David Kealy

David Kealy
University of British Columbia - Vancouver | UBC · Department of Psychiatry

PhD

About

192
Publications
44,234
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
1,404
Citations
Citations since 2016
168 Research Items
1322 Citations
20162017201820192020202120220100200300400
20162017201820192020202120220100200300400
20162017201820192020202120220100200300400
20162017201820192020202120220100200300400
Introduction
I'm an Associate Professor in the Psychotherapy Program and Institute of Mental Health at the Department of Psychiatry, University of British Columbia, and currently a Michael Smith Foundation for Health Research Scholar. My research focuses on psychotherapy process/outcome, personality- and identity-related vulnerabilities that are often addressed in psychotherapy, and mental health issues among distinct populations such as young adults, men, and people who have experienced childhood trauma.
Additional affiliations
September 2015 - present
University of British Columbia - Vancouver
Position
  • Professor (Assistant)

Publications

Publications (192)
Article
Full-text available
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...
Article
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
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...
Article
Full-text available
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...
Article
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...
Article
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...
Article
Full-text available
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...
Article
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...
Article
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 c...
Article
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
Full-text available
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...
Article
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...
Article
Full-text available
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...
Article
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...
Article
Full-text available
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...
Article
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...
Preprint
Full-text available
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...
Article
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...
Article
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...
Article
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...
Article
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...
Article
Full-text available
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...
Article
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...
Article
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...
Article
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...
Preprint
Full-text available
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...
Article
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...
Article
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...
Article
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...
Article
Full-text available
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...
Article
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...
Article
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...
Article
Little empirical data exists regarding men’s preferences for therapist gender, including what predicts these preferences, and the impact they may have on satisfaction with care. To address this, data were drawn from an online survey of Australian men (n = 2002; aged 16–85; M = 43.8 years) reflecting on their preferences for and experiences of menta...
Article
Objective Considerable evidence has accumulated pointing to a wide array of mental health problems experienced by students attending post-secondary schools. Yet, much less attention has been focused on understanding who actually accesses mental health services on post-secondary campuses. Methods The current study reports on a national survey of 8,...
Article
The prevalence of male-type or externalising depression symptoms (e.g., anger, risk-taking, emotion suppression) were examined with cross-sectional online convenience sample of 1,277 help-seeking young men (M=23.64, SD=3.61 years). Almost a quarter (21.9%) of the sample reported childhood sexual abuse (CSA) exposure, and most (68.8%,) endorsed past...
Article
Full-text available
Objective: Interpersonal dysfunction is a hallmark feature of borderline personality disorder (BPD). Representing lifelong relational patterns based in internal representations, quality of object relations (QOR) has been theorized as a core aspect of borderline personality pathology; yet empirical inquiry of this relationship has been limited. The...
Article
Full-text available
Background: Loneliness, the painful affective state that reflects perceived deficits in social relationships, is a significant health issue requiring further understanding. Individual differences in awareness and disclosure of emotional concerns may contribute to loneliness, and may do so diversely according to gender and age. The present study exa...
Article
Full-text available
Anger has been a largely neglected emotion in prostate cancer research and intervention. This paper highlights the role of anger in the anxiety depression pathway among men with prostate cancer, and whether its impact is dependent on loneliness. Data are presented from a sample of men with prostate cancer (N = 105, M = 69.12 years, prostatectomy =...
Article
This study examined the mediating role of pathogenic beliefs on the relationship between patients' recollections of experienced adverse parenting in childhood and adult interpersonal and social problems. A total of 210 psychotherapy outpatients rated their experiences of perceived adverse parenting in childhood and completed measures of psychologic...
Article
Full-text available
While increasing numbers of Australian men are accessing mental health services, the sustainability of their therapy engagement varies significantly, with many men being lost to follow-up. The current study investigated dropout rates in a large community-based male sample to highlight the reasons for, and potential predictors of, men dropping out o...
Article
Full-text available
Background: Somatosensory amplification involves perceptual sensitivity to and cognitive-affective interpretation of bodily sensations and external stimuli, contributing to heightened experiences of somatic symptoms. However, little is known about somatosensory amplification in relation to vulnerabilities such as attachment insecurity. Aims: The pr...
Article
Full-text available
Impairment in the psychological balance between autonomy and connectedness––referred to as dysfunctional individuation––can interfere with wellbeing and contribute to mental health difficulties. Dysfunctional individuation may reflect problems in earlier parent-child relations, and may account for the relationship between such experiences and psych...
Article
Objectives: This study examined associations between generalized shame and guilt, and suicidal ideation. Methods: Individuals attending outpatient mental health services (N = 100) completed study measures at a single time point. Correlation and regression analyses examined associations between recent suicidal ideation and generalized shame and g...
Article
Full-text available
Narcissistic vulnerability has been proposed as a dispositional feature that confers susceptibility to depression from earlier maladaptive parent-child relations. Limited research has examined narcissistic vulnerability as a mediator between perceived parental responsiveness and depressive symptoms, particularly with consideration of interpersonal...
Article
Full-text available
Objective: Suicide in Canadian men is high and rising. Research consistently indicates increased suicide risk in male subgroups including sexual minority, Indigenous, middle-aged, and military men. The current scoping review addresses the research question: Among male subgroups featured in Canadian suicide research, what are the key findings to in...
Article
Full-text available
Mentalizing, or reflective functioning, refers to the capacity to reflect on one's own and others' mental states in terms of desires, intentions, and feelings. Reflective functioning in men's mental health is poorly understood, particularly in reference to men's resilience and motivation for personal growth. Using a cross‐sectional design, the pres...
Article
The present study used thematic analysis to explore participants’ subjective experiences of two group approaches targeting emerging adults’ possible selves. Eighty-six emerging adults were randomly assigned to one of the interventions and responded to four open-ended questions following the completion of the group program. The themes that materiali...
Article
Purpose: The COVID-19 pandemic has had a profound impact on the lives of men. In addition to physical health, there is increasing recognition of the need to understand the psychosocial impacts of COVID-19. The present study investigated psychosocial impacts of the COVID-19 pandemic on a help-seeking community sample of Canadian men, focusing on div...
Article
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-...
Preprint
Full-text available
Dispositional optimism is robustly associated with psychological wellbeing, and individuals with lower optimism tend to experience more depressive and anxiety symptoms. While mechanisms in this relationship such as coping and social integration have been explored, limited research has examined whether the self-conscious emotions of shame and guilt...
Article
Male suicide rates are high and rising, and important insights can be gleaned from understanding the experiences of men who have attempted suicide. Drawing from a grounded theory photovoice study of diverse Canadian men, three intertwined thematic processes were derived: (a) preceding death struggles, (b) life-ending attempts and saving graces, and...
Article
Objective When a client feels a threat to their freedom or autonomy as a result of external feedback, they can act out and respond in maladaptive ways. This state – referred to as reactance – has potential ramifications on interpersonal functioning. However, the underlying factors exacerbating this response including self‐esteem and gender are yet...
Article
Objective The purpose of the current study is to examine the relationship between the quality of the Patient-Doctor Relationship and suicidality among patients seeking mental health care; specifically, whether patients who perceive having a more positive relationship with primary care physician will have lower levels of suicidality. Method Cross-s...
Article
The way people derive inferences from actual adverse experiences plays an important role in the development of psychopathology. This study aims to examine the mediating role of pathogenic beliefs (i.e., emotion-laden, powerful, painful convictions about self and others) on the relation between perceived adverse parenting behaviors in childhood and...
Article
Full-text available
Background Theorized to stem from experiences of childhood emotional neglect, narcissistic vulnerability has been identified as contributing to expressions of psychiatric distress such as depressive and anxiety symptoms, particularly due to shame-proneness. Aims To investigate narcissistic vulnerability and shame as mediators between perceived chi...
Article
In this article, Canadian psychotherapy researchers and teachers review the state of psychodynamic therapy (PDT) in Canada. We review the ways in which PDT has been implemented, developed and researched within the public and private sector, and how psychoanalytic and psychodynamic practitioners regionally have responded to the challenges of evidenc...