Premature termination is a substantial problem with significant adverse effects for clients, therapists, and treatment organizations. Unfortunately, it is also a relatively common phenomenon within mental healthcare settings. Across varied mental healthcare settings, rates of premature termination have reportedly ranged from 19.7 % to 40 %. Perhaps not surprisingly, the rate of premature termination in training clinics is substantially higher than in community mental health settings and private practice, with 75 to 80 % of clients ending treatment services prematurely. The purpose of this study was to explore the combined effect of intake therapist continuity or discontinuity, and quality of the therapeutic relationship on premature termination. Intake therapist continuity, measures of working alliance, and termination outcome from 524 clients at the University of North Texas Psychology Clinic were utilized for adults receiving individual therapy services between August 2008 and August 2013. Results of the study suggest intake therapist continuity did not predict subjective termination status (X2(2, n = 524) = 1.61, p = 0.45), nor did it predict change in symptomology status (X2(3, n = 453) = 1.14, p = 0.77). Additionally, working alliance predicted subjective termination status (X2(6, n = 212) = 21.17, p < 0.01), but not change …

The purpose of the current study was to examine neuropsychological functioning in patients with bipolar disorder (BD) with psychotic features. Data from a large, epidemiological study of patients with first-episode psychosis was used to examine verbal learning and working memory 10 years after onset of psychosis in patients with BD relative to patients with schizophrenia (SZ) and patients with psychotic major depressive disorder (MDD). Cross-sectional comparisons of verbal learning and working memory at the 10-year follow-up mirrored findings of relative performance at the 2-year follow-up (Mojtabai, 2000), as patients with SZ performed significantly worse than patients with psychotic affective disorders. When FEP patients' cognitive performance was examined longitudinally, all groups showed non-significant decline over time, with no significant diagnostic group differences after accounting for current symptoms. More frequent hospitalizations and longer treatment with antipsychotics were associated with poorer performance on cognitive testing 10 years after illness onset, but these associations disappeared when controlling baseline cognitive performance. Within the BD sample, current positive and negative psychotic symptoms were associated with poorer performance on cognitive testing. After controlling for baseline cognitive performance, markers of clinical course were unrelated to cognitive performance, consistent with existing literature on longitudinal cognitive functioning in patients with …

This study explored psychopathic personality traits among a non-criminal, college undergraduate sample. Much research has been done on conceptualizing the construct of psychopathy, but this work has been conducted primarily with incarcerated individuals using a structured interview, The Psychopathy Checklist – Revised (PCL-R; Hare, 1991, 2003). The goal of the current study was to assess psychopathic traits among non-criminal individuals using The Self-Report Psychopathy Scale - Version Four (SRP-IV; Paulhus, Neumann, & Hare, in press), and compare how SRP-IV scores were associated with a well recognized semi-structured interview for psychopathy, The Psychopathy Checklist – Screening Version (PCL: SV; Hart, Cox, & Hare, 1995). The study also examined whether psychopathic personality traits could be predicted using a measure of normal-range personality, based on the five-factor model (FFM; Digman, 1990), and a measure developed by Loevinger (1976) related to ego development. Five-Factor Model Rating Form (FFMRF; Mullins-Sweat, Jamerson, Samuel, Olson, & Widiger, 2006) scores and Total Protocol Ratings (TPR score) on the Washington University Sentence Completion Test (WUSCT; Hy & Loevinger, 1996) were used to predict psychopathy scores. Correlations of SRP-IV scores and PCL: SV scores with FFMRF scores and WUSCT TPR scores were also examined for their uniformity. As predicted, there …

Miranda understanding, appreciation, and reasoning abilities are essential to courts' determinations of knowing and intelligent Miranda rights waivers. Despite the remarkable development of Miranda research in recent decades, studies have generally focused on understanding and appreciation of Miranda rights, but have not examined Miranda reasoning and waiver decisions. Therefore, examining the nature of defendants' decisional capacities constitutes a critical step in further developing theoretical and clinical models for competent Miranda waiver decisions. The current study evaluated Miranda waiver decisions for 80 pretrial defendants from two Tulsa-area Oklahoma jails. Previously untested, the current study examined systematically how rational decision abilities affect defendants' personal waiver decisions. Components from general models of legal decision making, such as decisional competence and judgment models, were examined to determine their applicability to Miranda waiver decisions.

Studies of affective forecasting examine people’s ability to predict (forecast) their emotional (affective) responses to future events. Affective forecasts underlie nearly all decisions people make and the actions they take. However, people engage in systematic cognitive errors when making affective forecasts and most often overestimate the intensity and duration of their emotional responses. Understanding the mechanisms that lead to affective forecasting errors (e.g., immune neglect) and examining the utility of methods for improving affective forecasting errors (e.g., surrogation) can provide highly valuable information for clinicians as they assist clients in determining their goals both for therapy and for life. The first purpose of the current study was to determine if affective forecasting errors due to immune neglect lead to misjudgments about the relative emotional impact of minor versus moderate negative experiences (i.e., trauma severity). The second purpose was to examine the utility of surrogation for improving affective forecasts. Potential interaction effects between these two variables were also examined. The current study utilized a 2 (Trauma Severity: minor, moderate) X 3 (Prediction Information: surrogation information only, simulation information only, both types of information) experimental design. Undergraduates were recruited via the SONA system and randomly assigned to one of the six experimental …

The goal of this project was to understand ethnic and generational differences in attitudes towards caregiving and expected burden while taking into consideration factors such as gender, generation, familism, and acculturation. One hundred and sixteen young adults (ages 18-25) and 93 middle-age adults (ages 38-62) were enrolled in the study. Participants included European Americans, African Americans, and Hispanics. Using moderation analysis, two hypotheses were investigated: 1) Ethnicity relates to attitudes towards caregiving, moderated by gender, generation, familism, and acculturation. 2) Ethnicity and expected burden relate to each other, moderated by gender, generation, familism, and acculturation. Familism emerged as a moderator in the relationship between ethnicity and expected burden. Results suggested that the strength of the relationship between being African American and expecting burden was less for those with moderate familism (R =.078), slightly higher for low familism (R = .176), and the highest for high familism (R= .261). Additional results indicated that the strength of the relationship between being Hispanic, as opposed to being European American, and expected burden, was higher for middle-aged adults (R =.23) when compared to young adults (R =.19). The current findings lend support to the recently established idea that familism is not protective against burden …

The objectives of this study were to mathematically model the quality of college life (QCL) concept and to study the associations between attachment style, emotion regulation abilities, psychological needs fulfillment and QCL via structural equation modeling. Data was collected from 507 undergraduate students (men = 178, women = 329; age M = 21.78 years, SD = 4.37). This data was used to provide evidence for the validity of the College Adjustment Scales (CAS) as a measure of quality of college life. The CAS demonstrated good convergent validity with the World Health Organization Quality of Life measure (WHOQOL), Subjective Well-being and Psychological Well-being Scales. Results: Students who were insecurely attached were as likely to feel adequate in their academic and professional endeavors as securely attached students. However, insecurely attached students had lower QCL levels, lower fulfillment of psychological needs and more emotion regulation difficulties than securely attached students. The results also indicated that Anxious Attachment and Avoidant Attachment were positively and strongly associated. Nonetheless, Anxious Attachment and Avoidant Attachment affected QCL through different mechanism. Emotion regulation mediated the path between Anxious Attachment and QCL while the fulfillment of psychological needs mediated the path between Avoidant Attachment and QCL. The fulfillment of …

Cognitive impairment is common in multiple sclerosis (MS), with as many as 70% of patients with MS affected. Individuals with MS who experience cognitive deficits are less likely to be employed, and may have more difficulty performing independent activities of daily living. Most commonly, deficits are observed in processing speed, complex attention, and memory. Because lesion location varies widely among individuals, no clear pattern of cognitive dysfunction in MS has emerged. However, a number of risk and protective factors may influence the likelihood of individuals to develop and/or express dysfunction, though the contribution of each to specific domains of cognition has not been fully explored. Recently, support for the cognitive reserve hypothesis (i.e., enriching life experiences protect against cognitive decline despite disease burden) has emerged in the MS literature. The current study investigated the contributions of cognitive reserve to learning and memory functioning in MS and the interaction of cognitive reserve variables and risk factors known to impact cognitive functioning in individuals with MS. Finding revealed cognitive reserve protects against decline in the domains of processing speed and complex attention. Furthermore, indirect protective effects of cognitive reserve through these domains were observed for verbal learning and memory. Finally, in line …

Recent conceptualizations of psychopathy are moving toward more inclusive, purely trait-based models. However, researchers continue to heavily rely on assessments of psychopathy that include categorical behavioral elements. The newly developed Comprehensive Assessment of Psychopathic Personality – Institutional Rating Scale appears to be a promising interview-based measure of psychopathy, but research on its reliability and validity is in its infancy. As a second issue, the vast majority of research on psychopathy, particularly in offender populations, is conducted with male participants. Nonetheless, the growing body of literature involving incarcerated females suggests gender differences in the prevalence and manifestation of psychopathic traits. Reasons for these differences are unclear, but some have proposed socialized gender roles as a contributing factor. With a sample of 52 female 49 male offenders recruited from a large, metropolitan jail, this dissertation evaluated the construct validity of the CAPP-IRS and examined the effect of gender role conformity on the manifestation of psychopathic traits. Results indicated that a three-factor model of psychopathy represented by antagonistic interpersonal relations, restricted emotions, and disinhibited behavior best fit the data. Findings further suggested convergent and discriminant validity for the CAPP-IRS. Additionally, masculine and feminine gender role conformity differentially related to psychopathy, but generally accounted …

The study investigated an organized semantic fluency task, (the Controlled Animal Fluency Task - CAFT) as a measure of executive functioning (EF) in adults, and the relationship with instrumental activities of daily living (IADL). Participants (N = 266) consisted of a clinical sample (n = 142) utilizing neuropsychological assessment data collected at an outpatient psychological center, and a community sample (n = 124). The clinical sample was a heterogeneous mixed neurological group including a variety of health conditions and comorbid anxiety and depression. The CAFT Animals by Size demonstrated a significant positive correlation with Category Fluency (r = .71, n = 142, p < .001) , Animal Fluency (r = .70, n = 142, p < .001), and with other, established neuropsychological measures. The CAFT Animals by Size condition demonstrated a significant moderate negative correlation with IADL for the sample as a whole (r = -.46, n = 248, p < .001), and for the clinical sample (r = -.38, n = 129, p < .001), but not for the community sample. In a hierarchical regression analysis, CAFT Animal by Size explained additional variance in IADL (&#916;R2 = .15). In a hierarchical regression analysis predicting IADL with the control variables …

The effects of childhood exposure to parental intimate partner violence (EPIPV) on dating violence (DV) were examined through two layers of mediations. Based on attachment theory, individuals who are exposed to parental intimate partner violence are less likely to experience secure parent-child attachment, which in turn transfers to insecure adult attachment that is prone to perceive significant others as less trustworthy and less reliable as well as higher likelihood of over-reacting and/or staying in an unhealthy relationship. In the second layer of mediation, insecure adult attachment would lead to biased SIP which in turn, would result in an increase of DV. A total of 327 university students participated in the study by voluntarily completing the research questionnaires. Among them, 253 reported having experienced mild to severe DV and were included in the final data set. The data analyses procedures included examinations of the measurement models and structural equation modeling (SEM) analyses. Findings from the final models best supported by the data indicated that EPIPV predicted both dating violence perpetration and victimization and that EPIPV predicted adult attachment anxiety and avoidance, both of which are consistent with existing literature. However, findings revealed that EPIPV did not predict SIP and SIP was …

Although the experience of trauma is associated with a great deal of psychological distress, it may also lead to meaningful positive change, known as posttraumatic growth (PTG), evidenced as progression in areas of life appreciation, intimacy in relationships, sense of personal strength, new possibilities, and spiritual development. Utilizing an acceptance and commitment therapy (ACT) perspective, the current study explored whether self-compassion helped to explain the willingness to approach and make sense of a trauma, leading to growth. A sample of 758 undergraduate students completed online self-report questionnaires, and results suggested that self-compassion does partially predict PTG and support for how self-compassion may be understood in relation to PTG is provided. Implications of the current study's findings, as well as suggestions for future research related to trauma within a college population, are discussed.

Given the alarmingly high rates of premature termination in training clinics, research aimed at understanding the course of change and treatment outcomes in training clinics deserves considerable attention. Additionally, more research is needed to understand the effectiveness of psychotherapy training and whether more training is actually associated with better client outcomes. Thus, this study sought to investigate whether clinicians' level of training and experience were related to a variety of clients' outcomes (e.g., well-being, symptom reduction, and life functioning) based on the phase model of psychotherapy. Unfortunately, confirmatory factor analysis of the OQ45.2 did not support the three-factor conceptual model paralleling the phase model. Rather, a two-factor model of best fit was identified. Neither clinicians' level of clinical training nor therapeutic orientation were found to be related to client improvements. However, this finding may have been attenuated by limited variance in client outcomes. Implications for clinical training and future outcome research methodologies are discussed.

For response styles, malingering describes the deliberate production of feigned symptoms by persons seeking external gain such as financial compensation, exemption from duty, or leniency from the criminal justice system. In contradistinction, defensiveness occurs when patients attempt to downplay their symptoms of psychological impairment. Both of the aforementioned response styles can markedly affect the accuracy of diagnosis, especially on self-reports, such as multiscale inventories. As an important oversight, no studies have been conducted to examine the effect of culturally specific response styles on profile validity and the classification of malingering among Hispanic American clinical populations. The current study investigated whether the Spanish Personality Assessment Inventory (PAI) effectively distinguished between Spanish-speaking outpatient groups randomly assigned to honest, feigning, and defensive experimental conditions. In examining the results, PAI malingering indicators utilizing Rare Symptoms strategies (NIM and MAL) demonstrated moderate to large effect sizes. For defensiveness, Spanish PAI indicators also demonstrated moderate to very large effect sizes (M d = 1.27; range from 0.94 to 1.68). Regarding psychometric properties, Spanish PAI validity scales, provide adequate to good data on reliability and discriminant validity. Clinical utility of the Spanish PAI increases as different cut scores are employed.

While a significant amount of research illustrates the overall positive effects of therapists' general use of mindfulness, very few studies have addressed whether therapists' use of mindfulness translates to improved psychotherapy outcomes. The present study utilized a randomized-controlled design to test whether a brief mindfulness training program and pre-session mindfulness practice could have a positive impact on therapy; in particular, we hypothesized that mindfulness training and practice would improve ratings on therapeutic presence as rated by clients and therapists and session effectiveness as rated by clients. The present study also examined whether clients' subjective ratings of therapy outcome and therapists' theoretical orientation impacted outcome measures after therapists completed mindfulness training. The 20 participating therapists were randomly assigned to either the mindfulness training (MT) group or control group according to a computer generated randomization list. Results indicated that clients did not significantly improve on outcome measures after completing the mindfulness training. Clients' subjective ratings on a psychotherapy outcome measure did predict changes in their ratings of therapeutic presence. This finding may have important implications for future research examining client characteristics that may moderate the relationship between therapeutic presence and session outcomes. Limitations of the present study and future directions are discussed.

United States post-secondary education continues to see an increase in Hispanic enrollment, particularly those of Mexican heritage. The present study was designed to examine this population’s experience of stress, anxiety and academic approach-avoidance conflict. Data were collected at North Texas postsecondary institutions. Participants (N = 197) completed an online survey including a Picture Story Exercise (PSE), open-ended responses to hypothetical scenarios, and self-report measures. The current study utilized a mixed-method approach integrating content analysis measures and self-reports. Results indicated that anxiety symptoms expressed to academic, familial, and minority social situations differed, partial η2=.39; with the academic scenario including the highest and minority social scenario the lowest anxiety. Results suggested that Mexican-American college students may express cognitive and affective symptoms of anxiety more frequently than physical symptoms on scenarios but not on self-report scales (Personality Assessment Inventory Anxiety; PAI Anxiety). PSE responses suggested that Conflict and Drive for Goal Orientation were frequent among this sample. Academic Total Anxiety and Academic Physical Anxiety related positively to PSE Conflict, while Academic Cognitive Anxiety related negatively to PSE Positive Outcomes. Exploratory models predicting PSE variables from Academic Anxiety and PAI Anxiety were inconclusive but suggested that gender accounted for significant variance in PSE scores.

Structural equation modeling was used to examine how childhood sexual abuse (and other associated variables, such as family functioning and experiencing multiple forms of abuse) relates to revictimization and psychological distress. Participants were women who participated in Project HOW: Health Outcomes of Women interviews, a longitudinal study that spanned six waves of interviews. Only women with a history of childhood sexual abuse were included in the present study (n=178). Experiencing nonsexual child maltreatment in addition to childhood sexual abuse appears directly related to adult sexual and physical revictimization and indirectly related to psychological distress. Childhood sexual abuse alone was not predictive of revictimization or psychological abuse. This suggests that other mediating factors may explain the relation between CSA and revictimization found in other research. Clinical implications based on the results of the present study emphasize the importance of identifying children who have experienced multiple forms of abuse as particularly at risk for future victimization. In addition, providing interventions with a focus on education and empowerment might decrease risk for future violence and subsequent emotional maladjustment. Potential future research could examine the treatment outcomes and efficacy of these interventions as well as identify those mediating factors that increase the risk for …

Previous research has suggested that adult attachment disturbance is related to maladaptic interaction patterns and personality disorder constructs. Specifically, research indicates that those with attachment disturbance are significantly more likely to meet criteria for a number of personality disorders, including borderline personality disorder, narcissistic personality disorder, and antisocial personality disorder. The purpose of this study was to investigate the associations between adult attachment and the new dimensional model of personality disorders scheduled to be released in the Diagnostic and Statistical Manual for Mental Health Diosrders (5th ed.) in spring 2013. Participants completed the Schedule for Adaptive and Nonadaptive Personality (SNAP) to measure dimensional personality functioning and the Experiences in Close Relationships (ECR-R) and the Attachment Prototypes to measure adult attachment patterns. Additionally, select scales from the Personality Assessment Inventory (PAI) and the Five Factor Model (FFM) will be utilized as secondary measures of personality patterns. The results suggest strong associations between adult attachment orientations and specific maladaptive personality characteristics.

The fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM 5) presents an alternate model for personality disorders, blending categorical and dimensional assessment into a hybrid diagnostic procedure. Released concurrently, the Personality Inventory for DSM 5 (PID 5) measures the five domains and 25 facets that comprise the trait components of this hybrid model. However, the PID 5 currently lacks validity indicators to capture intentionally distorted responding. The current study investigated the susceptibility of the PID 5 to defensiveness and feigning among a large sample of undergraduate students. First, a detailed desirability analysis (N = 465) was conducted of the PID 5 items and response options. Responses from the study were used to create three desirability based validity scales. Next, in a between-subjects simulation design (N = 128), the effects of faking were explored at domain and facet levels. As a result, two symptom based validity scales were created. In a separate validation sample (N = 134), the five newly created validity scales were compared with the Paulhus Deception Scales for capturing both defensiveness and feigning. All five scales were evaluated for ruling out faking (i.e., identifying likely genuine respondents) and ruling in either defensiveness or feigning. …

The concept of decentering originated with Piaget, who defined decentering as a feature of operational thought, the ability to conceptualize multiple perspectives simultaneously. Feffer applied Piaget’s concept of decentering to the cognitive maturity of social content. This study used Feffer’s Interpersonal Decentering scoring system for stories told about TAT pictures to investigate the developmental hierarchy of decentering for children and adolescents. The participants originated from the Berkeley Guidance Study, a longitudinal sample of more than 200 individuals followed for more than 60 years by the Institute of Human Development at the University of California, Berkeley. The hypotheses tested were: (1) chronological age will be positively related to Decentering as reflected in Feffer’s Interpersonal Decentering scores obtained annually between ages 10 and 13 and at 18; (2) children born into higher class homes would have higher Age 12 Decentering scores; (3) children born later in birth order will have higher Age 12 Decentering scores; (4) children whose parents were observed to have closer bonds with their children at age 21 months will have higher Age 12 Decentering scores; (5) adolescents with higher scores from the Decentering Q-sort Scale (derived from adolescent Q-sorts) will have higher Age 12 Decentering scores; and (6) …

The purpose of this study was to examine the impact of military deployment on children, and the roles that risk and protective factors and parenting stress play in emotional symptoms and behaviors exhibited by children while their parents are deployed. A sample of 143 parents (recruited from all branches of the military) who remained at home while their spouses were deployed completed online self-report questionnaires measuring demographic and background information, child internalizing and externalizing behavior, parenting stress, child adaptability, valuing behavior, family cohesion/environment, and parenting behaviors. The sample primarily consisted of mothers (n = 141) and Caucasian individuals (n = 126), which may limit the generalizability of the findings. Results of the study suggest risk factors including parenting stress, corporal punishment, length of time a parent is deployed, and type of deployment (combat vs. non-combat) were predictive of poorer child outcomes. Protective factors including values consistent behavior, child adaptability, and family cohesion were predictive of better childhood outcomes. Parenting stress served as a mediating variable between the relationship of total risk and child outcomes, while values consistent behavior served as a mediating variable between the relationship of protective factors experienced by children and child outcomes. Military deployments not only impact …

The present study sought to more rigourously explore outcomes of psychological well-being immediately following a psychotherapeutic yoga class. Specifically, the study hypothesized improvements in state anxiety and subjective well-being as well as an observable relationship between state and trait mindfulness following a yoga intervention, all while controlling for differences between yoga instructors, prior yoga experience, and participant endorsements of psychological symptoms. Previous yoga experience was not found to be a significant factor in any of the tested hypotheses. Findings revealed that psychotherapeutic yoga decreased anxiety and increased subjective well-being, even after controlling for therapist variability, prior yoga experience, and client diagnosis. Results also indicate differential impacts on decreased anxiety and increased subjective well-being by class instructor. This is the first study to examine outcomes of an ongoing yoga based-practices in the naturalistic setting of an outpatient counseling center while rigorously controlling for confounding factors (e.g. therapist variability). Methodological and statistical limitations are discussed in depth, and future directions to improve on this study and clarify the present findings are emphasized.

Risk assessments for offenders often combine past records with current clinical findings from observations, interviews, and test data. Conclusions based on these risk assessments are highly consequential, sometimes resulting in increased criminal sentences or prolonged hospitalization. Offenders are therefore motivated to intentionally minimize their risk scores. Intentional minimization is especially likely to occur in offenders with high psychopathic traits because goal-directed deception is reflected in many of the core traits of the disorder, such as manipulativeness, glibness, and superficial charm. However, this connection appears to be based on the conceptual understanding of psychopathy, and it has rarely been examined empirically for either frequency or success. The current study examined the connection between psychopathic traits and the intentional minimization of risk factors using a sentenced jail sample. In general, offenders were able to effectively minimize risk on the HCR-20 and SAQ, while the PICTS, as a measure of cognitive styles, was more resistant to such minimization. Psychopathic traits, especially high interpersonal facet scores, led to greater minimization using a repeated measure, simulation design. Important differences in the willingness and ability to use deception were found based on (a) the content of subscales, and (b) the mode of administration (i.e., interview vs. …

The burden of depression requires modalities other than individual psychotherapy if we are to reduce it. Over the past two decades preventative programs for depression have been developed and refined for different populations. The six years since the last meta-analysis of preventative interventions—inclusive of all program types—have seen a number of new studies. The current study used the greater statistical power provided by these new studies to analyze moderators of, and sub-group differences in, the effect of these interventions on depression. Moreover, this meta-analysis synthesized effect sizes for outcomes other than, but often related to, depression (e.g., anxiety) and for within-group change scores with the goal of better informing program implementation and evaluation. Twenty-nine studies met inclusion criteria and indicated that small, robust effects exist for reductions in depression diagnoses and symptomatology. Significant effects were also observed for anxiety, general health, and social functioning.