The focus of this study was to explore how Clinical Psychologists narrate their experience of working on acute adult inpatient units. Mental health services in the UK are poorly resourced with treatments dominated by medical model perspectives. This model can conflict with the psychological and social models Clinical Psychologists are trained in. The aims of this study were to explore the experience of Clinical Psychologists working in acute adult inpatient units and, through this, develop insight into how the core values for improving inpatient care could be maintained. This study was guided by Social Constructionist principles. It required a critical stance to be applied on the current system with an understanding that knowledge is co-constructed between and within relationships. Eight individual semi-structured interviews with Clinical Psychologists who work on adult acute inpatient units were conducted and explored using Narrative Analysis. Four dominant narratives were found. These were; ‘You can’t beat the system’, ‘I am screaming’, ‘Connecting with humanity’ and ‘Someone is screaming’. These narratives related to the Clinical Psychologists themselves in conjunction with the system they were working in which included staff, patients, myself as the interviewer and society in general with the understanding that the interviews were co-constructed and represented multiple voices. This research confirmed that cuts and lack of resources to NHS services have created a massive strain on the system. The Clinical Psychologists working in this system are attempting to understand and support individuals in acute distress; however, they appear to be doing this in isolation which puts them in danger of burn out. It would seem the system is organised against thinking and feeling, affecting both staff and patients, and leaving their experiences unheard and invalidated. The people who are admitted to wards are likely to have had abusive and invalidating earlier experiences. Wards need to be a safe place where they can have time to express themselves, process this and experience validation. The opposite seems to be happening, thus, potentially perpetuating their experience of abuse and neglect. Compassion is a Government directive, yet it takes time and space and, thus, is not cost-efficient. To achieve a system, where people who are vulnerable can express their distress and feel heard, provision of ongoing support and resources is required. Further research could explore the experience of staff who work on inpatient units, for instance health care assistants, nurses, psychiatrists and managers in order to provide further insight into the system that is currently in place and help to develop ways to improve it. It would also give voice to professions that did not have a voice in this research. Experiences of Clinical Psychologists on inpatient units where the medical model is not dominant could also be explored, for instance, where the Open Dialogue approach is dominant. Comparisons between the different approaches could then be explored.

<p> Eating behavior in humans is complex and has developed over the millennia in intricate webs of biological, psychological, and social factors. While maladaptive eating strategies have been studied extensively, the adaptive eating strategy known as intuitive eating is gaining wider attention as a means to treat and prevent maladaptive eating behavior. Using multiple regression with self-report questionnaires, the researcher explored the psychosocial variables of impression management and subjective physical health as they relate to intuitive eating in men, who have been underrepresented in the literature on eating behavior. The results indicate that subjective physical health predicts eating disorder symptomatology, but may not predict intuitive eating in men. Further, while impression management predicts intuitive eating, anxiety may account for this relationship. Additionally, sexual orientation is discussed as a relevant predictor of eating behavior. Clinical and research implications, as well as future directions are discussed.</p>

<p> Approximately 20-30% of single American women have been involved with a married man during the course of their lifetime (Lindquist &amp; Negy, 2005; Oala, 2008; Perel, 2017; Richardson, 1988). Infidelity in Western society is perceived in a pejorative manner, and women are often negatively judged for their engagement in an extramarital affair. However, the prevalence of single women becoming involved with married men has increased in the 21^st century. This study sought to understand the lived experience of "the other woman" in contemporary Western society. By investigating woman's experiences through Interpretive Phenomenological Analysis this study aspired to contribute to clinical psychology in an effort toward destigmatization of women, and to provide a better understanding for the rationale as to why single women enter and remain in relationships with married men. Furthermore, this research sought to illuminate the shadow effects on the "the other woman's" psyche, to examine "the other woman's" desire to feel loved and appreciated in order to decrease vulnerability, and to explore "the other woman's" sense of self throughout an extramarital affair. </p><p>

<p> Research has shown that being a mental health therapist (MHT) is an extremely stressful vocation and often leads to burnout (Gibson, 2009). Evidence supports that humor and mindfulness assist in mitigating the negative effects of stress and burnout (Malinoski, 2013; Brown &amp; Ryan, 2003). It is also known that the effective use of humor (McGhee, 2010a) and mindfulness practices (Hayes, 2005) can be learned, practiced, and integrated into daily interactions across the lifespan. This research examined humor styles, trait mindfulness, and burnout of 94 licensed MHTs in community mental health centers located in Western Massachusetts in an attempt to add to research regarding burnout and protective factors that may minimize the impact of burnout. </p><p> Results found that MHTs with higher scores of trait mindfulness reported reduced levels of burnout, which supports existing research. Additionally, those reporting higher frequency of maladaptive styles of humor tend to report higher levels of Depersonalization. MHTs who reported the regular use of affiliative types of humor reported a lower rate of Emotional Exhaustion. These findings may be used to inform future pre-service and in-service training of MHTs to include attention to the possible protective factors of adaptive humor styles and trait mindfulness in an effort to prevent burnout among practicing MHTs thereby improving longevity in the field.</p>

<p> Following more than decade of U.S. military operations in the in the Middle East, it is important to understand the impact of prolonged combat operations on the wellbeing of Veterans. To understand this relationship accurately we must have access to reliable and valid measures of combat exposure. A meta-analysis of research with combat Veterans found relatively few studies adequately assessed nature and extent of Veteran&rsquo;s combat experiences (Institute of Medicine, 2008). </p><p> The purpose of this research was to develop a more comprehensive measure of combat exposure for use in research on post-combat psychological outcomes. Seventeen Veterans participated in focus groups to support the development the Assessment of Combat Experiences (ACE). A sample of 121 Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans was used to assess the psychometric properties of the ACE. Participants completed the ACE, as well as additional measures of combat exposure and psychopathology. The ACE demonstrated strong internal consistency (Cronbach&rsquo;s Alpha = . 96) and test-retest reliability (<i>r</i> = .85). Convergent and construct validity for the ACE were supported as evidenced by strong correlations (<i> r</i> = .72 to .86) with two combat-related subscales from the <i> Defense Risk and Resiliency Inventory - 2</i> (Vogt, Smith, King, &amp; King 2012), and the <i>Combat Exposure Scale</i> (Keane et al., 1989). The ACE demonstrated similar correlations with measures of psychopathology (PTSD, depression, and anxiety) as the CES and the DRRI-2. The ACE includes more detailed questions than other measures, allowing researchers to explore the impact of proximity to hostile fire, the frequency of exposures, the duration of specific exposures, and the nature of weapons used during combat operations better than is possible with other validated measures. Overall, there was strong evidence for the reliability and validity of the ACE in measuring combat exposure among this sample of OIF and OEF Veterans.</p>

<p>The general public harbors misconceptions about mental illnesses; particularly, auditory verbal hallucinations (AVHs). Misconceptions about the causes, dangerousness, and treatment of mental illnesses constitute barriers for treatment. The purpose of this study was to examine whether a neurobiological refutation text was more effective than a neurobiological expository text in changing knowledge and attitudes concerning AVHs. A MANOVA determined that the refutation text was not statistically different than the expository text in changing knowledge of AVHs [F(2, 95) = 0.982, p = 0.428]. Another MANOVA determined that the refutation text was not statistically different than the expository text in changing attitudes towards a person in a vignette with severe AVHs [F(2, 95) = 2.553, p = 0.083]. A bimodal distribution was observed in participants? level of contact with persons with severe mental illness. Supplemental analyses indicated that participants who read the expository text and reported high levels of contact endorsed significantly lower levels of social distancing behaviors towards the person in a vignette [t(47) = 1.983, p = .053, d =.57]. Participants who read the refutation text and reported low levels of contact attributed significantly less attitudes of fear and anger [t(41) = 2.664, p = .011, d =.82], and endorsed significantly lower levels of social distancing behaviors [t(41) = 2.829, p = .007, d =.87]. A refutation text may be more effective than an expository text in changing attitudes concerning AVHs, when a participant?s misconceptions of persons with severe mental illness are formed through observations and various forms of media.

Borderline personality disorder is a prevalent and oftentimes debilitating psychiatric disorder. Suicidal behaviors and non-suicidal self-injurious behaviors (NSSIB) are common among individuals with BPD. However, little is understood about what predicts these clinically important features of BPD. Object relations theory has a longstanding history in helping the field understand borderline psychopathology, and this theory may also be an illuminating model in the detection of suicidality and NSSIB. The goal of this study was to examine the independent and interactive influences of BPD symptomatology and object relations dimensions on prospectively measured suicidality and non-suicidal self-injurious behavior (NSSIB) in a treatment-seeking sample of 94 individuals with borderline personality disorder. Five dimensions of object relations (complexity of representation of people, affective quality of representations, emotional investment in relationships, understanding of social causality, and experiences and management of aggressive impulses) were assessed using the Social Cognition and Object Relations Scale – Global Rating Method (SCORS-G). Level of overall object relations did not predict suicidality/NSSIB. Emotional investment in relationships showed a trend toward predicting suicide attempts; the Affective Content Factor of object relations predicted NSSIB; patients who met the BPD criterion for inappropriate/intense anger tended to make more suicide attempts; and patients who met the BPD criterion for impulsivity engaged in significantly fewer episodes of NSSIB. The results are discussed in the context of understanding BPD psychopathology and clinical implications.

This dissertation presents the results of a study designed to explore the therapist's phenomenological awareness of spirituality in their work with their clients who are dealing with loss. The clinical literature reveals the individual's response to loss includes a spiritual dimension. As traditional psychology has not included spirituality in its study or practice, little is known of how psychotherapists are attending to and including this dimension in the therapy. The dissertation included a review of the literature on: bereavement studies, self renewal theory, adult development, creativity, and spiritual emergencies. All of which provide current information about spiritual experiences. Qualitative research was done with eight psychotherapists from four Out-Patient Mental Health Clinics. Data from in-depth interviews were coded. A thematic analysis offered 18 themes which were common to all participants and were organized under three sets: (1) Psychotherapy and Loss, (2) Loss and Spirituality, (3) Spirituality and Psychotherapy. Some examples of themes in set #1 are, "The Developmental Significance of Loss", "Variations in the Loss Response"; in set #2, "Faith as a Resource", "Variations in Spiritual Manifestations"; in set #3, "Spirituality as Part of Human Nature", "Evidence of Spirituality as a Dynamic in Psychotherapy". Four profiles were constructed to provide an added perspective of the interviews. The findings were unanimous in that all the psychotherapists could identify a spiritual dimension in the experience of loss, in their own personal and professional lives and in human nature. The findings were consonant with the literature and suggest the validity of the spiritual dimension in the loss experience and the need for more attention to the spiritual aspects of human experience in the training and practice of conventional therapists.

<p> Having a sibling with a disability has been found to have negative psychological effects, such as depression; however, very little research has focused solely on siblings of children with attention deficit hyperactivity disorder (ADHD). The current study attempted to highlight whether siblings of children with ADHD experience depression symptomology to a greater degree than siblings of children without disabilities. Participants were included in the current study based on meeting the following criteria: target participants were between the ages of 6 and 17 with a biological sibling who may or may not carry a diagnosis of ADHD. Families came from 2 groups based on the siblings&rsquo; diagnosis. Seven families with at least 1 child with ADHD, and 11 families with all non-disabled children participated. Parents were asked to complete an informed consent and demographic questionnaire, as well as the Conners Rating Scale for ADHD, Third Edition, Short Form (Conners-3) on the target participant to ensure that he/she did not meet the diagnostic criteria for ADHD. Taqrget participants were asked to complete an assent form, as well as the Center for Epidemiological Studies Depression Scale for Children (CES-DC). Two multiple regressions were completed. Results, omitting a statistical outlier within the group consisting of families with a child with ADHD, indicated that siblings of non-disabled children experienced more symptoms of depression than siblings of children with ADHD; however, results including the statistical outlier indicated that both groups of siblings experience similar symptomology of depression. Both results were contrary to the researcher&rsquo;s hypothesis. Given the small sample size of the current study, the individuals that participated in the study may not be a representative sample, and additional research is therefore needed. Overall, the findings of the current study will guide researchers in further investigating this most important topic, and therefore, addressing how to better support families with children with ADHD.</p>

Thesis (PH.D.)--Syracuse University, 2003. / "Publication number AAT 3081647."