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Use of the Beck Depression Inventory in Northern Brazil

Description: The Beck Depression Inventory (BDI) is a popular screening and research instrument for measuring severity of depression. The instrument was translated to Portuguese for use in Brazil in 1979; however, it was not until recently that its psychometric properties have been tested empirically for the Brazilian population. The purpose of the present study was to explore the BDI's psychometric properties in a northern region of Brazil and to test for possible relationships between certain demographic variables and BDI outcomes. Samples used in this study were from an urban area in Roraima, the northernmost state of Brazil. The BDI showed adequate levels of internal consistency in nonclinical and clinical samples. Female respondents had significantly higher scores than male respondents. Those who had lower levels of education, income, or occupational status had significantly higher scores than those with higher levels of these variables. Adolescents had significantly higher scores than adults from all age groups except those from age 19 to 22. No significant difference was found between those who identified themselves as “indigenous” and those who identified themselves as “non-indigenous.” Regression analysis results showed that the combination of gender, education, and age best accounted for the variance in BDI scores. An ANCOVA revealed that clinically depressed adults had significantly higher BDI scores than nonclinically depressed adults. Factor analysis results showed that there were two main factors in the item structure for both female respondents and male and female respondents combined: one factor of mainly cognitive-affective items and the other factor of mainly somatic items. The results were discussed in terms of the future use of the BDI in Brazil.
Date: May 2002
Creator: Albert, Christopher
Partner: UNT Libraries

Anxiety, Depression, and Sleep Disorders: Their Relationship and Reduction with Neurotherapy

Description: This study investigated the relationship among anxiety, depression, and sleep disturbances and the treatment of these three disorders through neurotherapy. Research suggests that these conditions commonly co-occur in the general population and that central nervous system (CNS) arousal may play a primary role in the development and maintenance of these disorders. Several recent studies suggested that neurotherapy, a biofeedback-based treatment for CNS dysregulation, might be an effective treatment for comorbid conditions, particularly the ones of interest here, depression, anxiety, and sleep disturbances. This investigation used a clinical case-series design to assess pre/post neurotherapy changes on objective measures of anxiety, depression, and sleep and to determine whether changes in anxiety and depression then predict improvements in sleep quality. Data for 23 participants (10 males) were obtained from files of adults (Mage = 40.22 years, SD = 16.20) who received at least 15 neurotherapy sessions (M = 47.83 sessions, SD = 22.23) the University of North Texas Neurotherapy Lab. Matched pair t-tests revealed that symptoms of sleep disturbance, depression, and anxiety showed significant improvements following neurotherapy. Neurotherapy treatment effect sizes generally ranged from moderate to large (d = .414 - .849). Multiple regression analysis found that changes in self-reported anxiety symptoms, but not depressive symptoms, predicted observed improvements in sleep quality (adjusted R2 = .26). Last, the implications and limitations were discussed in relation to neurotherapy practice and the associated research.
Date: August 2010
Creator: Fisher, Christopher, Alan
Partner: UNT Libraries

The Cross-Validation of AD/HD Instruments and the Relationship to Neurocognitive and Behavioral Measures

Description: The purpose of this study was twofold: to determine the construct validities of comparable AD/HD instruments that were developed according to our current, DSM-IV classification system for AD/HD; and to identify potential +neurocognitive and socioemotional markers for AD/HD. The sample consisted of 145 children ages 8 to 11 years of age who were diagnosed with Attention Deficit Hyperactivity Disorder (AD/HD), or Central Auditory Processing Disorder (CAPD). Children were administered a battery of neurocognitive tests and completed a self-report measure of personality. Parents completed several, AD/HD instruments pertaining to their children. The AD/HD instruments used in this study were the Attention Deficit Disorder Evaluation Scale-Home Version (ADDES), Attention Deficit Hyperactivity Disorder Test (ADHDT), and the Attention Problems and Hyperactivity scales from the BASC-Monitor (BASC-M). Of interest was how each AD/HD instrument compared to the DSM-IV, particularly in terms of the cross-consistency of AD/HD subtype classifications. The findings showed that the AD/HD instruments classified participants differently from the initial, DSM-IV entry diagnosis. Rates of agreement were better for some of the AD/HD instruments than for others yet there was little overall consistency. The neurocognitive measures used in the study were the Cognitive Assessment System-Basic Battery scales. The socioemotional measures used in the study were two parent-report scales from the BASC-M (Internalizing Problems and Adaptive Skills), and the child report scales from the BASC-Self Report of Personality. Results showed that the neurocognitive measures were relatively insensitive to AD/HD symptomatology while a nearly opposite trend was observed on the socioemotional measures. For the most part, participants classified as the ADHD-Combined Type (ADHD-CT), (regardless of which AD/HD instrument was used) had the most significant impairment in areas of social functioning and emotional symptoms across parent and self-reports.
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Date: August 2002
Creator: Hudson, Christine V.
Partner: UNT Libraries

The Effect of Web-Based Support as an Adjunct to a Self-Help Smoking Cessation Program

Description: For the past quarter century, the public has been educated and warned about the dangers of smoking, and both smokers and health researchers have been in search of cost-effective, smoking cessation programs that will lead to long-term cessation. This study used a randomized experimental design to investigate the effectiveness of adding Web-based support materials to a nationally sponsored self-help smoking intervention. There was no significant increase in abstinence rates nor progression through the stages of change by those participants who had access to the Web site. However, there were some overall significant trends that suggested these self-help interventions were successful at decreasing daily rates of smoking and nicotine dependency, as well as tended to encourage repeated quit attempts. Although Web-based supports did not appear to increase the effectiveness of the nationally sponsored self-help intervention, this study demonstrated overall 12 week follow-up abstinence rates of 30-32%--greater than what might be expected, given average success rates of other self-help interventions. This study also supports the notion that women may face additional barriers to smoking cessation. Limitations and implications for future research are discussed.
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Date: August 2002
Creator: Johs-Artisensi, Jennifer Lynn
Partner: UNT Libraries

Development of a Differential Neurocognitive Profile for Alzheimer’s Dementia and Vascular Dementia

Description: Alzheimer’s Dementia (AD) is among the most common diseases in the Geriatric population, and its prevalence is expected to quadruple by 2047.Vascular Dementia (VaD) is the second most frequent cause of dementia, with studies indicating VaD accounts for 10-20% of dementia cases across the globe. A diagnostic model differentiating AD and VaD would be clinically and scientifically valuable, considering the treatment approaches for these conditions are different. Although there are differences between AD and VaD on their neuropsychological profiles, a diagnostic model that successfully differentiates AD and VaD on neuropsychological testing has not been developed, despite previous attempts. Our study addresses this gap in the literature by examining two diagnostic models used to predict the conversion of AD from mild cognitive impairment, and a third model was proposed to differentiate AD from VaD. We conducted ROC Analyses using the variables LM II Standard Score, Animals Total, and CDRS Sum based on a previous diagnostic model. The sensitivity and specificity for the diagnosis of mild VaD were calculated for all possible scores of each test measure. The Animals Total cutoff score of 7 achieved excellent sensitivity and specificity, receiving 96% and 92%, respectively. In this sample, patients who could name at least seven animals under 60 seconds were highly likely to be diagnosed with VaD. LM II Scaled Score also achieved statistical significance (p <0.001) and a cutoff score of 4 received 96% sensitivity and 77% specificity. Patients who achieved an LM II Scaled Score of 4 or higher were highly likely to be diagnosed with VaD.
Date: August 2013
Creator: Hill, Jonathan
Partner: UNT Libraries

Treatment Outcomes Related to EEG-Biofeedback for Chemical Dependency: Changes in MMPI-2™ (University of Minnesota) Personality Measures and Long Term Abstinence Rates

Description: Peniston and Kulkosky (1989, 1990) demonstrated the effectiveness of alpha-theta EEG-Biofeedback (EEG-BFB) in treating inpatient alcoholics noting significant improvements in depression, psychopathology, serum β-endorphin levels, and abstinence rates. The present study is an extension of a previously unpublished replication of the Peniston EEG-BFB protocol with 20 chemically dependent outpatients (Bodenhamer-Davis, Callaway, & DeBeus, 2002). Fifteen subjects were "high risk for re-arrest" probationers. Data for the EEG-BFB group was collected from archival records. Subjects completed an average of 39 sessions (SD = 6.096), with 33 of those being EEG-BFB. Pre/post-treatment MMPI-2s™ (University of Minnesota) were collected and follow-up (4-11 years) data obtained (abstinence rates, re-arrests in some cases). Treatment effects were evaluated by comparing assessment data (pre/post) and documenting abstinence rates. Post-treatment MMPI-2 results were within normal limits, with several scales significantly reduced from baseline suggesting less psychopathology. Results were then compared to 20 subjects receiving standard addiction treatment (OT-CD group), but not EEG-BFB. OT-CD subjects completed a 2-week inpatient program followed by 18 outpatient sessions. Pre/post assessment and follow-up data was collected on the OT-CD group. The OT-CD group's post-assessment results showed three elevations (MMPI-2 scales 4/6/8), suggestive of characteriological problems. Post-MMPI-2 results of the two groups were compared via ANCOVAs. Findings indicated no significant differences between groups on targeted scales; however, there was a trend for the EEG-BFB group to have lower scores. Follow-up data was obtained on 13 EEG-BFB subjects. Results indicated 92% (n = 12) were sober, with 8% (n = 1) claiming significantly reduced alcohol intake. Probationer re-arrest and revocation rates were collected on the subset of probationers (n = 14 out of 15). The majority of the probationers (79%, n = 11) had not been re-arrested nor had their probation been revoked. Short-term follow-up information (35-131 days post-assessment), available at the time of writing, for ...
Date: May 2005
Creator: Callaway, Tonya Gayle
Partner: UNT Libraries

Personality Factors and Trust in Placebo Medical Trials

Description: Prior research has reported that individual differences influence both placebo and nocebo responses. The present study examined how individual personality, as well as trust, influence placebo/nocebo belief and symptom reporting after receiving an inert capsule that for some was described as an active “cognitively-enhancing” trial medication. Individuals (N = 104) were randomly assigned to one of three conditions: condition A participants were told they’d received the medication, condition B participants were told they’d received a placebo, and condition C participants were told, via random assignment, each would receive either the medication or placebo (after the experiment this condition listed the group – medication or placebo - each believed s/he was in). The study was completed in the UNT Student Health and Wellness Center to provide context in a medical setting. Of the 104 participants, 46 (44.2%) were either placed by experimental design or self-report in the medication group. Participants with a belief in medication ingestion, regardless of condition (i.e., A or C), reported significantly more symptoms (M = 16.65, SD = 3.178), than participants who believed they had ingested a placebo (M = 14.21, SD = 2.58), t (102) = 4.32, p = .001. Aspects of Neuroticism and Extroversion, as well as trust were correlated with symptom reporting and/or placebo/nocebo responses. It appears that that personality is part of a combination including trust, context and expectations. It is recommended that future research on personality and placebo effects consider the role of individual factors, context and communication of expectations.
Date: August 2013
Creator: Baker, Brandon Wade Roger
Partner: UNT Libraries

Treatment Effects Related to EEG-Biofeedback for Crack Cocaine Dependency: Changes in Personality and Attentional Variables

Description: EEG biofeedback (neurotherapy) has been demonstrated as effective in the treatment of alcoholism, as evidenced by Peniston and Kulkosky's research efforts. These neurotherapy pioneers evaluated the efficacy of alpha-theta brain wave biofeedback as a treatment for chronic alcohol abuse, citing 80% abstinence rates as measured by improvements in psychopathology, serum beta endorphin levels, and long-term alcohol abstinence. Most research with alpha-theta EEG biofeedback has addressed alcohol addiction. Cocaine is now considered to be the most common drug problem of patients entering treatment for drug abuse. To date, only one controlled study has been published that researched alpha-theta neurofeedback in the treatment of "crack" cocaine addiction. The present study was an extension of a 4-year EEG-biofeedback treatment outcome project underway at a faith-based homeless mission in Houston, Texas, with male "crack" cocaine addicts. Changes in personality, attention, and impulsivity were measured following 30 sessions of a non-individualized EEG -biofeedback protocol. Experimental subjects received a variant of the Peniston-Kulkosky alpha-theta protocol for 30 sessions while controls received all elements of the experimental protocol except the EEG biofeedback. Assessment measures included the MMPI-2 and the IVA. Although experimental subjects showed greater mean improvement on most MMPI basic scales and all IVA Attention related measures, results indicated no significant differences between control and experimental groups. The present study did not result in significant differences between control and experimental groups on attentional or personality variables in crack cocaine addicts. Implications and limitations of the study are discussed.
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Date: August 2005
Creator: Burkett, Virginia Shannon
Partner: UNT Libraries

Differences in Perceptual-motor Functioning Between Blind and Sighted Adults: a Neuropsychological Perspective.

Description: The purpose of the study was to explore perceptual-motor differences between blind and sighted adults from a neuropsychological perspective, and to analyze differences within the blind group. Perceptual-motor abilities were examined using the Comprehensive Vocational Evaluation System (CVES), a vocational rehabilitation and neuropsychological battery designed for use with blind populations. The data were processed using Analysis of Covariance. Results showed that sighted persons had better motor abilities, while persons with blindness were more skilled at haptic identification of shape and texture. Analysis within the blind group showed that texture identification skills are better when blindness occurs earlier in life and to the extent that the blindness is total. Later onset blindness and the retention of some functional vision may not lead to a refocusing of attentional states necessary to develop haptic images. New neural connections may develop in persons with congenital/total blindness, a hypothesis in line with recent neuroradiological findings that occipital lobe activation occurs when congenitally blind individuals engage in tactile processing tasks. One implication of the findings is that teaching individuals who retain some functional vision to read Braille is probably counterproductive. These individuals would be better served by learning to use a CCTV and large print books. Future researchers should examine blindness from a multivariate perspective, examining subsets of blind groups based on age at onset, visual status, and other pertinent variables. Other implications are discussed and recommendations for future research are provided.
Date: December 2002
Creator: Joyce, Arthur
Partner: UNT Libraries

Treatment efficacy in a chronic pain population: Pre- to post-treatment.

Description: The purpose of the current study was to investigate the effects of a multidisciplinary pain management program on five measures of subjective psychosocial factors. Ninety-five participants in the comprehensive multidisciplinary treatment group and the standard medical intervention control group were surveyed about various psychosocial factors using Axis II of the West Haven - Yale Multidimensional Pain Inventory (MPI), pre- to post-treatment. It was hypothesized that post-treatment levels would be significantly lower than pre-treatment levels for all five psychosocial variables. Additionally, gender and ethnicity variables were examined. Based on preliminary analyses indicating pre-treatment differences between the experimental and control group, five 2 x 2 x 3 analyses of covariances (ANCOVAs) were used to examine the above hypotheses. Results indicated significant differences between the treatment conditions on measures of control, with the comprehensive group feeling more in control than the standard group at post-treatment. No other significant main effects for treatment condition were found on the measures of pain severity, interference with daily activities, negative mood, or social support. However, a significant gender main effect was found for social support at post-treatment, with females reporting more social support than males. A significant gender x ethnicity interaction was also found for post-treatment control, with African-American females exhibiting higher levels of control than the other groups. Finally, a significant gender x treatment condition was found for negative mood, with males in the comprehensive group reporting more affective distress than those in the standard group. In this study, control appeared to be an integral factor in the chronic pain sample and greatly improved with comprehensive multidisciplinary treatment; while other areas of relative efficacy were not confirmed in this population.
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Date: December 2004
Creator: Bernstein, Dana N.
Partner: UNT Libraries

The Effects of Perceived Locus of Control and Dispositional Optimism on Chronic Pain Treatment Outcomes.

Description: The financial cost for health care and lost productivity due to chronic pain has been estimated at over $70 billion per year. Researchers have attempted to discover the psychosocial and personality factors that discriminate between people who learn to cope well with chronic pain and those who have difficulty adjusting. The purpose of the present study was to examine the effects of perceived locus of control and dispositional optimism on chronic pain treatment outcomes. Subjects reported significantly lower post-treatment pain levels as compared with pre-treatment levels (M = 0.66, SD = 1.58), t(45) = 2.85, p = .007 (two-tailed), but decreased pain was not associated with scores on the internality dimension of the Pain Locus of Control Scale (PLOC) or on the Life Orientation Test-Revised (LOT-R) (a measure of dispositional optimism). Overall, participants' increased coping ability was associated with scores on the LOT-R, but not with scores on the internality dimension of the PLOC. Subjects with the lowest pre-treatment scores on the LOT-R demonstrated significantly greater increases in post-treatment coping ability than those with the highest scores (F(2,40) = 3.93, p < .03). Participants with the highest pre-treatment scores on both the PLOC internality dimension and the LOT-R demonstrated greater post-treatment coping ability (F(2,32) = 4.65, p < .02), but not less post-treatment pain than other subjects. Participants' post-treatment LOT-R scores were significantly higher than their pre-treatment scores (M = 2.09, SD = 3.96), t(46) = 3.61, p = .001 (two-tailed), but post-treatment PLOC internality scores were not significantly higher than pre-treatment scores. Implications of these results are discussed.
Date: December 2004
Creator: Worsham, Scott L.
Partner: UNT Libraries

A Culturally Sensitive Intervention in Pain Management Settings: Use of Dichos in Multi-Ethnic Pain Groups.

Description: The present study explored whether use of Spanish language sayings, or dichos, improved group climate within multi-ethnic chronic pain groups. Use of this form of figurative language fits within psychological theory identifying use of metaphor as a means of promoting change and creating new meaning. Further, metaphor use is consistent with the broader aims of experiential therapy. Group climate was measured by group members' self reports using the Group Climate Questionnaire-Short Form. A pilot study involving Latino Americans in medical and non-medical contexts aided in categorizing dichos as high versus low-relevance. It was anticipated that clients would rate high-relevance sessions as involving greater engagement, and less conflict and avoidance than low-relevance groups. Participants were recruited from four multidisciplinary pain management clinics offering similar programs. Once every four to six weeks, group leaders were provided with a list of either high or low-relevance dichos, and were blind to the existence of dichos categories. Three hierarchical regression analyses were employed to determine whether dichos relevance, characterized as low, mixed or highly relevant, contributed to variance in group conflict, avoidance and engagement. Dichos familiarity was the last variable entered into the regression equation, with gender, ethnicity and acculturation score entered in sequential fashion. Consistent with predictions, low-relevance groups yielded higher conflict scores than all groups combined. Also, high-relevance groups predicted lower avoidance when compared to all groups. In contrast to hypotheses, high-relevance groups predicted lower ratings of group engagement when compared to all groups. Post-hoc analysis indicated the mixed-relevance groups yielded significantly higher engagement scores than the low and high-relevance groups. Implications of these findings are discussed in relation to impact on approaches to group therapy with Latino American clients, and within the chronic pain population. Limitations of the study and recommendations for future research are offered.
Date: December 2005
Creator: Riley, Celeste Arden
Partner: UNT Libraries

The theory of planned behavior and adherence to a multidisciplinary treatment program for chronic pain.

Description: The primary objective of this study was to examine the association between the theory of planned behavior (TBP) and adherence to a multidisciplinary pain center (MPC) treatment program for chronic pain. While the results of several studies have provided support for the efficacy of MPC treatment in chronic pain, the problems of adherence and attrition are important. TPB is a cognitive/social model of behavior that has been used to predict a variety of behaviors, although it has never been used to predict adherence to a multidisciplinary chronic pain treatment program. It was predicted that Adherence would be predicted by Intentions and that Intentions would be predicted by 1) Perceived Social Norms, 2) Perceived Behavioral Control, 3) Attitudes Toward New Behavior (completing the treatment program), and 4) Attitude Toward Current Behavior (maintaining current treatment and coping strategies). It was found that the total Intentions scores did not predict the total Adherence scores. However, Intentions was predicted by 1) Perceived Behavioral Control, 2) Attitudes Toward New Behavior (completing the treatment program), and 3) Attitude Toward Current Behavior (maintaining current treatment and coping strategies). The finding that Perceived Social Norms did not predict Intentions was consistent with results of previous studies with the TBP. The secondary objective was to examine the extent to which MPC treatment affects patients' attitudes towards behaviors that are associated with successful pain management. The majority of the patients (82%) developed a more favorable attitude toward the program and their average report of the importance of the program was 6.78 on a 10-point scale. The majority of patients (74%) reported experiencing a greater decrease in pain than expected, and the average amount of pain decrease was 5.39 on a 10-point scale.
Date: December 2005
Creator: Rogers, Randall E.
Partner: UNT Libraries

Evaluating the Role of C-reactive Protein on Cognition and Depressive Symptoms Among Women by Mexican American Ethnicity

Description: C-reactive protein (CRP) is a protein found in the blood that is synthesized by the liver and has been extensively studied due to its role in inflammatory and atherosclerotic processes. The importance of this biomarker in its role in vascular risk factors is increased with several lines of evidence pointing to its association with cognitive decline. The association between CRP and depression has been increasingly analyzed by various cross-sectional studies. The research between CRP and depressive symptoms in older women has yet to generate consistent trends. In the present study, a series of regression analyses was used to explore the association between CRP and both cognitive function and depressive symptomatology among a group of rural-dwelling women. Associations were evaluated through the use of data from Project FRONTIER, a rural-based research looking at both physical and cognitive aspects of health in rural-dwelling adults and elders. Comparisons were made between Mexican American women and a group of non-Hispanic Caucasian women. CRP was a significant independent predictor of total depression (beta = -.11, t = -1.99, p =.048). CRP was also a significant independent predictor of symptoms associated with meaningless within depression (beta = -.16, t = -2.94, p =.004). Contrary to prediction, CRP was not a significant independent predictor of overall cognitive function or performance in five specific cognitive domains. There is still needed evaluation on racial/ethnic differences present in regard to the impact of varied health factors on mental health within a culturally rich, rural cohort. It is recommended that future studies utilize standardized measurement of cognitive function to facilitate a more thorough understanding and comparison of change in this particular population.
Date: August 2014
Creator: Huerta, Serina
Partner: UNT Libraries

Lean on Me: Social Support Compensation and Risk of Death in Older Adults with Type 2 Diabetes

Description: Type 2 diabetes (T2DM) has an estimated incidence of nearly 11 million US adults aged 65 years and older. Evidence suggests that the quality of the marital relationship is an important factor for diabetes related health outcomes affecting self-management and adherence (Kiecolt-Glaser & Newton, 2001). However, an individual in need may compensate for primary support that is unavailable or not optimal by looking for other sources of support, which may be important for health outcomes (Rini, et al., 2008). The present study examined compensation for poor spousal support through other social relationships. A total of 12,640 participants reported they had diabetes and were married (Male = 6,317 and Female = 6,323), and of this group 1,084 men and 583 women had died over the course of the study period. Women reported lower spousal support, but significantly more aggregated social support across relationships than men. Few persons reported low spousal support and low support compensation, rendering the cell sizes highly unequal and the associated data uninterpretable. Ancillary analyses were conducted with the idea that some variance in total compensation support may moderate mortality risk finding that higher aggregated social support across non-spousal relationships was associated with lower risk of death accounting for ~3% of the variance in the final model. The current findings demonstrate how an individual can compensate for a poor primary support relationship through a broader support network. These findings should guide future research to focus on how individuals build, maintain, and seek support from social relationships.
Date: August 2014
Creator: Smith, Lauren Marie
Partner: UNT Libraries

Religiosity As a Coping Resource for Depression and Disease Management Among Older Diabetic Patients

Description: Compared to the general population, diabetic patients experience a higher prevalence of depression, which can often exacerbate diabetic symptoms and complicate treatment. Studies show that religion is associated with both better physical health and better psychological functioning; however, studies incorporating religion and depression among diabetic individuals are scarce. The present study addressed this gap in the literature by examining archival data from the 2008 and 2010 data waves of the Health and Retirement Study (HRS). Cross-sectional findings confirmed that stronger religiosity was positively correlated with perceived diabetes control and positive diabetes change, and negatively correlated with total number of depressive symptoms and total number of weeks depressed. Longitudinal findings confirmed that stronger religiosity in 2008 was positively correlated with perceived diabetes change in 2010 and negatively correlated with total number of depressive symptoms in 2010. Logistic regression and multiple regression analyses were performed to test four moderation models. Results showed that religiosity significantly moderated the relationship between perceived diabetes control and total number of weeks depressed. More specifically, for diabetics with low levels of religiosity, whether they believed their diabetes was under control or not did not make a significant difference in the total number of weeks depressed. However, high levels of religiosity served as a buffer against the duration of depressive symptoms but only for diabetics who perceived to have their diabetes under control. Understanding how these constructs jointly influence diabetes management and psychological functioning is critical in that medical professionals may utilize such knowledge to enhance treatment outcomes.
Date: August 2014
Creator: Dzivakwe, Vanessa G.
Partner: UNT Libraries

Neurocognitive implications of diabetes on dementia as measured by an extensive neuropsychological battery.

Description: Diabetes is a disease with a deleterious pathology that currently impacts 4.5 million individuals within the United States. This study examined the ability of a specific neuropsychological battery to identify and classify dementia type, investigated the impact of diabetes on cognition and analyzed the ability of the memory measures of the 7 Minute Screen (7MS) and the Rey-Osterrieth Recall to correctly categorize dementia type when not used in combination with a full battery. The battery in addition to exhaustive patient history, medical chart review and pertinent tests were used in initial diagnosis. Results indicated the battery was sufficient in the identification and classification of dementia type. Within the sample, diabetes did not appear to significantly impact overall battery results whereby only two measures were minimally affected by diabetes. Finally, the memory measures of the 7MS and the Rey-Osterrieth Recall were sufficient to predict membership into the Alzheimer's (AD) and vascular dementia (VD) groups with 86.4% accuracy. The classification percentage dropped to 68.3% with addition of the mild cognitive impairment category. The full battery correctly classified AD and VD dementia 87.5% and appeared to be the most robust.
Date: December 2008
Creator: Harris, Rebekah Lynn
Partner: UNT Libraries

An item response theory analysis of the Rey Osterrieth Complex Figure Task.

Description: The Rey-Osterrieth Complex Figure Task (ROCFT) has been a standard in neuropsychological assessment for six decades. Many researchers have contributed administration procedures, additional scoring systems and normative data to improve its utility. Despite the abundance of research, the original 36-point scoring system still reigns among clinicians despite documented problems with ceiling and floor effects and poor discrimination between levels of impairment. This study is an attempt to provide a new method based upon item response theory that will allow clinicians to better describe the impairment levels of their patients. Through estimation of item characteristic curves, underlying traits can be estimated while taking into account varying levels of difficulty and discrimination within the set of individual items. The ultimate goal of the current research is identification of a subset of ROCFT items that can be examined in addition to total scores to provide an extra level of information for clinicians, particularly when they are faced with a need to discriminate severely and mildly impaired patients.
Date: December 2008
Creator: Everitt, Alaina
Partner: UNT Libraries

Neurocognitive Variables Underlying Group Performance on a Measure of Effort: The Medical Symptom Validity Test (MSVT)

Description: This study utilized the Medical Symptom Validity Test (MSVT) and a set of standard neuropsychological instruments to determine the underlying construct of the MSVT that accounts for effort in mild traumatic brain injury (mTBI) patients by comparing/contrasting mTBI with dementia and an analog simulation. The results indicate that a common underlying neurocognitive construct (memory) exists between mTBI and dementia patients, which may account for poor effort as measured by the MSVT. Other underlying factors emerged for both groups, though they did not point to a common construct. This finding suggests that the overall effect of brain injury in neurologically impaired groups also impacts effort performance as measured by the MSVT. Similarly impaired performance patterns also emerged between mTBI and dementia groups in sub-groups that failed effort measures. Thus, failed effort tests may be a function of more pronounced deficits in these groups, rather than a function of effort. Finally, although similar effort profiles were noted between mTBI and analog simulators, the analog group was unable to mimic the neurocognitive effects of mTBI.
Date: December 2008
Creator: Covert, Julie Hart
Partner: UNT Libraries

Health message framing : motivating cardiovascular risk factor screening in young adults.

Description: As the leading cause of death in the United States, coronary heart disease (CHD) is a growing public health problem, despite the fact that many risk factors for the disease are preventable, especially if addressed early in life. The purpose of the current study was to examine the effects of loss-framed versus gain-framed versus information-only health messages on both intention to attend and actual attendance at an appointment to get screened for CHD risk factors (i.e., hypertension, diabetes, and dyslipidemia). It was hypothesized that a population of young adults would be more likely to view screening for CHD risk factors as a low-risk, health-affirming behavior as opposed to a risky, illness-detecting behavior and would thus be more strongly influenced by gain-framed messages than loss-framed messages. Additional goals included the exploration of the extensively researched individual health beliefs of perceived threat (as defined by the health belief model) and health locus of control as they relate to message frames. One hundred forty-three undergraduate students were randomly assigned to either the loss-framed, gain-framed, or information-only control conditions. Framing manipulation checks revealed that participants failed to discern differences in the tone and emphasis of the experimental pamphlets. As a result, no tests of framing effects could be conducted. Sixteen (11.2%) of the 143 participants who participated in Part 1 of the experiment participated in Part 2 (i.e., attended a risk factor screening appointment). Multiple regression analysis revealed risk index, age, and powerful others health locus of control as significant predictors of screening intention. Gender was the only demographic or health related variable that was significantly related to screening outcome, such that women were more likely to get screened than men. Limitations and recommendations are discussed.
Date: August 2008
Creator: Link-Malcolm, Jessica
Partner: UNT Libraries

Association Between Folate, Vitamin B12 and Cognitive Performance in Demented Elderly.

Description: Dementia is prevalent among elderly people. As the world population ages, it is projected that the number of people affected by dementia may triple in the next 50 years. Over the last two decades, research has focused on identifying potentially modifiable risk factors in development and progression of dementia, such as vitamin B12 and folate. Results concerning the effects of low folate and vitamin B12 on cognitive performance are mixed. The main objective of the present study was to investigate the effects of vitamin deficiency on cognitive functioning in a clinical sample of elderly individuals with cognitive problems using a comprehensive neuropsychological assessment. A retrospective chart-review was performed on the 102 records of patients from the Geriatrics Clinic at the University of North Texas Health Science Center who presented with cognitive deficits. Charts were reviewed to obtain data on vitamin supplementation, vitamin status, history of chronic conditions and other biochemical data. The available database was used to obtain data on neuropsychological assessment. The study demonstrated mild association between vitamin B12 and folate status and cognitive deficits. There appeared to be a higher cut-off level that is above the traditionally used levels for vitamin B12 and folate deficiency concentrations at which cognitive deficits became more pronounced. Clinical applications, limitations and suggestions for future research were discussed.
Date: August 2008
Creator: Serova, Svetlana
Partner: UNT Libraries

Heart rhythm variability in persons with chronic pain.

Description: The present study evaluated the utility of heart rhythm coherence (HRC) feedback to reduce the reported pain intensity of patients enrolled in a multimodal pain management program. Participants were recruited and assigned to a usual treatment group (UT) or a heart rhythm coherence feedback group (UT+HRC). It was hypothesized that UT+HRC participants who achieved heart rhythm coherence would report a reduction of pain intensity, as measured by the McGill Pain Inventory. For those whose pain intensity decreased, it was also expected that their self reported levels of depression as measured by the Beck Depression Inventory-Second Edition and state anger as measured by the State Trait Anger Inventory would decrease. It is also hypothesized that with a reduction in pain levels, anger, and depression, blood pressure would also decrease among those who had high blood pressure prior to the intervention. Multivariate analyses of variance (MANOVA) were used to investigate the relationship between treatment condition, coherence status and pain levels. A series of independent t-tests were utilized to investigate the change in pain, depression, and state anger from baseline to posttest, followed by Pearson product moment correlation coefficients on difference scores to understand the relationship between the outcome variables for Hypothesis 2. Standard multiple regression analyses were computed using difference scores to determine if the outcome measures were significant predictors of systolic blood pressure and diastolic blood pressure. Results indicated a failure to reject the null with regard to hypothesis one. No relationship between treatment assignment, coherence status or pain levels were found. Hypothesis 2 was partially supported. Although there was a positive significant relationship between depression and anger when utilizing difference scores, these affective measures were not related to difference scores on either pain measure. In regard to Hypothesis 3, there was also a failure to reject the null. None of ...
Date: August 2008
Creator: Saxon, LaDonna Christine
Partner: UNT Libraries

Evaluation of the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR) in a spinal cord injury population.

Description: Spinal cord injury (SCI) is an acute and devastating event that results in significant and permanent life changes for the individuals who are injured, as well as their families and friends. Depression has received more attention from clinicians and researchers than any other psychological issue among persons with SCI. Measurement of depression in this population has a variety of methodological issues, including inconsistent assessments used (self-report versus clinical interviews), varying definitions of depression, inclusion and exclusion of physical symptoms in the assessment process, and use of measures that do not represent DSM-IV criteria for major depressive disorder. The primary goal of this study was to evaluate the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR) and provide descriptive analyses of this measure with persons with SCI. Results showed that somatic symptoms were more frequently endorsed than psychological symptoms in this population. Additionally, scores on the QIDS-SR were significantly associated with a depression diagnosis in the patient's medical chart. However, QIDS-SR scores were not found to be correlated inversely with quality of life scores as predicted. The QIDS-SR was shown to have good internal consistency and convergent validity with patients with SCI. However, it failed to demonstrate construct validity. The QIDS-SR has the potential to be a valid measure with this population and further analysis of the psychometric properties with patients with SCI is warranted.
Date: August 2008
Creator: Reed, Kristin
Partner: UNT Libraries

Role of Parental Anxiety on Pediatric Feeding Disorders

Description: The proposed study examined the relationship between parental anxiety, measured both subjectively (via self-report questionnaires) and objectively (via salivary cortisol) and the child's feeding progress. Children diagnosed with a feeding disorder were recruited with their parents at Our Children's House at Baylor (n=19; 11 females, 8 males). The patients and their parents were housed in the clinic for an eight-week intensive multidisciplinary pediatric feeding disorder treatment program. Calorie intake was recorded daily as outcome measures of treatment progression. Parental anxiety was measured by the Pediatric Inventory for Parents (PIP), state anxiety on the State Trait Anxiety Inventory (STAI), and by salivary cortisol at three different time points. The present study attempted to examine whether parental feeding (phase three of treatment program) would continue to cause a decrease in the child's caloric intake. In averaging ten meals prior to parental feeding in comparison to the average of ten meals following parental feeding, there was no significant difference as measured by a t-test. Paired t-tests examined parental anxiety from time one to time two and found that salivary cortisol increased significantly t(15) = -6.07, p = .000 from Time 1 (M = 2.30, SD = 1.64) to Time 2 (M = 5.24, SD = 2.58). This demonstrated that while parental anxiety increased as measured by salivary cortisol, the children continued to make improvements. This may be the result of the multidisciplinary feeding program which encompassed a strong behavioral component and parent training. Even though the current results did not demonstrate a direct relationship between parental stress and caloric intake, parental stress as measured by salivary cortisol did increase.
Date: May 2009
Creator: Didehbani, Nyaz
Partner: UNT Libraries