M. Kati Lear

Portland Psychotherapy Clinic Research and Training Center

Psychological Inflexibility (PI) is reliably associated with adverse psychological outcomes but little research has explored how PI may affect therapeutic process in psychotherapy. The current study examined the longitudinal influence of PI measured at pre-treatment on likelihood of client non-disclosure of treatment-relevant information at 15-week...

Social anxiety disorder (SAD) is a prevalent and often debilitating psychiatric disorder that can assume a chronic course even when treated. Despite the identification of evidence-based pharmacological and behavioral treatments for SAD, much room for improved outcomes exists and 3,4-methylenedioxymethamphetamine (MDMA) has been proposed as a promis...

Objective Researchers have suggested that psychotherapy may be enhanced by the addition of 3,4-methylenedioxymethamphetamine (MDMA), particularly in the treatment of disorders wherein interpersonal dysfunction is central, such as social anxiety disorder. We review literature pertaining to three potential processes of change that may be instigated d...

Objective Shame is a transdiagnostic emotion of strong clinical and research interest. Yet, there is a lack of consensus on the definition and varying methods employed across self-report measures, potentially affecting our ability to accurately study shame and examine whether clinical interventions to alter shame are effective. This paper offers a...

Research suggests the link between self-criticism and low social belonging is partially explained by lower expression of positive emotions (Luoma & Chwyl, 2020), however, it is not well understood why high self-critics (HSCs) express less positive emotions. The purpose of this study is to investigate the underlying mechanisms that might explain thi...

In this study we assessed the construct validity of the recently published White Racial Affect Scale (Grzanka et al., 2020). Specifically, we assessed the convergent, criterion-related, and incremental evidence for construct validity of the White guilt, White shame, and White defensiveness (called “White negation” in the original article) factors....

In this study we assessed the construct validity of the recently published White Racial Affect Scale (WRAS; Grzanka et al., 2020). Specifically, we assessed the convergent, criterion related, and incremental evidence for construct validity of the White guilt, White shame, and White defensiveness (called “White negation” in the original paper) facto...

Background Instruments to measure substance use stigma are emerging, however little is known regarding their psychometric properties. While research has evolved to view substance use stigma as a context sensitive international phenomenon that is embedded within cultures, validated self-report measures are lacking and comprehensive reviews of the ex...

Psychological flexibility has been proposed as a core process of change when psychedelics are used for therapeutic purposes, but to date empirical outcomes have only documented changes on the Acceptance and Action Questionnaire (AAQ-II), a very general measure of psychological flexibility. This pilot study measured outcomes from psilocybin administ...

Objective: Chronic childhood trauma is consistently linked to negative mental health outcomes in adulthood, but research exploring specific paths of risk remains limited. The aims of the current study were to examine trauma cognitions as intervening variables in the relation of chronic victimization with perceived burdensomeness and thwarted belong...

Background Social anxiety disorder (SAD) is a serious and prevalent psychiatric condition that heavily impacts social functioning and quality of life. Though efficacious treatments exist for SAD, remission rates remain elevated and a significant portion of those affected do not access effective treatment, suggesting the need for additional evidence...

This study audited publications in the Journal of Contextual Behavioral Science (JCBS) to characterize the extent to which articles published by the journal 2020 - 2021 used commonly accepted open science practices that enhance transparency & reproducibility.

Objectives: Trauma and resulting functional limitations demonstrate associations with perceived burdensomeness and thwarted belongingness, factors contributing to elevated risk for suicidal ideation. However, survivors display differential risk in response to impairment, highlighting the need for research on exacerbating factors. The current study...

This study examined the association between self-criticism and the fulfillment of psychological needs. Informed by Self-Determination Theory, we tested the influence of participant self-criticism on the satisfaction of autonomy, relatedness, and competence needs among their peers. We also investigated whether the influence of relationship closeness...

Objective The current study aimed to (a) assess basic nonsuicidal self‐injury (NSSI) characteristics using a validated clinical interview among a sample of veterans not recruited for specific diagnostic or environmental criteria and (b) examine the relation between NSSI and medical severity of prior suicide attempts (SAs) among veterans. Design We...

Few studies have examined risk factors associated with suicidal ideation and attempts among younger adolescents compared to their high-school aged counterparts. To gain a better understanding of unique risk factors associated with suicidal ideation and attempts among middle-school aged students, the current study employed secondary data analyses on...

Objectives This paper tested two moderators, brooding and participant sex, on the respective relations between thwarted belongingness (TB), perceived burdensomeness (PB), and suicide risk. Method Using a cross‐sectional design in a sample of undergraduates (N = 278), two hierarchical regression models examining the three‐way interaction between br...

The Defective Self Model of self-injury (Hooley, Ho, Slater, & Lockshin, 2010) asserts that individuals choose to self-injure to gratify the desire for self-punishment associated with a self-critical cognitive style. Specifically, self-injury is used to regulate negative self-directed thoughts and emotions and is made accessible via the belief that...

The reliability and validity of reported exposure to significant trauma is critical to research evaluating outcomes following serious and distressing life events. The current study examined the reliability of reported exposure to disaster, fire, transportation accidents, physical assault, and sexual assault across 5- (N = 251), 12- (N = 223), and 2...

Little is currently known about the repetitive behaviors that take place before, during, and after nonsuicidal self-injury (NSSI). These practice patterns surrounding repetitive self-injury may be part of a habituation process in NSSI. Congruent with the opponent process theory (OPT), the mechanisms through which NSSI is reinforced may include prep...

The Interpersonal Theory of Suicide proposes that thwarted belongingness (TB) and perceived burdensomeness (PB) predict psychological pain and desire for suicide. Brooding may be a mechanism in explaining how TB and PB predict pain. The conceptual similarity between rejection sensitivity (RS) and TB suggests that individuals with high RS may be lik...

Injuries from nonsuicidal self-injury (NSSI) often result in scars that can serve as a reminder of the act of injury or an emotional event. In this study we examined whether there are differences in meanings and behaviors associated with scars from NSSI compared to other scars. Participants reporting scars from NSSI (n = 49) were compared to those...

Historically, inpatient hospitalization has historically been a primary approach for managing risk in suicidal adolescents. However, hospitalization is disruptive and its efficacy in reducing suicide risk for adolescents is unclear. Preliminary data suggest that hospitalization may be iatrogenic and result in increased risk for subsequent hospitali...

Recent research has linked identity instability with engagement in nonsuicidal self-injury (NSSI; Claes, Luyckx, & Bijttebier, 2014; Claes et al., 2015). This study examined the relationship between self-concept clarity (SCC), an index of identity stability, and NSSI in a sample of 147 college students, using a cross-sectional survey design. The re...