David Kealy

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Verified

David verified their affiliation via an institutional email.

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• PhD
• Professor (Associate) at University of British Columbia

Background: Previous research has highlighted motivational factors as being important in depression. The current study sought to examine the role of explicit motives and pathological narcissism in men's experiences of depression symptoms. The study examined a two-factor Approach-Avoidance model where we hypothesized approach-oriented motives and av...

The role of externalizing symptoms in men’s experiences of depression, including the link between externalizing symptoms and traditional masculinity ideologies (TMI), has emerged as a key consideration in men’s mental health. Within this context, men’s strategies to manage uncomfortable thoughts and emotions (e.g. restricted emotionality, alexithym...

Mental health difficulties typically develop during adolescence, yet service utilization rates among youth are low. We sought to understand perspectives among Canadian youth accessing mental health services at an integrated youth services centre called Foundry. Forty-one semi-structured qualitative interviews were conducted with youth aged 15–24 ye...

Understanding treatment failures is important for improving therapist responsiveness and mitigating negative outcomes in psychotherapy. One factor that may increase the risk for treatment failure is the therapist’s determination to adhere to a particular treatment model. While therapist adherence has mostly been discussed in reference to manualized...

Guilt and shame are emotions that, albeit subjectively negative, help humans adapt to their social environment. However, in some cases, there are pathogenic beliefs, shaped over the lifespan that sustain them and make them a source of psychopathological suffering. In this paper we will first briefly show how Control-Mastery Theory (CMT) considers s...

Existing research supports the therapeutic value of hope in different therapies and for diverse patient groups. Patients who are socially inhibited tend to have a particularly difficult time in group therapy, and the experience of hope in that context may be especially poignant for them. The present study investigated the impact of hope on the outc...

Excessive parental psychological control may disrupt individuals’ psychosocial development, thus influencing later psychological problems. The present study tests a retrospectively worded Parental Control and Disrespect Scale (PCDS) to examine factor structure and model fit as well as associations with individuation-related difficulties and negativ...

Objective This study examined therapists' dispositional empathy profiles and how they differ based on professional and personal characteristics. Method A total of 376 clinicians was recruited for this study. Dispositional empathy was assessed with the Interpersonal Reactivity Index (IRI). Profiles were generated using latent profile analysis. Pred...

Objective: This qualitative study explores patients’ experiences of psychotherapy, focusing on elements perceived as helpful or unhelpful and suggestions for improvement in the context of public mental health care. Methods: A total of 148 adults (Mean age = 32.24, SD = 9.92) who had been or are currently receiving psychological treatment from the...

Introduction During the COVID-19 pandemic individuals with mental illnesses faced challenges accessing psychiatric care. Our study aimed to describe patient characteristics and compare admissions and length of stay (LOS) for psychiatric-related hospitalizations before and during the COVID-19 pandemic. Methods We conducted a retrospective analysis...

Several decades of theory suggest that pathological narcissism (PN) may limit psychotherapy success, but empirical evidence for such theories is limited and mixed. In addition, it has been proposed that individuals with high levels of PN may benefit more from supportive compared to interpretive psychodynamic therapies, but no studies thus far have...

Research has indicated loneliness to be a detrimental correlate of narcissistic vulnerability. However, no research has examined if this relationship persists across time or why it occurs. The present study explores the link between nar-cissistic vulnerability and loneliness across time and examines which domains of personality dysfunction (i.e., i...

The culture around personality disorder treatment has changed drastically in the past generation. While once perceived as effectively untreatable, there are now numerous evidence-based treatment approaches for personality disorders (especially borderline personality disorder). The questions, however, of who should be matched to which treatment appr...

Cognitive fusion occurs when people experience their thoughts as literally true and allow them to dictate behavior. Fusion has been shown to be associated with increased symptoms of post-traumatic stress disorder (PTSD) and depression; however, the association between change in cognitive fusion, PTSD, and depression symptoms has been relatively uni...

Identity disturbance has been connected to both psychological distress and suicidality, and associated with emotion dysregulation. However, despite empirical evidence of a relationship between lack of identity and poor psychiatric outcomes, the link between impaired identity and emotion dysregulation in suicide risk remains underexplored, particula...

Objective: This randomized controlled trial investigated the efficacy of dynamic relational group therapy (DRT) relative to group psychodynamic supportive therapy (PST) in improving perfectionism-related attitudes and components of the perfectionistic self-relationship. Method: Based on a comprehensive conceptualization of perfectionism, 80 commun...

Parental factors, including pathological narcissism, a maladaptive form of personality style which is characterized by pronounced interpersonal problems, may confer vulnerability to children’s experiences of depression. However, the mechanisms underlying this risk remain largely unexplored. Our longitudinal study assessed whether parent pathologica...

Identifying personality features underlying pathological narcissism is important for informing treatment of pathological narcissism. The present study investigated both attachment insecurity and dysfunctional identity in relation to pathological narcissism, beyond five-factor personality traits, among 392 online responders. A proposed mediation mod...

Pathological narcissism is a personality constellation comprising distorted self-image, maladaptive self-esteem regulation , and difficulties in intimate relationships. Patients with elevated pathological narcissism may not necessarily meet criteria for narcissistic personality disorder, and may seek treatment for a range of mental health concerns...

Improved engagement of men in psychotherapy is an essential element in improving male health outcomes. This trial examined whether the Men in Mind intervention improved practitioners’ self-rated clinical competencies to engage and respond to male clients in therapy. A parallel, single-blind, wait-list randomized controlled trial was conducted with...

Il est essentiel d’être clair et transparent sur les résultats empiriquement valides de la recherche sur les traitements afin de protéger les patients, de guider les décideurs politiques et de faciliter l’expansion des connaissances empiriques. Dans le présent article, nous répondons aux critiques et aux allégations formulées par Egan et al. (2023)...

While important links have been described between childhood abuse and propensity to develop depressive disorders in adult life, less is known about mechanisms, such as identity and shame, that may contribute to this relationship and the effects of age. We examined the association between perceived childhood abuse and depressive symptoms––with age a...

Many factors are implicated in developing and maintaining loneliness, including aspects of personality functioning and experience of early adverse childhood events. This study aimed to examine the relationship between domains of personality dysfunction, including self- and interpersonal functioning, and loneliness and determine whether such persona...

Objectives: Up to 20% of individuals who die by suicide have visited an emergency department (ED) within 4 weeks of their death. Limited guidance is available regarding the modification of clinical outcomes following a psychosocial intervention in the ED for pediatric and adult populations. Methods: A systematic review following the Preferred Re...

The Psychic Pain Scale (PPS) measures a form of mental pain involving overwhelming negative affect and loss of self-control. Understanding psychic pain among men is needed to advance efforts for preventing male suicide. The present study examined the factor structure and psychosocial correlates of the PPS among 621 online help-seeking men. Confirma...

Background Treatment of major depressive disorder (MDD) in men is complicated by the endorsement of traditional masculinity ideologies (TMI) often leading to reluctance toward psychotherapy, therapy interfering processes, or premature termination. In addition, it has been shown that men with MDD have a significantly increased risk of being hypogona...

Background: While crisis intervention frameworks have indicated the importance of clients in suicidal crisis better understanding their distress to decrease suicidality, it is unclear how clients in suicidal crisis process their distress. Aims: To develop (Study 1) and validate (Study 2) a sequential distress-processing model for clients in suicida...

Objective: To describe key considerations for working with men experiencing distressed and disrupted intimate partner relationships. Methods: Individual Zoom interviews were conducted with help-seeking men (n = 25) who had experienced an intimate partnership break-up, and health service providers (n = 30) working with men in the relationships sp...

Background: Although studies have reported a significant inverse association between meaning in life and psychological distress, little is known about this association, specifically among men, or its potential underlying mechanisms. Accordingly, this study investigated prospective pathways connecting meaning in life to men's psychological distress...

Les méta-analyses concluent que la thérapie cognitivo-comportementale (TCC) pour le perfectionnisme est efficace sans aborder les indices d’efficacité tels que l’amélioration fiable, la détérioration, l’abandon et le changement lors du suivi. Nous avons abordé cette question par une réanalyse des 16 essais contrôlés randomisés inclus dans Galloway...

Men’s intimate partner relationship services have focused on correcting the behaviors of male perpetrators of intimate partner (IPV) and/or domestic violence (DV). There is a need to advance IPV and DV prevention efforts by better equipping men with relationship skills. This study explores service providers’ and stakeholders’ perspectives about the...

Introduction: Patients with avoidant personality disorder (AvPD) pathology tend to have poor prognosis in psychotherapy, yet there has been little research conducted to better understand why their outcomes are limited, making it difficult to improve treatments for them. Expressive suppression is a dysfunctional emotion regulation strategy that may...

Suicidal ideation among men during COVID-19: Examining the roles of loneliness, thwarted belongingness, and personality impairment. Scandinavian Journal of Psychology. Suicidal ideation (SI) is a known precursor to suicide among men. While loneliness and thwarted belongingness (TB) have been identified as key factors influencing SI, no study has re...

This study was developed to examine sexual risk behavior among patients seeking community-based mental health services, including associations with psychological distress, identity dysfunction, and childhood emotional neglect. A mediation model was examined regarding identity dysfunction mediating the link between emotional neglect and sexual risk...

Aim: Social support and resilient coping can aid mental health. The aim of this study was to examine age effects of social support on men's resilient coping for psychological distress. Methods: The sample consisted of 434 help-seeking Canadian men who completed standardized measures. Regression analyses tested a moderated moderation model, contr...

Effective communication is key to the quality of men’s intimate partner relationships. The current study examines men’s pathways and patterns for communication with intimate partners. Based on interviews with 47 Canadian and Australian participants (26–70-years-old; M = 40.87, SD = 10.59) who had experienced a relationship breakdown[s], three theme...

Objective: This randomized controlled trial investigated the efficacy of group dynamic-relational therapy (DRT) relative to group psychodynamic supportive therapy (PST) in treating perfectionism and improving psychological functioning. Hypothesis: Psychodynamically informed therapies, particularly DRT, will be efficacious in treating perfectioni...

Background: Treatment of major depressive disorder (MDD) in men is complicated by the endorsement of traditional masculinity ideologies (TMI) often leading to reluctance towards psychotherapy, therapy interfering processes, or premature termination. In addition, it has been shown that men with MDD have a significantly increased risk of being hypogo...

Background: Treatment of major depressive disorder (MDD) in men is complicated by the endorsement of traditional masculinity ideologies (TMI) often leading to reluctance towards psychotherapy, therapy interfering processes, or premature termination. In addition, it has been shown that men with MDD have a significantly increased risk of being hypogo...

The COVID-19 pandemic restrictions, uncertainties and management inconsistencies have been implicated in men’s rising distress levels, which in turn have somewhat normed the uptake of telemental healthcare services (i.e., phone and/or video-conference-based therapy). Given past evidence of poor engagement with telemental health among men, this mixe...

This study examined patients' personality traits as operationalized by the five-factor model in relation to early alliance and reduction of interpersonal distress through an intensive group treatment program for personality dysfunction. A sample of 79 consecutively admitted psychiatric outpatients with personality dysfunction who attended an 18-wee...

The aim of this article is to show how the plan formulation method (PFM), an empirically validated method for case formulation based on control mastery theory (CMT), can help clinicians make sense of and use what they feel during sessions to better understand and treat their patients. We give a brief overview of the main psychoanalytic conceptions...

Background: The COVID-19 pandemic has had a significant impact on men's lives. Investigating specific constructs and pathways related to men's mental health outcomes may help to more fully understand the short and long-term impact of the pandemic and illuminate opportunities to better promote men's mental health. In this study, we assessed the med...

For men, significant risks associated with partner-initiated break-ups include domestic violence, mental health challenges and difficultly with life transition. This narrative analysis study shares three storylines drawn from interviews with 25 men who experienced a partner-initiated break-up. Ill equipped to stay or to initiate leaving narratives...

The therapeutic relationship has emerged as one of the most important components of successful treatment outcomes, regardless of the specific form of therapy. Research has now turned its attention to better understanding how the therapeutic relationship contributes to patient improvement. Extant literature contends that a strong therapeutic relatio...

Major depressive disorder (MDD) is a highly heterogeneous diagnosis wherein the nine MDD criterion signs and symptoms reflect 256 unique symptom combinations. Accordingly, MDD comprises a broad set of phenotypes observed across clinical practice, including primary care. With intensifying global efforts to prevent male suicide, attention has rapidly...

The COVID-19 pandemic is causing extensive job loss leading to a loss of social status in many men. Endorsement of traditional masculinity ideology may render some men particularly sensitive to status loss and thereby to an increased risk for suicidality. In this anonymous online survey conducted in German-speaking European countries, 490 men compl...

Psychotherapists can experience various kinds of emotions in response to their patients' communications and behaviors over the course of therapy. These may be understood in the context of interpersonal dynamics associated with patients' testing activity. The concept of testing, as part of the patient's plan for therapy, is explained from the perspe...

Interpersonal guilt often encompasses pathogenic beliefs that imply omnipotent responsibility for others and concerns about abandoning, humiliating, or threatening others. This study sought to examine how interpersonal guilt may influence patients’ and therapists’ ratings of early working alliance and the potential moderating effect of perceived ad...

Deleterious effects of separation and divorce on men’s mental health are well-documented; however, little is known about their help-seeking when adjusting to these all-too-common life transitions. Employing interpretive descriptive methods, interviews with 47 men exploring their mental health help-seeking after a relationship break-up were analyzed...

Objective: Structured group therapies offer the delivery of theory-specific interventions combined with beneficial group processes. Usually time-limited, such treatments present several advantages for both clinicians and patients. Methods: Several different models of structured group therapy are highlighted, with a brief description of their int...

Background Although the proportion of men seeking professional mental health care has risen over the past two decades, on average, men continue to attend fewer sessions of psychotherapy and are more likely to drop out of treatment prematurely compared to women. Men account for three-quarters of suicide deaths; furthermore, over half of the males wh...

Understanding interpersonal guilt: Associations with attachment, altruism, and personality pathology. Scandinavian Journal of Psychology. The aim of this article is to empirically investigate the relationships among interpersonal guilt, as conceived within control-mastery theory (CMT), and attachment, altruism, and personality pathology in an Engli...

Background: Culturally diverse populations (CDPs), such as visible minorities, face challenges, such as lack of culturally tailored resources, when accessing mental health services. These barriers may be addressed by e-mental health (eMH) technologies. However, little attention has been devoted to understanding the cultural responsiveness of these...

The subjective experience of a sense of meaning in life is an important aspect of psychological well-being. Developmental experiences that contribute to attachment security or insecurity may shape individual differences in the capacity for meaning in life. Such relations may also be influenced by difficulties in emotional processing, such as alexit...

Meaning in life is an important aspect of wellbeing for young adults transitioning into new roles. While research suggests young adults’ quality of family environments is associated with meaning, few studies have examined mechanisms that explain how early parental support may facilitate young adults’ sense of meaning. Understanding factors that con...

The present paper outlines parental pathological projective identification as a form of childhood adversity that some patients attempt to address in psychotherapy. This phenomenon involves a parent’s unconscious relocation of an unbearable state of mind, combined with the interpersonal evocation of such in the child. A child’s effort to deal with t...

The COVID-19 pandemic has presented a suite of circumstances that will simultaneously affect mental health and mobilize coping strategies in response. Building on a lack of research specifically exploring men's mental health impacts during the COVID-19 pandemic, this study presents the results of a qualitative survey exploring men's self-reported a...

Aim of the study The Fear of COVID-19 Scale is a widely used measurement tool for related anxieties, however previous studies validating the scale report varying fit indices, often below accepted cut-off points. This suggests re-specification of the scale may be required. The present study aimed to examine the psychometric properties of the English...

In the light of the COVID-19 pandemic and claims that traditional masculinity may put some men at increased risk for infection, research reporting men’s health behaviors is critically important. Traditional masculine norms such as self-reliance and toughness are associated with a lower likelihood to vaccinate or follow safety restrictions. Furtherm...

Pathological narcissism is associated with problematic interpersonal behaviours. Because of the high need for external validation in pathological narcissism, the experience of loneliness may exacerbate the relationship between pathological narcissism and interpersonal problems. Moreover, these interpersonal problems may contribute to psychological...

Background In an age of increasing loneliness and associated poor mental health, research uncovering the extent to which social connection can be achieved digitally is paramount. This is particularly important among men, who experience unique barriers to achieving meaningful social connections due to masculine norms including independence and self-...

The most frequently examined aspect of the therapeutic relationship is the working alliance, which reflects the conscious collaborative bond, and agreement on task and goal. In addition to the established importance of the working alliance, the therapists’ attunement and responsiveness might reflect another important aspect of the therapeutic relat...

Men’s low job satisfaction has been shown to be associated with greater symptoms of psychological distress. Meaning in life may be an important factor in this relationship, but its role as a mediator has not been reported. The present study investigated meaning in life as a mediator in the relationship between job satisfaction and psychological dis...

The COVID-19 pandemic has significantly challenged many men’s mental health. Efforts to control the spread of the virus have led to increasing social disconnection, fueling concerns about its long-term effects on men’s mental health, and more specifically their experience of psychological distress. Social disconnection, psychological distress, and...

Individuals with features of borderline personality disorder (BPD) may have difficulty sustaining a sense of meaning in life. Although problematic interpersonal behaviours may account for the link between BPD features and meaning, few studies have examined this possibility. The present study examined the mediating role of interpersonal problems in...

This study aimed to evaluate the acceptability, feasibility, and potential efficacy of an online, 8-hr mental health practitioner training program, Men in Mind. To this end, 196 Australian-based mental health practitioners (72.1% female; Mage = 44.98 years, SDage = 11.75 years) completed a baseline survey and were provided access to Men in Mind. Th...

According to control-mastery theory (CMT), patients enter therapy with a plan (often unconscious) for how to work on their problems and disconfirm pathogenic beliefs. Patients want therapists to understand their plans and help them master their problems. CMT proposes that patients frequently coach their therapist to get them oriented and attuned to...

Background: In the light of the COVID-19 pandemic and claims that traditional masculinity may put some men at increased risk for infection, research reporting men's health behaviors is critically important. Traditional masculine norms such as self-reliance and toughness are associated with a lower likelihood to vaccinate or follow safety restrictio...

Although compassionate and reassuring self-responding has been consistently linked with wellbeing, the involvement of identity dysfunction in this association is unclear. This study examined the interaction of self-reassurance and identity dysfunction in relation to severity of psychological distress and social impairment among 243 clients attendin...

One factor that may help avoid treatment failure by premature termination is the therapist’s responsiveness to the patient’s coaching. Coaching refers to the patient’s efforts to inform and guide the therapist about the kinds of therapist behaviors, attitudes, and interventions that would advance the therapy. The case of Barb, from a naturalistic s...

Maladaptive schemas have been linked with increased posttraumatic stress disorder (PTSD) symptoms. Posttraumatic negative self-appraisals (i.e., posttraumatic shame and self-blame) have also been empirically supported as contributors to PTSD symptom severity following traumatic events. These associations are well known; however, the pathways betwee...

Objective: Emerging research highlights that therapists experience difficulty engaging and retaining male clients in talk therapy. Understanding therapists' challenges when working with men can inform gender-specific training efforts. Methods: Open-ended qualitative survey data were collected from a sample of 421 Australian-based therapists. Par...

While research has explored the intersection between masculinities and men’s experiences of suicidality, comparatively little attention has been paid to the stories surrounding suicidal men’s decision to seek help. The ways in which men experiencing suicidal thoughts and behaviors embody masculinities alongside their enlistment of mental health ser...

Investigations of individual differences that contribute to the severity of personality dysfunction are necessary for informing clinical best practices. This study examines the influence of two individual difference variables—quality of object relations (QOR) and psychological mindedness (PM)—on the severity of personality disorder (PD). Specifical...

Background: Whilst drinking to reduce negative affect (e.g., anxiety and depression) is a commonly reported motivation for consuming alcohol, minimal research has explored associations between shame proneness and self-reported outcome expectancies from alcohol use. The present study aimed to explore the relationship between guilt, shame and alcohol...

Loneliness is a significant health concern that may be influenced by dispositional features. Pathological narcissism may elevate loneliness through aversive interpersonal behaviors and negative social appraisals. The present study examined two dimensions of pathological narcissism, along with five‐factor personality traits, in relation to lonelines...

Pathological narcissism has been theorized to diminish one's sense of vitality, initiative, and mindfulness. These aspects of positive psychological functioning may account for the association between pathological narcissism and psychological distress symptoms. Given limited empirical exploration of this issue, the present study examined whether na...

Background: The COVID-19 pandemic is causing extensive job loss leading to a loss of social status in many men. Endorsement of traditional masculinity ideology may render some men particularly sensitive to status loss and thereby to an increased risk for suicidality. Methods: In this anonymous online survey conducted in German-speaking European cou...

Self-reliance features as one of the notable male norms espoused by traditional masculine socialization. Strict adherence to a self-reliant attitude has been found to confer risk for depression and suicidality among men. Yet, little research has investigated the factors that may contribute to self-reliance having a negative impact for men. Using da...

Although childhood maltreatment is known to elevate women’s risk for suicidal ideation and behavior, research concerning the mechanisms involved remains limited. While borderline personality disorder (BPD) has been implicated as mediating this association, such effects may differ depending on women’s age. The present study examined borderline perso...

Men have been underrepresented in research investigating the pathway from social anxiety through loneliness to suicidality. The present study examined loneliness as a mediator between social anxiety and suicidality among men, along with exposure to childhood trauma as a moderator of this pathway. A nationally representative sample of 530 Canadian m...

We examined whether men’s distress disclosure would be indirectly associated with psychological distress through feeling understood by others and loneliness as serial or parallel mediators. We conducted path analyses ( N = 1827 adult men; mean 37.53 years, SD = 14.14) to test the mediators while controlling for race/ethnicity. Post-hoc multi-group...

Recognition of the importance of mental health practitioners’ enactment of ‘gender competency’ when working with men is growing. This article describes the development and theoretical background to a novel online training program for practitioners, called Men in Mind. The training focuses on men’s gender socialization, engaging male clients in ther...

Issue addressed Many men are challenged by barriers to mental health help-seeking and engagement. For men who do access care, their pathways to engaging services can offer important insights to what might constitute gender-specific care. Methods Data were drawn from an online cross-sectional survey of N=2009 Australian men (aged 16-85; M=43.5) ref...