Theses and dissertations

This collection includes both ASU Theses and Dissertations, submitted by graduate students, and the Barrett, Honors College theses submitted by undergraduate students. 

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Culturally Motivated Clinician Drift in the Treatment of Eating Disorders: How Clinicians Adopt, Adapt, or Abandon CBT for Latino Clients

Description
Prior research has identified that clinicians in the treatment of eating disorders often do not adhere closely to empirically-supported treatments (EST), and are particularly likely to modify Cognitive-Behavioral therapy (CBT). Several reasons for this phenomenon, dubbed "clinician drift", have been identified, including level of clinician training, education, and type of…

Prior research has identified that clinicians in the treatment of eating disorders often do not adhere closely to empirically-supported treatments (EST), and are particularly likely to modify Cognitive-Behavioral therapy (CBT). Several reasons for this phenomenon, dubbed "clinician drift", have been identified, including level of clinician training, education, and type of patient care. In addition to the phenomenon of clinician drift, there has been a growing controversy within the field of clinical psychology about the compatibility of ESTs and multiculturalism. Some argue that the standardization inherent to EST resists the concept of cultural adaptability; while others have countered that cultural adaptability is essential in order for empirically supported treatments to remain relevant, ethical, and effective. In order to shed more light on this issue, this study examined how clinicians tend to drift from CBT in the treatment of Latinos suffering from eating disorders, in order to accommodate Latino culture and elements of eating behavior specific to Latino populations. We both attempted to replicate prior findings regarding predictors of clinician drift, as well as build upon the little existing research into the "culturally-motivated clinician drift." It was discovered that no therapist characteristics or client characteristics were predictive of drift. However, the majority of the sample still adapted or abandoned at least part of the CBT treatment. Their responses regarding the weaknesses of CBT for their Spanish-speaking clients can provide insight into how the treatment can be modified for more diverse clients.
ContributorsJosephs, Jamie Elise (Author) / Perez, Marisol (Thesis director) / Luecken, Linda (Committee member) / Davis, Mary (Committee member) / Department of English (Contributor) / Department of Psychology (Contributor) / Barrett, The Honors College (Contributor)
Created2017-12
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Disentangling the directions of influence among trauma exposure, posttraumatic stress disorder symptoms, and alcohol and drug problems

Description
The present study utilized longitudinal data from a high-risk community sample (n= 377; 166 trauma-exposed; 54% males; 52% children of alcoholics; 73% non-Hispanic/Latino Caucasian; 22% Hispanic/Latino; 5% other ethnicity) to test a series of hypotheses that may help explain the risk pathways that link traumatic stress, posttraumatic stress disorder (PTSD)…

The present study utilized longitudinal data from a high-risk community sample (n= 377; 166 trauma-exposed; 54% males; 52% children of alcoholics; 73% non-Hispanic/Latino Caucasian; 22% Hispanic/Latino; 5% other ethnicity) to test a series of hypotheses that may help explain the risk pathways that link traumatic stress, posttraumatic stress disorder (PTSD) symptomatology, and problematic alcohol and drug use. Specifically, this study examined whether pre-trauma substance use problems increase risk for trauma exposure (the high-risk hypothesis) or PTSD symptoms (the susceptibility hypothesis), whether PTSD symptoms increase risk for later alcohol/drug problems (the self-medication hypothesis), and whether the association between PTSD symptoms and alcohol/drug problems is due to shared risk factors (the shared vulnerability hypothesis). This study also examined the roles of gender and ethnicity in these pathways. A series of logistic and negative binomial regressions were performed in a path analysis framework. A composite pre-trauma family adversity variable was formed from measures of family conflict, family life stress, parental alcoholism, and other parent psychopathology. Results provided the strongest support for the self-medication hypothesis, such that PTSD symptoms predicted higher levels of later alcohol and drug problems among non-Hispanic/Latino Caucasian participants, over and above the influences of pre-trauma family adversity, pre-trauma substance use problems, trauma exposure, and demographic variables. Results partially supported the high-risk hypothesis, such that adolescent substance use problems had a marginally significant unique effect on risk for assaultive violence exposure but not on overall risk for trauma exposure. There was no support for the susceptibility hypothesis, as pre-trauma adolescent substance use problems did not significantly influence risk for PTSD diagnosis/symptoms over and above the influence of pre-trauma family adversity. Finally, there was little support for the shared vulnerability hypothesis. Neither trauma exposure nor preexisting family adversity accounted for the link between PTSD symptoms and later substance use problems. These results add to a growing body of literature in support of the self-medication hypothesis. Findings extend previous research by showing that PTSD symptoms may influence the development of alcohol and drug problems over and above the influence of trauma exposure itself, preexisting family risk factors, and baseline levels of substance use.
ContributorsHaller, Moira (Author) / Chassin, Laurie (Thesis advisor) / Davis, Mary (Committee member) / Pina, Armando (Committee member) / Tein, Jenn-Yun (Committee member) / Arizona State University (Publisher)
Created2014