<p> Willingness to expend effort has received increased attention over the past decade, and for good reason &ndash; effort is crucial to life's successes, and many of us wish we could harness and control it more optimally. In particular, cognitive effort is central to academic and vocational achievements. Though effort is important, it is also costly. If it were not, no projects would be left unfinished, and no treadmills would be abandoned early. Because it is costly, self-control is often required to exert and maintain effort. Reduced willingness to expend effort has also come into focus as a clinically relevant variable related to amotivation, most notably in schizophrenia. Additionally, both incentive motivation (immediate monetary reward availability) and effort have been linked with cognitive performance, suggesting that our measures of cognitive ability are inexorably linked to and to some degree confounded by cognitive effort.</p><p> In this dissertation, I present a novel paradigm developed for the assessment of perseverant cognitive effort in the absence of monetary incentive. The Cognitive Effort and DisEngagement (CEDE) task is a cognitive test that increases in difficulty and measures perseverant effort disengagement in a simple but novel way: participants are permitted to skip trials without penalty. The present work introduces the task, situates it within a framework of self-control divided into inhibitory and actuating mechanisms, and provides evidence of its association with stable traits, context, and psychosis.</p><p> The first set of studies (Chapter 1) tests the reliability and validity of the CEDE task in an undergraduate sample and a community sample. We find evidence of high internal consistency using a split-half method. We also find that skips on the CEDE show convergent validity in terms of correlation with self-reported perseverance and work ethic, as well as discriminant validity, showing lack of significant relationships with several theoretically distinct aspects of self-control. We also show evidence of tolerability of the paradigm and of face validity of skipping as an index of effort disengagement.</p><p> In Chapter 2, we test the effect of observation on perseverant effort on the CEDE task. We find that participants skip significantly more trials when they are observed by an experimenter with access to information about their performance via sound effects, compared with than when they have privacy (when the experimenter leaves the room, or when the participant wears headphones). We also find that self-reported internal motivational style predicts more perseverant effort when in private, whereas external motivational style predicts more effort when observed, suggesting that motivational styles exert influence differentially depending on features of the context. We also show that self-reported stress during the task negatively predicts performance, and that this relationship is fully mediated by skips. These results suggest that observation has a potent effect on cognitive task effort, affecting people differently according to motivational style, and that test anxiety also promotes effort disengagement. </p><p> In Chapter 3, we test for group differences in skips between individuals with first episode psychosis (FEP) and community controls, as schizophrenia is associated with both a cognitive and a motivational impairment. We show reduced perseverant cognitive effort on the CEDE in FEP. We find that this group difference specifically emerges during difficult trials, suggesting specifically a deficit in perseverance in reaction to difficulty rather than continuous attention throughout the test. We also show that reduction of effort in the form of skips is correlated with self-reported amotivation among patients. These results suggest clinical relevance of perseverant cognitive effort in schizophrenia as a component or reflection of motivational impairments.</p><p> Together, these findings provide novel insight into cognitive effort perseverance, its relationship to non-monetary motivations in terms of motivational style and observational context, and its reduction in psychosis. Our findings also highlight the relevance of cognitive effort perseverance to cognitive testing. Willingness to expend cognitive effort appears to be sensitive to numerous factors in the context of difficulty, when the demands on effort are higher, whereas it is relatively steadfast during easier tasks.</p><p>

<p> This hermeneutical research presents correlations between unconscious trauma responses and resultant sexual desire and behavior. Trauma reactions include reenactment, repetition compulsion, reverse reenactment, fawning, and dissociation. Clandestine sexual practices are often conducted surreptitiously, may co-occur with sexual paraphilia, and may include: infidelity; anonymous and group sex; pornography, cybersex, and virtual reality sex; sex with dolls and robots; and prostitution, strip clubs, and sex workers. The American Psychiatric Association&rsquo;s criteria for pathology are explored along with sex-positive psychology&rsquo;s position on the role of consent in diagnosing paraphilic disorder. Clinical manifestations of sexual distress including paraphilic and physiological disorders, sexually transmitted infections, sexual addiction, and related somatic and mood disorders are considered. Theories of ego-syntonia, ego-dystonia, and sexual consent are examined. Clinical applications include psychoeducation on unconscious trauma responses, a depth psychological approach to sexual content, explication of the original <i>dynamic sexual consent </i> theory and assessment tool, and frameworks for ego-syntonic sexuality.</p><p>

<p> This phenomenological study examined first-generation Latina women who developed a bicultural strategy when choosing professional careers. A qualitative research methodology sought to analyze the participants&rsquo; academic and career planning journey, the challenges they encountered, the support they received from their families, and how utilizing a bicultural strategy aided them in attaining their career goals. Five Latina women were interviewed with ages ranging from 30 to 50. Several key findings were found to be congruent with research literature such as acculturation influence on ethnic identity, ethnic identity as protective factors from discrimination, and the influence of traditional cultural values in pursuing college careers. Data was analyzed through the lens of developmental and acculturation theories. The findings revealed the participants&rsquo; demonstrated bicultural competence in how they negotiated with their families for support, and how they separated from their families influence to support their own professional goals. Family support was a significant factor for the participants&rsquo; successful navigation of career goals. Minimal family support revealed participants compensating by achieving higher standards for themselves. Based on the results of this study it is recommended that academic counselors and psychotherapists recognize the difficulty of Latina women living between two worlds and make efforts to increase their sensitivity of cultural gender role pressures that influence their career decisions. </p><p>

<p> Trauma and Post-Traumatic Stress Disorder have become widely researched topics within the field of military psychology; however, within the past few years, new research on the topic of moral injury has emerged. The studies conducted on moral injury are growing in number, though research continues to lack on the experience of moral injury within the female Veteran population. The goal of this research is to capture the lived meaning, or lived experiences, of moral injury in female Veterans. Four participants who identified as female Veterans, and who experienced one or more deployments throughout the duration of their military service, were asked about their experiences of moral injury during their time serving in the United States military. This study uses an existential-phenomenological method to understand the participant&rsquo;s experiences of moral injury. This study will conclude with implications for application to clinical care, and recommendations for future research.</p><p>

<p> Anxiety disorders are the most prevalent mental health concern in the United States. Yet, many who suffer from anxiety do not receive treatment or fail to respond to well-established cognitive and behavioral interventions. Mindfulness- and values-based strategies are possible alternatives for these individuals. However, values-based approaches have not been adequately studied in anxious populations and it is unclear how they may interact with mindfulness-based approaches. Moreover, little is understood about the mechanisms of action underlying behavioral changes resulting from mindfulness meditation (MM) practices. Acceptance and Commitment Therapy (ACT) is one approach that employs values clarification (VC) and mindfulness to bring about improvements in quality of life (QOL). ACT also provides a behavioral account of human vitality that may increase specificity of mediating and moderating variables that are critical for good outcomes following mindfulness-based treatment. The present investigation aimed to evaluate the effects of MM and VC on QOL and anxiety symptomology and to elucidate significant mediators and moderators of the relations between MM and VC and positive outcomes. In so doing, highly anxious participants (<i>N</i> = 120) were randomly assigned to a 10-min MM practice + control task or a 10-min MM practice + VC task. Pre, post, and daily diary assessments were employed over the course of 16 days and included several well-established process and outcome measures. Results suggest that 2-weeks of MM practice leads to decreases in anxiety symptom frequency and increases in QOL during the previous 24-hour cycle. VC did not significantly affect primary outcomes. Acceptance appears to be the most important mediator assessed herein of the daily effects of mindfulness on anxiety symptoms, though valued action was a numerically stronger mediator between mindfulness and QOL. Practice quality was related to daily reductions in anxiety symptoms and improvement in daily QOL. However, it did not moderate response to MM. Surprisingly, MM practice time, when controlling for average practice quality, was related to worse QOL outcomes for those who participated in VC. Results are discussed in terms of enhancing the impact of psychological treatments for the anxiety disorders, in addition to implications for personal mindfulness meditation practices.</p>

<p> Over recent decades, adolescent athletic participation has grown in the United States. The rise in participation means that mental health clinicians who work with adolescents are likely increasingly coming in contact with young athletes facing issues directly related to sports. The issues facing adolescent athletes create additional challenges that should be addressed in treatment to improve overall psychological well-being and to promote healthy development. In order to best meet the general mental health needs of these clients, clinicians need to be aware of the unique stressors and issues they frequently face. A resource manual was created to guide clinicians working with elite male athletes between the ages of 12 and 18 years in order to help them realize the benefits and avoid the adverse consequences that may be associated with elite-level sports participation. The manual was developed to be a resource for mental health clinicians seeking help in understanding the challenges faced by elite-level adolescent male athletes, guidance in identifying therapeutic interventions likely to be effective in addressing those challenges, and clarification of the mental skills training typically conducted by sport psychologists. The manual&rsquo;s content was informed by both a review of the relevant scholarly literature and by interviews conducted with a former elite adolescent athlete, a sports psychologist, and a mental health clinician who has worked with male adolescent athletes. Following a discussion of some strengths, limitations, and potential modifications to the current manual, plans for evaluating and disseminating it are described.</p>

<p> This study explored therapists' experiences working with individuals diagnosed with borderline personality disorder (BPD). Further, it hypothesized that clinician spirituality might positively influence their experience of working with this clinical population. An embedded mixed-methods design was used in this pilot study. Participants were licensed clinicians currently working with at least two clients diagnosed with borderline personality disorder. Participants completed a semistructured interview, which was analyzed using thematic analysis, and were administered two quantitative scales, the Spiritual Orientation Inventory (SOI) and the Assessment of Spirituality and Religious Sentiments (ASPIRES). Quantitative data were analyzed through SPSS (Version 17) for descriptions and correlations, and were used to support themes that emerged from the qualitative semistructured interview analysis. Thematic analysis resulted in twelve main themes specific to therapists' experiences of working with individuals diagnosed with borderline personality disorder. Specifically, therapists experienced this work as challenging, rewarding, and providing a sense of meaning to their lives. Quantitative analysis suggested that therapists sampled in this study were more spiritual as compared with normative sample scores. Embedded mixed-methods analysis did not provide a significant correlation between therapists' experiences and their spirituality. Implications of this study include validating and valuing therapists' experiences in their work with this clinical population. Further, this research provided evidence that therapists found personal practices such as meditation, mindfulness, and prayer to be supportive of their experiences working with individuals diagnosed with borderline personality disorder.</p>

Thesis (Ph.D.)--Pacific Graduate School of Psychology, 2004. / Source: Dissertation Abstracts International, Volume: 66-07, Section: B, page: 3942. Adviser: Larry W. Thompson.

Thesis (Ph.D.)--Indiana University, Dept. of Psychological and Brain Sciences and Program in Neuroscience, 2007. / Source: Dissertation Abstracts International, Volume: 68-10, Section: B, page: 6979. Adviser: William P. Hetrick. Title from dissertation home page (viewed May 21, 2008).

Thesis (Ph.D.)--Fairleigh Dickinson University, 2004. / Source: Dissertation Abstracts International, Volume: 65-07, Section: B, page: 3736. Chair: Neil Massoth. Available also in print.