Digital Commons Network^™

Psychotherapy Outcome For Eating Disorders: A Meta-Analysis, Julia Bryn Hubbard

Theses and Dissertations

The purpose of this project was to summarize psychotherapy outcomes for eating disorders using meta-analysis. Psychotherapy was defined as any psychosocial treatment including face-to-face therapy, self-help, and Internet approaches. All primary studies, meeting inclusion/exclusion criteria from 1980 to 2010, were included. Results suggested that individuals treated with active treatments demonstrate better outcomes than those in control conditions (d= 0.33, p <.01, 95% CI [0.19-0.46]). CBT was the most often occurring treatment in the primary studies and a small effect, favoring CBT, was found when the treatment was compared to all other active treatments (d = 0.16, p = .02, 95% CI [0.03-0.28]). Internet and self-help approaches continue to show promise with Internet treatments demonstrating superior outcomes to control conditions (d = 0.54, p <.01, 95% CI [0.19-0.90]). More research is needed to determine whether these approaches can suffice as stand-alone treatments or if they are best used in addition to already well-established approaches (i.e., individual CBT). The meta-analysis also explored whether treatment type, outcome measure, diagnosis, attrition, and diagnostic severity moderate treatment effect. Finally, the meta-analysis updated and improved upon previous meta-analyses by focusing on randomized controlled trials, including all diagnoses of eating disorder, only combining effect sizes from similar conditions, including all possible studies that meet inclusion criteria, computing and comparing effect sizes for outcome measures beyond those considered primary to eating disorder treatment, and also addressing outcomes for all brands of psychotherapy including traditional talk therapy, self-help, and Internet approaches.

Adaptation To The U.S. And Religion/Spirituality: Experiences Of Indian International Students, Kirti Potkar

Theses and Dissertations

Religion and spirituality are deemed an important aspect of human diversity, found to be important to people, and have significant impact on different aspects of functioning. Given the rising numbers of international students on U.S. campuses, it becomes important to examine how religion/spirituality impacts their sojourn in the U.S. This study explored the religious/spiritual experiences of Indian international students here in the U.S. using a qualitative approach. Thirteen Indian international students pursuing graduate degrees in the U.S. were interviewed. The interviews were then transcribed and analyzed using a synthesis of hermeneutic methods informed by Kvale (1996). The following themes emerged …

Qeeg Correlates Of Cognitive Deficits In Multiple Sclerosis During Targeted Cognitive Tasks, Robert B. Frost

Theses and Dissertations

Multiple sclerosis (MS) is the most common neurological disorder of young adulthood and is often associated with cognitive impairment and emotional dysfunction. Due to the nature of the disease, the cognitive deficits in MS are often variable in their presentation, and consist of deficits in processing speed, attention, working memory, and executive functioning. The purpose of the present study was to explore common methods of documenting MS-related cognitive deficits, to elucidate the relationship between the cognitive deficits seen in MS and physiological markers of cognitive functioning (i.e., quantitative EEG), and to analyze the relationship between cognitive deficits and mood dysfunction …

Educational Services For Tibetan Students With Disabilities In India: A Case Study, Britany Anne Barnes

Theses and Dissertations

This case study describes services for students with disabilities at Karuna Home in Bylakuppe, Karnataka, India. Karuna Home is a residential rehabilitation center for students with cognitive or physical disabilities whose parents are Tibetan refugees. The study triangulated data from interviews, observations, and school documents to describe educational policies and procedures, and cultural attitudes toward disability. Results show that the Karuna Home program is undergirded by Buddhist thought and theology regarding care and concern for those in difficult circumstances. The school serves students with a range of mild to severe disabilities and is fully staffed, but teachers and other service …

Error Processing And Naturalistic Actions Following Moderate-To-Severe Traumatic Brain Injury, Daniel A. Good

Theses and Dissertations

Moderate-to-severe traumatic brain injury (M/S TBI) can affect an individual's ability to perform daily tasks. For example, individuals with M/S TBI are more likely to commit errors on tasks such as making a meal or wrapping a present. The neural processes involved in such errors are poorly understood. Studies suggest that neurophysiologic markers of cognitive control and error processing may be helpful in gaining additional insight into errors on naturalistic action tasks. Unfortunately, previous experimental methods left a methodological gap which limited the use of neurophysiological markers in the study of naturalistic action. Several recent studies in healthy adults have …

Scheduled Healing: The Relationship Between Session Frequency And Psychotherapy Outcome In A Naturalistic Setting, David Mcconkie Erekson

Theses and Dissertations

The dose-effect relationship in psychotherapy has been examined extensively, but few studies have included session frequency as a component of psychotherapy "dose." Those studies that have examined the effects of session frequency have indicated that it may affect both the total amount of recovery and the speed of recovery. No studies were found examining the clinical significance of this construct in a naturalistic setting. The change trajectories of 16,003 clients were examined using multi-level modeling and including session frequency as a fixed effect. Of these clients, subgroups were identified that were scheduled approximately once a week or approximately once every …

The State Of The Research: Meta-Analysis And Conceptual Critique Of Mild Traumatic Brain Injury, Ryan Lance Nelson

Theses and Dissertations

Researchers studying the long-term cognitive sequelae of mild traumatic brain injury (mTBI) have produced disparate results. Some studies have shown little to no long-term cognitive effects while others have shown that persistent cognitive sequelae continue to affect a subgroup of patients. Meta-analysis has been used to try to integrate these contrasting results to foster a coherent understanding of the cognitive outcomes following mTBI. However, previous meta-analyses of long-term cognitive sequelae have used studies from a period of mTBI research where methodological rigor has been called into question (Carroll, Cassidy, Holm, Kraus, & Coronado, 2004). Using studies from this period, meta-analysts …

Perceptual Influences For Potential Hoarders, Sam Hardy, Marie Ricks, Brian Appel, Alex Dresden

FHSS Mentored Research Conference

Hoarding is defined as "(1) the acquisition of, and failure to, discard a large number of possessions that appear to be ... of limited value, (2) living spaces sufficiently cluttered so as to preclude activities for which these spaces were designed, (3) significant ... impairment in functioning caused by the hoarding, and (4) reluctance ... to return borrowed items." The average age of onset for hoarders is 11-15 years of age, with most hoarders reporting symptoms before age 20. Our research sought to find correlations regarding public perceptions of hoarding, including demographic, personal, and socioeconomic factors. Using a 55-question online …

Measuring Maladaptive Perfectionism, Joanna Burton, Amber Veazey, Melissa Tingey, Kat Green

FHSS Mentored Research Conference

Perfectionism is a personality trait in which individuals set high standards for themselves that are in line with an ideal image of how they should look, act, and perform. Perfectionism can be both adaptive and maladaptive. Identifying maladaptive perfectionism may aid individuals in consciously overcoming the negative side effects associated with maladaptive perfectionism and help individuals practice an adaptive perfectionism. We hypothesized that our measure, the Maladaptive or Adaptive Personality Scale (MAPS) would reliably and validly indicate and measure the presence of maladaptive perfectionism. Our measure used ten 4-point Likert scale questions measuring behavioral and emotional manifestations of perfectionism. MAPS …

Barriers To Accommodation Use For Students With Disabilities In Postsecondary Education, Michael James Lyman

Theses and Dissertations

Students with disabilities at the postsecondary level face a number of different barriers to accommodation use. Past research has shown that students with disabilities that use accommodations obtain greater academic achievement and higher graduation rates. Limited research has been conducted to identify barriers to accommodation use, and the research that has been conducted has not sampled a population that was specifically identified as having faced barriers to accommodation use. By interviewing students with disabilities, who had been identified as having faced barriers, this study identified seven themes. Four of the identified themes were considered complex as they contained sub-themes, while …

The Hispanic Mortality Paradox: A Systematic Review And Meta-Analysis Of The Longitudinal Literature, J. Ruiz, P. Steffen, Timothy B. Smith

Faculty Publications

Objectives: The current objective was to compare Hispanic mortality rates to those of other racial/ethnic groups in order to investigate the possibility of a Hispanic mortality advantage.

Methods: We conducted a systematic review and meta-analysis of the published longitudinal literature reporting Hispanic individuals’ mortality of any cause compared with that of any other racial/ethnic group.

Results: Across 58 studies (4,615,747 participants), the random effects weighted average effect size was OR = 0.825 (P < .001, 95% CI = 0.75 to 0.91), corresponding to a 17.5% lower risk of mortality among Hispanic populations compared to other racial groups. The difference in mortality risk tended to be greater among older populations and varied as a function of pre-existing health condition, with effects apparent for initially healthy samples and for those with cardiovascular diseases. The results also differed by racial group comparison: Hispanics had lower overall risk for mortality than non-Hispanic Whites and non-Hispanic Blacks, but overall higher risk for mortality than Asian Americans.

Conclusions: These findings provide evidence of a small Hispanic mortality advantage, with implications for conceptualizing and addressing racial/ethnic health disparities.

Predictors Of Perfectionism In Latter-Day Saint Students, Preston V. Tenney

Theses and Dissertations

The purpose of the present study was to gain insight into the prevalence, nature and etiology of perfectionism in a sample of devout Latter-day Saint college students at Brigham Young University. A number of variables-including self-conscious emotions, mental health, interpersonal/cognitive style, and religious orientation-were entered into multiple regression models to determine the strongest predictors of perfectionism. Participants were 245 students studying at Brigham Young University in Provo, UT in the spring of 1995. The self-conscious construct of shame demonstrated to be the strongest predictor of perfectionism followed by depression and religious fundamentalism. In addition to these findings, it was found …

Effects Of Teacher Gender On Screening For Social, Emotional, And Behavioral Concerns For A Middle School Population, Susan E. Hardman

Theses and Dissertations

Students with Emotional and Behavioral Disorders (EBD) often experience serious educational difficulties and negative outcomes (Gresham, MacMillan, & Bocian, 1996; Landrum, Tankersley, & Kauffman, 2003; Rock, Fessler, & Church, 1997). School-wide screening to identify students with social, emotional, and behavioral concerns (SEB) allows school personnel to identify at-risk students and connect them with needed resources. Some students appear to be identified disproportionally, with male students identified as at-risk more frequently then female students (Young, Sabbah, Young, Reiser, & Richardson, 2009). There are many possible factors that could contribute to this disproportionate identification. Since screening for EBD is often based on …

Meta-Analysis Of The Effectiveness Of Biological And Non-Biological Treatments For Postpartum Depression, Sarah Jeung Soon Christian

Theses and Dissertations

I provided an updated, comprehensive review of treatments for mothers diagnosed with postpartum depression. Studies included in this meta-analysis were single-group pre-posttest, non-randomized and randomized controlled studies published from 1986 to 2010 that included face-to-face psychotherapy and psychopharmacology as well as non-traditional methods such as exercise and nurse-assisted counseling. 53 published studies were analyzed. The randomized studies showed a moderate to large effects (d= 0.72 to 1.25, k= 9) when postpartum interventions were compared to a control condition, and smaller effects (d= 0.3 to 0.57, k = 13) to treatment as usual. When postpartum interventions were compared to each other …

Mood And Memory: An Association Between Pattern Separation And Depression, Don J. Shelton

Theses and Dissertations

Depression is associated with reduced declarative memory performance and decreased hippocampal volume. Depression has also been associated with decreased levels of adult neurogenesis in the dentate gyrus. Computational models propose that neurogenesis is critical for the computational process of pattern separation, whereby distinct memory representations are created for very similar stimuli and events. It has been proposed that depression negatively impacts pattern separation abilities; however, a link between depression and performance in pattern separation memory tasks has yet to be investigated. Accordingly, we designed a study to investigate the relationship between pattern separation performance and the severity of depression symptoms. …

A Tutorial On Count Regression And Zero-Altered Count Models For Longitudinal Substance Use Data, Scott A. Baldwin, David C. Atkins, Cheng Zheng, Robert J. Gallop, Clayton Neighbors

Faculty Publications

Critical research questions in the study of addictive behaviors concern how these behaviors change over time - either as the result of intervention or in naturalistic settings. The combination of count outcomes that are often strongly skewed with many zeroes (e.g., days using, number of total drinks, number of drinking consequences) with repeated assessments (e.g., longitudinal follow-up after intervention or daily diary data) present challenges for data analyses. The current article provides a tutorial on methods for analyzing longitudinal substance use data, focusing on Poisson, zero-inflated, and hurdle mixed models, which are types of hierarchical or multilevel models. Two example …

Preliminary Examination Of International Students' Adjustment And Loneliness Related To Electronic Communications., Timothy B. Smith, David A. Shwalb

Faculty Publications

Electronic communication (e.g., e-mail, internet) may facilitate international students’ adjustment through contacts maintained with their native country. In the present study, the scores of 45 international students on a measure of adjustment and the Revised UCLA Loneliness Scale were significantly associated with their electronic communications involving their native country but not with general internet or e-mail use. International students’ scores on the Multigroup Ethnic Identity Measure were positively correlated with their amount of contact with people in their native country but were not correlated with scores on the measures of adjustment or loneliness.

Culturally Congruent Practices In Counseling And Psychotherapy: A Review Of Research., Timothy B. Smith

Faculty Publications

Are mental health interventions that are intentionally made congruent with clients’ cultural contexts more effective than traditional practices? If a large body of empirical data supports an affirmative response to this question, then multiculturalism may be deemed not only legitimate within but integral (primary) to mental health interventions. However, if the data are inconclusive or deemed inadequate, then multiculturalism will remain marginalized (secondary) as an egalitarian ideal, possibly worthy of public praise but privately labeled as “impractical” or worse. All other things being equal, empirical evidence should determine which path will be taken; this chapter will attempt to provide direction.

Religious Acculturation And Spirituality In Latter-Day Saint Committed Converts, Kristin L. Hansen, Laurie Page, Lane Fischer, Marleen Williams

Issues in Religion and Psychotherapy

This study examines religious acculturation and spirituality in committed Latter-day Saint (LDS) converts living in Utah. We conducted a qualitative analysis using interviews from a sample of 20 North American and 20 International Latter-day Saint converts attending or working at Brigham Young University (BYU)—a western LDS private university—of varying age, time since baptism, and country of origin. Of the 40 converts, 39 were classified as committed in their LDS religious affiliation using Henri Gooren’s (2007) Conversion Career Model. Based on our analysis of the interviews, several pertinent themes emerged: converts (1) recognize and choose to acculturate; (2) report positive changes …

Robert Frost's "Mending Wall" As An Allegory Of Tolerance: Understanding, Acceptance, And Invitation, Kristina Hansen

Issues in Religion and Psychotherapy

Lane Fischer’s discussion of the nature of law in Turning Freud Upside Down (2005) describes tolerance as the combination of understanding, acceptance, and invitation to do better. This conceptualization of tolerance is equated to love for the other. The poem “Mending Wall” by Robert Frost is analyzed as an allegory of tolerance so defined.

The Influence Of Pornography On Sexual Scripts And Hooking Up Among Emerging Adults In College, Scott R. Braithwaite, Gwen Coulson, Krista Keddington, Frank D. Fincham

Faculty Publications

The explosive growth in access to the Internet has led to a commensurate increase in the availability, anonymity, and affordability of pornography. An emerging body of research has shown associations between pornography and certain behaviors and attitudes; yet, how pornography actually influences these outcomes has not been documented. In two studies (Study 1N=969; Study 2N=992) we examined the hypothesis that pornography influences potentially risky sexual behavior (hooking up) among emerging adults via sexual scripts. Our results demonstrate that more frequent viewing of pornography is associated with a higher incidence of hooking up and a higher number of unique hook up …

An Exploratory Investigation Of Marital Functioning And Order Of Spousal Onset In Couples Concordant For Psychopathology, Scott R. Braithwaite, Kimberly Van Orden, Mike Anestis, Katherine Merrill Timmons, Frank Fincham, Thomas E. Joiner Jr., Peter M. Lewinsohn

Faculty Publications

Individuals with a psychiatric disorder are significantly more likely to have a spouse with a clinical diagnosis—marital concordance. We used a community sample of 304 couples concordant for either Major Depressive Disorder (MDD) or Substance Use Disorders (SUDs) to examine the relationship between marital functioning and gendered patterns of mental health diagnosis onset. For SUD concordance, couples in which wives onset before husbands—in spite of typical later onset for males—reported lower levels of marital satisfaction compared to couples in which the husband onset first. For MDD concordance, couples in which husbands onset with depression before wives—in spite of typical later …

Value Conflicts In Psychotherapy, Aaron P. Jackson, Jamie Hansen, Juliann M. Cook-Ly

Issues in Religion and Psychotherapy

Psychotherapy has historically been viewed as value neutral; however, over the last half-century, developments have led many scholars to conclude that we can no longer dismiss the role of values in therapy. Our position is that therapists and clients will inevitably encounter value conflicts during the course of psychotherapy. This article postulates how such conflicts can be addressed so as to preserve and promote the integrity and well-being of both client and clinician. We review challenges to value neutrality and summarize ethical considerations. We discuss strategies to manage values in psychotherapy and conclude by recommending areas for consideration in professional …

Longitudinal Course Of Female Eating Disorder Risk At Brigham Young University, Lane Fischer, Jacob Fischer, Lanae Valentine, Erin Winters, Joy Wiechmann, Karen Gochnour, Kristina Hansen, Maren Kanekoa

Issues in Religion and Psychotherapy

Three cohorts of entering freshman women were assessed over the course of four years at Brigham Young University (BYU). The Eating Attitudes Test (EAT-26) and the Body Shape Questionnaire (BSQ) were administered at the beginning of each fall and winter semester. Results showed (a) steadily decreasing average levels of eating disorder risk and body shape dissatisfaction over time, which was mirrored in each cohort; (b) significantly lower eating disorder risk than other college samples; (c) a typically high percentage of women with clinically significant body shape dissatisfaction; (d) significant correlation between the EAT-26 and the BSQ; and (e) notable subgroups …

Video Self-Modeling On An Ipad To Teach Functional Math Skills To Adolescents With Autism And Intellectual Disability, Cami Elizabeth Burton, Darlene Anderson, Mary Anne Prater, Tina Taylor

Faculty Publications

Research suggests that video-based interventions can provide increased opportunity for students with disabilities to acquire important academic and functional skills; however, little research exists regarding video-based interventions on the academic skills of students with autism and intellectual disabilities. The current study used a multiple baseline design across participants to investigate the effects of video self-modeling (VSM) on the mathematics skill acquisition of adolescents with autism. Four adolescent male students viewed videos of themselves on an iPad solving mathematical problems to estimate the amount of money used to pay for a given item and the amount to receive in change. Findings …

Patient And Provider Attitudes Toward Genomic Testing For Prostate Cancer Susceptibility: A Mixed Method Study, Wendy C. Birmingham, Neeraj Agarwal, Wendy Kohlmann, Lisa G. Aspinwall, Mary Wang, Jay Bishoff, Christopher Decket, Anita Y. Kinney

Faculty Publications

Background: The strong association between family history and prostate cancer (PCa) suggests a significant genetic contribution, yet specific highly penetrant PCa susceptibility genes have not been identified. Certain single-nucleotide-polymorphisms have been found to correlate with PCa risk; however uncertainty remains regarding their clinical utility and how to best incorporate this information into clinical decision-making. Genetic testing is available directly to consumers and both patients and healthcare providers are becoming more aware of this technology. Purchasing online allows patients to bypass their healthcare provider yet patients may have difficulty interpreting test results and providers may be called upon to interpret results. …

The Quality Of Spouses’ Social Networks Contributes To Each Other’S Cardiovascular Risk, Wendy C. Birmingham, Bert N. Uchino, Timothy W. Smith, Mckenzie Carlisle, Kathleen C. Light

Faculty Publications

Objectives: Although the quality of one’s own social relationships has been related to cardiovascular morbidity and mortality, whether a partner’s social network quality can similarly influence one’s cardiovascular risk is unknown. In this study we tested whether the quality of a partner’s social networks influenced one’s own ambulatory blood pressure (ABP). Methods: The quality of 94 couples’ social networks was determined using a comprehensive model of relationships that separates out social ties that are sources of positivity(supportive), negativity (aversive), and both positivity and negativity (ambivalent). We then utilized statistical models (actor-partner analyses) that allowed us to separate out the links …

Transitioning To Independence And Maintaining Research Careers In A New Funding Climate: American Society Of Preventive Oncology Junior Members Interest Group Report, Wendy C. Birmingham, Jada G. Hamilton, Parisa Tehranifar, Melinda L. Erwin, William M. P. Klein, Linda Nebeling, Jessica Chubak

Faculty Publications

The American Society of Preventive Oncology (ASPO) is a professional society for multi-disciplinary investigators in cancer prevention and control. The ASPO Junior Members Interest Group promotes the interests of predoctoral, postdoctoral, and junior faculty members within the Society, and provides them with career development and training opportunities. To this end, as part of the 37th ASPO Annual Meeting held in Memphis, Tennessee in March 2013, the Junior Members Interest Group organized a session designed to address issues faced by early-career investigators as they navigate the transition to become an independent, well-funded scientist with a sustainable program of research in the …

Elucidating Satisfaction With Physical Activity: An Examination Of The Day-To-Day Associations Between Experiences With Physical Activity And Satisfaction During Physical Activity Initiation, Scott A. Baldwin, Austin Baldwin, Valerie G. Loehr, Julie L. Kangas, Georita M. Frierson

Faculty Publications

Satisfaction with physical activity is known to be an important factor in physical activity maintenance, but the factors that influence satisfaction are not well understood. The purpose of this study was to elucidate how ongoing experiences with recently initiated physical activity are associated with satisfaction. Participants (n = 116) included insufficiently active volunteers who initiated a self-directed physical activity regimen and completed daily diaries about their experiences for 28 days. We used multilevel models to examine the associations between experiences with physical activity and satisfaction. Significant between-person effects demonstrated that people reporting higher average levels of positive experiences and lower …

Respite Care, Marital Quality, And Stress In Parents Of Children With Autism Spectrum Disorders, Amber Harper, Tina Taylor, James Harper, Susanne Olsen Roper, Mikle South

Faculty Publications

Parents of children with autism spectrum disorders (ASD) are at risk for having higher stress and lower marital quality than other parents. Survey data regarding respite care, marital quality, and daily hassles and uplifts were obtained from 101 mother-father dyads who were together raising at least one child with ASD (total # of children = 118). Number of hours of respite care was positively related to improved marital quality for both husbands and wives, such that a one-hour increase in weekly respite care was associated with a one-half standard deviation increase in marital quality. This relationship was significantly mediated by …