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- Creators: Department of Psychology
- Creators: Lavoie, Michael
- Creators: Allen, Kelly Anne
Description
Military veterans have a significantly higher incidence of mild traumatic brain injury (mTBI), depression, and Post-traumatic stress disorder (PTSD) compared to civilians. Military veterans also represent a rapidly growing subgroup of college students, due in part to the robust and financially incentivizing educational benefits under the Post-9/11 GI Bill. The overlapping cognitively impacting symptoms of service-related conditions combined with the underreporting of mTBI and psychiatric-related conditions, make accurate assessment of cognitive performance in military veterans challenging. Recent research findings provide conflicting information on cognitive performance patterns in military veterans. The purpose of this study was to determine whether service-related conditions and self-assessments predict performance on complex working memory and executive function tasks for military veteran college students. Sixty-one military veteran college students attending classes at Arizona State University campuses completed clinical neuropsychological tasks and experimental working memory and executive function tasks. The results revealed that a history of mTBI significantly predicted poorer performance in the areas of verbal working memory and decision-making. Depression significantly predicted poorer performance in executive function related to serial updating. In contrast, the commonly used clinical neuropsychological tasks were not sensitive service-related conditions including mTBI, PTSD, and depression. The differing performance patterns observed between the clinical tasks and the more complex experimental tasks support that researchers and clinicians should use tests that sufficiently tax verbal working memory and executive function when evaluating the subtle, higher-order cognitive deficits associated with mTBI and depression.
ContributorsGallagher, Karen Louise (Author) / Azuma, Tamiko (Thesis advisor) / Liss, Julie (Committee member) / Lavoie, Michael (Committee member) / Arizona State University (Publisher)
Created2017
Description
An increasing number of military veterans are enrolling in college, primarily due to the Post-9/11 GI Bill, which provides educational benefits to veterans who served on active duty since September 11, 2001. With rigorous training, active combat situations, and exposure to unexpected situations, the veteran population is at a higher risk for traumatic brain injury (TBI), Post Traumatic Stress Disorder (PTSD), and depression. All of these conditions are associated with cognitive consequences, including attention deficits, working memory problems, and episodic memory impairments. Some conditions, particularly mild TBI, are not diagnosed or treated until long after the injury when the person realizes they have cognitive difficulties. Even mild cognitive problems can hinder learning in an academic setting, but there is little data on the frequency and severity of cognitive deficits in veteran college students. The current study examines self-reported cognitive symptoms in veteran students compared to civilian students and how those symptoms relate to service-related conditions. A better understanding of the pattern of self-reported symptoms will help researchers and clinicians determine the veterans who are at higher risk for cognitive and academic difficulties.
ContributorsAllen, Kelly Anne (Author) / Azuma, Tamiko (Thesis director) / Gallagher, Karen (Committee member) / Department of Speech and Hearing Science (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
An increasing number of veterans are transitioning from military service to college. Critical to academic success is the process of decision-making, which previous research has found to be influenced by a variety of factors including anxiety and working memory (WM). Many service-related conditions often influence anxiety and WM, and given the high prevalence of these conditions among veterans, the present study aimed to analyze the effects of working memory and anxiety on decision-making behavior in U.S. Military Veterans. Participants completed a large test battery including tasks assessing WM skills (Symmetry Span Task), anxiety (Beck Anxiety Inventory), and decision-making (Iowa Gambling Task). The study results indicated that WM and anxiety both play roles in decision-making performance in young military veterans. High anxiety is related to increased avoidance of adverse outcomes in decision-making for U.S. Military Veterans, while lower working memory span is associated with greater risk-taking behavior. This study provides both functional and clinical implications into areas of possible intervention that need to be assessed in military veterans, as well as modifications to these assessments that need to be made in order to appropriately measure decision-making behavior. Future work will be done in order to more effectively analyze the adverse impacts of service-related conditions and the ways in which intervention can be implemented in order to minimize these effects.
ContributorsTully, Mckayla Lynne (Author) / Azuma, Tamiko (Thesis director) / Gallagher, Karen (Committee member) / Department of Psychology (Contributor) / Sanford School of Social and Family Dynamics (Contributor) / Department of Speech and Hearing Science (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Mild TBI (mTBI) has been associated with subtle executive function (EF) and
cognitive-communication deficits. In bilinguals, there are unique cognitive demands required to control and process two languages effectively. Surprisingly, little is known about the impact of mTBI on EF, communication, and language control in bilinguals. Therefore, the aim of this study was to examine the cognitive-communication abilities in bilinguals with a history of mTBI, identify any language control impairments, and explore the relationship between these language control impairments and domain-general cognitive control abilities. To this end, three-hundred and twenty-seven monolingual and bilingual college students with and without mTBI history participated in two experiments. In these experiments, EF, communication, and language control were examined using experimental and clinical tasks as well as self-rating scales. In Experiment 1, there was an interaction between mTBI history and language group (monolinguals vs. bilinguals) in how participants performed on a clinical measure of EF and a verbal fluency task. That is, only bilinguals with mTBI scored significantly lower on these tasks. In addition, there was a significant correlation between errors on a language switching task and performance on non-verbal EF tasks. In Experiment 2, a subgroup of bilinguals with persistent cognitive and behavioral symptoms reported greater everyday communication challenges in their first and second languages. Also, unbalanced bilinguals reported greater EF difficulties than monolinguals and balanced bilinguals regardless of mTBI history. In conclusion, bilinguals may face unique cognitive-communication challenges after mTBI. Factors related to the bilingual experience (e.g., language balance, daily language use) should be
considered in clinical evaluation and future research.
cognitive-communication deficits. In bilinguals, there are unique cognitive demands required to control and process two languages effectively. Surprisingly, little is known about the impact of mTBI on EF, communication, and language control in bilinguals. Therefore, the aim of this study was to examine the cognitive-communication abilities in bilinguals with a history of mTBI, identify any language control impairments, and explore the relationship between these language control impairments and domain-general cognitive control abilities. To this end, three-hundred and twenty-seven monolingual and bilingual college students with and without mTBI history participated in two experiments. In these experiments, EF, communication, and language control were examined using experimental and clinical tasks as well as self-rating scales. In Experiment 1, there was an interaction between mTBI history and language group (monolinguals vs. bilinguals) in how participants performed on a clinical measure of EF and a verbal fluency task. That is, only bilinguals with mTBI scored significantly lower on these tasks. In addition, there was a significant correlation between errors on a language switching task and performance on non-verbal EF tasks. In Experiment 2, a subgroup of bilinguals with persistent cognitive and behavioral symptoms reported greater everyday communication challenges in their first and second languages. Also, unbalanced bilinguals reported greater EF difficulties than monolinguals and balanced bilinguals regardless of mTBI history. In conclusion, bilinguals may face unique cognitive-communication challenges after mTBI. Factors related to the bilingual experience (e.g., language balance, daily language use) should be
considered in clinical evaluation and future research.
ContributorsAlateeq, Halah (Author) / Azuma, Tamiko (Thesis advisor) / Ratiu, Ileana (Committee member) / Lavoie, Michael (Committee member) / Arizona State University (Publisher)
Created2020
Description
Chronic pain is devastating and highly prevalent among Veterans in the United States (Johnson, Levesque, Broderick, Bailey & Kerns, 2017). While there are various treatment options for chronic pain, opioids remain high in popularity. Although opioids are fast-acting and effective, potential consequences range from unpleasant side effects to dependence and fatal overdose (Baldini, Korff & Lin, 2012; Park et al., 2015; Kaur, 2007). The effects of opioid treatment can be further complicated by a history of alcohol abuse. Past alcohol abuse is a risk factor for opioid misuse (McCabe et al., 2008). One alternative to opioid medication is Cognitive Behavioral Therapy for Chronic Pain (CBT-CP). CBT-CP has shown small to moderate effects on chronic pain after the end of treatment (Naylor, Keefe, Brigidi, Naud & Helzer, 2008). The current study examined the effect of CBT-CP on opioid prescriptions, as well as the role of past alcohol abuse in CBT-CP efficacy, through an archival data analysis of Veterans Affairs patient charts. In order to determine the effect of CBT-CP on opioid prescriptions, an opioid change score was calculated from treatment start date to twelve months post-treatment. An analysis of 106 patient charts demonstrated no statistically significant difference in opioid prescriptions between Veterans who were referred and attended treatment (n = 24) and those who were referred but did not attend (n = 82). Veterans from both groups showed a reduction in prescribed opioids during a 12-month period. Furthermore, there was no statistically significant difference between Veterans with versus without a history of alcohol abuse in terms of the change in opioid prescriptions over a 12-month period (both groups showed reductions). This research suggests that opioid prescriptions may decrease over time among Veterans referred for CBT-CP, even among those who do not participate in the groups. More work is needed to understand the relationship between opioid prescriptions and actual opioid use over time among Veterans who do and do not choose to participate in CBT-CP. Continuing to address poly-substance use in chronic pain patients also is critical to ensure that Veterans suffering from chronic pain receive appropriate intervention.
ContributorsMiller, Stephanie C (Author) / Roberts, Nicole (Thesis director) / Gress-Smith, Jenna (Thesis director) / Burgess, Lisa (Committee member) / School of Social Transformation (Contributor) / Department of Psychology (Contributor) / Edson College of Nursing and Health Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05