Browsing by Author "Robillard, Rachel West"
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Item Anxiety and conduct problems in children and adolescents : the role of executive functioning in a dual-pathway model(2013-08) Mauseth, Tory Ann; Keith, Timothy, 1952-; Robillard, Rachel WestAlthough anxiety disorders and conduct problems often co-occur in children and adolescents, literature describing the effects of such co-occurrence is mixed. There is evidence that symptoms of anxiety disorders may mitigate symptoms of conduct problems (buffering hypothesis) or may exacerbate symptoms of conduct problems (multiple problem hypothesis). A dual-pathway model has been proposed that suggests several possible etiological or risk processes that may differentiate these pathways (i.e., the buffering hypothesis or the multiple problem hypothesis) (Drabick, Ollendick, & Bubier, 2010). Executive functioning is one factor that has been identified that may differentially confer risk to the proposed pathways; however, little research has been done investigating its role. The purpose of the present study was to evaluate the dual-pathway model by determining whether executive functioning abilities contribute to differentiating those youth for whom anxiety exacerbates conduct problems from those for whom anxiety mitigates conduct problems. Specifically, the study sought to examine if executive functioning moderated the effect of anxiety symptom severity on conduct problems. Latent variable structural equation modeling (SEM) was used to analyze the data of 221 youth aged 9 to 16 in a residential treatment center who completed a full neuropsychological evaluation. Results of the study failed to support the hypothesis that executive functioning moderates the effect of anxiety on conduct problems. Furthermore, a structural equation model without an interaction between executive functioning and anxiety was found to fit the data better than a model with an interaction between those variables. Overall, the study found that executive functioning abilities could not distinguish youth for whom anxiety exacerbates conduct problems from youth for whom anxiety mitigates conduct problems. Recommendations for future research in light of the limitations of the current study, as well as remaining gaps in the literature, are discussed.Item Anxiety sensitivity index (ASI) correlation to positron emission tomography (PET) scans of individuals coping with an anxiety producing situation(2002-08) Robillard, Rachel West; Semrud-Clikeman, Margaret; Liotti, MarioItem Emotional and behavioral late effects in pediatric oncology survivors(2010-12) Garcia, Michael Isaac; Robillard, Rachel West; Stark, Kevin Douglas; Tharinger, Deborah; Mercer, Walt; Borich, GaryThe most common form of childhood cancer is Acute Lymphoblastic Leukemia (ALL). Patients treated for ALL may experience short- and long-term physiological and cognitive effects due to treatment. However, delayed emotional and behavioral effects in pediatric survivors, as well as risk-factors that may make them more susceptible to developing problems with psychological and behavioral functioning are less understood. Studies investigating pediatric survivors have demonstrated that negative emotional and behavioral late effects can and do occur (Hobbie et al., 2000; Buizer et al. 2006; Novakovic et al., 1996; Mulhern, Wasserman, Friedman, & Fairclough, 1989), and it has been purported that survivors experience higher rates of depression, anxiety and low self-esteem (Koocher, O’Malley, Gogan, & Foster, 1980; Kazak, 1994). Anxiety in particular, has been identified as one of the longest lasting psychological sequelae of cancer (Kazak, 1994). Still, the data on long-term psychological sequelae is mixed, with some studies suggesting healthy, long-term, psychological adjustment (Brown et al., 1992; Fritz, Williams & Amylon, 1988; Greenberg, Kazak, & Meadows, 1989). This pilot study attempted to investigate emotional and behavioral late effects of cancer as reported by survivors and their caregivers on the Behavior Assessment System for Children, Second Edition (BASC-2). This study also investigated potential risk factors that made it more likely to develop emotional and behavioral late-effects. This study hypothesized that females, those undergoing high intensity chemotherapy, and those starting chemotherapy at an earlier age, would report significantly more internalizing and externalizing problems. Analysis revealed significant differences in reporting of anxiety, depression, attention and hyperactivity symptoms combined based on the age when treatment started. No other significant findings were uncovered; however, in an effort to provide directions for future research, patterns in the data were examined by comparing overall means on BASC-2 subscales. For example, females reported more hyperactive symptoms than males. In general, individuals who started treatment at younger ages reported more difficulty with emotional and behavioral functioning. Additionally, males and females adaptive behavior fell within normal limits. Overall, no BASC-2 mean scores were in the at-risk or clinically significant range of impairment suggesting adequate emotional, behavioral and adaptive functioning overall.Item Emotional trauma and children’s executive functioning : is there a connection?(2012-08) Holder, Christen Marie; Robillard, Rachel West; Allen, Greg, doctor of clinical psychology; Schallert, Diane; Tharinger, Deborah; Whittaker, Tiffany; Mercer, WaltThe purpose of this dissertation was to examine the connection between emotional trauma and executive function ability in children and adolescents. Trauma is defined as an overwhelming event that is beyond the realm of what might be an expectable occurrence for the average person. A serious outcome, occurring in around 14% of those children who experience trauma, is the development of Post Traumatic Stress Disorder, which is classified as an anxiety disorder occurring after exposure to a traumatic event, in which symptoms of re-experiencing, avoidance, and arousal are present. In addition to the numerous physical, emotional, and social effects of trauma, neuropsychological and imaging research has confirmed that children’s neuroanatomy and cognitive functioning are often affected. It has been proposed that intrusive thoughts occurring immediately after the trauma event may modify the neural network function, setting the stage for neurobiological dysregulation. One of the most common neural anatomic areas of concern following trauma is the prefrontal cortex, a structure that continues to develop until the third decade of life, and that has been implicated as the home of executive function, an idea conceptualized in a number of ways, but that is most often considered an umbrella term describing essential functions of the mind, such as planning, inhibition, attention, and working memory. The scope of literature addressing the effect of trauma on executive function is minimal. It is the hypothesis of this study that early trauma may disrupt the normal development of the PFC and subsequently result in decreased executive functioning abilities. In order to explore this hypothesis, a set of neuropsychological measures were selected as representative of executive functioning, based on previous research. An initial factor analysis was conducted in order to determine if, as suspected, all subtests chosen load on a common factor of executive function. Multiple linear regression was used to determine whether children who experienced trauma have impaired executive functioning abilities, if there was a significant gender difference, and what, if any, differences there were between children who developed PTSD and children who did not.Item Parent stress and child anxiety in a community mental health center(2012-05) James, Sarah E.; Robillard, Rachel West; Allen, Greg, doctor of clinical psychology; Stark, Kevin; Whittaker, Tiffany; Jones, Barbara L.; Felker, JenniferThe primary focus of this study was to examine the relationship between parent stress and child anxiety. In addition, differences in child anxiety by gender and ethnicity were explored. Finally, data were evaluated to determine differences in types of anxiety symptoms reported by children. Participants were 34 parent-child dyads from Morrison Child and Family Services in Portland, Oregon. Children (20 females, 14 males) ranged in age from 8 years to 12 years. The parent group (30 females, 4 males) included only biological parents or legal guardians, with 23 parents reporting a single-caregiver home. Results were not significant for correlations between parent stress or parent life stress and child anxiety or for differences in child anxiety by gender or ethnicity. Results did indicate that on the MASC, children reported significantly higher scores on the Harm Avoidance scale than any other index. Limitations and future directions are discussed.Item Processing speed and executive function in pediatric acute lymphoblastic leukemia survivors(2012-12) Garrison, Daniel Alexander; Carlson, Cindy I., 1949-; Robillard, Rachel WestThis study examined processing speed and executive function late effects in survivors of pediatric ALL (hereafter referred to as Survivors). Late effects are long-term, treatment-related health problems associated with the neurotoxic side-effect of cancer treatment on brain development. Processing speed —mental and motor speed with which a person can solve nonverbal problems — was estimated via an composite of processing speed attained from several measures of processing speed. Executive function — a collection of processes orchestrated in the performance of purposeful, goal-directed behavior — was measured using the Parent and Teacher forms of the Behavior Rating Inventory of Executive Function (BRIEF). This study also explored the effect of previously identified risk factors for processing speed and executive function late effects. Finally, executive function late effects were further explored via the use of performance-based measures, including the Tower and Trail Making (Condition 4) tests of the Delis-Kaplan Executive Function System (D-KEFS). Hypotheses included (1) Survivors would demonstrate significantly poorer processing speed; (2) late effects risk factor variables (i.e., greater elapsed time since completion of treatment, lower age at diagnosis, and higher intensity of treatment) would predict poorer processing speed; (3) female gender would predict poorer processing speed; (4) parents and teachers would demonstrate both low interrater agreement (Hypothesis 4a) and differ significantly in the severity (Hypothesis 4b) of their ratings of Survivor executive function; (5) parent and teacher ratings of executive function would indicate significantly poorer Survivor metacognition (Hypothesis 5a), whereas Survivor behavioral regulation would not differ significantly (Hypothesis 5b); (6) risk factor variables would predict poorer Parent and Teacher ratings of Survivor metacognition; (7) female gender would predict poorer Parent and Teacher ratings of Survivor metacognition; (8) survivor processing speed and Parent and Teacher ratings of executive function would exhibit a positive relationship; and (9) poorer Survivor processing speed would predict poorer parent and teacher ratings of executive function. Results provided support for hypothesis 1 and 5a. Partial support was obtained for hypotheses 4a, 4b, and 7. Hypotheses 2, 3, 5b, 6, 8, and 9 were not supported.Item Working memory late effects in survivors of pediatric acute lymphoblastic leukemia(2011-08) Winter, Amanda Lee; Robillard, Rachel West; Carlson, Cindy I., 1949-; Keith, Timothy; Allen, Greg; Mercer, WaltAcute Lymphoblastic Leukemia (ALL) is the most commonly diagnosed malignancy in children (Pui, 2000; Steen & Mirro, 2000; American Cancer Society, 2009; Westlake & Bertolone, 2002). Modern advances in cancer treatment, such as combination chemotherapy (Ettinger, Bond, & Sievers, 2002; Rodman & Reed, 2009), have increased survivorship of ALL to nearly 85% (Westlake & Bertolone, 2002). This new population of ALL survivors is displaying a unique profile of cognitive late effects that are a result of the treatment (e.g. chemotherapy) which while effective in eradicating the disease, has neurotoxic properties (American Cancer Society, 2009). Late effects have been discovered in a variety of cognitive skills, including academic achievement, visual-spatial skills, and processing speed, but the most commonly seen late effects are in the areas of attention and memory (e.g. Askins & Moore, 2008; Cullen, Derrickson, & Potter, 2002; Leigh, 2000). While working memory is a skill that depends on both attention and memory (Baddeley 2000) and is important in both academic performance and life skills (Dark & Benbow, 1991; Geary, Hoard, & Hamson, 1999), it is relatively unstudied in this population. The purpose of this study was to investigate working memory abilities in survivors of pediatric ALL. Working memory skills in this population were compared to both sample and population IQ. Comparisons of verbal and nonverbal working memory and male and female working memory skills were compared as well. First, working memory, as measured by a composite, was not found to be significantly impaired when compared to sample and population mean IQ. However, a single subtest, Digit Span Backward from the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV; Wechsler, 2003), when compared to IQ outside the composite, was found to be significantly below IQ for both the sample and population mean. Second, no gender differences were found for working memory abilities. Finally, there was no difference between nonverbal and verbal working memory performance. While the results were nonsignificant, verbal working memory was worse than nonverbal working memory, which was the opposite of the hypothesized pattern. Implications, recommendations, and limitations of this study are discussed in detail.