Theses and Dissertations from UMD
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New submissions to the thesis/dissertation collections are added automatically as they are received from the Graduate School. Currently, the Graduate School deposits all theses and dissertations from a given semester after the official graduation date. This means that there may be up to a 4 month delay in the appearance of a give thesis/dissertation in DRUM
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Item Client Attachment Dimensions and Therapist Skills: A Longitudinal Analysis(2023) Gerstenblith, Judith; Hill, Clara E; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Although scholars have highlighted the usefulness of attachment theory for psychotherapy (e.g., Bowlby, 1988; Holmes & Slade, 2018; Mallinckrodt, 2010), minimal empirical research exists examining the relationship between client attachment and therapist skills. In this study, we first investigated the factor structure of the therapist- and client-rated Helping Skills Measure (HSM; Hill & Kellems, 2002) for 5,830 psychodynamic psychotherapy sessions of 202 adult community clients working with 25 doctoral student therapists in a university clinic. The multilevel-confirmatory factor analysis supported a 3-factor structure (Exploration, Insight, Action), stable across time, at the session level in psychodynamic psychotherapy. Next, using a dynamic structural equation model for 592 sessions of 37 clients working with 6 therapists using both the HSM and the Experiences in Close Relationships-Short Form (Wei et al., 2007), we found a slight increase in exploration and insight skills as rated by therapists, but no significant change in client attachment dimensions over time. For the model using the therapist-rated HSM, we found significant and positive auto correlations for Anxiety, Avoidance, and Action, and a significant and positive cross-lagged correlation for Avoidance in one session predicting Action in the next session. For the model using the client-rated HSM, we found significant and positive auto correlations for Anxiety, Avoidance, and Exploration, and significant and negative cross-lagged correlations for Anxiety in one session predicting Exploration and Action in the next session. We did not find any significant cross-lagged correlations for therapist skills in one session predicting client attachment dimensions in the next session. We provide suggestions for practice and research, including training in attachment-informed therapy to improve therapist responsiveness and linking associations between client attachment and therapist skills to client outcome.Item Attachment and Peer and Romantic Relationship Functioning: The Role of Social Information Processing(2022) Fitter, Megan Haley; Cassidy, Jude; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Perhaps the most central tenet of attachment theory is that individual differences in attachment quality relate to social functioning (Bowlby, 1969/82, 1973, 1980). Indeed, abundant research demonstrates that early insecurity toward caregivers relates to poor functioning in later peer and romantic relationships (Englund et al., 2011; McElwain et al., 2008), and individuals’ attachment orientations relate to their concurrent functioning with peers and romantic partners (Collins et al, 2006; Groh et al., 2014). For decades, researchers have been trying to understand why these connections exist. The aim of this dissertation is to help answer this question with a collection of three empirical studies testing social information processing (SIP) as a mechanism through which attachment predicts individual differences in social functioning. The present studies focus on two critical components of SIP—expectations and attributions. Study 1 (N = 2100) examined the indirect effects of adolescents’ attachment style dimensions on their acceptance by peers—assessed with sociometric peer ratings—through negative expectations of peers’ behaviors. Findings revealed that adolescents with greater attachment anxiety (fears of rejection and abandonment) and avoidance (discomfort with closeness) held negative expectations for how their peers would behave, and negative expectations in turn related to low acceptance by peers. Study 2 (N = 347) examined the role of attribution biases and friendship quality on pathways from early attachment to young adolescent romantic relationship quality. Longitudinal latent variable structural equation modeling analyses did not yield evidence for attribution biases or friendship quality as mediators on such pathways. Further, no direct links between early attachment to mothers and romantic relationship quality emerged. Findings did, however, show relations between early attachment to mothers and negative attribution biases about peers, as well as between friendship quality and romantic relationship quality. Study 3 (N = 198) examined a causal link between young adults’ attachment and attribution biases using an experimental priming procedure. Security priming—temporarily boosting feelings of security—led participants to make fewer negative attributions about hypothetical romantic partners’ transgressions. Participants with fewer negative attributions, in turn, reported that they would respond less negatively to the transgressions. Findings across the three studies provide support for SIP as a mechanism through which some conceptualizations of attachment (i.e., attachment style dimensions and temporary feelings of security) relate to social functioning, but findings do not support the theory that SIP explains longitudinal links between early attachment and later social functioning.Item Changing Attachments: The Client-Therapist Relationship and Outcome(2020) Hillman, Justin William; Kivlighan, Jr., Dennis M; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)From the perspective of attachment theory (Bowlby, 1988), this study examined if client attachment to therapist developed over the course of psychotherapy and if changes in attachment to therapist were associated with treatment outcomes. Clients (N = 112), receiving psychodynamic therapy from trainee therapists (N = 29), completed the Client Attachment to Therapist Scale (Mallinckrodt, Gantt, & Coble, 1995) and the Outcome Questionnaire-45 (Lambert et al., 1996) at baseline and every eighth session. Multilevel linear growth curve analyses showed that secure attachment to therapist increased and avoidant-fearful attachment to therapist decreased. Multilevel linear regression showed that when within-client secure attachment to therapist was higher, subsequent symptoms improved more. Client-level and therapist-level effects were explored. Results suggest that the development of a secure attachment to therapist is important for positive treatment outcomes. Implications for practice and research are discussed.Item Client Laughter, Not a Laughing Matter: The Interpersonal Role of Client Laughter in Psychotherapy(2017) Gupta, Shudarshana; Hill, Clara E; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The purpose of this study was to investigate the presence of 5 characteristics (cheerfulness, politeness, reflectiveness, nervousness, and contemptuousness) in client laughter, and to examine the relationship between the presence of these 5 laughter characteristics and client attachment styles as observed in psychotherapy. The primary investigator, and 6 undergraduate students coded 813 laughter episodes, which were nested within 33 clients, nested under 16 therapists, in one psychotherapy clinic. Judges rated the intensity of each laughter episode in terms of the presence of these 5 laughter characteristics. Initial client attachment style was measured using a self-report measure. Laughter occurred on average, in 9 out of 10 sessions, and was rated highest on politeness and reflectiveness, followed by cheerfulness and nervousness, and was rated lowest on contemptuous. Initial attachment style of the clients influenced the characteristic observed in client laughter, throughout therapy. As theorized by Nelson (2012) clients seemed to use laughing to both connect and disconnect with the therapist. Implications for practice and research are discussed.Item Attachment Security and Caregiving Scripts: Links to Prosocial Comforting(2016) Martin, David R.; Cassidy, Jude A; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Prosocial behavior is a key marker of healthy social development in children. Studies consistently find that attachment security is an important predictor of children’s prosocial behavior. Studies investigating mechanisms that explain this relation are not necessary for understanding prosocial development. The goal of this study was to investigate a proposed mechanism, caregiving scripts, that might explain the relation between attachment security and prosocial comforting. A community sample of four-year old children (n = 88) completed a series of lab tasks assessing their attachment security, caregiving script knowledge, and response to an experimenter’s distress. Results reveal that attachment security predicted children’s comforting behavior and caregiving script knowledge. However, contrary to hypotheses, caregiving scripts did not mediate the relation between attachment security and prosocial comforting These findings are partially consistent with previous results and suggest that further study is necessary to understand the function of the caregiving script.Item Trauma, Depression, Early Attachment, and Neonatal Health Outcomes among African American Mothers and their Infants(2016) Morrison, Colleen Isabel; Jones Harden, Brenda; Human Development; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Young children whose mothers are depressed are vulnerable to a range of negative developmental outcomes beginning during the prenatal period and persisting throughout childhood. There is a large and growing need for evidence-informed pre-and postnatal services for pregnant women, especially in high-risk populations. More research is needed to inform practices relative to identifying pregnant women at risk for depression, providing treatment of depression and its concomitants during pregnancy and the postpartum period, and promoting positive developmental outcomes in infants who have been exposed to perinatal depression. The goal of this study was to enhance our knowledge of perinatal depression (i.e., depression that occurs during pregnancy or within the first 12 months following delivery) as well as its impact on maternal functioning in low-income, African American women and the health and developmental outcomes of their young infants. Participants were low-income African American women (N = 70), recruited during their third trimester of pregnancy, and their newborns. Data collection took place over two time periods: during the third trimester of pregnancy and at one month postpartum. Prenatal data collected include information on a range of risk and protective factors, including prenatal depression, health behaviors, and maternal-fetal attachment (i.e., mother’s feelings of attachment to her unborn child). Postnatal data collected include information on depression, neonatal outcomes (e.g., birth weight), and maternal feelings of attachment to her infant. Multiple regression, logistic regression, and measured variable path analysis were used to test the relationships between risk factors, maternal functioning, and neonatal outcomes. Although his study relied on a small convenience sample of pregnant women, and is not generalizable to a broader population, there are still several findings of note. Marital status and trauma exposure significantly contributed to prenatal depressive symptoms. Also, maternal-fetal attachment mediated the relationship between prenatal depressive symptoms and health practices, but only for participants who were not married or cohabitating. Finally, maternal-fetal attachment significantly predicted maternal-infant attachment. Implications for policy and practice are presented.Item The Effect of Supportive Social Interaction Priming on Children's Prosocial Comforing Responses to Distressed Others(2016) Brett, Bonnie Erin; Cassidy, Jude A; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The ability to sensitively care for others’ wellbeing develops early in ontogeny and is an important developmental milestone for healthy social, emotional, and moral development. One facet of care for others, prosocial comforting, has been linked with important social outcomes such as peer acceptance and friendship quality, underscoring the importance of determining factors involved in the ability to comfort. Although social support has been linked with a number of important social outcomes, no study has directly examined whether felt social support can foster children’s positive behavior toward others. The purpose of the current investigation was to use an experimental priming paradigm to demonstrate that felt social support a) enhances children’s ability to respond prosocially to the distress of others and b) decreases children’s expressions of personal distress when faced with the distress of another person. Participants were 94 4-year-old children (M = 53.56 months, SD = 3.38 months; 52 girls). Children were randomly assigned to either view pictures of mothers and children in close, personal interactions (supportive social interaction condition), happy women and children in separate pictures, presented side-by-side (happy control condition), or pictures of colorful overlapping shapes (neutral control condition). Each set of 20 pictures was presented in the context of a categorization computer game that participants played 4 times throughout the course of the study. Immediately following the first three computer games, children were given the opportunity to comfort someone who was distressed; twice it was the adult experimenter working with the child, and once it was an unseen infant crying over a monitor that participants had been trained to use. Comforting behaviors and distress/arousal were coded in 10-second time segments and yielded a global comforting score and a distress proportion score for each task. Results indicated that priming condition had no effect on either prosocial comforting behavior or expressions of personal distress. I discuss these null findings in light of the available literatures on priming mental representations in children and on prosocial comforting, and suggest some future directions for continued investigation in both fields.Item CLIENT ATTACHMENT AS A PREDICTOR OF THERAPIST INTERVENTIONS, THE WORKING ALLIANCE, AND THE REAL RELATIONSHIP IN THE INITIAL, MIDDLE, AND FINAL PHASES OF PSYCHOTHERAPY(2013) Jackson, John Lawrence; Hill, Clara E; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)This study investigated client attachment style as a predictor of (a) therapist interventions in an early, middle, and late session of psychotherapy; (b) client and therapist post-session ratings of the working alliance over the course of therapy; and (c) client and therapist post-session ratings of the real relationship over the course of therapy. A total of 41 clients and 14 therapists completed measures prior to and throughout open-term courses of psychotherapy ranging from 8 to 106 sessions. Client attachment style was measured using the anxiety and avoidance subscale scores from the Experiences in Close Relationships scale (ECR; Brennan, Clark, & Shaver, 1998). Therapist interventions were coded by trained observers using the Psychotherapy Q-Set (PQS; Jones, 2000). A factor analysis of therapist interventions revealed four factors: Therapist Facilitative Approach (TFA), Therapist Psychodynamic versus Behavioral Interventions (TPB), Therapist Supportive Approach (TSA), and Therapist Process Comments (TPC). Client attachment avoidance was positively associated with Therapist Supportive Approach (TSA), such that therapists were more likely to use directly supportive interventions with clients who endorsed higher levels of attachment avoidance at the outset of therapy. Otherwise, client attachment ratings were not significantly associated to overall levels of therapist interventions or change in therapist interventions over the course of therapy. Neither client attachment anxiety nor avoidance significantly predicted initial levels, mean levels, or patterns of change in client or therapist ratings of the working alliance or the real relationship over the course of psychotherapy. The findings are discussed in the context of findings and methodological differences from other investigations of client attachment, therapist interventions, and client and therapist ratings of the working alliance and the real relationship. Implications for future research and clinical practice are also discussed.Item Cognitive and Physiological Mediators of the Link Between Maternal Attachment and Self-Reported Responses to Child Distress(2013) Brett, Bonnie Erin; Cassidy, Jude A; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Given recent evidence that caregivers' responses to their children's distress are predictive of a host of child outcomes, the goal of the present study was to examine attachment related differences in maternal responses to child distress. In addition, I examined whether the link between maternal attachment and maternal responses to child distress was mediated by maternal negative attribution biases about infant distress and maternal electrodermal reactivity in the context of infant distress. Path analyses revealed that (a) maternal attachment-related anxiety was positively related to maternal distress reactions to child distress, (b) that maternal negative attribution biases were negatively related to supportive maternal responses, and (c) that maternal electrodermal reactivity was positively linked with unsupportive maternal responses. These findings advance the literature on the maternal characteristics associated with supportive and unsupportive maternal responses to child distress.Item The Role of Mothers' Authoritative Parenting in Adolescent Attachment and Social Relationships(2011) Beck, Kathryn Maria; Leslie, Leigh A; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Research has shown the increasing importance of peer relationships for adolescents and a variety of positive outcomes for adolescents with quality, supportive friendships. The literature shows that both parenting style and attachment security influence adolescent social support. However, the mechanism through which parenting style influences adolescent social support remains undetermined. The current study, utilizing a clinical sample of 118 mothers and adolescents, explores the role of adolescent attachment security as a mediating variable for this relationship. Authoritative parenting is assessed using the Parenting Practices Questionnaire (Robinson et al., 1995); attachment using the Relationship Questionnaire (Hazan & Shaver, 1987); and social support using the Social Support Questionnaire (Procidano & Heller, 1983). The findings indicate no significant relationship between mothers' authoritative parenting and adolescent attachment security, but a positive relationship between adolescent attachment security and social support. The possible meaning of the lack of significant relationship for this sample is discussed.