Theses and Dissertations

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    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 member
    Adolescents 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.
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    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 member
    Background: 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.
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    Open Access
    Implications of late autism spectrum disorder diagnosis for females
    (Colorado State University. Libraries, 2023) Tomasula Martin, Lily, author; Hepburn, Susan, advisor; Ortega, Lilyana, committee member; Harman, Jennifer, committee member
    The purpose of this qualitative case study is to examine the implications of the timing of an Autism Spectrum Disorder (ASD) diagnosis for females, specifically its impact on psychological well-being. While it is well-known that females are less likely to be identified at young ages than their male counterparts, we know relatively little about the experiences or service needs of women with Autism Spectrum Disorder (ASD) who are identified later in life. Five women, ages 22 to 46 years who received a formal diagnosis after the age of 12 years, participated in an in-depth interview with a clinician focused on the impacts of a late Autism Spectrum Disorder diagnosis and the participants' overall well-being. Participants also completed a standardized self-report measure of psychological well-being. Participants then partook in a semi-structured interview to share their experiences of being a female with ASD. Responses from the questionnaires were summarized to provide a baseline understanding of participants' well-being while the semi-structured interview was analyzed to find themes in participant experiences. This qualitative case study includes a small number of participants, but we learned about the potential impacts of late diagnosis for females and their self-report of overall well-being. Both of which has implications for both research and practice.
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    Mother-child and father-child emotional availability during the COVID-19 pandemic
    (Colorado State University. Libraries, 2023) Dungan, Maggie Elise, author; Biringen, Zeynep, advisor; Harvey, Ashley, committee member; Yoder, Jamie, committee member
    While the body of literature on COVID's impact to family life is rapidly expanding, most studies are based entirely on self-report data, leaving a critical gap in observational studies of parent-child interactions. The goal of this study was to evaluate parent-child relationships during the COVID-19 pandemic using the observational Emotional Availability (EA) construct. Parents (N = 43) were assessed using the Epidemic Pandemic Impacts Inventory (EPII), the Flourishing Scale (FLS), and Adverse Childhood Experiences (ACEs) questionnaires. The subcategories of the EPII were used to develop an EPII negative and an EPII positive for each parent. EA (sensitivity, structuring, nonhostility, nonintrusiveness, child responsiveness, and child involvement) was coded from filmed parent-child interactions. Separate hierarchical multiple regressions (HMRs) were run to evaluate each of the variables of interest (EPII and FLS) as predictive of EA. Child age and ACEs were added in subsequent steps for EPII negative and positive if the initial step was significant. For mothers, results demonstrated EPII negative as a significant predictor of EA with child age and ACEs adding only small amount of variance to the prediction. The same HMR process was repeated for flourishing, with the covariate child age alone. For fathers, flourishing was a significant predictor of EA and child age added only a small amount of variance to the prediction. Results indicate that experiencing high COVID-related stressors is associated with lower EA for mothers, but not fathers. Having high levels of flourishing during the pandemic was predictive of higher EA for fathers, but not mothers.
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    Emotional availability (EA) brief: single session feedback and coaching for improving fathers' emotional availability across a wide developmental spectrum
    (Colorado State University. Libraries, 2023) Lincoln, Michael, author; Biringen, Zeynep, advisor; Prince, Mark, committee member; Harvey, Ashley, committee member
    Fathers are a historically underrepresented population in developmental research and must be considered for their modern presentation in parenting processes. Emotional Availability (EA) is a construct that captures the parent-child relationship quality and predicts positive outcomes for children. A recently developed intervention, the EA Brief, is a program conceptualized for easy administration that may be utilized to improve father-child dyadic functioning across a range of child ages. The final sample of interested fathers was 18 fathers with children between 4-months and 13.5-years. For pretest sessions, all fathers completed surveys (demographic information, the Emotional Availability Self Report, and the Flourishing Scale) via Qualtrics, followed by a 20-minute filmed interaction via Zoom which was later coded for EA. Immediate Intervention Group (IIG) received one pretest before the intervention and one posttest after the intervention over a 3-5 week intervention delivery. The intervention involved a 2-hour interactive Zoom workshop where information about EA, attachment, and mindfulness was provided, a 1-hour individualized, Zoom EA feedback/coaching session, and two weeks of text reminders about the covered content. In contrast to the IIG, the Waitlist Control (WC) participants received two pretests (same assessments as above) separated by the 3-5 week time period corresponding to the timing of intervention delivery for the IIG. After the second pretest, they received the same intervention as the IIG. All IIG and WC fathers received posttest sessions (exact same assessments as for the pretests noted above). Across 16 target variables assessing EA, six observed variables showed post-intervention improvement (a < .05) though no significant findings were found on self-reported measures. These findings suggest that fathers respond to programs that provide guidance for clinically informed, research-based parenting despite the program having limited effect on their self-perceptions of how they parent.