Dissertations / Theses on the topic 'Clinical health psychology : Social psychology'

The purpose of this dissertation is to examine licensed mental health professionals' attitudes towards rape survivors. Research indicates that the attitudes of police officers, mental health professionals, and the general public may influence the psychological adjustment of rape survivors and, consequently, whether or not that person seeks mental health treatment after the assault (Vincent, 2009). The negative impacts of rape on a person may not be specific only to the act of violence, but may also include secondary victimization from the survivors' negative experiences with authorities such as legal and mental health professionals (Campbell & Raja, 1999) who may hold negative beliefs about sexual assault and rape survivors (Nagel, Matsuo, McIntyre, & Morrison, 2005). Exposure to these negative beliefs held by others may be associated with negative secondary emotions in the survivor, such as guilt; guilt associated with actions taken or not taken in the context of rape has been observed to be positively correlated with posttraumatic stress disorder, depression, low self-esteem, social anxiety, and suicidal ideation (Kubany, Abueg, Owens, Brennan, Kaplan, & Watson, 1995). It is therefore important to examine the attitudes licensed mental health workers hold towards rape survivors, as these rape survivors may seek services from mental health professionals, and the clinicians' attitudes towards these clients' experiences may significantly impact survivors' recovery from a sexual assault. In addition to measuring the acceptance of rape myths in licensed mental health providers, this study aims to explore how demographic variables in mental health professionals, such as gender, type of graduate degree, or participant rape survivor status, are related to the attitudes participants report about sexual assault. It was hypothesized that male study participants would attribute greater responsibility to survivors than female study participants would, based on the results of the updated Illinois Rape Myth Acceptance Scale, and congruent with published research highlighting this gender difference (Grubb & Harrower, 2009). It was hypothesized that mental health providers who have had more years of training in their graduate degree program would report lower levels of rape myth acceptance compared with those who had a shorter degree program. It was also hypothesized that participants who themselves identified as a rape survivor or who had a close friend or family member who is a survivor would attribute less responsibility to rape survivors, as research supports the observation that those who identify as survivors or friends of survivors may reject negative biases towards sexual assault survivors.

After completing both independent t-tests and Mann-Whitney U statistical analyses, gender identity was the only demographic for which statistically significant mean differences were seen in total rape myth acceptance scores (p = .012). This finding is not surprising, as much of the current literature supports that men, in general, attribute more blame to rape survivors than women. Prior to the current study there was no published research using licensed mental health providers as participants in a study using the updated Illinois Rape Myth Acceptance Scale. Data gathered from the current study will therefore offer a valuable contribution to the literature on this topic. Further, it is hoped that this data can be used in the development of graduate programs, continuing education courses, and didactic seminars that debunk rape myths and promote competency around rape survivor issues.

This parent training program was designed to be utilized within the Early Head Start Program. The proposed program is an eight-module program design to be implemented in eight sessions, two hours each, for a one-month duration. The aim of the parent training program is to increase parent participation in their child’s therapy sessions. The participants are parents of children with developmental delays who are found to be eligible for the Early Head Start Program. Through attending the parent training program, several outcomes are likely to occur including, increased social and emotional developmental outcomes for the child, a stronger parent-child bond, an increased awareness for the parent regarding how to effectively promote learning for their child with special needs, a more authoritative parenting style to be adopted by the parents, and a decreased likelihood of abuse and neglect for the child. The proposed parent training program provides a parent training implementation outline, an initial parent survey, and several quizzes to determine the parent’s competency throughout the modules. Suggestions for future research, discussions of strengths and limitations, and program evaluations were offered for discussion.

Depression is a serious disability around the world that can cause harm to a person's physical and mental well-being. Little research has been done on the effects of social cohesion on depression. This study used a cross-sectional descriptive survey design to analyze a sample from the California Health Interview Survey (CHIS) to determine whether or not there was a relationship between how often a person feels depressed and social cohesion factors: (1) willingness of people in the neighborhood to help each other, (2) trust in people in the neighborhood and (3) doing volunteer work or community service in the past year.

Using, Chi-square analysis, it was determined that these three social cohesion variables showed a significant relationship with how often a person feels depressed. Having substantial social networks may act as protective barriers to stress, fear, and lack of control. These protections have positive impacts on depression and depressive symptoms.

Depression and anxiety during pregnancy can have a host of negative effects on mothers and their infants, such as premature delivery and increased risk for postpartum depression. Few studies have examined whether levels of the sex hormones progesterone and estradiol, which rise dramatically over the course of pregnancy, are associated with depression and anxiety. This study examined whether higher salivary progesterone and estradiol levels were associated with self-reported depression and anxiety scores among a sample of 128 low-income pregnant women, and whether these relationships were moderated by social support. The results showed that only social support levels had significant negative associations with both depression and anxiety levels. Sex hormones were not significantly associated with depression and anxiety, and social support was not a significant moderator in these relationships. Future studies should continue to address the dearth of research on assessing the roles of sex hormones in relation to mental health during pregnancy.

Objective: The primary goal of the current study was to characterize perceived social support (PSS) and isolation longitudinally among people with chronic pain (CP) who were and were not receiving group psychosocial interventions for CP. The second goal of the study was to describe how PSS and isolation variables are associated with quality-of-life (QOL) variables over time for those same participants.

Background: Previous research has demonstrated that positive social support can predict better outcomes for people with CP and negative social support can predict poorer outcomes. Furthermore, CP is associated with decreased social support and greater isolation. Despite the knowledge that PSS can be an important coping resource for people with CP, research on the longitudinal patterns of PSS and isolation and their relationships to QOL variables over time is lacking, especially among people with CP.

Method: Social health and QOL data from 290 participants from the Learning About My Pain study (Eyer & Thorn, 2015) were used to examine longitudinal PSS and isolation with piecewise linear growth models using multilevel modeling. Participants were randomly assigned to participate in group cognitive-behavioral therapy (CBT), group pain psychoeducation (EDU), or medical treatment-as-usual (TAU) for 10 weeks followed by a 6-month post-treatment follow-up period. Participants were assessed pre-, mid-, and post-treatment, as well as at follow-up.

Results: PSS was relatively stable over the treatment and follow-up periods except for small decreases in emotional and informational support among TAU and social isolation among EDU during the follow-up period. Companionship was associated with decreasing pain interference, disability, and depression, and emotional support was associated with decreasing pain interference and depression, whereas instrumental support and isolation were associated with worsening QOL. The Buffering Hypothesis of PSS was not supported in the current sample.

Conclusions: A potential benefit of participating in psychosocial group treatments for CP appears to be the lack of deterioration of emotional and informational support for CBT and EDU and decreasing isolation for EDU participants. Social health was predictive of QOL. Future research and treatment of CP should account for PSS and isolation and the ways in which they interact with pain and QOL.

Negative social reactions that sexual assault survivors receive upon disclosure have been correlated with psychological distress such as posttraumatic stress disorder, depression, and problem drinking. However, the impact of ethnicity in the relationship between unsupportive reactions to assault disclosure and the psychological sequelae remains unclear. Using hierarchical linear regressions and a sample of 665 African-American, Latina, and Caucasian female adult sexual assault survivors, the present study examined the role of ethnicity in that relationship. The results suggest that ethnicity moderates the influence of negative disclosure reactions on psychological symptoms, however, the moderation impact was not similar across races and psychological outcomes. With regard to posttraumatic stress disorder and depression, contrary to expectations, African-Americans were less impacted by negative reactions as compared to Caucasians. However, as predicted, more African-Americans and Latinas reported problem drinking upon receiving unsupportive responses than Caucasians.

This study examined secondary data that originated from Kaiser Permanente's Multidimensional Chronic Pain Treatment Program and focuses on ”primary social support” and its significance in predicting chronic pain outcomes. Primary social support refers to the support derived from the one person whom the participant feels is his/her main supporter (i.e., a spouse, friend, neighbor, etc.). This study divides primary social support into four subcategories: general social support (PreSS), emotional support (PreEM), instrumental support (PreIN), and negative reactions (PreNeg). The hypotheses in this study predict that each social support subcategory can predict post-treatment pain severity (PostPain). Four hundred twenty five participants from four Kaiser Permanente hospitals participated in a Multidimensional Chronic Pain Treatment Program. Of the 425 participants, the scores of 196 participants with moderate to severe pain and impairment were eligible for data analysis. The treatment program consisted of a 10-week, 2.5 to 3-hour structured group intervention, with the goal of improving functioning, activity levels, coping skills, and overall emotional well-being (Bertagnolli, 2001). The participants completed the West Haven Yale Multidimensional Pain Inventory (WHY-MPI) at both the start and end of treatment. Through hierarchical linear regression analyses, negative reactions were found to significantly predict an increase of post-treatment pain scores. Meanwhile, general social support, emotional support and instrumental support were not significant in predicting post-treatment pain scores. These findings may guide future research of social support within a Multidimensional Chronic Pain Treatment Program.

The present study examined the influence of attachment style, social support, and family resiliency on levels of stress, depression, and anxiety in parents who have children with autism. The study concentrated on investigating the impact of attachment anxiety, attachment avoidance, social support from family and friends, and family resiliency on stress, depression, and anxiety in parents who have children with autism. One hundred and eighty-nine participants, who were parents of children with autism and belonged to various local and national parent support organizations, filled out an online survey provided to them via email, newsletter, or group forum. Results showed that attachment avoidance, social support from friends, and family resiliency are significant predictors of stress. Furthermore, attachment anxiety, attachment avoidance, and family resiliency were indicated as being significant predictors of anxiety and depression. The findings from this study suggest that attachment style, family resiliency, and social support outside the family are important factors to consider in the psychological well-being of parents who have children with autism.

This study set out to understand the lived experience of children with mental health diagnoses. With the Foucaldian concepts of historicizing, biopower, power and nominalism, combined with the Disability Studies concepts of the social construction of disability, normative culture, and child voice, the study focused on six boys with mental health diagnoses placed in a summer day treatment program. Data collection included child interviews, field observations in the day treatment center, and the review of documentary evidence including educational files, and treatment center artifacts. The data were analyzed for individual child stories, file review data comparison, turn taking, and pieces of the conceptual framework.

Critical discourse analysis determined decades of social construction and normative culture were at play in both the child experiences and in the researcher’s gathering and understanding of the data. Despite the purpose of the research to step away from these influences and allow the participants’ stories to organically emerge, the researcher co-produced truth with the children that reinforced the status quo. The three themes emerging from the initial data analysis of child sense of self, adult knowledge & power, and child power led to a revised conceptual framework with power as a more constant, fluid piece of the children’s lived experiences. Further analysis suggests historicizing, nominalism, biopower, social construction, and normative culture, while seemingly invisible, are constantly interacting and leaning on each other to create the researcher’s lens and reality as well as the participant lived experiences. Power moves among the pieces while holding them together.

The ability to self-regulate cognitive, emotional, and physiological activity is integral to mental and physical health. Teaching these skills in early childhood is a promising preventative health intervention. Mindfulness-based Social Emotional Learning (MBSEL) programs aim to enhance social-emotional competencies and improve academic outcomes in classroom children. Barriers to implementing MBSEL programs include the need to alter existing classroom curricula, and allocating resources towards training classroom teachers or hiring an experienced mindfulness facilitator. Inner Explorer (IE) is a MBSEL program that uses audio-guided MP3 tracks to teach mindfulness in 10-minute daily sessions, minimizing classroom interference and negating the need for a facilitator. The current study evaluated the impact of IE on self-regulation skills and academic outcomes in 2^nd-4^th grade students and teachers in two Southern California elementary schools. Eighty-four students and seven teachers were assigned to either the IE or control group. Students were measured on mindfulness, executive functioning (EF), emotion regulation, and heart rate variability (HRV) at pre- and post-intervention. Teacher-rated grades (School 1 only), days absent and tardy (School 2 only), and social-emotional learning (SEL) scores were provided at the end of trimesters 1-3 (School 1) and semesters 1-2 (School 2). Teachers were measured on mindfulness at pre- and post-intervention. Students in the IE group did not show any pre-post differences in mindfulness, executive functioning, or emotion regulation compared to the control group. Contrary to hypothesis, the IE group showed a significant reduction in HRV from pre- to post-intervention; however, HRV changes were not significant between groups. The IE and control groups did not show any significant differences in grades, SEL scores, or days absent or tardy. Neither teachers in the IE nor control group reported significant changes in mindfulness. Children with lower levels of emotion regulation and mindfulness at baseline were more likely to report “uncomfortable experiences” when practicing mindfulness. Results are discussed in the context of methodological challenges in MBSEL research and future directions are suggested. Teaching self-regulation in early childhood is a promising approach to mitigating future mental and physical health problems, however this study raises questions about the most effective format, delivery, and measurement of MBSEL curricula.

Indirect exposure to a traumatic event is associated with the development of posttraumatic stress disorder (PTSD) symptoms. Indeed, emerging research demonstrates that exposure to media coverage of violent acts has the potential to cause PTSD symptoms. Theoretical conceptualizations for the development and maintenance of trauma- and anxiety-related disorders suggest that avoidance behaviors of trauma-related stimuli may ultimately lead to the development and maintenance of PTSD symptoms through negative reinforcement processes. Assessing learned associations between environmental stimuli and anxiety may help identify those at risk for the development of PTSD such that those individuals with more learned associations between environmental stimuli and anxiety may engage in greater avoidance behaviors. A highly publicized traumatic event occurred in Lafayette, Louisiana in the summer of 2015. Following the trauma, the community held several vigils and slogans, and banners were displayed throughout the city to show support for the victims. For some individuals, these community support stimuli may have been associated with comfort; however, some may have developed associations between these community support stimuli and the traumatic event and anxiety. As such, the current study sought to examine the learned associations between community support stimuli and comfort and anxiety. Additionally, this study sought to explore the relation between these learned associations and avoidance behaviors, as well as PTSD symptoms. Overall, participants exhibited greater implicit associations between community support stimuli and anxiety stimuli than with community support stimuli and calm stimuli (M = 0.10, SD = 0.31, 95% CI [0.05, 0.16]). These associations did not predict PTSD symptoms or avoidance behaviors. Findings indicate that although community support stimuli were associated with anxiety, these associations may not contribute to the development and maintenance of PTSD symptoms. Rather, community support stimuli may serve to facilitate effective coping strategies through exposure to anxiety- and fear-eliciting stimuli.

Mental health stigma, while common, leads to harmful consequences. There is some evidence to show that education reduces stigma. The reduction, however, is short term and only observed in those who are relatively open and flexible with their beliefs. Emerging research suggests that variables such as empathy, perspective taking, and psychological flexibility may be key processes in stigma reduction. Relational Frame Theory (RFT) provides a framework for understanding the development of stigma, the role of inflexibility in maintenance of stigma, and how education that targets flexibility might facilitate reduction in stigma. Applications of RFT have resulted in the development of the Implicit Relational Assessment Procedure, a tool that can be applied for assessment of not only implicit stigmatizing attitudes, but also the flexibility with which they are held. The current study examined the impact of divergent educational experiences on mental health stigma using college students with various levels of formal education relevant to psychological difficulties both implicitly with self-report measures and explicitly with the IRAP. Also examined were empathy and psychological flexibility as moderators of the relationship between education and stigma. Data suggest that mental health bias is a function of education, but that didactic and experiential education may have differential effects. Increases in education and empathy factors were associated with reduced stigma measured explicitly; however, these variables did not correlate with the measure of implicit stigma. Additionally, when empathy moderated the relationship between education and implicit stigma, high levels of empathy were associated with increases in implicit stigma. Inconsistencies in results from implicit and explicit measures indicate a clear need for continued research in this area to more fully understand mental health stigma and to develop reduction interventions.

On any given day, one in 28 children loses a parent to incarceration, creating a higher risk for mental health concerns and antisocial and criminal behavior. This study examined negative outcomes, such as antisocial behavior and criminal behavior, of children who have experienced a parent’s incarceration. A closer look was taken at the effects of mix timing incarceration, in and out of prison, on children. There was also an analysis on the influence of intergenerational criminal behavior on a child’s wellbeing and long-term outcome. The results of this study indicated that a parent incarcerated with mix timing during their children’s childhood and adolescence leads to a higher risk of mental health concerns in the minors. Depression was significantly higher in children with a history of parent imprisonment (M 54.6, SD 14.8) in comparison to children with a stable household (M 46.3, SD 9.6). All effect sizes showed that parental imprisonment with mix timing was associated with higher rates of child mental health concerns. Furthermore, findings showed that parental imprisonment was associated with higher rates of antisocial or criminal behavior among children. Children with imprisoned mothers reported being convicted for criminal activity at more than double the rate of the control group. Meanwhile, a significantly higher proportion of inmates had a history of paternal imprisonment (39%) than the control group (7%). As for aggressive and antisocial behavior, the odds ratio for children with parental imprisonment was 2.2 ( CI= 1.6-3.0) for boys and 1.7 (CI= 1.3-2.4) for girls. The results of the study provide insight and awareness of the increasing numbers of children falling into a pattern of intergenerational incarceration, as well as mental health concerns and antisocial or criminal behavior. This dissertation provides evidence of the need for resources, awareness, and further prevention.

The researcher used phenomenological psychological analysis to explore the experiences of recovery from childhood psychosocial trauma of seven adult participants through the use of Experiential Reframing (ER). ER is a psychotherapeutic modality of clinical significance because it may allow patients to overcome the amygdaloidal hijacking and distorted meanings incident to traumagenic triggers in a relatively short-term intervention. The recollected experiences of participants’ before, during and after interventions were collected through semi-structured interviews. Study results were then tied to neurobiological research that might correspond with the phenomenological experiences of participants. Before treatment experiences of participants were marked by phobic relationships to anxiety and other emotions. The protocol served to reveal to patients the relationship between past experiences and current dysfunction. Post treatment, participants had new experiences of trigger events, specifically an ability to stay present to current experience, theorized to be the result of successful enough reconfiguring of autonomic system responses to certain somatosensory-based cues. The phenomenology of recovery was that there was a sudden shift that opened up the ability to deploy an observing ego perspective in the aftermath of (previously) trauma triggering events, but that the process was quite effortful for the first few times. While the experience of effortful mediation of experience in the aftermath of a trauma trigger never went away entirely for participants the process did become easier. Phobic positions with respect to emotions and anxiety dissolved, latent anxiety lowered, and lives opened up.

Although there is an extensive literature on women who are overweight, obese, or suffer from eating disorders, less is known about women who are at a healthy weight yet who are attempting to lose weight. To learn more about the psychological characteristics and behavioral patterns of such women, this study analyzed data from the American College Health Association's National College Health Assessment (ACHA-NCHA-II). We compared these women with two groups of women: (a) those who are at a healthy weight but who are not attempting to lose weight and (b) overweight women who are attempting to lose weight. We employed numerous variables including BMI, depression, anxiety, academic performance, exercise, and diet strategies in these comparisons. In terms of psychological health and weight-related behavior, healthy women attempting weight loss are more similar to overweight women who are attempting weight loss than they are to healthy women who are not attempting to lose weight. We found comparatively high rates of depression, anxiety, and academic difficulty among our target population. Based on our findings and the relevant literature, we recommend that university health officials provide weight-related educational information to female students in an effort to promote psychological well-being and healthy weight practices.

Gatekeeper Suicide Prevention Trainings such as Question Persuade and Refer (QPR) are used to increase suicide awareness and teach participants basic suicide intervention skills. Previous researchers showed that QPR training increases knowledge of suicide risk factors and increases participants' willingness to intervene with individuals at risk of suicide. It was hypothesized that completion of QPR would also increase positive attitudes toward the utilization of mental health services and that this outcome would be more pronounced among male participants. The examination of attitudes was rooted in the theoretical framework of Ajzen's theory of planned behavior. The Inventory of Attitudes toward Seeking Mental Health Services (IASMHS) was the instrument used for the study. The study occurred in a rural community college in southern Oregon. Student attitudes were assessed prior to completion of a 1-hour QPR presentation followed by a 3-week post assessment. Analysis of Variance revealed significant effects of QPR training. IASMHS scores were significantly higher at post QPR training. A significant interaction between gender and QPR training showed that women scored significantly higher than men only at pre QPR training. There was no statistical gender difference in attitudes measured by the IASMHS at post QPR training. QPR increased help seeking attitudes in both men and women with the increase being more pronounced in men. Increasing positive attitudes toward help seeking can contribute to positive social change. Practitioners in the field of men's health should consider using gatekeeper suicide prevention training such as QPR as a means of increasing male help seeking.

This dissertation is a phenomenological analysis of the lived experiences of adult daughters who perceive their mothers to have struggled with a mental illness throughout their childhood, adolescence, or even into adulthood. An extensive review of the literature showed a noticeable dearth in the existing literature regarding the lived experiences of adult daughters who experienced maternal mental illness first-hand. Qualitative face-to-face interviews were conducted with eight female participants in an effort to obtain a more comprehensive understanding of their retrospective account of living with a mother who is mentally ill. Of particular interest was creating a space for the women to re-tell their stories and to identify ways in which their own relationship with their mothers has had a trans-generational effect on the relationship and parenting styles with their own children. Several thematic patterns were obtained from the interviews including parentification (mothering the mother), minimization of the mother's mental illness, and feelings of anger, sadness, embarrassment that came up as the daughters dealt with the impact of maternal psychopathology. The stories told by these women will hopefully contribute to the existing literature on attachment, maternal mental illness, and the subsequent impact on parenting practices.

Psychological struggle seems to be an inherent part of the human experience. Unfortunately, the public attitude towards the obese focuses more on negative stereotypes (e.g., undisciplined, ugly, stupid, and lazy) than on the underlying psychological components that lie at the heart of the struggle. Negative stereotypes like these have an affect upon the way the obese think about themselves and may lead to self-stigmatization, which in turn may interfere with a person's attempt to gain control of their health and emotional well-being when eating is used to relieve the associated distress. Many people who struggle with their weight are found to be very rigid in their thought processes regarding food. Perhaps it is not the content of food and body-related cognitions that is important, but the inflexibility with which they are held.

The current study will investigate the relationships among avoidant eating behavior, perceived stigmatization, self-stigmatization, and psychological flexibility. Participants will be recruited from a population of obese individuals who are seeking help at a bariatric clinic, and from Facebook. Participants will initially complete a packet of questionnaires on psychological flexibility, perceived stigmatization, self-stigmatization, and eating behavior online. Then for seven days they will receive four text messages a day for seven days, three of which will provide them with a link to the Periodic Assessment of Stigmatizing Experiences, and one text message providing a link to the Daily Eating Survey. It is hypothesized that 1) Perceived stigmatizing experiences (i.e., a fear of enacted stigma from society) will predict disordered eating 2) Weight- and food-related psychological inflexibility will moderate the relationship between perceived stigmatizing experiences and disordered eating 3) Self-stigma (i.e., self-devaluation due to perceived stigmatization from society) will moderate the relationship between perceived stigmatizing experiences and disordered eating 4) Psychological inflexibility will predict increased perceived self-stigma.

There is limited understanding of the variables that impact trainee performance in clinical settings. As such, investigating the tools used to assess performance was warranted. In the first part of the present research study, I investigated the independent factors that comprised the FPEF using 294 archival forms completed by clinical supervisors at the California School of Professional Psychology, Alliant International University, San Francisco. The five conceptually derived domains of clinical competency of the FPEF included: psychological intake, evaluation and assessment; clinical interventions; professional roles and behaviors; self-examination and development; and supervision. A principal factor analysis was conducted to determine whether the items of the FPEF comprised performance factors that were based on these FPEF domains. Results yielded a four-factor solution based on how the items clustered together. Thus, subscales were retitled as follows: Clinical Development, Professional Roles and Behaviors, Psychological Conceptualization and Intervention, and Psychological Assessment Skills. The second part of the present study included trainee self-ratings and supervisor ratings on the FPEFs for 47 school-based mental health trainees. This part of the study focused on whether the internal psychological variables of role conflict, role ambiguity, and self-efficacy (domain specific), and the external variables of both organizational support and supervisory support were associated with performance ratings on the FPEF. Findings indicated that the internal and external variables were both associated with trainees' performances across various domains. However, some of these relationships were contrary to what was expected. Organizational support and supervisory support were found to have negative associations with specific performance domains, which may have been due to limitations of the instruments or moderating variables that were not measured in this study.

Obesity is a chronic and debilitating medical condition that results from a complex mix of genetic, physiological, psychological, and social factors. Despite a recognized consensus regarding the complexity of obesity, little is known about how various demographic, medical, and cognitive performance variables interact in this population, especially in relation to factors which may contribute to the maintenance of obesity over time. Research has supported that one key aspect of this process is eating in response to psychological rather than physiological cues. Given the increased prevalence of psychopathology, particularly mood disorders, in obese individuals, the question arises as to whether there exists an underlying impairment in emotion recognition.

The current study sought to examine the associations among demographic and medical variables as well as performance on cognitive tests of memory, attention, executive function, sensory-motor, and verbal skills. Contrary to the hypothesis that BMI would be inversely related to performance on tests of emotion recognition, results indicated that as BMI increases, reaction time to complete these tasks decreases. This finding was noted even after the effects of age, gender, estimated pre-morbid IQ, pre-existing medical conditions, and performance in all neurocognitive domains was removed. In addition, when examined across BMI categories, it was observed that participants with BMIs greater than 40 kg/m2 showed the fastest reaction times. Overall, these findings provide support for contemporary theories of emotion which generally agree that emotions evolved to facilitate adaptation to environmental threat.

This liberation-psychology study included several years’ immersion in the Tibetan refugee community in Dharamsala, India, where I offered Somatic Experiencing-informed (SE) sessions to exprisoner refugees. During the course of conversations with refugees, this study shifted from an investigation of SE as a trauma-healing intervention to a cross-cultural dialogical approach to the healing of the psychological and physical sequelae of forced displacement, imprisonment, and torture of Tibetan expolitical prisoners. Tibetan refugee expolitical prisoners living in Dharamsala, India, were asked to describe their emotional and somatic sequelae, as well as the alleviated factors and conditions of these sequelae, which stemmed from experiences of political incarceration, loss of homeland, torture, and escape. Purposeful sampling was employed, and 17 participants were observed in a 2-day Freirean-inspired dialogic workshop participant observations in which sequelae and processes of amelioration and responses to the Western SE therapy were identified and recorded. Also, 12 participants were interviewed on their experiences and perceptions of the workshop; 9 of whom volunteered for SE sessions. Data were analyzed by thematic content analysis.

Major findings on emotional distress included loneliness due to separation from friends and families, helplessness to assist other Tibetans, and distress of “non-being” brought on by occupation, displacement, and unofficial refugee status. Physical sequelae were digestive problems, difficulty breathing, pain and tightness, dizziness, weakness, and fatigue. A Buddhist approach was distinguished as a dependable route to mental health and Tibetan Buddhist methods were highlighted as unique in achieving lasting well-being. Community interdependence and preservation of Tibetan Buddhist culture were preferred over individualized approaches to trauma healing. Implications include a potential shift in international trauma fieldwork to a cross-cultural psychological approach.

One commonly accepted protective factor, social support, is hypothesized to be both helpful and harmful following exposure to traumatic events (Bonanno, 2008; Ellis, Nixon, & Williamson, 2009; Lyons, 1991). Although at least 10 theoretical models have been proposed to explain the relationship between social support and post-traumatic responses, existing theories do not adequately capture the multidimensional experience of social support, which is comprised of several constructs and structures (e.g., received and perceived support; support functions and content). Moreover, existing social support theories have not been studied in research related to therapy with traumatized clients. The present study, therefore, examined how clients who experienced trauma expressed social support in psychotherapy. A qualitative content analysis was conducted using a directed coding system developed for this study that was based on the constructs and structures commonly discussed in psychology literature on post-traumatic experiences, namely: (a) received support, (b) perceived support, (c) extended support, (d) social support functions, and (e) social support contents.

The current study observed that clients who have experienced trauma are likely to mention social support in sessions but that salient factors related to the benefits and harms associated with social support were discussed less. Although many expressions of social support fell into "not otherwise specified" categories because the quality or type of support experienced was not clearly stated, inductive analysis identified the following salient factors: support needs, relationship elements, planned future support activities, past perceived support, and past support that did not occur. The study also provided support for some existing models of social support and trauma (i.e., network orientation, stress-buffering, erosion, social-cognitive processing, and COR models).

Clinical implications related to social support discussions in individual therapy include the need to examine and potentially change therapists' views of social support. Psychotherapists are encouraged to explore the support relationships identified by clients, as well as the quality and types of support experienced and perceived, in order to understand the role and impact of social support and address the benefits and risks associated with support. Clinicians should also recommend that clients engage in adjunctive mutual aid and affiliative support groups.