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Chronic Insomnia and Healthcare Utilization in Young Adults

Description: Chronic insomnia is a highly prevalent disorder in general and young adult populations, and contributes a significant economic burden on society. Previous studies have shown healthcare utilization (HCU) is significantly higher for people with insomnia than people without insomnia. One limitation with previous research is accurate measurement of HCU in people with insomnia is difficult due to a high co-morbidity of medical and mental health problems as well as varying operational definitions of insomnia. Assessing HCU in people with insomnia can be improved by applying research diagnostic criteria (RDC) for insomnia, using a population with low rates of co-morbid medical/mental health problems, and measuring HCU with subjective, objective, and predictive methods. The current study found young adults with chronic insomnia had greater HCU than normal sleepers, specifically on number of medications, and chronic disease score (CDS) estimates of total healthcare costs, outpatient costs, and predicted number of primary care visits. The presence of a medical and/or mental health problem acted as a moderating variable between chronic insomnia and HCU. Simple effects testing found young adults with chronic insomnia and a medical/mental health problem had the greatest HCU followed by normal sleepers with a medical/mental health problem, chronic insomnia, and normal sleepers. Exploratory analyses found young adults with chronic insomnia had a greater likelihood of emergency room visits and overnight hospital admissions. More efforts for early identification and intervention of insomnia are necessary to help reduce costs associated with chronic insomnia co-morbid with medical and/or mental health problems.
Date: August 2011
Creator: Bramoweth, Adam Daniel

Posttraumatic Growth: Behavioral, Cognitive, and Demographic Predictors

Description: Recent trauma research argues trauma results in distinct positive and negative consequences, however; many trauma variables positively correlate with both outcomes. This study examined posttraumatic growth (PTG) and post-traumatic stress disorder (PTSD) symptoms as positive and negative trauma outcomes. Behavioral, cognitive, and demographic correlates and predictors were assessed to help clarify differences between the two outcomes. While several behavioral factors were common to both PTG and PTSD symptoms, centrality of event and problem focused coping were the strongest PTG predictors, whereas centrality of event and avoidant coping were the strongest PTSD predictors. These findings indicate while greater incorporation of a trauma/stressful event into one’s identity is a key component of both PTG and PTSD development, behavioral response may be a determining factor between growth or debilitation.
Date: August 2011
Creator: Schuettler, Darnell

Relationship of Alpha-Theta Amplitude Crossover during Neurofeedback to Emergence of Spontaneous Imagery and Biographical Memory

Description: I obtained 182 session graphs from 10 client records from a university-based neurotherapy clinic and from a private practitioner. These graphs were used to examine the relationship of therapeutic crossover activity (defined as at least 3 minutes in duration and at least 1μv in amplitude) with and without predetermined amplitude thresholds of beta (15-20Hz) to client reports of imagery and to treatment outcomes. Crosstab analysis revealed that significantly more reports of imagery were observed in the therapeutic crossover with beta condition and that higher amplitudes of slower brainwave activity correlated with progression to deeper states of consciousness. Multi-level modeling revealed a significant interaction between therapeutic crossover activity, higher beta frequency amplitude, and reported salient imagery. Due to small sample size, significance testing was not deemed appropriate. However, observation in change of pre-post scores suggested that individuals who experienced more therapeutic crossover with sufficient beta amplitude conditions had greater improvements on post-test measures (BAI, BDI, BHS, PSQI and MMPI) than those with no or few crossovers. Higher amplitudes of slower brainwave activity correlated with progression to deeper states of consciousness, with delta amplitude positively correlating with transpersonal states. Reports of imagery and/or biographical memory are much more likely to occur during theta-alpha crossover activity characterized by 3 minutes or more in duration, one microvolt or more in amplitude, and 3.75μv amplitude or more of beta. This defined therapeutic crossover condition does appear to facilitate recall of imagery and memories during alpha-theta neurofeedback and was related to better treatment outcomes.
Date: August 2011
Creator: Johnson, Mark Lawrence