Clinical Psychology -- General

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Introduction to Clinical Psychology Textbooks: What’s Missing?
(Vanderbilt University, 2025-05) Talia Kunin; Advisor: Elisabeth Dykens
Textbooks are fundamental to higher education. Scholars have previously evaluated texts from a wide range of disciplines. However, similar analyses have yet to assess Introduction to Clinical Psychology (ICP) textbooks. This study examined 15 ICP textbooks, scanning for content on Intellectual and Developmental Disabilities (IDDs), with a secondary focus on the Eugenics movement. A 0-5 scale, with labels of “no rating, scant, brief, adequate, substantial, and extensive” was employed to code results. The results indicate that the mode values for general coverage of Developmental Disabilities, the Eugenics movement, as well as Intellectual Disabilities for children and adults were zero, or “no rating.” The mean ratings for each general category fell between “no rating” and “scant.” Frequency counts of specific IDDs were also investigated, with Autism Spectrum Disorder (ASD) being, on average, the most prevalent. This study could be a catalyst for further analyses of ICP textbooks, and reflection about the content that psychological pedagogy prioritizes going forward. Keywords: Intellectual and Developmental Disabilities, Eugenics
Examination of Associations between Social Reward Responsiveness, Social Media Use, and Suicidal Thoughts and Behaviors in Adolescents
(Vanderbilt University, 2025-05) Weis, Vanessa; Long, Yinru; Vernanzi, Lisa; Marlowe, Rachel; Bettis, Alex; Kujawa, Autumn; Dr. Autumn Kujawa
Adolescent suicide rates have surged by 52.2% in the past twenty years, necessitating targeted prevention strategies (CDC, 2021). This study explores a neurophysiological marker of social reward responsiveness derived from the electroencephalogram (EEG), specifically social reward positivity (RewP), and social media use as predictors of suicidal thoughts and behaviors (STBs) in adolescents. The study included 76 participants ranging from 14-17 years old. The study examined the associations between RewP, social media, and STBs from high-risk acute psychiatric treatment and community samples. Additionally, the study aims to test social media use and social RewP as unique associations of suicidal ideation and history of suicide attempt(s). We found a significant positive association between social media coping skills and suicidal ideation severity, as well as a significant positive relationship between social RewP and social media coping skills. Moreover, we found that social RewP was not associated with STBs. These findings suggest that rather than looking at the overall use of social media, understanding how adolescents use social media to cope could be key in determining suicidal ideation. Although neural measures were not directly correlated with STBs, further consideration in larger samples is warranted.
Effects of Text Message Reminders of Safety Behavior Reduction on Health Anxiety: A Randomized Controlled Trial
(Vanderbilt University, 2024-03-27) Jakes, Kavi; Jessup, Sarah; Olatunji, Bunmi
Health anxiety is a chronic issue associated with poor functioning that is especially important to study in the context of the COVID-19 pandemic. Cognitive-behavioral models of health anxiety posit that safety behaviors are a key maintenance factor in health anxiety. The present study evaluated the effects of a safety behavior reduction text message reminder on symptoms of health anxiety. A sample of health-anxious participants (N = 99) were randomized to either a safety behavior reduction (SB) or mindfulness-based present-centered (PC) condition. Participants received text messages every other day for four weeks reminding them either to stop using their most common safety behaviors (SB) or to remain focused on the present (PC). Measures of safety behavior use, mindfulness, and health anxiety symptoms were completed at baseline, mid-treatment, post-treatment, and a four-week follow-up. It was hypothesized that participants in both conditions would report significant reductions in health anxiety symptoms over time, and that participants in the SB condition would report significantly greater reductions in health anxiety symptoms over time relative to the PC condition. Results indicated that participants in both conditions experienced significant reductions in health anxiety symptoms over time, with no significant difference in reductions between the two conditions. These findings suggest that both increasing mindfulness and reducing safety behavior use are relevant mechanisms through which health anxiety can be reduced. Implications for further development of scalable interventions for anxiety-related disorders are discussed.
Embodied Trauma: The Relationship Between Interoception and Emotional Experience
(Vanderbilt University, 2024-04) Babbitt, Kathryn
While post-traumatic stress disorder (PTSD) can manifest as a variety of different symptom profiles, many cases of the disorder involve interoceptive difficulties. The goal of this study was to further investigate the relationship between emotional embodiment and interoceptive changes often associated with traumatic events. We conducted two experiments in a sample of healthy participants (n = 48). In experiment 1, emotional embodiment was examined with a topographical body sensation mapping task (EMBODY; Nummenmaa et al., 2014). We assessed interoceptive accuracy in experiment 2 using the Heartbeat Counting Task (HBCT; Schandry, 1981) and the Multidimensional Assessment of Interoceptive Awareness (MAIA; Mehling et al., 2012). Trauma was measured using the Brief Trauma Questionnaire (BTQ; Schnurr et al., 1999). We hypothesized that individuals with PTSD would show abnormal embodiment of emotions as well as disrupted interoceptive awareness. Results showed slightly more diffuse embodiment of sensations in body maps of emotions and signs of altered interoception in the MAIA, but no evidence of impairments of interoceptive accuracy in the HBCT. These results offer additional evidence for the factors influencing the relationship between trauma and the development of subsequent illnesses. Clarifying this relationship has important implications for the treatment of interoceptive deficits in psychiatric disorders.
The Relationship Between Core Values, Religiosity and Spirituality, and Health
(Vanderbilt University, 2023-03) Wang, Stella
Individuals’ values and religious beliefs can impact their behavior and mental state, and in turn, their health. Therefore, it is crucial to understand the effects of personal ideology on physical and mental health. This study seeks to fill in current literature gaps by examining the effect of the triad of values, religiosity, and spirituality on health. Data was collected using various validated measures of values, religiosity, and health from 2537 American, English- speaking respondents on Amazon Mechanical Turk. The findings from this study show that values and religiosity have a significant additive relationship with overall health, even when controlling for demographic variables. Spirituality, when looked at in relation to religiosity, cannot be used to predict health or values. This study has implications for health practitioners and policymakers, as certain interventions which target values and religiosity may be helpful in creating behavioral change. Due to the overall modest effect sizes and value interdependence, further research is needed to fully understand the underlying mechanisms and potential interventions.
Affective Considerations in Anxiety and Depression Comorbidity
(Vanderbilt University, 2023-03-20) Keith, Rebecca
Generalized anxiety disorder (GAD) and major depressive disorder (MDD) co-occur at rates much higher than chance. Because of overlapping risk factors and higher rates of comorbidity than other anxiety disorders, researchers have proposed reclassifying GAD; one of the most influential proposals calls for GAD and MDD to be classified together as anxious-misery disorders, with the remaining anxiety disorders reclassified as fear disorders. The tripartite model attempts to explain comorbidity of depression and anxiety through positive affect, negative affect, and physiological hyperarousal. However, its theory that low positive affect is exclusive to depression has been questioned – instead, low rates of positive affect are found in all anxiety disorders, especially in GAD. The current study examines positive affect in anxious-misery symptoms and fear symptoms to determine if positive affect varies in a manner consistent with the model and if it supports the reclassification of mood and anxiety disorders. Using a sample of adolescents and young adults (n=904), correlations and linear regression were conducted on positive affect and mood disorder symptoms. Symptoms of depression, generalized anxiety, social anxiety, and panic disorder each had significant negative correlations with positive affect. A regression analysis controlling for the overlapping variance among symptoms demonstrated that depression showed the strongest negative relationship with positive affect, followed by generalized anxiety and social anxiety. There was no significant relationship between positive affect and panic disorder symptoms. These findings support the close relationship between depression and generalized anxiety but also demonstrate that positive affect may not be adequate to differentiate anxious-misery and fear disorders.
Mindfulness-Based Music and Songwriting: Pilot Data from a Novel Telehealth Intervention for Parents of Children with Disabilities
(Vanderbilt University, 2022-03-28) Crawley, Zoe
The Mindfulness-Based Music & Songwriting (MBMS) intervention is a novel 7-week telehealth program aimed at reducing stress in caregivers of children with developmental and intellectual disabilities. The intervention curriculum combines mindfulness principles with therapeutic music and songwriting and is taught by a certified Music Therapist (MT-BC) over seven one-hour sessions. Measures of stress, wellbeing, depression, and anxiety were taken at baseline, post- study, and at a 4-week follow-up. Measures of affect and connection to the therapist were taken immediately before and after each session. The preliminary review of this intervention includes three primary analyses: evaluating changes in multiple outcome variables across baseline, post- study, and 4-week follow-up; changes in affect and connection to the therapist across the intervention; and changes in affect and connection to the therapist within individual sessions. Preliminary results show significant increases in wellbeing and decreases in stress and depression across the study, as well as significant increases in affect and connection to the therapist across all sessions. Limitations include small sample size and potential impacts on stress due to COVID-19. Findings support the continuation of the program, implementation of a randomized control trial, and further analyses of affect regulation as a primary mechanism.
Direct and Indirect Associations of Parental Mindfulness with Child Coping and Child Depression
(Vanderbilt University, 2022-03-27)
Children of depressed parents are at an increased risk for depression and other forms of internalizing and externalizing psychopathology, but certain factors may interrupt or moderate this transmission. Specifically, both dispositional mindfulness and secondary control coping are negatively associated with depression. The present study seeks to understand the intergenerational associations between mindfulness in depressed parents, their children’s coping strategies, and children’s depression, internalizing and externalizing symptoms. Using data from 242 children and 180 target parents, we assessed the effects of parent mindfulness on child depression through child coping strategies. Regression analysis revealed significant relations between all variables being studied, and modeling of the pathways suggested that there is a partial indirect effect of parent mindfulness on offspring depression or anxiety through secondary control coping skills. This study has potential implications for the clinical application of mindfulness within the context of family interventions.
Peer Observation and Error Monitoring in First-Year Students: An Examination of Associations with Internalizing Symptoms
(Vanderbilt University, 2021-03-29) Okland, Sydney
Because of the unique factors impacting the first year of college, specifically the potential for increased comparison to and evaluation by peers and risk of anxiety and depression, making a mistake can be very distressing. Using electroencephalogram (EEG) and focusing on an event-related potential (ERP) known as the error-related negativity (ERN), we examined how perceived observation, symptoms of anxiety, and symptoms of depression affected neural and behavioral error responses in first-year college students. Participants were more accurate in the observation than control condition. There was a significant difference in the ERN between error and correct responses in both conditions, but there was not a significant difference in error response in the observation compared to the control condition. Symptoms of anxiety and depression were not significantly related to error responses. Despite the nonsignificant results, this study is an important first step in understanding how multiple factors may affect error responses so that we can intervene to improve adjustment for first-year college students. This paper was completed in PSY/PSY-PC 4999-01 (Honors Thesis), with Dr. Autumn Kujawa as the faculty mentor.
A Pilot Study: Virtual Reality-Delivered Support Groups for Substance Use Disorders
(Vanderbilt University, 2021-03) Mahapatra, Anjali
Substance abuse often occurs as a way to cope with negative affect and life stressors in an unsupportive social context. As a result, affective regulation and social support play a key role in relapse prevention and recovery. The purpose of this study was to test the feasibility of a novel virtual reality (VR)-based peer support community. The objectives for this intervention were to provide affective regulation and social support to individuals seeking substance abuse recovery. Seventeen participants in recovery attended virtual peer-support meetings for at least two months. All participants completed questionnaires to assess perceived online social support, group therapy alliance, and changes in affect from attending VR sessions. Structured qualitative interviews with eleven participants revealed the psychological benefits and social support offered by sessions along with various challenges in navigating VR and the user interface. Quantitative data showed that improvement in mood, perceived online social support, and satisfaction with group-therapy alliance were associated with VR meeting attendance. With further research and improvements, this virtual intervention may be an effective tool to teach cognitive-behavioral skills, regulate affect, and provide social support to individuals who are at risk for relapse or in long-term recovery.
Eating Disorders Among Ethnic Minorities
(Vanderbilt University, 2020-04-24) Chung, Suemin (Christy)
Given the gravity of recent increasing eating disorder diagnoses, the amount of research dedicated to eating disorders and ethnicity/acculturation is insufficient. This study explores the differences in eating disorder risk factors based on ethnicity/acculturation and the prediction of eating disorder diagnoses based on ethnicity/acculturation. The participant pool was made of 579 females (ages 18-64, U.S. residents, proficient in English) recruited using Sona Systems at Vanderbilt University and Amazon Mechanical Turk (MTurk). A survey was compiled using the online survey manager REDCap consisting of various risk factor scales/tests (Y-BOCS, TQ-R, PROMIS Short form for anxiety, PHQ-8, EDI), an acculturation scale (AHIMSA), and an eating disorder assessment (EDE-Q). Participants were compensated for taking the survey with either 2 academic credits (Sona) or a monetary reward of $2.00 (MTurk). Results showed that while there was no significant difference in risk factors based on ethnicity/acculturation, there was a difference among risk factors pertaining to body image (shape concern, weight concern, drive for thinness, restraint, body dissatisfaction, eating concern) based on the interaction effect between race/ethnicity and immigration status. These findings highlight the need for further research on eating disorders and demonstrate the nuances through which eating disorder risk factors/symptoms can manifest, particularly through ethnic and cultural factors.
The Role of Executive Function on Adolescent Affective Problems
(Vanderbilt University, 2019-03-15) Grice, Tori; Compas, Bruce
Objective: The current study examined the associations among executive function, secondary control coping and affective problems. Method: A sample of 104 adolescents (ages 9-15 years old) completed cognitive assessments and self-report measures of affective problems and secondary control coping. Results: A history of maternal depression was associated with higher levels of affective problems in adolescents. Additionally, lower levels of working memory were associated with higher levels of affective problems in older adolescents. Secondary control coping and an interaction between age and working memory both predict levels of affective problems in adolescents, but secondary control coping did not explain the relationship between working memory and affective problems. Conclusions: Results highlight the potential importance of executive function in addition to secondary control coping when examining affective problems in adolescents.
Self-Criticism, Sexual Minority Stress and Disordered Eating Behaviors
(Vanderbilt University, 2017-04) Heiman, Ellen R.; Cole, David A.
Minority stress theory recognizes the presence of added stress for individuals that belong to marginalized minority groups (Meyer, 2003). When considering the mental health of those who identify as sexual minorities, the role of internalized heterosexism (i.e. negative, self-hating thoughts attributed to a pervasive culture that stigmatizes non-heteronormativity) becomes crucial (Szymanski, 2008; Watson et al., 2016). We measured the relation between heterosexist discrimination as a measure of sexual minority stress and endorsement of disordered eating behaviors and cognitions in a sample of university students and then tested self-criticism as a moderator of this relation. Participants completed a battery of self-report instruments measuring self-criticism, heterosexism, and disordered eating behaviors and cognitions via an online platform. Main effects of self-criticism on specific DE outcomes were found, along with zero-order correlations between sexual minority stress, self-criticism, and DE outcomes.
Effects of Music on Gait Presented Emotion Perception
(Vanderbilt University, 2016) Harvey, Kamyl; Park, Sohee
Research on embodied emotions suggests that our ability to simulate bodily emotions enables us to better understand others’ emotions. Music has been shown to influence emotion processing, and music therapy is effective in improving social functioning. In this study, we explored the potential impact of emotional music on the processing of visual, whole-body, social cues. It was expected that listening to happy music would facilitate the visual perception of happy gait whereas listening to angry music would facilitate the perception of angry gait. Furthermore, it was hypothesized that for neutral gait stimuli, the current mood state of the participant would bias the participant to ‘perceive’ emotion in the neutral stimuli in the non-music group. Fifty-six healthy participants were randomly assigned to three-music manipulation conditions happy music, angry music, or no music. The emotional gait perception task involved viewing a mannequin walker and deciding whether the walker looked happy or angry. Three types of gaits were presented: happy, angry, or neutral (no emotion). Mood and personality traits of the participants were assessed with self-report questionnaires. The results indicate that regardless of music manipulation, all groups were more accurate in detecting happy gait. Congruence of the valence of music and the valence of the gait stimuli did not influence the accuracy on the gait perception. There were no significant correlations between gait perception and mood or personality traits. Suggestions for a future study are described.
Social Brains, Social Bodies: Investigating the Role of Personality in Embodied Emotion
(Vanderbilt University, 2016-04-07) Blain, Scott D.; Park, Sohee
Accurate emotion perception is essential for adaptive social functioning. Abnormal emotion perception and associated social impairments are core features of neuropsychiatric conditions such as schizophrenia and autism. Such deficits extend to healthy individuals who share latent liability for these conditions, such as those with elevated schizotypal or autistic traits. Although much is known about emotion perception deficits in the schizophrenia- and autism- spectrum, underlying mechanisms have not been elucidated. One proposed mediating mechanism is alexithymia, a difficulty labeling and describing feelings. In turn, alexithymia is associated with abnormal interoception and experience of embodied emotion. The goal of the current study was to examine alexithymia’s contribution in the impact of schizotypal and autistic traits on embodied emotion, as assessed by an emotion perception task that asks participants to discriminate emotions from the gait of polygonal avatar walkers and a visual body mapping task that asks participants to map emotions onto an outline of a body. Results indicated negative correlations between low-threshold emotion perception via gait and autism-spectrum quotient (ρ = -0.23, p < 0.05), as well as positive schizotypy (ρ = -0.28, p = 0.01) but not alexithymia. Decreased emotion perception was associated with decreased report of embodied emotion, on the body mapping task. The study also replicated previously demonstrated correlations between alexithymia, schizotypy, and autism-spectrum quotient (p < 0.05), serving as further validation of the AQ-10 item version. In summary, the current study further clarifies our understanding of emotion perception in the extended phenotypes of autism- and schizophrenia-spectrum, while also indicating connections between interpersonal and intrapersonal embodied emotion.
Child and Parental Factors Affecting Coping Strategies and Psychosocial Outcomes for Parents with Children with Prader-Willi Syndrome
(Vanderbilt University, 2016-04-12) Jurgensmeyer, Sarah; Dykens, Elisabeth M.
Prader-Willi Syndrome (PWS) is a rare, genetic neurodevelopmental disability characterized by hyperphagia, mood swings and intellectual disability. Families with a child with PWS often experience increased family tensions and a greater number of stressors, even compared to families with children with different intellectual and developmental disabilities (IDDs). However, there is variation in parental stress, anxiety and depression levels. This study explored the effects of both child factors, such as hyperphagia and severity of behavioral problems, and parental factors, such as coping strategies, on parental stress, anxiety and depression, for parents of children with PWS (n = 154). Results show that child factors significantly impact parental stress, anxiety and depression. Parental usage of rational, active coping strategies is strongly linked to lower stress and depression levels, while parents who employ avoidant, helplessness coping strategies are more likely to have higher levels of stress, depression and anxiety. While there were no significant interaction effects between parental coping strategies and the severity of the child’s behavioral issues on parental stress levels, the best outcomes were achieved when parents did not use avoidant coping strategies and their children had fewer behavioral problems. Future research implications and outcomes are discussed.
A Cross-Cultural Comparison of Schizotypy and Social Trait Judgments
(Vanderbilt University, 2016-04-18) Zhao, Zidong; Park, Sohee
Rapid and accurate judgments of social traits from faces are indispensable to successful interpersonal interactions. Anomalous trait judgment has been observed in the schizophrenia spectrum and may lead to delusion formation and reduced social functioning. Furthermore, individual differences in social trait judgments are likely to be influenced by culture and gender. The current study investigated the role of culture and schizotypal personality traits on rapid trait judgments from faces in age-matched college student samples from China and the US using a trait judgment task and a battery of self-report questionnaires. We found no relationship between schizotypy and trait judgments. However, positive schizotypy, disorganized schizotypy, cognitive empathy, and affective empathy were higher in Chinese students than in American students. We also found lower level of consummatory interpersonal pleasure among Chinese students. These findings indicated that individuals from Chinese and North American cultures differ in their tendency to make mental inferences during social interactions, as well as in how much they enjoy social interactions. These differences potentially pointed to the relative cultural specificity of the schizotypal personality construct, as well as the need for culturally specific symptom measures and diagnostic criteria.
Predictive Effects of Quality and Duration of Sleep on Cognition and CSF Biomarkers
(Vanderbilt University, 2015-12) Calabro, Alexandria; Jefferson, Angela Lee
Current literature on the effects of sleep on cognition has shown conflicting results regarding the effects of long and short sleep duration. Using previously collected data from the Vanderbilt Memory & Aging Project, this study explored the association between sleep and cognitive functioning and cerebrospinal fluid biomarker components of Alzheimer’s disease pathophysiology in older adults with normal cognition and mild cognitive impairment. Sleep quality was hypothesized to be a better predictor of cognitive functioning and cerebrospinal fluid biomarkers. The sample consisted of 66 older adults, with a mean age of 73.29. Half of the sample had mild cognitive impairment, while the other half had normal cognition. Results showed no significant predictive effects of either sleep quality or sleep duration on either cognitive measures or cerebrospinal fluid biomarker levels. However, results did show some sleep quality x diagnosis interaction effects for information processing speed, executive function and amyloid-beta levels, and sleep quality x sleep duration interaction for global cognition and amyloid-beta levels.
Eating Disorders and Life Span Development
(Vanderbilt University, 2015-11-19) Culbertson, Lauren; Schlundt, David G.
Current research shows a relationship between age and eating disorder diagnoses but does not fully understand how symptoms manifest at different stages of Life Span Development (LSD). To identify the difference of eating disorder symptoms by age, the study analyzed existing EDI-2 scores and other demographic data from 2247 female adolescent and adult patients at a commercial residential eating disorder treatment center. Results from this study showed that anorexia nervosa is most common in female adolescents and older adults, but bulimia nervosa emerges as the most common diagnosis for young adults. Levels of comorbid psychopathology and EDI-2 scores are lower for young adolescents but higher for young adults. Comorbidity decreases slightly in the older adults, but perfectionism remains high. As age increases, eating disorder treatment needs to focus more on comorbidities. Further research can explore if treatment effectiveness can be improved by paying attention to an individual’s developmental stage.
Tracking the Trajectories of Peer Victimization and Negative Self-Cognitions in Children: A Longitudinal Approach to Approximating Causality
(Vanderbilt University, 2014-04) Kaskas, Maysa; Cole, David A.
This study investigates the effect of targeted peer victimization (TPV) on negative self-cognitions as a function of victimization type through a three-wave longitudinal study. Measures of TPV and cognitions were collected from 956 students equally distributed through grades three through eight. Two types of TPV were analyzed: physical peer victimization, which occurs when a person is controlled or injured by physical means, and relational peer victimization, which includes acts or statements intended to harm peer relationships and social acceptance. Obtained results are as follows: (a) both negative self-cognitions and TPV have high rates of stability over time; (b) while both genders experience higher levels of relational victimization than physical victimization, females experience more relational victimization than males do, and males experience more physical victimization than females do; and (c) relational victimization was more related to changes in depressive self-cognitions than was physical victimization. However, neither type of PV was significant after controlling for prior levels of the cognitive variable. Implications and avenues for future research are discussed.

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