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Type 1 Diabetes Mellitus (T1DM) is a chronic disease that requires maintaining tight metabolic control through complex behavioral and pharmaceutical regimens. Subtle cognitive impairments and stress response dysregulation may partially account for problems negotiating life changes and maintaining treatment adherence among emerging adults. The current study examined whether young adults

Type 1 Diabetes Mellitus (T1DM) is a chronic disease that requires maintaining tight metabolic control through complex behavioral and pharmaceutical regimens. Subtle cognitive impairments and stress response dysregulation may partially account for problems negotiating life changes and maintaining treatment adherence among emerging adults. The current study examined whether young adults with T1DM physiologically respond to psychological stress in a dysregulated manner compared to non-diabetic peers, and if such individuals also demonstrated greater cognitive declines following psychological stress. Participants included 23 young adults with T1DM and 52 non-diabetic controls yoked to T1DM participants based on age, gender, ethnicity, participant education, and maternal education. Participants completed a laboratory-based social stressor, pre- and post-stressor neurocognitive testing, provided fingerstick blood spots (for glucose levels) and salivary samples (for cortisol levels) at five points across the protocol, and completed psychosocial questionnaires. Related measures ANOVAs were conducted to assess differences between T1DM participants and the average of yoked controls on cortisol and cognitive outcomes. Results demonstrated that differences in cortisol reactivity were dependent on T1DM participants' use of insulin pump therapy (IPT). T1DM participants not using IPT demonstrated elevated cortisol reactivity compared to matched controls. There was no difference in cortisol reactivity between the T1DM participants on IPT and matched controls. On the Stroop task, performance patterns did not differ between participants with T1DM not on IPT and matched controls. The performance of participants with T1DM on IPT slightly improved following the stressor and matched controls slightly worsened. On the Trail Making Test, the performance of participants with T1DM was not different following the stressor whereas participants without T1DM demonstrated a decline following the stressor. Participants with and without T1DM did not differ in patterns of performance on the Rey Verbal Learning Task, Sustained Attention Allocation Task, Controlled Oral Word Association Task, or overall cortisol output across participation. The results of this study are suggestive of an exaggerated cortisol response to psychological stress in T1DM and indicate potential direct and indirect protective influences of IPT.
ContributorsMarreiro, Catherine (Author) / Luecken, Linda (Thesis advisor) / Doane, Leah (Thesis advisor) / Barrera, Manuel (Committee member) / Aiken, Leona (Committee member) / Arizona State University (Publisher)
Created2013
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Description
ABSTRACT Post-Traumatic Stress Disorder (PTSD), depression, and insomnia are prevalent among United States (US) military veterans. This study investigates whether Brain Boosters, a new cognitive enhancement group therapy, improves symptoms of PTSD, depression, and insomnia among veterans completing the groups. The study population includes 64 US military veterans treated in

ABSTRACT Post-Traumatic Stress Disorder (PTSD), depression, and insomnia are prevalent among United States (US) military veterans. This study investigates whether Brain Boosters, a new cognitive enhancement group therapy, improves symptoms of PTSD, depression, and insomnia among veterans completing the groups. The study population includes 64 US military veterans treated in the setting of the Veterans Affairs (VA) Health Care System in Phoenix, AZ. Group members were US military veterans, age 22 to 87 (mean age=53.47), who had served in or after World War II (WWII), who sought mental health care at the Phoenix VA from 2007 through 2011. Participants were treated with Brain Boosters therapy. They completed measures of mental-health related symptoms before and after this therapy. Participants were assessed pre and post group with the PTSD Checklist for military personnel (PCL-M), the Patient Health Questionnaire (PHQ-9; a measure of depression symptoms), and the Insomnia Severity Index (ISI). Statistical analyses were done with paired samples t-tests and McNemar's tests, using SPSS. The hypotheses were that symptoms of PTSD, depression, and insomnia would show statistically significant improvement with Brain Boosters therapy. Results supported the hypotheses that symptoms of PTSD and depression would improve significantly. Insomnia did not show significant improvement. The results showed the mean PCL-M score was 54.84 before Brain Boosters therapy and 51.35 after (p= 0.008). The mean PHQ-9 score was 15.21 before Brain Boosters therapy and 13.05 after (p= 0.002). The mean ISI score was 15.98 before Brain Boosters Therapy and 14.46 after (p= 0.056). Although this is a nonrandom, uncontrolled trial, findings nevertheless suggest that Brain Boosters may be an effective therapy to reduce PTSD symptom severity and depression symptom severity. This may be especially important for veterans seeking alternatives to pharmacological intervention or traditional therapeutic interventions.
ContributorsWalter, Christina M (Author) / Roberts, Nicole A. (Thesis advisor) / Burleson, Mary H. (Committee member) / Miller, Paul (Committee member) / Arizona State University (Publisher)
Created2012