This study investigated the Rorschach responses of adolescent male child sexual abuse (CSA) survivors to see if reliable object relations differences could be found in the protocols of boys who did and did not exhibit sexual offending behaviors. Fifty-one Rorschach protocols of 12 to 17 year old boys were selected to form 3 groups: Non-Offending CSA survivors, Sexually-Offending CSA survivors, and a Comparison Group of non-victimized non-offenders. All 3 groups were approximately matched for age at testing, race, and age at first sexual victimization. The primary hypothesis was that the Rorschachs of sexual-offenders and non-offenders would differ in affective reactivity, thought disorder, object relationships, self-perception, and psychological defenses. Urist Mutuality of Autonomy Scale, Blatt & Ritzler Thought Disorder Continuum, Saunders Atypical Movement score, MOR, R, AFR, EB, M, and WSUMC were used to assess differences. Results confirmed the hypothesis in all but the affective reactivity dimension. The protocols of Sexually-Offending survivors had more dependent and maladaptive object relationships, more severe thought disorder, and more MOR and Atypical Movement responses. Although differences in affective reactivity were not found, comparisons made with Exner's norms indicated that AFR was significantly lower than normal among SO-S and NO-S subjects, and that R was significantly higher than normal in the SO-S group. A linear discriminant function analysis showed significant and accurate differentiation between SO-S and NO-S subjects (correct classification rate = 87%) based primarily on the object relations and thought disorder scales. Because the discriminant function and classification were based on the same sample, this finding is quite tentative. Additional research with larger samples of protocols and a wider array of Rorschach variables are needed and could result in the future discovery of a stable and reliable discriminant function for differentiating sexually offending and non-offending CSA survivors on the basis of Rorschach performance.

The "delicate self-cutting syndrome" (Pao, 1969) refers to repetitious non-lethal cutting or scratching traditionally associated with female adolescents. While research and theory have explained the reasons for this behavior in various ways, little attempt has been made to integrate these reasons into broader models. An examination of the literature suggested eight clearly differentiable models that integrated groups of reasons: behavioral, systemic, avoidance of suicide, sexual, expression of affect, control of affect, ending depersonalization and creating boundaries. This study evaluated these models and investigated the relationships between them by surveying therapists about the conceptualizations they use to understand patients who engage in delicate self-cutting. Related developmental issues were also briefly investigated. A pretest was conducted with clinical psychology graduate students and faculty to validate the theoretical associations between specific reasons and the models used to integrate them. The main survey asked a nationwide sample of psychologists and social workers who treat adolescents and adults in individual outpatient therapy to rate a patient on the specific reasons for cutting and the integrative models. Forty-four completed surveys were analyzed. The systemic, suicide, sexual, expression, depersonalization and boundaries models were supported by a factor analysis and the generation of alpha coefficients. Examination of the patterns of relationships between and within models and individual reasons suggested that the behavior model was undifferentiable from the systems model and that the control model addressed the general need to regulate affect and was an issue underlying all other models. The expression model showed a similar patterns of relationships while maintaining its ability to be differentiated. A new structure is hypothesized with control and expression models reflecting basic underlying functions of the self-cutting behavior and the other six models reflecting more subjective meaning assignment. Results also indicated that therapists find the expression, control, depersonalization and boundaries models most useful in understanding and treating their patients. There was little support for the sexual or suicide models. Implications for therapeutic interventions and difficulties are examined in light of the new structure and therapists' preferences for certain models. Directions for future research are proposed.

This study examined the role of the coping process as a mediator of the long-term psychological adjustment of survivors of childhood sexual abuse, with a focus on three specific areas of coping: self-criticism, support seeking behavior, and disengaged coping. The study also addressed a limitation of the existing research in this area by controlling for the potentially confounding effects of depression through the use of a control sample that was matched for the level of depressive symptomatology. Fifty-one undergraduate women with a history of childhood sexual abuse and eighty-eight nonabused undergraduate women completed the Depressive Experiences Questionnaire, the Coping Strategies Inventory, the Beck Depression Inventory, the Symptom Checklist 90-Revised, and the Relationship Questionnaire. There were significant relationships between abuse-severity characteristics and elevated levels of self-criticism and differences in interpersonal functioning. Both self-criticism and avoidant coping predicted psychological symptomatology, but these associations were not specific to abuse victims. Hypothesized relationships between social support and adjustment were not confirmed; however, the findings suggest that attachment style is a particularly sensitive measure of interpersonal functioning within abuse victims.

One of the most commonly reported findings in the epidemiology of psychological disorders is the 2:1 ratio of women to men who suffer from depression, a difference in prevalence rates that first emerges during the adolescent years. Although aspects of the feminine gender role have been identified as risk factors for depressive symptoms, the analysis of interpersonal interaction is rarely used to assess how these constructs may be behaviorally enacted. In this dissertation, interactions between mothers and adolescents were analyzed to identify specific sequences of behavior associated with adolescents' depressive symptoms, with the aim of clarifying reasons for the dramatic increase in depression among adolescent girls. A community sample of 79 adolescents & their families participated over a 3-year period. Thirty-two consecutive segments of a videotaped problem-solving interaction task were viewed by participants and coded on the dimensions of support, conflict, giving-in, humor, misunderstanding , and sarcasm. Using sequential analyses and multiple linear regression, I assessed the extent to which sequences consistent with the feminine gender role (conflict paired with giving-in ) predicted concurrent and future depressive symptoms. Additional exploratory analyses examined maternal reactions to adolescent conflict. Results indicate that the pairing of conflict with giving-in during problem-solving interactions is predictive of future depressive symptoms, and that adolescent sex and history of depressive symptoms moderate this relation. As expected, the behavioral combination of conflict with giving-in was a riskier one for girls and for adolescents with a history of depressive symptoms. Maternal responses to adolescent conflict did not differ when mother-son dyads were compared to mother-daughter dyads.

In a sample of non-patient late adolescent women (N=110), this study investigated associations between pubertal timing, interpersonal conflict, and HPA-Axis dysregulation. Primary focus was on the interactional nature of pubertal timing as a risk factor, and the potential mediating role of specific coping behaviors. At high levels of perceived conflict, earlier pubertal timing was associated with both high stress in anticipation of interpersonal negotiation and low physiological recovery following the interaction. At low levels of perceived conflict, later pubertal timing was associated with both high stress in anticipation of interpersonal interaction and low physiological recovery following the interaction. Results suggest further investigation of behaviors which mediate between pubertal timing and girls' physiological response to stress.

The objective of this study was to respond to two primary questions: (1) What is the process of self transformation for the recovering alcoholic? and (2) What is surrender and what role does it play in that process of transformation? Eight subjects were interviewed who have maintained abstinence from alcohol for over ten years and who are active members of Alcoholics Anonymous. Subjects were chosen though two key informants who participated in a pilot study. Key informants were long-term recovering alcoholics and referred the researcher to individuals who could provide in-depth and process-oriented reflections about their experiences. Subjects were asked to tell their story of addiction and recovery in their own terms. An interview guide with focal and follow-up questions insured that each subject gave his/her own authentic and full account of the process of self transformation and experiences of surrender. Grounded Theory guided the collection and analysis of the data generated in the interviews. Analysis of data revealed common themes and patterns in regard to the recovery process and the experiences of surrender. A common pattern of recovery, illustrated as a gestalt process model, involved four components: action, awareness, connectedness, and choice. These components were found to be highly interactive, each contributing to or augmenting the other three. No common sequence was found; instead, any one of the components could serve as an entry into a cyclical, multileveled system of interaction of all four components, in ways that led to crucial experiences of surrender. Although surrender was found to be the necessary and critical core experience in all the sustained recoveries, differing forms of surrender were described, and various names for the experience were identified. All subjects described the process of recovery and the experiences of surrender as what led them to new "ways of being", forms of "knowing", and different modes of consciousness.

This study explored the relationships among separation-individuation, bulimia, social characteristics, and perceived parenting style in a sample of 192 non-bulimic and 39 bulimic college females. There was support for the hypothesis that bulimics are underseparated from their parents when compared to non-bulimic subjects. The bulimic women exhibited a distinctly different pattern of social qualities characterized by higher levels of depression, lower self-esteem, higher private and public self-consciousness, and higher social anxiety than the non-bulimic subjects. It was not possible to discriminate between bulimic and non-bulimic subjects based on the parental rearing styles they experienced. However, there were strong relationships between type of parenting style received and level of independence; the warm and flexible authoritative parenting style was most closely linked to a supportive relationship between parent and child that is free from undercurrents of anger and resentment. Suggestions for future research are discussed.

Attention-deficit/hyperactivity disorder (ADHD) is characterized by inattention, hyperactivity, and impulsivity. ADHD children are at significant risk for cognitive deficits and academic underachievement, as well other comorbid psychiatric disorders. A number of studies have examined differences among subtypes of school-aged ADHD children on a variety of cognitive measures. The results from these studies have been largely inconsistent. Although traditionally not diagnosed until school age, preschool children often develop significant externalizing symptoms including those related to ADHD and Oppositional Defiant Disorder (ODD). Few studies have examined the cognitive abilities of preschoolers with externalizing problems. The present study examined cognitive differences among 206 children with different level of externalizing and attentional problems, and compared those children to an additional 56 comparison, "non-problem" children. This study focused on the following areas: Verbal ability, Performance/nonverbal reasoning ability, motor ability, pre-academic achievement, and early language skills. The results suggested that hyperactivity/impulsivity in children was specifically linked to greater cognitive and academic problems, children with comorbid hyperactive and aggressive symptoms were at risk for greater impairment than children with hyperactive/impulsive symptoms alone, and that attention problems was associated with greater motor impairment.

Deleterious early experiences, wrought by childhood abuse, parental dysfunction, and inconsistent relationships with parents, have been repeatedly associated with suicidal ideation and suicide attempts in adolescence and young adulthood. Both depression and aggression have been correlated with suicidality as well. The precise relationships among these variables remain largely unspecified, however, and contradictory findings portend our imperfect understanding of youth suicide. Psychoanalytic object relations theory suggests a mechanism by which early experiences influence later functioning, providing a link between disrupted caretaking in childhood and suicidal ideation in early adulthood. Using structural equation modeling (SEM), this study examined the extent to which experiences of loss, trauma, and deprivation in early life induced an object world that left one vulnerable to suicidal ideation in young adulthood. The dual aim of the study was to obtain confirmation for the mediating role of object relations in the development of suicidal ideation, and to explore the specific relationships among early experiences, object relations, depression, aggression, and suicidal ideation. Two hundred and fifty college undergraduates participated in group administrations of the Thematic Apperception Test (TAT), and completed the Adult Suicidal Ideation Questionnaire, Beck Depression Inventory, Hopelessness Scale, Aggression Questionnaire, Early Experiences Questionnaire, and Suicide Attempts Questionnaire. The Social Cognition and Object Relations Scale (Western, 1990a) was used to assess four dimensions of object relations from TAT stories. SEM supported the hypothesis that object relations play a crucial role in mediating between deleterious early experiences and suicidal ideation in young adulthood. Traumatic early experiences, particularly physical, sexual, and emotional abuse perpetrated by trusted adults, left an inedible mark on object relations. An object world marked by expectations of unpredictability, rejection, and potential malevolence from others in the context of earnest investment in interpersonal relationships led to elevated levels of both depression and aggression in these college students. Depression, but not aggression, precipitated thoughts of suicide, lending support for the psychoanalytic postulate that depression ensues when aggression is turned toward the self. Some intriguing results and their relation to the literature, limitations of the study, and directions for future research are discussed.

This dissertation constitutes an initial inquiry into the experience of psychological epiphany. In this investigation, the epiphanic experience is conceptualized as one of sudden, discontinuous change, leading to profound, positive, and enduring transformation through the reconfiguration of an individual's most deeply held beliefs about self and world. To explore the nature of the epiphanic experience, a qualitative, empirical inquiry was undertaken to determine its fundamental features. Though the generalizability of the findings is limited by the small sample size (five individuals were interviewed indepth), the study revealed a number of characteristic features. The experience was found to be affectively intense, egosyntonic, and profoundly liberating. The experience of epiphany among the participants studied occurred primarily during adolescence or early adulthood, was preceded by a period of internal conflict during which feelings of alienation, anxiety and depression were common, and followed by a period of productive activity and heightened energy. Given the lack of a theoretical framework within which such experiences of discontinuous psychological change could be investigated, two theoretical perspectives originating outside psychology were explored for their applicability. The first, general systems theory, provided a distinction between changes that occur within a system, versus changes to the system as a whole. Systems theory was therefore found to be useful in addressing the impact of epiphanic experiences as experiences which seem to effect changes to an individual's system of world assumptions. However chaos theory, because it offers a way of distinguishing between different kinds of discontinuous change, was found to provide an even more comprehensive metatheoretical framework within which epiphanies could be conceptualized. Chaos theory holds that significant structural changes to a system which are highly adaptive, often follow from periods of turbulence and seemingly random behavior. Though clinical psychology generally encourages the view that chaos is negative, the findings of the present study suggest that a period of seeming psychological chaos must be carefully evaluated by the clinician as it may be a prelude to important and enduring positive change in an individual's most basic world assumptions.