Psychology (Functional Area: Clinical Psychology)

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Open Access
A Lonely Time to Live: Assessing the Severity and Chronicity of Loneliness in Emerging Adults
(2024-10-28) Rose, Alison Lesley; Goldberg, Joel
Severe and chronic forms of loneliness are thought to contribute to declines in both mental and physical health. Although the impacts of loneliness are well-established, little is known about the extent to which more severe and chronic forms of loneliness impede on individuals’ functioning and well-being. This oversight is in large part due to the lack of an adequate measure that more fully assesses the severity and chronicity of loneliness. By extension, little is understood about the extent to which severe and chronic forms of loneliness affect emerging adults in general and in challenging times (e.g., during the pandemic). Considering these observations, three multi-method studies were conducted to address this gap in the literature. Study One is a qualitative study conducted during the height of the COVID-19 public health crisis which found that both internal (personal) and external (social and situational) mental health concerns emerged as themes related to the perception and experience of loneliness (N = 37). Study Two (N = 289) and Study Three (N = 371) both involved collecting data from two self-report online surveys during ensuing stages of the pandemic to test the psychometric properties of a newly developed scale (the Severe Enduring Loneliness Factors Questionnaire; SELF) and the extent to which it is predictive of risk and resilience indicators above existing loneliness scales with samples exclusively composed of emerging adults. Overall, findings suggest that it is useful to view and use the measure as two separate subscales that individually evaluate the severity and chronicity of loneliness. As well, the majority of regression analyses showed that both factors of the SELF were either individually or simultaneously predictive, although not uniquely predictive, of the majority of outcomes such as higher levels of depression and shame and lower levels of mattering to others. Notably, an enduring sense of loneliness was uniquely predictive of lower levels of total hope. Study Two compared participants identifying no chronic loneliness (N = 29) with those reporting chronic loneliness to a high degree (N = 84), as well as Study Three (no chronic loneliness, N = 33; high chronic loneliness, N = 125). Both studies found significant, consistent group differences in psychological strengths and vulnerabilities between those reporting an absence versus a heightened level of chronic loneliness. Findings from the present series of studies suggest that the SELF questionnaire shows promise not just in terms of demonstrating sound psychometric properties but also with respect to providing a more comprehensive understanding of the kinds of loneliness that are characterized as more extreme and persistent. The implications of these findings and recommendations for further advancements pertaining to the research and clinical applications of this work are outlined and discussed.
Open Access
A Longitudinal Study of Gaming Patterns during the First Nine Months of the COVID-19 Pandemic
(2022-12-14) Ritchie, Emma Victoria; Keough, Matthew
The current longitudinal study explored the gaming behaviours of Canadians during the COVID-19 pandemic. A total of 332 people (Mean age = 33.79, 60.8% men) who played video games responded to four waves of surveys (spaced 3 months apart) on the crowdsourcing platform Prolific from March 2020 to February 2021. The main outcome of interest was time spent gaming, measured in hours spent gaming in the past 30 days prior to each assessment wave. Latent growth curve modelling showed that participants reported high initial levels of gaming, but progressively declined in gaming activity across the subsequent waves. Several sociodemographic, COVID-19-specific, and gaming-related measures were significant predictors of increased gaming at the outset of the pandemic, but these factors were not related to longer-term declines in gaming during the pandemic. The findings of this study indicate that gaming may have been an adaptive, rather than maladaptive, behaviour during the pandemic.
Open Access
A Mobile-Based Mindfulness Intervention for Chronic Pain
(2018-03-01) Latman, Vered Valeria; Katz, Joel D.
Very little is known about effective interventions for chronic pain in young adults. Available treatments are often inaccessible and unaffordable. The present study tested the effects of a newly developed 12-minute mobile-based mindfulness application on mood, pain intensity and present-awareness in four groups of university students (n=180) with chronic pain, symptoms of depression/anxiety, and condition-free controls with and without a mobile application. Results revealed that anxiety, distress, and anger were significantly reduced post intervention in participants with chronic pain and mood/anxiety symptoms. Pain intensity and present awareness remained unaffected post intervention. This study was one of the first to show the effectiveness of a brief mobile-based intervention in altering unpleasant mood states in young adults with chronic pain and depression/anxiety. These findings have highlighted the potential benefits of using technological interventions to improve mental health symptoms in individuals with chronic pain and symptoms of depression and anxiety.
Open Access
A Narrative Care Intervention to Support the Post-Cancer Treatment Transition from Primary to Follow-up Care: Analysis of Outcomes and Content
(2021-07-06) Ianakieva, Iana Roumenova; Fergus, Karen D.
The needs and ways of supporting individuals during the transitional phase after completion of treatment for primary cancer are less well-studied compared to other phases of the cancer journey. It is important to better understand this transitional juncture as it is one where individuals experience pronounced distress and grapple with various existential concerns. Thus, the current study implemented and evaluated a narrative care-informed intervention, the Narrative Care Interview (NCI), to allow participants to story their experience of being diagnosed with and treated for a primary cancer and to share their outlook on life moving forward. The NCIs goal was to support participants in constructing a cohesive narrative that incorporated their confrontation with cancer into their broader life story, with the intention of aiding adaptation to cancer-related changes. The studys primary objective was to evaluate the NCIs effectiveness and acceptability by assessing whether it led to any changes on various relevant psychosocial variables including resilience, overall affect, quality of life, anxiety and depressive symptoms, self-efficacy, life satisfaction, and perceived personal meaning, and by assessing treatment satisfaction. A secondary objective was to better understand changes in self, life-perspective, and outlook on relationships during the transition following treatment. Twenty-seven adults who had completed treatment for primary cancer within the past two years completed questionnaires assessing the variables listed above and participated in the NCI, and 20 participants completed the post-intervention questionnaires. Results showed a moderate improvement in social wellbeing and a generally favourable review of the NCI. With respect to the secondary objective, a modified grounded theory analysis of interview content led to the development of the core category, Transience as a Catalyst for Change, which consisted of three main categories: Woundedness and Healing; Refining and Solidifying Identity; and Maximizing Time. The core category, or theory of change, represented realizations about the impermanence of life, health, and time, which sparked changes in participants sense of self, life-perspective, and outlook on relationships. Overall, the current study demonstrated the potential utility and benefit of a brief, narrative care-based intervention in providing support to individuals during the uncertain transitional period between primary cancer treatment and follow-up.
Open Access
A Pilot Feasibility Study of an Online Lifestyle Group Intervention for Breast Cancer Survivors: The Healthy Lifestyle Modification After Breast Cancer (HLM-ABC) Program
(2020-11-13) Male, Dana Alexandra; Fergus, Karen D.
Overweight is a common concern for many breast cancer survivors (BCSs), which coincides with serious comorbidities and/or health risks, including diminished quality of life, poorer cancer prognosis and/or increased mortality. Most weight-loss interventions for this population seek to modify either physical activity and/or diet with a focus on weight loss as the primary objective. Such approaches, however, often overlook the importance of psychological well-being as an inextricable part of womens health and overall functioning. This study sought to develop and evaluate a novel group-based lifestyle intervention (Healthy Lifestyle Modification after Breast Cancer; HLM-ABC) to help BCSs make healthy lifestyle changes that extend beyond physical outcomes to include greater behavioural, emotional, and mental well-being. The feasibility, acceptability, and preliminary effectiveness of this intervention was assessed using a single-arm, mixed-method design. Fourteen women participated in the 10-week online intervention and completed various quantitative measures (weight, body mass index, waist circumference, self-efficacy, motivation, intuitive eating habits, physical activity level, quality of life, psychological distress, body image) at baseline, post-treatment, six-month, and 12-month follow-ups. Qualitative data was also obtained at post-treatment via semi-structured interviews and open-ended responses on a treatment satisfaction questionnaire. Given the exploratory nature of this pilot study, the findings were triangulated to generate a comprehensive understanding of participants experience of the HLM-ABC program and its preliminary impact. Results suggest that this intervention is feasible to implement and satisfactory to the recipients. Furthermore, the program demonstrates promise with respect to the potential to help BCSs manage their weight, develop greater intuitive eating practices, move their bodies more and in increasingly satisfying ways, inspire positive shifts in motivation and attitudes toward health behaviour change, and improve their body image. Implications for fostering optimal interpersonal conditions in online psychoeducational groups are discussed, along with the value of incorporating deliberate strategies into health behaviour change interventions that appeal to individuals universal and basic motivations to feel self-governed, efficacious, and connected with others. Finally, a rationale is offered for more widespread adoption of a broad definition of health that emphasizes not only a persons bodily measurements, but also their behaviour, psychosocial well-being, and (often unmodifiable or uncontrollable) context.
Open Access
A Qualitative Analysis of Expressed Needs Early in Experiential Treatment for Depression
(2018-03-01) Ferreira, Natalie Dias; Pos, Alberta E.
A thematic analysis of early expressed needs of 10 (five good and five poor long-term outcome) clients in experiential therapy for depression. The study sought to: (1) establish a need theme structure from the current data set; (2) validate a previously established need theme structure of early expressed needs; (3) explore whether differences emerge in the types of expressed needs between good outcome and poor outcome cases; and, (4) begin exploration of coded depressogenic etiologies. Findings suggest: (1) the previously established need structure was validated by the current need theme structure; (2) good outcome clients express more self-oriented need themes, whereas poor outcome clients express more other-oriented need themes; and, (3) a common need conflict expressed in good outcome clients suggest these clients were willing to explore their experience in therapy in the service of self-growth, whereas poor outcome clients appear to struggle with more complex systemic need conflicts.
Open Access
A Self-Guided E-Learning Program Improves Metamemory Outcomes in Healthy Older Adults: A Randomized Controlled Trial
(2023-12-08) Yusupov, Iris; Rich, Jill Bee
The majority of older adults will experience normal age-related memory changes. Memory programs offer a promising solution to mitigate decline and promote brain health. Memory programs have evolved over time, progressing from single mnemonic techniques to the combination of mnemonics, then to multicomponent programs offering participants a more holistic approach to enhancing their memory and brain health. A large body of literature demonstrates that in-person memory interventions can increase knowledge, support the acquisition of memory strategies, improve metamemory outcomes, and promote healthy lifestyle behaviors among participants. With the advancement of technology and the goal of attaining scalable and accessible solutions, researchers and clinicians are developing online memory programs. Our team developed a self-guided, e-learning program based on the well-validated, in-person Memory and Aging Program®. The objective of this dissertation was to evaluate efficacy of the e-learning program compared to a waitlisted control group through a randomized controlled trial. The trial was registered at clinicaltrials.gov (identifier: NCT03602768). As part of a larger, multi-arm, controlled trial, 115 healthy older adults (ages 60-84, 71% female) were randomized into an intervention or a delayed-start control condition. Team members involved in data collection were masked to participant grouping. Outcome measures were completed by telephone interviews (assessing memory knowledge) and online questionnaires (assessing metamemory and health-promoting lifestyle behaviors) at three time points (pre-program, post-program, and 6- to 8-week follow-up). Reasons for attrition were explored with a brief feedback survey. Improvements over time in memory knowledge, the acquisition of memory strategies and their use in daily life, and memory satisfaction and ability were larger in the group that completed the intervention than the control group. There was no interaction effect for health-promoting lifestyle changes. Attrition was 43%, and the most common participant-reported reasons for attrition included a breakdown in communication, personal circumstances, dissatisfaction with the e-learning program, and technical/instructional issues. Overall, this self-guided, e-learning memory program may be an effective, accessible, flexible, and potentially cost-effective intervention that has the potential to achieve similar metamemory outcomes as the original in-person version in participants that complete the program. This research identified opportunities to design e-learning interventions to better support healthy lifestyle changes and potentially improve participant retention. Findings are discussed in relation to evidence-based practice in psychology.
Open Access
A Task Analysis of Therapeutic Engagement in a Professionally Facilitated Online Intervention for Young Couples Affected By Breast Cancer
(2015-12-16) Roumenova Ianakieva, Iana; Fergus, Karen D.
Engagement in online intervention, defined as the extent to which participants are involved in and attentive to the contents of the intervention, has been shown to predict treatment outcome. Because professional facilitation has been shown to increase intervention participation and effectiveness, the therapeutic alliance that develops between facilitators and participants might be one factor that influences engagement. Thus, in this study a modified task analysis was conducted in order to examine how facilitators develop a therapeutic alliance with participants to increase engagement in an online intervention for couples affected by breast cancer, called Couplelinks. Our findings suggest that engagement promotion involves three meta-processes, designated as ‘friendly and positive yet firm approach,’ ‘inclusive empathic attitude,’ and ‘humanizing the technology,’ as well as various behavioural facilitator interventions. In the process of measuring engagement, we also found that couples could be separated into ‘engagement-types.’ Implications, limitations, and suggestions for future research are discussed.
Open Access
A Three-Factor Model of Personality Predicts Changes in Depression and Subjective Well-Being Following Positive Psychology Interventions
(2018-03-01) Barnes, Caroline Elizabeth; Mongrain, Myriam
These studies investigated a new model of personality and its relationship to positive psychology interventions. Previous theoretical models and research into the structure of personality has seen disagreement concerning the true number of factors at the basis of personality. Furthermore, the link between personality and positive psychology interventions has been unclear. The following studies were undertaken to determine the structure of personality in a Canadian sample (N = 4375 at baseline) and to investigate how these personality factors predict depression, satisfaction with life, and affect following positive psychology interventions. Participants were recruited online and randomly assigned to one of ten exercise conditions which were performed every day for one week. Follow-ups were conducted one, three, and six months later. Using half of the sample (n = 2188), exploratory factor analysis was conducted on a comprehensive battery of personality questionnaires, which included measures of extraversion, neuroticism, conscientiousness, agreeableness, and openness to experience (the five-factor model) in addition to neediness, self-criticism, efficacy, self-esteem, gratitude, self-compassion, and attachment styles. The resulting three-factor model was validated using confirmatory factor analysis with the second half of the sample (n = 2186). The best fitting model for personality involved a three-factor solution interpreted to represent Equanimity, Insecurity, and Agency. The factors were then included in a latent growth curve model to determine how personality interacted with positive psychology interventions to predict depression and subjective well-being, both at baseline and over time. The results support the validity of a three-factor model of personality. In addition, this model proved useful in the study of individual differences in responding to positive psychology interventions. Limitations of this research and future directions are discussed.
Open Access
Abnormal Structural Connectivity Patterns in Large-Scale Brain Networks in Schizophrenia
(2020-05-11) Pinnock, Farena Soshana; Heinrichs, Robert Walter
Background: While cognitive impairment is a core feature of schizophrenia, a minority of patients demonstrate average to superior ability on many standard cognitive measures with no attenuation of the psychotic disease process (Heinrichs et al. 2008; Muharib et al., 2014). The data imply a dissociation of cognitive and psychosis-generating neural mechanisms whereby patients share a disease process that leads to psychosis but vary in terms of the pathophysiology that causes cognitive impairment. Furthermore, current views hold that schizophrenia involves abnormalities in the connectivity of large-scale brain networks [default mode (DMN), salience (SN), central executive (CEN), and social brain (SBN)]. However, these findings may reflect pathophysiology related to both the cognitive and psychotic features of schizophrenia. Therefore, we asked: Are aberrations in cortical thickness and/or structural connectivity within and between networks associated with cognitive impairment and/or the severity of psychotic psychopathology? Method: Structural magnetic resonance (MRI) and diffusion tensor imaging (DTI), cognitive, and clinical data were collected from 121 participants, which include 16 cognitively-intact and 48 cognitively-impaired schizophrenia patients as well as 36 cognitively normal and 21 below-normal controls. Between-group comparisons and region-of-interest analyses of cortical thickness and structural integrity in the DMN, SN, CEN, and SBN were performed on MRI and DTI data. Results: Cognitively normal controls had greater DMN and SN cortical thickness than both cognitively normal and below-normal patients. Structural integrity of the genu of the corpus callosum was significantly different between cognitively normal controls and both patient groups. Superior longitudinal fasciculus connectivity patterns differed between cognitively normal controls and below-normal patients. Lastly, the inferior longitudinal and inferior fronto-occipital fasciculi combined were significantly different between cognitively normal controls and patients. Conclusions: The results suggest that cortical thinning may represent the presence of psychotic psychopathology independent of cognitive impairment. However, tract integrity may index cognitive status, the psychotic disease process, or both. The similarities in white matter integrity associations with cognition among cognitively normal patients and controls suggest shared neurocognitive processes, and the dissimilarities may point to cortical structure aberrations that give rise to psychotic psychopathology. Taken together, this study contributes to the advancement of the literature by providing evidence for dissociable or partially dissociable disease processes in psychotic illness.
Open Access
Accuracy of the Montreal Cognitive Assessment in Detecting Cognitive Impairment Following Stroke
(2018-11-21) Zaidi, Syeda Khush-Bakht; Rich, Jill Bee
Vascular cognitive impairment (VCI) post stroke is frequent, but may go undetected, which highlights the need to better screen cognitive functioning post stroke. We sought to examine the diagnostic accuracy of the Montreal Cognitive Assessment (MoCA), a cognitive screening measure recommended for use with stroke populations. We assessed cognitive status in 161 individuals who were at least 3 months post stroke with a comprehensive battery of neuropsychological measures. We compared diagnostic accuracy using a single cut point compared to two cut points and determined that sensitivity and specificity were optimal when two cut points were applied. This resulted in three groups, where 27% of participants scored 23 and were classified as high likelihood of cognitive impairment, and 25% of participants scored 28 and were classified as low likelihood of cognitive impairment. The remaining 47% of participants scored from 24 to 27 and were classified as indeterminate likelihood of cognitive impairment. The addition of a processing speed measure improved classification for this group by correctly classifying 71% of the individuals in this category. We provide a three-category diagnostic approach to better identify individuals as certain and uncertain likelihood of cognitive impairment. The addition of a processing speed measure provides a practical and efficient method to increase confidence in the determined outcome, while also expanding the utility of the MoCA.
Open Access
Acts of kindness in close relationships reduce depression
(2016-06-23) Barnes, Caroline
This study investigated the benefits of performing kind acts within close relationships. Practicing kindness has been shown to strengthen relationships and increase social support. It was expected to be particularly relevant for needy people who are driven by a need for closeness and are vulnerable to depression in the face of interpersonal stress. It was hypothesized that a short term, online kindness exercise would decrease depression and increase happiness in a community sample (at baseline N = 364), and would be particularly beneficial for individuals high on neediness. Participants were recruited online and randomly assigned to one of two conditions. Participants in the kindness condition performed a kind, loving gesture towards someone close and described the ensuing interaction; while participants in the control condition simply wrote about an interaction they had with someone close. Each exercise was repeated every second day for roughly three weeks. The kindness exercise was associated with significant decreases in depressive symptoms when compared to the control condition, and these decreases were maintained up to the two-month follow-up for the general sample. The findings for happiness were mixed and participants high on neediness did not show superior benefits over participants low on neediness from the kindness intervention. The results suggest that practicing kindness within the context of a close relationship can lead to general and sustained improvements in depression. Furthermore, this study offers support for the efficacy of brief, online interventions in the improvement of depressive symptoms.
Open Access
Ambivalence as a Moderator of Treatment Outcomes in Motivational Interviewing and Cognitive Behavioural Therapy for Generalized Anxiety Disorder
(2019-03-05) Button, Melissa Lauren; Westra, Henny Alice
Although there is a robust finding documenting the efficacy of Cognitive Behavioural Therapy (CBT) in treating anxiety, a significant proportion of clients fail to respond optimally to treatment. A major focus of psychotherapy research involves client-treatment matching, which examines client characteristics as potential predictors of treatment response. Client ambivalence has been identified as a key marker in psychotherapy with wide-ranging implications for engagement in therapy. Motivational Interviewing (MI) has strong empirical support for increasing client commitment for change through the resolution of ambivalence. Though it may be speculated that integrating MI into CBT may be more efficacious for clients high in ambivalence than CBT alone, the investigation of these critical client-treatment matching research questions has been hampered by inadequate measures of ambivalence. This study sought to examine this question in the context of CBT alone versus MI-CBT for 85 clients with severe generalized anxiety disorder (GAD). Rather than relying on self-report, the study used an observational measure (client in-session talk against change) to quantify ambivalence. Findings suggest MI-CBT resulted in better long-term worry outcomes than CBT alone for clients who were high in early ambivalence, whereas clients low in early ambivalence did better with CBT alone. In other words, client ambivalence significantly moderated treatment outcomes. In contrast, there was no moderation effect of ambivalence on interpersonal problems. Here, results revealed that regardless of their early ambivalence levels, clients who received MI-CBT reported significantly fewer interpersonal problems at long-term follow-up than clients receiving CBT alone. Client ambivalence seems to represent a key individual difference variable, and tailoring standard CBT protocols to incorporate MI may be particularly efficacious for clients who are highly ambivalent about change. The results also emphasize the potentially broader benefits of MI, in that, integrating MI into CBT may be an effective way of reducing interpersonal problems for all clients, regardless of their early ambivalence levels. Overall, these findings support the benefit of systematic training in identifying and flexibly responding to in-session markers of client change language, and suggest that treatment outcomes can be improved by training CBT therapists to incorporate the MI spirit during moments of ambivalence.
Open Access
An Agile Development Cycle of a Web-Based Memory Intervention Program for Healthy Older Adults
(2018-11-21) Yusupov, Iris; Rich, Jill Bee
The Memory and Aging Program is an in-person psychoeducation intervention for healthy older adults provided at Baycrest Health Sciences. The program has been shown to significantly increase participants' memory knowledge, strategy use, and satisfaction with their memory, promote healthier lifestyle behaviors, and decrease intentions to seek unnecessary medical attention. To increase outreach, a web-based version of the program was created through an agile development cycle: an iterative process involving end-users feedback. The current thesis outlines this process according to the four translational (T) phases of the Clinical and Translational Research Spectrum. First, an overview of the design phase (T1) is provided. In the T2 phase, 26 older adults participated in piloting of individual modules. Additionally, 20 older adults completed the program in its entirety from their homes (T3). Qualitative feedback, results of memory measures, lessons learned for tailoring the e-learning experience to older adults, and next steps (T4) are discussed.
Open Access
An Empirical Phenomenological-Psychological Investigation of Urinary Urgency in Incontinent Women
(2015-08-28) Miceli, Paula; Katz, Joel D.
Many barriers to help seeking for urinary incontinence (UI) have been reported in the literature. In the past decade, studies of Overactive Bladder Syndrome (OABS), a condition characterized by symptoms of urinary urgency with or without urgency incontinence, have suggested that urinary urgency may be a useful target to promote recognition of continence problems at earlier stages of illness. This qualitative study was conducted to advance health promotion through the clarification of the phenomenon of urinary urgency in ambulatory incontinent women diagnosed with OABS. Ten female patients with a diagnosis of OABS or mixed UI with clinically significant urinary urgency were recruited at a community urological clinic. Interviews were conducted to obtain descriptions of situations in which urinary urgency occurred. Three transcripts were analyzed using the empirical phenomenological-psychological approach and a single psychological structure was generated. Phenomenological reflections revealed that urinary urgency was an episodic phenomenon that was lived through in association with a concomitant urine flow (flow urgency) or a sense of imminent flow (pre-flow urgency). During episodes of urinary urgency, participants were aware that they lacked the capacity to contain urine in a situation (sense of inefficacy), and they felt “pressed” to get to a toilet quickly, as well as uncertain about being able to get to a toilet before urine leakage emerged. Irrespective of whether urine leakage occurred, all participants described emotional sequelae related to the disclosure of urinary flow to others (i.e., distress, embarrassment, sense of inadequacy), which the women attempted to alleviate using material, psychological, relational, and medical strategies. The emotional impact was intensified when access to toilets was hindered by idiographic health and environmental circumstances. These structural features may be useful for enhancing communication between healthcare practitioners and patients regarding urgency during consultations. The results supported a conception of urine containment as an embodied, generative capability that is influenced by one sense of efficacy, or self belief in that capability. The results also supported the need to explore ways in which self-efficacy could be enhanced in patients diagnosed with OABS as a means to promote therapeutic change.
Open Access
An Examination of the Interrelation of Narrative and Emotion Processes in Emotion-Focused Therapy for Trauma
(2017-07-27) Bryntwick, Emily Gail; Angus, Lynne
According to narrative-informed approaches to psychotherapy, self-narratives that no longer align with lived experience, and thereby impede coherent meaning-making, often bring individuals into treatment. Exposure to trauma can result in fragmented or disorganized self-narratives, and Emotion-focused Therapy for Trauma (EFTT) (Paivio & Pascual-Leone, 2010) is one treatment approach that helps trauma clients access, explore, and integrate traumatic memories into coherent personal narratives. The Narrative-Emotion Process Coding System (NEPCS 2.0; Angus Narrative-Emotion Marker Lab, 2015) is a video-based coding system that consists of 10 narrative-emotion markers (i.e., client storytelling processes) that have been divided into three NEPCS marker subgroups, based on their degree of narrative-emotion integration: Problem, Transition, and Change markers. The aim of the current study was to examine the relationship between NEPCS markers and outcome (i.e., recovered vs. unchanged) across stage of therapy in a complex trauma sample receiving EFTT (N = 12 clients). The key hypotheses included: recovered clients would have significantly higher proportions of Transition markers in the early and middle stages of therapy, and significantly higher proportions of Change markers in the late stage of therapy, while unchanged clients would have significantly higher proportions of Problem markers across all stages of therapy. Additionally, recovered clients would have significantly higher proportions of shifting (i.e., movement between one NEPCS marker and a different NEPCS marker), and significantly higher proportions of productive shifting (i.e., movement away from Problem markers), whereas unchanged clients would have higher proportions of unproductive shifting (i.e., movement to Problem markers). Results suggested that, in line with theoretical expectations and previous NEPCS research applications, recovered clients showed significantly higher proportions of Transition and Change markers, whereas unchanged clients demonstrated higher proportions of Problem markers. Increased levels of NEPCS shifting, or flexibly moving between NEPCS markers, was also associated with recovery. Furthermore, recovered clients demonstrated significantly higher proportions of productive shifting, while their unchanged counterparts demonstrated more unproductive shifting, suggesting that the type of narrative flexibility may be an important prognostic indicator. A direction for future NEPCS research is to elucidate therapeutic interventions that facilitate client movement from unproductive to more productive modes of narrative-emotion processing.
Open Access
An Experimental Investigation of the Factors that Lead to Fat Talk
(2018-11-21) Shannon, Amy Marie; Mills, Jennifer S.
Fat talk describes self-disparaging remarks made about ones weight or shape. Despite the fact that fat talk has been associated with a number of negative outcomes including eating pathology, fat talk has become a social norm and many women engage in it on a regular basis. The factors that lead these women to engage in fat talk are currently unknown. As such, in a series of three studies, I sought to investigate what factors lead to fat talk. This research builds on displacement theory, which holds that experiencing negative affect will lead to increased fat talk. For Study 1, food-related guilt was investigated as a possible factor that leads to fat talk. It was found that undergraduate women were more likely to anticipate initiating a fat talk conversation after undergoing an induction in which they think about eating fattening food (i.e., food-related guilt), and this effect was unique to fat talk rather than other self-disparaging talk. Study 2 replicated and extended the findings of Study 1 by adding an academic-related guilt condition as well as exploring differences between restrained and unrestrained eaters. The findings for food-related guilt replicated and did not emerge for participants in the academic-related guilt condition. In addition, restrained eaters reported an increased likelihood of engaging in self-disparaging talk in general (i.e., they endorsed increased likelihood of initiating both fat talk and unproductive talk conversations) across experimental conditions. In Study 3 I added a sadness condition and explored interpersonal traits as possible predictors of fat talk likelihood. Experiencing decreased body image once again led to increases in anticipated fat talk but experiencing increased sadness did not. Restrained eaters also reported increased fat talk likelihood across experimental conditions. In conclusion, contrary to displacement theory, the present findings suggest that decreased body image specifically, as opposed to any type of negative affect, leads to increased anticipated likelihood of fat talk. Moreover, perhaps due to their tendency to feel more negatively about their bodies, restrained eaters are more likely to anticipate initiating fat talk across situations. Clinical implications and directions for future research are discussed.
Open Access
An Experimental Investigation of Ways to Negate the Harmful Effects of Fat Talk
(2015-12-16) Shannon, Amy Marie; Mills, Jennifer S.
Fat talk refers to self-disparaging remarks made about one’s weight or shape and has been associated with a number of negative outcomes. Two experimental studies investigated the ability of different conversational responses to negate the negative impact of fat talk. Dietary restraint was also examined as a possible moderating factor of the effects of different conversational responses to fat talk. In Study 1 participants were exposed to a vignette containing either norm focused rebuttal or appearance-based reassurance in response to fat talk, and I assessed changes to food consumption, mood, and body esteem. In Study 2, participants were exposed to a vignette containing norm focused rebuttal, appearance-based reassurance, or distraction in response to fat talk, and I assessed changes to mood and body esteem. Overall, results were mixed regarding which response to fat talk resulted in the best outcomes. Moreover, restrained and unrestrained eaters responded similarly to the different vignettes.
Open Access
An Exploration of Spatial Memory Through Eye Movements and Navigation in Virtual Reality
(2020-11-13) Farzanfar, Delaram; Rosenbaum, Shayna
Finding ones way in different environments is a common everyday experience. As experiences navigating an environment accumulate over time, spatial representations of visuoperceptual identities of landmarks and geometric relations between them are formed in the brain. Navigation in a familiar environment may be guided by a neural interaction between different types of spatial representations: visual percepts and long-term spatial knowledge of geometric relations, resembling schemas. This thesis explores whether navigation in a virtual-reality simulation of a familiar environment can be explained by analysis of eye movements during travel periods and the quality of spatial memories, which were acquired when individuals navigated the same environment in real life over months to years. Results show a link between spatial memory integrity and eye movements during navigation in virtual reality. In multilevel models of navigation performance, the interaction between spatial memory and eye movements did not adequately predict outcomes after practice effects were controlled. These findings suggest that analysis of eye movements during navigation in a familiar environment may provide insight into retrieval cues that activate schema-like spatial representations to guide optimal wayfinding decisions.
Open Access
An Imagery Rescripting Intervention for Internalized Weight Stigma in Women with Elevated Weight Concerns
(2021-11-15) Samson, Lindsay Erin; Mills, Jennifer S.
Weight stigma, or negative attitudes directed toward individuals based on larger body size, is associated with decreased physical and psychological wellbeing, particularly when these attitudes are internalized and directed towards the self. The current study aimed to determine whether an online imagery rescripting intervention is effective at reducing internalized weight stigma and associated risk (fear of self-compassion and disordered eating) and protective (body image flexibility and self-compassion) factors in women with elevated weight concerns. Female undergraduate students (N = 171, 18-30 years of age) completed a screening measure and baseline assessment, and then all participants underwent a body dissatisfaction induction to re-experience their first body shame memory. Participants were then randomly assigned to either an imagery rescripting intervention group or a control group who underwent informal mindfulness. Participants in the imagery rescripting group were instructed to complete five days of imagery rescripting practice. Outcome measures were completed by all participants on day seven of the study. Contrary to hypotheses, participants in both groups displayed significant improvements on internalized weight stigma, body image flexibility, and disordered eating, whereas neither group improved on self-compassion or fear of self-compassion. Qualitative data suggest that individuals in the control group found the study to be impactful. The discussion examines the potential role of placebo and demand characteristic effects in the study results, as well as the potential impact of re-experiencing body shame combined with introspective questionnaires in producing change over the course of the study. Although the current study did not yield significant results, other recent studies have found imagery rescripting to be a promising intervention for those at risk of eating disorders. Future research should continue to explore imagery rescripting as a possible intervention for internalized weight stigma and other risk and protective factors in individuals with elevated weight concerns.