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In investigating mediating processes, researchers usually use randomized experiments and linear regression or structural equation modeling to determine if the treatment affects the hypothesized mediator and if the mediator affects the targeted outcome. However, randomizing the treatment will not yield accurate causal path estimates unless certain assumptions are satisfied. Since

In investigating mediating processes, researchers usually use randomized experiments and linear regression or structural equation modeling to determine if the treatment affects the hypothesized mediator and if the mediator affects the targeted outcome. However, randomizing the treatment will not yield accurate causal path estimates unless certain assumptions are satisfied. Since randomization of the mediator may not be plausible for most studies (i.e., the mediator status is not randomly assigned, but self-selected by participants), both the direct and indirect effects may be biased by confounding variables. The purpose of this dissertation is (1) to investigate the extent to which traditional mediation methods are affected by confounding variables and (2) to assess the statistical performance of several modern methods to address confounding variable effects in mediation analysis. This dissertation first reviewed the theoretical foundations of causal inference in statistical mediation analysis, modern statistical analysis for causal inference, and then described different methods to estimate causal direct and indirect effects in the presence of two post-treatment confounders. A large simulation study was designed to evaluate the extent to which ordinary regression and modern causal inference methods are able to obtain correct estimates of the direct and indirect effects when confounding variables that are present in the population are not included in the analysis. Five methods were compared in terms of bias, relative bias, mean square error, statistical power, Type I error rates, and confidence interval coverage to test how robust the methods are to the violation of the no unmeasured confounders assumption and confounder effect sizes. The methods explored were linear regression with adjustment, inverse propensity weighting, inverse propensity weighting with truncated weights, sequential g-estimation, and a doubly robust sequential g-estimation. Results showed that in estimating the direct and indirect effects, in general, sequential g-estimation performed the best in terms of bias, Type I error rates, power, and coverage across different confounder effect, direct effect, and sample sizes when all confounders were included in the estimation. When one of the two confounders were omitted from the estimation process, in general, none of the methods had acceptable relative bias in the simulation study. Omitting one of the confounders from estimation corresponded to the common case in mediation studies where no measure of a confounder is available but a confounder may affect the analysis. Failing to measure potential post-treatment confounder variables in a mediation model leads to biased estimates regardless of the analysis method used and emphasizes the importance of sensitivity analysis for causal mediation analysis.
ContributorsKisbu Sakarya, Yasemin (Author) / Mackinnon, David Peter (Thesis advisor) / Aiken, Leona (Committee member) / West, Stephen (Committee member) / Millsap, Roger (Committee member) / Arizona State University (Publisher)
Created2013
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Description
Accumulating evidence implicates exposure to adverse childhood experiences in the development of hypocortisolism in the long-term, and researchers are increasingly examining individual-level mechanisms that may underlie, exacerbate or attenuate this relation among at-risk populations. The current study takes a developmentally and theoretically informed approach to examining episodic childhood stressors, inherent

Accumulating evidence implicates exposure to adverse childhood experiences in the development of hypocortisolism in the long-term, and researchers are increasingly examining individual-level mechanisms that may underlie, exacerbate or attenuate this relation among at-risk populations. The current study takes a developmentally and theoretically informed approach to examining episodic childhood stressors, inherent and voluntary self-regulation, and physiological reactivity among a longitudinal sample of youth who experienced parental divorce. Participants were drawn from a larger randomized controlled trial of a preventive intervention for children of divorce between the ages of 9 and 12. The current sample included 159 young adults (mean age = 25.5 years; 53% male; 94% Caucasian) who participated in six waves of data collection, including a 15-year follow-up study. Participants reported on exposure to negative life events (four times over a 9-month period) during childhood, and mothers rated child temperament. Six years later, youth reported on the use of active and avoidant coping strategies, and 15 years later, they participated in a standardized psychosocial stress task and provided salivary cortisol samples prior to and following the task. Path analyses within a structural equation framework revealed that a multiple mediation model best fit the data. It was found that children with better mother-rated self-regulation (i.e. low impulsivity, low negative emotionality, and high attentional focus) exhibited lower total cortisol output 15 years later. In addition, greater self-regulation in childhood predicted greater use of active coping in adolescence, whereas a greater number of negative life events predicted increased use of avoidant coping in adolescence. Finally, a greater number of negative events in childhood predicted marginally lower total cortisol output, and higher levels of active coping in adolescence were associated with greater total cortisol output in young adulthood. Findings suggest that children of divorce who exhibit better self-regulation evidence lower cortisol output during a standardized psychosocial stress task relative to those who have higher impulsivity, lower attentional focus, and/or higher negative emotionality. The conceptual significance of the current findings, including the lack of evidence for hypothesized relations, methodological issues that arose, and issues in need of future research are discussed.
ContributorsHagan, Melissa (Author) / Luecken, Linda (Thesis advisor) / MacKinnon, David (Committee member) / Wolchik, Sharlene (Committee member) / Doane, Leah (Committee member) / Arizona State University (Publisher)
Created2013
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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

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
The main objective of this study was to use a genetically-informative design to examine the putative influences of maternal perceived prenatal stress, obstetrical complications, and gestational age on infant dysregulation, competence, and developmental maturity. Specifically, whether or not prenatal and obstetrical environmental conditions modified the heritability of infant outcomes was

The main objective of this study was to use a genetically-informative design to examine the putative influences of maternal perceived prenatal stress, obstetrical complications, and gestational age on infant dysregulation, competence, and developmental maturity. Specifically, whether or not prenatal and obstetrical environmental conditions modified the heritability of infant outcomes was examined. A total of 291 mothers were interviewed when their twin infants were 12 months of age. Pregnancy and twin birth medical records were obtained to code obstetrical data. Utilizing behavioral genetic models, results indicated maternal perceived prenatal stress moderated genetic and environmental influences on developmental maturity whereas obstetrical complications moderated shared environmental influences on infant competence and nonshared environmental influences on developmental maturity. Gestational age moderated the heritability and nonshared environment of infant dysregulation, shared and nonshared environmental influences on competence, and nonshared environmental influences on developmental maturity. Taken together, prenatal and obstetric conditions were important nonlinear influences on infant outcomes. An evolutionary perspective may provide a framework for these findings, such that the prenatal environment programs the fetus to be adaptive to current environmental contexts. Specifically, prenatal stress governs gene expression through epigenetic processes. Findings highlight the utility of a genetically informative design for elucidating the role of prenatal and obstetric conditions in the etiology of infant developmental outcomes.
ContributorsMcDonald, Kristy (Author) / Lemery-Chalfant, Kathryn S (Thesis advisor) / Fabricius, William (Committee member) / Luecken, Linda (Committee member) / Spinrad, Tracy (Committee member) / Arizona State University (Publisher)
Created2011
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Description
The purpose of this study was to examine under which conditions "good" data characteristics can compensate for "poor" characteristics in Latent Class Analysis (LCA), as well as to set forth guidelines regarding the minimum sample size and ideal number and quality of indicators. In particular, we studied to which extent

The purpose of this study was to examine under which conditions "good" data characteristics can compensate for "poor" characteristics in Latent Class Analysis (LCA), as well as to set forth guidelines regarding the minimum sample size and ideal number and quality of indicators. In particular, we studied to which extent including a larger number of high quality indicators can compensate for a small sample size in LCA. The results suggest that in general, larger sample size, more indicators, higher quality of indicators, and a larger covariate effect correspond to more converged and proper replications, as well as fewer boundary estimates and less parameter bias. Based on the results, it is not recommended to use LCA with sample sizes lower than N = 100, and to use many high quality indicators and at least one strong covariate when using sample sizes less than N = 500.
ContributorsWurpts, Ingrid Carlson (Author) / Geiser, Christian (Thesis advisor) / Aiken, Leona (Thesis advisor) / West, Stephen (Committee member) / Arizona State University (Publisher)
Created2012
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Description
Family plays an important yet understudied role in the development of psychopathology during childhood, particularly for children at developmental risk. Indeed, much of the research on families has actually concentrated more on risk processes in individual family members or within-family subsystems. In general, important and complex associations have been found

Family plays an important yet understudied role in the development of psychopathology during childhood, particularly for children at developmental risk. Indeed, much of the research on families has actually concentrated more on risk processes in individual family members or within-family subsystems. In general, important and complex associations have been found among family-related constructs such as marital conflict, parent-child relationships, parental depression, and parenting stress, which have in turn been found to contribute to the emergence of children's behavioral problems. Research has begun to emerge that certain family system constructs, such as cohesion, organization, and control may influence children's development, but this research has been limited by a focus on parent-reports of family functioning, rather than utilizing observational methods. With notable exceptions, there is almost no observational research examining families of children at developmental risk. This study examined the longitudinal relations among family risk and family system constructs, as well as how family systems constructs mediated the relations between family risk and child outcome. Further, the study examined how developmental risk moderated these relations. The sample followed 242 families of children with and without developmental risk across the transition-to-school period. Family risk factors were assessed at 5 years, using parental reports of symptomatology, parenting stress, and marital adjustment, and observational assessments of the parent-child relationship. Family system constructs (cohesion, warmth, conflict, organization, control) were measured at age 6 using structured observations of the entire family playing a board game. Child behavior problems and social competence were assessed at age 7. Results indicated that families of children with developmental delays did not differ from families of typically developing children on the majority of family system attributes. Cohesion and organization mediated the relations between specific family risk factors and social competence for all families. For families of typically developing children only, higher levels of control were associated with more behavior problems and less social competence. These findings underscore the importance of family-level assessment in understanding the development of psychopathology. Important family effects on children's social competence were found, although the pathways among family risk and family systems attributes are complex.
ContributorsGerstein, Emily Davis (Author) / Crnic, Keith A (Thesis advisor) / Aiken, Leona (Committee member) / Bradley, Robert (Committee member) / Gonzales, Nancy (Committee member) / Arizona State University (Publisher)
Created2012
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Description
Specific cultural variables have been found to protect against the onset of alcohol, tobacco and drug use among Latino adolescents. It has been suggested that targeting similar cultural components during the treatment of drug dependence and abuse for Latino adults may also enhance the effectiveness of the intervention, although few

Specific cultural variables have been found to protect against the onset of alcohol, tobacco and drug use among Latino adolescents. It has been suggested that targeting similar cultural components during the treatment of drug dependence and abuse for Latino adults may also enhance the effectiveness of the intervention, although few studies have explored this hypothesis. The current study attempted to remedy this disparity by exploring the potentially protective influence of two cultural variables, ethnic pride and family traditionalism, on self-efficacy to avoid drug use following residential substance abuse treatment among 99 Hispanic and 85 non-Hispanic White males. Results of the study indicate that higher levels of ethnic pride predict greater confidence to remain abstinent from drugs following substance abuse treatment, and that this relationship is stronger among Hispanic participants than non-Hispanic White participants. Family traditionalism was not a significant predictor of drug avoidance self-efficacy for either group, suggesting that some specific cultural variables may be better targets for substance abuse treatment than others. Study limitations and future directions for research and clinical practice are discussed.
ContributorsBoyd, Stephen James (Author) / Gonzalez Castro, Felipe (Thesis advisor) / Barrera, Jr., Manuel (Committee member) / Aiken, Leona (Committee member) / Arizona State University (Publisher)
Created2011
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Description
Dysregulated cortisol has been linked to a variety of adverse physical and psychological consequences. Stressors in the childhood family environment can influence cortisol activity throughout development. For example, research has shown that both infants and children of depressed mothers exhibit altered levels of cortisol compared to infants and children of

Dysregulated cortisol has been linked to a variety of adverse physical and psychological consequences. Stressors in the childhood family environment can influence cortisol activity throughout development. For example, research has shown that both infants and children of depressed mothers exhibit altered levels of cortisol compared to infants and children of non-depressed mothers. It is unclear, however, whether exposure to maternal depression in childhood and adolescence is related to cortisol activity at later stages of development. The current study examined the longitudinal relation between maternal depressive symptoms during late childhood (9-12 years old) and adolescence (15-19 years old) and cortisol activity in offspring in young adulthood (24- 28 years old) in a sample of 40 young adults and their mothers. Maternal depressive symptoms were prospectively assessed at four time points across the 15 year study. Cortisol samples were collected from young adult offspring at the final time point. Findings revealed that higher levels of maternal depressive symptoms during late childhood were associated with lower total cortisol output in young adulthood. Results suggest that attenuated cortisol levels, which put these young adults at risk for a variety of stress-related physical and psychological illnesses, may be a long-term consequence of exposure to maternal depression,. Depressive symptoms in mothers during their child's adolescence, however, did not relate to cortisol output. These findings suggest a sensitive period in late childhood during which the development of HPA activity may be susceptible to the environmental stressor of maternal depression.
ContributorsMahrer, Nicole Eva (Author) / Wolchik, Sharlene (Thesis advisor) / Luecken, Linda (Thesis advisor) / Tein, Jenn-Yun (Committee member) / Arizona State University (Publisher)
Created2011
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Description
Background: An emerging literature has found associations between food insecurity and disordered eating behaviors. This study was two-fold. First, to replicate the existing literature that food insecurity is associated with disordered eating symptoms including loss of control over eating. Second, to expand the existing literature by examining stigma control theory,

Background: An emerging literature has found associations between food insecurity and disordered eating behaviors. This study was two-fold. First, to replicate the existing literature that food insecurity is associated with disordered eating symptoms including loss of control over eating. Second, to expand the existing literature by examining stigma control theory, which purports that experiences related to food insecurity potentially induce stigma-related shame, with disordered eating behaviors used to cope with the shame. Further, to explore if emotion coping strategies moderate associations between shame and disordered eating. Method: This is a secondary analysis of a cross-sectional study of 582 adults with food insecurity. Participants completed a 20-minute online survey on food insecurity, shame related to food insecurity, coping strategies, and disordered eating behaviors. Analyses: Hierarchical regressions were computed where food insecurity, shame, and emotion focused coping were entered as predictor variables, followed by their interaction terms, and with disordered eating behaviors entered as outcome variables. Results: Regressions suggest that a) internalized shame partially mediated the relationship between food insecurity and global disordered eating, b) internalized shame did not mediate the relationship between food insecurity and loss of control, c) emotion focused coping did not moderate any relationship. Discussion: Internalized shame may be one mechanism in which disordered symptoms arise in food insecure populations, however emotion focused coping does not have any effect on this relationship. Results indicate that coping strategies alone may not reduce eating disorder symptoms, and internalized shame may be an important predictor of disordered eating in food insecure populations.
ContributorsGomez, Francesca (Author) / Perez, Marisol (Thesis advisor) / Berkel, Cady (Committee member) / Luecken, Linda (Committee member) / Arizona State University (Publisher)
Created2022
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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,

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