Theses and Dissertations from UMD
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New submissions to the thesis/dissertation collections are added automatically as they are received from the Graduate School. Currently, the Graduate School deposits all theses and dissertations from a given semester after the official graduation date. This means that there may be up to a 4 month delay in the appearance of a give thesis/dissertation in DRUM
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Item 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.Item 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.Item The Presence of Playfulness in the Context of Couple Relationship, Relationship Satisfaction and its Associations With Symptoms of Depression(2018) Herrick, Pamela; Barros, Patricia; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The present study investigated the associations between playfulness in the context of couple relationship, relationship satisfaction, and symptoms of depression. Research suggests the potential for play to help improve relationship quality and decrease the symptoms of depression. However, the empirical evidence is limited in the literature. This study was a secondary analysis of data from 294 individuals seeking couple therapy at a university based family clinic. Two significant main effects were found in this study. Both the increase in relationship satisfaction is associated with decreased depressive symptoms and the increase of play, above and beyond relationship satisfaction, is associated with decreased depressive symptoms. Gender as a moderator was not established between playfulness and depression. Implications of these findings are discussed.Item FOREIGN VERSUS U.S.-BORN BLACK ADULT OBESITY AND DEPRESSION: AN ANALYSIS OF ENDURING PATTERNS AND MECHANISMS(2017) Brewton-Tiayon, Shanna; Rendall, Michael; Milkie, Melissa; Sociology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Foreign-born Blacks have better health outcomes than U.S.-born Blacks. The extent to which the health status of foreign-born Blacks change with increased exposure to the U.S. socio-cultural environment is less known than for other immigrant groups. Two prominent theories used to understand foreign and U.S.-born health disparities are the immigrant health paradox theory and immigrant health assimilation theory. The literature is conclusive that foreign-born Blacks have better health outcomes than U.S.-born Blacks, but this dissertation questions the appropriateness of framing this pattern as an immigrant health paradox due to the better socioeconomic status (SES) of foreign-born Blacks, relative to U.S.-born Blacks in general. The literature has been inconclusive on the extent to which immigrant health assimilation describes the health trajectories of foreign-born Blacks with increased duration of residence of the first generation in the U.S. or in comparing the first generation to subsequent generations. This dissertation interrogates the utility of immigrant health assimilation theory to describe the health trajectories of Black immigrants. Specifically, the dissertation focuses on the health outcomes of body mass index (BMI), obesity, depressive symptoms and depressive disorder. The sample of the dissertation includes foreign and U.S.-born Blacks generally, first generation foreign-born Afro Caribbeans, second and third generation U.S.-born Afro Caribbeans and U.S.-born African Americans. Collectively the three papers of this dissertation confirm a healthy immigrant effect for the health outcomes studied, when comparing the foreign-born to U.S.-born Blacks generally or African Americans specifically. In these comparisons first generation foreign-born Blacks have better socioeconomic status than the U.S.-born or African Americans. There is an immigrant health paradox for the health outcomes studied when comparing foreign born Afro Caribbeans to U.S.-born Afro Caribbeans, where U.S.-born Afro Caribbeans have better SES than the foreign-born. The dissertation does not find support for immigrant health assimilation. For BMI and obesity, the foreign-born Black trajectories compared to U.S.-born Blacks indicates patterns of no convergence or divergence. Intergenerationally, while first generation foreign-born Afro Caribbeans had lower obesity rates than second and third generation U.S.-born Afro Caribbeans, U.S.-born Afro Caribbeans had higher rates of obesity than African Americans. A similar intergenerational pattern was found for depressive disorder. Immigrant health assimilation theory predicts convergence of health outcomes between U.S.-born Afro Caribbeans and African Americans, not worse outcomes. The dissertation uncovers two mechanisms that help to explain the observed health trajectories of foreign-born Blacks. The lower first generation foreign-born Afro Caribbean obesity rates compared to second and third generation U.S.-born Afro Caribbeans is explained by differential rates of return on characteristics: the same characteristics provide more obesity protection for the foreign-born than the U.S.-born. Also perceived discrimination was informative in explaining variations in depression. U.S.-born Blacks reported higher levels of perceived discrimination than the foreign-born and foreign and U.S.-born Black women experienced higher depressive symptoms with increased perceived discrimination than men.Item EXERCISE AND PREVALENCE AND FIRST ONSET DEPRESSION IN WOMEN OF CHILDBEARING AGE(2017) Kinsey, Celena; Slopen, Natalie; Epidemiology and Biostatistics; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Background: Major depressive disorder is the leading cause of disability disproportionately affecting women of reproductive age. Prior research suggests that exercise may be an effective preventative measure. Objective: To examine the association between exercise and current and first onset major depressive episodes (MDE) among women 20-45 years (n=8175) participating in National Epidemiologic Study of Alcohol and Related Conditions II (2004-2005). Methods: Logistic regression models were used to examine the relationship between exercise and MDE prevalence and incidence. Results: Some exercise was associated with elevated odds of first onset MDE, compared to no exercise, but this association was not significant after controlling for covariates (adjusted odds ratio = 0.87, 95% confidence interval:0.75-1.01). No other associations were observed. Conclusion: This study did not find evidence of an association between exercise and prevalence or incidence of MDE in reproductive-aged women. Future research with prospective study designs and objective exercise measures needed.Item 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.Item The Role of Self-Esteem in the Relationship Between Sexual Minority Status and Depressive Symptoms(2015) Ng, Diane; Lee, Sunmin; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Sexual minority (SM) youth have been found to experience higher rates of depression and depressive symptoms compared with heterosexual youth. It has been suggested that there are mediators in the pathway between stigma-related stress and psychopathology, such as self-esteem. This study was interested in investigating whether self-esteem is a mediator between SM status by romantic attraction and the outcome depressive symptoms during the transition from adolescence to adulthood, and whether sex moderated this mediation. Results showed that those who were both-sex attracted had significantly higher depressive symptoms than their opposite-sex attracted counterparts (β=0.04,p=0.049). Further, findings showed that self-esteem is a mediator in the pathway between both-sex attraction and depressive symptoms (p=0.007). Although females were found to have higher depressive symptoms than males, no significant interaction with sexual minority status was found. These results can have implications for possible interventions to reduce depressive symptomatology for sexual minority groups transitioning into adulthood.Item The Association between Literacy and Work Performance as Mediated by Depression(2015) Foss, Lindsey E.; Epstein, Norman B.; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Approximately 90 million Americans are functionally illiterate, meaning that they cannot accomplish basic tasks such as interpreting a bus schedule or filling in an order form (Lincoln et al., 2008). Low levels of literacy have been associated with poor health outcomes, including anxiety and depression, in addition to poor work performance. This study examined the possible mediating role of depression in the association between literacy and work performance, using a nationally representative sample of young adults from the National Longitudinal Survey of Youth - 1997. The results indicated that after controlling for race and gender there was a significant association between emotional distress and the degree to which emotional problems limited work performance. The trend toward an association between literacy and the degree to which emotional distress affects work did not hold once race and sex were controlled. Suggestions are provided for future research that can more thoroughly test the effects of literacy on work performance.Item PREFERENCE-FOR-SOLITUDE, FRIENDSHIP SUPPORT, AND INTERNALIZING DIFFICULTIES DURING EARLY ADOLESCENCE IN THE U.S.A. AND CHINA(2014) Wang, Jennifer M.; Rubin, Kenneth H.; Human Development; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Social withdrawal has been associated with adjustment difficulties across development. Although much is known about shyness, little is known about preference-for-solitude; even less is known about how friendship might influence its relations with adolescent adjustment across different cultures. In particular, despite the significance of friendship for youth adjustment, not much is known about the ways in which friendship quality might lead to different adjustment outcomes for youth who prefer solitude; even less is known about these relations across different cultures. Accordingly, the overall goal of this research was to examine the relations between preference-for-solitude, friendship support, and internalizing difficulties during early adolescence in the U.S.A. and China. Specifically, this research examined the moderating role of friendship support in the relations between preference-for-solitude and internalizing difficulties (negative affect, negative self-esteem) in early adolescence across the U.S.A. and China. The U.S.A sample comprised 300 American youth (121 boys; M age = 14.28 years, SD = .51) from the greater Washington DC metropolitan area. The China sample comprised 201 youth living in Beijing, China (86 boys; M age = 14.21 years, SD = .62). Participants across both samples completed self- reports of social withdrawal (shyness; preference-for-solitude), friendship support, and internalizing difficulties (negative affect; negative self-esteem). Results from structural equation modeling demonstrated that preference-for-solitude and shyness emerged as related but unique dimensions of withdrawal across both the U.S.A. and China. Consistent with previous research, preference-for-solitude was positively associated with negative affect and negative self-esteem across both samples. In the U.S.A., friendship support significantly moderated the link between preference-for-solitude and negative self-esteem: preference-for-solitude was most associated with negative self-esteem beyond shyness for American youth with low friendship support. This was not found for negative affect; friendship support did not significantly moderate the effect of preference-for-solitude on negative affect in American youth. In China, friendship support did not significantly moderate any of the relations between preference-for-solitude and internalizing difficulties. Rather, for Chinese youth, preference-for-solitude and friendship support contributed independently beyond the effects of shyness to negative affect and negative self-esteem. In summary, preference-for-solitude was positively associated with negative affect and negative self-esteem in early adolescence across the U.S.A. and China. In the U.S.A., preference-for-solitude was most associated with negative self-esteem for youth with low friendship support. In addition to contributing to the developmental literature on preference-for-solitude, findings highlight the role of close interpersonal relationships for understanding the heterogeneity of withdrawal in development and across different cultures.Item 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.