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Title: PAST- AND FUTURE- ORIENTED COGNITIONS IN PTSD: THE RELATIONSHIP BETWEEN RUMINATION AND WORRY IN DEPRESSION AND ANXIETY SYMPTOMS
Creator: Stickney, Laurie
Date: 2016, 2016-07
Description: Post-Traumatic Stress Disorder (PTSD) is a complex disorder characterized by symptoms of both anxiety and depression. Likewise, individuals...
Show morePost-Traumatic Stress Disorder (PTSD) is a complex disorder characterized by symptoms of both anxiety and depression. Likewise, individuals with PTSD experience Repetitive Negative Cognitions in the form of rumination and worry that may be focused on the past, present, or future. Although cognitions in individuals with PTSD have been studied, there is some question as to what types of cognitions individuals with PTSD generally experience and to what extent different types of cognitions contribute to different PTSD symptomatology. Further, although worry and rumination in PTSD have been studied, the question of the importance of the time-focus of cognitions in PTSD has not been adequately addressed. Time-focused cognitions and the relationships among depression, anxiety, rumination and worry were examined in this study using experience sampling method. Participants were asked to fill out a short survey measuring depression, anxiety, rumination, worry and time-focus five times per day for seven days. Results indicated that the presence of Current-focused cognitions strengthened the relationship between worry and anxiety compared to Future-focused cognitions. These findings suggest that in terms of the relationship between anxiety and worry, it is current-focus that is important not future-focus. Additionally, worry partially mediated the relationship between rumination and anxiety, and rumination partially mediated the relationship between worry and depression. Overall, the results suggest that time-focus may be important in some areas of PTSD, and the study highlights the complex relationships among depression, anxiety, rumination, worry and time-focused cognitions.
Ph.D. in Psychology, July 2016
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Title: COGNITIVE IMPAIRMENT, DEPRESSION, AND INFLAMMATION IN OLDER HEMATOPOIETIC STEM CELL TRANSPLANT RECIPIENTS
Creator: Fong, Wing Man
Date: 2015, 2015-07
Description: Cancer is a common disease that increases in prevalence with age; it predominantly affects individuals over the age of 55. Cancer can be...
Show moreCancer is a common disease that increases in prevalence with age; it predominantly affects individuals over the age of 55. Cancer can be associated with a number of health complications due to the disease itself and/or its treatments such as higher risk of infection, anemia, fatigue, and cognitive dysfunction. Risks of developing these complications increase with age. Despite the increased vulnerability among older individuals, the existing literature and clinical trials show a disproportionately low enrollment rate for this population. This study aimed to provide to a mechanism-based understanding of cognitive impairment in older patients with hematologic malignancy who were scheduled to undergo hematopoietic stem cell transplantation (HSCT). Emerging evidence suggests that a significant portion of older persons with cancer demonstrate cognitive impairment prior to HSCT, and that cognitive deficits prior to HSCT are related to post-transplant complications. Hence, the goals of the study were to characterize cognitive impairment in older cancer patients prior to HSCT, and to examine the relations between cognitive impairment, depression, and inflammation. Sixty-one patients with hematologic malignancy participated in the current study and were administered a comprehensive neuropsychological assessment. Results showed that 50% of the sample was impaired on verbal memory. Correlation analyses revealed a significant association between depression and attention, with inflammation found to be a non-significant mediator. Possible alternative explanations with implications for future research and limitations of the study were discussed.
Ph.D. in Psychology, July 2015
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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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Title: A Randomized Controlled Trial of Direct-to-Consumer Advertising of Cognitive-Behavior Therapy for Depression
Creator: Antler, Caroline
Date: 2020
Description: Almost half of individuals in the US struggling with depression never seek treatment and, of those that do, over half receive inadequate care....
Show moreAlmost half of individuals in the US struggling with depression never seek treatment and, of those that do, over half receive inadequate care. Although the efficacy of CBT for MDD is well established, the rate of individuals receiving psychotherapy has declined. With copious evidence supporting the effectiveness of direct-to-consumer advertising (DTCA) of pharmaceuticals, the current study evaluated the potential utility of DTCA of CBT for MDD.One hundred seventy-eight adults with (a) prior exposure to DTCA for antidepressants and (b) no mental health diagnoses or treatment were randomly assigned to view one of three video conditions: CBT for depression (CBT, n = 60), CBT plus information on antidepressants (CBT+MED, n = 58), or Control (arthritis and diabetes Public Service Announcements (PSAs); n = 60). After viewing the video participants completed measures of attitudes about, and willingness to engage in, CBT and antidepressant medication. The study was conducted online with participants being recruited through Prolific and the survey created via Qualtrics.Compared to controls, participants viewing CBT DTCA videos (with or without information on antidepressants) were more willing to engage in CBT, had less public and self-stigma associated with CBT, and believed CBT has less potential for harm. Compared to the CBT group, the CBT+MED group reported greater concern about the risks of disclosing personal information in a therapy setting.These results extend previous findings by applying the DTCA marketing style to a specific diagnosis and type of therapy. Findings indicate that DTCA-style ads for CBT for MDD can be effective in reducing stigma and increasing treatment willingness. They further suggest that DTCA-style marketing of evidence-based psychotherapies can be efficacious when created for specific treatments and disorders. The findings have substantial implications for public health and the dissemination of evidence-based practice.
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Title: The effect of information overload on knowledge recall and related cognitions for an educational program based on the Mental Health First Aid Model
Creator: Bink, Andrea B.
Date: 2020
Description: Early-intervention public health education programs have been effective at teaching a skillset to help others. However, some of these programs...
Show moreEarly-intervention public health education programs have been effective at teaching a skillset to help others. However, some of these programs have also been criticized for delivering more information than is necessary to learn the skill. Receiving too much information could cause information overload and interfere with program goals. The current study investigated the differential effect on outcomes of two trainings: (i) a standard training with lecture material about depression and anxiety (illness-information), and a skillset to guide interpersonal support for someone with depression and anxiety (skill-information); and (ii) a targeted training that omitted the lecture material and only presented the skillset. Predicted outcomes were that the combination of illness-information and skill-information in the standard training would result in information overload and would interfere with skill-information recall and attitude change. The current study also investigated two variables that could influence outcomes: general information overload about mental health (MHIO) and interest in the topic of mental health. Results were that participants in the standard training endorsed significantly more information overload and performed significantly better on recall measures than participants in the targeted training. Both trainings were effective at attitude change. Finally, preexisting MHIO was associated with training information overload, care seeking, and skill-information recall. Preexisting topic interest was associated with skill-information recall. Results suggest that some background lecture material might be necessary to learn how to support someone with depression and anxiety. Also, programs that promote interpersonal support are effective at attitude change no matter how much information they provide.
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Title: The Impact of Depression and Cognitive Dietary Restraint on the Association between Obstructive Sleep Apnea and Disordered Eating Behaviors
Creator: Schwartz, Natalie
Date: 2020
Description: Obstructive sleep apnea (OSA) is characterized by loud snoring and repeated episodes of obstruction in the upper airway during sleep that...
Show moreObstructive sleep apnea (OSA) is characterized by loud snoring and repeated episodes of obstruction in the upper airway during sleep that cause partial or total stop in the airflow, often resulting in short, disruptive sleep. Sleep disruption as a result of OSA has been shown to result in reduced cognitive functioning and disordered eating behaviors, however, few studies to date have sought to determine whether OSA is associated with disordered eating behaviors. Bariatric patients are asked to restrict their food intake prior to surgery; however, restraint theory suggests that the eating behavior of those intending to restrict their intake can be disinhibited by a variety of conditions, which cause the restrained eater to engage in disinhibited and overeating behaviors. Depression has also demonstrated an association with disordered eating behaviors and cognitive dysfunction. Affect regulation theory is often cited as a possible explanation for this association, with the desire to avoid unpleasant affective states resulting in disordered eating behaviors. A sample of 93 bariatric surgery candidates were recruited from an academic medical center in a large metropolitan city to participate in the current study. Participants were recruited during their routine pre-surgical assessment for bariatric surgery and completed measures of disordered eating and depression. Both body mass index and diagnosis of OSA were obtained from patient medical chart. It was hypothesized that the presence of OSA would be related to higher levels of disordered eating behaviors, including disinhibited eating, frequency of loss of control and frequency of binge eating. Additionally, it was hypothesized that cognitive dietary restraint would moderate the association between OSA and disordered eating in bariatric patients, such that the greater the intent to strictly control food intake (i.e., greater cognitive dietary restraint), the more strongly sleep disturbance will be associated with disordered eating. Finally, it was hypothesized that depression would mediate the association between OSA and disordered eating in bariatric patients, such that depressive symptomatology accounts for the relation between OSA and disordered eating behaviors. Results indicated that the presence of OSA was not related to higher levels of disordered eating behaviors, nor did depression mediate the association between OSA and the disordered eating outcomes. Two of the moderation models were significant, including the disinhibited eating model and the frequency of loss of control over eating model. Although bariatric patients are encouraged to restrict their food intake, findings suggested that restraint does not appear to function as intended in reducing disinhibited eating behaviors in individuals with OSA. The findings for the loss of control model supported restraint theory and suggested that those with OSA who also endorse high restraint are at increased risk for experiencing loss of control over eating, whereas those who do not have cognitive dysfunction associated with OSA may or may not exhibit the same association. The current study highlights the impact of restraint on bariatric patients’ disordered eating behaviors, suggesting that restraint theory may not be entirely applicable to bariatric populations and may depend on the disordered eating behavior being examined. The current study also points to numerous gaps in the current literature and provides future directions for research on OSA and disordered eating in bariatric populations.
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Title: Attitudes of Adults Treated for Depression Toward Technology-Assisted Therapy
Creator: Johnston, Winter D.
Date: 2021
Description: Depression is associated with functional impairment (Saarni et al., 2007), high economic costs (Cuijpers et al., 2007; Greenberg & Birnbaum,...
Show moreDepression is associated with functional impairment (Saarni et al., 2007), high economic costs (Cuijpers et al., 2007; Greenberg & Birnbaum, 2005), and loss of quality of life (Rapaport et al., 2005), and has been named a major reason for illness-related disability worldwide (Vos et al., 2013). Barriers to treatment include being physically limited to access services (Apolinario-Hagen et al., 2018), fear of stigmatization, desire to handle the problem on ones’ own, lack of confidence in the healthcare system (Königbauer et al., 2017), lack of motivation to change, and negative perception of psychological and/or drug treatments (Richards et al., 2015). As technological options have advanced and become more reliable, they have become tools to improve access to care and reduce barriers. Clinicians’ attitudes have been studied pertaining to incorporating different technology modalities into traditional therapy; however, client attitudes are less explored. The present study aims to (1) explore client attitudes towards hypothetical technology-assisted interventions, (2) assess the relative preferences for various technology-assisted interventions, (3) identify correlates of the participant’s preference of different technology-assisted interventions, including: (a) attitudes towards technology-assisted therapy, (b) sociodemographic variables, (c) help-seeking variables (seeking health information, use of technology outside therapy, awareness of technology-assisted options for therapy), (d) previous therapy experience (therapeutic approach, helpfulness of therapy, number of previous therapists), and (4) assess if working alliance with participants’ most recent therapist moderated the effect of therapist condition (current/recent or new) on preferences. The technology options in this study are videoconferencing, online therapy, mobile phones, and virtual reality/avatars. Individuals were asked to imagine continuing therapy using these technological options. Participants viewed videos demonstrating how each technology is used in a therapeutic setting and provided their attitudes and preferences afterwards. The participants consisted of adults who currently or in the recent past have received therapy to treat any severity of depression. Overall, participants had a positive attitude towards technology-assisted therapy. Participants’ relative preference for various technology-assisted interventions and their first-choice modality of therapy did not differ by whether the participant was to keep their same therapist or start therapy with a new therapist. A variety of determinants were associated with greater preference towards the different modalities. Lastly, the strength of working alliance did not moderate whether preferences differed based on staying with the participant’s current/most recent therapist or starting with a new therapist. Limitations, strengths, and conclusions are also discussed.
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Title: CARING FOR THE CAREGIVER: INTERPERSONAL FACTORS AND DEPRESSION AS PARALLEL-SERIAL MEDIATORS BETWEEN STIGMA AND SUICIDAL IDEATION
Creator: Tsen, Jonathan Y.
Date: 2022
Description: Background/Objectives: This study applied Joiner's Interpersonal PsychologicalTheory to a caregiver population, by describing relationships...
Show moreBackground/Objectives: This study applied Joiner's Interpersonal PsychologicalTheory to a caregiver population, by describing relationships among affiliate stigma, thwarted-belongingess (TB), perceived-burdensomeness (PB), and depression, and suicidal ideation (SI). Participants/Setting: 243 adult caregivers participated in this study via Prolific Academic and caregiver-related websites. Design/Main Outcome Measures: This study used a cross-sectional, survey-based design including demographics, the Affiliate Stigma Scale (α=.93), Interpersonal Needs Questionnaire-15 (α=.95), Center of Epidemiology Studies–Depression-10 (α=.90), and Depressive Symptom Inventory— Suicide Subscale (α = .91) via Qualtrics. Analyses run on SPSSv27/Hayes’ PROCESS macro. Results: Parallel-serial mediation found after controlling for covariates that the total indirect effect of affiliate stigma on SI through both TB and PB then through depression was significant, B = .0271, SE = .0062, β = .1659, 95%CI [.0152, .0393]. Conclusions: Findings indicated that affiliate stigma indirectly affected SI through both TB and PB then through depression. Interventions to improve caregiver wellbeing should capitalize on both improving interpersonal functioning and depressive symptoms in tandem in order to reduce SI risk.
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Title: Stigma, depression, and help-seeking: Experiences of parents/caregivers of children with mental health challenges
Creator: Serchuk, Marisa D.
Date: 2023
Description: The impacts of stigma on people with lived-experience are widely recognized, however, stigma has been noted to extend to family members. The...
Show moreThe impacts of stigma on people with lived-experience are widely recognized, however, stigma has been noted to extend to family members. The current investigation examines how specific types of stigma experienced by parents/caregivers (N=250) of children with mental health challenges are related to symptoms of depression and attitudes towards help-seeking. Results found that higher levels of public stigma, self-stigma, and vicarious stigma were associated with higher levels of depression and were differentially associated with attitudes towards help-seeking. Findings from this investigation add to the small body of literature examining stigma experienced by parents/caregivers of children with mental health challenges.
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