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- Genre: Doctoral Dissertation
Description
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
Description
Many schools have adopted programming designed to promote students' behavioral aptitude. A specific type of programming with this focus is School Wide Positive Behavior Supports (SWPBS), which combines positive behavior techniques with a system wide problem solving model. Aspects of this model are still being developed in the research community, including assessment techniques which aid the decision making process. Tools for screening entire student populations are examples of such assessment interests. Although screening tools which have been described as "empirically validated" and "cost effective" have been around since at least 1991, they have yet to become standard practice (Lane, Gresham, & O'Shaughnessy 2002). The lack of widespread implementation to date raises questions regarding their ecological validity and actual cost-effectiveness, leaving the development of useful tools for screening an ongoing project for many researchers. It may be beneficial for educators to expand the range of measurement to include tools which measure the symptoms at the root of the problematic behaviors. Lane, Grasham, and O'Shaughnessy (2002) note the possibility that factors from within a student, including those that are cognitive in nature, may influence not only his or her academic performance, but also aspects of behavior. A line of logic follows wherein measurement of those factors may aid the early identification of students at risk for developing disorders with related symptoms. The validity and practicality of various tools available for screening in SWPBS were investigated, including brief behavior rating scales completed by parents and teachers, as well as performance tasks borrowed from the field of neuropsychology. All instruments showed an ability to predict children's behavior, although not to equal extents. A discussion of practicality and predictive utility of each instrument follows.
ContributorsHall, Morgan (Author) / Caterino, Linda (Thesis advisor) / Mathur, Sarup (Thesis advisor) / Husman, Jenefer (Committee member) / Arizona State University (Publisher)
Created2012
Description
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by difficulties in aspects of executive functioning such as inattention, hyperactivity, and impulsivity (American Psychiatric Association [APA], 2022). These challenges may impact learning and information retrieval, leading to variations in academic, vocational, and social skill development (APA, 2022). Precise assessment of these skills is crucial for understanding the diverse cognitive, behavioral, and emotional challenges associated with an ADHD diagnosis. Despite a global prevalence rate between 5-10%, no standardized assessment method has been established (Neprily et al., 2023). The development of digital tools like the NIH Toolbox Cognition Battery (NTCB) and Test of Variables of Attention (T.O.V.A.) offer enhanced accessibility and efficacy in early detection (Greenberg et al., 2007; Weintraub et al., 2013).The study evaluates select NTCB measures of executive functioning, assessing their convergent and discriminant validity alongside established neuropsychological tests. It also investigates whether the T.O.V.A. and NTCB can identify unique cognitive profiles in an ADHD sample, further evaluating sex- and age-based profile differences. Correlation analyses using SPSS (Version 28) revealed strong convergent and discriminant validity of the NTCB Flanker, Dimensional Change Card Sort, and Pattern Comparison tests, with variable discriminant validity on the List Sorting test. Latent profile analysis (LPA) was used to identify distinct profiles using NTCB and T.O.V.A. tests within a sample of 213 participants between the ages of 5 and 26 years diagnosed with ADHD. Analyses were performed using MPlus8 statistical software, with missing data being accounted for by using full information likelihood estimation (FIML). Model selections were based on the number of fit indices and criteria (Nylund et al., 2013). By adjusting unique combinations of subtests and scores from both measures, 2 to 3 distinct profiles emerged within the data, underscoring the heterogeneity and complexity of this clinical population. The data did not support sex-based performance differences; however, older cohorts demonstrated stronger NTCB working memory and processing speed performances.
The results highlight the versatility of the NTCB and T.O.V.A. in identifying unique neurocognitive profiles. Future research should explore their efficacy in diagnosing ADHD within diverse medical and psychiatric cohorts, aligning with emerging neuronal circuit theories.
ContributorsSchaefer, Amber Nicole (Author) / Capielo Rosario, Cristalís (Thesis advisor) / Truong, Nancy (Committee member) / Nicholls, Christopher J (Committee member) / Lavoie, Michael (Committee member) / Arizona State University (Publisher)
Created2023