Alumni Dissertations

 

Alumni Dissertations

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  • The relationship between reflective functioning and severity of agoraphobia in the outcome of a psychoanalytic psychotherapy for panic disorder

    Author:
    Elizabeth Graf
    Year of Dissertation:
    2009
    Program:
    Psychology
    Advisor:
    Diana Diamond
    Abstract:

    This study examined the relationship between reflective functioning and severity of agoraphobia in the context of an outcome study investigating psychoanalytic psychotherapy for panic disorder. The DSM-IV identifies two subtypes of Panic Disorder: Panic Disorder with and without agoraphobia. The agoraphobic syndrome is associated with the most impaired end of the diagnostic continuum, the poorest prognosis, and lower response rates to existing efficacious treatment. A better understanding of the patients who develop severe agoraphobia is important in guiding interventions. This study involved secondary data analysis drawn from two studies. In the first, Milrod et al. conducted a randomized controlled trial of Panic Focused Psychodynamic Psychotherapy (PFPP) v. Applied Relaxation Therapy (ART) for panic disorder. As part of this larger project, Rudden et al. conducted a pilot study of reflective functioning (RF) in patients enrolled in the Milrod's study. The Reflective Functioning Scale is a validated measure of individuals' abilities to understand mental states in themselves and other people and to link mental states to behavior and symptoms. Impairments in reflective functioning have been associated with a range of psychiatric disturbances, and studies have demonstrated that improvements in RF are related to response to psychotherapy in patients with borderline personality disorder. For this reason, an investigation of the relationship between severe agoraphobia and reflective functioning is an important next step in better understanding this group of patients. The study participants were 30 patients with panic disorder with or without agoraphobia who completed both studies. This project determined that reflective functioning is not related to severity of agoraphobia. Rather, within this population, there is a large range of RF, suggesting that this is a heterogeneous group. As a secondary aim, this study investigated whether baseline panic specific reflective functioning (PSRF) is associated with poorer response to PFPP and ART. While PSRF did not moderate outcome, this study found that patients with severe levels of agoraphobia did significantly better in PFPP than in ART, the first time a psychodynamic treatment has demonstrated effectiveness in treating agoraphobia.

  • Does cross-examination help jurors detect deception?

    Author:
    Sarah Greathouse
    Year of Dissertation:
    2009
    Program:
    Psychology
    Advisor:
    Margaret Bull Kovera
    Abstract:

    Both the Constitution and case law establish cross-examination as a crucial method for eliciting testimony that will assist fact finders in determining the truthfulness of a witness's testimony. Despite the legal system's faith in the efficacy of cross-examination as a safeguard against deceptive witnesses, no studies have tested the assumption that cross-examination will help jurors discriminate between truthful and false testimony. The cross-examination strategies that trial technique manuals advocate are based on commonsense notions of human behavior, but these strategies have not been empirically tested to determine if they help jurors accurately discriminate between truthful and lying witnesses. Although traditional cross-examination techniques have not been empirically studied, psychological research has identified specific strategies that improve laypeople's ability to detect deception when viewing an interrogation of a suspect. The present research examined the effectiveness of currently employed cross-examination techniques in determining the truthfulness of a witness's testimony. In addition, the traditional cross-examination techniques were tested against cross-examination strategies that were based on techniques derived from the deception detection literature. In the first phase, 106 participants either witnessed a confederate steal a wallet or they were not exposed to the theft. In phase II of the experiment, I manipulated participants' motivation to either lie or tell the truth about what they saw. Witnesses' direct and cross-examinations were videotaped in a mock courtroom, and witnesses either underwent a traditional cross-examination, a cross-examination based on deception detection research, or no cross examination. In phase III of the study each of the witnesses' examinations were edited into the larger context of a theft trial. Mock jurors viewed the trial and provided veracity judgments for each of the witnesses and rendered a verdict. Although behavioral differences were observed between deceptive witnesses who underwent a research based cross-examination and deceptive witnesses who underwent a traditional cross-examination, cross-examination type did not influence jurors' evaluations of witness truthfulness. Implications for the legal systems and future research directions are discussed.

  • The Situated and Dialogical 'Nature' of (In)Competence: A Socio-Cultural Approach to Informed Consent Treatment Decision-Making Competence in Adults Diagnosed with Intellectual Disability

    Author:
    Lisa Greco-Joseph
    Year of Dissertation:
    2013
    Program:
    Psychology
    Advisor:
    Joseph Glick
    Abstract:

    The Situated and Dialogical 'Nature' of (In)Competence: A Socio-Cultural Approach to Informed Consent Treatment Decision-Making Competence in Adults Diagnosed with Intellectual Disability Assessment of treatment decision-making competence emerges in situations where incompetence is suspected, for example in situations involving adults diagnosed with intellectual disability. Competence Judgments have traditionally been considered a matter of individual intellect. Alternatively, a developmental perspective based within a socio-cultural framework considers competence an interactional process and a matter of dialogical self-other encounters where information is exchanged and perspective taking where the point of view of the 'other' is legitimized as being worthy of consideration. This qualtiative study examined reports of self-other encounters by adults diagnosed with intellectual disability placed in residential agencies and the employees of those agencies. Encompassing a variety of perspectives 44 individuals acros three non profit agencies within New York State participated. Interviews were used to elicit accounts of self-other encounters from 29 adults diagnosed with intellectual disability and 19 employees across a range of positions from direct-care to upper management. Findings revealed that accountability issues were particularly salient for employees with and across agencies tailoring policies, practices and type of encounters with the adults placed. Employee encounters with placed adults were characterized by monological relations; constraining access to necessary social knowledge and information required to demonstrate competence. Autonomy relating to treatment decisions hinged on employee and professional's judgment of placed adults as 'kinds of persons'--competent or incompetent. Incompetence frequently emerged based on their 'placed status' positioning them 'recipients of' rather than 'agents for' services and treatments. Accordingly, many placed adults perceived medical and mental health services and treatments as devoid of choice. Responses to a standardized capacity assessment instrument employing vignettes evidenced their knowledge of the distance between their actual experiences and 'ideal forms' hypothetically constructed. Shifts in judgments allowing them greater autonomy occurred when they articulated legitimate forms of social knowledge in self-other encounters; often not predicted by IQ scores or assessment outcomes. Accessing these legitimate forms came from sources primarily outside of the agencies--through self-other encounters involving dialogical relations (e.g. with pharmacists) or accessing 'tools' self-appropriated through available technology (e.g. Television commercials, computers). Including the perspective and knowledge of adults diagnosed with intellectual disability these findings demonstrate that from an agency point of view, in the context of accountability, incompetence is the default and 'safe' position. Shifting this view rests on increasing inclusive practices--encouraging dialogical relations in self-other encounters between adults diagnosed with intellectual disability and the professionals providing services to them, through which knowledge and information is made accessible. Implications of these findings impact law and policy regarding competency evaluations, guardianship, and rights as these pertain to adults diagnosed with intellectual disability.

  • FATHER ABSENCE, THE MYTHICAL FATHER, AND THEIR INFLUENCE ON AFFECT MATURITY

    Author:
    Daniel Greenspun
    Year of Dissertation:
    2011
    Program:
    Psychology
    Advisor:
    Steven Tuber
    Abstract:

    This study investigates the influence of father absence on a son's ability to experience emotion in mature, differentiated ways--to show affect maturity. According to Anne Thompson (1986), affect maturity "determines how an individual will experience and cope with his or her feelings" (p. 212). This, according to Thompson (1986), has consequences for tolerating negative affects, reflecting on possible decisions instead of acting impulsively, and reality testing one's emotions. This study was founded upon the notion that the father, whether present or not, is internalized by his son and therefore plays an essential role in identity formation and the regulation of intense affect. Consequently, it was hypothesized that a father's absence would have deleterious affects on his son's attainment of these developmental milestones, and affect maturity. Interviews of young men who responded to Thematic Apperception Test (TAT) cards were quantitatively analyzed using Thompson's (1986) Affect Maturity Scale (which measures affect from the most primitive to the most mature). Additionally, subjects' responses to the TAT, and to questions about their early relational experience with their fathers, were qualitatively analyzed to help understand the father's role in shaping their son's internal world. Contrary to what was predicted, affect maturity scores of young men with regular father contact growing up were significantly lower than those with no father contact growing up. Furthermore, neither subset experienced a loving, nurturing, and supportive father--a good enough father--who could be internalized and then serve as an identification figure and to regulate emotion. However, those with regular father contact appeared to be additionally impaired by the consistently problematic interaction with their father. In this regard, this study's results suggest that it is not simply the father's presence or absence that impacts affect maturity, but the quality of the relationship. Similarly, they suggest that consistent interaction with a benevolent, nurturing father is an important variable in determining a son's affect maturity. The lack of a group in this study with positive father-son interactions, and the possible influence of social class, poverty, and peer groups on the findings limit the certainty that results are due solely to absence of a good-enough father. Nevertheless, the notion that a benevolent and nurturing father is important for healthy development is consistent with existing research and theory and has wide-ranging implications for clinical practice.

  • THE ROLE OF CLOCK AND MEMORY PROCESSES IN THE TIMING OF FEAR CUES IN HUMANS

    Author:
    Erich Grommet
    Year of Dissertation:
    2013
    Program:
    Psychology
    Advisor:
    Bruce Brown
    Abstract:

    Recent research on the effects of fear on timing has focused on two accounts proposed by Scalar Expectancy Theory (Church, 1984; Gibbon, 1977) for why the durations of fear stimuli are overestimated in comparison to the durations of neutral stimuli. One possibility is that fear serves as an arouser that increases the speed of a hypothetical internal clock. In this account, greater temporal overestimation of fear relative to neutral stimuli is predicted for longer stimulus durations relative to shorter stimulus durations. The other account is that fear increases attention to time, which results in organisms beginning to time fear-evoking stimuli sooner than they do neutral stimuli. In this possibility, the effect of fear does not interact with stimulus duration. Experiment 1 asked which of these two possibilities was the underlying mechanism of temporal overestimation of fear cues by manipulating emotion-evoking pictures (fear-evoking vs. neutral) across multiple duration ranges in the temporal bisection task. Larger effects of fear were observed at the longest duration range in comparison to the shortest duration range, supporting the arousal hypothesis. A related area that has been left relatively unexplored is the role that reference memory may play in the temporal overestimation of fear-evoking stimuli. Penney, Gibbon, and Meck's (2000) memory mixing hypothesis proposes that overestimation is only possible in preparations that allow for recalled reference memories for stimulus durations to be mixed across conditions. Therefore, in the second experiment, we manipulated whether or not fear and neutral cues were presented within the same session, a condition that may be necessary for memory mixing to occur. Fear cues were overestimated relative to neutral cues within the session in which fear and neutral cues were both presented, but no effect of emotion was observed between the two sessions in which fear and neutral cues were presented separately.

  • Unexpected Work Intrusions into Employees' Personal Lives: Investigation, Measure Development, and Exploration of Causes and Consequences

    Author:
    Angela Grotto
    Year of Dissertation:
    2013
    Program:
    Psychology
    Advisor:
    Karen Lyness
    Abstract:

    The present research explored unplanned work performed during employees' nonwork hours in response to unexpected work intrusions. Three studies were conducted to achieve four goals: 1) better understand the nature of switching from nonwork roles to the work role in response to work intrusions during nonwork hours, 2) help distinguish unplanned role switching from planned role transitions (e.g., bringing work home), 3) develop and validate new episodic measures of work intrusions and three aspects of unplanned nonwork-to-work role switching (frequency, mental difficulty, and physical effort), and 4) begin developing a nomological net of antecedent and outcomes variables surrounding the construct. In Study 1 I conducted employee interviews using the critical incident technique to clarify the nature of unplanned role switching and how it differs from planned role transitions. Analysis of rich qualitative data revealed important characteristics of unplanned role switching that help differentiate it from planned role transitions. The qualitative data also helped in developing episodic measures of work intrusions and unplanned role switching. In Study 2, the new measures were refined based on feedback from subject matters experts and interviewees from Study 1. Study 3 was a repeated measures design in which the refined measures from Study 2 were administered during a 10-day daily study period to assess employees' responses to discrete work intrusions during a typical workweek. Antecedents (individual differences and job characteristics) and outcomes (work interference with nonwork, burnout, and poor physical health symptoms) were examined using HLM. Results indicated that the antecedents differed for the three aspects of unplanned role switching. However, exploratory results demonstrated the importance of work intrusion characteristics in predicting all three aspects of unplanned role switching. Additionally, Study 3 results underscored the importance of examining intrusions and unplanned role switching, as both were related to negative employee outcomes, such as poor physical healthy symptoms. Also, the outcomes differed for the three aspects of unplanned role switching, indicating that it is a complex construct with distinct psychological and physical processes. The theoretical and practical implications of these findings are discussed, as well as ideas for future research.

  • Neuropsychological and Neuropsychiatric Prediction of Cognitive Functioning and Cognitive Decline: A Cross-Cultural Perspective

    Author:
    Elizabeth Guerrero Berroa
    Year of Dissertation:
    2011
    Program:
    Psychology
    Advisor:
    Alan Kluger
    Abstract:

    The goal of this study was to examine whether seven neuropsychological tests and three depression measures were associated with cognitive functioning among Hispanic elderly, and to assess whether they operated differently for Hispanic and White ethnic groups. Participants were 89 community-dwelling elderly Hispanics and 89 Whites matched on clinical and demographic characteristics, all followed longitudinally at the NYU Alzheimer's Disease Center (NYUADC). Their cognitive functioning ranged from normal to moderate dementia. Although a large proportion of the measures evidenced an association with cognitive status, hierarchical regression analyses showed that the initial recall of the NYU-Paragraph Test and the Retardation measure (especially for Spanish-speaking Hispanics), as well as WAIS-Digit Symbol (especially for English-speaking Hispanics) were most strongly associated with cognitive status after controlling for demographic and other cognitive measures. Retardation (for the entire Hispanic group) and the total score of the Hamilton Depression Rating Scale (HDRS; for the entire White group) differentiated between normal cognition and Mild Cognitive Impairment (MCI). For the full range of cognitive status, the combined predictive usefulness of the 10 measures differed significantly between Hispanics and Whites; this difference was especially driven by the Retardation measure. For nondemented participants, only the depression measures predicted differently between the two ethnic groups. When the analyses examined the primary language of the participants, the predictive usefulness of neuropsychological and depression measures differed between Spanish-speaking Hispanics and their matched Whites, but no differences were found between English-speaking Hispanics and their White counterparts. Subsequent analyses showed that, for Hispanics, the usefulness of the 21-item HDRS-total score reflected the contributions of Work and Activities and Retardation, but not the other 19 items. The WAIS-Digit Symbol lacked specificity for Spanish-speaking Hispanics. Preliminary longitudinal analysis showed that the delayed recall of the NYU-Paragraph Test predicted cognitive decline among Spanish-speaking Hispanics. These results suggest that the NYU-Paragraph Test and Retardation may improve diagnostic accuracy and prediction of decline among Spanish-speaking Hispanics.

  • Repetition: From Compulsion to Structure

    Author:
    Sibel Halfon
    Year of Dissertation:
    2012
    Program:
    Psychology
    Advisor:
    Lissa Weinstein
    Abstract:

    This work studied the different functions of repetition in the course of a long-term psychoanalysis. In empirical psychoanalytic research, repetition has been viewed as a maladaptive behavioral structure or speech disfluency. However, it was argued that repetition is a unique function of the mind that has various uses. Repetition can manifest as dominance of inertia; it can also be associated with traumatic anxiety and help develop a structure to alleviate the impact of trauma. In addition, some repetitions are in the service of difference where they modify and enrich the psyche. In an effort to study the linguistic expressions of these different kinds of repetitive phenomena, this study identified the patient's use of fixed repetitions, where the same words were used over and over again to narrate an experience. It was proposed that an increase in the use of such fixed repetitions would point to an inability to create new meaning. In contrast, when the patient is able to reach an evocative, vivid and specific representation, the use of fixed repetitions was expected to decrease. A further goal of the study was to explore the relationship between repetition and defensive processes. It was expected that an increase in the use of fixed repetitions bespeaks of a failure in defensive strategies. With these multiple objectives in mind, the transcripts of ten audio-taped psychoanalytic sessions were coded for the exact repetition of verbs. The language of verbs was expected to capture repetitions used with intention. Computerized linguistic measures of referential activity, which is a measure of imagistic language, as well as computerized linguistic measures of intellectualization and negation were used in order to capture patient's representational language and defensive processes. As expected, the results showed a general negative correlation between fixed repetitions and representational speech. No consistent pattern was found between repetition and the measured defensive processes. The results were discussed through a clinical qualitative analysis. The study marked repetition as a significant measure that is able differentiate between sessions in terms of their affective and symbolic qualities.

  • Mindfulness Based Stress Reduction in Couples Facing Multiple Sclerosis: Impact on Self Reported Anxiety and Uncertainty

    Author:
    Vered Hankin
    Year of Dissertation:
    2009
    Program:
    Psychology
    Advisor:
    Arietta Slade
    Abstract:

    Nearly 2.5 million people in the world have MS (The Multiple Sclerosis International Federation, 2007). MS is an auto-immune disorder, involving the white matter of the brain and spinal cord. Symptoms vary and can come and go, appear in any combination, and may be mild, moderate, or severe. The prognosis and time-course of the disease is often unclear. The disease can create a great deal of uncertainty, particularly in newly diagnosed patients (Noseworthy et al., 2000). Approximately 50% of patients and partners showed significant levels of either anxiety or distress (Pakenham, 1998). Additionally, patients who reported their spouses to be more encouraging have been shown to be significantly less depressed (Schwartz & Kraft, 1996). Thus, couples "react to disease as a unit" (Pakenham, 1998, p. 269). Rolland (1985) concurs that "the well spouse faces many of the same dilemmas" (p. 240). Mindfulness Based Stress Reduction (MBSR), an eight-week course incorporating yoga, meditation, and mind-body awareness, is a skills training technique which has successfully combated many physical and emotional ailments. This study evaluated the effect of MBSR on the uncertainty and resulting anxiety of each partner, as well as on the relationship. Twenty-five couples were recruited into two MBSR groups, with one couple partner diagnosed with Relapse-Remitting MS. Quantitative self report measures assess physical symptoms, anxiety, relationship satisfaction, perceived illness uncertainty, and intolerance of uncertainty. Data was collected before and immediately after the intervention. Results indicated a positive change in patient and partners levels of anxiety and uncertainty as well as in their relationship satisfaction. Results from this study contribute to the field of available interventions for couples dealing with chronic illness, and specifically MS. Additionally, it illuminates an important and yet undiscovered element of mindfulness meditation as a tool in coping with family illness.

  • The Relationship of Impulsive and Dysregulated Behaviors to Substance Use

    Author:
    Seth Harty
    Year of Dissertation:
    2011
    Program:
    Psychology
    Advisor:
    Jeffrey Halperin
    Abstract:

    Longitudinal studies indicate that individuals diagnosed with attention-deficit/hyperactivity disorder (ADHD) exhibit elevated rates of substance use and substance use disorders (SUDs). The development of substance use in individuals with ADHD has been found to be largely impacted by the presence of comorbid conduct disorder (CD). Several studies have shown an association between ADHD and increased substance use over the risk posed by CD whereas others have suggested that CD mediates the relationship between ADHD and later substance misuse. The diagnostic criteria for CD, ADHD, and SUD are notable for the presence of impulsive behaviors. One of the most robust predictors of maladaptive substance use is a persistent pattern of impulsive behavior. This series of studies investigated the relationship between substance use and impulsive behavior using animal models of impulsivity and longitudinal studies of youth with ADHD. Study I employed animals and measured the degree to which impulsive behavior was impacted after chronic drug (heroin) administration. Studies II and III characterized substance use outcomes as a function of impulsive and dysregulated behaviors and psychostimulant treatment in a large sample of ethnically diverse, lower SES urban youth diagnosed with ADHD. Study II examined late adolescent substance use outcomes in relation to childhood CD and psychostimulant treatment in youth diagnosed with ADHD in childhood and Study III examined the degree to which ratings of aggression, delinquency and attention are differentially related to adolescent substance use outcomes. These results further clarify the relations between impulsive behaviors and maladaptive substance use. Study I did not provide support for the idea that impulsivity is caused by drug use. Study II reported robust findings indicating that dysregulated behaviors associated with childhood diagnoses of CD, and not ADHD, portend both greater substance use severity and impairment. Further, a diagnosis of CD is characterized by both delinquent and aggressive behaviors and Study III provided evidence that delinquency is the most robust predictor of adolescent substance use outcome. These findings have important implications regarding delinquent behaviors and substance use outcomes. Identifying impulsive behaviors related to the delinquency may be a focus of continued efforts in the areas of preventative treatments.