Clinical Psychology Literature Research Articles

1 Neuropsychological Assessment with Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ+) Individuals: Results from a Practice, Education, and Training Survey

Objective:The field of clinical neuropsychology has increasingly recognized the importance of cultural and identity factors through the development of clinical, research, and educational initiatives. Only within the last 10 years have guidelines for psychological practice with lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people included recommendations for neuropsychological assessment. However, it remains unclear to what extent neuropsychologists have acquired the knowledge and skills necessary to implement these recommendations. It is also unknown whether they engage in LGBTQ+ inclusive neuropsychological assessment. In this study, we surveyed the LGBTQ+ related education, training, and clinical practice of independently licensed neuropsychologists in the United States. We sought to understand the implementation of inclusive guidelines, including factors that predict affirmative neuropsychological assessment. We hypothesized that sexual/gender identities, female identity, recency of training, and LGBTQ+ related education would be associated with use of recommended practices.Participants and Methods:A workgroup of clinical psychologists with experience in LGBTQ+ psychology and neuropsychology developed a survey to identify personal and professional factors that predict LGBTQ+ affirmative neuropsychological assessment practices. The survey was distributed through professional organizations and listservs between August and September 2021 with 118 responses meeting inclusionary criteria. We used logistic, multinomial logistic, and ordinal logit regressions to examine unadjusted, univariate effects. Predictors included in the final, adjusted, univariate and multivariate models were those for which we had specific hypotheses and variables that predicted more than two affirming practice behaviors.Results:The majority of participants identified as heterosexual (70.3%), cisgender (97.5%), and female (66.1%). Participants reported obtaining their highest degree between 1977 and 2019. Most obtained a Ph.D. (73.7%), were not board-certified (69.5%), and worked primarily with adults (54.2%). Generally, participants reported having little experience working with LGBTQ+ patients. However, they reported greater exposure to lesbian, gay, and bisexual identities as compared to transgender and queer identities. Most (48-63%) received LGBTQ+ training post-licensure. Between 19% and 32% of participants reported never completing LGBTQ+ specific education. Participants described using affirmative clinical practice behaviors either “always/often” or “never/rarely.” Factors predicting those practice behaviors were LGBTQ+ education/training, prior experience with LGBTQ+ patients, primary patient population (child vs. adult), and personal background (sexual minority status, female gender, and years since degree). When in need of consultation, the current sample consulted with their colleagues most often (n = 95) followed by academic literature (n = 90) and professional organizations (n = 80). Qualitative responses indicated varying attitudes and knowledge regarding collection of LGBTQ+ information and modification of clinical practice.Conclusions:Consistent with the broader clinical psychology literature, neuropsychologists have limited education/training on LGBTQ+ concepts. Neuropsychologists underutilize affirming practices as evidenced by low rates of querying pronouns, knowing whether LGBTQ+ health information is available at their institutions, and adjusting evaluation and feedback approaches. Our findings imply a great need to expand continuing education trainings to address providers’ gaps and limitations, including opportunities for inclusive neuropsychological services throughout the assessment process (interview, testing, feedback). We present additional recommendations for future research as well as resources.

Need for emotional closure scale: Testing for measurement invariance in Turkish and English versions

Emotional closure is a feeling of subjective completeness of a past event evoking feelings of closure as opposed to openness. People might differ in need for emotional closure over past open experiences. In the current two studies, we aimed to create a valid scale to measure this need as a personality tendency. We asked participants (N = 265, N = 207, respectively) to fill out the constructed need for emotional closure scale in Turkish (Study-1) and in English (Study-2). Additionally, participants filled out the intolerance to uncertainty, ruminative responses, and need for cognitive closure scales in random order. We conducted a series of exploratory factor analyses in the Turkish version, which revealed four factors: Emotional disturbance, interpersonal discussions, bother, and regret. In Study-2, multi-group confirmatory factor analysis of the English adaptation showed an adequate fit. A measurement-invariant English version was created with high internal reliability and convergent validity. We discuss these findings concerning the importance of this tendency, why it can be a helpful measurement, and possible implications for clinical psychology literature.

Smartphone addiction and phubbing behavior among university students: A moderated mediation model by fear of missing out, social comparison, and loneliness.

This article examines mediators and moderators that may explain the link between smartphone addiction and phubbing behavior using a sample of 794 university students. A mediation model was tested to test the hypothesis that social comparison orientation and fear of missing out would mediate the link between smartphone addiction and phubbing behavior. Additionally, a moderated mediation model was leveraged to examine loneliness as a moderator within the hypothesized model. The data collected were analyzed using SPSS. The findings show a significant positive relationship between smartphone addiction and phubbing behavior. The findings confirm the hypothesized associations and reveal that smartphone addiction is positively linked to phubbing behavior. The link, on the other hand, is partially and sequentially mediated by the fear of missing out and social comparison orientation. As a result, both mediators might be regarded as proximal variables of phubbing behavior. Moreover, the associations between both smart addiction and phubbing behaviors as well as social comparison orientation and phubbing behaviors are moderated by loneliness. These two effects were stronger for university students with high loneliness than for those with low loneliness. This study addresses a major gap in the clinical psychology literature through the attempt to explore the relationship between smartphone addiction and increased phubbing behavior among university students.

I’m Doing it Right, Right? Reassurance-Seeking in the Workplace: Employees with OCD

Despite the breadth of literature in clinical psychology, obsessive-compulsive disorder (OCD) and reassurance-seeking behaviors remained unexamined in workplace contexts. This is a critical omission considering OCD symptomatology spans contexts and reassurance-seeking is the most common interpersonal manifestation. The general population is also likely to engage in reassurance-seeking. The present research examined antecedents and consequences of reassurance-seeking using purposive sampling of people with OCD. We leveraged archival data from online forums where participants built upon the responses of one another’s ideas. We collected 53 comments from 20 different forums using web-based data extraction in R in which authors discussed their experiences with OCD and reassurance-seeking at work. Three coders completed thematic analysis to determine antecedents and consequences of reassurance-seeking behavior at work. Our findings suggest that lack of clarity and poor communication are prevalent antecedents of reassurance-seeking behavior in the workplace. Further, lower perceptions of competence, increased turnover, and worsening OCD symptoms were pervasive consequences of workplace reassurance-seeking for people with OCD. The findings illustrate a strong connection between the antecedents and consequences of reassurance-seeking, such that actions to improve task clarity, workplace communication, and positive reinforcement could have a vast positive impact on employee performance, burnout/turnover, and OCD symptoms.

The benefits of positive affect? Dysregulated positive activation in the workplace as a function of emotional intelligence

ABSTRACT The positive psychology literature has suggested that states of positive activation (high arousal positive affect) are broadly beneficial, but the clinical psychology literature has highlighted phenomena counter to this idea. By aligning a dual process model of self-regulation with functions ascribed to emotional intelligence, the present investigation pursued the premise that the behavioral tendencies elicited by positive activation are likely to vary – and perhaps qualitatively so – by variations in ability-related emotional intelligence (ability EI). In two studies (total N = 248), employees characterized their levels of positive activation in the workplace and reported on their tendencies toward counterproductive work behavior (e.g., theft). In both studies, affect/behavior relationships varied by emotional intelligence, such that states of positive activation precipitated counterproductive behaviors, but only at low levels of ability EI. The findings highlight a critical role for ability-related emotional intelligence in understanding reflexive behavioral responses to positive activation states.

Using robots at work during the COVID‐19 crisis evokes passion decay: Evidence from field and experimental studies

The growing trend of introducing robots into employees' work lives has become increasingly salient during the global COVID‐19 pandemic. In light of this pandemic, it is likely that organisational decision‐makers are seeing value in coupling employees with robots for both efficiency‐ and health‐related reasons. An unintended consequence of this coupling, however, may be an increased level of work routinisation and standardisation. We draw primarily from the model of passion decay from the relationship and clinical psychology literature to develop theory and test a model arguing that passion decays as employees increasingly interact with robots for their work activities. We demonstrate that this passion decay leads to an increase of withdrawal behaviour from both the domains of work and family. Drawing further from the model of passion decay, we reveal that employees higher in openness to experience are less likely to suffer from passion decay upon more frequent interactions with robots in the course of work. Across a multi‐source, multi‐wave field study conducted in Hong Kong (Study 1) and a simulation‐based experiment conducted in the United States (Study 2), our hypotheses received support. Theoretical and practical implications are discussed.

Psychometric Properties of the Defense Mechanisms Rating Scales-Self-Report-30 (DMRS-SR-30): Internal Consistency, Validity and Factor Structure

Assessment of defense mechanisms has a longstanding history within the clinical psychology and psychopathology literature. Despite their centrality to clinical practice, there are few self-report measures that assess defenses and, those that do exist, have limitations in addressing individual defenses and levels of defensive functioning. To address this need, we investigated the psychometric properties of the Defense Mechanisms Rating Scale - Self-Report − 30 item (DMRS-SR-30) with a global, community sample of 1,539 participants who responded to an online survey about distress and coping. Exploratory factor analysis found a three-factor model for the DMRS-SR-30 – mature, mental inhibition and avoidance, and immature-depressive. Internal consistency was high for the Overall Defensive Functioning (ODF) and the three extracted factors with coefficient alphas ranging from .75 to .90. Examination of concurrent validity with a commonly used measure of defensive functioning found significant relationships in the predicted directions. The group of immature defenses had the strongest concurrent validity (r = .50). Finally, correlations with external criteria – including psychological distress and adverse childhood experiences – supported the convergent and discriminant validity of the DMRS-SR-30. The three factor structure of the DMRS-SR-30 has good psychometric properties. Limitations and directions for future research, as well as clinical implications, are described.

A Data-Driven Analysis of Sociocultural, Ecological, and Economic Correlates of Depression Across Nations

The prevalence of depression varies widely across nations, but we do not yet understand what underlies this variation. Here we use estimates from the Global Burden of Disease study to analyze the correlates of depression across 195 countries and territories. We begin by identifying potential cross-correlates of depression using past clinical and cultural psychology literature. We then take a data-driven approach to modeling which factors correlate with depression in zero-order analyses, and in a multiple regression model that controls for covariation between factors. Our findings reveal several potential correlates of depression, including cultural individualism, daylight hours, divorce rate, and GDP per capita. Cultural individualism is the only factor that remains significant across all our models, even when adjusting for spatial autocorrelation, mental healthcare workers per capita, multicollinearity, and outliers. These findings shed light on how depression varies around the world, the sociocultural and environmental factors that underlie this variation, and potential future directions for the study of culture and mental illness.

A Behavioral Economic Model of Help-Seeking for Depression.

Findings from the clinical psychology literature indicate that many who experience depression do not seek treatment when needed. This may be due to help-seeking models and interventions failing to account for the behavioral characteristics of depression that affect decision making (e.g., altered sensitivity to punishment and reward). Behavioral economics can provide a framework for studying help-seeking among individuals with depression that explicitly considers such characteristics. In particular, the authors propose that depression influences help-seeking by altering sensitivity to treatment-related gains and losses and to the delays, effort, probabilities, and social distance associated with those gains and losses. Additional biases in decision making (e.g., sunk-cost bias, default bias) are also proposed to be relevant to help-seeking decisions among individuals with depression. Strengths, limitations, and future directions for research using this theoretical framework are discussed. Taken together, a behavioral economic model of help-seeking for depression could assist in identifying those who are at greatest risk of going untreated and in creating more effective help-seeking interventions.

“Give me perfection or nothing!”: The impact of perfectionism on product evaluation as moderated by secrecy effect and name volatility

AbstractWhile perfectionism has been extensively explored in psychiatric and clinical psychology literature, theoretical understanding of the effects of perfectionism on consumers' evaluations of the advocated product is promising but underexplored. Therefore, this research aims to employ cases of perfectionism and secrecy effect to examine whether name volatility can moderate consumers' product evaluations. The experiment was designed to examine the effect of perfectionism on product evaluation by presenting a variety of advertisements that differed in name volatility and secrecy context manipulation. In the experiment, a total of 217 participants were randomly assigned to a 2 (secrecy context: secret vs. non‐secret) × 2 (name volatility: volatile vs. calm) × 2 (perfectionism: self‐oriented vs. socially prescribed) between‐subjects factorial design. Results demonstrated that for consumers who showed variances in the type of perfectionism, advertisements characterized by different secrecy (secret context vs. non‐secret context) and name volatility (volatile vs. calm) will lead to differential product evaluations. This research takes up the call to extend the limited attention given to perfectionism in the domain of marketing. Specifically, this research aims to explore how consumers' perfectionism affects their product evaluations and the moderating effects of secrecy and name volatility.

Let's Talk About Mental Health and Mental Disorders in Elite Sports: A Narrative Review of Theoretical Perspectives.

The objective of this article is to discuss: (a) the various theoretical perspectives on mental health and mental health disorders adopted in sport psychology, and (b) how the adoption of these various theoretical perspectives in studies might impact upon the interpretations and conclusions in research about the mental health of participants in elite sports. Well-being as a target construct, holistic models, the single continuum or stage models, and Keyes' dual-continuum model of mental health are described, together with a sports psychiatric view of mental health. The strengths and limitations of various mental health perspectives are discussed. We conclude that mental health is a complex construct and that the sport psychology literature, much like the clinical psychology literature, has struggled to reach a consensus regarding a definition or a feasible approach to investigating mental health. For the researcher, it becomes important to make explicit the underlying theoretical perspective adopted and the operationalization upon which conclusions about elite athletes' mental health are based so that an increased knowledge base with high scientific credibility can be established and consolidated over time.

THE RELATIONSHIP BETWEEN PSYCHOTHERAPIST’S MORAL DECISIONS AND EMOTIONS, PERSONALITY FEATURES

In clinical psychology literature, the topic of ethical decisions is limited to a couple of descriptive studies, with an exception of a single local study, exploring the conflicting issues that arise despite the existence of a professional moral code. Moreover, these studies investigated only demographic factors such as age, gender, experience etc., as possible correlates of these ethical decisions, but failed to propose consistent and meaningful results. The aim of the present study was to explore the relationship between psychotherapists’ ethical decisions – emotions and personal tendencies. The deontological/utilitarian decision-making tendencies of psychotherapists in psychotherapist moral dilemmas were compared with those of undergraduate psychology students. The relationship between deontological/utilitarian decision-making tendencies and frequently used personality features in international moral psychology studies such as empathic concern, psychopathy, analytical thinking and altruistic utilitarianism was explored as well as the correlation between negative mood of the participants and deontological decision-making tendencies. Regarding both conventional and process dissociation analyses, research results revealed that there wasn’t a significant relationship between mood of the participants in both groups and their deontological/utilitarian decision- making tendencies. Psychotherapists’ deontological decision-making tendency was found to be higher than that of the students. Two groups were not differentiated on the basis of empathic concern but psychology students’ both Machiavellist and antisocial tendencies were higher those the psychotherapists. Furthermore, the results indicated that investigated personality variables were not correlated with utilitarian/deontological decision-making tendencies in general independent of the calculation method used. These results seemed to indicate that the personality features related to moral decisions in these scenarios would be different than those of the classical moral dilemmas and further research is needed to explore these personality features. Key Words: Psychotherapist moral dilemmas, deontology, utilitarianism, process dissociation analysis

Resilience, Psychological Well-being, and Emotional Regulation: A Comparative Study of Military Personnel Vs. Civilian Population

Present research aimed to know the difference between military personnel with endurance training and civilian population (with no endurance training), with respect to resilience, psychological well-being, and emotional regulation. Correlation and comparative design was used for this study. A sample of 180 participants with age range of 20-55 years was taken from different walks of military units and civilian population by using snowball sampling, and purposive sampling strategies respectively. The Adult Resilience Measure (Ungar & Liebenberg, 2011), Oxford Happiness Questionnaire (Hills & Argyle, 2002), and Emotional Regulation Questionnaire (Gross & John, 2003) were used to assess variables. The results indicated that the military personnel with endurance training were significantly higher on psychological well-being than the civilian population (with no endurance training); while, the civilian population was significantly higher on expressive suppression facet of emotional regulation than the military personnel. There was a significant positive relationship of resilience with psychological well-being and emotional regulation in each group. Additionally, resilience predicted psychological well-being and emotional regulation in both groups, after controlling the effect of demographic characteristics. This research gives an insight into resilience, psychological well-being, and emotional regulation in military personnel with endurance training and the civilian populations with no endurance training. This research also adds to the body of literature in counselling and clinical psychology especially, in Pakistani perspective.

HARMFUL ATTRIBUTIONS: THE ROLE OF MIND PERCEPTION.

Drawing from literature in social and clinical psychology, we explore mechanisms associated with the lack of empathy for people who engage in self-injurious behaviors. Using implicit and explicit measures across three samples, we tested whether knowledge of prior self-injury impacts observers' empathy, perceived agency, perspective taking, and willingness to help a target individual. We found in Studies 1-2 that observers report decreased empathy, perceive less agency, and make more dispositional attributions toward a person who engages in deliberate self-injury, compared to accidental injury. Study 3 indicates that observers perceive a target who engaged in deliberate self-injury to have lower agency. Furthermore, when evaluating a target who has been victimized, observers report less empathy, compassion, and likelihood of helping if the target has a history of deliberate self-injury. Perceived agency accounted for decreased empathy, whereas empathy accounted for lower likelihood of helping. Our findings imply that observers may be better able to empathize with people with a history of self-injury if they focus on the agency of the individual and situational causal explanations for the behavior.

The large Type 1 error associated with responder analyses

Background: A trend in the NIBS literature is to assess the efficacy of an intervention using a responder analysis whereby participants are di- or trichotomised in order that they may be classified as either responders or non-responders. Yet, responder analyses in the clinical medicine and psychology literature have been criticised by methodologists. A major criticism has been the susceptibility to false positive (Type I errors).

Advancing the Assessment of Anger in Sports: Gender Differences and STAXI-2 Normative Data for College Athletes

The State Trait Anger Expression Inventory-2 (STAXI-2) is one of the most widely used anger assessments in the clinical psychology literature. It describes multiple facets of anger including: state/trait anger levels, experience of anger, anger expression, and anger control. Prior to this study, normative data was lacking for college athletes. Without normative data established, it was difficult to accurately compare the scores of college athletes to a relevant comparison group, and thus, difficult to effectively assess athletes presenting with anger issues. This study provides normative data for college athletes (N = 534), as well as an examination of anger differences between gender and compared with a “non-specfic adult” population. Male college athletes scores indicated higher anger levels on several scales, demonstrating scores indicative of being more likely to express anger and less likely to manage feeling angry and expressing anger than both the normal population and female college athletes.

It’s Time to Broaden the Replicability Conversation: Thoughts for and From Clinical Psychological Science

Psychology is in the early stages of examining a crisis of replicability stemming from several high-profile failures to replicate studies in experimental psychology. This important conversation has largely been focused on social psychology, with some active participation from cognitive psychology. Nevertheless, several other major domains of psychological science—including clinical science—have remained insulated from this discussion. The goals of this article are to (a) examine why clinical psychology and allied fields, such as counseling and school psychology, have not been central participants in the replicability conversation; (b) review concerns and recommendations that are less (or more) applicable to or appropriate for research in clinical psychology and allied fields; and (c) generate take-home messages for scholars and consumers of the literature in clinical psychology and allied fields, as well as reviewers, editors, and colleagues from other areas of psychological science.

Enjeux et fondements d’une évaluation qualitative des dispositifs de drama-thérapie avec adolescents en structures psychiatriques

BackgroundThis study focuses on the methodology of qualitative evaluation of psychoanalytic therapeutic settings. It aims to elaborate a qualitative evaluation of a drama-therapy setting with teenagers. This method of evaluation of drama-therapy could offer an alternate option to randomized trials. As a matter of fact, randomized trial often generates biases in the collection of the material, especially with teenagers that are not very reliant to treatment and with whom the diagnosis is not steady. Moreover, quantitative researches do not take in account the plurality of dimensions activated by those specific group settings. ObjectiveWhat are the underlying psychological processes involved in drama-therapy sessions with teenagers? This qualitative analysis is fundamental to fully understand the complexity of those settings that mix art and therapy. Qualitative analyses of the health care treatments are important to address the question of the subjectivity of the efficiency of the treatment. Qualitative studies are however complex to conceive. MethodAfter a review of studies on this matter in the drama-therapy and clinical psychology literature, a qualitative method of evaluation of drama-therapy with teenagers is presented. Its underlying theory and protocol are explained. The goal is to create a rating grid of this health care setting. Using grounded method to analyze the clinical material of drama-therapy sessions, the author selected the significant behaviors of a psychological involvement of the teenagers in drama-therapy sessions. ResultsThis evaluation table highlights the signs of a significant psychic functioning of teenagers in this therapeutic setting. Thus, this table offers a picture of the psychological state of the patient at a specific time of his treatment. The comparison of the results to this grid for a patient at different moments of his treatment gives elements to analyze very precisely his evolution. It also gives elements to adjust the therapeutic setting to the needs he shows in sessions. A case study illustrates the findings of this method of qualitative evaluation of drama-therapy with teenagers. ConclusionsThis method offers alternate ways to think the evaluation of health care treatments, adjusting to the complexity of what we are trying to assess. It also gives new perspectives in the training of drama-therapists. Work still has to be put into the construction of this method of evaluation of drama-therapy, in particular a quantitative evaluation of the correlation between the changes of the patients, as it appears on the table and the changes in their general psychological functioning.

Emotion dysregulation: A review of the concept and implications for clinical practice

IntroductionOver the past decade, emotion dysregulation has become a very popular term in the psychiatric and clinical psychology literature and it has been described as a key component in a range of mental disorders. For this reason, it has been recently called the “hallmark of psychopathology” (Beauchaine et al., 2007). However, many issues make this concept controversial.ObjectivesTo explore emotion dysregulation, focusing on problems related to its definition, meanings and role in many psychiatric disorders.AimsTo clarify the psychopathological core of emotion dysregulation and to discuss potential implications for clinical practice.MethodsA literature review was carried out by examining articles published in English between January 2003 and June 2015. A search of the databases PubMed, PsycINFO, Science Direct, Medline, EMBASE and Google Scholar was performed to identify the relevant papers.ResultsAlthough, there is no agreement about the definition of emotion dysregulation, the following five overlapping, not mutually exclusive dimensions were identified: decreased emotional awareness, inadequate emotional reactivity, intense experience and expression of emotions, emotional rigidity and cognitive reappraisal difficulty. These dimensions characterise a number of psychiatric disorders in different proportions, with borderline personality disorder and eating disorders seemingly more affected than other conditions.ConclusionsThis review highlights a discrepancy between the widespread clinical use of emotion dysregulation and inadequate conceptual status of this construct. Better understanding of the various dimensions of emotion dysregulation has implications for treatment. Future research needs to address emotion dysregulation in all its multifaceted complexity.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Applying psychology to understand relationships with technology: from ELIZA to interactive healthcare

ABSTRACTIncreasingly sophisticated interactive devices are being developed to meet the requirements of healthcare services that place greater emphasis on self-management. This article considers the importance of the relationships that users form with technology from the perspective of the human–computer interaction literature and the clinical psychology literature. It is argued that users are often willing to engage in relationships with technology that share many features of relationships between humans. Furthermore, within human-delivered healthcare, the quality of the relationship formed with a clinician predicts the effectiveness of the treatment. Thus, the effectiveness of interactive healthcare technology is, in part, dependent on the relationship the user forms with the technology. Applying psychological theory to the relationship between user and technology provides a way of understanding these human–computer interactions and thus improving the process of developing self-management technology.