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Cognitive Performance as a Function of Sleep Disturbance in the Postpartum Period

Description: New mothers often complain of impaired cognitive functioning, and it is well documented that women experience a significant increase in sleep disturbance after the birth of a child. Sleep disturbance has been linked to impaired cognitive performance in several populations, including commercial truck drivers, airline pilots, and medical residents, though this relationship has rarely been studied in postpartum women. In the present study 13 pregnant women and a group of 22 non-pregnant controls completed one week of actigraphy followed by a battery of neuropsychological tests and questionnaires in the last month of pregnancy (Time 1) and again at four weeks postpartum (Time 2). Pregnant women experienced significantly more objective and subjective sleep disturbance than the control group at both time points. They also demonstrated more impairment in objective, but not subjective cognitive functioning. Preliminary analyses indicated increased objective sleep fragmentation from Time 1 to Time 2 predicted decreased objective cognitive performance from Time 1 to Time 2, though small sample size limited the power of these findings. Implications for perinatal women and need for future research were discussed.
Date: August 2015
Creator: Wilkerson, Allison K.

Combining Select Blood-Based Biomarkers with Neuropsychological Assessment to Detect Mild Cognitive Impairment among Mexican Americans: A Molecular Neuropsychology Approach

Description: Mexican Americans face a significant health disparity related to the development of Mild Cognitive Impairment (MCI) when compared to other ethnic groups. Recent work has documented the utility of utilizing blood-based biomarkers in the detection of amnestic MCI among this population. Efforts to enhance the utility of biomarkers in detecting disease through the inclusion of select neuropsychological measures, an approach termed Molecular Neuropsychology, has shown promise. The present study sought to utilize the molecular neuropsychology approach and examine biobanked serum samples as well as neuropsychological assessments from the Health and Aging Brain among Latino Elders (HABLE) study. Random Forest analyses were conducted to determine the proteomic profile of MCI. Then separate linear regression analyses were conducted to determine the variance accounted for by the biomarkers within the select neuropsychological measures. Trail Making Test Part B was identified as having the least amount of variance and was combined with top five biomarkers within the MCI proteomic profile to create a biomarker-cognitive profile for detecting disease presence. This same method was applied to the amnestic and non-amnestic forms of MCI. The overall biomarker-cognitive profile was shown to be 90% accurate in the detection of MCI, with no significant increase when demographic variables were included into the model. Among amnestic MCI cases, the detection accuracy of the biomarker-cognitive profile was 92% and increased to 94% upon inclusion of demographic variables.
Date: August 2017
Creator: Edwards, Melissa

Community-based Participatory Research: HIV in African American Men Who Have Sex with Men

Description: To date, traditional behavioral interventions have done little to reduce the prevalence and transmission of HIV among African American men who have sex with men (AAMSM), a highly at risk group. Some researchers theorize that the lack of success may be because these interventions do not address contextual factors among AAMSM. Community-based participatory research (CBPR) is one approach to research with the potential to lead to effective interventions in the future. CBPR is a collaborative, mixed-methods and multidisciplinary, approach to scientific inquiry, which is conducted with, and within, the community. The current study follows the CBPR approach to engage and develop a relationship with the African American communities in the Dallas/Fort Worth Metroplex. Contextual issues were discussed in order to identify emerging themes regarding HIV health related issues among AAMSM to provide the groundwork for continued CBPR research and future interventions with AAMSM in the Dallas/Fort Worth Metroplex. To accomplish this goal, researchers began the CBPR process by conducting interviews and focus groups with a sample of approximately 62 (34 from key informant interviews, 28 from focus groups [gender balanced]) AIDS service organization leaders and workers, advocates, medical doctors and community members with first-hand knowledge of HIV health issues in the AAMSM community. Transcripts of these interviews and focus groups were analyzed to identify emerging themes at the societal (religious doctrine, African American Culture, age-related norms and stigma), community (education, religious views/policy and community norms) and individual (disclosure, personal identity, sexual behavior/risk, accessing care and communication) levels. This data was used to create a holistic narrative report that will be used to direct the community advisory board (CAB) and guide future research and interventions.
Date: August 2015
Creator: Miller, James MS

An Experimental Study of Bifurcated (Weekend and Weekday) and Unitary (Past Week) Retrospective Assessments of Sleep

Description: Discordance between weekday and weekend sleep schedules is common (Bonnet & Arand, 1995; Breslau, Roth, Rosenthal, & Andreski, 1997; Machado, Varella, & Andrade, 1998; Strauch & Meier, 1988; Tsai & Li, 2004). Brief retrospective self-report measures are essential for epidemiological research studies (Moul, Hall, Pilkonis, & Buysse, 2004), but self-reports are prone to error in recall, and the greater the variability in nightly sleep, the less reliable are retrospective reports (Babkoff, Weller, & Lavidor, 1996). More accurate self-report responses may be possible if measures prompt participants to consider variations in sleep schedules that are consistent (i.e., weekday and weekend sleep schedules). The current study experimentally examined whether Bifurcated (Weekday and Weekend) retrospective assessments of sleep are more accurate than Unitary (Past Week) assessments. Participants were randomly assigned to complete one of the two versions (Bifurcated vs. Unitary) of the Sleep Questionnaire. One hundred and thirty-one participants were included in the analyses. Results of a a series of analyses demonstrated that the Bifurcated version of the Sleep Questionnaire provided more accurate and less variable estimates of total sleep time than the Unitary version of the Sleep Questionnaire. Differences between the versions of the Sleep Questionnaire for other sleep variables were less consistent, and the increased length of the Bifurcated version of the Sleep Questionnaire may have contributed to increased missing and unusable data in this group. Overall, the findings suggest that in both research and clinical work, retrospective measures that examine weekday and weekend sleep separately may offer advantages over retrospective measures that do not differentiate between weekday and weekend sleep.
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Date: August 2016
Creator: Sethi, Kevin J.

Forgiving the Unforgivable: Forgiveness in the Context of LGBT Partner Violence

Description: Intimate partner violence (IPV) in sexual and gender minority relationships is an underexplored and misunderstood phenomenon. Much of what has been investigated has explored IPV from a heterosexual lens, without taking into account the complexities of these relationship dynamics. Further, outcomes of IPV traditionally focus on negative sequelae, such as depression or anxiety. In this study, we examined the propensity to forgive partner abuse as a means of adaptively coping with the trauma. Further, we looked at resilience as a possible factor in the process of forgiveness. We hypothesized that psychological resilience significantly moderates the forgiveness process in sexual and gender minorities who have experienced IPV. Our sample of 77 gender- and sexual-minority participants completed measures of psychological and physical IPV, resilience, and forgiveness. A regression analysis found our model accounted for 36% of the variance in forgiveness of self (adj. R2=.36, F (4, 72) = 10.34, p < .01) and 20% of forgiveness of others (adj. R2=.20, F (4, 72) = 5.01, p < .01). However, there was no significant moderating effect, nor was IPV a significant contributor to forgiveness. Results suggest trauma does not influence one’s likelihood to forgive, though some personal trait, such as resilience, is more likely to contribute to the forgiveness process. Implications are discussed.
Date: August 2015
Creator: Lopez, Eliot Jay

The Impact of Observational Learning on Physical Activity Appraisal and Exertion Following Experimental Back Injury and the Role of Pain-Related Fear

Description: Chronic low back pain (CLBP) is one of the most prevalent and disabling health conditions in the US and worldwide. Biomedical explanations of acute injury fail to account for why some individuals experience remission of pain and restoration of physical function while others do not. Pain-related fear, accompanied by elevated appraisals of physical exertion and avoidance of physical activity, has emerged as a central psychosocial risk factor for transition from acute injury to chronic pain and disability. Research has indicated that these pain-related factors may be maintained through observational learning mechanisms. To date, no studies have experimentally examined the role of observational learning and pain-related fear in the context of actual musculoskeletal injury. Accordingly, the present study examined the impact of observational learning and pain-related fear on activity appraisals and exertion following experimentally- induced acute low back injury. Healthy participants' appraisal of standardized movement tasks along with measures of physical exertion were collected prior to and following a procedure designed to induce delayed onset muscle soreness (DOMS) to the lower back. Following induction of DOMS, participants observed a video prime depicting CLBP patients exhibiting either high or low pain behavior during similar standardized movements. In line with hypothesized effects, participants assigned to the high pain behavior prime demonstrated greater elevation in pain and harm appraisals as well as greater decrement in physical exertion. Further in line with hypotheses, significant changes in appraisal and physical performance following the high pain behavior prime were only observed among participants endorsing high pain-related fear during baseline assessment. Discussion of findings addresses potential mechanisms of action as well as study limitations and direction for future research.
Date: August 2017
Creator: Guck, Adam

A Mixed Methods Approach to Exploring Social Support and Resilience in Coping with Stigma and Psychological Distress among HIV-Positive Adults

Description: Since its emergence in the U.S., HIV has been a stigmatized illness. People living with HIV (PLH) are a minority and prone to psychological distress and poor mental health outcomes due to HIV-related stigma. PLH who identify with another minority group in addition to being HIV-positive (e.g., gay, African-American) experience multiple forms of oppression or layered stigma. Affirmative social support and resilience are negatively associated with HIV-stigma and are important coping resources for PLH. We used an explanatory sequential mixed methods design study involving a quantitative survey phase and a qualitative interview phase. We explored whether social support and resilience (Positive Psychological Resources) mediate or moderate the relationship between HIV Stigma and Psychological Distress among HIV-positive adults using partial least squares (PLS) path modeling and multiple regressions. Via PLS, we found Positive Psychological Resources partially mediated the relationship between HIV Stigma and Psychological Distress: the path between HIV Stigma and Psychological distress reduced (from t = 5.49, p = .000 to t = 2.39, p = .000) but remained statistically significant. Similarly, via regression, the Sobel test was significant (Sobel = .26, SE = .07, z = 3.63, p = .000). However, moderation was not found (HIV Stigma x Positive Psychological Resources β = .05, t = .66, p = .508). Overall, our quantitative survey and qualitative interview data were consistent. We anticipate that our findings will inform strengths-based therapeutic interventions to mitigate stress and stigma among PLH.
Date: August 2017
Creator: Fritz, Sarah-mee

Nice Dissertation, for a Girl: Cardiovascular and Emotional Reactivity to Gender Microaggressions

Description: Gender microaggressions are normative messages that communicate harmful stereotypes or attitudes towards women. Research suggests that being the target of microaggresions may contribute to negative mental and physical health outcomes. The current study examined how gender microaggressions affect emotional and physiological reactivity as well as performance on a working memory task. Results indicated condition (i.e., control vs. sexual objectification microaggression vs. denial of sexism microaggression) did not have a significant affect on reactivity or performance. Issues of population bias and essentialism may have played an important role in study findings. Future directions are discussed.
Date: August 2015
Creator: Prather, Courtney C.

Nightmare Disorder Prevalence as Defined by the DSM-5 in a College Sample

Description: The nightmare prevalence literature to date has largely focused on nightmare episode severity (i.e. frequency), with 8%-87% of individuals reporting these events in the past week to year. While this has helped to determine the prevalence of these events, focus on the episode severity alone is problematic because it means little is known about the actual prevalence of nightmare disorder. Moreover, focus on episode severity likely overestimates the actual prevalence of clinically significant nightmares while also obscuring clinically significant consequences of the disorder. Understanding the prevalence of nightmare disorder can help guide treatment planning and interventions. The present study recruited UNT undergraduates (N = 372; 351 analyzed) and managed all participant data using Research Electronic Data Capture (REDCap). The present study aimed to determine the prevalence of nightmare disorder, as stated in the DSM-5, to facilitate accurate characterization of the disorder. Additionally, as part of the secondary aim the influence of gender on nightmare disorder status and psychological wellbeing as measured by psychological and sleep outcome variables was examined. Finally, comparisons of individuals with DSM-5-defined nightmare disorder to those without the disorder were conducted on previously examined correlates (e.g., trauma symptoms, depression).
Date: August 2017
Creator: Estevez, Rosemary

Racial Microaggressions: Relationship to Cardiovascular Reactivity and Affect Among Hispanic/Latinos and Non-Hispanic Whites

Description: Racial microaggressions are a type of perceived discrimination entailing a brief pejorative message by a perpetrator, whether verbal or nonverbal, intentional or unintentional, about a target person that operates below the level of conscious awareness. Research supports a relationship between perceived discrimination and worse mental and physical health outcomes, with the literature centered mainly on non-Hispanic blacks. Less research exists on how perceived discrimination, specifically racial microaggressions, affects the mental and physical health of Hispanic/Latinos. This study examined how exposure to racial microaggressions, using an experimental design whereby a confederate delivers two types of racial microaggressions, influences affect and cardiovascular reactivity (CVR) among Hispanic/Latinos and non-Hispanic whites. Results revealed that the experience of racial microaggressions did not evoke larger and longer lasting emotional and physiological arousal among Hispanic/Latinos and non-Hispanic Whites. Future directions are discussed.
Date: August 2015
Creator: Hoar, Mariana

The Role of Injury-related Injustice Perception in Adjustment to Spinal Cord Injury: an Exploratory Analysis

Description: Research has begun to explore the presence and role of health-related injustice perceptions in samples of individuals who experience chronic pain associated with traumatic injury. Existing studies indicate that higher level of injustice perception is associated with poorer physical and psychosocial outcomes. However, to date, few clinical populations have been addressed. The aim of the current study was to explore injustice perceptions in a sample of individuals who have sustained a spinal cord injury (SCI), as research suggests that such individuals are likely to experience cognitive elements characteristic of injustice perception (e.g., perceptions of irreparable loss, blame, and unfairness). The study explored the relationship between participants’ level of perceived injustice and several variables associated with outcomes following SCI (depression, pain, and disability) at initial admission to a rehabilitation unit and at three months following discharge. The Injustice Experience Questionnaire was used to measure injustice perceptions. IEQ was found to significantly contribute to depression and anger at baseline. IEQ significantly contributed to depression, present pain intensity, and anger at follow-up. The implication of these preliminary findings may be beneficial for development of future interventions, as many individuals in the United States experience the lifelong physical and psychological consequences of SCI at a high personal and public cost.
Date: December 2015
Creator: Garner, Ashley Nicole

Self-Control in Overweight and Obese Individuals: The Relationship of Dispositional Self-Control and Blood Glucose

Description: Currently, the etiology of obesity is conceptualized as a confluence of environmental, socioeconomic, behavioral, biological and genetic factors. With regard to behavioral factors, some have suggested that a failure of self-control may contribute to the difficulty of an overweight/obese individual because of their inability to resist food or maintain physical activity. Recent research proposed that self-control could be described as similar to a muscle that can be fatigued. Thus, if an individual engages in a self-control task they have lessened ability to utilize self-control on a subsequent task. Theory also suggests self-control may be fueled by a finite resource, identified as blood glucose. The role blood glucose plays is important to understand, especially in overweight and obese populations, as they may be more likely to be insulin resistant. In effect overweight and obese individuals are less likely to adequately process glucose. Therefore overweight/obese individuals might react to self-control tasks differently than normal weight individuals. Participants who were considered normal weight, overweight, and obese were recruited from the UNT research pool. They answered questions about their trait self-control in daily life and engaged in either a task that required them to exert self-control (e.g., resist crossing out a letter unless criteria is met) or a control task (e.g., cross out a letter without restriction). All participants then engaged in a subsequent self-control task to assess if engaging in the initial self-control task reduced performance on the subsequent self-control task compared to the control task. The current research findings were not in line with previous research, in that a depletion effect in self-control was not observed; in neither the normal weight individuals nor the overweight and obese groups. There were several limitations that may have contributed to these findings including; higher DSC than observed in the general population and a possible adaptation ...
Date: August 2016
Creator: Edwards, Kate

Sleep in Early Adolescence: an Examination of Bedtime Behaviors, Nighttime Sleep Environment, and Parent-set Bedtimes Among a Racially/ethnically Diverse Sample

Description: Early adolescence (e.g., 10-14 years old) is a time during which health habits and behaviors first develop that carry over into adulthood. This age range is also a time when changes are often first observed in typical sleep patterns, such as a delay in bedtimes, decreased total sleep times, and increased sleep problems. Electronic media and social networking have become essential to adolescent interpersonal communication and are negatively associated with adolescent sleep. Room and/or bed sharing practices and having a parent-set bedtime are still common in this age range, though no study has examined the relationship between these culturally influenced practices and the sleep of racially/ethnically diverse early adolescents. The current study examined if differences exist between 1272 Caucasian, Hispanic/Latino, and African American early adolescents (ages 10-14 years) on self-reported bedtime, SOL, TST, and sleep efficiency, and whether these differences persist when taking into account presence of electronic media in the bedroom (i.e., TV, videogame console, computer, cellphone), media use at bedtime (i.e., watching TV, playing video/computer games, social networking, texting), room sharing, and parent-set bedtimes. Preliminary results showed that females reported worse sleep than males (i.e., longer sleep onset latency, shorter TST, and lower sleep efficiency, with a trend for having a later bedtime), and that African Americans and Hispanics reported later bedtimes than Caucasians, Hispanics reported shorter sleep onset latency and longer sleep efficiency than Caucasians, and African Americans reported shorter total sleep time than Caucasians. Presence of any type of media in the bedroom or use of any type of electronic media at bedtime was associated with later bedtimes and shorter total sleep times, but not with SOL or sleep efficiency. Parent-set bedtimes were associated with earlier bedtimes, longer sleep onset latency, longer TST, and lower sleep efficiency. After controlling for significant bedtime factors, only the main ...
Date: August 2015
Creator: Marczyk Organek, Katherine D.

Social Support as a Moderator of Racial/Ethnic Differences in Subclinical Atherosclerosis: The North Texas Heart Study

Description: This study examined racial/ethnic differences in pre-clinical disease, social support, and tested whether social support was a moderator of racial/ethnic differences in subclinical atherosclerosis. Participants were NHWs, NHBs, and Latinos (n = 283) from the baseline and cross-sectional sample of the North Texas Heart Study. Results from unadjusted models showed no significant racial/ethnic differences for common or bifurcation intima-media thickness (cIMT). However, unadjusted models for cIMT showed a main effect for race/ethnicity F(2, 229) = 3.12, p = .046, partial η2 = .027, with Latinos demonstrating significantly greater internal cIMT compared to NHB but not NHWs. In minimally adjusted models, there was a main effect for race/ethnicity, F(2, 227) = 3.10, p = .047, partial η2 = .027, with significantly greater internal cIMT in Latinos compared to NHBs but not NHWs. In fully adjusted models, racial/ethnic differences in cIMT were attenuated. Contrary to study hypotheses, no racial/ethnic differences in social support were found and social support was not a moderator of racial/ethnic differences in subclinical disease. In the North Texas Heart Study, few racial/ethnic differences emerged, with fully adjusted risk factor models accounting for these differences.
Date: August 2017
Creator: Garcia, James Jonathan

Stigma and Psychological Quality of Life in People Living with HIV: Self-Esteem as a Mediating Factor

Description: Although the negative impact of HIV stigma is well documented, a gap exists in exploration of constructs that mediate the relationship between HIV stigma and psychological QOL (PQOL). Self-esteem is often conceptualized as a protective factor. We used PLS-SEM to explore the relationships between HIV stigma, PQOL and self-esteem, where PQOL and self-esteem are latent constructs represented by direct observations. Our hypotheses were supported - stigma is negatively related to self-esteem (as measured by self-blame, forgiveness of self, acceptance without judgment and self-esteem), self-esteem is positively related to PQOL (as measured by depression, mental health, QOL and perceived stress) and when the two aforementioned relationships are controlled for, a previously significant relation between stigma and PQOL changes its value significantly. These findings have implications for interventions designed to mitigate the negative psychosocial effects of stigma in PLH.
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Date: August 2017
Creator: Wike, Alexandra

Stigma, Spirituality and Psychological Quality of Life in People Living with HIV: A Mixed Methods Approach

Description: HIV is a potentially fatal virus that affects over 1,148,200 people in the United States. Due to the minority status that comes with living with HIV, PLH (people living with HIV) often encounter various aspects of stigma due to HIV, which contributes to suppressed overall psychological quality of life (PQOL).While the relationship between stigma and PQOL in PLH is well documented, little research examines mediators of this relationship. We hypothesized that spirituality (as measured by sense of peace, forgiveness of self and perceived fulfillment of life's goal) mediates the relationship between stigma and PQOL (as measured by depression, mental health and stress). We used an explanatory sequential mixed methods design which utilizes two distinct phases of the research process: quantitative (QUANT) analysis followed by qualitative (QUAL) analysis. Results of the QUANT phase suggest spirituality is a partial mediator in the relationship between stigma and PQOL in PLH. In the QUAL phase, we interviewed 15 PLH to elaborate on the relationships between the three constructs. We found PLH endorsed personalized stigma most frequently. Similarly, our results also indicate PLH experience stress, depression and anxiety as a result of their HIV status. Lastly, participant's interviewed most commonly described their spiritual beliefs as relating to religion or God, which is in contrast to how spirituality was conceptualized in the quantitative portion of our study. In all, QUAL results confirmed QUANT findings, with the one main difference between how spirituality was conceptualized between the QUANT and QUAL qualitative portions of our study. Results highlight the importance of clinicians inquiring about PLH's PQOL, experiences of stigma and spiritual beliefs.
Date: August 2016
Creator: Purser, Megan