Social and Behavioral Sciences Commons^™

Evaluating The Association Between Depressive Symptoms And Glycemic Control Among Residents Of Rural Appalachia, Brittany L. Smalls, Adebola Adegboyega, Ellen Combs, Eli W. Travis, Felipe De La Barra, Lovoria B. Williams, Nancy Schoenberg

Journal of Appalachian Health

Introduction: Type 2 diabetes mellitus (T2DM) is associated with a range of co-morbid physical and psychological conditions, including depression. Yet there is a dearth of evidence regarding the prevalence of depression among those in Appalachia living with T2DM; this gap persists despite the higher regional prevalence of T2DM and challenging social determinants of health.

Purpose: This study aimed to provide greater detail about the relationships between T2DM and depressive symptoms in adults living in Appalachia Kentucky.

Methods: The present study was a cross-sectional analysis of baseline data derived from an ongoing study of Appalachia Kentucky adults living with T2DM. Outcome …

Alcohol Use, Sleep, And Depression Among Family Caregivers In The Time Of Covid-19, Ashley M. Strzelecki, Mairead E. Moloney, Alyssa T. Brooks, Jessica Weafer

Psychology Faculty Publications

The COVID-19 pandemic has substantially altered daily life around the world, resulting in significant impacts on health behaviors. The additional burdens imposed by family caregiving (i.e., providing unpaid care for children and/or adults) may further exacerbate negative effects of the pandemic on health and health behaviors, including increased alcohol consumption, poor sleep, and increased depressive symptoms. The current study examined this possibility. Participants (N = 320, mean age = 35.11 years) completed an online questionnaire assessing alcohol use, sleep, and depression during the COVID-19 pandemic (June–August 2020) and retrospectively assessed the same health behaviors in the months prior to the …

Differences In Distress Between Rural And Non-Rural Appalachian Breast Cancer Patient / Caregiver Dyads During The First Year Of Treatment, Jordan Tasman, Callie D. Mcadams, Jillian Lloyd, Ashton J. Brooks, Patricia Nola Eugene Roberson

Journal of Appalachian Health

Introduction: Breast cancer patients and their caregivers living in rural Appalachia face substantial health disparities compared to their non-rural Appalachian counterparts. However, there is limited research on how these specific health disparities in rural Appalachian communities may impact patient psychological distress and caregiver strain during the first year of breast cancer treatment.

Purpose: The purpose of the current study was to assess differences in patient psychological distress (depression and anxiety) and caregiver strain between rural non-rural Appalachian breast-cancer-affected dyads (patients and their caregivers) during the first year of treatment.

Methods: A total of 48 Appalachian breast cancer patients (with a …

Mental Health In The Courtroom: How Victim Mental Illness Impacts Juror Decision-Making In A Rape Case, Mary M. Levi

Theses and Dissertations--Psychology

The influence of mental illness on jury decision-making has rarely been investigated, and even fewer studies have examined how jurors perceive a victim with mental illness. The present study investigated the effect of victim mental illness on jury decision-making in a rape trial using a 3 (victim mental health status: schizophrenia, depression, no illness) x 2 (participant gender: female, male) between-subjects design. I hypothesized that mock jurors would render fewer guilty verdicts in the schizophrenia condition compared to the depression condition, and render fewer guilty verdicts in the schizophrenia and depression conditions compared to the control. I also hypothesized that …

Promotion Of Early Recognition Of Depression To Improve Health Related Quality Of Life In Pediatric Oncology Patients, Jennifer Blankenship

DNP Projects

Background: Depression and anxiety are serious complications of cancer and deemed a challenging diagnosis due to the symptoms of depression mimicking common side effects of chemotherapy and radiation. Signs/symptoms frequently are underrecognized thus appropriate treatment is delayed, compromising the health-related quality of life (HRQOL) for pediatric oncology patients.

Purpose: Analyze existing physician and Advanced Practice Provider (APP) clinical practice regarding depression, via a pre- and post-survey and educational PowerPoint on the use of the Center for Epidemiological Studies Depression Scale for Children (CES-DC) to promote early recognition of depression.

Methods: A prospective, single-arm, study was completed in the Kentucky Children’s …

The Effect Of Travel Burden On Depression And Anxiety In African American Women Living With Systemic Lupus, Ashley A. White, Brittany L. Smalls, Aissatou Ba, Trevor D. Faith, Viswanathan Ramakrishnan, Hetlena Johnson, Jillian Rose, Clara L. Dismuke-Greer, Jim C. Oates, Leonard E. Egede, Edith M. Williams

Family and Community Medicine Faculty Publications

The United States has a deficit of rheumatology specialists. This leads to an increased burden in accessing care for patients requiring specialized care. Given that most rheumatologists are located in urban centers at large hospitals, many lupus patients must travel long distances for routine appointments. The present work aims to determine whether travel burden is associated with increased levels of depression and anxiety among these patients. Data for this study were collected from baseline visits of patients participating in a lupus study at MUSC. A travel/economic burden survey was assessed as well as the 8-item Patient Health Questionnaire (PHQ-8) and …

An Examination Of Communication Sequencing In Enacted Support Interactions For People With Major Depressive Disorder, Madison Adams

Theses and Dissertations--Communication

Social support is integral to helping one manage Major Depressive Disorder [MDD], but enacted social support, or the supportive behavior itself, is not always beneficial. Using a normative theoretical perspective on social support and theory related to sequencing as guiding frameworks, in this thesis I examined common sequential patterns of enacted support between support providers and individuals with MDD. Moreover, I investigated how individuals with MDD evaluated the helpfulness of each of the different sequential patterns. To examine the sequential patterns and how individuals with MDD evaluated their helpfulness, I interviewed 20 participants who had been diagnosed with MDD. The …

Socioemotional Selectivity And Psychological Health In Amyotrophic Lateral Sclerosis Patients And Caregivers: A Longitudinal, Dyadic Analysis, Suzanne C. Segerstrom, Edward J. Kasarskis, David W. Fardo, Philip M. Westgate

Psychology Faculty Publications

Objective: Socioemotional selectivity theory predicts that as the end of life approaches, goals and resources that provide immediate, hedonic reward become more important than those that provide delayed rewards. This study tested whether these goal domains differentially affected psychological health in the context of marital dyads in which one partner had been diagnosed with amyotrophic lateral sclerosis (ALS), a life-limiting disease.

Design: ALS patients (N = 102) being treated in three multidisciplinary clinics and their spouses (N = 100) reported their loneliness, financial worry and psychological health every 3 months for up to 18 months.

Main …

Evaluating The Relationship Between Phq9 And Global Pain Scale (Gps) Scores In Opioid Dependent Adults: A Retrospective Correlational Study, Lori Nolan

DNP Projects

Background: Depression, chronic pain and opioid dependence are conditions commonly encountered in primary care settings. These comorbidities create treatment challenges while negatively influencing outcomes of care. The Patient Health Questionnaire (PHQ9) and Global Pain Scale (GPS) are valid screening tools used to score depression and pain symptoms. The purpose of this study was to determine the relationship between the PHQ9 and Global Pain Scale (GPS) scores in opioid dependent adults with chronic pain to determine whether both tools are necessary.

Methods: This was a descriptive study using a retrospective correlational research design. Data was obtained from the electronic medical records …

Diabetes-Related Distress Screening: A Survey Of Primary Care Providers' Knowledge, Attitudes, And Practices In Treating Patients With Difficulty Meeting Glycemic Goals., Michele Patrice Paxton

DNP Projects

A patient with diabetes is two to three times more likely to be depressed than the general population. Furthermore, the combination of diabetes and depression is associated with increased morbidity and mortality. However, research has shown that treatment for depression does not correlate with lower HbA1c levels or a decrease in morbidity and mortality. Recently, a body of evidence has shown that increased HbA1c levels and depression are associated with the emotional burden of managing diabetes. The emotional burden is caused by the constant behavioral and mental demands of managing the disease and the worry and fear of the impending …

Transactions Between Thinness Expectancies And Depression In The Prediction Of Adolescent Weight Restricting Behaviors, Anna Marie L. Ortiz

Theses and Dissertations--Psychology

Both the transdiagnostic risk associated with depression and the eating disorder-specific risk associated with expectancies for reinforcement from thinness have been identified as risk factors for the development of weight restricting behaviors. The purpose of this study was to examine if these risk factors transact to further predict risk in youth. Depression, thinness expectancies, and weight restriction were assessed in 1,907 adolescents three times during the transitional period between middle school and high school. We compared three different possible transactional processes. Mediation tests demonstrated that depression in 8th grade predicted an increase in the number of weight restricting behaviors endorsed …

Psychosocial Functioning And The Cortisol Awakening Response: Meta-Analysis, P-Curve Analysis, And Evaluation Of The Evidential Value In Existing Studies, Ian Andres Boggero, Camelia E. Hostinar, Eric A. Haak, Michael L. M. Murphy, Suzanne C. Segerstrom

Psychology Faculty Publications

Cortisol levels rise immediately after awakening and peak approximately 30-45 minutes thereafter. Psychosocial functioning influences this cortisol awakening response (CAR), but there is considerable heterogeneity in the literature. The current study used p-curve and metaanalysis on 709 findings from 212 studies to test the evidential value and estimate effect sizes of four sets of findings: those associating worse psychosocial functioning with higher or lower cortisol increase relative to the waking period (CARi) and to the output of the waking period (AUCw). All four sets of findings demonstrated evidential value. Psychosocial predictors explained 1%-3.6% of variance in CARi and AUCw …

Latent Profile Analysis Of The Five Facet Mindfulness Questionnaire In A Sample With A History Of Recurrent Depression, Jenny Gu, Anke Karl, Ruth A. Baer, Clara Strauss, Thorsten Barnhofer, Catherine Crane

Psychology Faculty Publications

Background: Extending previous research, we applied latent profile analysis in a sample of adults with a history of recurrent depression to identify subgroups with distinct response profiles on the Five Facet Mindfulness Questionnaire and understand how these relate to psychological functioning. Method: The sample was randomly divided into two subsamples to first examine the optimal number of latent profiles (test sample; n = 343) and then validate the identified solution (validation sample; n = 340). Results: In both test and validation samples, a four-profile solution was revealed where two profiles mapped broadly onto those previously identified in nonclinical samples: “high …

The Impact Of A Civic Service Program On Biopsychosocial Outcomes Of Post 9/11 U.S. Military Veterans, Monica M. Matthieu, Karen A. Lawrence, Emma Robertson-Blackmore

Social Work Faculty Publications

Volunteering as a health promotion intervention, improves physical health, mental health, and social outcomes particularly in older adults, yet limited research exists for veterans. We conducted a preliminary study to explore whether volunteering impacts a variety of biopsychosocial outcomes, including symptoms of post-traumatic stress disorder (PTSD) and depression, among returning military veterans from Iraq and Afghanistan. A survey enrolling a prospective cohort of United States (U.S.) veterans who served in the military after 11 September 2001 and who participated in a national civic service program was conducted. A total of 346 veterans completed standardized health, mental health, and psychosocial self-report …

Trait Anxiety And Economic Risk Avoidance Are Not Necessarily Associated: Evidence From The Framing Effect, Ruolei Gu, Runguo Wu, Lucas S. Broster, Yang Jiang, Rui Xu, Qiwei Yang, Pengfei Xu, Yue-Jia Luo

Behavioral Science Faculty Publications

According to previous literature, trait anxiety is related to the tendency to choose safety options during risk decision-making, that is, risk avoidance. In our opinion, anxious people’s risk preference might actually reflect their hypersensitivity to emotional information. To examine this hypothesis, a decision-making task that could elicit the framing effect was employed. The framing effect indicates that risk preference could be modulated by emotional messages contained in the description (i.e., frame) of options. The behavioral results have showed the classic framing effect. In addition, individual level of trait anxiety was positively correlated with the framing effect size. However, trait anxiety …

Mental Health Treatment Seeking Patterns And Preferences Of Appalachian Women With Depression, Claire Snell-Rood, Emily Hauenstein, Carl G. Leukefeld, Frances Feltner, Amber Marcum, Nancy E. Schoenberg

Behavioral Science Faculty Publications

This qualitative study explored social-cultural factors that shape treatment seeking behaviors among depressed rural, low-income women in Appalachia—a region with high rates of depression and a shortage of mental health services. Recent research shows that increasingly rural women are receiving some form of treatment and identifying their symptoms as depression. Using purposive sampling, investigators recruited 28 depressed low-income women living in Appalachian Kentucky and conducted semistructured interviews on participants’ perceptions of depression and treatment seeking. Even in this sample of women with diverse treatment behaviors (half reported current treatment), participants expressed ambivalence about treatment and its potential to promote recovery. …

Intimate Partner Violence And Women's Cancer Quality Of Life, Ann L. Coker, Diane R. Follingstad, Lisandra S. Garcia, Heather M. Bush

CRVAW Faculty Journal Articles

Purpose

Because intimate partner violence (IPV) may disproportionately impact women’s quality of life (QOL) when undergoing cancer treatment, women experiencing IPV were hypothesized to have (a) more symptoms of depression or stress and (b) lower QOL as measured with the Functional Assessment of Cancer Therapy (FACT-B) and Functional Assessment of Chronic Illness Therapy—Spiritual Well-being (FACIT-SP) Scales relative to those never experiencing IPV.

Methods

Women, aged 18–79, who were included in one of two state cancer registries from 2009 to 2015 with a recent incident, primary, invasive biopsy-confirmed cancer diagnosis were recruited and asked to complete a phone interview, within 12 …

Extended Family Relationships: How They Impact The Mental Health Of Young Adults, Kayla Jansen

Theses and Dissertations--Family Sciences

This study bridges the gap in literature about the impact of extended family relationships on young adult depression and self-esteem. A sample of 304 undergraduate students between the ages of 18 and 21 at the University of Kentucky was recruited to complete an online survey about their immediate and extended family relationships and their mental health. The largest predictor of self-esteem and depression in early young adults is perceived social support from the family of origin, which is also moderately correlated with perceived support from extended family members. This indicates that extended family support collaborates with family of origin support …

What Can Parents Do? Examining The Role Of Parental Support On The Negative Relationship Between Racial Discrimination, Depression, And Drug Use Among African American Youth, Tamika C. B. Zapolski, Sycarah Fisher, Wei-Wen Hsu, Jessica Barnes

Educational, School, and Counseling Psychology Faculty Publications

African American youth who experience racial discrimination are at heightened risk to use drugs as a coping response to distress. Based on the buffer-stress hypothesis, we proposed that parental support would attenuate this effect. Participants were 1,521 African American youth between 4th and 12th grade. As hypothesized, a mediation pathway was observed among racial discrimination, depression symptoms, and drug use. This effect was observed for both genders, although the pathway was partially mediated for males. In addition, as hypothesized, parental support buffered the negative effect of depression symptomatology on drug use as a consequence of discrimination. Our findings highlight the …

Reducing Depression Among Older Adults: Informal Helping Versus Volunteering, Salih Salihoglu

MPA/MPP/MPFM Capstone Projects

Volunteerism is an unpaid productive activity that is exercised within a formal organization to benefit others that are not part of family or friends (Musick & Wilson, 2008). Alternatively, individuals could engage in informal helping which would be an activity undertaken outside a formal, structured organization. This paper addresses whether informal helping is also effective in reducing depression for older adults alongside volunteering. I hypothesize that informal helping is effective in reducing depression only when exercised for short durations. On the other hand, I hypothesize that volunteerism is only effective when exercised for long periods of time. I try to …

Postpartum Depression: The Effects Of A Video Intervention On Knowledge And Stigma, Lekie Dwanyen

Theses and Dissertations--Family Sciences

Postpartum Depression (PPD) has gained well-deserved traction in healthcare policy discourse as a public health concern. Although one in seven American women are believed to experience PPD, mental illness stigma induces feelings of shame and guilt, reduces treatment-seeking behaviors, and ultimately contributes to a low PPD diagnosis rate. Risk of experiencing PPD is associated with various contextual factors, yet little is known about the association between stigma and PPD risk factors. A multiple-segment factorial vignette was used with 1,871 respondents to examine the impact of maternal age, depression history, infant temperament, and diagnosis on attitudes toward PPD. In addition, the …

Relations Among Gender-Typical And Gender-Atypical Uses Of Aggression, Popularity, And Depression, Melissa Murphy

Kaleidoscope

The purpose of this study was to investigate how types of bullying engaged in by high school students (relational, physical, or verbal aggression) vary with gender and how they may be related to a student’s social status. Children in the ninth grade, from four different Kentucky high schools, were administered various measures as part of a larger study on social development in their own classroom. Measures used in our analysis included a bully and victim self-reported narrative, Bullying Questions and Belonging Questionnaire, and a Peer Nomination Scale. Results indicated that females used more relational aggression than males, and males used …

The Longitudinal Effects Of Participation In Structured Extracurricular Activities On Educational Achievement, Future Earnings, And Symptoms Of Depression With School Belongingness As A Mediating Variable In A Low-Income Sample, Christina L. Stacy

Theses and Dissertations--Educational, School, and Counseling Psychology

The purpose of this study was to examine the potential outcomes of participating in structured extracurricular activities (SEA) as an adolescent. Research has previously demonstrated that beneficial outcomes commonly associated with SEA participation include academic achievement and educational/career ambitions, positive social outcomes, and psychological well-being. It is thought that the benefits of SEA participation may be mediated by adolescents’ feelings of school belongingness and positive relationships. By extension, school belongingness is a key contributor to engagement, academic achievement, positive social relationships, and mental well-being. Although the research is typically positive, one must be careful in overgeneralizing that increasing student participation …

Effectiveness Of Psychotherapy For Youth In Poverty: A Benchmarking Study Of A Public Behavioral Health Agency Using A Client Feedback System, Jonathan Kodet

Theses and Dissertations--Educational, School, and Counseling Psychology

Objective: The purpose of this study was to evaluate the effectiveness of a public behavioral health (PBH) agency that had implemented continuous outcome feedback as a quality improvement strategy.

Method: I investigated the pre-post treatment outcomes of 4,389 ethnically diverse youths (6 to 17 years old) at or under the poverty line participating in treatment (from January 2008 to March 2014) for a broad range of primary diagnoses including depression and anxiety disorders (23%); adjustment disorders (27%); Attention Deficit/Hyperactivity Disorder (13%), various V-codes (18%); bipolar disorders (3%); and substance use disorders (2%). I also investigated the treatment outcomes …

Improving Depression Care For Older Home Health Patients, Sarah R. Schirmer

DNP Projects

Rates of depression in older home healthcare (HH) patients are highly prevalent. Although depression in this population is associated with increased rates of re-hospitalization, falls, and suicides, it is frequently under diagnosed and under treated. This Capstone Report examined this problem through three interrelated manuscripts. The first manuscript explored the problem through a review of the literature. This review determined that while there are many barriers to adequate depression care, programs that train clinicians to screen for depression and connect patients to depression care encourage adequate evaluation and treatment and can result in clinically significant changes in depression scores. This …

Emotion Recognition And Social Functioning In Children With And Without Attention Deficit Hyperactivity Disorder, Rebecca Flake Aldea

Theses and Dissertations--Psychology

This study examined the emotion recognition of children (ages 7-9 years) with and without Attention Deficit Hyperactivity Disorder (ADHD). Children completed two emotion recognition measures, the Diagnostic Analysis of Nonverbal Accuracy 2 (DANVA2) and the Child and Adolescent Social Perception measure (CASP). Children and their parents also completed an assessment of children’s social skills, the Social Skills Improvement System (SSIS). Children with ADHD reported a significantly greater level of depressive symptoms and had significantly lower full scale IQ scores than children without ADHD. When these differences were accounted for, children with ADHD continued to show a handful …

Acculturative Stress And Depressive Symptoms Among Korean Immigrant Elders Residing In Non-Korean Ethnic Enclaves, Stephanie Lyu Rhee

Theses and Dissertations--Social Work

Few studies have examined the relationships among personal factors, acculturative stress, coping resources, and depression of Korean immigrant elders residing in areas without any Korean ethnic enclave. Based on the stress and coping model and the sociocultural model of stress, coping, and adaptation, this cross-sectional study examined the relationships among acculturative stress, coping, and depression in 111 non-institutionalized Korean immigrant elders aged 60 and older residing in areas without any Korean ethnic enclaves in three neighboring states of Southwestern Ohio, North Central Region of Kentucky, and Southern Indiana. A majority of convenience and snowball sample participated in self-administered mailed surveys, …

Effects Of A Short-Term Mindfulness Intervention On Depression And Immune Function, Erin C. Walsh

Theses and Dissertations--Psychology

Pro-inflammatory cytokines have been implicated in the pathophysiology and maintenance of depression. This study investigated the effects of a short mindfulness intervention on pro-inflammatory correlates of depression (IL-6 and TNF-α) and selfreported psychological health. Sixty-four college females were assigned to a four-week mindfulness training group or a contact-control group. Cytokines and psychological health were assessed at baseline, post-treatment, and 3-month follow-up (mindfulness group only). IL-6 and TNF-α significantly decreased from baseline to post-treatment in the mindfulness group only; these changes were sustained at 3-month follow-up. No between-group differences in psychological health emerged. Although reductions in proinflammatory cytokines in the mindfulness …

Shame, Guilt, And Knowledge Of Hpv In Women Recently Diagnosed With Hpv-Related Cervical Intraepithelial Neoplasia (Cin), Sarah E. Flynn

University of Kentucky Doctoral Dissertations

The current study investigated the relationships between state shame, guilt, and disease knowledge in women recently diagnosed with cervical intraepithelial neoplasia (CIN) caused by the human papillomavirus (HPV). Recent research has indicated that diagnosis of HPV can elicit negative self-directed affect, including persistent experiences of shame. Studies have also shown that knowledge of HPV is low in the general population, even though it is the most common sexually transmitted infection. It is important to understand how shame affects those with HPV because shame is related to a decline in important immune parameters that may be essential in HPV clearance. A …

Depression, Sensation Seeking, And Maternal Smoking As Predictors Of Adolescent Cigarette Smoking, Judy Van De Venne, Kay Bradford, Catherine A. Martin, Megan Cox, Hatim A. Omar

Family Sciences Faculty Publications

The purpose of this study was to examine maternal and adolescent depression, maternal and teen sensation seeking, and maternal smoking, and their associations with adolescent smoking. Data were collected from a sample of 47 male and 66 female adolescents (ages 11-18 years) and their mothers from three different health clinics. The findings indicated that maternal sensation seeking was linked indirectly with adolescent smoking through teen sensation seeking, both of which were significantly associated with teen smoking (β = 0.29, p < 0.001 and β = 0.32, p < 0.001, respectively). Teen depression was associated positively with teen smoking (β = 0.24, p < 0.01) when controlling for sensation seeking behaviors. Maternal smoking was also directly linked to adolescent smoking (β = 0.20, p < 0.05). These findings underscore a potentially important role of sensation seeking in the origins of adolescent smoking, and clarify pathways of influence with regard to maternal attitudes and behaviors in subsequent teenage nicotine use.