Browsing by Author "Ready, Charlotte Beth"
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Item An examination of meaning-making processes in trauma-focused cognitive behavioral therapy for childhood trauma(University of Delaware, 2015) Ready, Charlotte BethClinical research has shown that cognitive components of overgeneralization are associated with Posttraumatic Stress Disorder (PTSD). Previous findings from treatment studies for adult PTSD suggest that cognitive shifts from overgeneralized to more balanced, accommodated beliefs are important change processes in PTSD treatment. Conversely, avoidance has been identified as an inhibitor of symptom improvement. It is not yet clear whether: 1) change in both overgeneralization and new beliefs (accommodation) are required for symptom change, 2) change in overgeneralization or accommodation alone is sufficient, or 3) whether chronic avoidance exacerbates the negative effects of overgeneralization. Previous research has not examined predictors of long-term change and has focused only on adult populations. This study examined the relationships between overgeneralization, accommodation, avoidance, and symptom reduction in a sample of 81 youth (age 7-17 years) receiving Trauma-Focused Cognitive Behavioral Therapy. Overgeneralization, accommodation, and avoidance expressed during the exposure phase of treatment were coded in audio-recorded therapy sessions. Overgeneralization, accommodation, avoidance, and their interactions were examined as predictors of symptoms at treatment and the follow-up period. Interaction findings revealed that overgeneralization was associated with higher posttreatment internalizing problems, but not when accommodation was high or when avoidance was low. Overgeneralization also predicted a worsening of externalizing symptoms over the follow-up period, but accommodation again reduced this effect and avoidance worsened this effect. These findings suggest that overgeneralization might inhibit therapeutic change in youth with PTSD, but the elicitation of accommodated beliefs and reduction of avoidance may buffer these negative effects.Item Limitations of a self-distanced perspective : alexithymia as a moderator of self-distancing and emotional processing(University of Delaware, 2012) Ready, Charlotte BethMany researchers view cognition and emotion as interconnected components of emotional processing. Research indicates that adopting a “distanced” perspective, in which an individual explores an emotional experience from a cognitive distance, facilitates adaptive cognitive reappraisal and emotional processing of the experience. However, little is known about the benefits of self-distancing in individuals who have difficulties integrating their cognitive and emotional experiences. Alexithymia is a construct that characterizes a disconnect between cognitions and emotions, and individuals with high levels of alexithymia may not have the ability to fully engage and benefit from adopting a self-distanced perspective. Using a college-student population over-sampled for moderate to high alexithymia (N=211 study completers), the current study examined alexithymia as a moderator of the association between self-immersed and self-distanced perspectives and emotional processing when recalling an interpersonal rejection experience. Self-immersed and self-distanced perspectives were associated with higher negative affect compared to a distraction group, and alexithymia did not moderate the association between perspective and negative affect. However, alexithymia moderated the relationship of self-immersed and self-distanced perspectives with one of two measures of processing, indicating that higher levels of alexithymia may inhibit processing during self-distancing. Further examination identified the externally-oriented thinking factor of alexithymia as particularly relevant in self-distancing. Implications of these findings for the benefits of self-distancing, the conceptualization of alexithymia, and treatment are discussed.