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PATHWAYS TO HIGH-LETHALITY SUICIDE ATTEMPTS
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The purpose of this study was to develop a model of the trajectory to high-lethality suicidal behavior for individuals with Major Depressive Disorder (MDD) and Borderline Personality Disorder (BPD). An increased number of previous suicide attempts, substance use immediately prior to the attempt, and objective planning were proposed to lead directly to an attempt of higher lethality. Meanwhile, aggression and impulsivity were hypothesized to lead indirectly, through their association with past suicidal behavior, to a higher lethality attempt. Path analysis revealed a revised model that applied only to individuals with BPD. In this final model, impulsivity was found to be significantly associated with higher-lethality suicide attempts and the frequency of an individual's past suicidal behavior. Additionally, the traits of impulsivity and aggression were found to be significantly correlated in the multivariate model. Pathways linking alcohol use at the time of the attempt to the lethality of suicidal behavior and aggression to the frequency of an individual's past suicidal behavior were not found to be significant, and no model using the variables of interest in this study could be determined for individuals with MDD. These results are discussed in light of current theories of suicidal behavior and in terms of their implications for clinical practice.
Changing gender: Gender role, class and the experience of Chinese female immigrants
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This dissertation analyzes gender role identity development in Chinese female immigrants from diverse work and education backgrounds. This study focuses on Chinese female immigrants, bakery salesladies and social workers, to addresses a gap in the existing literature, which has previously emphasized factory workers and students, on gender role identity development at the interface of social context and activity system dynamics. To understand further the Chinese female immigration experience, this research investigates how gender role identity is manifested across different social contexts and institutions. I administered questionnaires and conducted interviews with Chinese female immigrants residing in New York City. The sample consisted of two groups with different occupations, educational back¬grounds, socio-economic statuses, and levels of cultural assimilation: bakery salesladies and social workers. I captured the process of gender role identity development through participants' own voices and narratives. I analyzed the data and discussed it in light of an activity theory framework. The key finding was that, for both groups, gender role identity was deeply influenced by traditional Chinese ideology including the traditional gender hierarchy, male supremacy, and the values of modesty, and maintaining interpersonal harmony. Bakery salesladies encountered less conflict at work and were more likely to avoid conflict at home. In contrast, social workers expressed a greater predisposition to voice their opinions without being confrontational at work and were ready to halt conversations when they sensed that their husbands were getting upset. Furthermore, in terms of life goals, the bakery salesladies tended to focus on their family needs and perceive the success of family members as their own success, whereas the social workers often had aspirations that went beyond traditional gender roles and valued and aspired to contributing to society. The findings reveal gender role identity to be an active and non-homogenous process of "doing gender" through which women negotiate various positions across cultural contexts, social locations, histories and ideologies within their unique activity systems.
FLUID OCCUPANCY: POLITICS AND SPACE IN A TAIPEI NIGHT MARKET
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This dissertation shows how street vendors in Shilin Night Market, in Taipei City, Taiwan, through spatial, social, and material practices, shape and reshape an urban landscape. I find the space they produce to be a vernacular representation of modernity for an authentic urban identity. Dealing with the municipality and local community, street vendors have continually appropriated public and private property in both legal and extralegal situations. Municipal officials and urban planners have followed these spatial practices in an effort to fix, standardize, and tax their vending spaces. Extralegal vendors, provoked by this official scrutiny, developed a spatial practice of "fluid occupancy" supported by social relations, micro politics, and embodied performances to sustain their operation outside legal boundaries. Culturally speaking, the culinary practices of domestic and migrant food vendors, and the clothing vendors' involvement with transnational wholesale trades, stretch the identity of Shilin Night Market from that of a local trading place to a liminal space that subsumes a grounded, place-specific practice within a network of transnational flows. Despite the fact that street vendors created economic and cultural capital as the basis of a thriving market, they eventually became the targets of removal in the political discourse of reframing the market as a tourist space shaped in the spirit of capitalist modernity. To maximize the transnational quality of Shilin Night Market as they seek to forge a cosmopolitan identity for Taipei, municipal officials redeveloped the market into a prominent tourist destination, building a new, indoor market and relocating extralegal vendors into storefront arcades under the privatized governance of a property association. Eventually, some street vendors were incorporated into the municipal prototype, and others have kept contesting unauthorized space. I celebrate the hybridity of this commercial landscape that unifies the steady and the fluid occupancies of public space, as well as the global and the local synergy infused within the setting. My dissertation suggests that modern design practices can pursue process-driven planning strategies that forego displacement and exclusion, seeking instead to balance esthetic and economic concerns with an acknowledgement of the social ecologies of physically and culturally distinct, urban places.
The Eye and the Couch: Dialectical and Metaphorical Aspects of Seeing and Being Seen in Development and Psychoanalytic Treatment
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ABSTRACT The Eye and the Couch: Dialectical and Metaphorical Aspects of Seeing and Being Seen in Development and Psychoanalytic Treatment by Komal Choksi The iconic scene of the psychoanalytic setting depicts two individuals present in the same physical space but looking away from one another. This scene invites the question of the role of gaze both in psychoanalysis and in the broader course of human interaction. These are the topics explored in this thesis, which is largely theoretical. The conscious and unconscious associations to looking and being looked at provide the data for a contextual analysis of the use of the psychoanalytic couch which systematically prevents facial-affective reading and interaction between patient and analyst. A review of literature was undertaken to understand the meanings of seeing and being seen with a different conceptual lens adopted in each chapter. The first chapter, covering phylogeny and ontogeny, established the biological roots of gaze and gaze aversion and the unconscious processes involved in visuofacial interaction. The second chapter demonstrated the paramount significance of maternal-infant gazing in the development of both psychic and interaction structures. The coupling of gazing with sexuality, shame, and envy was revealed in the third chapter. The fourth chapter considered gaze in existentialist philosophy in which gaze is alienating, in feminist theory, in which gaze is indicative of power and status, and in current contemporary culture, which is increasingly exhibitionistic and voyeuristic. Literature on the rationale for the couch with an emphasis on the visual dimension was reviewed in the subsequent chapter. The literature demonstrated the persistent associations of libido and aggression to gaze and provided the possible motives for its exclusion in analytic treatment. The last chapter was an attempt to apply these findings to the clinical encounter and consider therapeutic action in both physical-interactive setups - face to face and with the use of the couch. The significance of nonverbal affective communication, shame, analytic voyeurism, regression, internal focus, holding, separation-individuation, loss, and symbolization were considered, along with amodal perceptual functioning and the role of mirror neurons in analytic empathy. It was concluded that the decision to treat a patient face to face or not must involve an attunement to the possible idiosyncratic meanings for the patient of the analyst's gaze and face.
Use of the Modified Emotional Stroop Task to Detect Suicide Risk in College Students
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It is a challenge to detect those who are at potential risk for suicide because the base rate of suicidal behaviors in non-clinical samples is low. The aim of the present study was to investigate the concurrent and predictive validity of the emotional Stroop task (EST) as a behavioral marker for suicidal behaviors in a college population. Eight hundred and twenty students were asked to perform the EST and to respond to suicide-related self-report measures and were followed up with18 months later. The results indicated that participants with past suicide attempts had longer response latencies to the word "suicide" as compared to non-attempters. Further, those with attentional bias toward suicide-related words at baseline were more likely to report suicidal behaviors during the follow-up period. The EST latencies were not affected by ethnicity, but a possible gender effect was detected. These results are discussed as they pertain to suicide risk assessment among college students.
Dissertation The relationships among custody and visitation arrangements, parental conflict, and adolescent outcomes in the context of divorce
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Experiencing parental divorce during adolescence has been associated with a number of negative adolescent outcomes. A high level of parental conflict has been identified as an important determinant of adolescents' adjustment to their parents' divorce. This study sought to examine the relationships between level of parental conflict, custody and visitation arrangements, and negative adolescent outcomes. This research is based on archival data obtained in the course of a forensic child custody evaluation, and utilized a sample of 89 couples and 196 pre-adolescents and adolescents. Results demonstrated that higher levels of parental conflict were associated with a greater number of negative adolescent outcomes. It was also found that children whose parents had joint custody experienced fewer negative adolescent outcomes than those who were in the sole custody of one parent. These results suggest several important implications for practice, policy, and future research.
MERIT- Mentalization Enhanced Remediation an Integrated Treatment - A Comprehensive Intervention for Children with Autism
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In the treatment of autism two models have evolved that have attempted to integrate aspects from skill based approaches with a more developmental model. These models remain predominantly developmental. Although these more integrated models have taken into consideration the advances that have allowed us to better understand the neuropsychological profiles of children on the spectrum, they do not attempt to intensively remediate many of the areas we know to be compromised. In this dissertation I will propose a treatment model that considers these specific deficits while integrating valuable aspects of various existing models and thereby optimizes the outcome for children with autism. I have been implementing this approach for over 15 years and will support its effectiveness with clinical case vignettes. This approach allows the successful integration of the remediation aspects of ABA with interpersonal approaches. It is extremely effective with children with a more severe constellation of symptoms as it remediates in a thorough and global manner. Mentalization based therapy will be used to foster the developmental approach. Mentalization based therapy offers a less structured treatment which more practically allows the integration of these two previously disparate approaches. Additionally mentalization allows parents and practitioners to better understand the inner world of the child. In this sense the heterogeneneity of each child is considered which is paramount to designing a successful intervention.
An Investigation of the Psychological Processes Involved in Juror Rehabilitation
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Judges often attempt to rehabilitate jurors who express an inability to be fair during voir dire. The present research examined psychological mechanisms operating during juror rehabilitation. Study One investigated whether the influence of rehabilitative questioning on juror judgments observed in previous research is attributable to informational or normative influence from the judge. I manipulated the presence of two components of rehabilitation (i.e., legal instruction and elicitation of a commitment to forgo bias) within a mock voir dire. I also varied evidence strength to assess whether rehabilitative questioning improves the quality of jurors' judgments. Jurors watched a trial and rendered a verdict. Rehabilitative instructions reduced the number of guilty verdicts for biased and unbiased participants. Rehabilitation did not increase jurors' sensitivity to evidence strength. Study Two tested the hypothesis that traditional suppression rehabilitation will lead to increased accessibility of PTP under conditions of cognitive load. I manipulated exposure to PTP and the type of rehabilitation questioning received (i.e., no rehabilitation, rehabilitation framed in terms of suppression, rehabilitation framed in terms of concentration). Efforts were taken to induce a state of cognitive busyness in all participants while they watched the trial; after the trial participants deliberated to a verdict. Exposure to PTP increased the likelihood that participants would vote guilty. In the no rehabilitation and concentration conditions, participants who read PTP perceived the defendant as more guilty than did participants who did not view PTP. However, in the suppression rehabilitation condition, participants who read PTP perceived the defendant as less guilty than did participants who did not read PTP. Rehabilitative instructions and suppression rehabilitation resulted in more lenient judgments than the no-rehabilitation control, suggesting that participants were not well calibrated to the magnitude of their bias, and when prompted to be unbiased, overcorrected in the opposite direction. Although rehabilitated jurors may be motivated to correct for bias, they appear to have difficulty estimating the degree to which biases influence their judgments. It is possible that jurors may be better able to assess the presence of and correct for a biasing influence if it is discrete rather than attitudinal in nature.
The Relationship Specificity of the Reflective Function: An Empirical Investigation
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The present study examines the stability of the Reflective Function (RF) across relationship contexts by testing the correlation between mothers' RF in discussing their children/parenthood and their RF in discussing their parents/childhood. It was hypothesized that RF would be stable across these contexts as evidenced by a positive, significant correlation between RF scores on separate interviews that focus on parenthood and childhood in detail. Subjects were 40 first-time mothers between the ages of 25 and 40, all of whom were middle-class and in stable, cohabiting relationships at the time of the study. They were interviewed using the Adult Attachment Interview (George, Kaplan, & Main, 1996) while in the third trimester of pregnancy, and with the Parent Development Interview (Slade, Aber, Bresgi, Berger & Kaplan, 2003) when their children were 10 months old. The Reflective Function Manual for Application to Adult Attachment Interviews (Fonagy, Steele, Steele, & Target, 1998) was used to determine the level of RF regarding childhood, and the Addendum to the Reflective Function Manual for use with the Parent Development Interview (Slade, Bernbach, Grienenberger, Levy, & Locker, 1999) was used to determine the level of RF regarding parenthood. Results supported the study's hypothesis: There was a highly significant, positive correlation between RF scores across the two interviews. These results are discussed in terms of their implications for attachment theory, the theory of mentalization and affect regulation, psychoanalysis, and clinical treatment. In order to form hypotheses about the potential sources of unstable RF, qualitative analyses are performed on two subjects with significantly discrepant scores across interviews.
THE DIFFERENT MEANINGS OF HOME FOR RESIDENTS AND PROFESSIONALS IN THE PLANNING AND DESIGN OF SOCIAL HOUSING IN COLOMBIA
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This dissertation compares and contrasts the perspectives of residents and housing related professionals involved in a social housing program in Bogotá, Colombia to offer an in-depth understanding of how different meanings of `home' influence the production and consumption of housing. It is based on the crucial need for architects, planners, and housing policy-makers to better understand the experiences of residents in the housing that they help to create. This study focuses on two of Metrovivienda's master-planned communities and illustrates the multiple perspectives of residents and housing related professionals through the rubric of an "emerging housing practice" (Ferguson & Navarrete, 2003). This practice encompasses four dimensions of what it means to create and live in these new communities: the meanings of homeownership, experiences in formal urbanizing spaces, misunderstandings and problems that arise from living under a `new' horizontal property scheme, and strained attempts at ameliorating housing complex convivencia (mutual co-existence) issues via housing governance. This exploration of people's meanings also reveals an underlying story of how these dimensions function as both city-building and citizenship-building projects of the state. The dissertation concludes with the argument that social housing is designed by the state to contribute to its citizenship goals of fostering convivencia. It does this through the horizontal property law and systems of local governance that are new and unexpected by the residents. The study builds on interdisciplinary literature from environmental psychology and the social sciences, together with architecture and urban planning theory. It adopts a narrative inquiry approach in order to provide a complementary perspective to the largely quantitative field of housing studies. Specifically, data are comprised of 24 in-depth narrative interviews of residents and professionals, additional informal interviews with professionals, participant-observation field notes, a discussion group, and document research. Fieldwork was conducted in 2010 and 2011. The findings have direct implications in Colombia, as this model of social housing is currently being expanded by national and local governmental initiatives.