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Cognitive Coping Strategies with Chronic Back Pain Patients

Description: Low back pain has long been estimated to be the most prevalent and debilitating source of chronic pain. The present study first reviews the literature addressing the various theories of pain, the physiological and psychological variables important in pain research, and the psychotherapeutic approaches that have been used to date to reduce pain. Thirty-seven hospitalized chronic back pain patients were administered the cold-pressor test and a medical pain stimulus procedure which was medically relevant to their back pathology. A card-sort method was utilized in order to assess the coping strategies employed by the patients during these two pain stimulus tasks. These procedures were repeated following treatment. Coping strategies used by patients during the two pain tasks were compared. Results demonstrated that there was a significant difference in the manner in which patients coped with the two types of pain. Cold-pressor measures of pain threshold and tolerance were not significantly different between pretreatment and post-treatment. These measures were also not positively correlated with treatment outcome. A multiple regression approach demonstrated that particular coping strategies were significantly predictive of treatment outcome. The medical pain stimulus procedure was found to provide more significant pedictor variables than the cold-pressor test. At pre-treatment assessment, patients who relied on dramatized coping strategies were less likely to be successful in treatment. Breathing activity and pain acknowledgement were positive coping techniques highly predictive of successful outcome in this study. The use of computers for assessment and other recommendations for future research were discussed.
Date: December 1985
Creator: Hinnant, Donald Wayne

Mirthful Laughter and Directed Relaxation: a Comparison of Physiological Response

Description: The differences among certain physiological changes occurring in response to mirthful laughter, directed relaxation, and verbal speech were investigated. These changes included amount of muscle tension, as measured with surface electromyography, in the forehead and in the upper body as recorded from the forearms bilaterally, peripheral surface skin temperature, heart rate, and respiration rate. The study sought to determine whether the net effect of laughter, as measured on these five variables after a three-minute refractory period, is a more relaxed state than existed before the laughter. Determination of the similarity between the changes following laughter and the changes following directed relaxation was made in comparison with the changes following verbal speech. Factors of prior anxiety, pre- and post-self-esteem levels, humor level, and laughter intensity were examined. Historical and theoretical perspectives were reviewed, as well as the known information on physiological responses to laughter.
Date: August 1985
Creator: Woods, Barbara Jane Simmons

Temperature Biofeedback and Visual Imagery in the Treatment of Migraine Headaches

Description: After an initial four week baseline period, during which headache activity and medication consumption were monitored, 28 migraineurs were randomly assigned to one of the following groups: (a) the biofeedback temperature warming group, (b) the visual imagery group, (c) the combined treatment group, or (d) the comparison group. All four groups continued to monitor their headache activity and medication consumption during the eight week treatment period and the eight week follow-up period. A two way analysis of variance computed on groups over time indicated a significant decrease in headache activity and medication consumption. During the follow-up period (a) the combined treatment group had significantly fewer headaches than the biofeedback group or the comparison group and (b) the visual imagery group and the combined treatment group had significantly fewer headache hours than the biofeedback group or the comparison group. These results do not appear to be attributable to differences between groups on the amount of time spent in home practice or subjective ratings of relaxation. There was no consistent relationship between increases in finger temperature and headache activity improvement. Decreases in powerful other scores, as measured by the Health Attribution Test, and increases in subjective ratings of internal control were consistent with a reduction in headache activity and medication consumption.
Date: December 1985
Creator: Clark, Susan Matthews

Assessment of Brain Damage: Discriminant Validity of a Neuropsychological Key Approach with the McCarron-Dial System

Description: The present study investigates the predictive accuracy of a key approach to interpretation of the verbal-spatialcognitive (VSC) and sensorimotor (SM) factors of the McCarron-Dial System (MDS). The subjects include 99 brain damaged and 30 normal adults. The following research questions are addressed: (a) Does the neuropsychological key classify brain damaged and non-brain damaged subjects at a level significantly above chance? (b) Among the brain damaged subjects, does the neuropsychological key identify right brain damage, left brain damage and diffuse brain damage at an accuracy level significantly above chance? (c) Is the neuropsychological key approach superior to the empirical model derived from discriminant function analysis in predictive accuracy? The neuropsychological key correctly classifies 90% of the cases as brain damaged and 90% of the cases as non-brain damaged, for a total of 89.9% predictive accuracy. The obtained Kappa coefficient of .74 is statistically significant. The key accurately classifies 71.4% of the brain damaged group as right damage, 70% as left damage, and 93.8% as diffuse damage, for a total predictive accuracy of 7 9.5%. The Kappa coefficient of .68 is statistically significant. Chi square analysis of the difference between the key approach and multiple discriminant function analysis reveals that no significant difference is present between the accuracy of the two approaches in differentiating between brain damaged and non-brain damaged, or in differentiating among left, right and diffuse brain damage. The results support the validity of a neuropsychological key approach to interpretation of the McCarron-Dial System, although cross-validation is indicated to confirm the stability of these results. Differences in sex, educational level and racial composition of the comparison groups may have affected the results obtained. Refinement of the key in future research and the addition of test instruments assessing memory, auditory processing, attention and emotional/behavioral variables are recommended.
Date: December 1985
Creator: Norton, Carole Lynn

A Comparison of Imagery Relaxation and an Educational Treatment Modality for Dysmenorrhea

Description: This study is a comparison of four treatments involving education and imagery relaxation for the amelioration of dysmenorrhea. Treatment was presented to 76 subjects by videotape during a one-hour session. A six month follow-up was performed using one of the original instruments, the Symptom Severity Scale (Cox & Meyer, 1978) and a questionnaire designed for the study. Analysis of the test instruments indicated a significant treatment effect for the educational group. The second most effective treatment was a combined treatment utilizing imagery relaxation and education, although this group did not produce significant results. The no-treatment control group was more effective in diminishing symptoms than the fourth group, imagery relaxation alone. The lack of effectiveness of the imagery relaxation treatment was hypothesized to be due to lack of reinforcement of the technique. The educational treatment modality offered the individual an opportunity to learn about many different etiological facets of dysmenorrhea, including biological, learning, and cognitive factors. The presentation also introduced the individual to several different treatment modalities in order to provide an armamentarium of effective methods for diminishing or eliminating dysmenorrhea. These results suggest that there is a need for education about dysmenorrhea before menarche, in order to prepare, prevent, treat, and cope with this syndrome.
Date: August 1986
Creator: Skewis, Sally Sweitzer

Anger Reduction in Closed Head Injured Individuals with Group Social Skills Training

Description: In the present study, an anger management treatment program was compared to a pseudo-social skills training program (self-help group) and waiting list control group to determine its effectiveness in reducing irritable/angry behavior in head injured subjects. Subjects consisted of 28 adults with previous head injury trauma who had difficulty with excessive irritability and anger. Subjects averaged 35.4 years of age and had an average of 8.9 years post head injury. Treatment consisted of 10 group sessions over a five week period. Anger management training was designed to teach subjects self management skills aimed at reducing the frequency of angry acting out behavior. Training methods included role playing, relaxation training, assertiveness training and cognitive restructuring. The pseudo-social skills training group was a self-help group designed to encourage discussion of irritability problems without teaching specific coping techniques. To assure some degree of homogeneity in cognitive abilities among subjects, minimum eligibility scores were required on five subtests of the Wechsler Adult Intelligence Scale - Revised and the Peabody Picture Vocabulary Test. Dependent measures were pre and posttreatment scores obtained from five categories of the Katz Adjustment Scale - Relative form: belligerence, negativity, general psychopathology, social obstreperousness, and social role functioning. In addition, pre and posttreatment recordings of observed angry/irritable behavior in the subjects were obtained from a significant other. Results failed to reveal statistically significant differences on the dependent measures between the three study groups. In addition, analysis failed to reveal any significant variables that predicted outcome. It is evident that much more organized research is needed to further investigate the possibilities of treatment for various problems encountered by those with head injuries.
Date: May 1990
Creator: Nicolette, Myrna K. (Myrna Kay)

Pediatric Feeding Disorders: A Controlled Comparison of Multidisciplinary Inpatient and Outpatient Treatment of Gastrostomy Tube Dependent Children

Description: The efficacy of multidisciplinary inpatient and outpatient treatment for transitioning children with severe pediatric feeding disorders from gastrostomy tube dependency to oral nutrition was investigated utilizing caloric and fluid intakes as an outcome measure. The study involved 29 children ages 12 months to 5 years of age with gastrostomy tube dependency. Treatments were provided by speech therapists, occupational therapist, dietician and psychologist for a 30 day period. Four treatment groups were evaluated and average intakes compared at 4 observation periods including pretreatment, initiation of treatment, completion of treatment at 30 days and 4 month follow-up. Children receiving inpatient treatment for feeding disorders evidenced significant differences in oral caloric intake from pretreatment to discharge than outpatient treatment (p < .01) and wait list control group (p = .04). Oral caloric intake from discharge to 4 month follow up yielded no significant differences indicating treatment gains were maintained. Change in environment and caretaker showed a significant effect for the inpatient group (d = 1.89). Effects of treatment by age and weight at 4 month follow up were also analyzed.
Date: December 2010
Creator: Cornwell, Sonya L.

Hierarchical neuropsychological functioning in pediatric survivors of acute lymphoblastic leukemia.

Description: Acute lymphocytic leukemia (ALL) is one of the most common types of pediatric cancers. Improvements in treatment within the last 20 years have resulted in reduced mortality and a greater focus upon quality of life. Several researchers have documented neuropsychological impairments in children following treatment for ALL; however, there have not been any comparative studies documenting differences in neuropsychological functioning based upon treatment modality despite the documented effects of radiation therapy and combined radiation/chemotherapy upon the developing brain. In addition, past studies have focused on unitary measures, ignoring the hierarchical relationship between basic cognitive functions and more abstract skills. This study examined the neuropsychological functioning of 81 children who were treated for ALL at a metropolitan children's hospital. All children were tested a minimum of two years after the final treatment session and were administered the NEPSY. Results do not support any interactions or main effects with the exception of the age of the child at diagnosis. Children diagnosed prior to the age of 5 showed greater impairments on tasks measuring attention, memory, and visuospatial reasoning in comparison to peers diagnosed after age 6.
Date: August 2007
Creator: Larery, Angela R. D.

Predictors of Successful Aging: Associations between Social Network Patterns, Life Satisfaction, Depression, Subjective Health, and Leisure Time Activity for Older Adults in India

Description: Aging in the new millennium is greatly influenced by both global and region-specific factors. In Asia, the aged population is increasing at a faster rate than both Europe and North America, making issues related to older adults needing immediate attention of researchers & planners. This study aims at identifying the predictors of successful aging. Successful aging as a construct often has an integration of good social engagement, sense of purpose in life, maintaining cognitive capacity and functional autonomy. One hundred fifty participants in India completed the Life Satisfaction Questionnaire, Geriatric Depression Scale, Health Awareness Schedule, and the Leisure Time Activity Record. Firstly, it is mainly evident that social support network is larger for older adults residing in a joint family as compared to a nuclear family setup. Further, married males in a joint family have the largest network size compared to all the other groups. The study however, reveals an interesting reverse trend of widowed females having a larger network size compared to widowed males. Statistical analysis found measures of successful aging to be highly correlated with each other, with subjective health and depression being significant predictors of life satisfaction. Further, life satisfaction, depression levels, and leisure time activities were all significant predictors of subjective health. Significant gender differences were found on life satisfaction and subjective health with married males living in joint families reporting the highest scores on all the above measures. In addition, widowed women showed the highest levels of depression, which relates to their lower life satisfaction, poor ratings of health and low involvement in leisure activities. The study achieved a higher understanding of successful aging and presented a novel finding of educational level being significantly correlated with all measures of successful aging. This study is the first of its kind to measure successful aging in an ...
Date: August 2007
Creator: Varshney, Swati

Transportation trauma and psychological morbidity: Anxiety, depression, PTSD and perceived control in a hospitalized sample.

Description: Transportation-related collisions are ubiquitous and often traumatic. Identifying post-collision psychological distress and the characteristics of the collision survivor that lead to distress are vital to the development of early and appropriate interventions. The goals of this study were: 1) to use a questionnaire as opposed to a typical diagnostic interview, 2) to confirm that psychological distress is present in currently hospitalized transportation-related collision survivors, 3) to confirm that different types of distress co-occur, 4) to determine if distress is more likely to occur in those who have had prior distress, and 5) to explore the relationship between symptoms of distress and perception of control by self, others, and God/Higher Power of past, present, and future collision-related events. Subjects were 100 English speaking adult inpatients, 16 years and older, who were less than 3 weeks post-injury, and receiving some rehabilitation. Participants completed a questionnaire which included the Center for Epidemiologic Studies Depression Scale (CES-D), Beck Anxiety Inventory (BAI), and Davidson Trauma Scale (DTS) as well as questions regarding demographics, details of the collision/injury, alcohol/drug use, pain, past and present stressors, social support, and perceptions of life change. Information about head injury and collision-concurrent alcohol and/or drug use was collected from the patient's medical chart. Compared to other traumatic experiences (e.g., physical/sexual abuse, war combat), transportation-related collisions share the characteristics of being sudden, unexpected, relatively brief in duration, and potentially lethal. Prior studies used diagnostic interviews to identify psychological distress in post hospitalized collision survivors. This study used questionnaire-based depression, anxiety, and trauma symptom inventories in a currently hospitalized sample and included head injured patients. As hypothesized there was a significant correlation between the CES-D total score and the BAI total score [Hypothesis 1], the DTS total score [Hypothesis 2], and collision concurrent alcohol and/or drug use (as indicated by medical chart ...
Date: August 2007
Creator: Biggs, Quinn M.

Boston Naming Test with Latencies (BNT-L)

Description: Although most people have experienced word-finding difficulty at one time or another, there are no clinical instruments able to reliably distinguish normal age-related effects from pathology in word-finding impairment. Two experiments were conducted to establish a modified version of the Boston Naming Test (BNT) that includes latency times, the Boston Naming Test of Latencies (BNT-L), in order to improve the instrument's sensitivity to mild to moderate word-finding impairment. Experiment 1: Latency times on the 60-item BNT (Goodglass et al., 2001) for 235 healthy adults' ages 18-89 years were collected on a representative sample. Qualitative features of the BNT items, statistical analyses, IRT, and demographic considerations of age, gender, education, vocabulary, race and culture, helped create a reduced BNT-L version with 15 of the most discriminating items. Statistically sound and sophisticated normative tables are provided that adjust for unseen covariates. Response latencies did not indicate earlier age-related decline in an optimally healthy sample. Experiment 2: Twenty-three patients referred for neuropsychological testing were administered the BNT-L. Patients referred for evaluation of mild cognitive impairment or possible dementia produced significantly different response BNT-L latencies from the healthy sample whereas patients referred for mild brain injury evaluation did not. Normal word-finding problems were discussed in terms of serial stage models of lexical access, as well as in terms of automatic and controlled cognitive processes in younger and older adults. Statistical process for creating a psychometric instrument using latencies is illustrated.
Date: May 2007
Creator: Budd, Margaret Anne

Factor Analysis of the Clinical Scales on the Luria-Nebraska Neuropsychological Battery, Form II

Description: The Luria-Nebraska Neuropsychological Battery (LNNB) was published in 1980 as an attempt to provide clinicians with a standardized version of the neuropsychological assessment and diagnostic procedures proposed by A. R. Luria and A, L. Christensen. Research on the LNNB included a series of factor analyses for each of eleven clinical scales. The analyses were completed on the combined scores obtained from a sample of normal, brain-damaged, and psychiatric populations. A second version of the LNNB was published in 1985 as a largely parallel version of Form I, but included changes in stimulus materials, administration procedures, and scoring procedures. The present study completed factor analyses on same eleven clinical scales using data generated with the newer LNNB Form II. The statistical procedures and criteria employed in the present investigation were identical to those used earlier on Form I to allow for comparisons between the two resulting sets of factor structures. The patient populations were different, however, in that all subjects in the current study were receiving inpatient care in a private psychiatric hospital which specializes in long-term treatment. Despite the changes in materials and procedures and the difference in subject parameters, the factors identified in the present investigation are similar to those seen in the Form I studies. However, two trends were observed when comparing the two sets of factor structures. First, in the present study several items were excluded from the statistical procedures because they were performed perfectly by almost everyone and the resulting scores lacked statistical variance. Second, more homogenous factors were obtained with the Form II analysis. That is, some of the complex LNNB Form I factors were reduced to two or more simpler factors. The results of the study lend support to Luna's conceptual model of higher cortical function and to the reliability of the LNNB as ...
Date: August 1987
Creator: Von Seggern, Heather Beth

The Role of Self-Efficacy in Predicting Adherence/Compliance to Health Behavior Regimens

Description: The purpose of the present study was to investigate the relationship between Self-Efficacy Theory (Bandura, 19 77) and adherence to health behavior prescription. A self report Self-Efficacy Questionnaire was developed to assess levels of efficacy. Dietary adherence was determined by self report as well as body composition assay and measurement of body weight. Levels of exercise compliance were assessed by self report in addition to a treadmill test.
Date: May 1985
Creator: Cline, Mark H. (Mark Holley)

Aerobic Conditioning: Effects on Locus of Control, Mood States, and General Well-Being

Description: This study was conducted to examine the sequelae of cardiovascular conditioning on locus of control, short-term mood, and psychological well-being. A pre-post test design, with control group, was used to measure the effects of a one month program of aerobic conditioning on adult volunteers. This study also sought to examine ways in which fitness changes covaried with psychological changes, and to describe patterns of change taking place during aerobic conditioning.
Date: December 1987
Creator: Bertschler, John Joseph, 1948-

A Measure of Dependency in Patients with Chronic Illness: Clinical Ecology

Description: This study briefly reviews both historical and recent conceptualizations of dependency. In particular, it focuses on this concept's applicability to patients with chronic illnesses, especially those with allergies. Type and degree of dependency were seen as an important factor in the approach to the medical and psychological treatment of clinical ecology patients. The purpose of the study was to develop an objective measure of dependency which could quickly identify patients whose dependency conflicts interfere with the treatment process. The study was divided into three phases. In the first phase test responses by 84 inpatients to the CAQ, MMPI, and the HAT as well as historical and demographic data were analyzed by a series of stepwise discriminant analysis. The 53 resulting items were examined for those which most concisely discriminated between the two identified groups (pathologically dependent and nonpathologically dependent). These 15 items were used to test 120 additional patients in phase II. Fourteen items were retained and the coefficients obtained classified the patients in phase I and II with a 98.81 percent and 94.17 percent degree of accuracy respectively. These classification coefficients were used to classify another 30 patients in phase III with a 96.67 percent rate of accuracy. These results provide exceptionally strong support for the hypothesis that group classification can be obtained through the use of an objective screening instrument. The pathologically dependent patients tend to focus on disease, frequently are unemployed, have histories of childhood illnesses, have limited emotional controls, are depressed, ambivalent, and distrustful. Additionally, they experience difficulty establishing goals or accepting personal responsibility. Those patients identified as nonpathologically dependent exemplify the more positive aspects of these traits. The pathologically dependent patients appear to be caught in a dilemma between wellness and satisfaction of dependency needs. While all patients need an organized approach to treatment, the ...
Date: December 1985
Creator: Jones, Frances McManemin

Family Environment, Social Support, and Psychological Distress of Women Seeking BRCA1 and BRCA2 Genetic Mutation Testing

Description: Shared characteristics and predictors of psychological distress are beginning to be identified in research on women seeking genetic testing for BRCA1 and BRCA2 gene mutations. This study further explored patterns of psychological distress for 51 community women waiting to receive such genetic test results. There was no significant relationship between psychological distress and family cancer history, personal cancer history, social support networks, and family environment. Women in this sample tended to rely more on females and relatives for support than males and friends. Social support satisfaction was not related to gender or number of relatives providing support. Thirty-four of the 36 women classified on the family environment type were from Personal Growth-Oriented families. Comparisons with normal and distressed family means revealed increased cohesion and expressiveness with decreased conflict, indicative of supportive family environments. Limitations and implications are discussed.
Date: August 2002
Creator: Keenan, Lisa A.

Improving the Definition of Exercise Maintenance: Evaluation of Concepts Related to Adherence

Description: Physical activity has been demonstrated in the literature as an effective way to reduce the risk for development of chronic disease. The Transtheoretical Model (TTM) of behavior change has been developed as a means to predict and facilitate movement into healthier lifestyle behaviors. The model is centered on "stages of change", which describe a continuum of readiness to engage in a health behavior change. Stages contain temporal, qualitative, and quantitative characteristics. This was a six-month study that evaluated the effectiveness of stage-matched (theorized to be pertaining only to the maintenance stage of change) vs. generic (theorized to be pertaining to anyone, regardless of stage) newsletters in assisting subjects to attain the Maintenance stage of change. It also sought to identify further qualitative characteristics that can differentiate between the Action and Maintenance stages of change. Results indicated that monthly stage-matched newsletters were no more effective in helping subjects reaching Maintenance than were the generic newsletters. Exerciser self-schema was related to stages of change, but those relationships differed from baseline to six-month follow-up, indicating development of exerciser self-schema during the study period. Implications of this are discussed. Other concepts discussed included "structure" of change process, in that three new scores were developed and correlated with self-efficacy as well as intercorrelated. Motivation was also evaluated and compared across levels of success at adhering to exercise during a three-month period. Limitations of the study and implications are discussed.
Date: August 2002
Creator: Wilcox, Susan E.

Predicting Weight Loss in Post Surgical Laparoscopic Banding Patients

Description: The present study was a retrospective chart review (N=128) that investigated the efficacy of profiles derived from the three factors of the Eating Inventory® test (EI) - cognitive restraint, disinhibition, and hunger - to predict successful weight loss in post surgical laparoscopic banding patients at 6 and 9 months post surgery. Although the EI is commonly used in bariatric presurgical assessment, few studies have found consistent relationships between presurgical factor scores and subsequent weight loss in this population. Based on restraint theory, 7 profiles (high CR, super high CR, high D, super high D, high H, super high H, and null) were derived from the raw scores on the subscales of the EI and tested for weight loss predictive ability using direct logistic regression. Results were mixed with high CR, super high CR, and null profiles accurately predicting successful weight loss. Raw scores on the three factors (cognitive restraint, disinhibition, and hunger) were tested individually for predictive ability using direct logistic regression. Overall results indicated that the profile model accurately predicted more cases than the general factor model. This study significantly contributes to both the bariatric presurgical assessment literature and the restraint theory literature. Suggestions for future research are offered.
Date: May 2007
Creator: Frensley, Susan J.

Organization of Narrative Discourse in Children and Adolescents with Acute Traumatic Brain Injury

Description: Children with a recent history of TBI often demonstrate impaired memory, which can be affected by impaired attention, processing speed or impaired verbal information processing. The purpose of this study was to determine if qualitative differences exist among the narrative recall of TBI patients that is not adequately accounted for by standard scoring methods. Sixty-six TBI subjects ranging in age from 6 to 16 were given the Wide Range and Memory and Learning (WRAML) Story Memory subtest and selected subtests from the Wechsler Intelligence Scale for Children - Third Edition (WISC-III). Mean elapsed time since injury was 53 days. Recall of the story on the WRAML subtest was hand-recorded by the examiner. A supplemental scoring method accounted for differences in length, errors, and disorganization. Comparisons were made to a randomly selected control group consisting of 16 hospitalized subjects between 7 and 15 years with no history of head injury, neurological condition or event. Findings suggest the WRAML Story Memory subtest is relatively robust in providing information regarding the quality of recall, with the exception of not accounting for the addition of erroneous details. Subjects with both cortical and subcortical injuries were more likely to add superfluous details to their stories. Results also demonstrated significant differences between the TBI subjects and control group in how well the stories were recalled, primarily in the order of details recalled and in retention after a 30 minute delay. Location was not a significant predictor of narrative organization. Although using this comprehensive supplemental scoring system a regular basis has practical limitations, hand-recording the narrative takes relatively little time and does appear to provide useful additional information concerning the nature of the child's verbal memory difficulties. Furthermore, the more knowledgeable the child, parents and teacher are about these difficulties and about remediation strategies, the more likely ...
Date: May 2002
Creator: Thomas, Kathy Lee

Partner abuse: Health consequences to women.

Description: Intimate partner violence is endemic in the United States. According to the American Medical Association (1992), one-fifth to one-third of women will sustain violence from a partner or ex-partner in their lifetime. The relevant literature was organized by ICD-9-CM categories. This study examined the health consequences of partner abuse in a sample of community women using a sample consisting of 564 women in three ethnic groups. Because prior research has failed to account for variations by type of abuse on health consequences, this study assessed psychological abuse, violence and sexual aggression by women's partners. To determine whether or not different types of abuse had an effect on women's health, hierarchical regression analyses were conducted. The regression equations were calculated for women within each ethnic group to facilitate identification of similarities and differences and to control for ethnic differences in risk for specific diseases. The results were consistent with past research on health consequences of abuse and extended the prior literature by showing that psychological abuse had a pervasive effect on health conditions, distress and use of health care resources. Additionally, ethnic differences emerged. As expected, ethnicity appeared to function as a moderator. Clinical implications and recommendations are made for future research, suggesting the development of a new assessment tool for partner abuse screening.
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Date: December 2003
Creator: Warren, Ann Marie

Influence of executive function on medication adherence in neurologically impaired and non-impaired elderly.

Description: Medication non-compliance has become one of the most prevalent reasons for hospitalization and doctor's visits by the elderly. As the elderly population is more likely to have decreased cognitive abilities, it is suggested that neuropsychological factors, especially executive function, are more influential in medication non-compliance than once thought. This study looked at executive function performance on a traditional battery of neuropsychological tests, self-report of perceived ability to perform executive function tasks, and the newly developed Pillbox Test, a performance based IADL measure. The Pillbox Test is designed to replicate a type of medication-management specific IADL as a means to asses executive function. Standard executive function measures only tap a portion of executive function, but it is believed that the Pillbox Test incorporates all four theoretical domains of executive function. The multiple measures of executive function performance were compared in three prevalent subgroups of the elderly population (mixed neurological group, cardiac medical-control group, and healthy community-control group). Results found significant differences, where the community-control and cardiac groups outperformed the mixed neurological group on the large majority of executive function tasks. Smaller differences were also noted between the community-control and cardiac groups and between the cardiac and mixed neurological groups. Together, these findings provide support for the diagnostic prevalence of mild cognitive impairment in the older adult cardiac population. Results also indicated the level of executive dysfunction on standardized neuropsychological measures was highly correlated with performance on both the Pillbox Test and the IADL based Direct Assessment of Functional Status measure. Finally, the Pillbox Test has moderate to strong ecological validity with 75% sensitivity and 87.5% specificity for five or more errors on this test.
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Date: August 2006
Creator: Zartman, Andrea Leigh

Changes in Quantitative EEG and Low Resolution Tomography Following Cranial Electrotherapy Stimulation.

Description: The effects of cranial electrotherapy stimulation (CES) on human EEG and brain current density were evaluated by quantitative electroencephalography (qEEG) and low resolution brain electromagnetic tomography (LORETA). A total of 72 research subjects were provided with a single session of CES, 38 were provided with 0.5 Hz CES while 34 were provided with 100 Hz CES. The qEEG paired t-tests revealed that in both frequencies of CES there was a significant (.05) increase in alpha relative power with concomitant decreases in delta and beta relative power. The 0.5 Hz CES decreased a wider frequency range of delta activity, while the 100 Hz CES decreased a wider frequency range of beta activity; suggesting some difference may exist in the EEG response to different frequencies of CES. The changes found in qEEG relative power were consistent with the affective and cognitive effects of CES reported in the literature, such as increased relaxation and decreased anxiety. Statistically significant changes for qEEG values other than relative power, such as coherence, amplitude asymmetry, phase lag and power ratios were also found. The LORETA paired t-tests found statistically significant (.05) increases in cortical and subcortical theta and alpha frequency current density with concomitant decreases in delta and beta current density. The effects of CES on current density varied by frequency, but did not show a differential in response based on proximity to the contacts, or structures within the brain. Statistically significant changes in current density were found in all 2394 gray matter voxels represented by LORETA, indicating a whole brain response to the CES stimulus. The qEEG and LORETA findings revealed that a single 20-minute session of CES does have a significant effect on the cortical and subcortical activity of the human brain resulting in activity consistent with decreased anxiety and increased relaxation.
Date: August 2006
Creator: Kennerly, Richard C.

Pathophysiology and Racial/Ethnic Disparities in the Progression of Metabolic Syndrome

Description: Disparities exist in the U.S. between the health status of African American and Hispanic individuals and the health status of non-Hispanic Caucasian individuals across all age groups. Those minority individuals age 55 and over are more likely to suffer from specific health disparities in areas such as diabetes, heart disease, and cancer than their white majority counterparts. Among the most common chronic disorders experienced within this age group are obesity, type II diabetes and cardiovascular disease, all three of which collectively form what has recently become known as metabolic syndrome. As of 2004, metabolic syndrome is diagnosable once criteria are clinically significant for a variety of different risk factors designated by the World Health Organization. However, like many syndromes these criteria are not stable across individuals, and leaves variability between individuals being diagnosed. It has been seen that each of the above mentioned racial/ethnic groups experience the individual risk factors at disproportionate rates, making it plausible that metabolic syndrome could be experienced in distinctly different ways depending upon racial/ethnic background. Using two nationally representative data sets, it is first largely evident that African American and Hispanic individuals are reaching higher peak rates of diabetes and cardiovascular disease much earlier in age than are non-Hispanic Caucasian individuals. The study goes on to reveals that the metabolic syndrome appears to follow one underlying progressive syndrome that begins with obesity and progresses towards heart disease. Each of the racial/ethnic groups experience significantly different progressions of the syndrome across time. Behavioral analysis found significant differences in health behaviors across the three groups; however a more pervasive lack of initiative in practicing preventive health behaviors is also present. The study achieved a higher understanding of individual differences within metabolic syndrome and insight into how and at what time in the lifespan health services can be ...
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Date: August 2006
Creator: O'Neill, Amy E.

NEPSY profiles in children diagnosed with different ADHD subtypes.

Description: The purpose of this study was to determine if attention-deficit/hyperactivity disorder (ADHD) subtypes (predominantly hyperactive/impulsive, ADHD-HI; predominantly inattentive, ADHD-IA; combined, ADHD-C) exhibit distinct neuropsychological profiles, using the Attention and Executive Function subtests of the Developmental Neuropsychological Assessment, (NEPSY) and the omission and commission scores obtained on the Conners' Continuous Performance Test-II (CPT-II), a test that assesses attention processes. The sample was selected using archival data collected in a neurodevelopmental clinic over the past decade and consisted of 138 children between the ages of 6 and 12 years old. Using the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV) criteria, the children were placed in either the ADHD-HI (n = 40), ADHD-IA (n = 35), or ADHD-C (n = 36) group, or a symptom free comparison group (n = 27). It was hypothesized that children with elevations on the impulsivity/ hyperactivity (ADHD-HI and ADHD-C) scale would be impaired on measures of inhibition and those with elevations on the inattention scale (ADHD-IA and ADHD-C) would be impaired on tests of attention, vigilance, and other executive functions. A one-way multivariate analyses of variance (MANOVA) was conducted (Group X Task), with significant results for overall main effect for group on the 7 dependent variables post hoc tests using the Tukey's honestly significant difference (HSD) revealed the following: the ADHD-HI group scored significantly lower on tests that require behavioral inhibition processes (Knock and Tap, Statue and CPT-Commission errors). The ADHD-IA group scored significantly lower on tests of problem-solving and planning (Tower) but not on tests of attention as was expected. The ADHD-C group scored significantly lower on tests of inhibition, attention, and other executive functions (Auditory Attention Response Set, Visual Attention, Tower, Knock and Tap, Statue, and CPT-Omission and CPT-Commission errors). Overall results suggest that the NEPSY Attention and Executive Function subtests are ...
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Date: December 2006
Creator: Couvadelli, Barbara