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The Impact of Spirituality and Trauma on Appraisals of Psychotic-Like Experiences By: Kathleen S

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The Impact of Spirituality and Trauma on Appraisals of Psychotic-Like Experiences By: Kathleen S City University of New York (CUNY) CUNY Academic Works All Dissertations, Theses, and Capstone Projects Dissertations, Theses, and Capstone Projects 9-2017 The Impact of Spirituality and Trauma on Appraisals of Psychotic- Like Experiences Kathleen Isaac The Graduate Center, City University of New York How does access to this work benefit ou?y Let us know! More information about this work at: https://academicworks.cuny.edu/gc_etds/2339 Discover additional works at: https://academicworks.cuny.edu This work is made publicly available by the City University of New York (CUNY). Contact: [email protected] THE IMPACT OF SPIRITUALITY AND TRAUMA ON APPRAISALS OF PSYCHOTIC-LIKE EXPERIENCES By KATHLEEN S. ISAAC A Dissertation submitted to the Graduate Faculty in Psychology in partial fulfillment of the requirements for the degree of Doctor of Philosophy, The City University of New York 2017 2017 KATHLEEN S. ISAAC All Rights Reserved The Impact of Spirituality and Trauma on Appraisals of Psychotic-Like Experiences By: Kathleen S. Isaac This manuscript has been read and accepted for the Graduate Faculty in Psychology in satisfaction of the dissertation requirement for the degree of Doctor of Philosophy __________________________ ___________________________ Date Deidre Anglin Chair of Examining Committee ___________________________ ____________________________ Date Richard Bodnar Executive Officer, Psychology Supervisory Committee: Elliot Jurist Glen Milstein Tiffany Floyd Lina Jandorf THE CITY UNIVERSITY OF NEW YORK iii ABSTRACT The Impact of Spirituality and Trauma on Appraisals of Psychotic-Like Experiences By: Kathleen S. Isaac Advisor: Deidre Anglin, Ph.D. Background: A substantial portion of the general population (2.5% to 31.4% internationally) reports psychotic-like experiences, which are paranormal, psychic or bizarre perceptual experiences such as voice hearing, or holding strong beliefs (i.e. superstitions) that are neither experienced as pathological nor indicative of a psychotic disorder. Cognitive models of psychosis suggest that the cognitive appraisal (i.e. personal interpretation) of the experience may help distinguish non-clinical psychotic-like experiences from clinical psychotic symptoms. This dissertation attempted to add to cognitive models by assessing whether cultural and personal factors such as spirituality and trauma inform the appraisals of anomalous experiences. This study used a moderated-mediation model to explore associations between degree of spirituality, appraisals of anomalous experiences, and trauma. This dissertation tested the hypothesis that spirituality informs the content, valence, and emotional valence attributed to psychotic experiences among individuals who endorse such experiences. Trauma was suggested as a moderator of the relationship between spirituality and the valence of appraisals. High spirituality was expected to be associated with positive spiritual appraisals and positive emotional responses, while a history of trauma was expected to modify the relationship between appraisals and valence, such that high spirituality was expected be associated with negative spiritual appraisals and negative emotional responses in the context of a trauma history. Method: In this mixed-methods study, 29 iv undergraduate students enrolled at the City College of New York who endorsed lifetime anomalous experiences, completed self-report measures assessing psychotic symptoms, appraisal style, spirituality and trauma history. Participants were also interviewed to assess anomalous experiences, their appraisals and their spiritual history. Hypotheses were tested by conducting bivariate correlational analyses to test associations between level of spirituality, number of traumatic events, psychotic symptoms and appraisals of experiences. A qualitative analysis of appraisals of lifetime anomalous experiences was also conducted to test the hypotheses. Results: Overall, participants were more likely to have mixed emotional reactions to their experience, regardless of whether they appraised the experience as positive or negative. Spiritual appraisals were made across all spiritual identity categories. Spiritual individuals were more likely to make negative appraisals. Family spirituality was found to have a significant influence over spiritual appraisals. Distressing psychotic symptoms were positively associated with the number of traumatic events, negative appraisal style and negative emotional responses. The majority of the sample (86%) reported a history of trauma. The moderation effect therefore could not be tested, but this may also explain why spiritual appraisals were positively associated with negative religious coping in this highly traumatized sample. Emotional distress was a significant situational context for the onset of anomalous experiences. Conclusion: Specific aspects of spirituality, such as religious coping and family spirituality should be incorporated into cognitive models of psychosis, as they inform the nature of appraisals of anomalous experiences. The situational context and the type of experience should also be considered as factors that inform the nature of appraisals. Future studies should v compare clinical and non-clinical samples to explore the nature of appraisals and emotional responses among individuals who report psychotic experiences. Key words: Spirituality, Psychosis, Trauma, Appraisals, Cognition vi ACKNOWLEDGEMENTS “To EVERY thing there is a season, and a time to every purpose under heaven…He hath made everything beautiful in his time: also he hath set the world in their heart, so that no man can find out the work that God maketh from the beginning to the end.” –Ecclesiastes 3:1 &11 (KJV) Depuis ou gen Bon Dieu nan vie ou, toute va marche! All honor and glory goes to God, who has kept me throughout this journey. Without my faith, I wouldn’t have been able to overcome all that I have to make it to this point in my life. Thank you Lord for guiding me, challenging me and showing me that I can do anything as long as I continue to keep my focus on you. I am grateful for the opportunity to honor you through studying spirituality, which is a testament to your continued influence over my life. Let your light continue to shine through me… I have such a strong support system! Thank you lord for family! I am grateful to honor the legacy of my late parents Rev. Dr. Acelius and Lenite Isaac, by following in my father’s footsteps and getting my PhD! In my parents’ absence, I must thank my siblings Jerry, Muriel, Knaack and Michelle for supporting me in so many ways. Thank you to my second family, Geneva, Kristin, and Manny for encouraging me. Thank you Mom for standing in the gap, loving me and mothering me and providing just what need when I need it. Thank you to the rest of my family and friends for your support. Thank you to my Sorors of the Gorgeous Gamma chapter of Delta Sigma Theta for continuing to inspire and motivate me. My ride or die, Kristina, I don’t know what I would do without you. vii Mentorship has been essential to my development as a clinician and researcher. As I prepare to embark on the career I know I was destined for, I am grateful for the students and faculty I have met during this long PhD journey. Thank you Diana Punales for your warmth and encouragement and supporting my growth as a clinician. Thank you to my clinical supervisors who helped me learn how to hone my clinical skills. Thank you to my committee members Elliot and Professor Milstein for lending your expertise to help with this dissertation. Lina, I had no clue how to analyze this qualitative data and I’m grateful for your guidance during this process and for connecting me with Jamilia Sly, who also helped me think through the qualitative analyses. I remember walking in the halls of City College when I was a research assistant and imagining myself as a doctoral student in the clinical program. Thank you Tiffany for not only giving me that first research job, but continuing to mentor me throughout my time at City. I have so many mentors! Alyson Moadel, thank you for supporting my interests in cancer and for going above and beyond to support me and my family in our time of need. Thank you to the CCNY-MSKCC partnership for health disparities for supporting my cancer research. Thank you to my Jacobi mentors, especially Kate, Jantra, Laura, Willann and Todd for your support during such a difficult internship year. Thank you to every patient I have had the opportunity to encounter. I have learned so much about myself and about humanity through my work. I believe being a clinician is my God-Given calling and I am grateful every day that I get to spend the rest of my life doing what I love. viii I cannot forget my amazing research assistants Bharathy, Raisa and Meghna. I couldn’t have done this dissertation without you. Thank you Veronica for helping me with analyses and for your friendship this year. Finally, I thank my chair and mentor Deidre Anglin. I have been blessed to have you as my advisor for the past 6 years. You have shepherded me through every major milestone in this program and I am so very grateful for your example. Thank you for expecting nothing less than the best and pushing me towards excellence! May I never forget that I am standing on the shoulders of many who have sacrificed and fought for the opportunities I have been blessed with. May I never lose my passion for social justice. Black Lives Matter! ix TABLE OF CONTENTS ABSTRACT………………………………………………………………………..iv ACKNOWLEDGMENTS………………………………………………………….vi
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