Psychology Theses and Dissertations

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https://hdl.handle.net/1794/995

This collection contains some of the theses and dissertations produced by students in the University of Oregon Psychology Graduate Program. Paper copies of these and other dissertations and theses are available through the UO Libraries.

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Browsing Psychology Theses and Dissertations by Author "Allen, Nicholas"

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    A Micro-Randomized Trial To Improve College Students’ Wake Time Regularity
    (University of Oregon, 2020-09-24) Latham, Melissa; Allen, Nicholas
    Many college students experience irregular sleep patterns due to their unique schedule. These patterns confer risk for other sleep problems as well as mental health difficulties including mood disorders, physical aggression, and suicidal ideation. Current interventions to improve college students’ sleep are often created using Cognitive Behavioral Therapy for Insomnia components, although the components used are often not consistent. These interventions are also plagued by drop out, often by those that need the intervention the most. The current study takes a step toward creating an intervention with fewer, simpler components that is more agreeable to college students due to its ease and delivery through a phone-based application. In order to achieve this, I use a micro-randomized trial design to assess the most effective timing and content for an intervention that reminds students of techniques to help increase the regularity of their wake up times. The aims of the study were 1) to determine the feasibility and acceptability of the intervention; 2) to determine the effect of the reminders on immediate use of sleep hygiene strategies and on subsequent wake time regularity; and 3) to determine whether proximal outcomes were related to variability in wake times at the end of the intervention. Participants completed a baseline week of sleep diaries, an online psychoeducation module about sleep regularity, and then entered the intervention phase, where they were randomized each day to receive a reminder. If they were randomized to receive one, the timing and content of that reminder were also randomized. The results of this study indicate that participants were invested in completing our intervention and found it somewhat helpful. However, there was no effect of the reminders nor their timing or content on proximal outcomes. Lastly, there was no relationship between sleep hygiene use and wake time variability during the final week of the study. Although our results indicate that the intervention components were not effective, future iterations of the study are being planned to address several important limitations. The goal of the next iteration will be to assess the effect of these reminders without a number of unintended, confounding factors.
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    DIGITAL MENTAL HEALTH: MODERATORS AND MECHANISMS OF AN ONLINE MENTAL HEALTH INTERVENTION
    (University of Oregon, 2024-12-06) Pettitt, Adam; Allen, Nicholas
    In the last few decades, digital approaches to mental health treatment has become more prevalent and widespread in an effort to make mental health treatment more accessible to a wider range of individuals. This dissertation aimed to identify and characterize the moderators and mechanisms of a digital mental health intervention (DMHI). Because of the nascent nature of the field, much of the research that has been conducted has focused on if digital mental health interventions are effective. Much of that research has shown it to be on-par with in-person interventions. However, little research has examined the mechanisms by which these interventions are effective. Across five sub-studies, this dissertation sought to elucidate some of the underlying mechanisms for who this DMHI is effective for, how individuals interact with the DMHI, and identify the underlying mechanisms of improvement in symptoms of depression and anxiety. Participants were drawn from a larger sample of individuals who participated in the Meru Health Program, which is a DMHI platform available to the public. Participants underwent an 8-week or 12-week intervention (depending on which version they were given) that focused on therapeutic techniques derived from Cognitive Behavioral Therapy, Mindfulness Based Stress Reduction, and other evidence-based therapies. Participants were administered demographic questions at the beginning of the intervention and administered depression and anxiety questionnaires at enrolment and every 2 weeks until the end of treatment. The analyses used in this dissertation were mixed-methods ranging from mixed-effects modeling to qualitative thematic analyses aimed at understanding the underlying mechanisms for efficacy within the MHP. Results from Chapter 1 Study 1 revealed that across age, gender, and race, the DMHI was effective for all groups, and in particular (from Chapter 1 Study 2) there was a disproportionate drop in suicidality within gender expansive individuals when compared with cis gender individuals. Additionally, results from Chapter 2 study 1 indicate that participants engaged in messaging with their therapist for a wide array of reasons, including rapport building and solving tech difficulties. Further analyses in Chapter 2 Study 2 revealed that, within the first week, days active within the app was the most predictive of completion of the DMHI. Finally, the results from Chapter 3 demonstrated that improvements in HRV across the DMHI are associated with reductions in depressive symptoms. The implications of these findings and proposed areas for ongoing research are discussed.
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    Parenting and Adolescent Health: Mechanisms of Stress-Disease Comorbidity
    (University of Oregon, 2020-09-24) Nelson, Benjamin; Allen, Nicholas
    Adolescence is partly characterized by alterations in affective functioning during which individuals are at increased risk for the onset of mental health disorders. The experience of stress during adolescence has the potential to influence health trajectories across the lifespan as comorbidity between mental health and physical disease processes start to unfold during this period. Importantly, close relationships, such as those between adolescents and their parents, have the potential to influence and moderate (i.e., buffer or exacerbate) the expression of psychopathology and associated disease processes to influence these health trajectories. In this dissertation, I present three multimethod studies integrating clinical diagnoses, parent-adolescent interactions, self-reported affect, observed behavior, psychophysiology, inflammation, and cellular aging to better elucidate the role parent-adolescent relationships play in influencing adolescent mental and physical health trajectories. In Chapter I, the introduction elucidates the association between parent-adolescent relationships with both adolescent mental and physical health by presenting a biological cascade model from stress to disease. Chapter II presents the first study, which examines how context, specifically varying emotionally charged interactions with parents, influence the expression of adolescent depression at the level of self-report, behavior, and psychophysiology. Chapter III presents the second study, which utilizes a multi-system approach to investigate the effect of observed parental behavior on the relationship between sympathetic physiology and inflammation in adolescents. Chapter IV presents the third study, elucidating that association between maternal depression and measures of basal stress and social stress reactivity across measures of affect, cardiovascular functioning, and biological aging in their adolescent children. Lastly, Chapter V provides a brief overview of each study and discusses theoretical implications of findings. In addition, the discussion presents future directions that focus on how smartphone, wearable, and smart home devices can provide an opportunity to advance psychological science by providing a passive sensing ecosystem in order to bring the laboratory out into real world environments in order to improve ecological validity, while simultaneously allowing for the advent of a novel precision psychology approaches to prevention and intervention in order to improve healthcare outcomes and better understand how relationships impact health across the lifespan.
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    Utilization of Linguistic Markers in Differentiation of Internalizing Disorders, Suicidality, and Identity Distress
    (University of Oregon, 2024-01-09) Ivie, Elizabeth; Allen, Nicholas
    The adolescent period of development is associated with a significant increase in the occurrence of mental illness. In addition, death by suicide is one of the leading causes of death amongst adolescents. Identity formation is a key developmental task of adolescence, and successful navigation of this process is associated with greater well-being and resilience, while difficulties are associated with risk for mental health disorders and suicidality. Adolescents today spend enormous amounts of time on digital devices, which have become a new instrument by which they explore and confirm their identities and experiences. The study of natural language use is related to wide range of psychological phenomena, including psychopathology, and offers a tool by which we can begin to ask and answer these questions utilizing new tools that allow us to passively collect adolescents’ language use directly from their digital devices. The current study leverages a unique clinical sample of adolescents who have been followed over six months to explore the relationship between both between and within participant measures of psychopathology, suicidal thought and behaviors, and putative linguistic markers of adolescent identity formation derived from online communications in order to further understand the association between these variables using ecologically valid measures in a community sample of adolescents experiencing significant mental health challenges. The aims of the study were to (1) assess whether there are differences in how adolescents with psychopathology, suicidal ideation, and previous suicide attempts use language, (2) language differences associated with mental illness symptomology, (3) and language differences in hypothesized identity domains associated with mental illness symptomology communicated through social communication apps via text. Participants completed baseline measures of depression, suicidality, and anxiety symptoms. Participants downloaded the EARS tool onto their digital devices that passively collected text data sent through social communication applications. The results of this study indicated that there are natural language use differences between adolescents with psychopathology and those who experience suicidality, depression, and anxiety symptoms.
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    When “Self-Harm” Means “Suicide”: Adolescent Online Help-Seeking for Self-Injurious Thoughts and Behaviors
    (University of Oregon, 2024-03-25) Lind, Monika; Allen, Nicholas
    The sensitive period of adolescence facilitates key developmental tasks that equip young people to assume adult roles. Adolescence features important strengths, like the need to contribute, and some risks, like vulnerability to the onset of mental ill health. Adolescence increasingly occurs online, where existing in-person dynamics and new affordances of digital technology combine. Online help-seeking suits the needs and preferences of adolescents, and online peer support capitalizes on adolescent strengths. The success of online peer support communities for self-injurious thoughts and behaviors (SITB) may depend on the balance of social support and social contagion in these communities. In this study, we investigated adolescent help-seeking and peer support for SITB online. We used topic modeling, machine learning classification, and multilevel modeling in pursuit of three aims. In the first aim, we discovered the topics that characterized help-seeking expressions of over 100,000 posters who chose to post in the “Self Harm” category of an online peer support platform. In the second aim, we measured the amount and type of social support provided in over a million comments in response to these posts. In the third aim, we tested whether the topics of help-seeking expressions predicted the presence and type of social support provided. The over-arching goal of these aims was to help inform policy and guide the design of online spaces to support healthy adolescent development, especially amongst adolescents experiencing mental health challenges. From the first aim, we learned that adolescents seek help online for serious problems and suffering. From the second aim, we learned that their peers provide social support most of the time, but this social support often lacks specificity and elaboration. From the third aim, we learned about the power of help-seeking expressions focused on “hopeless suicide,” “self-harm abstention,” and “hiding self-harm” to elicit social support. Across all three aims, we learned that platform design matters, and platform designers can do more to support healthy development. Adolescent online help-seekers need help that makes them feel connected. Academic researchers and corporations must work together to help young people help each other.