnement des enfants lorsqu'ils doivent expliquer les raisons pour lesquelles une personne dissimule son émotion. Le deuxième objectif est de comprendre la nature des difficultés rencontrées par les enfants dans le développement de la compréhension de la dissimulation. Quatre études ont été menées dans le but de répondre à ces objectifs. Dans chacune d'elle, une épreuve de compréhension a été administrée à des enfants âgés entre 5 et 10 ans. Les enfants devaient écouter de courtes histoires dans lesquelles le personnage principal était motivé à dissimuler l'expression de son émotion. La tâche des enfants était d'indiquer les émotions réelles et apparentes du personnage principal et d'expliquer leurs choix. Les résultats ont révéle que les enfants de 9-10 ans comprennent mieux la distinction entre les émotions réelles et apparentes que ceux de 5-6 ans et que leur raisonnement est plus juste et plus complexe. Les enfants de 5-6 ans ont plus de difficulté à expliquer les raisons qui conduisent une personne à dissimuler une émotion. Ils ont tendance à se representer le phénomène de la dissimulation en termes de changement d'émotion réelle. À cet egard, les analyses ont montré que les enfants de 5-6 ans ont plus de difficulté à comprendre que l'émotion apparente est exprimée au même moment que l'émotion ressentie lorsqu'une personne dissimule son émotion. Enfin, les analyses ont également révélé qu'il est plus difficile pour les jeunes enfants de comprendre l'effet trompeur que la dissimulation peut provoquer chez autrui. En somme, la dissimulation des émotions semble être un phénomène difficile à comprendre pour les jeunes enfants. Le développement de la compréhension de ce phénomène semble s'étendre tout au long de l'enfance.

It has been proposed that body image is an important aspect of quality of life that has received insufficient attention in research on medical populations (Pruzinsky & Cash, 2002). The present study was designed to assess the level of body image concerns in androgen-deprived and non-androgen deprived men undergoing radiation therapy for localized prostate cancer, and a comparison group of men without cancer. The relationship between body image concerns and quality of life, and the influences of disease-specific factors, physical functioning, and cognitive investment in appearance on body image was examined. 55 men receiving androgen deprivation therapy (ADT) and radiation therapy, 41 men receiving radiation only (RT), and 56 cancer-free men (CG) completed global and disease-specific measures of body image and quality of life. Only a minority of men with localized prostate cancer (13-30%) endorsed body image concerns above normative levels. After controlling for educational status, levels of body image concerns were comparable across the three groups. Higher levels of body image distress were associated with worse quality of life scores (mental health subscale, 36-item Short-Form Medical Outcomes Study Heath Survey); however, there was no group for whom this relationship was most salient. Despite ongoing interest in quality of life outcomes associated with ADT, findings from the present study suggest that ADT (for a minimum of 3 months) does not increase risk of body image concerns during radiation treatment. However, bother associated with hormone symptoms, as well as marital status, sexual functioning, perceived physical functioning, and cognitive investment in appearance were associated with body image concerns. Findings provided preliminary support for the cognitive-behavioural model of body image disturbance in cancer patients proposed by White (2000), such that cognitive investment in appearance predicted body image concerns above and beyond demographic, medical, sexual and physical functioning variables. By focusing on men receiving radiation therapy, including a comparison group, and including a comprehensive battery of disease-specific and theoretically-based body image measures, the present study addressed some of the gaps in the previous research. Findings suggest targeting several factors amenable to counselling or behavioural interventions, such as partner support, cognitive investment in appearance, and bother associated with ADT and physical functioning, to reduce body image concerns. Whereas diverse factors were relevant to body image concerns, findings showed that a specific focus on men's perceived physical functioning, and losing weight would likely improve body satisfaction in men undergoing treatment for localized prostate cancer.