Theses and Dissertations

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    Competence to Stand Trial: Restoring Competence in an Inpatient Forensic Hospital Setting
    (Washburn University, 2024-04-09) Davenport, Shelly
    The following is a de-identified case study that describes how competency restoration treatment, psychiatric treatment, and assessments were used to assist Competency to Stand Trial restoration with a patient who has intellectual and psychiatric disabilities, in a state funded and forensicfocused in-patient residential hospital facility. Jack was a 20-year-old White male whose main struggles were with anger and impulsivity. His primary diagnoses were Attention Deficit/Hyperactivity Disorder, and Intellectual Disability. He has a secondary diagnosis of Other Specified Personality Disorder, and a differential diagnosis of Autism Spectrum Disorder. He was recommended by the unit psychologist for individual competency restoration treatment in addition to the group sessions he was assigned to as part of his more comprehensive treatment. Jack was assessed with an initial interview covering psychosocial history and mental status. Formal assessment instruments used included the Emotional Problems Scales (EPS), the Conners’ Adult ADHD Rating Scales (CAARS), and the Competence Assessment for Standing Trial for Defendants with Mental Retardation (CAST*MR). Individual competency restoration treatment sessions were based on and/or accessed from materials included in the Florida State Hospital CompKit manual (Florida State Hospital, 2011), and supplemented with available Mindfulness materials to increase coping skills and decrease impulsive behaviors. Included in this document is a transcript of a mock competency to stand trial evaluation that was the final session for Jack and designed to demonstrate his overall improvement as a result of the individual competency to stand trial treatment.
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    Inauthenticity as a Predictor of Depression and Negative Affect Among University Students
    (Washburn University, 2024-04-09) Carver, Jane E.
    Authenticity is a construct that while not new, is gaining momentum in the field of social psychology. Finding a potential link between authenticity and the clinical construct of depression was the goal for the current study. This study was conducted in two parts: Study 1 was designed to assess the relationship between authenticity and depression. Study 2 was designed to replicate and extend the results of Study 1 by predicting whether an emotional disclosure writing exercise related to (in)authenticity could cause a change in participants’ affect. Contrary to our hypothesis, the results indicated a significant positive relationship exists between authenticity and depression and the introduction of an emotional disclosure exercise did not significantly change the participants’ affect. Interestingly, when supplemental analyses were conducted to examine the relationships between the subscales of authenticity and depression, one of the subscales (i.e., self-alienation) significantly correlated with depression, which was consistent with our hypothesis. More research is needed to further assess the link between authenticity, depression, and other related constructs to determine how such variables could potentially assist clinicians in their practice. Authenticity is an important factor in the lives of individuals and by raising further awareness with the current study, we hope to give people insight into the mental health benefits of being themselves.
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    Anti-Transgender Voting Behavior: A Justification/Suppression Model Approach
    (Washburn University, 2024-04-22) Falck, Wednesday
    Anti-transgender legislation grows prevalent across numerous regions of the United States. Thus, investigating predictors of anti-transgender sentiment as well as the impact of pro- and antitransgender rhetoric on voting behavior offers a timely research opportunity. Previous research has suggested that the expression of prejudice might be conditional on justification factors that excuse prejudice or suppression factors which make it feel socially undesirable. In this experiment, 186 participants were exposed to either pro- or anti-transgender priming vignettes or a neutral control condition before being asked to vote on a hypothetical anti-transgender “bathroom bill” to determine whether the justification/suppression theory could be used to influence voting behavior. Participants also self-reported on several personal belief scales, including religious fundamentalism, social dominance orientation, transphobia, and critical consciousness to confirm the results of previous research which suggests that critical consciousness might moderate the predictive relationship between transphobia and antitransgender voting behavior. Results did not indicate an effect of the experimental conditions on voting behavior. Surprisingly, critical consciousness correlated with transphobia, such that higher levels of voiced support for transgender rights corresponded with stronger endorsement of transphobic beliefs. This research suggests that the relationship between voiced and actionable support for transgender people may be complex, and that voting behavior on the subject of transgender rights may not be easily swayed with simple exposure to shallow rhetoric in either direction of support.
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    Treatment of Social Anxiety Disorder: A Case Study of a 24-Year-Old
    (Washburn University, 2024-04-21) Heidorn, Alex
    The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) describes the primary feature of social anxiety disorder (SAD) as persistent and significant fear of judgment in social situations; avoidance of feared social situations is a common feature (American Psychological Association, APA, 2013). The person might fear being judged as anxious, weak, crazy, stupid, boring, intimidating, dirty, or unlikable. The socially anxious individual may fear that their symptoms of social anxiety will be noticed by others and lead to negative evaluation. Some examples of these symptoms include blushing, trembling, sweating, stumbling over words, and staring. To receive a diagnosis of SAD, the individual must almost always experience fear or anxiety in relevant social situations, meaning that someone who only occasionally becomes anxious will most likely not meet criteria. The anxiety experienced by the individual must also be disproportionate to the context of the situation. The social anxiety must cause clinically significant distress or impairment in important areas of functioning (e.g., social life, job) for 6 months or more and cannot be explained by the physiological effects of a substance or another mental disorder. If another medical condition that could cause anxiety is present (e.g., Parkinson’s disease), the individual’s fear must be unrelated to that condition or excessive. The DSM-5 (APA, 2013) states that the most common comorbid disorders are other anxiety disorders, major depressive disorder, and substance use disorders. With most comorbid disorders, SAD precedes them except for specific phobia and separation anxiety disorder. The following are common comorbidities in the DSM-5: major depressive disorder, substance use disorders, specific phobia, separation anxiety disorder, bipolar disorder, and body dysmorphic disorder.
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    Treatment of Social Anxiety Disorder: A Case Study of a 17-Year-Old Female
    (Washburn University, 2024-04-03) Huffman, Laurrel
    The following is a de-identified case study that presents the treatment process and outcome for Allie, a 17-year-old female with social anxiety disorder. Names and other identifying details have been changed to maintain confidentiality. Allie graduated high school during the course of treatment. Allie began services at a certified community behavioral health center after referral by her primary care physician. Allie presented with moderate to severe anxiety symptoms that impacted her ability to engage socially with peers and adults. Allie’s anxiety manifested through negative cognitions, physiological symptoms, emotional and behavioral avoidance which created interference and impaired functioning. Congruent with literature on empirically supported treatments for adolescents with social anxiety disorder, Cognitive Behavioral Therapy (CBT) was utilized. The use of CBT supported Allie in learning and applying therapeutic interventions (i.e., psychoeducation, cognitive restructuring, fear hierarchy, graduated exposures) to effectively reduce and manage anxiety symptoms. Information provided includes a literature review, client interview, diagnostic assessments, treatment plan, treatment interventions, and therapist self-reflection. A transcript of one individual session is included to provide insight into Allie’s presentation in-session, as well as application of treatment interventions by this therapist. In the treatment plan review, Allie reported inconsistent and insignificant progress on her goal of managing anxiety. Allie actively engaged in sessions but displayed low homework compliance and admitted to providing inaccurate self-report scores due to fear of upsetting the therapist. After nine sessions, her selfreported social anxiety score on a validated measure showed no significant reduction. Consistent with this score, Allie reported no significant reduction for interference and impairment.