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Description
This study examined whether cognitive behavioral therapy and mindfulness interventions affect positive (PA) and negative affect (NA) reports for patients with rheumatoid arthritis (RA) before, during, and after stress induction. The study also investigated the effects of a history of recurrent depression on intervention effects and testing effects due to the Solomon-6 study design utilized. The 144 RA patients were assessed for a history of major depressive episodes by diagnostic interview and half of the participants completed a laboratory study before the intervention began. The RA patients were randomly assigned to 1 of 3 treatments: cognitive behavioral therapy for pain (P), mindfulness meditation and emotion regulation therapy (M), or education only attention control group (E). Upon completion of the intervention, 128 of the RA patients participated in a laboratory session designed to induce stress in which they were asked to report on their PA and NA throughout the laboratory study. Patients in the M group exhibited dampened negative and positive affective reactivity to stress, and sustained PA at recovery, compared to the P and E groups. PA increased in response to induced stress for all groups, suggesting an "emotional immune response." History of recurrent depression increased negative affective reactivity, but did not predict reports of PA. RA patients who underwent a pre-intervention laboratory study showed less reactivity to stressors for both NA and PA during the post-intervention laboratory study. The M intervention demonstrated dampened emotional reactions to stress and lessened loss of PA after stress induction, displaying active emotion regulation in comparison to the other groups. These findings provide additional information about the effects of mindfulness on the dynamics of affect and adaptation to stress in chronic pain patients.
ContributorsArewasikporn, Anne (Author) / Zautra, Alex J (Thesis advisor) / Davis, Mary C. (Committee member) / Karoly, Paul (Committee member) / Arizona State University (Publisher)
Created2012
Description
Despite the strong link between pain and depressive symptoms, the mechanisms by which they are connected in the everyday lives of individuals with chronic pain are not well understood. In addition, previous investigations have tended to ignore biopsychosocial individual difference factors, assuming that all individuals respond to pain-related experiences and affect in the same manner. The present study tried to address these gaps in the existing literature. Two hundred twenty individuals with Fibromyalgia completed daily diaries during the morning, afternoon, and evening for 21 days. Findings were generally consistent with the hypotheses. Multilevel structural equation modeling revealed that morning pain and positive and negative affect are uniquely associated with morning negative pain appraisal, which in turn, is positively related to pain’s activity interference in the afternoon. Pain’s activity interference was the strongest predictor of evening depressive symptoms. Latent profile analysis using biopsychosocial measures identified three theoretically and clinically important subgroups (i.e., Low Functioning, Normative, and High Functioning groups). Although the daily pain-depressive symptoms link was not significantly moderated by these subgroups, individuals in the High Functioning group reported the lowest levels of average morning pain, negative affect, negative pain appraisal, afternoon pain’s activity interference, and evening depressive symptoms, and the highest levels of average morning positive affect across 21 days relative to the other two groups. The Normative group fared better on all measures than did the Low Functioning group. The findings of the present study suggest the importance of promoting morning positive affect and decreasing negative affect in disconnecting the within-day pain-depressive symptoms link, as well as the potential value of tailoring chronic pain interventions to those individuals who are in the greatest need.
ContributorsMun, Chung Jung (Author) / Karoly, Paul (Thesis advisor) / Davis, Mary C. (Thesis advisor) / Suk, Hye Won (Committee member) / Dishion, Thomas J (Committee member) / Arizona State University (Publisher)
Created2017
Description
This study investigated low regulatory flexibility as a mechanism of the associations of rumination with affect, internalizing symptoms, and substance use and problems. 403 first-year college students completed an online baseline survey assessing rumination, regulatory flexibility, internalizing symptoms, alcohol use, cannabis use, alcohol problems, and cannabis problems. Roughly 2.67 months later, 261 of these participants completed a follow-up survey assessing internalizing symptoms and substance use and problems. Additionally, 71 of the 403 participants completed an experimental study. Thirty-three participants were randomly assigned to undergo a rumination induction, and 38 were assigned to a control condition. All lab participants underwent an interpersonal stress task during which regulatory flexibility was observed and completed pre-test and post-role-play measures of positive and negative affect. Experimental study results showed regulatory flexibility did not mediate effects of rumination induction on positive (indirect effect: standardized beta (β)=-0.01, unstandardized beta (b)=-0.12, 95% Confidence Interval (CI) [-0.64, 0.41], p=.66) or negative affect (indirect effect: β=0.01, b=0.17, 95% CI [-0.29, 0.63], p=.48). Longitudinal study results showed regulatory flexibility did not mediate associations between baseline rumination and follow-up internalizing symptoms (indirect effect: b=0.01, 95% CI [-0.03, 0.05], p=.57), alcohol use (indirect effect: b=-0.03, 95% CI [-0.09, 0.04], p=.39), cannabis use (indirect effect: b=0.10, 95% CI [-0.06, 0.26], p=.21), alcohol problems (indirect effect: b=-0.05, 95% CI [-0.18, 0.07], p=.40), or cannabis problems (indirect effect: b=-0.10, 95% CI [-0.36, 0.16], p=.43). However, rumination predicted greater internalizing symptoms (Incidence Rate Ratio (IRR)=1.26, b=0.23, 95% CI [0.08, 0.37], p=.003) and cannabis problems (IRR=1.73, b=0.55, 95% CI [0.23, 0.87], p=.001). Regulatory flexibility predicted fewer alcohol use days (IRR=0.76, b=-0.27, 95% CI [-0.49, -0.05], p=.015) and problems (IRR=0.58, b=-0.55, 95% CI [-0.95, -0.15], p=.007), and less cannabis use for women (IRR=0.59, b=-0.53, 95% CI [-0.92, -0.14], p=.007) and fewer cannabis problems for men (IRR=0.21, b=-1.55, 95% CI [-2.50, -0.60], p=.001). Lack of agreement about how best to measure regulatory flexibility makes it unclear whether null associations were due to measurement problems or actual null effects. Research on how best to measure this construct is a priority. Findings indicate rumination and regulatory flexibility may be promising intervention targets.
ContributorsHill, Melanie Laurel (Author) / Meier, Madeline H (Thesis advisor) / Karoly, Paul (Committee member) / Luecken, Linda J. (Committee member) / Infurna, Frank J. (Committee member) / Arizona State University (Publisher)
Created2020