The Impact of Spirituality and Trauma on Appraisals of Psychotic-Like Experiences

217 Pages·2017·1.24 MB·English

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Dissertations, Theses, and Capstone Projects CUNY Graduate Center
9-2017
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Kathleen Isaac
The Graduate Center, City University of New York
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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
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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
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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
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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

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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.
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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.
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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!

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