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
Accumulating evidence implicates exposure to adverse childhood experiences in the development of hypocortisolism in the long-term, and researchers are increasingly examining individual-level mechanisms that may underlie, exacerbate or attenuate this relation among at-risk populations. The current study takes a developmentally and theoretically informed approach to examining episodic childhood stressors, inherent and voluntary self-regulation, and physiological reactivity among a longitudinal sample of youth who experienced parental divorce. Participants were drawn from a larger randomized controlled trial of a preventive intervention for children of divorce between the ages of 9 and 12. The current sample included 159 young adults (mean age = 25.5 years; 53% male; 94% Caucasian) who participated in six waves of data collection, including a 15-year follow-up study. Participants reported on exposure to negative life events (four times over a 9-month period) during childhood, and mothers rated child temperament. Six years later, youth reported on the use of active and avoidant coping strategies, and 15 years later, they participated in a standardized psychosocial stress task and provided salivary cortisol samples prior to and following the task. Path analyses within a structural equation framework revealed that a multiple mediation model best fit the data. It was found that children with better mother-rated self-regulation (i.e. low impulsivity, low negative emotionality, and high attentional focus) exhibited lower total cortisol output 15 years later. In addition, greater self-regulation in childhood predicted greater use of active coping in adolescence, whereas a greater number of negative life events predicted increased use of avoidant coping in adolescence. Finally, a greater number of negative events in childhood predicted marginally lower total cortisol output, and higher levels of active coping in adolescence were associated with greater total cortisol output in young adulthood. Findings suggest that children of divorce who exhibit better self-regulation evidence lower cortisol output during a standardized psychosocial stress task relative to those who have higher impulsivity, lower attentional focus, and/or higher negative emotionality. The conceptual significance of the current findings, including the lack of evidence for hypothesized relations, methodological issues that arose, and issues in need of future research are discussed.
ContributorsHagan, Melissa (Author) / Luecken, Linda (Thesis advisor) / MacKinnon, David (Committee member) / Wolchik, Sharlene (Committee member) / Doane, Leah (Committee member) / Arizona State University (Publisher)
Created2013
Description
Although it has been established that children raised by lesbian and gay (LG) parents are comparable in psychological adjustment to those raised by heterosexuals, there are unique stressors that these families must face as members of a social minority group. For example, chronic exposure to stigma and discrimination has been associated with several poor psychological and behavioral outcomes in children, as well as high levels of stress experienced by LG parents. Thus, the current study sought to examine LG parents' coping actions and parenting strategies as used during and after an act of antigay discrimination which also involved their children, or as these involved an act which their children witnessed. This study also sought to define the parenting needs of LG parents. The research plan utilized an integrative mixed methods approach to examine the qualitative text narratives of 43 LG parents (29 mothers and 14 fathers) ranging in age from 28-56 years old with school-aged children (6-12 years). Results revealed that LG parents' negative emotion-based coping actions predicted higher depressive symptoms (β= .41,t(33) = 3.17, p < .01), LG parents' avoidant/escape coping actions predicted lower parenting self-agency (β = -.34, t(33) = -2.23, p < .05), and LG parents' engagement in understanding and coping with discrimination parenting strategies predicted lower post-traumatic stress problems in their children (β = -.33, t(33) = -1.96, yp = .059). Last, a family needs assessment survey was used to determine the unique parenting needs of these LG parents. The results of this survey indicated that LG parents endorsed the following three topic areas as most important to them: (a) LG Family Community Services, (b) Information about Child Development, and (c) Explaining LG Family to Others. These findings reinforce existing knowledge in terms of the effects of discrimination on LG parents and their children. Indeed, results indicate the importance of providing LG parents with adaptive discrimination coping and parenting strategies, as well as offering valuable information concerning their specific needs.
ContributorsKellison, Joshua G (Author) / Gonzalez Castro, Felipe (Thesis advisor) / Crnic, Keith (Thesis advisor) / Barrera, Jr., Manuel (Committee member) / Marsiglia, Flavio (Committee member) / Wolchik, Sharlene (Committee member) / Arizona State University (Publisher)
Created2014
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 effects of preventive interventions are found to be related to participants' responsiveness to the program, or the degree to which participants attend sessions, engage in the material, and use the program skills. The current study proposes a multi-dimensional method for measuring responsiveness to the Family Bereavement Program (FBP), a parenting-focused program to prevent mental health problems for children who experienced the death of a parent. It examines the relations between individual-level risk-factors and responsiveness to the program, as well as the relations between responsiveness and program outcomes. The sample consists of 90 caregivers and 135 children assigned to the intervention condition of an efficacy trial of the FBP. Caregivers' responsiveness to the 12-week program was measured using a number of indicators, including attendance, completion of weekly "homework" assignments, overall program skill use, perceived helpfulness of the program and program skills, and perceived group environment. Three underlying dimensions of responsiveness were identified: Skill Use, Program Liking, and Perceived Group Environment. Positive parenting and child externalizing problems at baseline were found to predict caregiver Skill Use. Skill Use and Perceived Group Environment predicted changes in caregiver grief and reports of child behavior problems at posttest and 11-month follow-up. Caregivers with better Skill Use had better positive parenting outcomes. Skill use mediated the relation between baseline positive parenting and improvements in positive parenting at 11-month follow-up.
ContributorsSchoenfelder, Erin (Author) / Sandler, Irwin N. (Thesis advisor) / Wolchik, Sharlene (Committee member) / Millsap, Roger (Committee member) / Barrera, Manuel (Committee member) / Arizona State University (Publisher)
Created2012
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
The purpose of this study was to examine if certain child demographics and risk modifiers of the child (i.e., anxiety sensitivity, depressive symptoms, anxiety control, and social competence) predict program response to a Child Anxiety Indicated Prevention and Early Intervention protocol (Pina, Zerr, Villalta, & Gonzales, 2012). This anxiety protocol focused on cognitive behavioral techniques (e.g., systematic and gradual exposure) that used culturally responsive implementation strategies (Pina, Villalta, & Zerr, 2009). The current study aims to investigate specific predictors of program response to this anxiety protocol. First, it was of interest to determine if child demographics and risk modifiers of the child at baseline would predict program response to the early anxiety intervention protocol. Second, it was of interest to see if an interaction with one of the four risk modifiers at baseline and sex or protocol condition would predict program response to the early anxiety intervention protocol. This study included 88 youth (59.14% Hispanic/Latino and 40.9% Caucasian) who were recruited through referrals from public schools and randomized to one of two protocol conditions (i.e., child-only or the child-plus-parent protocol), which had varying levels of mothers’ participation within the Child Anxiety Indicated Prevention and Early Intervention protocol (Pina et al., 2012). Participants ranged from 6 to 17 years of age (M = 10.36, SD = 2.73), and 48.9% were boys. The four risk modifiers were assessed using the Childhood Anxiety Sensitivity Index (CASI; Silverman, Fleisig, Rabian, & Peterson, 1991), Children's Depression Inventory (CDI; Kovacs, 1981), Anxiety Control Questionnaire for Children-Short Form (ACQ-C-S; Weems, 2005), and Social Competence scale from the Child Behavior Checklist (CBCL; Achenbach & Resorla, 2001). Program response was measured by pre-to-posttest changes in anxiety outcomes. Regarding the first aim, each of the four risk modifiers was related to pre-to-posttest changes in program response outcomes. Regarding the second aim for interactions between each of the four focal predictors, sex and protocol condition emerged as moderators. These results have potential implications for clinicians and researchers interested in understanding why some children might experience more or less change when participating in an early intervention protocol for anxiety.
ContributorsWynne, Henry (Author) / Pina, Armando (Thesis advisor) / Luthar, Suniya (Committee member) / Enders, Craig (Committee member) / Wolchik, Sharlene (Committee member) / Arizona State University (Publisher)
Created2017
Description
Anxiety is one of the most common psychiatric disorders among children yet characterized by lower use of mental health services. Preventive efforts have demonstrated promise in the ability to reduce anxiety symptoms. However, as evidence-based interventions move into real-world settings, there is a need to systematically examine potential implementation factors that may affect program outcomes. The current study investigates the relations between different aspects of implementation and their effect on outcomes of a school-based preventive intervention targeting anxiety symptoms. Specifically, the study examines: (1) the measurement of quality of delivery, (2) specific relations among implementation components, (3) relations between these facets and anxiety program outcomes. Implementation data were collected from nine school-based mental health staff and observer ratings. Program outcomes (pretest and immediate posttest) were measured from 59 participants and their parents (mostly mothers) in the intervention condition. Implementation components included adherence, quality of delivery, time spent, participant responsiveness, and perceived usefulness of program materials. Program outcomes included child-reported emotional expressivity, physiological hyperarousal, negative cognitions, social skills, self-efficacy, and child and parent reported levels of child anxiety. Study findings indicated that quality of delivery was best captured as two facets: skillful presentation and positive engagement. Adherence and quality of delivery were associated with greater participant responsiveness, although time spent was not. Significant relations were found between some implementation components and some program outcomes. Further efforts can be used to optimize the translation of evidence-based programs into real-world settings.
ContributorsChiapa, Amanda (Author) / Pina, Armando (Thesis advisor) / Dishion, Thomas (Committee member) / Wolchik, Sharlene (Committee member) / Grimm, Kevin (Committee member) / Berkel, Cady (Committee member) / Arizona State University (Publisher)
Created2017
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