Browsing by Subject "Stress, Psychological"
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Item Attachment Influences within a Gynecologic Cancer Population(2012-08-31) Adams, Cassandra Leigh; Evans, Harry Monty, Ph.D.Despite significant levels of distress and demonstrated benefits of psychosocial intervention, few women diagnosed with gynecologic cancers utilize psychosocial resources. Research indicates adult attachment style and perception of social support impact distress. However, relationships between these variables are poorly understood. Participants completed measures of distress, adult attachment style, and perception of social support and provided information regarding self-reported openness to psychosocial services and barriers to using those services. Our analyses identified significant relationships between adult attachment dimensions, distress, perceived social support, and openness to and use of psychosocial services. Distress was significantly associated with openness to and use of psychiatric medication. Perceived social support demonstrated significant mediation effects between attachment anxiety and distress. Similarly, perceived social support demonstrated significant mediation effects in the relationship of elevated depression and high attachment avoidance to use of psychiatric medication. However, significant study limitations may be assumed to have negatively impacted the ability to draw meaningful conclusions from the data. Future research would benefit from further examination of the relationships among adult attachment, distress, perceived social support, and openness to and use of psychosocial services. Clearer understanding the nature of these relationships could guide care providers in being able to more effectively provide services to women who are experiencing significant distress but fail to access services. More effective provision of services and subsequent reduction in distress would likely improve health outcomes.Item Benefit Finding, Negative Affect, and Daily Diabetes Management among Adolescents with Type 1 Diabetes(2010-11-02T18:19:51Z) Tran, Vincent Huy; Wieb, DeborahThis study examined whether benefit finding was associated with daily experiences of diabetes stress, negative affect, and diabetes management (e.g. daily average blood glucose and daily perceptions of coping effectiveness) among adolescents with type 1 diabetes. Early adolescents aged 10-15 with type 1 diabetes (n=209) completed a benefit finding measure prior to vi participating in a 14-day daily diary study that provided information on daily diabetes stress, daily reports of how well they managed daily diabetes stressors, and daily emotional experiences. Blood glucose readings were also collected during the two-week study, and daily averages were calculated. Hierarchical linear modeling (HLM) was utilized to investigate day-to-day fluctuations of diabetes stress, emotion, and diabetes management as well as investigate whether these daily fluctuations differed as a function of benefit finding. Benefit finding was associated with overall reported higher average daily levels of both positive and negative affect across a two-week period. Benefit finding was associated with a stronger negative correlation between anxiety and lower perceived coping effectiveness. It was also marginally associated with a greater decline in next-day anxiety among older adolescents. Although benefit finding did not buffer adverse associations between negative affect and poorer diabetes management, there was evidence that it may serve to regulate anxiety over time. These findings are consistent with prior research suggesting that benefit finding occurs in a context of distress and anxiety and may serve as an emotion coping resource. However, questions arise about whether benefit finding facilitates better daily diabetes management in the context of ongoing stress and negative emotion during adolescence.Item Childhood Trauma, Adult Psychosocial Stress, and the Mediating Effects of Alcohol Consumption(2011-12-12) Fielding, Sarah Katherine; Adinoff, Bryon HarlenThe present study examined the relationship between childhood trauma and adult psychosocial stress, and assessed for the potential mediating effects of alcohol consumption. Data were collected from 66 alcohol dependent men currently enrolled in residential drug and alcohol treatment. Participants completed interviews and questionnaires to assess for the experience of childhood trauma, chronic psychosocial stress experienced in the six months preceding treatment, and the frequency and quantity of alcohol consumption. While the relationship the experience of childhood trauma and adult psychosocial stress was not found to be significant, the presence of a statistical trend was identified. Additionally, alcohol did not mediate the relationship between childhood trauma and adult psychosocial stress. While study hypotheses were not supported, significant relationships were identified between various domains childhood trauma and alcohol consumption. Major findings included significant positive correlations between a total measure of childhood trauma and the number of drinks and the number of drinks consumed per drinking day in the six months preceding treatment, and number of drinks consumed in the six months preceding treatment. Present findings expand upon existing literature by using continuous variables to assess both trauma and stress in an alcohol dependent population.Item Predictors of Quality of Life in Multiple Sclerosis: Relationships between Cognitive, Physical, and Subjective Measures of Disease Burden(2011-12-14) Noll, Kyle Richard; Lacritz, Laura H.The varied constellation of symptoms characteristic of multiple sclerosis (MS) are often functionally impairing, affecting the health-related quality of life (QoL) of many of those afflicted. However, it remains unclear to what extent subjective, cognitive, and physical measures differentially predict overall health-related QoL in MS, and which (combination of) factors are most useful when making clinical inferences regarding patient well-being. Stepwise linear regression analyses were used to investigate predictors of QoL in 55 consecutive MS patients, recruited as part of the Cognition and Demyelinating Disease project at the UTSW MS Clinic. Out of all cognitive, physical, and self-report predictors of overall health-related QoL, only the Modified Fatigue Impact Scale (MFIS) was significant, accounting for 31% of the variance in Overall scores on the MSQOL-54 (p < .001). Significant predictors of mental health-related QoL included the Quick Inventory of Depressive Symptoms (QIDS) and the Modified Fatigue Impact Scale (MFIS) (p < .001). The QIDS alone accounted for 64% of the variance in MSQOL-54 Mental Composite scores, which increased to 71% with the inclusion of the MFIS. Significant predictors of physical health-related QoL included the MFIS, Timed 25-Foot Walk (T25FW), and Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) (p < .001). The MFIS alone accounted for 72% of the variance in MSQOL-54 Physical Composite scores, which increased to 76% with the inclusion of the T25FW, and 78% when the MSNQ was also added. These results suggested that measures of self-reported fatigue and depression were the best predictors of health-related QoL in the domains of overall, physical, and mental functioning. In light of these findings, screening for fatigue and mood dysregulation should be incorporated into routine clinical evaluations of MS patients. Results of ROC analyses revealed that the QIDS and MFIS were both significant discriminators of level of QoL (high vs. low) for each of the three MSQOL-54 summary measures (AUCs = .79 to .92). Examining rates of correct classification, specificity, and sensitivity, indicated that cut-scores of greater than nine on the QIDS and greater than 37 on the MFIS were optimal for discriminating between low and high QoL.Item Regulation of Adult Hippocampal Neurogenesis: Insights from Mouse Models of Dementia and Depression(2009-05-13) Donovan, Michael Harry; Eisch, Amelia J.While neurogenesis is largely complete by birth, the subgranular zone (SGZ) in the adult hippocampus continues to produce functional young neurons. The last decade has produced a multitude of research demonstrating that the process of SGZ neurogenesis is dynamically regulated. Stimuli that negatively impact SGZ neurogenesis include stress, depression models, aging and models of neurodegenerative disease. Positive regulators of SGZ neurogenesis include antidepressants and hippocampal-dependent learning. These results have sparked tremendous speculation, both scientific and popular, that adult hippocampal neurogenesis might be critical for mood regulation and/or memory, and might be a promising target for the treatment of depression and dementia. However, we still know little about underlying mechanisms of how increases and decreases in SGZ neurogenesis occur. Here, I examine several manipulations of adult hippocampal neurogenesis, focusing on potential neuromechanisms underlying alterations in SGZ neurogenesis. First, in a mouse model of dementia, I find that in addition to agedependant decline in SGZ proliferation, these mice have retarded migration and maturation of new SGZ neurons and ectopic proliferation in a normally non-neurogenic region. Second, I explore how the antidepressant fluoxetine increases SGZ neurogenesis. I show that the increase occurs only after chronic administration and is not preceded by changes in cell death, cell-cycle or proliferating cell lineage. I next address the capacity of proliferating SGZ cells to respond to brain-derived neurotrophic factor (BDNF), a neurochemical implicated in antidepressant action and neurogenesis regulation. I find that most proliferating cells do not contain the necessary TrkB receptors in vivo, and thus BDNF action is likely indirect or through type-1 stem cells, which contain TrkB. Finally, I look at changes in neurogenesis in a social-defeat depression model. I find that, like other models of repeated stress, social-defeat stress appears to produce a stress-induced decrease in S-phase cells. However, closer analysis reveals that this decrease does not indicate decreased proliferation, and mice that are behaviorally sensitive to the stress actually show an increase in neurogenesis overall. Taken together, these results emphasize the complexity of the processes that comprise adult hippocampal neurogenesis, highlighting the importance of further investigation into the neuromechanisms of changes in neurogenesis.