Sarah Holley

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Lower Income is Associated with Greater Pandemic Related Infertility Stress During the COVID-19 Pandemic

Fertility and Sterility, 2021

Clinical Psychology Training Program

The UCSF Clinical Psychology Training Program (CPTP) offers a two-year fellowship comprised of a ... more The UCSF Clinical Psychology Training Program (CPTP) offers a two-year fellowship comprised of a one-year general clinical psychology internship (APA-accredited) and a oneyear postdoctoral clinical and clinical research fellowship, based on the scientist-practitioner model. Graduates are expected to pursue careers emphasizing research and training in academic/research settings, including those affiliated with health and mental health service systems.

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The Demand-Withdraw Communication Pattern in Middle-Aged and Older Couples: A Longitudinal Study

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Awe walks' boost emotional well-being

Anxiety and Depression in Patients Undergoing Oocyte Cryopreservation and Infertility

Fertility and Sterility

The interactive effect of family conflict history and physiological reactivity on different forms of aggression in young women

Biological Psychology

Depression, emotion regulation, and the demand/withdraw pattern during intimate relationship conflict

Journal of Social and Personal Relationships

The demand/withdraw pattern is a detrimental set of communication behaviors in which one partner ... more The demand/withdraw pattern is a detrimental set of communication behaviors in which one partner nags or pressures while the other partner avoids or withdraws. Past studies evaluating the influence of depression on this pattern have shown mixed findings. The present study sought to advance what is known by investigating whether difficulties in emotion regulation mediated the association between depression and the demand/withdraw pattern. A sample of 253 romantic couples participated in an online survey. Data were analyzed using a mediated actor–partner interdependence model framework. Results indicated that the association between an individual’s level of depression and his or her tendency to withdraw while the partner demanded was fully mediated by difficulties in emotion regulation. This study supports the notion that there is a link between depression and the demand/withdraw pattern and further suggests that difficulties in emotion regulation may play an important role in underst...

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Can Need for Affect and Sexuality Differentiate Suicide Risk in Three Community Samples?

Journal of Social and Clinical Psychology

Prevalence rates, reporting, and psychosocial correlates of stalking victimization: results from a three-sample cross-sectional study

Social psychiatry and psychiatric epidemiology, Jan 12, 2018

Public health and criminal justice stalking victimization data collection efforts are plagued by ... more Public health and criminal justice stalking victimization data collection efforts are plagued by subjective definitions and lack of known psychosocial correlates. The present study assesses the question of stalking victimization prevalence among three groups. Psychosocial risk and protective factors associated with stalking victimization experiences were assessed. Archival data (n = 2159) were drawn from a three-sample (i.e., U.S. nationwide sexual diversity special interest group, college student, and general population adult) cross-sectional survey of victimization, sexuality, and health. The range of endorsement of stalking-related victimization experiences was 13.0-47.9%. Reported perpetrators were both commonly known and unknown persons to the victim. Participants disclosed the victimization primarily to nobody or a family member/friend. Bivariate correlates of stalking victimization were female gender, Associates/Bachelor-level education, bisexual or other sexual orientation m...

Lifetime Suicide-Related Behavior, Violent Victimization, and Behavioral Health Outcomes: Results From a Vulnerable Population Needs Assessment

Journal of interpersonal violence, Jan 28, 2018

This study is concerned with two risk factors that have been independently associated with poor b... more This study is concerned with two risk factors that have been independently associated with poor behavioral health: (a) lifetime suicide-related behavior (SRB) and (b) interpersonal violence victimization experiences. The purpose of this article was to assess whether the combination of SRB (ideation, attempt) and violent victimization exacerbates behavioral health symptom risk. This pattern is examined across three vulnerable population samples: community-based adults, college students, and bondage and sadomasochism (BDSM) community members. Data from a community health and sexuality survey ( n = 2,175) were collected as a health needs assessment in partnership with the National Coalition for Sexual Freedom; latent class analysis (LCA) was then employed to identify intersectionality. This paper builds on prior findings yielding two distinct violence-related classes: (a) SRB only and (b) violent victimization + SRB. Controlling for demographic covariates, analyses revealed a consisten...

The intersection of interpersonal and self-directed violence among general adult, college student and sexually diverse samples

The International journal of social psychiatry, 2017

Suicide and interpersonal violence (i.e. victimization and perpetration) represent pressing publi... more Suicide and interpersonal violence (i.e. victimization and perpetration) represent pressing public health problems, and yet remain mostly addressed as separate topics. To identify the (1) frequency and overlap of suicide and interpersonal violence and (2) characteristics differentiating subgroups of violence-related experiences. A health survey was completed by 2,175 respondents comprised of three groups: college students ( n = 702), adult members of a sexuality special interest organization ( n = 816) and a community adult sample ( n = 657). Latent class analysis was used to identify subgroups characterized by violence experiences; logistic regression was used to identify respondent characteristics differentiating subgroups. Overall rates of violence perpetration were low; perpetration, victimization and self-directed violence all varied by sample. Adults with alternative sexual interests reported high rates of victimization and self-directed violence. Analyses indicated two subgro...

Romeo, Romeo: A Look at a Winding Journey to Lesbian Parenthood

Http Dx Doi Org 10 1080 00918369 2014 969612, Jan 6, 2015

Interpersonal Emotional Behaviors and Physical Health: A 20-Year Longitudinal Study of Long-Term Married Couples

Emotion (Washington, D.C.), Oct 23, 2016

Objectively coded interpersonal emotional behaviors that emerged during a 15-min marital conflict... more Objectively coded interpersonal emotional behaviors that emerged during a 15-min marital conflict interaction predicted the development of physical symptoms in a 20-year longitudinal study of long-term marriages. Dyadic latent growth curve modeling showed that anger behavior predicted increases in cardiovascular symptoms and stonewalling behavior predicted increases in musculoskeletal symptoms. Both associations were found for husbands (although cross-lagged path models also showed some support for wives) and were controlled for sociodemographic characteristics (age, education) and behaviors (i.e., exercise, smoking, alcohol consumption, caffeine consumption) known to influence health. Both associations did not exist at the start of the study, but only emerged over the ensuing 20 years. There was some support for the specificity of these relationships (i.e., stonewalling behavior did not predict cardiovascular symptoms; anger behavior did not predict musculoskeletal symptoms; neithe...

Addressing the needs of fertility treatment patients and their partners: are they informed of and do they receive mental health services?

Fertility and sterility, Jul 24, 2016

To determine the extent to which fertility patients and partners received mental health services ... more To determine the extent to which fertility patients and partners received mental health services (MHS) and were provided with information about MHS by their fertility clinics, and whether the use of MHS, or the provision of information about MHS by fertility clinics, was targeted to the most distressed individuals. Prospective longitudinal cohort study. Five fertility practices. A total of 352 women and 274 men seeking treatment for infertility. No interventions administered. Depression, anxiety, and MHS information provision and use. We found that 56.5% of women and 32.1% of men scored in the clinical range for depressive symptomatology at one or more assessments and that 75.9% of women and 60.6% of men scored in the clinical range for anxiety symptomatology at one or more assessments. Depression and anxiety were higher for women and men who remained infertile compared with those who were successful. Overall, 21% of women and 11.3% of men reported that they had received MHS, and 26...

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The Demand-Withdraw Communication Pattern in Middle-Aged and Older Couples: A Longitudinal Study

The demand-withdraw interaction pattern is a common, deleterious pattern in which one spouse blam... more The demand-withdraw interaction pattern is a common, deleterious pattern in which one spouse blames or pressures while the other spouse avoids or withdraws (Christensen, 1988). Studies consistently show that: 1) there tends to be gender differentiation in the interaction roles, with women demanding and men withdrawing, and 2) demand-withdraw behaviors are associated with marital dissatisfaction. The existing observational research on marital interactions, however, has been overwhelmingly conducted with relatively young couples and does not take into account other known predictors of marital dissatisfaction. The present study examined demand-withdraw behaviors longitudinally in a sample of middle-aged and older couples. Later life stages may be associated with changes in emotion-related behaviors (e.g., Carstensen, 1991) and in gender roles (e.g., Gutmann, 1987). Studying demand-withdraw behaviors over time in middle-aged and older couples enables a determination of whether the manifestations of this set of behaviors, and its negative association with marital satisfaction, change during the later stages of development. This study further evaluated the effect of demand-withdraw on marital satisfaction in relation to other factors known to be negatively associated with this important outcome (e.g., physiological arousal, self-reported negative affect, and negative emotion behaviors during conflict). A sample of 126 married couples (63 middle-aged, 63 older) were observed at three time points across a 13-year span as they engaged in a 15-minute conversation about an area of relationship conflict. Conversations were videotaped and trained raters used an observational coding system to quantify each partner's demand and withdraw behaviors. During or shortly following the conflict conversations, measures of physiological arousal, self-reported negative affect, and emotion behavior were also collected. The couples also completed self-report measures of marital satisfaction at each of the three time points of observational data collection, as well as at two subsequent time points. Results showed that demand-withdraw behaviors occur during conflict in both middleage and older couples at overall comparable rates. Combining this finding with previous work indicates that this pattern is found throughout the life course. Importantly, the specific pattern of behaviors changes with age. There appears to be a marked increase in one type of withdraw behavior, avoidance, over time. Moreover, contrary to theories proposed by Gutmann and others that gender differences diminish in later life, gender differentiation appears to become greater over time with wives in the demand role and husbands in the withdrawing role. Results further demonstrated that the relationship between demand-withdraw behaviors and marital dissatisfaction remains the same across the lifespan. That is, for both middle-aged and older couples, demand-withdraw behaviors are negatively associated with concurrent levels of marital satisfaction. Furthermore, these behaviors show significant interactions with other factors known to be associated with lower levels of marital satisfaction (e.g., physiological arousal, self-reported negative affect, and negative emotion behaviors). The general pattern was that demand-withdraw behaviors, while deleterious on their own accord, are particularly pernicious when manifest in the context of other factors associated with marital dissatisfaction. When examining the longitudinal effect of demand-withdraw behaviors, however, results indicated that after controlling for initial levels of marital satisfaction, these behaviors were not strong predictors of the trajectory of change in marital satisfaction over time. The findings are discussed in terms of socioemotional changes couples undergo as they move from middle-age into late life. This study offers evidence not only about changes in demand-withdraw behaviors themselves but also as to how marital processes and gender roles may change over the life course. Future work will be valuable in further elucidating changes in the nature of demand-withdraw behaviors and in the consequence of this interaction pattern for marital satisfaction at different life stages. Eldridge, Sevier, Jones, Atkins, & Christensen, 2007; Vogel & Karney, 2002). This was important because, as Gottman and Notarius (2002) note, observational research not only contributes depth and richness to the study of marriages, but also adds predictive power and theoretical clarity. In addition, other studies incorporated longitudinal research designs (e.g., Caughlin, 2002; Heavey, Christensen, & Malamuth, 1995; Kurdek, 1995), which are superior to correlational designs in examining causal mechanisms. Despite all this work examining characteristics and repercussions of the demandwithdraw pattern, there remain some important gaps in the literature. One notable area pertains to the lack of research on the demand-withdraw behaviors in older couples who have already had a relative amount of-success‖ in remaining together in a long-term marriage 1. In their review of marital research in the 20 th century, Gottman and Notarius noted that the existing observational research on marital interactions has been overwhelmingly conducted with relatively young couples (Gottman & Notarius, 2002). Further, that research has primarily focused on characterizing marriages that dissolve versus marriages that endure (e.g. Gottman, Coan, Carrere, & Swanson, 1998; Gottman & Levenson, 1992). While it is understandable that researchers have focused on marriages in early stages of life in an effort to identify and intervene in the processes that may lead to marital instability and dissolution, it is also important to remember that individuals and relationships continue to change across the lifespan (Carstensen, Mayr, Pasupathi, & Nesselroade, 2000; Mares & Fitzpatrick, 1995). These changes may affect the way that behaviors such as demand-withdraw are manifest, as well as the way in which they impact the marital relationship. Demand-Withdraw and Age Research suggests that marriages in middle and late life may differ in many important aspects from marriages in early adulthood, as well as from each other. For example, the average age of newlyweds is approximately 26 years old (U.S. Census Bureau, 2003). Partners at this stage are most likely to idealize each other, and issues concerning the development of intimacy and attachment are particularly important (Murray, Holmes, & Griffin, 1996; Pasch & Bradbury, 1998). By mid-life, (defined here as 40-50), spouses are often dealing with tasks such as raising a family, facing increased responsibility in the workplace, and are coping with greater role strain than at any other life stage (Burr, 1972). By the time spouses reach later life stages (defined here as age 60 or over), many of these responsibilities have subsided as the children have left home and individuals have retired from work (e.g. Moen, Kim, & Hofmeister, 2001; Orbuch, House, Mero, & Webster, 1996). New difficulties can arise, however, due to changes in living arrangements, reductions in income, and/or declining health and vitality (e.g. Barnes & Parry, 2004; Burman & Margolin, 1992). 1 By definition, long-term marriages (i.e. 20+ years of marriage) involve middle-aged and older couples. Importantly, when considering the development processes involved in long-term marriages, it is critical to distinguish between the affect of age versus marital duration. While these variables are often correlated, they are not always linked (as in the case of a 60-year old who just married for the first time) and they conceptually indicate distinctive life course processes. A focus on age presumes developmental change that comes with increasing personal experience or maturation. In contrast, a focus on marital duration presumes that change occurs as a result of increasing time spent in the married status. A study by Umberson and colleagues (Umberson, Williams, Powers, Chen, & Campbell, 2005) comparing the effect of age versus marital duration on marital quality indicated that age is more strongly associated with marital quality than is marital duration. Therefore, the current study will be focusing on changes in marital functioning associated with aging, with the understanding that the differences we are examining may be tied to differences in the duration of marriage as well.

format_quoteDemand-withdraw behaviors negatively correlate with marital satisfaction consistently across middle-aged and older couples, indicating persistent relationship issues throughout the lifespan.format_quote

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The Relationship Between Emotion Regulation, Executive Functioning, and Aggressive Behaviors

Journal of interpersonal violence, Jan 30, 2015

Emotion regulation deficits and executive functioning deficits have independently been shown to i... more Emotion regulation deficits and executive functioning deficits have independently been shown to increase vulnerability toward engaging in aggressive behaviors. The effects of these risk factors, however, have not been evaluated in relation to one another. This study evaluated the degree to which each was associated with aggressive behaviors in a sample of 168 undergraduate students. Executive functioning (cognitive inhibition and mental flexibility) was assessed with a Stroop-like neuropsychological task. Emotion regulation and aggressive behaviors were assessed via self-report inventories. Results showed main effects for both emotion regulation and executive functioning, as well as a significant interaction, indicating that those who scored lowest in both domains reported engaging in aggressive behaviors the most frequently. When different types of aggression were examined, this interaction was only significant for acts of physical aggression, not for acts of verbal aggression. The...

Social functioning in Alzheimer's disease: A study of mutual gaze and its physiological correlates

PsycEXTRA Dataset, 2005

Counseling lesbian, gay, bisexual and transgender patients

Clinical Guide and Case Studies, 2015

Counseling single women and single men choosing parenthood

Clinical Guide and Case Studies, 2015

The interplay between cognitive and emotional risk factors for aggressive behaviors

PsycEXTRA Dataset, 2014

Sarah Holley

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