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APPLICATION OF THE FEAR-AVOIDANCE MODEL OF CHRONIC PAIN TO UNDERSTAND NEUROCOGNITIVE AND BEHAVIORAL FACTORS THAT CONTRIBUTE TO FUNCTIONAL IMPAIRMENT AND DEPRESSION IN ADULTS WITH SICKLE CELL DISEASE
Title
APPLICATION OF THE FEAR-AVOIDANCE MODEL OF CHRONIC PAIN TO UNDERSTAND NEUROCOGNITIVE AND BEHAVIORAL FACTORS THAT CONTRIBUTE TO FUNCTIONAL IMPAIRMENT AND DEPRESSION IN ADULTS WITH SICKLE CELL DISEASE
Creator
Piper, Lauren E.
Date
2017, 2017-07
Description
Acute and chronic pain in sickle cell disease (SCD) are associated with functional impairment and depressive symptoms. Given the suboptimal...
Show moreAcute and chronic pain in sickle cell disease (SCD) are associated with functional impairment and depressive symptoms. Given the suboptimal management of pain in SCD and serious health risks associated with current treatment methods for pain, there is a need to identify factors associated with pain that impact functional outcomes and depression. The fear-avoidance (FA) model of chronic pain has been examined in other chronic pain populations as a means to understand how pain-related cognitive and behavioral factors contribute to functional impairment and depression, but has not been applied in individuals with SCD. The purpose of the present study was to apply the FA model of chronic pain to adults with SCD via mediation analyses. Additionally, mental flexibility was examined as a possible moderator in the FA model. Results demonstrated that pain catastrophizing mediated the relationship between pain severity and pain-related fear. No other mediators within the model were identified. Additionally, results did not demonstrate that mental flexibility moderated the relationship between pain severity and pain catastrophizing. Post-hoc exploratory analyses demonstrated that pain catastrophizing and pain-related fear significantly predicted functional impairment and depression, respectively, above and beyond pain severity. Overall, results suggest that the FA model of chronic pain does not apply to individuals with SCD and the predictive roles that pain catastrophizing and pain-related fear play in functional impairment and depression are not consistent with results in other chronic pain populations. Further studies are needed to identify factors that explain the relationship between pain, functional impairment, and depression so that these factors may be targeted for intervention as a means to improve pain, mood, and functional independence.
Ph.D. in Psychology, July 2017
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The Differential Influence of Computerized Neuropsychological Assessment Across Psychopathology
Title
The Differential Influence of Computerized Neuropsychological Assessment Across Psychopathology
Creator
Singh, Shifali
Date
2020
Description
The method of administering neuropsychological assessments has transformed with the advent of novel technologies. The present study examined...
Show moreThe method of administering neuropsychological assessments has transformed with the advent of novel technologies. The present study examined how the manual versus computerized administration of the Wisconsin Card Sorting Test (WCST) influenced the relation between psychological symptom severity and performance on the WCST, using perseverative responses and failures to maintain set (FMS) subscales. The Dot Counting Test, Depression Anxiety Stress Scales, and SUPPS-P Impulsive Behavior Scale were used to measure performance validity, depression and anxiety, and impulsivity. Eighty-five participants were recruited from the Chicagoland area. Participants reported their age, gender, handedness, education, ethnicity, computer and smartphone familiarity, and medication use. Age ranged from 18 to 66 years (mean (SD) = 34.3 (15.8)), and 49.4% were recruited from an outpatient facility. For perseverative responses, both method of administration of the WCST were equivalent regardless of psychological symptom severity. For FMS, method of administration itself influenced performance, and particularly the impact of impulsivity symptom severity on FMS. Specifically, method of administration significantly moderated the relationship between FMS and Lack of Perseverance, Sensation Seeking, and Positive Urgency. There were also significant main effects between FMS, Lack of Perseverance, and Positive Urgency. The findings from this study suggest that the equivalence between the manual and computerized versions of the WCST depends on the WCST subscale and the type of psychological symptom. New normative data need to be developed for the computerized WCST, along with a more consistent method of scoring and interpreting WCST subscales.
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DIAGNOSING AND TREATING ADHD: CLINICIAN CHARACTERISTICS, METHODS OF DIAGNOSIS, DIAGNOSTIC RATES, AND TREATMENT RECOMMENDATIONS
Title
DIAGNOSING AND TREATING ADHD: CLINICIAN CHARACTERISTICS, METHODS OF DIAGNOSIS, DIAGNOSTIC RATES, AND TREATMENT RECOMMENDATIONS
Creator
Haak, Christopher Luke
Date
2019
Description
Attention-deficit/hyperactivity disorder (ADHD) is one of the top five most common referrals among all neuropsychologists (Sweet et al. 2015)...
Show moreAttention-deficit/hyperactivity disorder (ADHD) is one of the top five most common referrals among all neuropsychologists (Sweet et al. 2015) and continues to elicit public and professional concern about over-diagnosis in children (Sciutto & Eisenberg, 2007) and under-diagnosis in adults (Asheron et al., 2012; Kooji et al., 2010). In recent years, the prevalence of ADHD has increased (Polanczyk et al., 2007 & 2014, Thomas et al., 2015). It is unclear what is driving these changes though changes in criteria may be playing a role (van de Voort et al., 2014). Further, there has been little research on whether professional training, beliefs, and practice factors can influence the likelihood to diagnose ADHD. The purpose of this study was to examine the extent to which neuropsychologists’ professional characteristics, training, and beliefs about ADHD diagnosis and treatment influence their likelihood to diagnose ADHD. The study also evaluated whether there are differences in assessing and treating ADHD based upon the client population focus (child, lifespan, or adult) of neuropsychologists. Participants in this study were 106 neuropsychologists from across the United States and Canada who were recruited through neuropsychology listservs to participate in an online survey. Results indicated that population focus was associated with significant differences in approach to diagnosing and treating ADHD, with child- and lifespan-focused neuropsychologists reporting higher rates of ADHD diagnosis. Additionally, having a higher percent of clinical cases in which ADHD is a referral question and greater self-reported adherence to following full diagnostic criteria for making a diagnosis were associated with higher ADHD diagnostic rates, controlling for age, gender, ethnicity, and other professional characteristics. This study is among the first to examine specific clinician factors impacting diagnostic rates and its findings have several implications for practice and research.
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Distinctive Categorization Deficits in Repeated Sorting of Common Household Objects in Hoarding Disorder
Title
Distinctive Categorization Deficits in Repeated Sorting of Common Household Objects in Hoarding Disorder
Creator
Hamilton, Catharine Elizabeth
Date
2022
Description
The present study examines sorting techniques and deficits among individuals with hoarding disorder (n = 34) compared to age- and gender...
Show moreThe present study examines sorting techniques and deficits among individuals with hoarding disorder (n = 34) compared to age- and gender-matched adults (n = 35) in the general population. Performance was compared on the Booklet Category Test (BCT), selected other neuropsychological measures, and an ecologically valid sorting task designed for the study to model the Delis-Kaplan Executive Function System (D-KEFS) Sorting subtest but with common household objects as stimuli. Contrary to predictions, individuals with hoarding disorder did not perform significantly worse than controls on the BCT or the sorting task designed for the present study. Also contrary to predictions, the hoarding group performed significantly better when initiating their own sorts of the objects than when tasked with naming categories grouped by the researcher. These findings are discussed as well as exploratory analyses suggesting participants with hoarding put forth more mental effort sorting the household objects (shoes and mail). They provided significantly more individual responses on the task with significantly more description errors. IQ and performance on other selected neuropsychological measures were not significantly different between groups. These findings provide preliminary evidence there may be specific types of real-life sorting difficulties associated with hoarding disorder that are subtle and beyond what existing neuropsychological tests can measure. Given that current CBT treatments for hoarding presuppose a certain level of competency in sorting (e.g., recognizing and naming different categories of household items to complete a personal organizing plan), it is important to clarify potential sorting and categorization deficits in this group as one possible avenue to help improve treatment response among individuals struggling with hoarding disorder.
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DIAGNOSING AND TREATING ADHD: CLINICIAN CHARACTERISTICS, METHODS OF DIAGNOSIS, DIAGNOSTIC RATES, AND TREATMENT RECOMMENDATIONS
Title
DIAGNOSING AND TREATING ADHD: CLINICIAN CHARACTERISTICS, METHODS OF DIAGNOSIS, DIAGNOSTIC RATES, AND TREATMENT RECOMMENDATIONS
Creator
Haak, Christopher Luke
Date
2019
Description
Attention-deficit/hyperactivity disorder (ADHD) is one of the top five most common referrals among all neuropsychologists (Sweet et al. 2015)...
Show moreAttention-deficit/hyperactivity disorder (ADHD) is one of the top five most common referrals among all neuropsychologists (Sweet et al. 2015) and continues to elicit public and professional concern about over-diagnosis in children (Sciutto & Eisenberg, 2007) and under-diagnosis in adults (Asheron et al., 2012; Kooji et al., 2010). In recent years, the prevalence of ADHD has increased (Polanczyk et al., 2007 & 2014, Thomas et al., 2015). It is unclear what is driving these changes though changes in criteria may be playing a role (van de Voort et al., 2014). Further, there has been little research on whether professional training, beliefs, and practice factors can influence the likelihood to diagnose ADHD. The purpose of this study was to examine the extent to which neuropsychologists’ professional characteristics, training, and beliefs about ADHD diagnosis and treatment influence their likelihood to diagnose ADHD. The study also evaluated whether there are differences in assessing and treating ADHD based upon the client population focus (child, lifespan, or adult) of neuropsychologists. Participants in this study were 106 neuropsychologists from across the United States and Canada who were recruited through neuropsychology listservs to participate in an online survey. Results indicated that population focus was associated with significant differences in approach to diagnosing and treating ADHD, with child- and lifespan-focused neuropsychologists reporting higher rates of ADHD diagnosis. Additionally, having a higher percent of clinical cases in which ADHD is a referral question and greater self-reported adherence to following full diagnostic criteria for making a diagnosis were associated with higher ADHD diagnostic rates, controlling for age, gender, ethnicity, and other professional characteristics. This study is among the first to examine specific clinician factors impacting diagnostic rates and its findings have several implications for practice and research.
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