CHP FALL SYMPOSIUM
October 30, 2009

Project Title: Family Predictors of Weight Control Behaviors in Overweight and Obese Youth
Student Presenter: Megan Crawford, BA
Faculty Mentor: David Janicke, PhD; Associate Professor

As childhood obesity rates rise, more children experience pressure to lose weight. Oftentimes, weight loss attempts are unsupervised by health care professionals, leaving families to make their own decisions about the use weight control behaviors (WCBs). Overweight children are more likely to engage in unhealthy WCBs when compared to their healthy peers. However, little data exists to help identify children at risk for engaging in unhealthy WCBs.
The current study aims are to: (1) describe the use of WCBs in overweight youth. (2) determine if family functioning is related to the use of unhealthy and healthy WCBs. Participants were 57 overweight or obese youths, ages 10-17, and their parent attending a regularly scheduled Lipid or Obesity clinic appointment. Families filled out questionnaires regarding WCBs, parent-child conflict, family mealtime interactions, and global family functioning. Children who were older and heavier reported increased use of unhealthy WCBs. While general family functioning were not related to WCBs, children who reported more positive family mealtime interactions reported fewer unhealthy WCBs. These data suggest that family interactions specific to mealtime environments are an important factor children’s use of unhealthy WCB. Future research should focus on further identifying types of family interaction which are related to both healthy and unhealthy WCB to develop targets for intervention.

Sponsored by: This project was supported by a mini grant from the Center of Pediatric Psychology and Family Studies at the University of Florida.

Project Title: The Relationship Between Basic Cognition, Everyday Cognition and Everyday Function: a Longitudinal Approach
Student Presenter: Anna Yam, B.A.
Faculty Mentor: Michael Marsiske, Ph.D.

Elders’ ability to perform instrumental activities of daily living (IADLs) is a key determinant of their ability to live independently. Traditional neuropsychological measures of “basic” cognition (e.g., memory, processing speed, reasoning) are often only modest predictors of IADLs. Several studies have argued that measures of everyday cognition, which simulate cognitive challenges encountered in everyday life, are more predictive of IADLs, and mediate the effects of basic cognition. To date, most studies have focused on cross-sectional associations. The present study used the no-treatment control group of the ACTIVE trial (N=698, 74% female, mean age = 74 years, mean education = 13 years), which had five occasions of measurement (baseline, and follow-up assessments after 1-, 2-, 3-, and 5-years). Mixed effects longitudinal models revealed a quadratic decline trend for all constructs, with steeper decline for basic cognitive measures than everyday cognition or IADL functioning. Individual differences in memory, processing speed and everyday cognition emerged as significant unique predictors of IADL level. In addition, intra-individual changes in memory and everyday cognition were uniquely and significantly coupled with changes in IADLs over the 5-year period. Implications for the ecological validity of the assessment of older adults, and for longitudinal aging research will be discussed.

Sponsored by: This research was sponsored by #: 5U01AG014276-10, PI: Michael Marsiske, Title: ACTIVE Phase III: UF/WSU Field Site, Funding Agency: National Institute on Aging, and #: 64441, PI: Patricia Belchior, Title: Action Video Games to Improve Everyday Cognitive Function in Older Adults, Funding Agency: Robert Woods Johnson Foundation.

Project Title: Effects of coping statements on experimental pain in chronic pain patients.
Student Presenter: Daniela Roditi, B.A.
Student Mentor: Michael Robinson, Ph. D.

The present study measured the effects of catastrophizing self-statements and positive coping self-statements on cold pressor-induced pain. Participants were 58 adult chronic pain patients with current facial pain. It was hypothesized that catastrophizing would lead to a decrease in pain endurance whereas positive coping would lead to an increase in pain endurance. It was also hypothesized that catastrophizing would lead to an increase in peak pain intensity whereas positive coping would lead to a decrease in peak pain intensity. At pretest, participants submerged their non-dominant hand in the cold pressor. Pain Sensitivity Ranges (PSR) were subsequently determined by calculating the difference between tolerance and threshold times. Ratings of peak pain intensity were measured using a pressure sensitive bladder/transducer. Participants underwent random assignment to either a catastrophizing group or a positive coping self-statement group. ANCOVA results revealed that on average, participants employing catastrophizing statements as a coping strategy experienced significantly lower PSR (M = 35.53, SD = 39.71) compared to participants employing positive coping self-statements (M = 73.70, SD = 86.14) when controlling for pretest PSR. Group assignment had no significant influence on peak pain intensity ratings. Thus, our results reveal that manipulation of coping causes changes in pain endurance.

Sponsored by: Sponsored by the Center for Pain Research and Behavioral Health

Project Title: Alpha-Amylase and Cortisol in Women with Endometrial Cancer: Comparing Diurnal Profiles in Relation to Stress
Student Presenter: Stephanie L. Garey, B.S.
Faculty Mentor: Deidre B. Pereira, Ph.D.

Alpha(a)-amylase and cortisol are stress hormones produced via independent stress systems. Following stress, a-amylase is released by the sympathetic nervous system (SNS), while cortisol is released by the hypothalamic-pituitary-adrenal (HPA) axis. Although the psychoneuroimmunologic (PNI) mechanisms involved in HPA stress responses have been studied in medical populations, less is known about mechanisms of limbic HPA-independent a-amylase. This study compared the diurnal output of a-amylase and cortisol, and examined stress/anxiety and a-amylase relations in women with endometrial cancer (EC). Participants were 15 women drawn from a larger study of PNI relations in EC. A moderate effect size (ES) correlation emerged between greater cortisol and lower a-amylase at 8AM. A moderate ES correlation also emerged between greater changes in cortisol and greater changes in a-amylase per unit time. Furthermore, a large ES correlation was revealed between greater 8AM stress levels and greater 12PM a-amylase. Statistically significant correlations emerged between greater anxiety and less change in a-amylase per unit time, lower 8AM values, and less total diurnal output, a possible pattern of SNS activity blunting. Although based on a small sample, these findings suggest stress/anxiety may be associated with SNS-dependent a-amylase in women with cancer. Future research should replicate/expand upon these findings in a larger sample.

Sponsored by: This research was sponsored by a graduate research grant awarded by the College of Public Health and Health Professions.

Project Title: Social Competence Deficits in Preschoolers with Behavioral Disorders
Student Presenter: Nicole Ginn, BA
Faculty Mentor: Sheila M. Eyberg, Ph.D., ABPP,
Stephen Boggs, Ph.D., ABPP,
Regina Bussing, M.D.

Children diagnosed with behavioral disorders like Attention Deficit Hyperactivity Disorder (ADHD) or Oppositional Defiant Disorder (ODD) are likely to have significant deficits in social competence and to be rejected by their peers, to be less popular, and to have fewer friends than control children. Children diagnosed with comorbid ADHD and ODD show greater deficits in social competence than children diagnosed with either ADHD or ODD alone. It is unclear, however, which specific behaviors associated with these disorders contribute to these deficits in social competence. This study examines the association between children’s participation in Parent-Child Interaction Therapy (PCIT) and social competence. It was hypothesized that children would show an increase in social competence following treatment and that higher levels of hyperactive and oppositional behaviors would be associated with lower social competency before treatment. It was further hypothesized that children with comorbid diagnoses would exhibit lower social competence before treatment and less improvement after treatment than children with single diagnoses. Results with 42 children ages 3 to 6 provide support for the primary hypothesis. Across all children, social competence increased after completing PCIT, t(41) = -2.02, p = .05. In addition, higher levels of oppositional behavior, but not hyperactive behavior, predicted lower social competence at pre-treatment, (?= -.53, p<.01). No significant differences, however, were found between single- versus dually-diagnosed children at either pre- or post treatment. These findings provide evidence supporting the effectiveness of PCIT for improving social competence deficits in children with disruptive behavioral disorders.

Sponsored by: This project was supported by grants from the National Institute of Mental Health (R01 MH60632, R01 MH072780).

Project Title: Developing a cognitive-affective neuroimaging probe to explore differential diagnosis of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD): A preliminary study

Student Presenter: Callie E. Tyner, B.A.

Faculty Mentor: William M. Perlstein, Ph.D.

TBI survivors often experience persistent post-concussive symptoms, including cognitive, affective, and somatic complaints. These symptoms reflect problematic overlap with those of PTSD, complicating differential diagnosis and potentially hampering tailoring of treatment. This investigation aims to develop an fMRI probe of rostral anterior cingulate cortex (rACC) and other emotion-critical brain regions using a cognitive-affective task—the Cued Emotional Counting Stroop—modeled after one used to probe caudal ACC in TBI. Our larger aim is to develop an fMRI probe to differentiate TBI and PTSD.
Four neurologically-normal adults completed an event-related fMRI paradigm using this task, which includes an instructional-cue followed by a stimulus-probe containing pleasant, neutral, and unpleasant words. We predicted cue-related activity in dlPFC, emotional probe-related activity in rACC and amygdalae, and increased latency and error rates to emotionally salient words.
No significant differences in RT or error-rates by probe-stimulus valence were found. Neuroimaging revealed task-related activity to emotionally salient words in bilateral amygdalae and rACC (p <.028), and right dlPFC activation during context maintenance (p <.015). Results support further exploration of this task as a reliable probe of rACC and cognitive-affective brain circuits important in both PTSD and TBI. Further application to clinical populations, in conjunction with measures of symptomatology, is encouraged.

Sponsored by: This project was supported by grants from the McKnight Brain Institute (FF-26) and National Institute of Mental Health (R21 MH073076) to WMP.

Project Title: Maintenance of Lost Weight: An Examination of the Appearance Motivation Hypothesis
Student Presenter: Valerie J. Hoover, B.A.
Faculty Mentor: Michael G. Perri, Ph.D., A.B.P.P

Most obese individuals are motivated to lose weight to improve their physical appearance. Some theorists posit that failure to achieve substantial progress towards this objective may lead to abandonment of changes to diet and physical activity and ultimately to weight regain. We examined these propositions in the context of an 18-month randomized trial of obesity treatment. We hypothesized that a) body image dissatisfaction at pretreatment would be associated with higher levels of desired weight loss, b) the change in the discrepancy between actual and desired body weight at posttreatment (6 months) would be inversely associated with weight regain at follow-up (18 months), and c) self-rated improvements in physical appearance at posttreatment would be inversely associated with weight regain at follow-up. Participants were 298 obese women (mean ± SD, age=59 ± 6 [range=50 to 75], BMI=37 ± 5 [range=29 to 51]). Results indicated a significant association between body image dissatisfaction and amount of desired weight loss at pretreatment (r=0.17, p=0.02). However, the change in the discrepancy between actual and desired weight at posttreatment was not associated with weight regain at follow-up (r=-0.08, p=0.25). Similarly, self-rated improvements in physical appearance at posttreatment were not associated with weight regain at follow-up (r=-0.03, p=0.72). Collectively, these findings suggest that while body image dissatisfaction may be related to desired weight loss, neither posttreatment changes in the discrepancy between actual and desired weight nor posttreatment improvement in physical appearance are associated with the regaining of lost weight.

Sponsored by: This project was supported by a grant from the National Heart, Lung, and Blood Institute (R18 HL073326).

Project Title: Impact of Abuse on Externalizing Symptoms in Children: Findings from a
Rural School Sample

Student Presenter: Jennifer Rosado, MA

Faculty Mentor: Brenda Wiens, PhD

Child abuse continues to be a pressing concern, as abuse places children at risk for a number of adverse outcomes, including behavioral problems. In this study, data on abuse history and abuse type (physical, sexual, and neglect) were extracted from charts of children and adolescents who were referred for counseling due to behavioral problems in school in order to test the relationship between a history of abuse and externalizing behaviors as rated by teachers. This population consisted of 322 participants, ages 3 to 19, from a rural county in Northeastern Florida. Approximately 42% of the sample endorsed experiencing abuse. Of those who endorsed an abuse history, 15% were physically abused, 15% were sexually abused, and 28% were neglected. The relationship between abuse and externalizing problems (inattention, aggression, and hyperactivity) was then assessed using the corresponding scales from the teacher version of the Behavior Assessment System for Children. There were significant gender, minority, and age differences, in that males, minorities, and younger children, were rated as having more externalizing problems. Furthermore, results demonstrated that physically abused children were rated as having more aggression problems and behavior referrals, while neglected children were less likely to have attention and hyperactivity problems.

Sponsored by: This research was supported in part by subcontracts on two Department of Education grants (#S184L020327 and #Q184A050262).

Project Title: Predicting Treatment Initiation in a Rural, School-Referred Sample
Student Presenter: Eileen Matias Davis, B.A.
Faculty Mentor: Brenda Wiens, Ph.D.

Although researchers continue to investigate factors that contribute to treatment attendance and adherence, relatively little is known about what factors influence treatment initiation. This study examines the role of parent-rated symptom severity, and parent-teacher concordance as predictors of treatment initiation. The current sample consists of 144 children and adolescents (68% male) referred by their schools for a psychological evaluation in a rural Florida county. The Behavior Assessment System for Children (BASC), Parent and Teacher versions, as well as the Achenbach’s Child Behavior Checklist and Teacher Report Form were used to test the relationship between parent-teacher concordance and treatment initiation. The Parent BASC was also used to determine whether higher parent-rated symptom severity predicted greater treatment initiation. Logistic Regression analyses were used to test these relationships. Demographic variables (child age, gender, ethnicity, and income status) were not significant predictors of treatment initiation and thus were not included in these analyses. Parent-rated symptom severity on the four BASC Composites (Externalizing, Internalizing, Behavior Symptoms Index, and Adaptive Skills) did not significantly predict treatment initiation. Similarly, parent-teacher concordance did not predict treatment initiation in this sample. Parent-rated symptom severity and parent-teacher concordance are not significant predictors of treatment initiation.

Sponsored by: This work was supported in part by a subcontract from a Department of Education grant, Columbia Acting Together for Children (#S184L020327), awarded to the Columbia County School District.

Project Title: Comparing Behavioral Therapy for Insomnia in Older Adults with and without a History of Chronic Pain
Student Presenter: Jacob Williams, B.S.
Faculty Mentor: Christina McCrae, Ph.D.

Previous research has shown sleep improvements are possible using Cognitive-Behavioral Therapy for insomnia with individuals with chronic pain. However, previous research has lacked a non-pain comparison. We hypothesized that individuals with insomnia and a history of chronic pain (HCP) who receive Behavioral Therapy for insomnia (BTi) would show significant improvements on outcome measures but individuals without chronic pain will have greater improvements. Older adults with insomnia (N=55, Mage=70.3) completed baseline, 4-week BTi treatment (stimulus control, sleep restriction, relaxation) or control, and post-treatment. Throughout the study, individuals completed daily sleep diaries. Repeated measures ANCOVAs compared change in sleep outcomes from baseline to posttreatment, controlling for the number of medical conditions. Between-groups factors were BTi versus control and presence/absence of HCP. Both the HCP and non-HCP participants receiving BTi showed significant improvements (p<.001) from baseline on outcome variables. Participants receiving treatment fell asleep faster (~27 min), woke less in the night (~35 min), and rated their sleep more positively at posttreatment compared to baseline (p<.001). The control groups did not see any significant improvements. Equivalency testing revealed no significant differences between HCP and non-HCP participants receiving treatment. This suggests that BTi can be a brief and effective sleep intervention among individuals with HCP and there is no statistical reason to separate individuals with HCP from those without HCP.

Sponsored by: This project was supported by a grant from the National
Institute of Health/National Institute of Aging (1 R21 AG024459-01 Christina S. McCrae, PhD, PI).

Project Title: Associations Among Type D Personality, Cytokines, and Human Herpesvirus Infection in Allogeneic Hematopoietic Stem Cell Transplant (HSCT) Recipients
Student Presenter: Seema M. Patidar, B.S.
Faculty Mentor: Deidre B. Pereira, Ph.D.

Cytomegalovirus (CMV) is a latent Herpesvirus that may cause life-threatening illness in immunocompromised individuals. T-helper cell type 1 (Th1) cytokines (Interleukin-12 [IL12], Interferon-gamma [IFN?], and Tumor Necrosis Factor-alpha [TNFa]) facilitate cell-mediated immunity and immunosurveillance of latent CMV. Psychosocial factors, including stress and negative mood states, are associated with poorer CMV immunosurveillance. However, no research has examined psychoneuroimmunologic relations in HSCT recipients at risk for CMV disease. The present study examined relationships among social inhibition/negative expressivity (“Type D personality” traits), Th1 cytokines, and CMV reactivation in HSCT. Eighty-six subjects (M age=46.83 yrs; SD=11.83yrs) completed the Millon Behavioral Medicine Diagnostic (MBMD) before HSCT. Th1 cytokine levels were examined in sera at HSCT Days 0 and 28. Subjects were followed for development of CMV antigenemia (ag) for 4 years. Using regression analyses, Type D personality was not associated with Th1 cytokines or greater odds of CMVag. However, greater Introversion, specifically, was associated with higher Day 28 TNFa (a CMVag risk factor in HSCT), and this relationship was partially mediated by higher Day 0 IL12. These findings suggest Introversion is associated with cytokines that may increase risk for CMV disease in HSCT. Future research should attempt to replicate/expand upon these findings in a larger, more diverse HSCT sample.

Project Title: Measuring brain MRI White Matter Hyperintensities in Dementia
Student Presenter: Stephen Towler, BS
Faculty Mentor: Dr. Catherine Price

Clinicians are increasingly integrating neuropsychological and neuroradiological data for dementia subtype diagnosis. Visual rating scales commonly used to evaluate one neuroradiological marker, white matter hyperintensities (WMH), fail to capture important measurable lesion properties. OBJECTIVE: Improve WMH measurement by 1) developing a reliable method for manual 3D mapping of WMH, 2) comparing 3D maps to a widely-used visual rating scale, and 3) examining a previously published hypothesis that WMH severity is related to distinct cognitive profiles in dementia (Price et al., 2005).

METHODS AND RESULTS: Neuropsychological data and brain MRIs from 84 individuals with probable Alzhemier’s disease (age mean±s.d. = 79.7±5.1y) were analyzed. Fifteen individuals’ MRIs were used to develop a 3D WMH mapping technique, producing WMH volumes reliable within and between two raters (ICCs > .94, p<0.001). The remaining 69 MRIs were 3D-mapped by one rater, and resulting volumes correlated positively with previously acquired visual rating scores (Spearman’s rho =0.76, p <0.001). Like visual ratings, 3D-mapped WMH volumes tended to be larger in participants with worse executive function (Spearman’s rho=-0.216, p<.05). CONCLUSION: Manual 3D mapping of WMH can be reliable with visual ratings scales. Researchers and clinicians are encouraged to consider 3D mapping as it enables the investigation of how cognitive profiles in dementia vary with the location, volume, and MR signal of WMH.

Sponsored by: NINDS K23NS060660(CP), AlzAssociation IIRG0627542(DL)

Project Title: The Pupil as a Measure of Emotion Modulated Arousal in Parkinson’s Disease

Student Presenter: Jenna Dietz, B.A.
Faculty Mentors: Dawn Bowers, Ph.D.; Margaret Bradley, Ph.D.

Parkinson’s disease (PD) is a neurodegenerative disease that primarily affects motor function, but also has cognitive and emotional consequences. Previous research has documented muted physiologic reactivity to emotional materials as measured by skin conductance response, an autonomic measure of arousal. The basis for reduced SCR in PD is unclear, but possibly relates to peripheral factors (i.e., fewer sweat glands in the skin), rather than reflecting a more central arousal deficit. In the present study, we used another index of autonomic arousal, the pupillary response, to test the hypothesis that PD patients would show muted reactivity to emotional materials. Participants included 14 nondemented PD patients and 12 healthy controls. Pupil diameter was recorded while participants viewed negative, neutral, and positive images (total N=42) from the International Affective Picture System. Analyses revealed significant effects for Group (F(1,24)=8.2, p<.01, ?p2=.26) and Valence F(2,48)=6.4, p<.01, ?p2=.21). For both groups, emotional images (positive, negative) elicited significantly greater pupil dilation than neutral pictures. However, the PD group demonstrated significantly less pupil dilation across all picture types. Taken together, these pupillometry findings indicate that while PD patients differentially responded to emotional vs. neutral pictures, their overall degree of physiological reactivity was reduced. These results will be discussed in terms of underlying neural systems and implications for emotional changes in PD.

Sponsored by: This project was supported by grants from the National Institutes of Health (R01 MH12345 to MB; R01 NS50633 to DB) and the Michael J. Fox Foundation.

Project Title: Muted Enhancement of Emotional Memory in Parkinson Disease
Student Presenter: Lizabeth Jordan, BS
Faculty Mentor: Dr. Dawn Bowers, PhD
Previous research has found that patients with Parkinson disease (PD) have blunted reactivity to emotionally arousing stimuli as indexed by startle eyeblink and skin conductance responses. Based on these observations, we hypothesized that PD patients would fail to show a commonly observed “emotional enhancement” effect in their recall of emotional vs neutral memories. To test this hypothesis, 23 PD patients, 23 healthy elders, and 25 young adults were shown a set of 46 standardized emotional pictures (negative-high arousal, neutral, positive-high arousal) and later asked to recall as many as possible. Results supported our hypothesis. While recall of neutral pictures was comparable among the 3 groups, only the younger and older controls recalled more emotionally arousing pictures (negative & positive) than neutral low-arousing pictures. Improved recall of emotional information was not observed in PD patients. The absence of the emotional enhancement effect in PD patients was not due to generalized memory failure or lack of appreciation of emotional value of the pictures. These results may reflect diminished arousal and/or a disconnect between arousal and amygdala-hippocampal systems that underlie memory encoding/retrieval. The implications of these findings will be discussed in terms of contemporary views of emotional deficits in Parkinson disease.
Sponsored by: NIH R01-NS0653, Michael J. Fox Foundation

Award and Reception Photos