Psychology Theses and Dissertations

Permanent URI for this collectionhttp://hdl.handle.net/1903/2801

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    HIPPOCAMPAL SUBREGION VOLUME IN HIGH-RISK OFFSPRING PREDICTS INCREASES IN DEPRESSIVE SYMPTOMS ACROSS THE TRANSITION TO ADOLESCENCE
    (2020) Hubachek, Samantha Qirko; Dougherty, Lea R.; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    The hippocampus has been implicated in the pathophysiology of depression. This study examined whether youth hippocampal subregion volumes were differentially associated with maternal depression history and youth’s depressive symptoms across the transition to adolescence. 74 preadolescent offspring (Mage=10.74+/-.84 years) of mothers with (n=33) and without a lifetime depression history (n=41) completed a structural brain scan. Youth depressive symptoms were assessed prior to the neuroimaging assessment at age 9 (Mage=9.08+/-.29 years), at the neuroimaging assessment, and in early adolescence (Mage=12.56+/-.40 years). Maternal depression was associated with preadolescent offspring’s reduced bilateral hippocampal head volumes and increased left hippocampal body volume. Reduced bilateral head volumes were associated with offspring’s increased concurrent depressive symptoms. Furthermore, reduced right hippocampal head volume mediated associations between maternal depression and increases in offspring depressive symptoms from age 9 to age 12. Findings implicate reductions in hippocampal head volume in the intergenerational transmission of risk from parents to offspring.
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    A Daily Diary Analysis of Preschool Depressive Behaviors: Same Day and Prospective Associations Across 14 Days
    (2018) Leppert, Katherine A; Dougherty, Lea R; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Depressive disorders can be observed in early childhood and are associated with significant concurrent and prospective impairment. Although young children demonstrate similar depressive behaviors as older children and adults, certain depressive behaviors, such as sadness and irritability, are more common in early childhood whereas other depressive behaviors, such as loss of pleasure and suicidal ideation, are much less common. However, little is known about day-to-day variations in common depressive behaviors and factors impacting those variations in early childhood. The current study examined the day-to-day variability and co-occurrence of two common depressive behaviors in young children, sadness and irritability, and predictors of their day-to-day change. Participants included 291 parents of preschool-aged children (ages 3-5). Parents completed a baseline questionnaire assessing demographics, current emotional/behavioral problems, and functional impairment, and then completed an electronic daily diary for 14 days assessing the frequency of daily depressive behaviors, sleep quality, and parent-child relationship functioning. Results indicated that irritability and sadness frequently co-occurred during the same day and were concurrently and prospectively associated with parent-child relationship functioning but not sleep quality. Moreover, we observed between-person stability, but within-person variability, in children’s sadness and irritability across 14 days, and that this variability was moderated by several factors. With few exceptions, we observed greater between-person stability in sadness and irritability for older preschoolers, for males, and for children with overall better functioning (e.g., absence of less common depressive symptoms, fewer baseline psychiatric symptoms, lower baseline impairment, better parent-child relationship functioning and sleep quality). Importantly, our findings highlight stability of children’s sadness and irritability relative to peers and variability relative to their own mean sadness and irritability, as well as provide evidence regarding factors predicting the day-to-day stability or variability of these common depressive behaviors. Understanding daily variation in child depressive behaviors and factors predicting variation can identify at-risk children and provide targets for prevention and intervention, which is particularly crucial given that preschool depression predicts later depression and other psychiatric disorders.
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    RECURRENCE AND TIMING OF EXPOSURE TO MATERNAL DEPRESSION AND THE DEVELOPMENT OF DEPRESSIVE AND CONDUCT SYMPTOMS IN CHILDREN WITH AND WITHOUT ADHD
    (2015) Wang, Christine; Chronis-Tuscano, Andrea; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    The current study examined the longitudinal associations between recurrence and timing of exposure to maternal depression and the development of depressive and conduct symptoms in children with and without ADHD. Methods: 125 children with ADHD and 122 comparison children, ages 4-6, were followed over an 8-year period (until age 12-14). Results: Total recurrence of maternal depression was associated with youth depressive and conduct symptoms. Moreover, early adolescent exposure to maternal depression predicted youth depressive symptoms for all children. Exposure to maternal depression during preschool, childhood, and early adolescence each independently predicted youth conduct symptoms. Child ADHD status moderated the link between total recurrence of maternal depression and youth depressive symptoms and the link between preschool exposure and youth depressive symptoms. Child ADHD status did not moderate relations between total recurrence and timing of exposure to maternal depression and youth conduct symptoms.
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    Mediators of the Relationship between Depression and Medication Adherence among HIV Positive Substance Users
    (2012) Magidson, Jessica F; Lejuez, Carl W; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Medication adherence is of utmost importance in predicting health outcomes across numerous chronic conditions, particularly HIV/AIDS. Highly active antiretroviral therapy (HAART) to treat HIV/AIDS requires high levels of adherence to maintain viral suppression, which is crucial for optimal HIV treatment and prevention. One of the most significant patient-level barriers to medication adherence is depressive symptoms. Even at subclinical levels, depressive symptoms predict nonadherence above and beyond other relevant psychosocial factors. Despite the focus on depressive symptoms as a reliable and powerful predictor of nonadherence, few studies have sought to test potential mechanisms underlying this relationship, which is an important step to advance our understanding of how depression affects adherence to inform intervention efforts. The current study utilized early behavioral theories of depression (Lewinsohn, 1974; Ferster, 1973) to select potential mediators that may be relevant to both depression and adherence. Specifically, we tested the key components of these models, (1) goal-directed activation, (2) positive reinforcement, and (3) punishment in one's environment as potential mediators of the relationship between depressive symptoms and medication adherence among HIV positive individuals in substance abuse treatment (n = 73). We examined adherence to HAART as well as adherence to other daily medications using a combination of self-report assessments (% of doses missed over past four days, frequency of doses missed across common reasons for nonadherence) and viral load. Greater levels of punishment mediated a positive relationship between clinician-rated depressive symptoms and greater frequency of missed doses across common reasons for nonadherence. Activation and positive reinforcement were unrelated to adherence or viral load in this sample. Findings suggest the importance of punishment in explaining the relationship between depression and medication nonadherence. Individuals with elevated depressive symptoms may perceive greater negative consequences related to medications (e.g., side effects, stigma) and may be less likely to overcome barriers necessary for optimal adherence. If findings continue to replicate, this may suggest a need to target punishment in HIV prevention and treatment, for instance in the context of integrated cognitive behavior therapy interventions that target depression and adherence among substance users.
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    BRIEF BEHAVIORAL ACTIVATION TREATMENT FOR DEPRESSION IN SPANISH-SPEAKING LATINOS: ACCEPTABILITY AND PRELIMINARY EVALUATION
    (2012) Collado-Rodriguez, Anahi D.; MacPherson, Laura; Lejuez, Carl W; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Although depression is highly treatable, disparities in mental health treatment in the US have prevented Latinos who lack English language proficiency from accessing efficacious interventions. Reasons cited for these disparities include language barriers, high cost of services, lack of culturally sensitive treatments, and stigma toward mental health treatment. A direct Spanish translation of the Brief Behavioral Activation Treatment for Depression (BATD) may be well-equipped to address the existing barriers through its focus on individual and cultural values, its efficiency and straight-forward nature, itsfocus on developing existing and new strengths, and conceptualization of depression as a consequence of clients' environments and not of cognitive processes, which may serve to decrease stigma associated with care. Using this translation, the current study sought to establish preliminary efficacy and acceptability of BATD in a group of depressed Spanish-speaking Latinos (N=10) . Results showed that over time there was a significant decrease in self-reported depression and a significant increase in activation as indicated by multiple self-report measures. Further, increases in activation corresponded to decreases in depression. Sustained clinical gains through a one-month follow-up were observed. Taken together, these results provide preliminary support for BATD as an efficacious treatment for depression. Consideration of the results combined with interview-based feedback obtained from participants provide several domains for modification of this treatment for future studies, and suggest that the next logical step is to include a treatment control group and a larger sample size in future investigations.
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    Work-Family Experiences Among Employed Mothers
    (2011) Ganginis Del Pino, Heather Victoria; O'Brien, Karen M.; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    The purpose of this study was to extend knowledge regarding the predictors and outcomes associated with work-family conflict and work-family enrichment with a sample of employed mothers. Specifically, grounded in the work of Greenhaus and Powell (2006), this study examined the extent to which employed mothers' personality (neuroticism, agreeableness, and conscientiousness), styles of coping, and employer sensitivity were predictive of work-family conflict (work-to-family and family-to-work), and work-family enrichment (work-to-family and family-to-work), and how these constructs related to psychological functioning (i.e., well-being and depression), satisfaction with life/love (i.e., life and relationship satisfaction), and work satisfaction. Participants included 305 employed mothers. We tested the hypothesis that the indirect effects model would be a better fit to the data than the direct and indirect effects model, which was not supported. The direct and indirect effects model, after modifications (correlated uniqueness terms), was a better fit to the data. Directions for future research and the limitations of this study are discussed.
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    EMOTION REGULATION MEDIATES THE RELATIONSHIP BETWEEN ADHD AND DEPRESSIVE SYMPTOMS IN YOUTH
    (2010) Seymour, Karen E.; Chronis-Tuscano, Andrea M.; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    A significant body of longitudinal research suggests increased rates of mood disorders as well as depressive symptoms in youth diagnosed with attention deficit/ hyperactivity disorder (ADHD) in contrast to non-ADHD comparison youth. Furthermore, individuals with co-occurring ADHD and mood disorders experience more serious impairments and worse outcomes than those with either disorder alone. However, few studies have examined the underlying mechanisms which may better elucidate the relationship between ADHD and depression in youth. The present study examined emotion regulation as a mediator in the relationship between ADHD and depressive symptoms in youth. Moreover, effortful control was examined as a mediator in the relationship between ADHD and emotion regulation. Participants included 69 youth between the ages of 10 and 14 with (n = 37) and without (n = 32) DSM-IV ADHD. Parent and youth ratings of depressive symptoms and emotion regulation were collected, and youth completed computerized measures of effortful control. Results demonstrated significant differences between youth with and without ADHD on depressive symptoms and emotion regulation ability, but not effortful control. Furthermore, emotion regulation fully mediated the relationship between ADHD and depressive symptoms. Clinical implications and limitations are discussed.
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    Examining the Effect of the LET'S ACT Behavioral Activation Treatment for Depression on Substance Abuse Treatment Dropout
    (2009) Magidson, Jessica F; Lejuez, Carl W.; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Despite the prevalence of depression among substance users and the negative impact of depressive symptoms on substance abuse treatment outcomes, few interventions targeting depression have been developed to meet the needs of depressed substance users, particularly in low-income urban areas. The current study aimed to replicate and expand upon promising preliminary findings for the use of a brief behavioral activation approach [Life Enhancement Treatment for Substance Use (LET'S ACT; Daughters et al., 2008)] to treat depression in the context of inner-city residential substance abuse treatment. Main extensions to the previous study include a comparison of LET'S ACT to a contact-time matched control treatment, Supportive Counseling (SC), and a more definitive evaluation of the effect of LET'S ACT on substance abuse treatment dropout. Results indicated that compared to SC, participants receiving LET'S ACT evidenced significantly lower rates of substance abuse treatment dropout and depressive symptoms, as evidenced by a significant treatment x time interaction with the change in self-reported and clinician-rated depressive symptoms from baseline to the 2-week follow up, as well as significantly higher rates of behavioral activation, as evidenced by a significant treatment x time interaction with scores on the Behavioral Activation for Depression Scale (BADS) from pre- to post-treatment. This study builds on preliminary evidence for LET'S ACT as a short-term behavioral treatment for depression in residential substance abuse treatment and offers initial support for the effect of LET'S ACT on substance use outcomes.
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    A Behavioral Activation Approach to Smoking Cessation for Depressed Smokers at VA Medical Centers.
    (2007-07-19) Bercaw, Edwin; Lejuez, Carl W; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Depressed smokers experience greater difficulty in quitting, and patients who report improvement in depressive symptoms during smoking cessation treatment achieve higher rates of abstinence. Patients may benefit from a novel treatment approach that combines standard smoking cessation with behavioral activation treatment for depression (BA; Jacobson et al., 1996). Veterans Affairs (VA) Medical Center patients are a psychiatrically complex population with a smoking prevalence 10% higher than the general population. VA patients experience low cessation rates and may be underserved by standard treatments. The purpose of the present study was the development and initial investigation of a brief BA-based smoking intervention called the Life Enhancement Treatment for Smoking (LETS-Quit). A total of 21 VA patients with elevated (>12) Beck Depression Inventory-II scores (BDI-II; Beck, Steer, & Brown, 1996) received 3-sessions of LETS-Quit or a control treatment and were followed for 30 days. A small sample size limited treatment evaluation and no benefit of LETS-Quit on smoking outcome was noted. However, findings suggested a strong effect of LETS-Quit on depressive symptoms. Treatment of depression during smoking cessation may greatly improve long-term success rates for this difficult to treat population. The feasibility and potential effectiveness of LETS-Quit in outpatient medical settings is discussed to guide further treatment evaluation.