Master of Arts in Psychology, Cleveland State University, 2024, College of Sciences and Health Professions

Despite extensive research highlighting elevated rates of suicidality among people with borderline personality disorder (BPD), the underlying factors that contribute to this risk remain less understood. Theory-driven research elucidating pathways to suicidality may inform the development of targeted treatments to mitigate this risk. Prior studies have established a strong link between BPD features and use of ineffective emotion regulation strategies, especially rumination (Bud et al., 2023). Additionally, prior studies suggest attention disengagement difficulties may underlie rumination (Koster et al., 2011). Therefore, these studies investigated longitudinal and cross-sectional components of the emotional cascade model (Selby et al., 2008). Study 1 investigated the intervening role of rumination and potentiating role of eye-tracking attention disengagement from sad facial content on the relationship between BPD and suicide-related rehospitalization among inpatient adults (N = 95). The results confirm a robust relationship between elevated BPD features and ruminative tendencies; however, the hypothesized mediating and moderating roles were not supported. Study 2 investigated an extension of the emotional cascade model by testing the relationships between mindfulness, rumination, and their sequential effects on suicidogenic cognitions among diverse community adults diagnosed with BPD (N = 81). This study found support for the hypothesized intervening role of rumination between BPD features and suicide cognitions. Although BPD and difficulty employing mindfulness were strongly related, the mediation was not supported. Collectively, these studies provide partial support for ruminative cycles as an intervention target to alleviate suicide-related outcomes for BPD. Additionally, these results provide thought-provoking insights into study limitations. They also suggest considerations for the conceptualization of BPD and the incorporation of attention paradigms in future r (open full item for complete abstract)

Committee: Ilya Yaroslavsky (Committee Chair); Amir Poreh (Committee Member); Kelsey Pritchard (Committee Member); Eric Allard (Committee Member) Subjects: Clinical Psychology; Psychology

Psy. D., Antioch University, 2019, Antioch Santa Barbara: Clinical Psychology

Most crisis stabilization, and mental health treatment in general, is delivered solely to the individual in crisis, by professionals who are careful to protect the individual's right to privacy. An unintended consequence of this objective, unfortunately, can be the undermining of the potentially significant role played by family members in the treatment, maintenance, and stabilization of individuals with mental illness. Without family involvement, some individuals burdened by mental illness slowly and steadily decline. This study investigates how familial relationships impact mental health problems, specifically psychiatric hospital readmissions. The goal of this study is to determine whether being estranged from one's family increased the number of times an individual was readmitted to an inpatient psychiatric hospital. This study makes use of de-identified, archival data from Ventura County Behavioral Health (California), to examine the association between family support and inpatient hospital readmission rates. This data set provides information regarding clients' previous hospitalizations, if any, Crisis Team contacts, number of years of outpatient mental health treatment, and documented family support. Furthermore, this study aims to identify possible recommendations for improving family involvement in an individual's care in an attempt to reduce the number of inpatient psychiatric hospital readmissions. These treatment recommendations will seek to improve the quality of life for the individual suffering from mental illness, as well as their family; as well as strive to save scarce resources (personal and societal). In summary, this study aims to shine light on a bleak and controversial issue that is impacting millions of Americans. Better research may lead to earlier diagnosis and better treatment of mental illness, leading to longer, happier lives for individuals who are touched by mental illness. The consequences of inadequate treatment for the mentally ill (open full item for complete abstract)

Committee: Betsy Bates-Freed PsyD (Committee Chair); Brett Kia-Keating Ed.D (Committee Co-Chair); Athena Lewis PsyD (Committee Member) Subjects: Clinical Psychology; Families and Family Life; Mental Health; Psychology

Master of Arts (MA), Bowling Green State University, 2018, Psychology/Clinical

Psychiatric hospitalization can be viewed as a difficult life event that can cause disruptions in several life domains (Cohen, 1994). Individuals who experience a psychiatric hospitalization are at a greater risk for experiencing readmission to the hospital and social stigma that can interrupt their ability to function in daily life, and even suffer work-related setbacks (Loch, 2014). Much of the research characterizes resiliency as a set of traits possessed by an individual. Studies using such measures found that adults with serious mental illness [SMI] have lower resiliency scores than the general population. However, relatively little is known about specific aspects of resiliency that adults might rely upon in their adjustment to community life after psychiatric hospitalization. The present qualitative study examined first-person accounts of eleven adults coping with a serious mental illness who have experienced a psychiatric hospitalization in a 24-month period. The research examines components of resiliency that assist adults in community adjustment following a psychiatric hospitalization. Results identify themes among participant perceptions of system- and individual-driven helpful and unhelpful aspects of the hospitalization. Results also provide more details to the nuances in individual resiliency components (i.e., goal-setting, commitment, patience, humor, past accomplishments) and social components that help adults with serious mental illness bounce back from psychiatric hospitalizations. About half (n=6) of the sample identified bouncing back to the same level of life satisfaction whereas the remainder identified bounding back to a higher level of life satisfaction. These results contribute to a better understanding of resiliency components associated with better post-discharge community integration which will help mental healthcare workers better serve individuals reentering their community.

Committee: Catherine Stein PhD (Advisor); Dryw Dworsky PhD (Committee Member); Dale Klopfer PhD (Committee Member) Subjects: Psychology

Psy. D., Antioch University, 2018, Antioch New England: Clinical Psychology

This mixed method study piloted a newly developed tool for monitoring preparedness among youth discharged from New Hampshire Hospital (NHH) and explored its influence on hospital discharge planning and follow-up care. This study spotlighted psychosocial variables in readmission risk for a psychiatric population and introduced a conceptualization of preparedness that included patient understanding of their discharge plan, as well as hope for change and supportive relationships. Quantitative methods were used to examine the relationship between aftercare and hospital readmission and further to explore the relationship between patient preparedness and readmission, as well as adverse events experienced post-discharge. Qualitative methods were used to explore the feasibility and utility of the preparedness tool. Chi-square results indicated that aftercare was associated with reduced readmission risk at 90-days. Regression analyses indicated preparedness scores did not contribute to the prediction of adverse events and hospital readmission. The Preparedness Assessment Tool's (PAT) three-point rating scale made it difficult to detect a statistically meaningful relationship between preparedness and these outcomes and to effectively track changes in preparedness over time. Overall, the Aftercare Coordinator (AC) considered the PAT to be an invaluable asset to her work with patients. The PAT was found to be user-friendly, modifiable, effective, and efficient. Further, it helped personalize care, guide interventions, increase patient and family collaboration and understanding, and help monitor progress and patient need.

Committee: James Fauth PhD (Committee Member); Vince Pignatiello PsyD (Committee Member); Michelle Mattison PsyD (Committee Member) Subjects: Clinical Psychology