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Fibromyalgia (FM) is a chronic pain condition characterized by debilitating fatigue. This study examined the dynamic relation between interpersonal enjoyment and fatigue in 102 partnered and 74 unpartnered women with FM. Participants provided three daily ratings for 21 days. They rated their fatigue in late morning and at the end of the day. Both partnered and unpartnered participants reported their interpersonal enjoyment in the combined familial, friendship, and work domains (COMBINED domain) in the afternoon. Additionally, partnered participants reported their interpersonal enjoyment in the spousal domain. The study was guided by three hypotheses at the within-person level, based on daily diaries: (1) elevated late morning fatigue would predict diminished afternoon interpersonal enjoyment; (2) diminished interpersonal enjoyment would predict elevated end-of-day fatigue; (3) interpersonal enjoyment would mediate the late morning to end-of-day fatigue relationship. In cross-level models, the study explored whether individual differences (between-person) in late morning fatigue and afternoon interpersonal enjoyment would moderate within-person relations from late morning fatigue to afternoon interpersonal enjoyment, and from afternoon interpersonal enjoyment to end-of-day fatigue. Furthermore, it explored whether the hypothesized relationships at the within-person level would also emerge at the between-person level (between-person mediation models). Multilevel structural equation modeling and multilevel modeling were employed for model testing, separately for partnered and unpartnered participants. Within-person mediation models supported that on high fatigue mornings, afternoon interpersonal enjoyment was dampened in the spousal and combined domains in partnered and unpartnered samples. Moreover, low afternoon interpersonal enjoyment in both the spousal and combined domains predicted elevated end-of-day fatigue. Afternoon interpersonal enjoyment mediated the relationship of late morning to end-of-day fatigue in the combined domain but in not the spousal domain. Cross-level moderation analyses showed that individual differences in afternoon spousal enjoyment moderated the day-to-day relation between afternoon spousal enjoyment and end-of-day fatigue. Finally, the mediational chain was not observed at the between-person level. These findings suggest that preserving interpersonal enjoyment in non-spousal relations limits within-day increases in FM fatigue. They highlight the importance of examining domain-specificity in interpersonal enjoyment when studying fatigue, and suggest that targeting enjoyment in social relations may improve the efficacy of existing treatments.
ContributorsYeung, Wan (Author) / Aiken, Leona S. (Thesis advisor) / Davis, Mary C. (Thesis advisor) / Mackinnon, David P (Committee member) / Zautra, Alex J (Committee member) / Arizona State University (Publisher)
Created2013
Description
Sometimes difficult life events challenge our existing resources in such a way that routinized responses are inadequate to handle the challenge. Some individuals will persist in habitual, automatic behavior, regardless of environmental cues that indicate a mismatch between coping strategy and the demands of the stressor. Other individuals will marshal adaptive resources to construct new courses of action and reconceptualize the problem, associated goals and/or values. A mixed methods approach was used to describe and operationalize cognitive shift, a relatively unexplored construct in existing literature. The study was conducted using secondary data from a parent multi-year cross-sectional study of resilience with eight hundred mid-aged adults from the Phoenix metro area. Semi-structured telephone interviews were analyzed using a purposive sample (n=136) chosen by type of life event. Participants' beliefs, assumptions, and experiences were examined to understand how they shaped adaptation to adversity. An adaptive mechanism, "cognitive shift," was theorized as the transition from automatic coping to effortful cognitive processes aimed at novel resolution of issues. Aims included understanding when and how cognitive shift emerges and manifests. Cognitive shift was scored as a binary variable and triangulated through correlational and logistic regression analyses. Interaction effects revealed that positive personality attributes influence cognitive shift most when people suffered early adversity. This finding indicates that a certain complexity, self-awareness and flexibility of mind may lead to a greater capacity to find meaning in adversity. This work bridges an acknowledged gap in literature and provides new insights into resilience.
ContributorsRivers, Crystal T (Author) / Zautra, Alex (Thesis advisor) / Davis, Mary (Committee member) / Kurpius, Sharon (Committee member) / Arizona State University (Publisher)
Created2014
Description
The primary aim of this study was to investigate resilient profiles in low-income Mexican American (MA) mothers. MA mothers are part of an under researched population, the fastest growing ethnic minority group, and have the highest birth rate in the United States, presenting a significant public health concern. The transition to motherhood can be an emotionally and physically complex time for women, particularly in the context of a stressful low-income environment. Although most low-income women navigate this transition well, a significant number of mothers develop moderate to severe depressive symptoms. The proposed research investigated profiles of resilience during the prenatal period using a person-centered approach via latent profile analysis. In alignment with current resilience theories, several domains of resilience were investigated including psychological, social, and cultural adherence (e.g., maintaining specific cultural traditions). Concurrent prenatal depressive symptoms and stress were correlated with the profiles in order to establish validity. Six week postpartum depressive symptoms and physiological processes (e.g., overall cortisol output, heart rate variability, and sleep) were also predicted by the prenatal resilient profiles. The resulting data revealed three separate profiles: low-resource, high-resource Anglo, and high-resource Mexican. These resilience profiles had differential associations with concurrent depressive symptoms and stress, such that women in the high-resource profiles reported less depressive symptoms and stress prenatally. Further, profile differences regarding cortisol output, resting heart rate variability, were also found, but there were no differences in insomnia symptoms. Profile classification also moderated the effects of prenatal economic stress on postpartum depressive symptoms, such that women in the high-resource Mexican profile were at risk for higher postpartum depressive symptoms under high economic stress compared to the high-resource Anglo group, which demonstrated a more resilient response. Overall, the results suggest the presence of multiple clusters of prenatal resilience within a sample of MA mothers facing health disparities, with various effects on perinatal mental health and postpartum physiological processes. The results also highlight the need for multi-dimensional models of resilience and the possible implications for interventions.
ContributorsGress Smith, Jenna L (Author) / Luecken, Linda J. (Thesis advisor) / Gonzales, Nancy (Committee member) / Okun, Morris (Committee member) / Zautra, Alex (Committee member) / Arizona State University (Publisher)
Created2014
Description
Fibromyalgia (FM) is a chronic musculoskeletal disorder characterized by widespread pain, fatigue, and a variety of other comorbid physiological and psychological characteristics, including a deficit of positive affect. Recently, the focus of research on the pathophysiology of FM has considered the role of a number of genomic variants. In the current manuscript, case-control analyses did not support the hypothesis that FM patients would differ from other chronic pain groups in catechol-O-methyltransferase (COMT) and mu-opioid receptor (OPRM1) genotype. However, evidence is provided in support of the hypothesis that functional single nucleotide polymorphisms on the COMT and OPRM1 genes would be associated with risk and resilience, respectively, in a dual processing model of pain-related positive affective regulation in FM. Forty-six female patients with a physician-confirmed diagnosis of FM completed an electronic diary that included once-daily assessments of positive affect and soft tissue pain. Multilevel modeling yielded a significant gene X environment interaction, such that individuals with met/met genotype on COMT experienced a greater decline in positive affect as daily pain increased than did either val/met or val/val individuals. A gene X environment interaction for OPRM1 also emerged, indicating that individuals with at least one asp allele were more resilient to elevations in daily pain than those homozygous for the asn allele. In sum, the findings offer researchers ample reason to further investigate the contribution of the catecholamine and opioid systems, and their associated genomic variants, to the still poorly understood experience of FM.
ContributorsFinan, Patrick Hamilton (Author) / Zautra, Alex (Thesis advisor) / Davis, Mary (Committee member) / Lemery-Chalfant, Kathryn (Committee member) / Presson, Clark (Committee member) / Arizona State University (Publisher)
Created2011
Description
The population of older adults and the percentage of people living in urban areas are both increasing in the U.S. Finding ways to enhance city-dwelling, older adults' social integration, cognitive vitality, and connectedness to nature were conceptualized as critical pathways to maximizing their subjective well-being (SWB) and overall health. Past research has found that gardening is associated with increased social contact and reduced risk of dementia, and that higher levels of social support, cognitive functioning, mindfulness, and connectedness to nature are positively related to various aspects of SWB. The present study was a pilot study to examine the feasibility of conducting a randomized, controlled trial of community gardening and to provide an initial assessment of a new intervention--"Mindful Community Gardening," or mindfulness training in the context of gardening. In addition, this study examined whether community gardening, with or without mindfulness training, enhanced SWB among older adults and increased social support, attention and mindfulness, and connectedness to nature. Fifty community-dwelling adults between the ages of 55 and 79 were randomly assigned to one of three groups: Traditional Community Gardening (TCG), Mindful Community Gardening (MCG), or Wait-List Control. The TCG and MCG arms each consisted of two groups of 7 to 10 participants meeting weekly for nine weeks. TCG involved typical gardening activities undertaken collaboratively. MCG involved the same, but with the addition of guided development of non-judgmental, present-focused awareness. There was a statistically significant increase in different aspects of mindfulness for the TCG and the MCG arms. The interventions did not measurably impact social support, attention, or connectedness to nature in this small, high functioning, pilot sample. Qualitative analysis of interview data from 12 participants in the TCG and MCG groups revealed that both groups helped some participants to better cope with adversity. It was concluded that it is feasible to conduct randomized, controlled trials of community gardening with urban older adults, and considerations for implementing such interventions are delineated.
ContributorsOkvat, Heather Audrey (Author) / Zautra, Alex J. (Thesis advisor) / Davis, Mary C. (Committee member) / Knopf, Richard C. (Committee member) / Okun, Morris A. (Committee member) / Arizona State University (Publisher)
Created2011
Description
This study examined whether cognitive behavioral therapy and mindfulness interventions affect positive (PA) and negative affect (NA) reports for patients with rheumatoid arthritis (RA) before, during, and after stress induction. The study also investigated the effects of a history of recurrent depression on intervention effects and testing effects due to the Solomon-6 study design utilized. The 144 RA patients were assessed for a history of major depressive episodes by diagnostic interview and half of the participants completed a laboratory study before the intervention began. The RA patients were randomly assigned to 1 of 3 treatments: cognitive behavioral therapy for pain (P), mindfulness meditation and emotion regulation therapy (M), or education only attention control group (E). Upon completion of the intervention, 128 of the RA patients participated in a laboratory session designed to induce stress in which they were asked to report on their PA and NA throughout the laboratory study. Patients in the M group exhibited dampened negative and positive affective reactivity to stress, and sustained PA at recovery, compared to the P and E groups. PA increased in response to induced stress for all groups, suggesting an "emotional immune response." History of recurrent depression increased negative affective reactivity, but did not predict reports of PA. RA patients who underwent a pre-intervention laboratory study showed less reactivity to stressors for both NA and PA during the post-intervention laboratory study. The M intervention demonstrated dampened emotional reactions to stress and lessened loss of PA after stress induction, displaying active emotion regulation in comparison to the other groups. These findings provide additional information about the effects of mindfulness on the dynamics of affect and adaptation to stress in chronic pain patients.
ContributorsArewasikporn, Anne (Author) / Zautra, Alex J (Thesis advisor) / Davis, Mary C. (Committee member) / Karoly, Paul (Committee member) / Arizona State University (Publisher)
Created2012
Description
Research has suggested that lonely people demonstrate distinct differences from nonlonely people in their behaviors, mood, and interpersonal experiences. Lonely people who are also enduring a chronic pain condition may be at an especially high risk for negative outcomes because of simultaneous issues such as stigma, mood disturbances, and pain-related disability. The current study examined chronic and transitory loneliness in a sample of 123 chronic pain patients. Participants completed daily diaries assessing the occurrence of positive and negative interpersonal events, appraisals of interpersonal events, pain, and mood. Multilevel modeling was used to examine effects of being a lonely person as well as having a lonely episode on daily life. Results indicated that both chronic and transitory loneliness were associated with more frequent negative and less frequent positive interpersonal events, higher levels of pain, more negative and less positive affect, and more stress and less enjoyment from social interactions. Loneliness did not affect reactivity to negative interpersonal events, but did influence responsivity to positive interpersonal events such that lonely people had greater boosts in enjoyment when experiencing more positive interpersonal events than usual. These findings suggest that both lonely people and individuals experiencing a lonely episode experience more negative consequences in their daily lives than nonlonely people. However, they can benefit from engaging in more frequent positive interpersonal events, which can help to inform future clinical interventions for lonely, chronic pain patients.
ContributorsDempsey, Laurie (Author) / Davis, Mary (Thesis advisor) / Zautra, Alex (Committee member) / Doane, Leah (Committee member) / Arizona State University (Publisher)
Created2012
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
Female infertility can present a significant challenge to quality of life. To date, few, if any investigations have explored the process by which women adapt to premature ovarian insufficiency (POI), a specific type of infertility, over time. The current investigation proposed a bi-dimensional, multi-factor, model of adjustment characterized by the identification of six latent factors representing personal attributes (resilience resources and vulnerability), coping (adaptive and maladaptive) and outcomes (distress and wellbeing). Measures were collected over the period of one year; personal attributes were assessed at Time 1, coping at Time 2 and outcomes at Time 3. It was hypothesized that coping factors would mediate associations between personal attributes and outcomes. Confirmatory Factor Analysis (CFA), simple regressions and single mediator models were utilized to test study hypotheses. Overall, with the exception of coping, the factor structure was consistent with predictions. Two empirically derived coping factors, and a single standalone strategy, avoidance, emerged. The first factor, labeled "approach coping" was comprised of strategies directly addressing the experience of infertility. The second was comprised of strategies indicative of "letting go /moving on." Only avoidance significantly mediated the association between vulnerability and distress.
ContributorsDriscoll, Mary (Author) / Davis, Mary C. (Thesis advisor) / Aiken, Leona S. (Committee member) / Luecken, Linda J. (Committee member) / Zautra, Alex J. (Committee member) / Arizona State University (Publisher)
Created2011
Description
Despite the strong link between pain and depressive symptoms, the mechanisms by which they are connected in the everyday lives of individuals with chronic pain are not well understood. In addition, previous investigations have tended to ignore biopsychosocial individual difference factors, assuming that all individuals respond to pain-related experiences and affect in the same manner. The present study tried to address these gaps in the existing literature. Two hundred twenty individuals with Fibromyalgia completed daily diaries during the morning, afternoon, and evening for 21 days. Findings were generally consistent with the hypotheses. Multilevel structural equation modeling revealed that morning pain and positive and negative affect are uniquely associated with morning negative pain appraisal, which in turn, is positively related to pain’s activity interference in the afternoon. Pain’s activity interference was the strongest predictor of evening depressive symptoms. Latent profile analysis using biopsychosocial measures identified three theoretically and clinically important subgroups (i.e., Low Functioning, Normative, and High Functioning groups). Although the daily pain-depressive symptoms link was not significantly moderated by these subgroups, individuals in the High Functioning group reported the lowest levels of average morning pain, negative affect, negative pain appraisal, afternoon pain’s activity interference, and evening depressive symptoms, and the highest levels of average morning positive affect across 21 days relative to the other two groups. The Normative group fared better on all measures than did the Low Functioning group. The findings of the present study suggest the importance of promoting morning positive affect and decreasing negative affect in disconnecting the within-day pain-depressive symptoms link, as well as the potential value of tailoring chronic pain interventions to those individuals who are in the greatest need.
ContributorsMun, Chung Jung (Author) / Karoly, Paul (Thesis advisor) / Davis, Mary C. (Thesis advisor) / Suk, Hye Won (Committee member) / Dishion, Thomas J (Committee member) / Arizona State University (Publisher)
Created2017