Psychology Department Theses and Dissertations

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    Accepting a Terminal Cancer Prognosis: Associations with Patient and Caregiver Quality-of-Life Outcomes and Treatment Preferences
    (2024-05) Krueger, Ellen; Mosher, Catherine E.; Rand, Kevin L.; Wu, Wei; Hickman, Susan
    Patients who are aware of their terminal cancer prognosis are more likely to receive end-of-life care consistent with their values. However, prognostic awareness has shown mixed associations with quality of life (QoL) outcomes. Based on theories of acceptance (i.e., Erikson’s stages of life development, Kubler-Ross’s stage model of grief, coping theories) and the Ottawa Decision Support Framework, acceptance of cancer may moderate relationships between prognostic awareness and QoL outcomes and end-of-life treatment preferences. Dyadic coping theories, such as the Systemic Transactional Model and the Dyadic Cancer Outcomes Framework, suggest that patients’ degree of prognostic awareness and acceptance of their illness may also impact their family caregivers’ QoL and end-of-life treatment preferences for the patient. The aim of the present study was to examine the potential moderating role of patient acceptance of cancer in the relationships between patient prognostic awareness and both patient and caregiver QoL and end-of-life treatment preferences. This study was a secondary analysis of cross-sectional data from advanced cancer patients (n = 243) and their caregivers (n = 87) enrolled in the multi-institutional Coping with Cancer-II study. Patient outcomes of physical, psychological, and existential QoL were examined in a moderation path analysis. Caregiver physical and psychological QoL were examined in separate moderation regressions. Patient and caregiver end-of-life treatment preferences were examined in multiple logistic regression moderation models. Results did not support my hypothesis, as patient illness acceptance did not moderate the relationships between patient prognostic awareness and patient and caregiver QoL outcomes and end-of-life treatment preferences. However, there were significant main effects of patient illness acceptance on their own physical, psychological, and existential QoL as well as caregiver psychological QoL. There were also significant main effects of patient prognostic awareness on their own physical QoL and both their own and their caregivers’ end-of-life treatment preferences. Findings suggest that increasing patient’s prognostic awareness and illness acceptance may help improve values-consistent end-of-life care and QoL outcomes in advanced cancer patient-caregiver dyads. Findings support timely conversations to promote advanced cancer patients’ prognostic awareness as well as further research examining the impact of acceptance-based interventions in advanced cancer.
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    Urgency as a Predictor of Change in Emotion Dysregulation in Adolescents
    (2024-05) Fisher-Fox, Lindsey; Cyders, Melissa; Zapolski, Tamika; Salyers, Michelle
    Adolescence is a key developmental period characterized by increased maladaptive risky behaviors. Two related, but distinct constructs, urgency (the tendency to act rashly in response to strong negative or positive emotions) and emotion dysregulation are important risk factors for engaging in maladaptive risky behaviors. Thus far, research has largely agreed that these two risk factors are highly correlated; however, the causal direction between these constructs is less understood. The goal of the current study is to determine whether urgency predicts emotion dysregulation among adolescents. This project is a secondary data analysis of a larger study designed to test the effectiveness of a school-based intervention for youth at risk of maladaptive risk taking, as compared to a control group of youth enrolled in a health class. The current study utilized data from the control youth (n=544, 49.8% female, Mage=14.22, SD=0.52) to test whether urgency at baseline predicts change in emotion dysregulation over a nine-week period, and whether that relationship differs across boys and girls. Results found that negative, but not positive, urgency significantly predicted emotion dysregulation change (negative urgency: b=0.11, p=0.03; positive urgency: b=0.03, p=0.54). Gender did not moderate either relationship (p’s>0.30). This work provides initial evidence of a temporal relationship between negative urgency and changes in emotion dysregulation. The next step is to determine whether negative urgency imparts risk for malapative behaviors through its effect on emotion dysregulation. This program of research may lead to better identification of effective interventions to decrease negative urgency-based risk-taking and better identify those at risk of developing maladaptive risk-taking.
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    Effects of Abstinence in Early Addiction Recovery on Functional Brain Networks and Behaviors
    (2024-05) Shen, Yitong; Oberlin, Brandon; Cyders, Melissa; Dzemidzic, Mario
    Background: Alcohol use disorder (AUD) poses negative health and social consequences, and is costly to affected individuals, loved ones, and society (Whiteford et al., 2013). It is a chronic neuropsychiatric disorder, associated with impaired decision making and altered functional connectivity patterns in the brain. Many studies have shown changes in the brain and behaviors after sustained abstinence using within-participant design or between-participant design comparing participants in recovery versus healthy controls (Muller & Meyerhoff, 2021; Wilcox et al., 2019). The purpose of this study was to investigate brain differences between participants in recovery and participants who are actively drinking. Specifically, this study evaluated within- and between-network resting-state functional connectivity (rsFC) strengths in the context of the triple network model, which focuses on three key networks for complex perceptual, emotional and behavior processing as well as introspection, theory of mind and self-awareness; the salience network (SN), the central executive network (CEN), and the default mode network (DMN) (Menon, 2019). Moreover, this study assessed the relationship between impulsive choices in temporal decision-making and changes in resting-state functional connectivity patterns in these networks. Methods: This study included two groups: the Recovery Group and the Drinking Group. The Recovery Group included participants who were starting recovery (within one year), met AUD diagnosis criteria or showed lifetime heavy drinking behaviors during a 12-month period, received treatment for substance use disorder for alcohol and/or illicit drugs, and showed ongoing intentions and efforts to maintain recovery (n=18, 6 females, mean age=32.4±7.4, 17 White, mean years of education=14.5±3.1, average days of abstinence prior to interview days=78.2±45.7). The Drinking Group included participants who were currently drinking that met diagnosis criteria for AUD or showed heavy drinking behaviors (n=49, 24 females, mean age=31.7±6.4, 29 White, mean years of education=13.6±2.3). Participants underwent an initial screen day where structured interviews were conducted to evaluate the number of lifetime AUD criteria and prior drinking patterns. On the study day, participants completed computer tasks and questionnaires prior to their functional Magnetic Resonance Imaging (fMRI) sessions. Participants in the Recovery Group received a virtual reality (VR) intervention targeting future self-continuity where they interacted with avatars that are versions of themselves (present self and future selves in recovery and relapsed) prior to MRI sessions. All participants completed baseline Delay Discounting (DD) to measure intertemporal choice preferences prior to the fMRI sessions and prior to the VR intervention for the Recovery Group. Results: This study did not find any significant differences in within- and between-network rsFC strength of regions of interest of this study within the triple networks between participants in recovery and those who were actively drinking. The study found that participants in recovery showed a greater preference for delayed rewards (measured by DD task) compared to participants who are actively drinking. Additionally, measures of self-reported impulsivity and impulsive decision-making were associated with resting state functional connectivity (rsFC) strength between regions within the Salience Network (SN), and between the SN and Central Executive Network (CEN). Specifically, baseline delayed reward preference was positively associated with the rsFC between two SN hubs: left dorsal anterior insula (dAIC) and dorsal anterior cingulate cortex (dACC). The rsFC between the left dACC (SN) and dorsolateral prefrontal cortex (dlPFC; CEN) negatively associated with subscales (including negative urgency, lack of perseverance, and lack of premeditation) of self-reported impulsivity measured by the Urgency-Premeditation-Perseverance-Sensation Seeking-Positive Urgency (UPPS-P) impulsive behavior scale. Together, these results suggested that there was an emerging pattern where enhanced the rsFC strength in these regions associated with higher impulsive tendencies. The exploratory analysis showed that the rsFC strength between the right precuneus and ventromedial prefrontal cortex (vmPFC) was related to abstinence length in participants in recovery. Conclusions: These findings indicated that participants in recovery exhibited higher delayed reward preference compared to participants who were actively drinking, alongside a significant relationship between measures of impulsivity and the rsFC within the SN and between the SN and CEN. These results highlighted the importance of the SN and its dynamic interaction with the CEN in self-reported impulsivity and impulsive decision making in addiction. Additionally, this study found that within-network functional connectivity strength in the DMN was related to abstinence length, suggesting that repairment in the rsFC strength within DMN might be integral to the process of addiction recovery.
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    Effects of Feedback Seeking Behavior on Supervisor Perceptions: Examining the Interaction of Seeking Frequency With Supervisor Implicit Person Theory and Feedback Orientation
    (2024-05) Schneider, Jacob; Williams, Jane; Stockdale, Margaret; Derricks, Veronica
    Feedback seeking is an essential process for employees to improve performance and clarify expectations (Renn & Fedor, 2001; Ashford & Tsui, 199). Certain factors such as ego and image defense limit feedback seeking in the workplace due to avoidance of negative outcomes (Ashford & Cummings, 1983), however we know less about whether feedback seeking does lead to actual negative outcomes for the employee (Ashford, De Stobbeleir, & Nujella, 2016). The current study examines the existence of actual costs to the seeker for seeking more frequently and adds to the literature by examining whether supervisor individual differences are related to perceptions of seeking behavior, namely implicit person theory and feedback orientation. With a sample of 275 adult supervisors recruited from Mturk, the current study measured participants on these individual differences and assessed perceptions of a fictional employee who either sought feedback with high or low frequency. The employee was rated on a selection of performance potential outcomes related to promotability, expectations of future performance, willingness to mentor, and candidacy for career development opportunities. Findings suggest there is a cost associated with seeking feedback at a higher frequency which manifests as a decrease in perceptions of confidence in the employee. Additionally, this perception of lower confidence from seeking feedback could contribute to more significant downstream outcomes such as expectations of lower quality performance and lower likelihood of being promoted. By understanding more about individuals’ perceptions of feedback seeking behavior, we may train supervisors how to be more receptive of different feedback seeking behavior. This could assist in fostering a performance improvement environment that ultimately improves organizational performance.
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    Reducing the Occurrence of Sexual Harassment: Investigating the Novel Approach of Empathy Training
    (2024-05) Tucker-Cesar, Mya Michele; Stockdale, Margaret S.; Derricks, Veronica; Johnson, India R.
    Sexual harassment remains prevalent, underscoring the urgent need for an updated approach to training aimed at reducing its occurrence. Previous studies have revealed that interventions focusing on elements of empathy, such as empathetic concern and perspective-taking, have been effective in diminishing antisocial attitudes like prejudice (Galinsky & Moskowitz, 2000; Levin et al., 2016; Paluck & Green, 2009). Thus, I suggest that cultivating empathy and perspective-taking may target the root cause of sexual harassment by disrupting the mechanisms that sustain its prevalence. The current study uses a 3 (training modality: Empathy Video Plus Exercises, Empathy Video, Control Video) × 2 (gender: Female and Male) between-subjects research design to investigate the effectiveness of empathy training, encompassing a ten-minute video and perspective-taking exercises, in fostering empathy toward targets of sexual harassment. The empathy video features a Ph.D. graduate student, "Diana," recounting her experiences with sexual harassment, based on a true story and portrayed by a professional actor. Participants engaged in perspective-taking exercises where they described the harassment experience from Diana's perspective and identified short and long-term consequences of experiencing sexual harassment. As anticipated, empathy training significantly increased feelings of empathy, aligning with the findings of Bolinger et al. (2023). Empathy training also significantly increased feelings of personal distress. This heightened feeling of empathy and personal distress subsequently bolstered intentions to engage in bystander intervention and supportive behaviors. However, empathy training did not yield a significant impact on reducing the acceptance of sexual harassment myths. Lastly, empathy training did not diminish intentions among men to engage in sex-based harassment. These findings underscore both the potential and limitations of empathy training in addressing attitudes and behaviors related to sexual harassment.
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    The Role Of Worry and Health Beliefs in COVID-19 Protective Behaviors Among Lung Cancer Patients
    (2024-05) Burns, Marcia F.; Mosher, Catherine E.; Hirsh, Adam T.; Salyers, Michelle P.
    Coronavirus disease 2019 (COVID-19) is a serious public health threat, and lung cancer patients are at high risk of poor outcomes from COVID-19 relative to the general population. Little is known about lung cancer patients’ beliefs and emotions regarding COVID-19 and COVID-19 protective behaviors (i.e., mask wearing, social distancing, hand hygiene). Prior research has found that Health Belief Model (HBM) variables (i.e., perceived risk of acquiring the illness, perceived illness severity, perceived benefits of and barriers to the preventive health behavior) and worry are predictive of engagement in preventive health behaviors. Drawing upon the HBM and theories of the role of emotion in decision-making, the current study examined psychological correlates of lung cancer patients’ engagement in COVID-19 protective behaviors. Lung cancer patients (N = 191) were recruited from Indiana University Simon Comprehensive Cancer Center to participate in a one-time survey from August 2021 through May 2022. Descriptive statistics were used to characterize COVID-19 protective behaviors. Multiple hierarchical regression models were used to examine associations between HBM constructs and engagement in COVID-19 protective behaviors. Higher-order regression models were then used to examine whether worry about COVID-19 was associated with COVID-19 protective behaviors above and beyond the effects of HBM variables. In general, the present sample showed high rates of engagement in all COVID-19 protective behaviors. Fewer perceived barriers to mask wearing were associated with greater mask wearing, and greater worry about COVID-19 was associated with greater mask wearing above and beyond the effects of HBM variables. Greater perceived severity of COVID-19 was associated with more social distancing, and higher levels of worry about COVID-19 were associated with more social distancing above and beyond the effects of HBM variables. HBM constructs (i.e., perceived risk of COVID-19, perceived severity of COVID-19) and worry about COVID-19 were unrelated to hand hygiene. Most findings are in line with theories on the central role of emotion in health-related decision-making and warrant replication in longitudinal research. Results point to several potential intervention targets, including worry about COVID-19, perceived severity of COVID-19, and perceived barriers to mask wearing, to improve COVID-19 protective behaviors in lung cancer patients.
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    Effect of Depression Treatment on Health Behaviors and Cardiovascular Risk Factors Among Primary Care Patients with Depression: Data from the eIMPACT Trial
    (2023-12) Schuiling, Matthew D.; Stewart, Jesse; Hirsh, Adam; Wu, Wei
    Background. Although depression is a risk factor for cardiovascular disease (CVD), few clinical trials in people without CVD have examined the effect of depression treatment on CVD-related outcomes. It’s unknown if successful depression treatment improves indicators of CVD risk, such as CVD-relevant health behaviors, traditional CVD risk factors, and CVD events. Methods. We examined data from eIMPACT trial, a phase II randomized controlled trial conducted from 2015-2020. Depressive symptoms, CVD-relevant health behaviors (self-reported CVD prevention medication adherence, sedentary behavior, and sleep quality) and traditional CVD risk factors (blood pressure and lipid fractions) were assessed. Incident CVD events over four years were identified using a statewide health information exchange. Results. The intervention group exhibited greater improvement in depressive symptoms (p < 0.01) and sleep quality (p < 0.01) than the usual care group, but there was no intervention effect on systolic blood pressure (p = 0.36), low-density lipoprotein cholesterol (p = 0.38), high-density lipoprotein cholesterol (p = 0.79), triglycerides (p = 0.76), CVD prevention medication adherence (p = 0.64), or sedentary behavior (p = 0.57). There was an intervention effect on diastolic blood pressure that favored the usual care group (p = 0.02). CVD-relevant health behaviors did not mediate any intervention effects on traditional CVD risk factors. Twenty-two participants (10%) experienced an incident CVD event. The likelihood of an CVD event did not differ between the intervention group (12.1%) and the usual care group (8.3%; HR = 1.45, 95% CI: 0.62-3.40, p = 0.39). Conclusions. Successful depression treatment alone improves self-reported sleep quality but is not sufficient to lower CVD risk of people with depression. Alternative approaches may be needed reduce CVD risk in depression. Trial Registration: Identifier: NCT02458690
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    Evaluating Sex and Line Differences in Successive Negative Contrast and Ethanol Consumption Using Alcohol Preferring and High Alcohol Drinking Rats
    (2023-12) Smith, Nicholle; Czachowski, Cristine; Grahame, Nicholas; Logrip, Marian
    A loss of a job or relationship are a few examples of unexpected reward loss. Life events such as these can induce negative emotional reactions (e.g., anxiety and stress) which have been associated with increased drinking and in turn, an increased risk of developing an alcohol use disorder (AUD) (Keyes et al., 2011, Sinha, 2008). The present study used a consummatory successive negative contrast (SNC) procedure to demonstrate unexpected reward loss reactivity in two lines selectively bred to consume high amounts of ethanol, alcohol preferring (P) and high alcohol drinking (HAD) rats. Following this reward loss, animals were given free access to ethanol to determine if ethanol consumption would increase to negate any negative emotional reaction provoked by this loss. P rats demonstrated a longer contrast effect than HAD rats, indicated by a longer recovery time following the downshift in reward. Conversely, HAD males did not demonstrate a contrast effect following this downshift in reward. Surprisingly, P rats who experienced a loss of reward consumed significantly less ethanol than animals who did not. Lastly, an individual measure of contrast size, or shift ratio, was significantly associated with greater ethanol consumption in HAD males only, who did not display a contrast effect. These data indicate different reactivity to SNC between these two lines and sexes, suggesting different genetic and sex-related mechanisms underlying sensitivity to an unexpected loss of reward.
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    Role of the Prefrontal Cortex to Dorsomedial Striatum Projections in Compulsive Alcohol Drinking
    (2023-12) Bauer, Meredith; Boehm, Stephen; Lapish, Christopher; Grahame, Nicholas; Gremel, Christina
    Compulsive alcohol drinking is a defining feature of alcohol use disorder and is characterized as drinking alcohol despite knowledge of negative consequences. This behavior is hypothesized to be due to a disruption in the decision-making process. Decision making relies on a balance between goal-directedness and habit systems to efficiently execute behavior. An important distinction between compulsive and non-compulsive individuals is the ability to withhold drinking in the face of a negative consequence. The dorsomedial striatum (DMS) and dorsomedial prefrontal cortex (dmPFC) are brain regions necessary for goal directed behavior where the dmPFC is important for cognitive control and behavioral inhibition while the DMS is important for action selection. Importantly, the dmPFC sends a glutamatergic input to the DMS. We hypothesize this input is a behavioral control which is necessary to withhold action selection. Thus, in order to maintain non-compulsive alcohol use, the dmPFC and DMS need to work together to orchestrate inhibition of action selection in the face of negative consequences. Previous research shows a causal role for both the dmPFC and DMS in preventing compulsive alcohol drinking and a role for the projections from the dmPFC to DMS in behavioral inhibition. However, no research has demonstrated a role for this circuit’s activity in prevention of compulsive alcohol use. The current experiment tested the hypothesis that inhibiting the glutamatergic projection from the dmPFC to the DMS will cause non-compulsive Wistar rats to drink alcohol compulsively.
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    Leveraging Whole Brain Imaging to Identify Brain Regions Involved in Alcohol Frontloading
    (2023-12) Ardinger, Cherish; Lapish, Christopher; Grahame, Nicholas; Czachowski, Cristine; Kimbrough, Adam
    Frontloading is an alcohol drinking pattern where intake is skewed toward the onset of access. The goal of the current study was to identify brain regions involved in frontloading using whole brain imaging. 63 C57Bl/6J (32 female and 31 male) mice underwent 8 days of binge drinking using drinking-in-the-dark (DID). Three hours into the dark cycle, mice received 20% (v/v) alcohol or water for two hours on days 1-7. Intake was measured in 1-minute bins using volumetric sippers, which facilitated analyses of drinking patterns. Mice were perfused 80 minutes into the day 8 DID session and brains were extracted and processed for iDISCO clearing and c-fos immunohistochemistry. For brain network analyses, day 8 drinking patterns were used to characterize mice as frontloaders or non-frontloaders using a change-point analysis described in our recent ACER publication (Ardinger et al., 2022). Groups were female frontloaders (n = 20), female non-frontloaders (n = 2), male frontloaders (n = 13) and male non-frontloaders (n = 8). There were no differences in total alcohol intake as a function of frontloading status. Water drinkers had an n of 10 for each sex. As only two female mice were characterized as non-frontloaders, it was not possible to construct a functional correlation network for this group. Following light sheet imaging, ClearMap2.1 was used to register brains to the Allen Brain Atlas and detect fos+ cells. Functional correlation matrices were calculated for each group from log10 c-fos values. Euclidean distances were calculated from these R values and hierarchical clustering was used to determine modules (highly connected groups of brain regions) at a tree-cut height of 50%. In males, alcohol access decreased modularity (3 modules in both frontloaders and non-frontloaders) as compared to water drinkers (7 modules). In females, an opposite effect was observed. Alcohol access (9 modules) increased modularity as compared to water drinkers (5 modules). These results suggest sex differences in how alcohol consumption reorganizes the functional architecture of networks. Next, key brain regions in each network were identified. Connector hubs, which primarily facilitate communication between modules, and provincial hubs, which facilitate communication within modules, were of specific interest for their important and differing roles. In males, 4 connector hubs and 17 provincial hubs were uniquely identified in frontloaders (i.e., were brain regions that did not have this status in male non-frontloaders or water drinkers). These represented a group of hindbrain regions (e.g., locus coeruleus and the pontine gray) connected to striatal/cortical regions (e.g., cortical amygdalar area) by the paraventricular nucleus of the thalamus. In females, 16 connector and 17 provincial hubs were uniquely identified which were distributed across 8 of the 9 modules in the female alcohol drinker network. Only one brain region (the nucleus raphe pontis) was a connector hub in both sexes, suggesting that frontloading in males and females may be driven by different brain regions. In conclusion, alcohol consumption led to fewer, but more densely connected, groups of brain regions in males but not females, and recruited different hub brain regions between the sexes. These results suggest target brain regions for future studies to try to manipulate frontloading behavior and more broadly contribute to the literature on alcohol’s effect on neural networks.