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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
The use of bias indicators in psychological measurement has been contentious, with some researchers questioning whether they actually suppress or moderate the ability of substantive psychological indictors to discriminate (McGrath, Mitchell, Kim, & Hough, 2010). Bias indicators on the MMPI-2-RF (F-r, Fs, FBS-r, K-r, and L-r) were tested for suppression

The use of bias indicators in psychological measurement has been contentious, with some researchers questioning whether they actually suppress or moderate the ability of substantive psychological indictors to discriminate (McGrath, Mitchell, Kim, & Hough, 2010). Bias indicators on the MMPI-2-RF (F-r, Fs, FBS-r, K-r, and L-r) were tested for suppression or moderation of the ability of the RC1 and NUC scales to discriminate between Epileptic Seizures (ES) and Non-epileptic Seizures (NES, a conversion disorder that is often misdiagnosed as ES). RC1 and NUC had previously been found to be the best scales on the MMPI-2-RF to differentiate between ES and NES, with optimal cut scores occurring at a cut score of 65 for RC1 (classification rate of 68%) and 85 for NUC (classification rate of 64%; Locke et al., 2010). The MMPI-2-RF was completed by 429 inpatients on the Epilepsy Monitoring Unit (EMU) at the Scottsdale Mayo Clinic Hospital, all of whom had confirmed diagnoses of ES or NES. Moderated logistic regression was used to test for moderation and logistic regression was used to test for suppression. Classification rates of RC1 and NUC were calculated at different bias level indicators to evaluate clinical utility for diagnosticians. No moderation was found. Suppression was found for F-r, Fs, K-r, and L-r with RC1, and for all variables with NUC. For F-r and Fs, the optimal RC1 and NUC cut scores increased at higher levels of bias, but tended to decrease at higher levels of K-r, L-r, and FBS-r. K-r provided the greatest suppression for RC1, as well as the greatest increases in classification rates at optimal cut scores, given different levels of bias. It was concluded that, consistent with expectations, taking account of bias indicator suppression on the MMPI-2-RF can improve discrimination of ES and NES. At higher levels of negative impression management, higher cut scores on substantive scales are needed to attain optimal discrimination, whereas at higher levels of positive impression management and FBS-r, lower cut scores are needed. Using these new cut scores resulted in modest improvements in accuracy in discrimination. These findings are consistent with prior research in showing the efficacy of bias indicators, and extend the findings to a psycho-medical context.
ContributorsWershba, Rebecca E (Author) / Lanyon, Richard I (Thesis advisor) / Barrera, Manuel (Committee member) / Karoly, Paul (Committee member) / Millsap, Roger E (Committee member) / Arizona State University (Publisher)
Created2013
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Description
Twenty-five percent of Americans are first- or second-generation immigrants (US Census, 2012). Thus, it is likely that many Americans identify with at least two cultures, that of the mainstream United States culture, and their ethnic culture from which they came, making them bicultural. However, current understanding of the impact of

Twenty-five percent of Americans are first- or second-generation immigrants (US Census, 2012). Thus, it is likely that many Americans identify with at least two cultures, that of the mainstream United States culture, and their ethnic culture from which they came, making them bicultural. However, current understanding of the impact of biculturalism on psychological functioning is quite limited in scope, as few studies have examined this association longitudinally or considered the moderating role of the cultural environment. The present study proposed to take a more comprehensive approach in understanding the consequences of biculturalism on psychological outcomes (i.e., depression, anxiety, and substance abuse symptoms) among Mexican American adolescents, as they belong to one of largest and fastest growing ethnic groups in the United States (US Census, 2013). The present study had two major goals. The first was to examine the influence of biculturalism on depression, anxiety, and substance abuse symptoms longitudinally over the course of two years. It was hypothesized that overall, biculturalism will lead to less depression, anxiety, and substance abuse symptoms. The results partially supported these predictions. For males, biculturalism was related to significantly fewer anxiety symptoms, but not for females. Further, no main effects of biculturalism were found for depression and substance abuse for males or females. The second goal of the study was to examine the potential moderating role of the cultural environment on the influence of biculturalism on mental health symptoms. It was hypothesized that bicultural individuals will exhibit less mental health symptoms in bicultural environments (person-environment fit) compared to more monocultural individuals (person-environment misfit). However, no differences are expected to ii emerge between bicultural and monocultural individuals in monocultural environments, as both groups should be well adapted in these settings. The results did not fully support these predictions. Though, biculturalism for male adolescents was related to significantly fewer anxiety symptoms in home environments where parents reported moderate degrees of biculturalism, and females' biculturalism was related to significantly fewer depression symptoms in neighborhood environments that were relatively bicultural; no effects of biculturalism were found in environments that were the most bicultural. The implications of the findings are discussed.
ContributorsBasilio, Camille D (Author) / Knight, George P. (Thesis advisor) / Kwan, Virginia S.Y. (Committee member) / Roosa, Mark W. (Committee member) / Gonzales, Nancy (Committee member) / Arizona State University (Publisher)
Created2014
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This dissertation examined Mexican American individuals' romantic relationships within two distinct developmental periods, adolescence and adulthood. Study 1 used latent class analysis to explore whether 12th grade Mexican Americans' (N = 218) romantic relationship characteristics, cultural values, and gender created unique romantic relationship profiles. Results suggested a three-class solution: higher

This dissertation examined Mexican American individuals' romantic relationships within two distinct developmental periods, adolescence and adulthood. Study 1 used latent class analysis to explore whether 12th grade Mexican Americans' (N = 218) romantic relationship characteristics, cultural values, and gender created unique romantic relationship profiles. Results suggested a three-class solution: higher quality, satisfactory quality, and lower quality romantic relationships. Subsequently, associations between profiles and adolescents' adjustment variables were examined via regression analyses. Adolescents with higher and satisfactory quality romantic relationships reported greater future family expectations, higher self-esteem, and fewer externalizing symptoms than adolescents with lower quality romantic relationships. Similarly, adolescents with higher quality romantic relationships reported greater academic self-efficacy and fewer sexual partners than adolescents with lower quality romantic relationships. Finally, adolescents with higher quality romantic relationships also reported greater future family expectations and higher academic self-efficacy than adolescents with satisfactory quality romantic relationships. To summarize, results suggested that adolescents engaged in three unique types of romantic relationships with higher quality being most optimal for their adjustment. Study 2 used latent growth modeling to examine marital partners' (N = 466) intra- and inter-individual changes of acculturative stress, depressive symptoms, and marital quality. On average across the seven years, husbands' acculturative stress remained steady, but wives' significantly decreased; partners' depressive symptoms remained relatively steady, but their marital quality significantly decreased. Although partners' experiences of acculturative stress were less similar than their experiences of depressive symptoms and marital quality, overall their experiences were interconnected. Significant spillover and crossover effects emerged between partners' initial levels of acculturative stress and depressive symptoms and between depressive symptoms and marital quality. Moreover, changes in husbands' depressive symptoms were negatively associated with changes in their marital quality. Overall, results suggested that partners' experiences were interconnected across time.
ContributorsMoosmann, Danyel A. V (Author) / Roosa, Mark W. (Thesis advisor) / Christopher, F. Scott (Committee member) / White, Rebecca M B (Committee member) / Millsap, Roger E (Committee member) / Arizona State University (Publisher)
Created2014
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Recent reports have indicated that there are both mental health and educational disparities between Latino youth and their European American counterparts. Specifically, Latin youth are at a heightened risk for negative mental health outcomes in comparison to their non-Latino youth (e.g., Eaton et al., 2008). Further, 16.7% of Latino adolescents

Recent reports have indicated that there are both mental health and educational disparities between Latino youth and their European American counterparts. Specifically, Latin youth are at a heightened risk for negative mental health outcomes in comparison to their non-Latino youth (e.g., Eaton et al., 2008). Further, 16.7% of Latino adolescents dropped out of high school compared to 5.3% of European American youth over the past several decades (1960-2011; U.S. Department of Education, 2013). Mexican American (M.A. youth in particular, have the lowest educational attainment among all Latino ethnic groups in the U.S. (U.S. Census Bureau, 2010). While these mental health and educational disparities have often been attributed to discrimination experiences that Latino youth encounter, there is also consistent empirical evidence linking discrimination with these maladjustment problems. These studies confirmed that discrimination directly related to depressive symptoms (e.g., Umana-Taylor et al., 2007), externalizing behaviors (Berkel et al., 2010), self-esteem (e.g., Zeiders et al., 2013), and academic outcomes (e.g., Umana-Taylor et al., 2012). Few studies to date have examined the underlying mechanisms (i.e., moderation and mediation) that help us to better understand resiliency paths for those Latino youth that display positive adjustment outcomes despite being faced with similar discrimination encounters that their maladjusted peers face. Therefore, the following two studies examined various mechanisms in which discrimination related to adjustment to better understand potential risk and resiliency processes in hopes of informing intervention research. Paper 1 explored cultural influences on the association between discrimination, active coping, and mental health outcomes in M.A. youth. Paper 2 examined how trajectories of discrimination across 5th, 7th, and 10th grades related to cultural values, externalizing behaviors, and academic outcomes in M.A. youth. Taken together, these studies provide a culturally informed overview of adjustment processes in M.A. adolescents who face discrimination in addition to identifying critical directions for future research in efforts to gaining a more contextualized and comprehensive understanding of the dynamic processes involved in discrimination and adjustment in M.A. youth.
ContributorsO'Donnell, Megan (Author) / Roosa, Mark W. (Thesis advisor) / Dumka, Larry (Committee member) / Gonzales, Nancy (Committee member) / Barrera, Manuel (Committee member) / Arizona State University (Publisher)
Created2014
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Although research has documented robust prospective relationships between externalizing symptomatology and subsequent binge drinking among adolescents, the extent to which internalizing symptoms increase risk for drinking remains controversial. In particular, the role of anxiety as a predictor of binge drinking remains unclear. Recent evidence suggests that one possible reason for

Although research has documented robust prospective relationships between externalizing symptomatology and subsequent binge drinking among adolescents, the extent to which internalizing symptoms increase risk for drinking remains controversial. In particular, the role of anxiety as a predictor of binge drinking remains unclear. Recent evidence suggests that one possible reason for these mixed findings is that separate dimensions of anxiety may differentially confer risk for alcohol use. The present study tested two dimensions of anxiety - worry and physiological anxiety -- as predictors of binge drinking in a longitudinal study of juvenile delinquents. Overall, results indicate that worry and physiological anxiety showed differential relations with drinking behavior. In general, worry was protective against alcohol use, whereas physiological anxiety conferred risk for binge drinking, but both effects were conditional on levels of offending. Implications for future research examining the role of anxiety in predicting drinking behavior among youth are discussed.
ContributorsNichter, Brandon (Author) / Chassin, Laurie (Thesis advisor) / Barrera, Manuel (Committee member) / Presson, Clark (Committee member) / Arizona State University (Publisher)
Created2014
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The effects of preventive interventions are found to be related to participants' responsiveness to the program, or the degree to which participants attend sessions, engage in the material, and use the program skills. The current study proposes a multi-dimensional method for measuring responsiveness to the Family Bereavement Program (FBP), a

The effects of preventive interventions are found to be related to participants' responsiveness to the program, or the degree to which participants attend sessions, engage in the material, and use the program skills. The current study proposes a multi-dimensional method for measuring responsiveness to the Family Bereavement Program (FBP), a parenting-focused program to prevent mental health problems for children who experienced the death of a parent. It examines the relations between individual-level risk-factors and responsiveness to the program, as well as the relations between responsiveness and program outcomes. The sample consists of 90 caregivers and 135 children assigned to the intervention condition of an efficacy trial of the FBP. Caregivers' responsiveness to the 12-week program was measured using a number of indicators, including attendance, completion of weekly "homework" assignments, overall program skill use, perceived helpfulness of the program and program skills, and perceived group environment. Three underlying dimensions of responsiveness were identified: Skill Use, Program Liking, and Perceived Group Environment. Positive parenting and child externalizing problems at baseline were found to predict caregiver Skill Use. Skill Use and Perceived Group Environment predicted changes in caregiver grief and reports of child behavior problems at posttest and 11-month follow-up. Caregivers with better Skill Use had better positive parenting outcomes. Skill use mediated the relation between baseline positive parenting and improvements in positive parenting at 11-month follow-up.
ContributorsSchoenfelder, Erin (Author) / Sandler, Irwin N. (Thesis advisor) / Wolchik, Sharlene (Committee member) / Millsap, Roger (Committee member) / Barrera, Manuel (Committee member) / Arizona State University (Publisher)
Created2012
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Parenting approaches that are firm yet warm (i.e., authoritative parenting) have been found to be robustly beneficial for mainstream White Americans youths, but do not demonstrate similarly consistent effects among Chinese Americans (CA) adolescents. Evidence suggests that CA adolescents interpret and experience parenting differently than their mainstream counterparts given differences

Parenting approaches that are firm yet warm (i.e., authoritative parenting) have been found to be robustly beneficial for mainstream White Americans youths, but do not demonstrate similarly consistent effects among Chinese Americans (CA) adolescents. Evidence suggests that CA adolescents interpret and experience parenting differently than their mainstream counterparts given differences in parenting values and child-rearing norms between traditional Chinese and mainstream American cultures. The current study tests the theory that prospective effects of parenting on psychological and academic functioning depends on adolescents' cultural frameworks for interpreting and understanding parenting. CA adolescents with values and expectations of parenting that are more consistent with mainstream American parenting norms were predicted to experience parenting similar to their White American counterparts (i.e., benefiting from a combination of parental strictness and warmth). In contrast, CA adolescents with parenting values and expectations more consistent with traditional Chinese parenting norms were predicted to experience parenting and its effects on academic and psychological outcomes differently than patterns documented in the mainstream literature. This study was conducted with a sample of Chinese American 9th graders (N = 500) from the Multicultural Family Adolescent Study. Latent Class Analysis (LCA), a person-centered approach to modeling CA adolescents' cultural frameworks for interpreting parenting, was employed using a combination of demographic variables (e.g., nativity, language use at home, mother's length of stay in the U.S.) and measures of parenting values and expectations (e.g., parental respect, ideal strictness & laxness). The study then examined whether prospective effects of parenting behaviors (strict control, warmth, and their interaction effect) on adolescent adjustment (internalizing and externalizing symptoms, substance use, and GPA) were moderated by latent class membership. The optimal LCA solution identified five distinct cultural frameworks for understanding parenting. Findings generally supported the idea that effects of parenting on CA adolescent adjustment depend on adolescents' cultural framework for parenting. The classic authoritative parenting effect (high strictness and warmth leads to positive outcomes) was found for the two most acculturated groups of adolescents. However, only one of these groups overtly endorsed mainstream American parenting values.
ContributorsLiu, Freda Fangfang (Author) / Gonzales, Nancy A. (Thesis advisor) / Tein, Jenn-Yun (Committee member) / Yoo, Hyung Chol (Committee member) / Barrera, Manuel (Committee member) / Arizona State University (Publisher)
Created2011
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When people pick up the phone to call a telephone quitline, they are taking an important step towards changing their smoking behavior. The current study investigated the role of a critical cognition in the cessation process--self-efficacy. Self-efficacy is thought to be influential in behavior change processes including those involved in

When people pick up the phone to call a telephone quitline, they are taking an important step towards changing their smoking behavior. The current study investigated the role of a critical cognition in the cessation process--self-efficacy. Self-efficacy is thought to be influential in behavior change processes including those involved in the challenging process of stopping tobacco use. By applying basic principles of self-efficacy theory to smokers utilizing a telephone quitline, this study advanced our understanding of the nature of self-efficacy in a "real-world" cessation setting. Participants received between one and four intervention calls aimed at supporting them through their quit attempt. Concurrent with the initiation of this study, three items (confidence, stress, and urges) were added to the standard telephone protocol and assessed at each call. Two principal sets of hypotheses were tested using a combination of ANCOVAs and multiple regression analyses. The first set of hypotheses explored how self-efficacy and changes in self-efficacy within individuals were associated with cessation outcomes. Most research has found a positive linear relation between self-efficacy and quit outcomes, but this study tested the possibility that excessively high self-efficacy may actually reflect an overconfidence bias, and in some cases be negatively related to cessation outcomes. The second set of hypotheses addressed several smoking-related factors expected to affect self-efficacy. As predicted, higher baseline self-efficacy and increases in self-efficacy were associated with higher rates of quitting. However, contrary to predictions, there was no evidence that overconfidence led to diminished cessation success. Finally, as predicted, shorter duration of quit attempts, shorter time to relapse, and stronger urges all were associated with lower self-efficacy. In conclusion, understanding how self-efficacy and changes in self-efficacy affect and are affected by cessation outcomes is useful for informing both future research and current quitline intervention procedures.
ContributorsGoesling, Jenna (Author) / Barrera, Manuel (Thesis advisor) / Shiota, Lani (Committee member) / Enders, Craig (Committee member) / Presson, Clark (Committee member) / Arizona State University (Publisher)
Created2011
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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