Psychology
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Item Early Adolescent Romantic Experiences: Early Childhood Predictors and Concurrent Associations with Psychopathology(2019) Foster, Chelsey Barrios; Dougherty, Lea R; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Research has demonstrated that early adolescent romantic relationships are prevalent, and initiation of romantic relationships at younger ages bears important implications for youths’ future development. Although earlier dating involvement may increase risk for negative outcomes, the majority of research on teen relationships focuses on older adolescents; a paucity of research explores the phenomenology of preteen romantic relationships. Further, a striking gap exists in the study of how early childhood factors may affect early adolescent romantic relationships. In order to address these gaps, the current study aimed to elucidate the phenomenology and concurrent psychosocial correlates of preteen (age 12) romantic relationships and to delineate early childhood variables that predict involvement in and quality of preteen romantic relationships. In a longitudinal sample of 440 youth, we examined concurrent associations between multiple dimensions of age 12 romantic relationships (dating experiences, risky dating, relationship discord, relationship closeness, sexual experience) and friendship competence, and age 12 psychopathology (anxiety, depression, attention-deficit hyperactivity disorder [ADHD], disruptive behavior disorder [DBD] symptoms) and psychosocial functioning. Given prior research indicating that pubertal status and child sex may also play a role in romantic relationship involvement, we examined these two variables as moderators in concurrent analyses. In addition, we examined how two salient dimensions of early childhood (temperament and parenting, assessed at age 3) predicted romantic relationship outcomes at age 12. Results indicated that more frequent romantic experiences at age 12 were associated with increased psychosocial distress and poorer functioning; however, youth with higher quality romantic relationships evidenced lower levels of psychiatric symptoms and better psychosocial functioning. In addition, the associations between early adolescent romantic relationships and adjustment were complex and were moderated by child sex and pubertal status. Further, dimensions of age 3 childhood temperament and parenting differentially predicted dimensions of early adolescent romantic relationships and friendship competence. Importantly, our findings contribute to a growing body of literature on preteen romantic relationships, and are among the first data to examine early childhood predictors of age 12 romantic relationship outcomes. These findings hold important clinical implications for future early adolescent prevention and intervention programs.Item CONSTRUCTING A BIFACTOR MODEL OF SAFETY SEEKING BEHAVIORS IN ADOLESCENT SOCIAL ANXIETY(2019) Qasmieh, Noor; De Los Reyes, Andres; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Safety behaviors are subtle avoidance strategies used to manage distress in social situations. Inconsistent findings create uncertainty about whether safety behavior use leads to poorer outcomes. To reconcile these inconsistencies, we leveraged a theoretical model of safety behaviors that classifies safety behaviors according to function using two categories: active behaviors that aim to enhance social performance, and restrictive behaviors that aim to reduce involvement within social situations. This informed development of a measurement model tested with a confirmatory bifactor approach in a mixed-clinical/community sample of 127 adolescent reports of safety behavior engagement. We identified two distinct factors of safety behaviors (i.e., active and restrictive). These factors predicted differential outcomes: increased restrictive safety behaviors predicted increased internalizing concerns and poorer social skills, and increased active safety behaviors predicted higher substance use. These findings have important implications for understanding conceptual and measurement models of safety behaviors in research and clinical contexts.Item Predictors and Moderators of Parent Engagement in Early Interventions for Behaviorally Inhibited Preschool-Aged Children(2019) Novick, Danielle; Chronis-Tuscano, Andrea; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Behavioral inhibition (BI) is a temperamental style that poses risk for later anxiety. Efficacious interventions have been developed for inhibited children, but their success depends on parent engagement. However, little is known regarding predictors of parent engagement in early interventions for BI. This study examined parent-, child- and treatment-level (i.e., parent-only or parent-child) factors as independent and interactive predictors of parent engagement (attendance, and parent-reported homework completion and treatment satisfaction) in a randomized-controlled trial comparing two interventions for inhibited preschoolers (N = 151). Results suggest that child anxiety may motivate parent engagement, particularly when children receive concurrent treatment and/or in-vivo coaching. However, intensive treatment may be too burdensome for depressed parents, whereas less intensive treatments may be more acceptable to non-anxious parents of anxious children.Item THE NEURAL CORRELATES OF SOCIAL MOTIVATION IN AUTISM SPECTRUM DISORDER DURING A REAL-TIME PEER INTERACTION(2018) Kirby, Laura Anderson; Redcay, Elizabeth; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Autism Spectrum Disorder (ASD) is characterized by difficulties with social motivation and social interaction. However, the neural underpinnings of these processes are poorly understood, and past studies investigating this subject have significant methodological limitations. This study is the first to investigate the neural correlates of social interaction in children and adolescents diagnosed with ASD using a naturalistic “chat” paradigm that mimics real-world reciprocal conversations. Despite core weaknesses in social interaction, participants with ASD showed similar brain activation to their neurotypical counterparts while initiating conversations and receiving replies from peers. Two notable group differences emerged, however. Participants with ASD showed blunted responses in the amygdala while initiating conversations and receiving replies, and they showed hyperactive responses in the temporal parietal junction (TPJ) while initiating conversations with peers. Findings have implications for how we understand social motivational and social cognitive weaknesses in ASD.Item MATERNAL AND PATERNAL ANXIETY DISORDERS AND EARLY INTERVENTION FOR BEHAVIORALLY INHIBITED PRESCHOOL CHILDREN(2018) Wang, Christine; Chronis-Tuscano, Andrea; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Behavioral inhibition (BI) and, subsequent, social withdrawal (SW), are overlapping, but distinct concepts, and both are risk factors for the development of later child anxiety. Anxiogenic parenting (i.e. any parenting behavior that promotes anxiety in offspring) and negative peer interactions both contribute to the pathway from child BI/SW to later anxiety (Rubin, Coplan, & Bowker, 2009). Parents’ own anxiety is associated with offspring anxiety and may raise the risk for anxiogenic parenting (Murray, Creswell & Cooper, 2009). Thus, through targeting anxiogenic parenting and negative peer relations, early intervention has the potential to alter the trajectory from child BI/SW to later anxiety. However, several gaps exist in the literature. One, few treatments exist for preschool BI/SW. Two, despite parents’ key role during the preschool years and robust evidence showing parent anxiety reduces treatment efficacy for older anxious youth, the role of parent clinical anxiety in preschool treatment outcomes has not been rigorously assessed. Three, despite meta-analytic data showing fathers’ importance in the development of preschool anxiety (Möller, Nikolić, Majdandžić, & Bögels, 2016), few researchers have examined effects of fathers’ anxiety on preschool treatment outcomes. Relatedly, the unique effects of mothers’ and fathers’ anxiety on preschool treatment outcomes have yet to be tested. Lastly, despite the dual roles of parents and peers in the pathway from child BI/SW to later anxiety, no study has used a true experimental design to test whether treatment for preschool BI/SW that targets both domains can attenuate the effect of parent anxiety on reduced treatment outcomes more than that of interventions that directly target parents only, the most common approach used in existing interventions for preschool BI/SW or anxiety. The current dissertation study was drawn from a larger NIMH-funded study comparing two early intervention programs for preschool BI/SW. The first program was Cool Little Kids (CLK), a parent-only psychoeducation group, which has been shown to be efficacious in reducing later anxiety among highly inhibited preschoolers (Rapee, Kennedy, Ingram, Edwards, & Sweeney 2005). The second program was the “Turtle Program,” which included concurrent parent and child groups, targeting both anxiogenic parenting and child social skills, respectively (Chronis-Tuscano et al., 2015). The first study aim was to examine the separate and unique roles of clinician-rated maternal and paternal lifetime anxiety disorders (ADs) as predictors of preschool treatment outcome across treatment conditions. It was hypothesized that, separately, maternal and paternal lifetime ADs would negatively predict child treatment outcome in both groups. When maternal and paternal lifetime ADs were examined in the same model, it was further hypothesized that paternal lifetime ADs would continue to predict child treatment outcomes. The second aim was to examine whether the associations between maternal and paternal lifetime ADs and child treatment outcomes differed as a function of treatment condition. It was hypothesized that the in-vivo, intensive nature of the “Turtle Program” might mitigate the negative effects of parents’ anxiety, such as parental avoidance, anxious modeling, and overcontrol, on child treatment outcomes. Further, the child group component of the Turtle Program might improve child social approach behaviors, making it easier for parents to facilitate child social exposures. Thus, it was hypothesized that maternal and paternal lifetime ADs would have weaker associations with child treatment outcome in the “Turtle Program” than in CLK. Lastly, given that child BI/SW are predictors of social anxiety specifically, and social anxiety is heritable (Isomura et al., 2015), the role of maternal and paternal lifetime social anxiety disorder (SAD) on child treatment outcomes was also examined as an exploratory aim. Results indicated that, when examined in the same model, maternal lifetime ADs predicted worse post-treatment child total anxiety, but paternal lifetime ADs predicted better post-treatment child total anxiety. This relation did not significantly differ as a function of treatment condition. Regarding the exploratory aim, when examined in the same model, maternal (not paternal) SAD predicted worse post-treatment child total anxiety. Further, maternal SAD predicted worse post-treatment child total anxiety only in CLK (and not the Turtle Program), suggesting that in-vivo therapist coaching of parents and/or direct child social skills training may have mitigated negative effects of maternal SAD on reduced treatment efficacy. Clinical implications and future directions are discussed.Item EXPLORING THE ROLES OF SOCIAL ANXIETY, TRAUMA, AND URBANICITY IN THE RELATION BETWEEN POSITIVE AND NEGATIVE SYMPTOMS IN PSYCHOSIS(2018) Garcia, Cristina Phoenix; Blanchard, Jack J; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Background: Research shows that positive and negative symptoms of schizophrenia are separate but related factors. However, it is unclear which specific symptoms may drive this relation or whether there are moderating factors. Moreover, it is unknown whether the relation between positive and negative symptoms is specific to schizophrenia or exists for individuals with psychosis regardless of diagnosis. Research is needed that looks specifically at individual symptoms within positive and negative symptom domains in a sample of mixed diagnoses. The current study examines whether paranoia, a positive symptom, and deficits in motivation and pleasure, a negative symptom, are correlated with one another in a transdiagnostic sample of individuals with psychosis. Literature suggests that paranoia and deficits in motivation and pleasure are both interpersonal in nature. This shared interpersonal characteristic suggests that these symptoms may be linked through social stressors. Method: Participants were 38 people with psychosis and six people without a psychiatric diagnosis. They completed the Clinical Assessment Interview for Negative Symptoms (CAINS), including the Motivation and Pleasure (MAP) subscale; the Green et al. Paranoid Thought Scales (GPTS), including Social Reference (SR) and Persecution (P); the Social Interaction Anxiety Scale (SIAS); the Self-Beliefs Related to Social Anxiety scale (SBSA), including Unconditional Beliefs (UB); the Trauma History Questionnaire (THQ); and the Neighborhood Health Questionnaire (NHQ), including Activities with Neighbors (AN). Results: Inconsistent with hypotheses, neither GPTS nor its subscales was significantly correlated with CAINS MAP. GPTS was significantly correlated with SIAS, SBSA, and THQ totals; in exploratory analyses, the GPTS SR was significantly correlated with SBSA UB. CAINS MAP was significantly correlated with NHQ AN. Conclusions: This study revealed novel associations between paranoia and social anxiety cognitions and between motivation and pleasure deficits and neighborhood socialization. We explore reasons for null results (e.g., limitations with the transdiagnostic approach; low symptomatology in the sample). Future directions include examination of other positive and negative symptoms; investigation into facets of social anxiety and their overlap with paranoia; and assessment of urbanicity/neighborhood health and its relation to paranoia.Item Developmental pathways from maternal emotion dysregulation to parenting behaviors and adolescent emotion lability: interactive effects of youth ADHD symptoms and sex(2019) Oddo, Lauren Elizabeth; Chronis-Tuscano, Andrea; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)A large literature base convincingly suggests that maternal and child characteristics interact to predict parenting practices and children’s emotional development. However, the independent and interactive effects of parent- and youth-level risk factors on emotion parenting behaviors and adolescent emotion lability over time is largely unknown. Using secondary data analyses of a longitudinal community sample of adolescents and their caregivers (N = 277), the current study examined the extent to which supportive vs. harsh parenting reactions to adolescents’ expressions of negative emotions underlie the longitudinal association between maternal emotion dysregulation and changes in adolescent emotion lability, and whether youth ADHD symptoms and sex impact these processes. Using structural equation modeling, results showed that mothers who reported being more emotionally dysregulated were more likely to endorse engaging in harsh parenting for boys with more ADHD symptoms, relative to mothers of adolescent girls or adolescents with fewer ADHD symptoms. Contrary to hypotheses, no other pathways were statistically significant. These results partially align with a transactional model of parenting wherein parent- and adolescent-level risk factors interact to confer risk for maladaptive parenting. Future work should further attempt to characterize the independent and interactive effects of maternal emotion dysregulation and youth ADHD symptoms on parenting and adolescent outcomes over time.Item Early Life Stress Predicts Decreased Total Brain Volume, Cortical Thickness, and Cognitive Functioning in School-Age Children(2018) Chad-Friedman, Emma; Dougherty, Lea R; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Severe early life stress (ELS) (e.g., maltreatment/institutionalization) is associated with atypical neurological and cognitive development. Few studies have prospectively examined the neurological mechanisms underlying the cognitive deficits associated with less severe and more common forms of ELS. The current study examined the impact of common forms of ELS assessed during early childhood on children’s brain volume, cortical thickness, and memory and executive functioning assessed three years later in school age children, controlling for current stress. Participants included 63 children (50.8% female) assessed during preschool (Wave 1 age: M=4.23 years, SD=.84) and three years later (Wave 2 age: M=7.19 years, SD=.89). ELS included low socioeconomic status, single parent household, low parental education, child exposure to parental depression, and child exposure to high parental hostility. Children’s current life stress, cognitive abilities, and brain structure were assessed at Wave 2. ELS predicted reduced total gray volume, cortex volume, right inferior parietal thickness, and right superior parietal thickness, controlling for covariates and current stress. ELS also predicted poorer memory and attention shifting, controlling for current stress. Right superior parietal thickness mediated the effects of ELS on story recall memory. Results highlight the possible consequences of less severe forms of ELS on brain volume and cognitive functioning, suggesting potential neural mechanisms to further explore. Early childhood may be a particularly important time for intervention efforts to mitigate the neural and cognitive risks associated with early stress exposure.Item EXAMINING THE INTERACTION OF INTERNALIZING AND EXTERNALIZING DISORDERS WITH HIV STATUS IN RELATION TO RESIDENTIAL SUBSTANCE USE TREATMENT DROPOUT(2017) Seitz-Brown, Christopher Jonathan; Bernat, Edward; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Each year approximately 34 billion dollars are spent on treatment for alcohol and drug use problems in the United States, yet less than half of clients complete their programs. Treatment dropout is a significant predictor of negative outcomes including substance use relapse and incarceration. The consequences of dropping out of substance use treatment are more severe for HIV-positive individuals—active drug use is associated with poor HIV medication adherence and higher mortality. Previous literature on risk factors for dropout has not explored what predictors are most relevant to HIV-positive clients and most studies have focused primarily on outpatient treatment settings, which may not generalize to residential programs. For example, substance users who enter residential care frequently present with a history of co-occurring medical and psychiatric problems, such as HIV, internalizing disorders (INT), and externalizing disorders (EXT). Internalizing and externalizing psychopathology are known to relate to both substance treatment dropout and worse health outcomes among people living with HIV. Thus, this study aimed to explore the interactions of HIV status with INT and EXT as predictors of residential substance use treatment dropout. Utilizing intake data from 1613 clients entering residential substance use treatment, we used regression models to examine several hypotheses concerning dropout risk. We hypothesized that the two-way interactions between HIV status and 1) INT and 2) EXT would be associated with dropout, such that HIV-positive individuals with higher INT or EXT would be more likely to drop out. We also predicted that those interactions would relate to fewer days spent in treatment until dropout. For the three-way interaction between HIV, INT, and EXT, we hypothesized that greater INT and EXT among HIV-positive individuals would relate to a greater likelihood of dropout and fewer days in treatment. We did not find differences between HIV-positive and HIV-negative clients in dropout rates, and the interactions between HIV and INT/EXT were not significant predictors of dropout. Results suggest that other variables such as age, education level, marital status, and court-mandated treatment status may be stronger predictors of residential substance use treatment dropout. Future directions are discussed in light of these nonsignificant findings.Item Environmental Reward, Goal-Directed Activation and Depressive Symptoms as Predictors of Transdermal Nicotine Patch Adherence in a Randomized Controlled Trial of Behavioral Activation Treatment for Smoking(2017) Hoffman, Elana Michelle; Chronis-Tuscano, Andrea; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Cigarette smoking remains the leading cause of morbidity and mortality in the U.S., and smoking rates are high. Nicotine Replacement Therapy (NRT) is sold over-the-counter and often distributed in smoking cessation clinical trials. With proper use, the nicotine patch is effective at helping individuals quit smoking and stay quit. However, rates of NRT adherence are low, and there is little research on the psychological predictors of compliance. Drawing from the larger medication adherence literature, we know that depressive symptoms predict poor medication adherence, though this has never been studied as it relates to NRT use. Furthermore, Behavioral Activation Treatment for Smoking (BATS) is hypothesized to reduce depressive symptoms through increases in both positive reinforcement from the environment and goal-directed activation. Thus, it is possible that individuals who receive this treatment may exhibit increased compliance to the patch first through increases in environmental rewards or goal-directed activation, and subsequently though decreases in depressive symptoms. Using data from a stage-II randomized controlled trial (RCT) examining BATS compared to standard smoking cessation treatment (ST), we utilized a serial mediation model to examine this question. The aims of the study were: (1) to examine a serial mediation model in which BATS would affect NRT adherence through increases in environmental reward at mid-treatment and decreases in end-of-treatment depressive symptoms; and (2) to examine a serial mediation model in which BATS would affect NRT adherence through increases in goal-directed activation mid-treatment and decreases in end-of-treatment depressive symptoms. We hypothesized that BATS would produce increases in environmental reward, which in turn would decrease depressive symptoms, which in turn would predict greater patch use. Our second model examined goal-directed activation as a mediator, and we hypothesized that BATS would predict increases in goal-directed activation, which in turn would predict decreases in depressive symptoms, which in turn would predict increases in NRT adherence. We examined these models using Structural Equation Modeling (SEM). Our serial mediation model examining treatment conditionenvironmental rewardsdepressive symptomsNRT adherence was not supported, and neither was our model examining treatment conditiongoal-directed activationdepressive symptomsNRT adherence. However, we found significant pathways from mid-treatment goal-directed activation and NRT adherence, and end-of-treatment depressive symptoms to NRT adherence in our model examining goal-directed activation. Changes in both goal-directed activation and depressive symptoms may be key when predicting NRT adherence in a sample of adult smokers enrolled in smoking cessation treatment.