Clinical Psychology Commons^™

Emotion Regulation Flexibility: Investigating Perseverative Thinking As A Novel Context, Beatris Garcia

Arts & Sciences Electronic Theses and Dissertations

Emotion regulation (ER) flexibility is a rapidly evolving field within affective science. Current advances have identified context sensitivity as a leading method for measuring ER flexibility, largely focusing on affectivity and situational control as markers of context. In this study, we propose an innovative approach to expand the list of contextual features tied to ER flexibility by using a framework based on Perseverative Thinking (PT). We examined seven PT dimensions, including pleasantness, repetitiveness, self-focus, other-focus, certainty, controllability, and temporal orientation, along with six ER strategies: reappraisal, acceptance, problem solving, expressive suppression, distraction, and cognitive avoidance. Once a day over the …

Social Anxiety And Romantic Conflict: Examining Prospective Interpersonal Dynamics, Julia Levitan

Arts & Sciences Electronic Theses and Dissertations

Social anxiety disorder (SAD) is associated with impairment in close relationship functioning, including romantic relationships. Although interpersonal theories point to dimensions of dominance and warmth as relevant factors, the momentary interpersonal dynamics that may be contributing to relationship problems remain poorly understood. In the present study, I aimed to examine contemporaneous and prospective associations between dominance and warmth in individuals with (n = 30) and without (n = 29) SAD and their romantic partners during a 10-minute conflict task. Using the Continuous Assessment of Interpersonal Dynamics (CAID) system and multilevel dynamic structural equation modeling (ML-DSEM), I found that …

Transdiagnostic Predictors Of Everyday Functioning: Examining The Relationships Of Depression And Reinforcement Learning, Nada Dalloul

Arts & Sciences Electronic Theses and Dissertations

Background and Hypothesis. Identifying the factors contributing to functional deficits in psychotic disorders is essential to developing effective interventions. To address gaps in the literature, the current study had several goals: examine whether there are differential relationships across domains of neurocognition and function, assess whether reinforcement learning is related to function, identify how and if predictors of function are transdiagnostic, determine whether depression and positive symptoms contribute to function, and to further explore whether the modality of assessing function impacts the observed relationships.

Study Design. We examined the neurocognitive and symptomatic predictors of individual functional domains across three measures …

Adapting Radically Open Dialectical Behavior Therapy (Ro-Dbt) For Adolescents: Preliminary Testing Of Mechanisms Of Change, Molly Fennig

Arts & Sciences Electronic Theses and Dissertations

Background: Overcontrol is a phenotype characterized by inflexibility, perfectionism, and a need for control or structure, which increases risk for disorders such as anorexia nervosa, social anxiety, and obsessive-compulsive disorder. Given high comorbidity and limited efficacy of current treatments for these disorders, Radically Open Dialectical Behavior Therapy for adolescents (RO DBT-A) attempts to improve outcomes by targeting overcontrol as a transdiagnostic mechanism. This study aimed to test preliminary efficacy of telehealth-delivered RO DBT-A in targeting overcontrol as a mechanism of psychopathology in a heterogeneous clinical sample.

Method: Participants were female adolescents (ages 13-21; 83% white; 80% non-Hispanic/Latino) who presented with …

An Online Vignette Study To Examine The Outcomes Of A Preclinical Alzheimer Disease Diagnosis, Matthew John Wynn

Arts & Sciences Electronic Theses and Dissertations

As Alzheimer disease research forges ahead, and new potential treatments are developed, a conceptualization is emerging of a presymptomatic disease stage. This stage, known as preclinical Alzheimer disease, is characterized by the buildup of amyloid beta and tau proteins in the brain to abnormal levels in a cognitively normal person. There are unknown potential risks and benefits of communicating biological marker risk information for Alzheimer disease using the preclinical Alzheimer disease diagnostic label. The current study uses a vignette methodology to measure older adults’ understanding of risk information when presented with information regarding their risk for developing Alzheimer dementia. Participants …

Interpersonal Emotion Regulation In Current And Remitted Major Depressive Disorder: An Experience Sampling Study, Yunjing Liu

Arts & Sciences Electronic Theses and Dissertations

Individuals with major depressive disorder (MDD) have difficulties regulating emotion on their own. As people also turn to others for help with emotion regulation (i.e., interpersonal emotion regulation [IER]), we examined whether these difficulties extend to IER in current and remitted MDD. We generally expected individuals with current MDD (and remitted MDD to a lesser extent) to utilize IER in distinct ways compared to those with no history of psychiatric disorders (i.e., controls) due to differences in emotional, cognitive, and interpersonal functioning. Using experience sampling, adults with current MDD (n=48), remitted MDD (n=80), and controls (n=87) reported on how frequently …

Personality Pathology And Cognitive Aging: The Role Of Interpersonal Stress, Patrick Joseph Cruitt

Arts & Sciences Electronic Theses and Dissertations

Research on the relationship between normal-range personality and cognitive aging has demonstrated consistent, but modest, effects. The current investigation seeks to increase our understanding of unhealthy cognitive aging by examining the maladaptive extremes of personality. Borderline and avoidant personality disorder (PD), but not obsessive-compulsive PD, were hypothesized to show prospective associations with cognitive aging. Interpersonal stress was expected to mediate these relationships. The current investigation tested these hypotheses in two longitudinal studies of older adulthood: the Alzheimer’s Disease Research Center cohort (ADRC, N = 434, Mage = 69.95, 56% women) and the St. Louis Personality and Aging Network study (SPAN, …

Altered Network Organization And Screen Time Use In Childhood Attention-Deficit / Hyperactivity Disorder (Adhd), Elizabeth Jane Hawkey

Arts & Sciences Electronic Theses and Dissertations

Introduction: Symptoms of attention-deficit/hyperactivity disorder (ADHD) have been associated with alterations in functional connectivity involving networks in the developing brain that support optimal cognitive control. However, a clear profile of altered connectivity has yet to emerge, and it remains unclear whether changes in behavioral patterns such as screen time (ST) contribute to ADHD symptomatology and altered connectivity in networks that support cognitive control. The current study examined connectivity between large-scale networks associated with cognitive control (CC), measures of executive function (EF) which index CC, and ST in children with ADHD. Methods: Our sample included 11,874 children (ages 9-11, 52% male) …

A Secondary Data Analysis Of The Prevalence Of Reported Dementia And Subjective Cognitive Decline Across U.S. National Surveys, Matthew C. Picchiello

Arts & Sciences Electronic Theses and Dissertations

Within the United States, many large-scale, nationally representative studies exist with the goal of tracking and monitoring aspects of health. These studies are often used to establish the prevalence of dementia and subjective cognitive decline (SCD) in the population. The goal of the current study is to examine how different population-based studies probe respondents about conditions related to cognitive impairment, and to assess similarities and differences in point estimates. We reviewed eight studies and identified comparable items related to dementia and SCD. We calculated design-appropriate point prevalence estimates and compared weighted estimates across studies, finding a wide range and statistically …

Fearful Versus Dismissive Beliefs About Emotion: Divergent Pathways To Non-Acceptance Of Emotion, Natasha Haradhvala Bailen

Arts & Sciences Electronic Theses and Dissertations

High non-acceptance of emotion, or the rejection of one’s own emotional experience as bad or unacceptable, is consistently associated with depressive pathology, including elevated depressive symptoms and past and current major depressive (MDD) diagnoses. To progress toward a fuller understanding of non-acceptance and depressive pathology, it is important to identify other associated constructs that could theoretically contribute to this association. Indirect evidence suggests that negative beliefs about emotion—that is, stable underlying negative beliefs about the meaning, value, or consequences of one’s emotions—could be one such factor, as could negative emotion intensity and emotional clarity (or the degree to which one …

Blood Phenylalanine Trajectory And Executive Function Outcomes In Individuals With Phenylketonuria, Clarissa Tardiff

Arts & Sciences Electronic Theses and Dissertations

Phenylketonuria (PKU) is an autosomal recessive disorder characterized by mutations in phenylalanine hydroxylase genes. As a result, phenylalanine (Phe) metabolism is disrupted, and this amino acid accumulates in blood and tissue (Pietz, 1998; Scriver et al., 2000). Although the most severe symptoms of PKU may be avoided by early detection and treatment, many individuals with early-treated PKU still experience difficulties in executive function, attention, and processing speed (Antenor-Dorsey et al., 2013; Araujo et al., 2013; Christ et al., 2020; Hawks, Strube, Johnson, Grange, & White, 2018; Hood, Grange, Christ, Steiner, & White, 2014; Janos et al., 2012; White et al., …

Social And Non-Social Pleasure In Schizophrenia: Associations With Negative Symptoms And Depression, Jaisal Merchant

Arts & Sciences Electronic Theses and Dissertations

Individuals with schizophrenia can experience both negative and depressive symptoms, which may differentially relate to hedonic experience. Additionally, it is unclear whether these symptoms relate to social pleasure in the same way as overall pleasure. This study used Ecological Momentary Assessment in schizophrenia to investigate the unique relationships of negative and depressive symptoms to anticipatory and consummatory pleasure overall, and when split into social and non-social instances. Depressive symptoms negatively related to both anticipatory and consummatory pleasure, while negative symptoms negatively related to anticipatory but not consummatory pleasure. Although negative symptoms negatively related to both anticipatory and consummatory non-social pleasure, …

Personalized Models Of Social Anxiety Disorder And Depression, Marilyn L. Piccirillo

Arts & Sciences Electronic Theses and Dissertations

Social anxiety disorder (SAD) is an important risk factor for major depressive disorder (MDD) and together this comorbidity constitutes a highly impairing syndrome and vicious cycle of symptomatology, associated with tremendous health costs and societal burden. Despite much group-level research examining risk factor for MDD specifically, there is limited group and individual-level research evaluating how individuals with SAD transition into depressive episodes. Clinical and theoretical evidence suggests that each patient may exhibit a unique personalized pattern of risk factors. These idiographic patterns may contradict relationships seen at the group level. In this dissertation, women (N = 35) with SAD and …

Decision-Making Difficulty In Major Depression: Understanding Indecisiveness And The Role Of Expected Affect, Haijing Wu Hallenbeck

Arts & Sciences Electronic Theses and Dissertations

Decision-making difficulty is a prevalent symptom among individuals with major depressive disorder (MDD). Decision-making difficulty has been found to be pervasive across different areas of decision-making in current MDD; however, its exact nature for some areas (e.g., indecisiveness) is not well characterized, and the extent to which it is a scar of MDD is not determined. Furthermore, affective disturbances (e.g., in expected affect) have been theorized to contribute to decision-making difficulty in MDD, but empirical studies are needed to test this theory. In my two-study dissertation on depression, Study 1 focused on the dimensionality and validity of indecisiveness, and Study …

Patterns Of General- And Eating Disorder-Related Psychopathology In Relation To Weight Change In Treatment-Seeking Children, Anne Claire Grammer

Arts & Sciences Electronic Theses and Dissertations

Few studies have examined the compounded impact of general psychopathology and eating disorder (ED) psychopathology on weight change in youth with overweight/obesity (OW/OB). We characterized patterns of general psychopathology and ED psychopathology in children with OW/OB and examined the impact on weight change following family-based behavioral obesity treatment (FBT). Children (n=172) with OW/OB participated in 4 months of FBT. General psychopathology (i.e., anxiety, depression), ED psychopathology (i.e., shape concern, weight concern, loss of control (LOC) eating), and child percent overweight (%OW) were assessed at baseline. Latent profile analysis identified patterns of general and ED psychopathology at baseline. Multiple linear regression …

Fear Of Positive Evaluation And Negative Affect From Inclusion In Cyberball, Jason Ted Grossman

Arts & Sciences Electronic Theses and Dissertations

Fear of positive evaluation (FPE) is a construct related to social anxiety that involves discomfort when receiving positive attention and feedback from others. FPE research has increased over the past decade, and results suggest that it may be an important part of social anxiety for some individuals; however, it is not yet known whether FPE may also include discomfort from being included in social situations. Level of inclusion was hypothesized to moderate the relationship between FPE and negative affect from being over included such that those with high FPE would feel more uncomfortable the more they were included. To test …

Neuroticism And Stressful Life Events: Probing Mechanisms Underlying Vulnerability To Stress-Related Depression, Erin Bondy

Arts & Sciences Electronic Theses and Dissertations

Elevated neuroticism (N) potentiates the depressogenic effects of stressful life events (SLEs). We first replicate this association using longitudinal data (N=971 older adults) from the St. Louis Personality and Aging Network (SPAN) study. Here, SLEs prospectively predicted future depressive symptoms, especially among those reporting elevated N, even after accounting for prior depressive symptoms and previous SLE exposure (NxSLE interaction: p=0.016, ΔR²=0.003). These findings were further replicated in cross-sectional analyses of the Duke Neurogenetics Study (DNS), a young adult college sample with neuroimaging data (n=1,343: NxSLE interaction: p=0.019, ΔR²=0.003). Because evidence suggests that stress may promote depression …

Effort, Avolition And Motivational Experience In Schizophrenia: Analysis Of Behavioral And Neuroimaging Data With Relationships To Daily Motivational Experience, Adam Culbreth

Arts & Sciences Electronic Theses and Dissertations

Recent research has suggested an association between motivational impairment in those with schizophrenia and reduced willingness to expend effort on experimental tasks. However, few studies have examined the neural correlates of effort-based decision-making in those with schizophrenia. In the current study, we aimed to examine willingness to expend effort, the associated neural circuitry of effort-based decision-making, and the impact of experimentally-defined effort-based decision-making on daily motivational experience in schizophrenia. We recruited 28 individuals with schizophrenia and 30 healthy controls to perform an effort-based decision-making task while undergoing fMRI scanning. In order to assess whether willingness to expend effort was associated …

Effort, Avolition And Motivational Experience In Schizophrenia: Analysis Of Behavioral And Neuroimaging Data With Relationships To Daily Motivational Experience, Adam Culbreth

Arts & Sciences Electronic Theses and Dissertations

Recent research has suggested an association between motivational impairment in those with schizophrenia and reduced willingness to expend effort on experimental tasks. However, few studies have examined the neural correlates of effort-based decision-making in those with schizophrenia. In the current study, we aimed to examine willingness to expend effort, the associated neural circuitry of effort-based decision-making, and the impact of experimentally-defined effort-based decision-making on daily motivational experience in schizophrenia. We recruited 28 individuals with schizophrenia and 30 healthy controls to perform an effort-based decision-making task while undergoing fMRI scanning. In order to assess whether willingness to expend effort was associated …

Spatial Navigation Ability As A Predictor Of Increased Clinical Impairment, Taylor Hendershott

Arts & Sciences Electronic Theses and Dissertations

Spatial navigation deficits are observed in Alzheimer disease (AD) cross-sectionally, but prediction of longitudinal clinical decline has been less examined. Cognitive mapping (CM) was assessed in 95 participants and route Learning (RL) was assessed in 65 participants at baseline. Clinical progression over an average of 4.16 years was assessed using the Clinical Dementia Rating scale. Relative predictive ability of these tasks was compared to episodic memory, hippocampal volume and cerebrospinal fluid (CSF) biomarkers (ptau₁₈₁/Aβ₄₂ ratio). CM and RL were significant predictors of clinical progression (ps181/Aβ₄₂ in prediction (psTaken together the results suggest that baseline spatial navigation …

Examining Emotional Pain Among Individuals With Chronic Physical Pain: Nomothetic And Idiographic Approaches, Madelyn Frumkin

Arts & Sciences Electronic Theses and Dissertations

Pain is often conceptualized as an experience that is both physical and emotional. These two components are often difficult to distinguish, which may contribute to the experience of chronic physical pain without an apparent physical cause. In the current two studies, I sought to examine whether emotional pain is associated with physical pain severity for individuals with chronic pain. Emotional pain and the more specific experiences of psychological and social pain have been defined as the experience of pain affect in response to non-physical stimuli (i.e., thwarted belongingness, loss, social rejection). In Study 1, I found that emotional and psychological …

Emotion Differentiation Moderates The Effects Of Rumination On Depression: A Longitudinal Study, Yunjing Liu

Arts & Sciences Electronic Theses and Dissertations

Elevated trait rumination is associated with and predicts the onset of major depressive disorder (MDD), but not all people with elevated trait rumination develop MDD. We hypothesize that certain emotional processes weaken the rumination-depression link, protecting people against increases in depression. In the current prospective longitudinal study, we examined one such process, emotion differentiation—the ability to identify and label specific emotions. Because higher negative emotion differentiation (NED) has been associated with greater psychological well-being and people typically ruminate in the context of negative affect, we predicted that NED, but not positive emotion differentiation (PED), would moderate the rumination-depression association, such …

Exercise Engagement And Longitudinal Change In Alzheimer's Disease Biomarkers, Regional Brain Structure, And Cognitive Functioning, Marta Stojanovic

Arts & Sciences Electronic Theses and Dissertations

No abstract provided.

Bivariate Latent Change Score Analysis Of Peer Relations From Early Childhood To Adolescence: Leading Or Lagging Indicators Of Psychopathology, Brent Ian Rappaport

Arts & Sciences Electronic Theses and Dissertations

Despite significant public health concerns, the association between problematic peer relations (e.g., bullying) and psychopathology remains unclear. Thus far research has suggested three possible models of this association: that peer relations lead, or are a risk factor for symptoms of psychopathology (interpersonal risk model); lag, or are a consequence of psychopathology (interpersonal scar model); or both lead and lag psychopathology (transactional model). We additionally propose and test the hypothesis that peer relations may be a leading or lagging indicator of psychopathology depending on the developmental period (developmental model). Measures of youth’s peer relations (as reported by a parent and teacher …

Biological And Behavioral Mechanisms Underlying Childhood Physical Abuse And Age-Related Disease: Borderline Personality Pathology And Inflammation, Christina Rae Di Iorio

Arts & Sciences Electronic Theses and Dissertations

Background: The frequent comorbidity of psychiatric and physical health conditions may be partially attributable to early life stress-related changes in inflammatory signaling and behavior (e.g., borderline personality pathology, health behaviors) that reciprocally maintain and enhance their effects on overall health.

Methods: Using data from older adults (n=1,630) who participated in the ongoing longitudinal St Louis Personality and Aging Network (SPAN) study, we examined associations between childhood physical abuse, borderline pathology, inflammation markers (i.e., interleukin 6, c-reactive protein), health behaviors, and physical health. Morning fasting serum IL-6 and CRP were assayed from a subset of participants (n=791). Borderline pathology factor scores …

Trans-Diagnostic Relations Between Functional Brain Network Integrity And Cognition, Julia May Sheffield

Arts & Sciences Electronic Theses and Dissertations

Cognitive impairment occurs across the psychosis spectrum. However it is unknown whether these shared manifestations of cognitive dysfunction also reflect shared neurobiological mechanisms, or whether the source of impairment differs. One common feature of cognitive impairment across psychotic disorders is that the impairments are often ҧeneralizedӬ indicating deficits in a range of cognitive domains, including executive functioning, processing speed, memory, and attention. The goal of the current study was to determine whether the similar generalized cognitive deficit observed across psychotic disorders is also associated with a shared putative mechanism of functional brain network integrity. To address this question, we estimated …

The Role Of Personality In The Development Of Health Disparities During Late-Mid Life, Juliette Mcclendon Iacovino

Arts & Sciences Electronic Theses and Dissertations

Objectives: The current study examined race/gender disparities in initial levels and trajectories of self-reported physical and mental health, and health care utilization, as well as the impact of personality and stressful life events on race/gender disparities. We hypothesized that health disparities would remain stable or decrease over time; that at-risk personality traits (e.g., high neuroticism) would have a more robust negative impact on health for black participants; that trust would mediate racial disparities in health; and that personality traits would moderate the association between stressful life events and health trajectories differentially across race/gender. Methods: Analyses utilized the first six waves …

Preschool Executive Function Predicts Childhood Resting State Functional Connectivity And Adhd And Depression, Elizabeth Hawkey

Arts & Sciences Electronic Theses and Dissertations

Background: Measures of executive function (EF), such as the Behavior Rating Inventory of Executive Function, distinguish children with Attention-Deficit/Hyperactivity Disorder (ADHD) from control children, but less work has examined relationships to depression or brain network organization. This study examined whether early childhood EF predicted a new onset or worsening of ADHD and/or depression, and examined how early childhood EF related to functional connectivity of brain networks at school age. Methods: Participants were 247 children, enrolled at ages 3-6, from a prospective study of emotion development. The BRIEF Global Executive Composite (BRIEF-GEC) was used as the measure of EF in early …

Changes In Personality Traits And Personality Pathology In Older Adults: Self And Informant Perspectives, Hannah R. King

Arts & Sciences Electronic Theses and Dissertations

A relatively small amount of research has examined personality and personality disorder change from more than one perspective, particularly in older adults. The main aim of this study is to examine personality and personality disorder change in older adults from multiple perspectives including an interview assessment, self-report, and informant-report. Data from the St. Louis Personality and Aging Network (SPAN), a representative sample of St. Louis residents with 1,630 participants and their informants, was used to study change. We use structural equation modeling to test mean-level changes and individual differences in change over the course of the study. For personality disorders, …

Evaluating A Targeted, Universal Middle School Program For Childhood Overweight And Obesity: Stayingfit, Myra Altman

Arts & Sciences Electronic Theses and Dissertations

ABSTRACT OF THE DISSERTATION

Evaluating a Targeted, Universal Middle School Program for Childhood Overweight and Obesity: StayingFit

by

Myra Altman

Doctor of Philosophy in Psychology

Washington University in St. Louis, 2016

Professor Denise E. Wilfley, Chairperson

Childhood obesity is a pressing public health concern associated with significant medical and psychosocial comorbidities. Intervention is crucial, and schools are often suggested as an important venue through which to intervene, although the results of such interventions are inconsistent and mixed. The present study sought to expand on the literature by evaluating the effect of a targeted and universal school-based obesity intervention, StayingFit, in …