Browsing by Author "Shomaker, Lauren, advisor"
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Item Open Access A pilot study of a mindfulness-based group program in adolescents at risk for excess weight gain(Colorado State University. Libraries, 2018) Burke, Morgan, author; Shomaker, Lauren, advisor; Lucas-Thompson, Rachel, committee member; Johnson, Sarah, committee memberThere is a cross-sectional and prospective association of depressive/anxiety symptoms with excess weight in adolescents. Theoretically, intervening to decrease mental health symptoms in adolescents at-risk for excess weight gain may offer a novel approach to also decrease the risk for excess weight gain. Mindfulness-based approaches show preliminary promise in adults with obesity and in some adolescent samples; yet feasibility and acceptability in adolescents at-risk for excess weight gain has not been determined. In this study, I examined the feasibility and acceptability of a 6-week mindfulness-based group program in adolescent girls and boys at-risk for excess weight gain, and I explored the effects of participation in a mindfulness-program on perceived stress, depression, anxiety, and body mass index (BMI) indices, as compared to a 6-week health education control group program. Participants were age 12-17 years old and determined to be at-risk for excess weight gain based upon above-average BMI percentile or a strong family history of overweight. Adolescents were assessed at baseline, 6-weeks/post-treatment, and a 6-month follow-up. Fifty-four adolescents were randomized to the mindfulness group program (n=29) or the health education control group (n=25). In the mindfulness group, participants were on average 13.97 years old, 66% non-Hispanic White, and 90% had overweight or obesity (BMI >=85th percentile). In the health education control group, participants were on average 14.49 years old, 72% non-Hispanic White and 84% had overweight or obesity. Feasibility and acceptability were measured by group attendance, homework completion, and program acceptability ratings. Depression, anxiety symptoms, and perceived stress were measured by validated surveys. Adolescents' median session attendance was six out of six sessions in both the health education group and the mindfulness group. In the mindfulness group, homework completion averaged 63%. In the mindfulness group, 92% thought that the group addressed their concerns, and 100% would recommend the group to others like them. Adolescents randomized to the mindfulness group showed greater decreases in perceived stress at post-treatment than adolescents in the health education group. There were some within-condition changes in key variables, but no other significant between-condition effects at either post-treatment or 6-months follow-up were observed. In conclusion, a relatively brief mindfulness-based group program appears to be feasible and acceptable to adolescents at-risk for excess weight gain. A mindfulness-based training program may offer some acute psychological benefits, particularly in terms of perceived stress. Yet, further research is needed on mindfulness programs for adolescents at-risk for excess weight gain with longer follow-up periods, and also with adolescents with elevated depression and anxiety at baseline.Item Embargo Ecological momentary assessment of mechanisms of change during a mindfulness-based intervention for adolescents exposed to chronic stressors(Colorado State University. Libraries, 2023) Miller, Reagan L., author; Lucas-Thompson, Rachel, advisor; Shomaker, Lauren, advisor; Haddock, Shelley, committee member; Prince, Mark, committee memberAdolescents exposed to chronic stressors (e.g., financial instability) are at heightened risk for developing mental health problems. Chronic stressors may contribute to greater mental health problems by interfering with adolescents' ability to effectively regulate emotions. According to the mindfulness stress buffering hypothesis, mindfulness acts as a buffer against the deleterious effects of life stressors by ameliorating maladaptive stress appraisals and by improving emotion regulation. However, an assumption of this hypothesis is that individuals can maintain mindfulness and regulate their emotions during periods of stress. These two papers explore this assumption by first investigating the real-time, dynamic relationship between life stressors, mindfulness, and emotion regulation difficulties (Study 1) and then by exploring if mindfulness training may help to ameliorate the negative effects of life stressors on mindfulness and emotion regulation (Study 2). Eighty-one participants who were 10-18 years of age (Mage=13.75 years, SD=2.17; 56% male; 57% Caucasian; 24% Hispanic/Latino; 7% Native American; 7% more than race; and 5% Asian/Pacific Islander or Black/African American) completed ecological momentary assessments (EMA) three times a day for seven days at three different intervals (baseline, mid-intervention and post-intervention) throughout the study, contributing to a total of 3,178 EMA reports. Multilevel structural equation modeling revealed that the presence (versus absence) of stressors and the greater severity of stressors both were associated with lower mindfulness and greater emotion regulation difficulties concurrently in the same moment, but not prospectively from one moment to the next. In other words, life stressors may only be more immediately associated with lower mindfulness and greater emotion regulation difficulties as short-term, delayed effects from one moment (T1) to the next moment (T2) were not observed. Also, mindfulness training, compared to an active control group, was protective at post-intervention against the negative (concurrent) effects of stressors on mindfulness and emotion regulation (Study 2). Findings highlight that adolescents' life stressors may degrade untrained mindfulness and emotion regulation at given moments, but mindfulness training may help to buffer against these negative impacts of life stressors. Going forward, it will be helpful to investigate these relationships in the context of mental and physical health outcomes and to include longer periods of follow-up to determine the sustainable benefits of mindfulness training for adolescent health.Item Open Access Effects of a mindfulness-based intervention on depressive symptoms, stress eating, and telomere length in adolescents at-risk for adult obesity(Colorado State University. Libraries, 2019) Hendrich, Silas Grant, author; Shomaker, Lauren, advisor; Quirk, Kelley, committee member; Bailey, Susan, committee memberRates of adolescent obesity and cardiometabolic diseases such as type 2 diabetes are increasing. Recent studies suggest that depression symptoms may be one contributor to obesity and cardiometabolic diseases through stress-related behavioral mechanisms (e.g., stress-eating) and physiological mechanisms (e.g. shortened telomeres). From an allostatic load framework, depression symptoms affect the biological system, potentially exerting sustained damage on stress physiology, and thus, contributing to cardiometabolic disease risk. Mindfulness-based interventions (MBIs) have demonstrated favorable impacts for lowering depression symptoms and lowering symptoms of stress-related eating patterns, yet these effects have not been well studied in adolescents. In the current randomized controlled pilot study, I conducted secondary analyses to explore the effects of a six-session MBI group on lowering depression symptoms, reducing stress-eating, and preserving telomere length, compared to a six-session health education (HE) control group, in 25 adolescent girls (n=14; 56%) and boys (n=11; 44%) at-risk for adult obesity (body mass index [BMI] z-score M=1.56, SD=.55). At baseline/prior to the intervention and again, at an 18-month follow-up, perceived stress and depression symptoms were assessed with validated surveys, stress-eating by laboratory test meal, and average telomere length from whole blood. Dispositional mindfulness by questionnaire, BMI from fasting weight and height, and fasting blood glucose levels were also measured at the same intervals. Analyses of covariance were used to test group condition as a predictor of baseline to 18-month change scores, controlling for the respective baseline level of the outcome variable. Results showed that adolescents who were randomized to the MBI group had less change in stress-eating from baseline to 18-months than those randomized to HE (M=-49.44, SD=81.47 kcal vs. M=217.42, SD=84.88 kcal, Cohen's d=.74, p=.04). There were no other significant between-condition effects. There were moderate, favorable non-significant effects of MBI, compared to HE, for perceived stress (d=.45, p=.21) and depression symptoms (d=.50, p=.23). There was no significant effect on telomere length (d=.05, p=.91). Changes in dispositional mindfulness, BMI, and fasting blood glucose levels were small and also non-significant. Findings from the current project suggest that a relatively brief, MBI group reduces stress-eating in adolescents at-risk for adult obesity over a year and a half later. To what extent MBI, delivered alone or in combination with additional supports, ultimately affects allostatic load and cardiometabolic health remains to be tested in a larger trial.Item Open Access Exploratory effects of a mindfulness+lifestyle program for type 2 diabetes prevention on parental psychosocial adjustment in families of Latino adolescents(Colorado State University. Libraries, 2020) Daniels, Raquel, author; Shomaker, Lauren, advisor; Bellows, Laura, committee member; Ortega, Lilyana, committee memberLatino adolescents have a particularly high risk of developing youth-onset type 2 diabetes (T2D) compared to other racial/ethnic groups. Latino families frequently experience high levels of stress due to a variety of social/environmental factors including stigma, discrimination, immigration, and acculturation. Culturally adapted, family-based intervention programs designed specifically for Latino adolescents to increase healthy eating and physical activity show strong potential to reduce adolescents' risk of T2D. Yet, existing programs rarely address the heightened psychological stress faced by Latino families, which is likely to interfere with making lifestyle changes. It is possible that the integration of mindfulness-based training into a culturally-adapted, family-based lifestyle program will result in more favorable family functioning and parental psychosocial adjustment than a lifestyle program alone. The current thesis project was a secondary data analysis of a randomized controlled trial designed to pilot a 6-week/12-session culturally-adapted, family-based lifestyle intervention, with and without a mindfulness-based training component, in N = 18 Latino families with adolescents at risk for T2D. The aims were to explore the comparative effectiveness of the mindfulness+lifestyle intervention, versus lifestyle only, on parent psychosocial adjustment and to characterize to what extent changes in parent psychosocial adjustment corresponded to changes in adolescents' own psychosocial adjustment and degree of risk for T2D. At baseline, immediate post-intervention, and six-months follow-up, parents completed validated survey measures of parent perceived stress and parent depression symptoms. Family functioning also was assessed at baseline. At all intervals, adolescents self-reported their levels of perceived stress and depression symptoms, and adolescent risk for T2D was determined from body mass index (BMI) metrics, insulin resistance, and fasting glucose. The analytic plan included analyses of covariance (ANCOVA) as well as a reliable change index. Correlations were used to describe simple correspondence between parent and adolescent characteristics. ANCOVA results indicated that changes in parent depression/stress at post-intervention and six-month follow-up not differ by intervention. Reliable change analyses revealed that one parent from each condition experienced a reliable change decrease in perceived stress and one parent from the lifestyle only condition experienced a reliable change decrease in depressive symptoms. In correlation analyses, greater decreases in parent depression symptoms were correlated with greater decreases in adolescent perceived stress at post-intervention, and this association was apparent in the mindfulness+lifestyle condition as opposed to lifestyle only. Also in mindfulness+lifestyle only, higher baseline family chaos and baseline parental depressive symptoms were correlated with greater decreases in adolescents' insulin resistance. These highly exploratory findings require follow-up in a larger, adequately powered trial, but suggest the possibility that family and parental psychosocial characteristics relate to health outcomes in adolescents at-risk for T2D among Latino families taking part in mindfulness+lifestyle programming. Consistent with a selective or indicated prevention framework, families with more psychosocial difficulties may stand to benefit the most from integrative health interventions.Item Open Access Exploring the potential utility of a mindfulness-based intervention for promoting intuitive eating in adolescents(Colorado State University. Libraries, 2022) Cutler, Addie K., author; Shomaker, Lauren, advisor; Lucas-Thompson, Rachel, committee member; Mueller, Megan, committee memberMetabolic diseases and other illnesses related to high weight are increasing in prevalence, which is of particular concern in adolescent populations due to the long-term health implications. Intuitive eating (IE), the ability to eat when hungry, stop when satisfied, and consume the foods that one prefers, has been inversely associated with body mass index (BMI; kg/m2) and, as such, is a construct of interest in the field of adolescent wellness. In theory, adolescent IE would be related to both greater mindfulness and less disordered eating. Yet, relatively few studies have examined IE in adolescents and even fewer studies have explored whether mindfulness-based intervention affect IE in adolescents. In this master's thesis, I explored the effects of a mindfulness-based intervention on increasing dispositional mindfulness and increasing IE in adolescents at risk for excess weight gain using baseline and 3-year follow-up data from a pilot randomized controlled trial of N=54 adolescent girls (55%) and boys 12-17 years old who were experiencing above-average weight or had a family history of experiences with obesity. Youth were randomized to either a mindfulness-based group intervention or health education control group for 6 hours spread over 6 consecutive weeks. Mindfulness and disordered eating were measured on validated self-report instruments at baseline and 3-year follow-up. IE was measured through adolescents' report on the Intuitive Eating Scale-2, measured only at 3-year follow-up. There were no significant differences between groups in mindfulness, disordered eating, or IE at 3-year follow-up. Disordered eating at 3-year follow-up was negatively correlated with total average IE at 3-year follow-up. These findings are limited based on the small, pilot nature of the study indicating that further research is needed in this area.Item Open Access Exploring the relationship between parent and adolescent dispositional mindfulness and adolescent mental health(Colorado State University. Libraries, 2022) Friedman, Terra S., author; Shomaker, Lauren, advisor; Lucas-Thompson, Rachel, advisor; Johnston, Sarah, committee memberInternalizing symptoms, including depression and anxiety symptoms, increase during adolescence, a sensitive life stage for forming coping strategies for handling stress. Adolescent internalizing symptoms have been related to a host of negative health outcomes, yet dispositional mindfulness, the propensity for present-moment, non-judgmental attention, has been associated with lower levels of internalizing symptoms. From a social learning framework, parents' own dispositional mindfulness is anticipated to relate to adolescent's degree of dispositional mindfulness. In the current thesis, I conducted secondary data analyses to explore the hypotheses that parental and adolescent dispositional mindfulness would be positively related, that there would be inverse relationships of parent dispositional mindfulness with adolescent perceived stress and anxiety/depression symptoms, and that parent mindfulness would contribute uniquely to variability in adolescent mental health indicators, even when accounting for adolescents' own mindfulness. Participants were 90 healthy adolescents (50% female), 12–17 years old (Mean = 14.3, SD = 1.7 years). Parental and adolescent dispositional mindfulness were evaluated using the Mindful Attention Awareness Scale. Adolescents reported stress on the Perceived Stress Scale and anxiety symptoms using the State Trait Anxiety Inventory for Children – Trait Version. They reported depression symptoms on the Center for Epidemiological Studies-Depression Scale (CES-D). Results of correlation and regression analysis found expected relationships based on prior literature between parent internalizing symptoms and parent mindfulness, and adolescent internalizing symptoms and adolescent mindfulness, but found no statistically significant connection between parent dispositional mindfulness and adolescent internalizing symptoms. Findings suggest more research needs to be conducted in this area to understand the mechanisms of dispositional mindfulness and internalizing symptoms in the context of family functioning. Future studies should focus on including more comprehensive measures of mindfulness and integrating an attachment framework into the research design.Item Open Access LGBTQ+ adolescent and young adult mental and physical wellbeing: examining the effects of non-adapted versus adapted mindfulness-based interventions(Colorado State University. Libraries, 2024) Klimo, Kasey D., author; Lucas-Thompson, Rachel, advisor; Shomaker, Lauren, advisor; Brown, Samantha, committee member; Carlson, Laurie, committee memberLesbian, gay, bisexual, transgender, queer and other gender and sexual minority identified (LGBTQ+) adolescents and young adults face mental and physical health disparities compared to their heterosexual and cisgender counterparts. These disparities in health are often due to minority stressors, like experiencing discrimination and oppression. Adolescence and emerging adulthood are vulnerable developmental periods for LGBTQ+ youth and young adults due to the prevalence of minority stressors while also navigating developmental tasks. Mindfulness based interventions (MBI) may be a potential method to intervene upon health disparities in this population, as the mindfulness stress-buffering hypothesis posts MBI may be the most beneficial in populations that experience high levels of stress. Chapter one explores the acceptability, feasibility, and effects of an online MBI, L2B, on sexual minority participants compared to heterosexual participants. Sixty-two college-aged participants completed baseline and post-test questions assessing mental health, mindfulness, self-compassion, emotion regulation, and substance usage (Mage=21.28, SD=4.17, 82.3% Caucasian, 85.5% Non-Hispanic/Latinx, 71% female, 37% LGBQ+). Results from chapter one indicated L2B was acceptable, but feasibility, as indicated by attendance and drop- out rates, could be improved. Furthermore, sexual minority participants saw statistically meaningful improvements in all outcomes except for substance usage and consequences of alcohol use. sexual minority participants may benefit more greatly from MBI related to mental health, internalized shame, consequences of Marjana use, accessing regulation strategies, and with goal-oriented behavior from just as much, or greater than heterosexual participants when related to mental health. However, further research is needed to explore the effects of MBI on substance use among sexual minority participants. Study two explores the initial acceptability and feasibility, along with the effects of an online MBI, L2B-Q, that was adapted specifically to meet the needs of LGBTQ+ adolescents. Twenty adolescents completed baseline and post-test assessments on mental health symptoms, mindfulness, stress-related health behaviors, and identity constructs. Participants also participated in a focus group to provide qualitative feedback on L2B-Q. Results from study two indicate L2B-Q was feasible and accepted, however further adaptations (e.g., changes in timing, and activity modifications) would be beneficial to the program. Furthermore, results indicate than an adapted MBI is highly effective in reducing mental health and stress, while increasing mindfulness and identity related variables. In the final chapter, I compare the effects found in chapter one and chapter two and discuss the ways in which each program differed from one another, and which program may be more effective among LGBTQ+ participants.Item Open Access Mindfulness-based group intervention for an adolescent girl at risk for type 2 diabetes: a case study(Colorado State University. Libraries, 2017) Dalager, Stephanie, author; Shomaker, Lauren, advisor; Coatsworth, Doug, committee member; Schmid, Arlene, committee memberAdolescent-onset type 2 diabetes (T2D) is a rising healthcare problem that disproportionately impacts females and historically disadvantaged racial/ethnic groups. Standard behavioral lifestyle interventions to prevent T2D by lowering body mass index (BMI) to lessen insulin resistance, a key precursor to T2D, unfortunately have had limited long-term success. Underlying psychosocial factors, particularly depressive symptoms, have been related to insulin resistance and T2D, independent of BMI. Mindfulness-based group interventions are being utilized increasingly in adults with T2D to address depression. More recently, using a prevention lens, mindfulness-based programs have shown preliminary promise for intervening with elevated depressive symptoms and insulin resistance in adolescents at risk for T2D. Yet given the newness of this area, little research exists to deepen understanding around clinical implementation and acceptability with this at-risk, adolescent population. In the current case study, we present the experience of an adolescent girl with elevated depressive symptoms, obesity, insulin resistance, and a family history of T2D, who participated in a six-week mindfulness-based group program delivered at an outpatient therapy clinic in the context of a pilot clinical research study. At baseline, immediately following the group program, and at one-year follow-up, surveys and interviews were administered to evaluate mindfulness and depression; hypothalamic-pituitary-adrenal axis activity; BMI and body fat were assessed; and insulin resistance was estimated from the homeostasis model assessment of insulin resistance (HOMA-IR). Case results indicated increased dispositional mindfulness, decreases in depressive symptoms, and lessening of insulin resistance. BMI and body fat were stable. Key therapeutic themes that emerged for the participant included increased recognition of internal experience and decreased reactivity to stress, which might help to explain the positive psychological and insulin outcomes. We discuss several implications of the case study for potentially increasing the success of implementing mindfulness-based programs in this population, including more emphasis on the promotion of social connections among group members, increasing adherence to home practice, and facilitation techniques to promote concrete understanding of abstract mindfulness concepts. The current case results suggest that teaching mindfulness skills to adolescent girls at risk for T2D with depressive symptoms possibly may offer benefits for depression and T2D risk. Adequately-powered clinical trial data are required to evaluate these results on a larger scale.Item Open Access Pressure to be thin and insulin sensitivity: an investigation of the potential moderating role of race/ethnicity among adolescent girls at risk for type 2 diabetes(Colorado State University. Libraries, 2021) Rayne, Lauren E., author; Shomaker, Lauren, advisor; Riggs, Nathaniel, committee member; Brown, Samantha, committee memberThe prevalence of youth-onset type 2 diabetes is a significant public health issue in the United States that disproportionately affects historically marginalized racial and ethnic groups. Previous research suggests that psychosocial stress resulting from poor body image and weight-related pressure may be associated with worsened metabolic health outcomes. This study examined the relationship between pressure to be thin and insulin sensitivity in adolescent girls at-risk for developing type 2 diabetes, who are susceptible to weight-based criticism and pubertal declines in insulin sensitivity. This study also aimed to explore the extent to which this association was moderated by racial/ethnic identity. Participants were 92 girls, (46% Hispanic; 34% non-Hispanic White; M±SD age = 14.95 ± 1.82 y), who completed a self-report measure of pressure to be thin from friends, family members, and partners. Parents also reported pressure to be thin of their adolescents by questionnaire. At baseline, participants' body mass index (BMI; kg/m2) was calculated, fasting blood samples were acquired to calculate insulin sensitivity, and body composition was measured with air displacement plethysmography. In contrast to hypotheses, there were no main effects, or interactional effects by race, of either adolescent-reported or parent-reported pressure to be thin on insulin sensitivity (all p-values > .05). Results indicate that future research is warranted to identify culturally relevant psychosocial stressors for adolescents of color.Item Embargo Sleep and insulin sensitivity in adolescents at risk for type 2 diabetes(Colorado State University. Libraries, 2023) Clark, Emma, author; Shomaker, Lauren, advisor; Lucas-Thompson, Rachel, committee member; Riggs, Nathaniel, committee member; Prince, Mark, committee memberBackground: Type 2 diabetes (T2D) is a chronic disease that is the 7th leading cause of death in the United States, and rates of adolescent-onset (<20 years of age) T2D are rising. Adolescent-onset T2D is associated with accelerated cardiometabolic comorbidities and shorter life expectancy compared to adult-onset T2D. As traditional behavioral weight loss approaches to T2D prevention show insufficient effectiveness in adolescents, it is critical to investigate novel, potentially modifiable factors that relate to poor insulin sensitivity, a key precursor of T2D. Poor sleep health is one such potentially modifiable contributor to poor insulin sensitivity and consequently, T2D; however, most research on sleep and T2D is in adults, and the specific characteristics of sleep health that relate to poor insulin sensitivity in adolescents at risk for T2D have not been thoroughly investigated. Further, research suggests that individual characteristics related to stress vulnerability, including dispositional mindfulness (i.e., non-judgmental awareness of the present moment) and self-compassion (i.e., treating oneself with an attitude of kindness and compassion), could alter the association of sleep characteristics with insulin sensitivity. In theory, dispositional mindfulness and/or self-compassion may act as a buffer in the association of poor sleep health and metabolic consequences. Thus, the specific research aims of this dissertation project were to determine to what extent objective characteristics of weekday and weekend sleep health, (1a) wake after sleep onset, (1b) sleep onset latency, (1c) time in bed, (1d) sleep duration, and (1e) sleep efficiency, were associated with insulin sensitivity, and (2) to evaluate mindfulness and self-compassion as moderators of the associations between sleep health and insulin sensitivity. Methods: A total of 128 adolescent girls (M ± SD age 14.40 ± 1.81 years) at risk for T2D participated in the cross-sectional, baseline phase of a parent study. Sleep disturbances were assessed with actigraphy over one week. Mindfulness was assessed with the Mindful Attention and Awareness Scale and self-compassion with the Self-Compassion Scale. The whole body insulin sensitivity index assessment of insulin sensitivity was determined from a 7-draw, 2-hour oral glucose tolerance test. Linear regressions were used to examine the links between sleep characteristics and insulin sensitivity, accounting for the potentially confounding variables of age, BMIz, race/ethnicity, and puberty. Dispositional mindfulness and self-compassion were tested as moderators of the association between sleep characteristics and insulin sensitivity. Results: Despite bivariate associations of insulin sensitivity with weekend wake time after sleep onset and weekend time in bed, after accounting for covariates, there were only two trend-level associations. Specifically, longer weekday sleep efficiency was related to greater insulin sensitivity at trend levels, and longer weekend wake time after sleep onset tended to be related to poorer insulin sensitivity at trend levels, accounting for covariates. Mindfulness and self-compassion moderated the associations of weekend sleep efficiency and weekday sleep efficiency, respectively, with insulin sensitivity at trend levels. Higher weekend sleep efficiency was associated with greater insulin sensitivity, only for adolescents with above-average levels of mindfulness. Higher weekday sleep efficiency was associated with greater insulin sensitivity, but only for adolescents with average or above-average levels of self-compassion. Conclusion: Sleep is an important area for future research in the prevention of T2D in at-risk adolescents. Mindfulness and self-compassion may moderate the associations between adolescent sleep quality and insulin sensitivity; however, these processes need further investigation. A comprehensive understanding of adolescent sleep will advance knowledge of sleep health, insulin sensitivity, and mindfulness/self-compassion in the prevention of adolescent-onset T2D.Item Open Access Supporting youth mental health through life coaching and mindfulness(Colorado State University. Libraries, 2022) Moran, Megan J., author; Shomaker, Lauren, advisor; Lucas-Thompson, Rachel, advisor; Merz, Emily, committee memberSchool-based prevention programs are a promising avenue to support youth mental health on a broad scale. Life coaching and mindfulness-based intervention are two specific approaches that may be effective in promoting resilience in the face of risk factors for adverse mental health outcomes and may be particularly well-suited for universal school-based delivery. Theory and limited empirical evidence suggest that these two types of interventions may share underlying mechanisms; however, there has not been any research directly investigating this overlap. This randomized controlled trial examined the effects of a school-based life coaching intervention with a mindfulness component on depression and anxiety symptoms as well as resilience, emotion regulation, self-efficacy, and mindfulness. Participants were N=230 early adolescents 9–13 years of age. Participants in the intervention condition received up to six weekly one-one-one coaching sessions, incorporated into the school day. All participants completed pre- and post-test self-report measures using scales validated for use with adolescents. Linear mixed effects models revealed no significant effect of the intervention on mental health outcomes, resilience, self-efficacy, or mindfulness. However, participants who received the intervention had a greater reduction in emotion regulation difficulties, relative to control, from pre- to post-intervention. Findings suggest that life coaching and mindfulness may be effectively integrated within a school-based intervention to reduce difficulties in emotion regulation, which have been shown in prior research to be precursors to mental health symptomology in adolescence.Item Open Access The role of developmental trauma in disordered eating and excess body weight in adolescence(Colorado State University. Libraries, 2018) Pivarunas, Bernadette, author; Shomaker, Lauren, advisor; Riggs, Nathaniel, committee member; Frank, Guido, committee member; Graham, Daniel, committee memberPsychological trauma and the human response to trauma have been characterized as one of the most important threats to public health. Developmental trauma, referring to traumatic events experienced during childhood and/or adolescence, is of particular concern given the potential biological, neurological, psychological, and relational impact of trauma on the developing child, with possible consequences lasting a lifetime. Youth may deal with developmental trauma by utilizing disordered eating behaviors like loss of control eating in efforts to cope with distress; loss of control eating can, in turn, cause excess weight gain. Adolescence is a particularly salient time for the initiation and maintenance of disordered eating, but it is unclear to what extent developmental trauma is associated with loss of control eating and excess weight in adolescence. Further, it is unknown what role developmental trauma has on affect and attachment, two developmental domains presumed to be affected by trauma, and how affect and attachment are associated with loss of control eating and excess weight gain in adolescence. This dissertation project utilized secondary data from a sample of adolescents at risk for excess weight gain, by having above-average body mass index (BMI >70 percentile for age and sex) or having a family history of overweight or obesity, to evaluate two aims. The first aim investigated associations between developmental trauma and disordered eating and developmental trauma and excess body weight, measured as BMI standard score, in adolescence. The second aim explored negative affect, measured as symptoms of depression and symptoms of anxiety, and attachment, measured as emotional support, as mediators of the associations of developmental trauma with disordered eating and BMI standard score. Approximately 58% of the sample endorsed at least one traumatic event. Developmental trauma count was associated with greater depressive and anxiety symptoms and lower BMI standard score, but it was not significantly associated with global disordered eating or loss of control eating. An indirect effect of developmental trauma on global disordered eating via depressive symptoms was observed. Symptoms of anxiety and emotional support did not mediate the associations of developmental trauma with disordered eating or BMI standard score. Results highlight the unique role of depressive symptoms in the relationship of developmental trauma to disordered eating. If replicated, particularly with a longitudinal design, findings have the potential to inform prevention and intervention efforts for a particularly vulnerable population: youth who have experienced trauma and may be at risk for or are experiencing disordered eating and excess body weight.Item Open Access The role of social relationship functioning in suicidal ideation among adolescents at-risk for adult obesity(Colorado State University. Libraries, 2020) Elliker, Elyse, author; Shomaker, Lauren, advisor; Lucas-Thompson, Rachel, committee member; Brown, Samantha, committee memberPrevalence of child and adolescent obesity represents a public health crisis in the United States and globally. Having tripled over the last 50 years, current rates of obesity show that approximately 18% of children aged 2-19 years in the United States are affected. While metabolic health consequences of obesity are of great concern, including insulin resistance and impaired glucose, obesity also is related to a range of adverse psychological concerns, including depression and suicidal ideation. Indeed, there has been an alarming rise in adolescent suicidal ideation and behavior, and a possibility that heavier youth are at higher risk. Yet, theoretical and empirical data support the possibility that positive social relationship functioning may play an important moderating role, by buffering the effects of weight discrimination on suicidal ideation in youth with overweight and obesity. In the current master's thesis proposal, I conducted a secondary analysis of the cross-sectional associations among social relationship functioning, suicidal ideation, and metabolic health characteristics in 90 adolescents aged 12-17 years (50% girls) at-risk for adult obesity. Adolescents completed survey measures of social relationship functioning and survey/interview measures of depression and suicidal ideation. Height and fasting weight were collected to determine body mass index (BMI) indices, and body fat was measured via air displacement plethysmography. A fasting blood sample was analyzed for fasting insulin, fasting glucose, and insulin resistance. I explored the bivariate associations among social functioning, depression, BMI, metabolic indices, and without suicidal ideation. Then I tested BMI/metabolic indices, social relationship functioning, and their interactions as a predictor of suicidal ideation, controlling for depression symptoms in order to evaluate the unique relation of BMI/metabolic indices and social functioning with suicide ideation. Nearly 30% of adolescents reported suicidal ideation. Contrary to hypotheses, results showed that neither BMI/body fat nor metabolic indices were related to suicidal ideation, nor did social act as a moderator of these associations. Accounting for age, sex, and BMI z, depression was robustly related to higher odds of suicidal ideation. Most dimensions of social functioning related in bivariate analyses to suicidal ideation, and some dimensions, even when accounting for depression symptoms and other covariates, showed a trend-level or significant association with suicidal ideation. These results point to the prevalence of suicidal ideation in adolescents at risk for adult obesity and suggest that elevated depression symptoms are the primary marker of risk for suicidal ideation in this population. Additional research with larger samples and longitudinal data are needed to further test the role of social functioning in mitigating, or perhaps mediating, suicidal ideation risk in adolescents at risk for adult obesity, as well as research into other possible protective factors.Item Open Access Understanding the link between parental and adolescent depressive symptoms in families at-risk for type 2 diabetes(Colorado State University. Libraries, 2015) Lehman, Devon Patricia, author; Shomaker, Lauren, advisor; Lucas-Thompson, Rachel, committee member; Wdowik, Melissa, committee memberDepression and type 2 diabetes (T2D) are serious chronic diseases that show familial aggregation. However, the connection between parent and child depression and T2D risk within families at risk for T2D is poorly understood. The primary objective of the current study was to examine associations among maternal depressive symptoms, adolescent depressive symptoms, and adolescent metabolic characteristics in at-risk families. The second objective was to examine to what extent adolescent coping techniques served as a mediator of the relationship between parental and adolescent depressive symptoms. To address these objectives, I conducted a secondary, cross-sectional data analysis of the baseline phase of a T2D prevention trial with adolescents. Participants were 119 girls (age 14±2y; 62% non-Hispanic Black) and a biological parent. All girls were at risk for T2D by being overweight or obese (BMI > 85th percentile) and having a first- or second-degree relative with diabetes. By study design, girls also had at least mild-to-moderate depressive symptoms as determined with the Center for Epidemiologic Studies-Depression Scale (CES-D, total score > 16). Adolescents reported a continuous measure of depressive symptoms on the Children's Depression Inventory, and parents described their own depressive/anxiety symptoms on the Adult Self-Report. Adolescent coping skills were measured by adolescents’ report on the Responses to Stress Questionnaire-Social Stress Version. Metabolic risk factor measures included fasting glucose, fasting insulin, insulin sensitivity determined with oral glucose tolerance tests, and body composition by dual-energy x-ray absorptiometry. Parental depressive/anxiety and adolescent depressive symptoms were positively correlated (p < .05), and this relationship remained even when accounting for race, age, puberty, body fat, lean mass, height, and presence of maternal diabetes (p = .01). Parental depression/anxiety symptoms were significantly related to adolescent BMI metrics, adjusting for similar covariates (all p < .05), but parental depression/anxiety did not relate to other insulin or glucose indices after accounting for body composition. Adolescent coping strategies of disengagement coping, involuntary engagement coping, and involuntary disengagement coping were all predictive of greater adolescent depressive symptoms in adjusted analyses (all p < .05). However, parental depression/anxiety and coping had independent main effects on adolescent depressive symptoms, and there was no evidence that coping mediated the relationship between parental depressive/anxiety symptoms and adolescent depressive symptoms (all p ≥ .34). In conclusion, among adolescent girls at-risk for T2D with some depressive symptoms, higher levels of parental depressive/anxiety symptoms were related to relatively higher levels of adolescent depressive symptoms and higher adolescent BMI. Frequency of negative coping skills also predicted relatively greater depressive symptoms among adolescent girls at-risk for T2D. The positive relationship of parental depression/anxiety and adolescent adverse coping skills to depressive symptoms in teens at-risk for T2D may have applied implications for preventative efforts targeting depression and T2D in these youth. However, longitudinal data are required to help elucidate the directional nature of these associations.