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Description
Fibromyalgia (FM) is a chronic musculoskeletal disorder characterized by widespread pain, fatigue, and a variety of other comorbid physiological and psychological characteristics, including a deficit of positive affect. Recently, the focus of research on the pathophysiology of FM has considered the role of a number of genomic variants. In the

Fibromyalgia (FM) is a chronic musculoskeletal disorder characterized by widespread pain, fatigue, and a variety of other comorbid physiological and psychological characteristics, including a deficit of positive affect. Recently, the focus of research on the pathophysiology of FM has considered the role of a number of genomic variants. In the current manuscript, case-control analyses did not support the hypothesis that FM patients would differ from other chronic pain groups in catechol-O-methyltransferase (COMT) and mu-opioid receptor (OPRM1) genotype. However, evidence is provided in support of the hypothesis that functional single nucleotide polymorphisms on the COMT and OPRM1 genes would be associated with risk and resilience, respectively, in a dual processing model of pain-related positive affective regulation in FM. Forty-six female patients with a physician-confirmed diagnosis of FM completed an electronic diary that included once-daily assessments of positive affect and soft tissue pain. Multilevel modeling yielded a significant gene X environment interaction, such that individuals with met/met genotype on COMT experienced a greater decline in positive affect as daily pain increased than did either val/met or val/val individuals. A gene X environment interaction for OPRM1 also emerged, indicating that individuals with at least one asp allele were more resilient to elevations in daily pain than those homozygous for the asn allele. In sum, the findings offer researchers ample reason to further investigate the contribution of the catecholamine and opioid systems, and their associated genomic variants, to the still poorly understood experience of FM.
ContributorsFinan, Patrick Hamilton (Author) / Zautra, Alex (Thesis advisor) / Davis, Mary (Committee member) / Lemery-Chalfant, Kathryn (Committee member) / Presson, Clark (Committee member) / Arizona State University (Publisher)
Created2011
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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)

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
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Description
Research has suggested that lonely people demonstrate distinct differences from nonlonely people in their behaviors, mood, and interpersonal experiences. Lonely people who are also enduring a chronic pain condition may be at an especially high risk for negative outcomes because of simultaneous issues such as stigma, mood disturbances, and pain-related

Research has suggested that lonely people demonstrate distinct differences from nonlonely people in their behaviors, mood, and interpersonal experiences. Lonely people who are also enduring a chronic pain condition may be at an especially high risk for negative outcomes because of simultaneous issues such as stigma, mood disturbances, and pain-related disability. The current study examined chronic and transitory loneliness in a sample of 123 chronic pain patients. Participants completed daily diaries assessing the occurrence of positive and negative interpersonal events, appraisals of interpersonal events, pain, and mood. Multilevel modeling was used to examine effects of being a lonely person as well as having a lonely episode on daily life. Results indicated that both chronic and transitory loneliness were associated with more frequent negative and less frequent positive interpersonal events, higher levels of pain, more negative and less positive affect, and more stress and less enjoyment from social interactions. Loneliness did not affect reactivity to negative interpersonal events, but did influence responsivity to positive interpersonal events such that lonely people had greater boosts in enjoyment when experiencing more positive interpersonal events than usual. These findings suggest that both lonely people and individuals experiencing a lonely episode experience more negative consequences in their daily lives than nonlonely people. However, they can benefit from engaging in more frequent positive interpersonal events, which can help to inform future clinical interventions for lonely, chronic pain patients.
ContributorsDempsey, Laurie (Author) / Davis, Mary (Thesis advisor) / Zautra, Alex (Committee member) / Doane, Leah (Committee member) / Arizona State University (Publisher)
Created2012
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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

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
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Description
Chronic or recurrent pain in childhood is a common and costly health problem, and increases the likelihood of experiencing chronic pain in adulthood. Existing evidence suggests that internalizing symptoms are a risk factor for the development of chronic pain in children and adults. Findings from a small body of

Chronic or recurrent pain in childhood is a common and costly health problem, and increases the likelihood of experiencing chronic pain in adulthood. Existing evidence suggests that internalizing symptoms are a risk factor for the development of chronic pain in children and adults. Findings from a small body of research also points to a flattened diurnal cortisol profile, alone and in combination with internalizing symptoms, as a risk factor for future chronic pain among adults. The present study aimed to evaluate whether internalizing, a flattened diurnal cortisol profile, and their combination prospectively predict chronic pain in middle childhood. It was hypothesized that: 1) both internalizing and a flattened diurnal cortisol profile at age 8 would independently predict acquisition of chronic pain at age 9, controlling for age 8 pain; and 2) the combination of high internalizing and a flattened diurnal cortisol rhythm would predict greater risk of increased pain over time. Multilevel models of longitudinal data collected from a sample of 748 twin children revealed that internalizing symptoms and a flattened cortisol slope independently acted as prospective risk factors for increased chronic pain in childhood one year later. However, the interaction between internalizing and diurnal cortisol did not predict future increases in pain. Exploratory analyses evaluating symptoms of overanxiousness demonstrated that the interaction between overanxiousness and a flattened cortisol profile emerged as a marginally significant predictor of future pain. The current findings point to the role of psychological and physiological risk factors for the development of chronic pediatric pain, and may help to identify early targets for prevention efforts.
ContributorsEltze, Lara Malin (Author) / Davis, Mary (Thesis director) / Doane, Leah (Committee member) / School of International Letters and Cultures (Contributor) / Department of Psychology (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-12
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Description
Pediatric chronic pain is surprisingly common and impactful, prospectively predicting poorer mental and physical health outcomes. Internalizing symptoms represents one such outcome. It is the most common cluster of symptoms in children, it is related to poorer child functioning, and it has been linked to future functioning/psychopathology. The psychosocial mechanisms

Pediatric chronic pain is surprisingly common and impactful, prospectively predicting poorer mental and physical health outcomes. Internalizing symptoms represents one such outcome. It is the most common cluster of symptoms in children, it is related to poorer child functioning, and it has been linked to future functioning/psychopathology. The psychosocial mechanisms through which child pain may impact internalizing have yet to be fully elaborated, but withdrawal from social engagement with peers has been proposed as one possible mechanism. Additionally, sibling relationships may play a role in enhancing or diminishing a child’s social engagement while they are in pain. The current study aimed to examine whether child social engagement at age 8 mediates the relation between child chronic pain at age 8 and internalizing symptoms at age 9. Further, the study tested whether sibling warmth and sibling conflict act as moderators between child chronic pain and child social engagement. The physical and emotional health, quality of sibling relations, and extracurricular social engagement of 491 twin children from 247 families were assessed at age 8 and age 9 via surveys completed by the children’s primary caregivers. Findings showed that child pain at age 8 did not predict lower levels of social engagement, and social engagement did not predict child internalizing at age 9. Sibling warmth, but not conflict, significantly moderated the pain—social engagement relation. Together, these findings indicate that the relation between chronic pain and internalizing functions differently in children than in adults through a variety of cognitive, environmental, and social factors. More longitudinal research in this area will help establish changes in the relation between pain and internalizing from childhood into adulthood.
ContributorsRichards, Nicole Eve (Co-author) / Richards, Nicole (Co-author) / Davis, Mary (Thesis director) / Presson, Clark (Committee member) / Lemery-Chalfant, Kathryn (Committee member) / Sanford School of Social and Family Dynamics (Contributor) / School of Art (Contributor) / Department of Psychology (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
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Description
Asthma is one of the most common chronic diseases affecting children, and investigators have identified a number of risk factors that worsen asthma symptoms. Most prior studies have concluded that there is an association between one risk factor, poor sleep quality, and asthma; however, whether sleep quality predicts future asthma

Asthma is one of the most common chronic diseases affecting children, and investigators have identified a number of risk factors that worsen asthma symptoms. Most prior studies have concluded that there is an association between one risk factor, poor sleep quality, and asthma; however, whether sleep quality predicts future asthma symptoms, asthma symptoms predict future sleep quality, or the relation is reciprocal is still unclear. The methodology of studies examining the asthma-sleep association has consisted of actigraphy and parent report to determine children's sleep duration and sleep efficiency, and lung function assessments with a spirometer on the participants to determine children's overall lung function. The purpose of the proposed study is to determine the strength of the cross-sectional and longitudinal associations between indicators of sleep quality and asthma. The proposed study plans to use a combination of actigraphy, sleep diaries, and lung function assessments using a spirometer to determine sleep quality and lung function, respectively. Future directions include determining the directionality of the association between sleep quality and asthma as well as strength of association.
ContributorsLacy, Kordell Reggie (Author) / Davis, Mary (Thesis director) / Miadich, Samantha (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
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Description
Early childhood environment is critical to subsequent physical health in children and is influenced by children's primary caregivers \u2014 typically mothers. Maternal stress, one aspect of a child's environment, may shape the functioning of the child's physiological stress response system, which has been linked to later health outcomes, including pain.

Early childhood environment is critical to subsequent physical health in children and is influenced by children's primary caregivers \u2014 typically mothers. Maternal stress, one aspect of a child's environment, may shape the functioning of the child's physiological stress response system, which has been linked to later health outcomes, including pain. The current study evaluated whether: 1) early maternal stress, defined as maternal depressive symptoms and low socio-economic status, predicts later child pain; 2) early maternal stress relates to later child daily cortisol output; and 3) child's cortisol output across the day mediates the relation between early maternal stress and child pain. Maternal stress was assessed via questionnaires at twin age 12-months. At twin age seven years, twins' salivary cortisol was collected three times per day for three days. At twin age nine years, twins rated how often they experienced stomach, headache, and back pain weekly or more frequently. Results of multilevel linear and logistic regression analyses showed that early maternal stress did not predict later children's daily cortisol output or extent of child pain. Therefore, findings were inconsistent with the proposed mediation model. However, there was a marginally significant negative relation between child daily cortisol output and later extent of child pain. Current findings suggest that functioning of the stress response system, reflected in cortisol output, may have implications for the development of child pain. Future work evaluating intensely stressful early environments may provide clues about the links between a child's early environment and the development of his/her stress response system.
ContributorsRoth, Winter Rayne Nicole (Author) / Davis, Mary (Thesis director) / Miadich, Samantha (Committee member) / Department of Psychology (Contributor) / School of Molecular Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
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Description
Children's chronic pain has many contributing factors, including family environment, genetics, and parenting. Still, pediatric chronic pain remains understudied, and little research has been conducted on predictors of child pain onset. This study aims to elucidate some of these factors by examining the role of parenting style and parental pain

Children's chronic pain has many contributing factors, including family environment, genetics, and parenting. Still, pediatric chronic pain remains understudied, and little research has been conducted on predictors of child pain onset. This study aims to elucidate some of these factors by examining the role of parenting style and parental pain in children's chronic pain experience. The study answered the following questions: 1) Is child chronic pain heritable?; 2) Do parenting styles and/or parental pain predict child pain?; and 3) Is parenting style the mediating variable in the relation between parent pain and child pain? A twin study design was employed to account for both genetic and environmental influences in pain. Primary and secondary caregivers completed pain questionnaires regarding their own and their children's pain. The caregivers also completed questionnaires regarding their own parenting styles. Observer ratings were used as additional measures of primary caregiver parenting. Results indicated that child pain is heritable and that parental pain was significantly related to child pain. However, parenting style did not predict child pain and was not a mediator in the relationship between parental pain and child pain. Further research on other parenting factors or predictors of pain may lead to prevention of pediatric chronic pain or more effective management of child pain symptoms.
ContributorsPatel, Maya (Author) / Davis, Mary (Thesis director) / Lemery, Kathryn (Thesis director) / Department of Psychology (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
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Description
The goal of my study is to test the overarching hypothesis that art therapy is effective because it targets emotional dysregulation that often accompanies significant health stressors. By reducing the salience of illness-related stressors, art therapy may improve overall mood and recovery, particularly in patients with cancer. After consulting the

The goal of my study is to test the overarching hypothesis that art therapy is effective because it targets emotional dysregulation that often accompanies significant health stressors. By reducing the salience of illness-related stressors, art therapy may improve overall mood and recovery, particularly in patients with cancer. After consulting the primary literature and review papers to develop psychological and neural mechanisms at work in art therapy, I created a hypothetical experimental procedure to test these hypotheses to explain why art therapy is helpful to patients with chronic illness. Studies found that art therapy stimulates activity of multiple brain regions involved in memory retrieval and the arousal of emotions. I hypothesize that patients with chronic illness have a reduced capacity for emotion regulation, or difficulty recognizing, expressing or altering illness-related emotions (Gross & Barrett, 2011). Further I hypothesize that art therapy improves mood and therapeutic outcomes by acting on the emotion-processing regions of the limbic system, and thereby facilitating the healthy expression of emotion, emotional processing, and reappraisal. More mechanistically, I propose art therapy reduces the perception or salience of stressors by reducing amygdala activity leading to decreased activation of the hypothalamic-pituitary-adrenal (HPA) axis. The art therapy literature and my hypothesis about its mechanisms of action became the basis of my proposed study. To assess the effectiveness of art therapy in alleviating symptoms of chronic disease, I am specifically targeting patients with cancer who exhibit a lack of emotional regulation. Saliva is collected 3 times a week on the day of intervention: morning after waking, afternoon, and evening. Stress levels are tested using one-hour art therapy sessions over the course of 3 months. The Perceived Stress Scale (PSS) assesses an individual's perceived stress and feelings in past and present situations, for the control and intervention group. To measure improvement in overall mood, 10 one-hour art sessions are performed on patients over 10 weeks. A one-hour discussion analyzing the participants' artwork follows each art session. The Spielberger State-Trait Anxiety Inventory (STAI) assesses overall mood for the intervention and control groups. I created rationale and predictions based on the intended results of each experiment.
ContributorsAluri, Bineetha C. (Author) / Orchinik, Miles (Thesis director) / Davis, Mary (Committee member) / Essary, Alison (Committee member) / School of Life Sciences (Contributor) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05