Cognitive Performance as a Function of Sleep Disturbance in the Postpartum Period (open access)

Cognitive Performance as a Function of Sleep Disturbance in the Postpartum Period

New mothers often complain of impaired cognitive functioning, and it is well documented that women experience a significant increase in sleep disturbance after the birth of a child. Sleep disturbance has been linked to impaired cognitive performance in several populations, including commercial truck drivers, airline pilots, and medical residents, though this relationship has rarely been studied in postpartum women. In the present study 13 pregnant women and a group of 22 non-pregnant controls completed one week of actigraphy followed by a battery of neuropsychological tests and questionnaires in the last month of pregnancy (Time 1) and again at four weeks postpartum (Time 2). Pregnant women experienced significantly more objective and subjective sleep disturbance than the control group at both time points. They also demonstrated more impairment in objective, but not subjective cognitive functioning. Preliminary analyses indicated increased objective sleep fragmentation from Time 1 to Time 2 predicted decreased objective cognitive performance from Time 1 to Time 2, though small sample size limited the power of these findings. Implications for perinatal women and need for future research were discussed.
Date: August 2015
Creator: Wilkerson, Allison K.
System: The UNT Digital Library
Nightmare Disorder Prevalence as Defined by the DSM-5 in a College Sample (open access)

Nightmare Disorder Prevalence as Defined by the DSM-5 in a College Sample

The nightmare prevalence literature to date has largely focused on nightmare episode severity (i.e. frequency), with 8%-87% of individuals reporting these events in the past week to year. While this has helped to determine the prevalence of these events, focus on the episode severity alone is problematic because it means little is known about the actual prevalence of nightmare disorder. Moreover, focus on episode severity likely overestimates the actual prevalence of clinically significant nightmares while also obscuring clinically significant consequences of the disorder. Understanding the prevalence of nightmare disorder can help guide treatment planning and interventions. The present study recruited UNT undergraduates (N = 372; 351 analyzed) and managed all participant data using Research Electronic Data Capture (REDCap). The present study aimed to determine the prevalence of nightmare disorder, as stated in the DSM-5, to facilitate accurate characterization of the disorder. Additionally, as part of the secondary aim the influence of gender on nightmare disorder status and psychological wellbeing as measured by psychological and sleep outcome variables was examined. Finally, comparisons of individuals with DSM-5-defined nightmare disorder to those without the disorder were conducted on previously examined correlates (e.g., trauma symptoms, depression).
Date: August 2017
Creator: Estevez, Rosemary
System: The UNT Digital Library
Forgiving the Unforgivable: Forgiveness in the Context of LGBT Partner Violence (open access)

Forgiving the Unforgivable: Forgiveness in the Context of LGBT Partner Violence

Intimate partner violence (IPV) in sexual and gender minority relationships is an underexplored and misunderstood phenomenon. Much of what has been investigated has explored IPV from a heterosexual lens, without taking into account the complexities of these relationship dynamics. Further, outcomes of IPV traditionally focus on negative sequelae, such as depression or anxiety. In this study, we examined the propensity to forgive partner abuse as a means of adaptively coping with the trauma. Further, we looked at resilience as a possible factor in the process of forgiveness. We hypothesized that psychological resilience significantly moderates the forgiveness process in sexual and gender minorities who have experienced IPV. Our sample of 77 gender- and sexual-minority participants completed measures of psychological and physical IPV, resilience, and forgiveness. A regression analysis found our model accounted for 36% of the variance in forgiveness of self (adj. R2=.36, F (4, 72) = 10.34, p < .01) and 20% of forgiveness of others (adj. R2=.20, F (4, 72) = 5.01, p < .01). However, there was no significant moderating effect, nor was IPV a significant contributor to forgiveness. Results suggest trauma does not influence one’s likelihood to forgive, though some personal trait, such as resilience, is more …
Date: August 2015
Creator: Lopez, Eliot Jay
System: The UNT Digital Library
Stigma, Spirituality and Psychological Quality of Life in People Living with HIV: A Mixed Methods Approach (open access)

Stigma, Spirituality and Psychological Quality of Life in People Living with HIV: A Mixed Methods Approach

HIV is a potentially fatal virus that affects over 1,148,200 people in the United States. Due to the minority status that comes with living with HIV, PLH (people living with HIV) often encounter various aspects of stigma due to HIV, which contributes to suppressed overall psychological quality of life (PQOL).While the relationship between stigma and PQOL in PLH is well documented, little research examines mediators of this relationship. We hypothesized that spirituality (as measured by sense of peace, forgiveness of self and perceived fulfillment of life's goal) mediates the relationship between stigma and PQOL (as measured by depression, mental health and stress). We used an explanatory sequential mixed methods design which utilizes two distinct phases of the research process: quantitative (QUANT) analysis followed by qualitative (QUAL) analysis. Results of the QUANT phase suggest spirituality is a partial mediator in the relationship between stigma and PQOL in PLH. In the QUAL phase, we interviewed 15 PLH to elaborate on the relationships between the three constructs. We found PLH endorsed personalized stigma most frequently. Similarly, our results also indicate PLH experience stress, depression and anxiety as a result of their HIV status. Lastly, participant's interviewed most commonly described their spiritual beliefs as …
Date: August 2016
Creator: Purser, Megan
System: The UNT Digital Library
The Impact of Observational Learning on Physical Activity Appraisal and Exertion Following Experimental Back Injury and the Role of Pain-Related Fear (open access)

The Impact of Observational Learning on Physical Activity Appraisal and Exertion Following Experimental Back Injury and the Role of Pain-Related Fear

Chronic low back pain (CLBP) is one of the most prevalent and disabling health conditions in the US and worldwide. Biomedical explanations of acute injury fail to account for why some individuals experience remission of pain and restoration of physical function while others do not. Pain-related fear, accompanied by elevated appraisals of physical exertion and avoidance of physical activity, has emerged as a central psychosocial risk factor for transition from acute injury to chronic pain and disability. Research has indicated that these pain-related factors may be maintained through observational learning mechanisms. To date, no studies have experimentally examined the role of observational learning and pain-related fear in the context of actual musculoskeletal injury. Accordingly, the present study examined the impact of observational learning and pain-related fear on activity appraisals and exertion following experimentally- induced acute low back injury. Healthy participants' appraisal of standardized movement tasks along with measures of physical exertion were collected prior to and following a procedure designed to induce delayed onset muscle soreness (DOMS) to the lower back. Following induction of DOMS, participants observed a video prime depicting CLBP patients exhibiting either high or low pain behavior during similar standardized movements. In line with hypothesized effects, participants …
Date: August 2017
Creator: Guck, Adam J.
System: The UNT Digital Library
Social Support as a Moderator of Racial/Ethnic Differences in Subclinical Atherosclerosis: The North Texas Heart Study (open access)

Social Support as a Moderator of Racial/Ethnic Differences in Subclinical Atherosclerosis: The North Texas Heart Study

This study examined racial/ethnic differences in pre-clinical disease, social support, and tested whether social support was a moderator of racial/ethnic differences in subclinical atherosclerosis. Participants were NHWs, NHBs, and Latinos (n = 283) from the baseline and cross-sectional sample of the North Texas Heart Study. Results from unadjusted models showed no significant racial/ethnic differences for common or bifurcation intima-media thickness (cIMT). However, unadjusted models for cIMT showed a main effect for race/ethnicity F(2, 229) = 3.12, p = .046, partial η2 = .027, with Latinos demonstrating significantly greater internal cIMT compared to NHB but not NHWs. In minimally adjusted models, there was a main effect for race/ethnicity, F(2, 227) = 3.10, p = .047, partial η2 = .027, with significantly greater internal cIMT in Latinos compared to NHBs but not NHWs. In fully adjusted models, racial/ethnic differences in cIMT were attenuated. Contrary to study hypotheses, no racial/ethnic differences in social support were found and social support was not a moderator of racial/ethnic differences in subclinical disease. In the North Texas Heart Study, few racial/ethnic differences emerged, with fully adjusted risk factor models accounting for these differences.
Date: August 2017
Creator: García, James J.
System: The UNT Digital Library
An Experimental Study of Bifurcated (Weekend and Weekday) and Unitary (Past Week) Retrospective Assessments of Sleep (open access)

An Experimental Study of Bifurcated (Weekend and Weekday) and Unitary (Past Week) Retrospective Assessments of Sleep

Discordance between weekday and weekend sleep schedules is common (Bonnet & Arand, 1995; Breslau, Roth, Rosenthal, & Andreski, 1997; Machado, Varella, & Andrade, 1998; Strauch & Meier, 1988; Tsai & Li, 2004). Brief retrospective self-report measures are essential for epidemiological research studies (Moul, Hall, Pilkonis, & Buysse, 2004), but self-reports are prone to error in recall, and the greater the variability in nightly sleep, the less reliable are retrospective reports (Babkoff, Weller, & Lavidor, 1996). More accurate self-report responses may be possible if measures prompt participants to consider variations in sleep schedules that are consistent (i.e., weekday and weekend sleep schedules). The current study experimentally examined whether Bifurcated (Weekday and Weekend) retrospective assessments of sleep are more accurate than Unitary (Past Week) assessments. Participants were randomly assigned to complete one of the two versions (Bifurcated vs. Unitary) of the Sleep Questionnaire. One hundred and thirty-one participants were included in the analyses. Results of a a series of analyses demonstrated that the Bifurcated version of the Sleep Questionnaire provided more accurate and less variable estimates of total sleep time than the Unitary version of the Sleep Questionnaire. Differences between the versions of the Sleep Questionnaire for other sleep variables were less …
Date: August 2016
Creator: Sethi, Kevin J.
System: The UNT Digital Library
Healthy Eating in College Students: 24-Hour Dietary Recall and the Theory of Planned Behavior (open access)

Healthy Eating in College Students: 24-Hour Dietary Recall and the Theory of Planned Behavior

The transition to college is marked by poorer eating behaviors. The Theory of planned behavior (TPB) represents a promising tool for predicting eating behaviors through the examination of attitudes (ATT), subjective norms (SN), perceived behavioral control (PBC), and intention (INT). Despite prior application of the TPB, there exist several key methodological issues in the literature addressing eating behaviors. The present study utilized an enhanced dietary assessment methodology, the ASA24 dietary recall, and a short-term prospective design to assess the healthy eating behaviors of emerging adults in college. Dietary recalls of 68 participants (average age = 20.76 years; 70.6% female; 70.6% non-Hispanic, 48.5% White, 22.10% Black/African American, 13.20% Asian) were analyzed using the Healthy Eating Index (HEI)-2010 scoring system. Results revealed that very few college students are meeting recommended dietary guidelines. Linear regression indicated that the indirect TPB variables (ATT, SN, and PBC) were related to INT (F[3,64] = 19.67, p < .001), although SN did not account for unique variance. Further, the direct TPB variables (INT and PBC) were related to HEI-2010 scores (F[2,65] = 4.00, p = .023); however, only PBC accounted for significant variance. Overall, findings suggest that more favorable attitudes relate to intention, but only perceived behavioral …
Date: August 2019
Creator: Douglas, Megan E.
System: The UNT Digital Library

Improving Actigraphy Specificity to Better Inform Insomnia Diagnosis and Treatment Decisions

Access: Use of this item is restricted to the UNT Community
Accurate assessment of sleep-wake patterns is important for sleep researchers and clinicians. Actigraphs are low-cost, non-intrusive, wrist-worn activity detectors used to estimate sleep-wake patterns in a natural environment for several nights. Although actigraphy shows good sensitivity (sleep detection), it has consistently demonstrated poor specificity (wakefulness detection while lying in bed relatively motionless). Because insomnia is characterized by wakefulness in bed, actigraphy may not be a valid objective measure of wakefulness for this group. It is possible that refinement of actigraphy software settings for sleep/wake algorithms might improve specificity. The current studies investigated this hypothesis by comparing wake parameters from 48 combinations of actigraphy settings to determine which sleep/wake algorithms best inform insomnia diagnosis and treatment. In the first study, none of the 48 actigraphy setting combinations consistently discriminated between adults with insomnia (n = 69) and non-insomnia (n = 80) on all three wake parameters, and no setting clearly discriminated between groups for the composite variable, total wake time. Similarly, in the second study, no setting combinations consistently discriminated between adults treated for insomnia (n = 18) and controls with untreated insomnia (n = 26) on all three wake parameters. Although two setting combinations discriminated between groups for the composite …
Date: August 2019
Creator: Francetich, Jade Marie
System: The UNT Digital Library
Self-Control in Overweight and Obese Individuals: The Relationship of Dispositional Self-Control and Blood Glucose (open access)

Self-Control in Overweight and Obese Individuals: The Relationship of Dispositional Self-Control and Blood Glucose

Currently, the etiology of obesity is conceptualized as a confluence of environmental, socioeconomic, behavioral, biological and genetic factors. With regard to behavioral factors, some have suggested that a failure of self-control may contribute to the difficulty of an overweight/obese individual because of their inability to resist food or maintain physical activity. Recent research proposed that self-control could be described as similar to a muscle that can be fatigued. Thus, if an individual engages in a self-control task they have lessened ability to utilize self-control on a subsequent task. Theory also suggests self-control may be fueled by a finite resource, identified as blood glucose. The role blood glucose plays is important to understand, especially in overweight and obese populations, as they may be more likely to be insulin resistant. In effect overweight and obese individuals are less likely to adequately process glucose. Therefore overweight/obese individuals might react to self-control tasks differently than normal weight individuals. Participants who were considered normal weight, overweight, and obese were recruited from the UNT research pool. They answered questions about their trait self-control in daily life and engaged in either a task that required them to exert self-control (e.g., resist crossing out a letter unless criteria …
Date: August 2016
Creator: Edwards, Kate
System: The UNT Digital Library

Universal Suicide Risk Screening in the Parkland Health and Hospital System: Evaluation of the Parkland Algorithm for Suicide Screening

Access: Use of this item is restricted to the UNT Community
Suicide is a significant public health issue in the US. Despite national and international prioritization since 1996, little definitive progress has been made in terms of identification and intervention in cases of elevated suicide risk. Forty percent of those who died by suicide attended an emergency department within a year of death. Therefore, universal suicide risk screening in emergency departments could prove a vital component to a national suicide prevention strategy. The present study empirically evaluated the universal suicide risk screening program recently implemented at Parkland Health and Hospital System. The sample consisted of patients over 18 years of age (N=333,855; Mage=42.7, 32% male) screened as part of routine clinical care from May 4th, 2015, through November 3rd, 2015. The Parkland Algorithm for Suicide Screening (PASS) is part of a clinical decision support system for responses to Columbia - Suicide Severity Rating Scale Clinical Practice Screener (C-SSRS) items, leading to an automated clinical response via three suicide risk stratification levels: no action for no risk identified, psychiatric social worker assessment for moderate risk identified, and psychiatrist/psychologist interview for high risk identified. The present study used receiver operating characteristic (ROC) curve analysis, which found the PASS predicted disposition (z=30.46, p<.001, AUC=.78, …
Date: August 2019
Creator: Goans, Christian
System: The UNT Digital Library
Community-based Participatory Research: HIV in African American Men Who Have Sex with Men (open access)

Community-based Participatory Research: HIV in African American Men Who Have Sex with Men

To date, traditional behavioral interventions have done little to reduce the prevalence and transmission of HIV among African American men who have sex with men (AAMSM), a highly at risk group. Some researchers theorize that the lack of success may be because these interventions do not address contextual factors among AAMSM. Community-based participatory research (CBPR) is one approach to research with the potential to lead to effective interventions in the future. CBPR is a collaborative, mixed-methods and multidisciplinary, approach to scientific inquiry, which is conducted with, and within, the community. The current study follows the CBPR approach to engage and develop a relationship with the African American communities in the Dallas/Fort Worth Metroplex. Contextual issues were discussed in order to identify emerging themes regarding HIV health related issues among AAMSM to provide the groundwork for continued CBPR research and future interventions with AAMSM in the Dallas/Fort Worth Metroplex. To accomplish this goal, researchers began the CBPR process by conducting interviews and focus groups with a sample of approximately 62 (34 from key informant interviews, 28 from focus groups [gender balanced]) AIDS service organization leaders and workers, advocates, medical doctors and community members with first-hand knowledge of HIV health issues in …
Date: August 2015
Creator: Miller, James MS
System: The UNT Digital Library