Matching Items (27)
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 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
Description
The present study examined the association of pain intensity and goal progress in a community sample of 132 adults with chronic pain who participated in a 21 day diary study. Multilevel modeling was employed to investigate the effect of morning pain intensity on evening goal progress as mediated by pain's interference with afternoon goal pursuit. Moderation effects of pain acceptance and pain catastrophizing on the associations between pain and interference with both work and lifestyle goal pursuit were also tested. The results showed that the relationship between morning pain and pain's interference with work goal pursuit in the afternoon was significantly moderated by a pain acceptance. In addition, it was found that the mediated effect differed across levels of pain acceptance; that is: (1) there was a significant mediation effect when pain acceptance was at its mean and one standard deviation below the mean; but (2) there was no mediation effect when pain acceptance was one standard deviation above the mean. It appears that high pain acceptance significantly attenuates the power of nociception in disrupting one's work goal pursuit. However, in the lifestyle goal model, none of the moderators were significant nor was there a significant association between pain interference with goal pursuit and goal progress. Only morning pain intensity significantly predicted afternoon interference with lifestyle goal pursuit. Further interpretation of the present findings and potential explanations of those inconsistencies are elaborated on discussion. Limitations and the clinical implication of the current study were considered, along with suggestions for future studies.
ContributorsMun, Chung Jung (Author) / Karoly, Paul (Thesis advisor) / Okun, Morris A. (Committee member) / Enders, Craig K. (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
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
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
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
Description
Prevailing models describing coping with chronic pain posit that it is a complex day-to-day process that can involve psychosocial factors, including cognitive appraisals about pain, interpersonal challenges such as distressed social relationships, and reduced engagement in enjoyable experiences. Few studies, however, have applied a process-oriented approach to elaborate the relations between key pain-related appraisals, social environmental factors, and self-efficacy, a key self-appraisal for successful adaptation to chronic pain. This study used within-day daily diary methodology to test the following hypotheses: (a) increases in morning pain catastrophizing predict decreases in end of day pain self-efficacy; (b) increases in perceived stressfulness of interpersonal relations occurring during the day exacerbate the negative effects of morning catastrophizing on end-of-day pain self-efficacy; and (c) increases in perceived enjoyment of interpersonal relations occurring during the day mitigate the negative effects of morning pain catastrophizing on end of day pain self-efficacy. Within-day measures, including morning pain catastrophizing, afternoon interpersonal stress and enjoyment ratings, and end-of-day pain self-efficacy, were collected for 21 days via an automated phone system from 223 participants with widespread chronic pain. The use of diary data allowed for examination of time-varying processes related to pain adaptation. Results of multilevel regression models indicated that, consistent with prediction, increases in morning pain catastrophizing and predicted decreases in end-of-day pain self-efficacy. Contrary to prediction, changes in midday interpersonal enjoyment and stress did not moderate the within-day catastrophizing-efficacy relation. Rather increases in midday enjoyment and stable individual differences in enjoyment predicted end-of-day efficacy. Overall, findings suggest a within-day relation between pain cognition and social context and subsequent self-efficacy, and highlight potential targets for intervention in chronic pain.
ContributorsThummala, Kirti (Author) / Davis, Mary C. (Thesis advisor) / Zautra, Alex (Committee member) / Okun, Morris (Committee member) / Arizona State University (Publisher)
Created2018
Description
Multiple health-related benefits have been associated with adherence to plant-based diets, including vegan, vegetarian, and pescatarian dietary patterns. Despite a consistent body of evidence on the importance of healthy diets, Americans continue to find difficulty in establishing and adhering to dietary goals that could elicit long-term health benefits. Recent research suggests an important role for goal-setting strategies in health behavior change attempts, with some success shown in dietary behavior change, specifically. The current study thus aimed to explore whether having multiple goals alongside one primary goal of following a vegetarian, vegan, or pescatarian diet would increase the achievability of that goal. Participants of this study were broken into two groups: currently following a plant-based diet (ADHERE) and striving to follow a plant-based diet (STRIVE). Researchers hypothesized that the number of health and/or diet related alternative goals set by participants would differ between the two groups, that the ADHERE group would report that their alternative goals were more helpful and less interfering in achieving their dietary goal than the STRIVE group, and that a higher rank of importance of the dietary goal would predict being in the ADHERE group. Results showed that the number of health and/or diet related alternative goals did not differ between groups. The ADHERE group and STRIVE group did not have significantly different helpfulness and interference reports. Although, in an exploratory analysis, it was shown that those participants who reported at least 2 health/diet related alternative goals found those goals to be significantly more helpful than those who reported 0 or 1 health/diet goal. Results showed that rank of dietary goal did not predict group assignment. Overall, the results from this study showed that the type of alternative goal was very important when pursuit of multiple goals was in effect. Type of alternative goal seemed to be a higher predictor of the perceived helpfulness of the alternative goals than previous achievement of goals.
ContributorsShilling, Katy (Author) / Wharton, Christopher (Christopher Mack), 1977- (Thesis advisor) / Karoly, Paul (Committee member) / Johnston, Carol (Committee member) / Arizona State University (Publisher)
Created2018
Description
Current models of pain coping typically focus on how pain contributes to poor physical and psychological functioning. Researchers have argued that this focus on the negative consequences is too narrow and does not account for times when individuals are able to maintain meaningful functioning despite their pain. Thus, the current study sought to investigate the day-to-day processes that both help and hinder recovery from pain and persistence towards daily goals. Specifically, the present study tested: a) a two-factor model of risk and resilience “factors” that capture key processes across affective, cognitive and social dimensions of functioning, and b) whether the relation between morning pain and end-of-day physical disability is mediated by increases in these afternoon risk and resilience factors. Within-day study measures were collected for 21 days via an automated phone system from 220 participants with Fibromyalgia. The results of multi-level confirmatory factor analysis indicated that, consistent with prediction, risk and resilience do constitute two factors. Findings from multilevel structural equation models also showed resilience factor mediated the link between late morning increases in pain and end-of-day disability, in line with hypotheses. Although the vulnerability factor as a whole did not mediate the within-day link between pain and disability, pain-catastrophizing individually did serve as a significant mediator of this relation. This study was the first to empirically test a within-day latent factor model of resilience and vulnerability and the first to capture the multidimensional nature of the pain experience by examining mechanisms across affective, cognitive and social domains of functioning. The findings of the current study suggest that in addition to studying the processes by which pain has a negative influence on the lives of pain sufferers, our understanding of the pain adaptation process can be further improved by concurrently examining mechanisms that motivate individuals to overcome the urge to avoid pain and to function meaningfully despite it.
ContributorsThummala, Kirti (Author) / Davis, Mary C. (Thesis advisor) / Doane, Leah (Committee member) / Karoly, Paul (Committee member) / Barrera, Manuel (Committee member) / Arizona State University (Publisher)
Created2018
Description
Abstract
Diagnosing psychogenic non-epileptic seizures (PNES) requires admission to an epilepsy monitoring unit, which is a lengthy and expensive process. Despite the cost of and time commitment to this inpatient evaluation, a definitive diagnosis at the end isn’t always guaranteed. Therefore, predictor variables such as demographic information and psychological testing scores can help improve the accuracy of diagnosing PNES or epilepsy at the end of a patient’s EMU admission. Locke et al. have demonstrated that the SOM scale and SOM-C subscale on the Personality Assessment Inventory (PAI) are the best indicators for predicting PNES diagnosis, with an optimal cut score of T≥70 on both of these scales. The aim of the current study was to determine whether evaluating male and female performance separately on these relevant PAI scales improves the accuracy of diagnosing PNES. The results support the hypothesis, such that male optimal cut scores on the SOM and SOM C scales are T=80 and T=75, respectively, and female optimal cut scores on the SOM and SOM C scales are T=71 and T=72, respectively. Utilizing the results of this study can help clinicians diagnose patients with PNES or epilepsy at the end of EMU evaluation with more certainty.
Diagnosing psychogenic non-epileptic seizures (PNES) requires admission to an epilepsy monitoring unit, which is a lengthy and expensive process. Despite the cost of and time commitment to this inpatient evaluation, a definitive diagnosis at the end isn’t always guaranteed. Therefore, predictor variables such as demographic information and psychological testing scores can help improve the accuracy of diagnosing PNES or epilepsy at the end of a patient’s EMU admission. Locke et al. have demonstrated that the SOM scale and SOM-C subscale on the Personality Assessment Inventory (PAI) are the best indicators for predicting PNES diagnosis, with an optimal cut score of T≥70 on both of these scales. The aim of the current study was to determine whether evaluating male and female performance separately on these relevant PAI scales improves the accuracy of diagnosing PNES. The results support the hypothesis, such that male optimal cut scores on the SOM and SOM C scales are T=80 and T=75, respectively, and female optimal cut scores on the SOM and SOM C scales are T=71 and T=72, respectively. Utilizing the results of this study can help clinicians diagnose patients with PNES or epilepsy at the end of EMU evaluation with more certainty.
ContributorsCorallo, Kelsey Lynn (Author) / Lanyon, Richard (Thesis director) / Knight, George (Committee member) / Karoly, Paul (Committee member) / Barrett, The Honors College (Contributor) / School of Social Transformation (Contributor) / Department of Psychology (Contributor)
Created2015-05