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Qualitative Analysis of Emotion Regulation As Seen in Middle Eastern American Psychotherapy Clients

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Qualitative Analysis of Emotion Regulation As Seen in Middle Eastern American Psychotherapy Clients Pepperdine University Pepperdine Digital Commons Theses and Dissertations 2018 Qualitative analysis of emotion regulation as seen in Middle Eastern American psychotherapy clients Jennifer Nehme Follow this and additional works at: https://digitalcommons.pepperdine.edu/etd Recommended Citation Nehme, Jennifer, "Qualitative analysis of emotion regulation as seen in Middle Eastern American psychotherapy clients" (2018). Theses and Dissertations. 959. https://digitalcommons.pepperdine.edu/etd/959 This Dissertation is brought to you for free and open access by Pepperdine Digital Commons. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of Pepperdine Digital Commons. For more information, please contact [email protected], [email protected], [email protected]. Pepperdine University Graduate School of Education and Psychology QUALITATIVE ANALYSIS OF EMOTION REGULATION AS SEEN IN MIDDLE EASTERN AMERICAN PSYCHOTHERAPY CLIENTS A clinical dissertation submitted in partial satisfaction of the requirements for the degree of Doctor of Psychology by Jennifer Nehme June, 2018 Susan Hall J.D., Ph.D. – Dissertation Chairperson This clinical dissertation, written by Jennifer Nehme under the guidance of a Faculty Committee and approved by its members, has been submitted to and accepted by the Graduate Faculty in partial fulfillment of the requirements for the degree of DOCTOR OF PSYCHOLOGY Doctoral Committee: Susan Hall, J.D., Ph.D., Chairperson Natasha Thapar-Olmos, Ph.D. Kristen Leishman, Psy.D. © Copyright by Jennifer Nehme (2018) All Rights Reserved TABLE OF CONTENTS Page LIST OF TABLES......................................................................................................................... ix LIST OF FIGURES .........................................................................................................................x VITA.............................................................................................................................................. xi ABSTRACT............................................................................................................................... xviii Chapter 1: The Problem...................................................................................................................1 Introduction..........................................................................................................................1 Background of Problem .......................................................................................................1 Purpose and Importance of Study........................................................................................3 Research Questions..............................................................................................................4 Clarification of Terms..........................................................................................................4 Middle East and Middle Eastern..............................................................................4 Iranian and Persian...................................................................................................5 Emotion Regulation and Dysregulation...................................................................5 Chapter 2: Review of Relevant Literature .......................................................................................6 Overview..............................................................................................................................6 Current Status of Theory and Research on Emotion and Regulation ..................................6 Definitions and Models of Emotion.....................................................................................7 Emotion Definition ..................................................................................................7 Emotion Models.....................................................................................................10 Emotion Regulation ...........................................................................................................11 Defining Emotional Regulation and Related Constructs.......................................12 Emotion Regulation Models ..................................................................................14 Extended Process Model of Emotion.........................................................15 Instrumental Approach...............................................................................17 Linehan’s Biosocial Model........................................................................19 Acceptance and Commitment Therapy......................................................23 Assessment of Emotional Regulation and Dysregulation..................................................26 Emotional Expression Measures............................................................................29 Emotion Regulation Measures...............................................................................31 Emotion Dysregulation Measures..........................................................................36 Summary....................................................................................................38 Current Status of Theory and Research on Middle Eastern Clients in Psychotherapy......38 Middle Eastern Cultural Identities.........................................................................39 Religious Identities ................................................................................................40 Immigration History to the United States and Acculturation ................................40 Cultural Values and Beliefs ...................................................................................42 Communication and Emotional Expression in Middle Eastern Culture............................43 Affective Expression..............................................................................................43 Concealment of Emotion .......................................................................................44 Somatization of Affective Disorders .....................................................................44 Current Status of Research on Middle Eastern Clients in Psychotherapy.........................45 Common Presenting Problems and Specific Treatment Recommendations......................48 Conclusion .............................................................................................................52 Summary of Literature Review..........................................................................................52 Chapter 3: Methodology and Procedures.......................................................................................54 Research Approach and Design.........................................................................................54 Subject Participants and Consent/Human Subjects Procedures.........................................55 Participant Cases....................................................................................................55 Client-Participant 1 ....................................................................................57 Client-Participant 2 ....................................................................................58 Client-Participant 3 ....................................................................................60 Researcher-participants..........................................................................................63 Human Subjects/Ethical Considerations................................................................64 Data Collection, Recording, and Analysis.........................................................................65 Sample Selection....................................................................................................65 Transcription..........................................................................................................67 Data Recording ......................................................................................................67 Data Process and Analysis.....................................................................................67 First Cycle Coding .....................................................................................69 Abstraction and Categorization..................................................................71 Chapter 4: Results..........................................................................................................................73 Overview............................................................................................................................73 Section 1: Parent Themes Across Participants...................................................................74 Emotion Dysregulation .........................................................................................75 Experiential Avoidance..............................................................................76 Negative Emotional Reactivity..................................................................78 Difficulty Labeling Current Affect ............................................................80 Emotion Regulation ..............................................................................................81 Acceptance.................................................................................................82 Increasing Positive Emotional Events .......................................................83
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