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- All Subjects: Clinical Psychology
- Genre: Doctoral Dissertation
- Creators: Davis, Mary
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
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
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
Guided by the Risky Families model and Daily Process methods, the present study examined how daily stressors are related to emotional well-being at the between- and within-person levels among adolescent grandchildren raised by grandmothers. This study also examined whether risk (i.e., adverse childhood experiences/ACES) and resilience (i.e., socio-emotional skills) factors were linked to differences in daily well-being, stressor exposure, and emotional reactivity, and evaluated the efficacy of an online social intelligence training (SIT) program on daily stressor-emotion dynamics. Data came from a subsample (n = 188) of custodial adolescents who participated in an attention-controlled randomized clinical trial and completed 14-day daily surveys prior to and following intervention. Analyses were conducted with dynamic structural equation modeling. Daily stressors, on average, and experiencing above average stressors, were associated with higher negative emotions and lower positive emotions and social connection. Those with more ACEs, on average, reported higher daily stressors and worse well-being, whereas those with higher socio-emotional skills, on average, reported lower daily stressors and better well-being. At the within-person level, more ACEs were associated with higher daily negative emotions. Nonverbal processing was linked to higher daily positive emotions and social connection. Conversational skills were associated with higher daily positive emotions and social connection, and lower, more inert daily negative emotions. Neither ACEs nor socio-emotional skills were associated with within-person reactivity to stressors. Also, the SIT program did not demonstrate efficacy for any outcome. My discussion focused on how findings extend the literature on custodial adolescents by showing that daily stressors impact well-being, offer knowledge of how ACEs and socio-emotional skills shape daily stressor-emotion dynamics, and considers reasons why the online, self-guided SIT program failed to show efficacy on key outcomes.
ContributorsCastro, Saul (Author) / Infurna, Frank (Thesis advisor) / Doane, Leah (Committee member) / Davis, Mary (Committee member) / Grimm, Kevin (Committee member) / Arizona State University (Publisher)
Created2023
Description
Cognitive reappraisal, or redefining the meaning of a stressful circumstance, is useful in regulating emotional responses to acute stressors and may be mobilized to up- or down- regulate the stressors’ emotional salience. A conceptually-related but more targeted emotion regulation strategy to that offered by cognitive reappraisal, termed positive cognitive shift, was examined in the current study. Positive cognitive shift (“PCS”) is defined as a point of cognitive transformation during a chronic, stressful situation that alters the meaning and emotional salience of the situation for the individual. Key aspects of the PCS that differentiate it from the broader reappraisal construct are that it 1) is relevant to responses to chronic (versus acute) aversive events, 2) is deployed when there is a mismatch between coping and stressors, and 3) involves insight together with redefinition in meaning of the situation generating stress. The current study used qualitative and quantitative analyses to 1) examine whether PCS is an observable, reliable, and valid experience in response to a stressful event that occurred in the past year, and 2) test whether PCS moderates the relations between the number of past-year stressful life circumstances and subsequent emotional well-being and functional health. A community sample of 175 middle-aged individuals were interviewed regarded a past chronic stressor and completed questionnaires regarding number of past year stressors and health outcomes. Theory-based coding of interviews was conducted to derive reliable scores for PCS, and findings indicated that PCS was evident in 37.7 % of participant responses. Furthermore, PCS scores were related positively to openness, personal growth from one’s most difficult lifetime event, and affect intensity-calm, in line with predictions. Also in line with prediction, PCS moderated the relations between number of past-year life events and health outcomes, such that the deleterious relations between past year stressful events and cognitive functioning, wellbeing, positive affect, and negative affect were weaker among individuals higher versus lower in PCS. Of note, PCS moderation effects diminished as the number of stressful events increased.
ContributorsRivers, Crystal (Author) / Davis, Mary (Thesis advisor) / Luecken, Linda (Committee member) / Infurna, Frank (Committee member) / Robinson Kurpius, Sharon (Committee member) / Arizona State University (Publisher)
Created2018
Description
Experiencing poor, unrefreshing sleep is a common occurrence for individuals with chronic pain. Sleep disturbance predicts not only greater pain and disability, but also heightened negative affect and reduced positive affect in individuals with chronic pain. Such fluctuations in affect have been linked with more negative and fewer positive social events. For those with chronic pain, negative social relations can exacerbate pain, whereas positive social interactions can help decrease disability. Thus, exploring the sleep‒social functioning process in chronic pain may be one way to improve daily functioning and quality of life. The current study examined positive and negative affect as two parallel mediators of the within-day relations between sleep quality and positive and negative social events in individuals with chronic pain. For 21 days, electronic daily diary reports were collected from 220 individuals with fibromyalgia, a condition characterized by widespread chronic pain. Within-person relations among reports of last night’s sleep quality, afternoon affects and pain, and evening social events were estimated via multilevel structural equation modeling. Findings showed that positive affect mediated both the sleep quality‒positive social events and sleep quality‒negative social events relations. That is, greater than usual sleep disturbance last night predicted afternoon reports of lower than usual positive affect. Low positive affect, in turn, predicted evening reports of fewer than usual positive social events and more than usual negative social events that day, controlling for the effects of afternoon pain. In addition, negative affect mediated the sleep quality‒negative social events link. That is, greater than usual sleep disturbance last night predicted afternoon reports of higher than usual negative affect, which, in turn, predicted evening reports of more than usual negative social events that day, controlling for the effects of afternoon pain. Of the three significant mediated paths, the sleep quality‒positive affect‒positive social events path was the strongest in magnitude. Thus, a night of poor sleep can have an impact on social events the next day in those with chronic pain by dysregulating affect. Further, findings highlight the key role of positive affect in the sleep‒social functioning process and potential socio-affective benefits of sleep interventions in chronic pain.
ContributorsKothari, Dhwani J. (Author) / Davis, Mary (Thesis advisor) / Luecken, Linda (Committee member) / Karoly, Paul (Committee member) / Infurna, Frank (Committee member) / Arizona State University (Publisher)
Created2019
Description
Subjective social status (SSS) is a marker of perceived social rank that has been linked with depressive symptoms over and above objective socioeconomic status (SES),
but longitudinal studies are limited. SSS has been theorized to capture perceived relative
versus absolute deprivation and the corresponding psychosocial processes underlying
status-based disparities in health. The literature suggests that upward social comparisons
inherent in appraising SSS may confer psychosocial risk, which may in turn increase risk
for depressive symptoms and stress-related inflammation involved in the pathogenesis of
depression. However, no studies have examined whether interpersonal and biological
factors simultaneously contribute to the inverse relation between SSS and depressive
symptoms. This study examined whether (1) lower SSS was longitudinally associated
with increased depressive mood symptoms, independent of income, and (2) whether
higher social strain and lower social support simultaneously mediated the SSS—
depressive mood symptoms relation directly and indirectly through higher interleukin-6
(IL-6). This study utilized secondary data from a representative community sample of
804 middle-aged adults taking part in a study of healthy aging between 2007 and 2012.
Plasma levels of IL-6 and self-reported SSS, social support, and social strain were
assessed at baseline, followed by an assessment of depressive mood symptoms by phone
interview on average 20 months later. Results from multiple regression analysis revealed
that lower SSS predicted higher depressive symptoms at follow-up after adjustment for
sociodemographic characteristics and baseline depressive mood symptoms. Path analysis
indicated that social strain significantly mediated the relation between SSS and
depressive mood symptoms, but not after adjustment for baseline mood symptoms.
Lower social support mediated the relation between lower SSS and higher depressive
symptoms, but relations were non-significant in adjusted models. Contrary to predictions,
paths including IL-6 were not significant. Lower SSS may represent a robust risk factor
for subsequent depressive mood symptoms above and beyond income, in line with the
conceptualization of SSS as a measure of relative deprivation. Further research
examining biopsychosocial mechanisms would elucidate the implications of perceived
low status and inform intervention efforts aimed at reducing the global burden of
depressive symptoms.
ContributorsMoore, Shannon Victoria (Author) / Davis, Mary (Thesis advisor) / Luecken, Linda (Committee member) / Anderson, Samantha (Committee member) / Infurna, Frank (Committee member) / Arizona State University (Publisher)
Created2021