Theses and Dissertations
This collection includes both ASU Theses and Dissertations, submitted by graduate students, and the Barrett, Honors College theses submitted by undergraduate students.
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- All Subjects: Clinical Psychology
Description
There is a lack of music therapy services for college students who have problems with depression and/or anxiety. Even among universities and colleges that offer music therapy degrees, there are no known programs offering music therapy to the institution's students. Female college students are particularly vulnerable to depression and anxiety symptoms compared to their male counterparts. Many students who experience mental health problems do not receive treatment, because of lack of knowledge, lack of services, or refusal of treatment. Music therapy is proposed as a reliable and valid complement or even an alternative to traditional counseling and pharmacotherapy because of the appeal of music to young women and the potential for a music therapy group to help isolated students form supportive networks. The present study recruited 14 female university students to participate in a randomized controlled trial of short-term group music therapy to address symptoms of depression and anxiety. The students were randomly divided into either the treatment group or the control group. Over 4 weeks, each group completed surveys related to depression and anxiety. Results indicate that the treatment group's depression and anxiety scores gradually decreased over the span of the treatment protocol. The control group showed either maintenance or slight worsening of depression and anxiety scores. Although none of the results were statistically significant, the general trend indicates that group music therapy was beneficial for the students. A qualitative analysis was also conducted for the treatment group. Common themes were financial concerns, relationship problems, loneliness, and time management/academic stress. All participants indicated that they benefited from the sessions. The group progressed in its cohesion and the participants bonded to the extent that they formed a supportive network which lasted beyond the end of the protocol. The results of this study are by no means conclusive, but do indicate that colleges with music therapy degree programs should consider adding music therapy services for their general student bodies.
ContributorsAshton, Barbara (Author) / Crowe, Barbara J. (Thesis advisor) / Rio, Robin (Committee member) / Davis, Mary (Committee member) / Arizona State University (Publisher)
Created2013
Description
Sometimes difficult life events challenge our existing resources in such a way that routinized responses are inadequate to handle the challenge. Some individuals will persist in habitual, automatic behavior, regardless of environmental cues that indicate a mismatch between coping strategy and the demands of the stressor. Other individuals will marshal adaptive resources to construct new courses of action and reconceptualize the problem, associated goals and/or values. A mixed methods approach was used to describe and operationalize cognitive shift, a relatively unexplored construct in existing literature. The study was conducted using secondary data from a parent multi-year cross-sectional study of resilience with eight hundred mid-aged adults from the Phoenix metro area. Semi-structured telephone interviews were analyzed using a purposive sample (n=136) chosen by type of life event. Participants' beliefs, assumptions, and experiences were examined to understand how they shaped adaptation to adversity. An adaptive mechanism, "cognitive shift," was theorized as the transition from automatic coping to effortful cognitive processes aimed at novel resolution of issues. Aims included understanding when and how cognitive shift emerges and manifests. Cognitive shift was scored as a binary variable and triangulated through correlational and logistic regression analyses. Interaction effects revealed that positive personality attributes influence cognitive shift most when people suffered early adversity. This finding indicates that a certain complexity, self-awareness and flexibility of mind may lead to a greater capacity to find meaning in adversity. This work bridges an acknowledged gap in literature and provides new insights into resilience.
ContributorsRivers, Crystal T (Author) / Zautra, Alex (Thesis advisor) / Davis, Mary (Committee member) / Kurpius, Sharon (Committee member) / Arizona State University (Publisher)
Created2014
Description
The primary aim of this study was to investigate resilient profiles in low-income Mexican American (MA) mothers. MA mothers are part of an under researched population, the fastest growing ethnic minority group, and have the highest birth rate in the United States, presenting a significant public health concern. The transition to motherhood can be an emotionally and physically complex time for women, particularly in the context of a stressful low-income environment. Although most low-income women navigate this transition well, a significant number of mothers develop moderate to severe depressive symptoms. The proposed research investigated profiles of resilience during the prenatal period using a person-centered approach via latent profile analysis. In alignment with current resilience theories, several domains of resilience were investigated including psychological, social, and cultural adherence (e.g., maintaining specific cultural traditions). Concurrent prenatal depressive symptoms and stress were correlated with the profiles in order to establish validity. Six week postpartum depressive symptoms and physiological processes (e.g., overall cortisol output, heart rate variability, and sleep) were also predicted by the prenatal resilient profiles. The resulting data revealed three separate profiles: low-resource, high-resource Anglo, and high-resource Mexican. These resilience profiles had differential associations with concurrent depressive symptoms and stress, such that women in the high-resource profiles reported less depressive symptoms and stress prenatally. Further, profile differences regarding cortisol output, resting heart rate variability, were also found, but there were no differences in insomnia symptoms. Profile classification also moderated the effects of prenatal economic stress on postpartum depressive symptoms, such that women in the high-resource Mexican profile were at risk for higher postpartum depressive symptoms under high economic stress compared to the high-resource Anglo group, which demonstrated a more resilient response. Overall, the results suggest the presence of multiple clusters of prenatal resilience within a sample of MA mothers facing health disparities, with various effects on perinatal mental health and postpartum physiological processes. The results also highlight the need for multi-dimensional models of resilience and the possible implications for interventions.
ContributorsGress Smith, Jenna L (Author) / Luecken, Linda J. (Thesis advisor) / Gonzales, Nancy (Committee member) / Okun, Morris (Committee member) / Zautra, Alex (Committee member) / Arizona State University (Publisher)
Created2014
Description
Adverse childhood family environments have been found to have long-term effects on a child's well-being. Although no prior studies have examined the direct effects of childhood family adversities on nighttime blood pressure (BP) dip, parental death and divorce in childhood, have been associated with a variety of related psychological problems in adulthood. The current study examined the direct effects of parental death and divorce in childhood and quality of early family relationships on adult nighttime BP dip as well as the mediating role of three psychosocial factors (depression, hostility and social stress). One hundred and forty-three young adults were asked to complete self-reported measures of the three psychosocial factors and quality of family relationships. Study participants wore an ambulatory blood pressure (ABP) monitor over a 24-hr period in order to assess nocturnal BP dip. Although neither childhood family adversity nor quality of childhood family relationships directly predicted nighttime BP dipping, quality of early family relationships predicted all three psychosocial factors, and hostility was found to mediate the relationship between quality of childhood family relationships and nighttime systolic BP dip. Early family experiences play an important role in influencing nighttime cardiovascular functioning by influencing an individual's psychological functioning in young adulthood. Because nighttime non-dipping has been associated with increased risk for cardiovascular disease and other serious health conditions, the results of the present study have important clinical implications and provide specific psychosocial pathways that may be targeted in future programs designed to prevent and treat cardiovascular disease.
ContributorsTanaka, Rika (Author) / Luecken, Linda J. (Thesis advisor) / Wolchik, Sharlene (Committee member) / Davis, Mary (Committee member) / Arizona State University (Publisher)
Created2012
Description
In rehabilitation settings, activity limitation can be a significant barrier to recovery. This study sought to examine the effects of state and trait level benefit finding, positive affect, and catastrophizing on activity limitation among individuals with a physician-confirmed diagnosis of either Osteoarthritis (OA), Fibromyalgia (FM), or a dual diagnosis of OA/FM. Participants (106 OA, 53 FM, and 101 OA/FM) who had no diagnosed autoimmune disorder, a pain rating above 20 on a 0-100 scale, and no involvement in litigation regarding their condition were recruited in the Phoenix metropolitan area for inclusion in the current study. After initial questionnaires were completed, participants were trained to complete daily diaries on a laptop computer and instructed to do so a half an hour before bed each night for 30 days. In each diary, participants rated their average daily pain, benefit finding, positive affect, catastrophizing, and activity limitation. A single item, "I thought about some of the good things that have come from living with my pain" was used to examine the broader construct of benefit finding. It was hypothesized that state and trait level benefit finding would have a direct relation with activity limitation and a partially mediated relationship, through positive affect. Multilevel modeling with SAS PROC MIXED revealed that benefit finding was not directly related to activity limitation. Increases in benefit finding were associated, however, with decreases in activity limitation through a significant mediated relationship with positive affect. Individuals who benefit find had a higher level of positive affect which was associated with decreased activity limitation. A suppression effect involving pain and benefit finding at the trait level was also found. Pain appeared to increase the predictive validity of the relation of benefit finding to activity limitation. These findings have important implications for rehabilitation psychologists and should embolden clinicians to encourage patients to increase positive affect by employing active approach-oriented coping strategies like benefit finding to reduce activity limitation.
ContributorsKinderdietz, Jeffrey Scott (Author) / Zautra, Alex (Thesis advisor) / Davis, Mary (Committee member) / Barrera, Manuel (Committee member) / Okun, Morris (Committee member) / Arizona State University (Publisher)
Created2012
Description
Prevailing models describing coping with chronic pain posit that it is a complex day-to-day process that can involve psychosocial factors, including cognitive appraisals about pain, interpersonal challenges such as distressed social relationships, and reduced engagement in enjoyable experiences. Few studies, however, have applied a process-oriented approach to elaborate the relations between key pain-related appraisals, social environmental factors, and self-efficacy, a key self-appraisal for successful adaptation to chronic pain. This study used within-day daily diary methodology to test the following hypotheses: (a) increases in morning pain catastrophizing predict decreases in end of day pain self-efficacy; (b) increases in perceived stressfulness of interpersonal relations occurring during the day exacerbate the negative effects of morning catastrophizing on end-of-day pain self-efficacy; and (c) increases in perceived enjoyment of interpersonal relations occurring during the day mitigate the negative effects of morning pain catastrophizing on end of day pain self-efficacy. Within-day measures, including morning pain catastrophizing, afternoon interpersonal stress and enjoyment ratings, and end-of-day pain self-efficacy, were collected for 21 days via an automated phone system from 223 participants with widespread chronic pain. The use of diary data allowed for examination of time-varying processes related to pain adaptation. Results of multilevel regression models indicated that, consistent with prediction, increases in morning pain catastrophizing and predicted decreases in end-of-day pain self-efficacy. Contrary to prediction, changes in midday interpersonal enjoyment and stress did not moderate the within-day catastrophizing-efficacy relation. Rather increases in midday enjoyment and stable individual differences in enjoyment predicted end-of-day efficacy. Overall, findings suggest a within-day relation between pain cognition and social context and subsequent self-efficacy, and highlight potential targets for intervention in chronic pain.
ContributorsThummala, Kirti (Author) / Davis, Mary C. (Thesis advisor) / Zautra, Alex (Committee member) / Okun, Morris (Committee member) / Arizona State University (Publisher)
Created2018
Description
The present study utilized longitudinal data from a high-risk community sample (n= 377; 166 trauma-exposed; 54% males; 52% children of alcoholics; 73% non-Hispanic/Latino Caucasian; 22% Hispanic/Latino; 5% other ethnicity) to test a series of hypotheses that may help explain the risk pathways that link traumatic stress, posttraumatic stress disorder (PTSD) symptomatology, and problematic alcohol and drug use. Specifically, this study examined whether pre-trauma substance use problems increase risk for trauma exposure (the high-risk hypothesis) or PTSD symptoms (the susceptibility hypothesis), whether PTSD symptoms increase risk for later alcohol/drug problems (the self-medication hypothesis), and whether the association between PTSD symptoms and alcohol/drug problems is due to shared risk factors (the shared vulnerability hypothesis). This study also examined the roles of gender and ethnicity in these pathways. A series of logistic and negative binomial regressions were performed in a path analysis framework. A composite pre-trauma family adversity variable was formed from measures of family conflict, family life stress, parental alcoholism, and other parent psychopathology. Results provided the strongest support for the self-medication hypothesis, such that PTSD symptoms predicted higher levels of later alcohol and drug problems among non-Hispanic/Latino Caucasian participants, over and above the influences of pre-trauma family adversity, pre-trauma substance use problems, trauma exposure, and demographic variables. Results partially supported the high-risk hypothesis, such that adolescent substance use problems had a marginally significant unique effect on risk for assaultive violence exposure but not on overall risk for trauma exposure. There was no support for the susceptibility hypothesis, as pre-trauma adolescent substance use problems did not significantly influence risk for PTSD diagnosis/symptoms over and above the influence of pre-trauma family adversity. Finally, there was little support for the shared vulnerability hypothesis. Neither trauma exposure nor preexisting family adversity accounted for the link between PTSD symptoms and later substance use problems. These results add to a growing body of literature in support of the self-medication hypothesis. Findings extend previous research by showing that PTSD symptoms may influence the development of alcohol and drug problems over and above the influence of trauma exposure itself, preexisting family risk factors, and baseline levels of substance use.
ContributorsHaller, Moira (Author) / Chassin, Laurie (Thesis advisor) / Davis, Mary (Committee member) / Pina, Armando (Committee member) / Tein, Jenn-Yun (Committee member) / Arizona State University (Publisher)
Created2014
Description
Guided by the Risky Families model and Daily Process methods, the present study examined how daily stressors are related to emotional well-being at the between- and within-person levels among adolescent grandchildren raised by grandmothers. This study also examined whether risk (i.e., adverse childhood experiences/ACES) and resilience (i.e., socio-emotional skills) factors were linked to differences in daily well-being, stressor exposure, and emotional reactivity, and evaluated the efficacy of an online social intelligence training (SIT) program on daily stressor-emotion dynamics. Data came from a subsample (n = 188) of custodial adolescents who participated in an attention-controlled randomized clinical trial and completed 14-day daily surveys prior to and following intervention. Analyses were conducted with dynamic structural equation modeling. Daily stressors, on average, and experiencing above average stressors, were associated with higher negative emotions and lower positive emotions and social connection. Those with more ACEs, on average, reported higher daily stressors and worse well-being, whereas those with higher socio-emotional skills, on average, reported lower daily stressors and better well-being. At the within-person level, more ACEs were associated with higher daily negative emotions. Nonverbal processing was linked to higher daily positive emotions and social connection. Conversational skills were associated with higher daily positive emotions and social connection, and lower, more inert daily negative emotions. Neither ACEs nor socio-emotional skills were associated with within-person reactivity to stressors. Also, the SIT program did not demonstrate efficacy for any outcome. My discussion focused on how findings extend the literature on custodial adolescents by showing that daily stressors impact well-being, offer knowledge of how ACEs and socio-emotional skills shape daily stressor-emotion dynamics, and considers reasons why the online, self-guided SIT program failed to show efficacy on key outcomes.
ContributorsCastro, Saul (Author) / Infurna, Frank (Thesis advisor) / Doane, Leah (Committee member) / Davis, Mary (Committee member) / Grimm, Kevin (Committee member) / Arizona State University (Publisher)
Created2023
Description
Adults with autism spectrum disorder (ASD) face heightened risk of co-occurring psychiatric conditions, especially depression and anxiety disorders, which contribute to seven-fold higher suicide rates than the general population. Mindfulness-based stress reduction (MBSR) is an 8-week meditation intervention centered around training continuous redirection of attention toward present moment experience, and has been shown to improve mental health in autistic adults. However, the underlying therapeutic neural mechanisms and whether behavioral and brain changes are mindfulness-specific have yet to be elucidated. In this randomized clinical trial, I utilized functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) to characterize fMRI functional activity (Study 1) and connectivity (Study 2) and EEG neurophysiological (Study 3) changes between MBSR and a social support/relaxation education (SE) active control group. Study 1 revealed an MBSR-specific increase in the midcingulate cortex fMRI blood oxygen level dependent signal which was associated with reduced depression. Study 2 identified nonspecific intervention improvements in depression, anxiety, and autistic, and MBSR-specific improvements in the mindfulness trait ‘nonjudgment toward experience’ and in the executive functioning domain of working memory. MBSR-specific decreases in insula-thalamus and frontal pole-posterior cingulate functional connectivity was associated with improvements in anxiety, mindfulness traits, and working memory abilities. Both MBSR and SE groups showed decreased amygdala-sensorimotor and frontal pole-insula connectivity which correlated with reduced depression. Study 3 consisted of an EEG spectral power analysis at high-frequency brainwaves associated with default mode network (DMN) activity. Results showed MBSR-specific and nonspecific decreases in beta- and gamma-band power, with effects being generally more robust in the MBSR group; additionally, MBSR-specific decreases in posterior gamma correlated with anxiolytic effects. Collectively, these studies suggest: 1) social support is sufficient for improvements in depression, anxiety, and autistic traits; 2) MBSR provides additional benefits related to mindfulness traits and working memory; and 3) distinct and shared neural mechanisms of mindfulness training in adults with ASD, implicating the salience and default mode networks and high-frequency neurophysiology. Findings bear relevance to the development of personalized medicine approaches for psychiatric co-morbidity in ASD, provide putative targets for neurostimulation research, and warrant replication and extension using advanced multimodal imaging approaches.
ContributorsPagni, Broc (Author) / Braden, B. Blair (Thesis advisor) / Newbern, Jason (Thesis advisor) / Davis, Mary (Committee member) / Brewer, Gene (Committee member) / Arizona State University (Publisher)
Created2022
Description
An abundance of data has established the links between both pain-related cognitions and relationship attachment qualities in the experience of pain, including long-term functional health in chronic pain patients. However, relatively few studies have explored the dynamic relation between pain and pain-related cognitions within a day, and no studies have tested the moderating role of relationship attachment on the within-day cognition—pain association in chronic pain patients. The objectives of this study were to: 1) assess whether late morning pain flares predicted changes in afternoon positive and negative pain-related cognitive appraisals, and whether these changes in turn predicted end-of-day pain, and 2) explore whether adult attachment anxiety moderated the pain-cognition relation in individuals with chronic pain due to fibromyalgia. One hundred and seventy four partnered individuals with fibromyalgia completed initial assessments of demographics and attachment anxiety, and subsequently completed electronic assessments of pain intensity and positive and negative cognitive pain-related appraisals three times a day for three weeks. Multilevel structural equation modeling established that a latent negative cognitive appraisal factor (encompassing shared variance from catastrophizing, pain irritation, and self-criticism related to pain) mediated the link between late morning and end-of-day pain intensity, in line with the hypothesis. Analyses also provided some support for a mediating role for a positive cognitive appraisal factor (a composite of pain control, pain self-efficacy, and feeling pain without reacting) in the daily course of pain; the mediated effect for positive appraisals was weaker than the mediated effect of negative appraisals, but was sustained in a model that included negative appraisals. Inconsistent with prediction, attachment anxiety did not moderate the within-day links between pain and cognitions. These findings establish the dynamic links within day between pain and pain-related cognitions, and highlight the potential impact of both negative and positive cognitions on daily pain regulation. They point to the value of broadening cognitive-behavioral treatment strategies for chronic pain patients to target not only negative but also positive cognitions.
ContributorsTaylor, Shannon Stark (Author) / Davis, Mary C. (Thesis advisor) / Zautra, Alex (Committee member) / Okun, Morris (Committee member) / Doane, Leah (Committee member) / Arizona State University (Publisher)
Created2015