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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 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
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
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
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
Description
Introduction: Depression is one of the most prevalent mental illnesses in the United States, and is characterized by feeling sad or empty most of the day, nearly every day (American Psychiatric Association, 2013). The experience of childhood trauma is one of many factors that may lead to depression, while trauma can also yield other adverse life outcomes, such as alcohol-related consequences (Felitti et al., 2001; Neumann, 2017). One of the specific aims of this investigation was to examine the direct influences of childhood trauma on depression. We also examined selected direct and indirect influences of childhood trauma on drinking outcomes through the potential mediating mechanism of depression. We examined three distinct drinking outcomes, 1) impaired control over drinking (i.e. the inability to stop drinking when intended), 2) heavy episodic drinking (four or more drinks on one occasion for men, four or more for women), and 3) alcohol-related problems. Methods: A survey was administered to 940 (466 women, 474 men) university students. Structural equation modeling was used to examine the data. Potential two- and three-path mediated effects were examined with the bias corrected bootstrap technique in Mplus (MacKinnon, 2008). Results: Emotional abuse was found to be positively associated with depression. In contrast, having an emotionally supportive family was found to be negatively associated with depression. Congruent with the Self-Medication Hypothesis, depression was found to be positively associated with impaired control over drinking. Physical neglect was found to be positively associated with impaired control. Lastly, emotional abuse was found to be indirectly linked to increased heavy episodic drinking and alcohol-related problems through depression and impaired control.
ContributorsBobel, Emily Rebecca Leslie (Author) / Patock-Peckham, Julie (Thesis director) / Glenberg, Arthur (Committee member) / Karoly, Paul (Committee member) / Department of Psychology (Contributor) / School of Criminology and Criminal Justice (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
Description
Self-control has been shown to predict both health risk and health protective outcomes. Although top-down or “good” self-control is typically examined as a unidimensional construct, research on “poor” self-control suggests that multiple dimensions may be necessary to capture aspects of self-control. The current study sought to create a new brief survey measure of top-down self-control that differentiates between self-control capacity, internal motivation, and external motivation. Items were adapted from the Brief Self-Control Scale (BSCS; Tangney, Baumeister, & Boone, 2004) and were administered through two online surveys to 347 undergraduate students enrolled in introductory psychology courses at Arizona State University. The Self-Control Motivation and Capacity Survey (SCMCS) showed strong evidence of validity and reliability. Exploratory and confirmatory factor analyses supported a 3-factor structure of the scale consistent with the underlying theoretical model. The final 15-item measure demonstrated excellent model fit, chi-square = 89.722 p=.077, CFI = .989, RMSEA = .032, SRMR = .045. Despite several limitations including the cross-sectional nature of most analyses, self-control capacity, internal motivation, and external motivation uniquely related to various self-reported behavioral outcomes, and accounted for additional variance beyond that accounted for by the BSCS. Future studies are needed to establish the stability of multiple dimensions of self-control, and to develop state-like and domain-specific measures of self-control. While more research in this area is needed, the current study demonstrates the importance of studying multiple aspects of top-down self-control, and may ultimately facilitate the tailoring of interventions to the needs of individuals based on unique profiles of self-control capacity and motivation.
ContributorsPapova, Anna (Author) / Corbin, William R. (Thesis advisor) / Karoly, Paul (Committee member) / Brewer, Gene (Committee member) / Arizona State University (Publisher)
Created2016
Description
There is a robust association between psychosis and cannabis use, but the mechanisms underlying this relation are poorly understood. Because both psychosis and cannabis use have been linked to cardiovascular problems, it is possible that cannabis use exacerbates an underlying vascular vulnerability in individuals prone to psychosis. To investigate microvascular differences in individuals with psychotic symptoms and cannabis use, the current study tested associations between psychotic-like experiences, cannabis use, and retinal vessel diameter in 101 young adults (mean age=19.37 years [SD=1.93]). Retinal venular diameter did not differ between participants with (M=218.08, SD=15.09) and without psychotic-like experiences (M=216.61, SD=16.18) (F(1, 97)=0.01, p=.93) or between cannabis users (M=218.41, SD=14.31) and non-users (M=216.95, SD=16.26) (F(1, 97)=0.37, p=.54). Likewise, mean retinal arteriolar diameter did not differ between participants with (M=157.07, SD=10.96) and without psychotic-like experiences (M=154.88, SD=9.03) (F(1, 97)=0.00, p=.97). However, cannabis users had statistically significantly wider retinal arterioles (M=159.10, SD=9.94) than did non-users (M=154.29, SD=10.20) (F(1, 97)=5.99, p=.016), and this effect was robust to control for covariates. There was no evidence of an interaction between psychotic-like experiences and cannabis use in predicting retinal vessel diameter. These results indicate that cannabis use is associated with microvascular differences in young adulthood. Given current trends toward legalization of recreational cannabis use, future research should explore these differences and their potential consequences for cardiovascular health.
ContributorsHill, Melanie (Author) / Meier, Madeline H (Thesis advisor) / Karoly, Paul (Committee member) / Brewer, Gene (Committee member) / Arizona State University (Publisher)
Created2016