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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
Autistic adults face heightened risk of psychiatric disorders, with depression occurrence estimated at quadruple the rate of the general population. Mindfulness Based Stress Reduction (MBSR), an intensive 8-week in-person intervention, reduces depressive symptoms in adults with autism spectrum disorder (ASD). However, access to these programs is restricted due to financial, geographic, and scheduling limitations. Additionally, lapses in practice post-intervention cause these effects to be short-lived. This study examines antidepressant effects of an 8-week app-delivered mindfulness meditation intervention using Ten Percent Happier in adults with ASD and explores whether anchoring meditation practice to a preexisting behavior will improve therapy compliance and depression-related efficacy. Ninety-seven participants were randomly assigned to either App Only (n=30), App + Habit training (n=27) or Waitlist Control (n=40). App Only and App + Habit groups were requested to meditate a minimum of 10 minutes per day, 5 days per week for 8 consecutive weeks using the mobile application. The App + Habit group received additional instruction to anchor leaving the bathroom each morning with meditation; The App Only group was only provided with education on habit formation. Participants completed the Beck Depression Inventory-II (BDI-II) at pre- and post-intervention. All groups received weekly ecological momentary assessments (EMAs) to assess frequency and length of practice. The App + Habit group was additionally assessed for cue-initiated meditation frequency. Data were analyzed using repeated measures analysis of variance (ANOVA). Pre-to-post changes on BDI-II scores indicated a group by time interaction (p=0.04) and a main effect of time (p <0.001). Post-hoc analysis revealed the App + Habit group exclusively showed significant decline in depressive symptoms (p<0.001). The App + Habit group showed greater number of days meditated, average minutes per day of meditating, and continuation of meditation practice 8-weeks after the intervention period, compared to the App Only group.
Findings support app-delivered mindfulness interventions as an accessible and cost-effective alternative to traditional in-person mindfulness training for Autistic adults. However, results suggest app-based mindfulness tools may only be effective when delivered with specific habit formation instruction. Additionally, habit formation instruction led to greater adherence to meditation practice after the study period ended.
ContributorsVink, Schuyler Rae (Author) / Braden, B. Blair (Thesis advisor) / Stecher, Chad (Committee member) / Dixon, Maria (Committee member) / Rogalsky, Corriane (Committee member) / Arizona State University (Publisher)
Created2022
Description
Autism shows a pronounced and replicable sex bias with approximately three-to-four males diagnosed for every one female. Sex-related biology is thought to play a role in the sex bias, such that female biology may be protective and/or male biology may increase vulnerability to autism in the context of similar genetic risk. Beyond etiology, sex-related biology has also been implicated in lifespan risk for health and psychiatric conditions that show common co-morbidity in autism. Thus, understanding how sex-related biology impacts autism etiology and progression has important implications for prognosis and treatment. Neuroimaging offers a powerful tool for in-vivo characterization of brain-based sex differences in autism, especially given emerging efforts to develop large, well-characterized longitudinal samples. To date, however, neuroimaging studies have shown mixed and inconsistent findings, which remain challenging to integrate in the broader literature context. In a recent systematic review of neuroimaging studies of typical sex differences, few to no replicable effects were found beyond brain size, suggesting the brain is not “sexually dimorphic.” Instead, it is argued that the brain is a “mosaic” of features from various sources, including masculine and feminine biological processes as well as individual genetics and environment. Thus, designing neuroimaging studies that are sensitive to brain-based sex differences in autism likely requires careful study design and analytical method selection. Through a series of studies, the overarching dissertation aim was to identify optimal methods for characterizing neuroimaging-based sex differences in autism and to test these methods in preliminary samples. Study 1 comprised a systematic review of studies examining neuroimaging-based sex differences in autism with the aim of identifying optimal study designs, neuroimaging modalities, and analytical methods. Study 2 focused on examining the sensitivity of a connectome-wide approach to identify functional connectivity hubs underlying sex-biased behavior associated with autism (e.g., camouflaging). Study 3 used a connectome-wide functional connectivity approach to characterize sex differences in longitudinal changes associated with autistic traits vs. categorical diagnosis. These studies suggest that optimizing study design and methods improves identification of biologically plausible and clinically meaningful brain sex differences in autism. The relevance of findings to etiology and prognosis are discussed.
ContributorsWalsh, Melissa (Author) / Braden, B. Blair (Thesis advisor) / Azuma, Tamiko (Committee member) / Rogalsky, Corianne (Committee member) / Arizona State University (Publisher)
Created2022
Description
Substance use disorder has been increasing in the United States year after year. Modern treatments fail as often as they succeed. The current standards of practice fail to provide patients with the ability to harness thoughts and control anxiety. Mindfulness practices are currently being adapted as a therapeutic technique to address some of these concerns. An exhaustive literature review was conducted to investigate how various mindfulness techniques impact substance use disorder. Ten high-quality studies were retained and synthesized to show current understandings of the effectiveness of a mindfulness therapeutic technique. An evidence-based intervention is suggested for implementing mindfulness-based relapse prevention into a residential treatment facility. The intervention created incorporates the self-efficacy theory and an adapted health-belief model. Adults in a residential treatment facility for substance use disorder were given eight mindfulness sessions over the course of four weeks. Participants were given pre- and post-intervention screenings for mindful attention and anxiety. The data analysis after two-tailed paired T-tests showed that anxiety significantly decreased (α=.05, p<.001) and mindful attention increased significantly (α=.05, p=.015). Overall, mindfulness shows promise in its potential to reduce substance abuse.
ContributorsWandler, Ryan (Author) / Nunez, Diane (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-27
Description
An alarming number of youth have mental health concerns, but of those who are diagnosed, only half receive treatment. Using Bandera's social cognitive theory, one can achieve behavioral changes through self-efficacy and control their actions by self-regulation. Mindfulness activities, when implemented early, can decrease stress, and improve well-being in youth.
Methods:
This project was implemented among students attending an alternative high school in Arizona. Nine students participated in four different mindfulness, hands-on activities during two classes- 1 hour each. Participants completed a pre and a post-test with the 10-item questionnaire Perceived Stress Scale (PSS), and a 3-question survey to evaluate the program at the end of the second week.
Results: Among the 9 participants (mean age = 16 SD=2.06), the stress levels were considered low to moderate in the pretest (mean=16.56) and the post-test (mean=15.89). Stress level scores were reduced after the education although the difference was not statistically significant. Furthermore, all participants agreed that the content and activities were appropriate, 88.9% agreed they had a "better understanding of how to reduce stress," and 77.8% stated their "knowledge of stress has improved."
Discussion/Conclusion:
This project aimed to help reduce vulnerable adolescents' stress level through mindfulness activities. Mental health education like this may help adolescents better manage stress and consequently promote their overall well-being. Future projects should recruit a larger sample and implement a longer time for larger and longer effects.
ContributorsQualman, Stephanie (Author) / Chen, Angela (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-05-10
Description
Loneliness and depression in older adults are under-recognized public health concerns that increase risks for all-cause mortality, medical morbidity, and rising healthcare costs. This quality improvement project assessed whether smartphone Mindfulness software mitigated self-reported feelings of loneliness and depression among community-dwelling older adults. Nine participants aged 65 and older, living at home, experiencing loneliness or depression, and owning a smartphone were recruited using newsletters and fliers. A short demographics questionnaire and two valid and reliable instruments, namely the University of California Los Angeles Loneliness Scale (UCLA V3) and Geriatric Depression Scale (GDS), were used in pre-intervention and four weeks post-intervention. Participants downloaded the UCLA Mindful app on their smartphones after attending a 20-minute Mindfulness education at a local church banquet room. Participants used the UCLA Mindful software twice weekly for ten minutes for four weeks. Of the nine participants, three completed the study. A two-tailed paired sample t-test and descriptive analysis were used to evaluate the efficacy of the UCLA Mindful smartphone software. The results of the two-tailed paired sample t-test were not statistically significant for the UCLA V3 Loneliness scale (p=.220) and GDS (p=.208) due to the small sample size. Although the results were negligible, participants nevertheless reported favorable impacts. Future research with a larger sample size is encouraged.
ContributorsMurdock, J. Kristine (Author) / Guthery, Ann (Thesis advisor) / College of Nursing and Health Innovation (Contributor)
Created2023-04-26
Description
This thesis explores the interplay of aphasia symptoms and brain connectivityusing resting-state functional Magnetic Resonance Imaging (MRI). The research presented here is a step towards understanding the neural basis of linguistic prosody in particular, and its relationship with language impairments in post-stroke aphasia. This study focuses on examining the functional connectivities of the frontal-parietal control network and the dorsal attention networks with specific regions within traditional language networks, as a growing body of research suggests that prosodic cues in speech may recruit control and attention networks to support language processing. Using resting- state fMRI, the present study examined the functional connectivity of the frontal parietal control and dorsal attention networks with traditional language regions in 28 participants who have experienced a stroke-related language impairment (i.e. aphasia) and 32 matched neurotypical adults. Overall, the study reveals significant functional connectivity differences of the frontoparietal control and dorsal attention networks between the stroke and control groups, indicating that individuals with aphasia have brain connectivity differences beyond the traditional language networks. Multiple regression analyses were then used to determine if functional connectivities of the frontoparietal control and dorsal attention networks within themselves and with traditional language regions could predict aphasia symptoms, as measured by the Western Aphasia Battery (WAB). Overall, the regression results indicate that greater functional connectivity between the frontoparietal control and dorsal attention networks with traditional language regions is associated with improved language abilities, with different connectivities predicting different types of aphasia symptoms (e.g. speech, naming / word finding, auditory comprehension, overall impairment). Altogether this study contributes to the understanding of the neural bases of language impairments post-stroke, highlighting the intricate connections between language and other cognitive networks, which may be mediated by prosody.
ContributorsMendhe, Surbhi Haridas (Author) / Rogalsky, Corianne (Thesis advisor) / Braden, B. Blair (Committee member) / Benitez, Viridiana (Committee member) / Arizona State University (Publisher)
Created2024
Description
With a growing number of adults with autism spectrum disorder (ASD), more and more research has been conducted on majority male cohorts with ASD from young, adolescence, and some older age. Currently, males make up the majority of individuals diagnosed with ASD, however, recent research states that the gender gap is closing due to more advanced screening and a better understanding of how females with ASD present their symptoms. Little research has been published on the neurocognitive differences that exist between older adults with ASD compared to neurotypical (NT) counterparts, and nothing has specifically addressed older women with ASD. This study utilized neuroimaging and neuropsychological tests to examine differences between diagnosis and sex of four distinct groups: older men with ASD, older women with ASD, older NT men, and older NT women. In each group, hippocampal size (via FreeSurfer) was analyzed for differences as well as correlations with neuropsychological tests. Participants (ASD Female, n = 12; NT Female, n = 14; ASD Male, n = 30; NT Male = 22), were similar according to age, IQ, and education. The results of the study indicated that the ASD Group as a whole performed worse on executive functioning tasks (Wisconsin Card Sorting Test, Trails Making Test) and memory-related tasks (Rey Auditory Verbal Learning Test, Weschler Memory Scale: Visual Reproduction) compared to the NT Group. Interactions of sex by diagnosis approached significance only within the WCST non-perseverative errors, with the women with ASD performing worse than NT women, but no group differences between men. Effect sizes between the female groups (ASD female vs. NT female) showed more than double that of the male groups (ASD male vs. NT male) for all WCST and AVLT measures. Participants with ASD had significantly smaller right hippocampal volumes than NT participants. In addition, all older women showed larger hippocampal volumes when corrected for total intracranial volume (TIV) compared to all older men. Overall, NT Females had significant correlations across all neuropsychological tests and their hippocampal volumes whereas no other group had significant correlations. These results suggest a tighter coupling between hippocampal size and cognition in NT Females than NT Males and both sexes with ASD. This study promotes further understanding of the neuropsychological differences between older men and women, both with and without ASD. Further research is needed on a larger sample of older women with and without ASD.
ContributorsWebb, Christen Len (Author) / Braden, B. Blair (Thesis advisor) / Azuma, Tamiko (Committee member) / Dixon, Maria (Committee member) / Arizona State University (Publisher)
Created2019
Description
Cognitive deficits often accompany language impairments post-stroke. Past research has focused on working memory in aphasia, but attention is largely underexplored. Therefore, this dissertation will first quantify attention deficits post-stroke before investigating whether preserved cognitive abilities, including attention, can improve auditory sentence comprehension post-stroke. In Experiment 1a, three components of attention (alerting, orienting, executive control) were measured in persons with aphasia and matched-controls using visual and auditory versions of the well-studied Attention Network Test. Experiment 1b then explored the neural resources supporting each component of attention in the visual and auditory modalities in chronic stroke participants. The results from Experiment 1a indicate that alerting, orienting, and executive control are uniquely affected by presentation modality. The lesion-symptom mapping results from Experiment 1b associated the left angular gyrus with visual executive control, the left supramarginal gyrus with auditory alerting, and Broca’s area (pars opercularis) with auditory orienting attention post-stroke. Overall, these findings indicate that perceptual modality may impact the lateralization of some aspects of attention, thus auditory attention may be more susceptible to impairment after a left hemisphere stroke.
Prosody, rhythm and pitch changes associated with spoken language may improve spoken language comprehension in persons with aphasia by recruiting intact cognitive abilities (e.g., attention and working memory) and their associated non-lesioned brain regions post-stroke. Therefore, Experiment 2 explored the relationship between cognition, two unique prosody manipulations, lesion location, and auditory sentence comprehension in persons with chronic stroke and matched-controls. The combined results from Experiment 2a and 2b indicate that stroke participants with better auditory orienting attention and a specific left fronto-parietal network intact had greater comprehension of sentences spoken with sentence prosody. For list prosody, participants with deficits in auditory executive control and/or short-term memory and the left angular gyrus and globus pallidus relatively intact, demonstrated better comprehension of sentences spoken with list prosody. Overall, the results from Experiment 2 indicate that following a left hemisphere stroke, individuals need good auditory attention and an intact left fronto-parietal network to benefit from typical sentence prosody, yet when cognitive deficits are present and this fronto-parietal network is damaged, list prosody may be more beneficial.
Prosody, rhythm and pitch changes associated with spoken language may improve spoken language comprehension in persons with aphasia by recruiting intact cognitive abilities (e.g., attention and working memory) and their associated non-lesioned brain regions post-stroke. Therefore, Experiment 2 explored the relationship between cognition, two unique prosody manipulations, lesion location, and auditory sentence comprehension in persons with chronic stroke and matched-controls. The combined results from Experiment 2a and 2b indicate that stroke participants with better auditory orienting attention and a specific left fronto-parietal network intact had greater comprehension of sentences spoken with sentence prosody. For list prosody, participants with deficits in auditory executive control and/or short-term memory and the left angular gyrus and globus pallidus relatively intact, demonstrated better comprehension of sentences spoken with list prosody. Overall, the results from Experiment 2 indicate that following a left hemisphere stroke, individuals need good auditory attention and an intact left fronto-parietal network to benefit from typical sentence prosody, yet when cognitive deficits are present and this fronto-parietal network is damaged, list prosody may be more beneficial.
ContributorsLaCroix, Arianna (Author) / Rogalsky, Corianne (Thesis advisor) / Azuma, Tamiko (Committee member) / Braden, B. Blair (Committee member) / Liss, Julie (Committee member) / Arizona State University (Publisher)
Created2019
Description
Individuals with autism spectrum disorder (ASD) are known to show impairments in various domains of executive function (EF) such as behavioral flexibility or inhibitory control. Research suggests that EF impairment in adults with ASD may relate to ASD core symptoms, restrictive behaviors and social communication deficits. Mindfulness-based stress reduction (MBSR) has shown promise for improving EF abilities in neurotypical adults, but research has not explored its efficacy or neural mechanisms in adults with ASD. This pilot study examines the effects of an 8-week MBSR intervention on self-report measures of EF and resting-state functional connectivity in a sample of adults with ASD. Fifty-four participants were assigned either to an MBSR group (n = 29) or a social support group (n = 25). Executive function was measured using the BRIEF-2 before and after the intervention for the twenty-seven participants in the second cohort. MBSR-specific improvements in EF were found for BRIEF measures of initiation, inhibition, and working-memory. Resting-state fMRI data was analyzed using independent component analysis (ICA), and group by time resting-state functional connectivity differences were observed between the cerebellar network and frontal regions including the right frontal pole (rFP), medial frontal cortex (MFC) and left and right superior frontal gyri (SFG). The MBSR group showed increases in functional connectivity between the cerebellum and EF regions which correlated with improvements in BRIEF-2 measures. These findings suggest that MBSR may improve EF domains in adults with ASD, and that increases in functional connectivity between the cerebellum and frontal regions while at rest may be a mechanism for such improvements.
ContributorsGuerithault, Nicolas (Author) / Braden, B. Blair (Thesis advisor) / Rogalsky, Corianne (Committee member) / Dixon, Maria (Committee member) / Arizona State University (Publisher)
Created2021