Browsing by Author "Snow, Lynn"

Now showing 1 - 9 of 9
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    Aggression Prevention Training for Individuals With Dementia and Their Caregivers: A Randomized Controlled Trial
    (Elsevier, 2020) Kunik, Mark E.; Stanley, Melinda A.; Shrestha, Srijana; Ramsey, David; Richey, Sheila; Snow, Lynn; Freshour, Jessica; Evans, Tracy; Newmark, Michael; Williams, Susan; Wilson, Nancy; Amspoker, Amber B.; Baylor College of Medicine; University of Alabama Tuscaloosa
    Objective: International appeals call for interventions to prevent aggression and other behavioral problems in individuals with dementia (IWD). Aggression Prevention Training (APT), based on intervening in three contributors to development of aggression (IWD pain, IWD depression, and caregiver-IWD relationship problems) aims to reduce incidence of aggression in IWD over 1 year. Design: Randomized, controlled trial. Setting: Three clinics that assess, diagnose, and treat dementia. Participants: Two hundred twenty-eight caregiver-IWD dyads who screened positive for IWD pain, IWD depression, or caregiver-IWD relationship problems randomized to APT or Enhanced Usual Primary Care (EU-PC). Intervention: APT, a skills-based intervention delivered over 3 months to address pain/depression/caregiver-IWD relationship issues. EU-PC included printed material on dementia and community resources; and eight brief, weekly support calls. Measurements: The primary outcome was incidence of aggression over 1 year, determined by the Cohen Mansfield Agitation Inventory-Aggression Subscale. Secondary outcomes included pain, depression, caregiver- IWD relationship, caregiver burden, positive caregiving, behavior problems, and anxiety. Results: Aggression incidence and secondary outcomes did not differ between groups. However, in those screening positive for IWD depression or caregiver-IWD relationship problems, those receiving EU-PC had significant increases in depression and significant decreases in quality of the caregiver-IWD relationship, whereas those receiving APT showed no changes in these outcomes over time. Conclusion: The cost to patients, family, and society of behavioral problems in IWD, along with modest efficacy of most pharmacologic and nonpharmacologic interventions, calls for more study of novel preventive approaches.
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    Attorney Perspectives of Financial Capacity Among Older Adults
    (University of Alabama Libraries, 2023) Bownes, Elizabeth Mcvay; Cox, Jennifer
    Annually in the United States, around five million older adults fall victim to financial abuse and/or exploitation of some form, losing an estimated $2.9 to $36.5 billion each year (National Council on Aging, 2021). While it is known that financial exploitation is under-detected and underreported, there are few data to explain the process of assessing capacity within the legal field. Using thematic analysis methodology, 18 attorneys with varying levels of elder law experience participated in a semi-structured virtual interview. Specifically, the current study sought to examine how attorneys perceive financial capacity, the typical conditions under which capacity issues are identified, and the protocol followed to address capacity concerns. Using thematic analysis, major and minor themes, as well as subthemes, were identified to explain ways in which attorneys tend to rely on their own experiential knowledge, semi-structured interview and evaluation process, and often longstanding relationships with their clients and/or their families to assess for financial capacity and detect financial capacity or exploitation concerns. Attorney understanding of financial exploitation was typically limited to family, friend, and/or caregiver perpetrators, though some attorneys cited past issues with financial representatives and/or designated power of attorney as well. Examples of cues included abnormal financial spending and/or requests and suspicious interpersonal relationships or interactions. In regards to assessing financial capacity, attorneys tended to again rely on experiential learning, as well as the use of routine interview questions, typically related to psychosocial and financial background. These findings highlight not only the need for future financial capacity and exploitation research involving attorneys and their older adult clients, but also the importance of increased interdisciplinary work among those in close proximity with older adults and improved policies to make financial capacity assessment and financial exploitation prosecution more feasible for all to obtain.
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    CNAS' Ratings of Nursing Home Residents' Pain: The Role of Empathy
    (University of Alabama Libraries, 2020) Behrens, Emily Anne; Parmelee, Patricia; University of Alabama Tuscaloosa
    Long-term care residents with and without cognitive impairment may experience undertreatment of persistent pain (Fain et al., 2017). Certified nursing assistants (CNAs) are important sources of information about resident pain as provide the majority of residents' hands-on care. Therefore, assessing the accuracy of CNAs' pain assessments and potential influencing factors may provide insight regarding the undertreatment of pain. Informed by prior research, this study examined resident pain catastrophizing and cognitive status as predictors of CNAs' pain assessment accuracy. CNA empathy was examined as a moderating variable. Analyses confirmed a relationship between pain catastrophizing and CNA pain rating accuracy. Hypotheses predicting a relationship between resident cognitive status and CNA pain rating accuracy and moderating effects of empathy were disconfirmed. Challenges of conducting research in long-term care are discussed.
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    Effects of Loneliness on Brain Structure and Cognition Across the Lifespan
    (University of Alabama Libraries, 2023) Apostolou, Hannah Lynne; McDonough, Ian
    In aging populations, increasing amounts of older adults are reporting high levels of loneliness. Previous research has demonstrated that people reporting more loneliness have smaller gray matter volumes using voxel-based morphometry (VBM). Although popular, VBM measures intensity of gray matter signal rather than volume, per se. Other common measures of brain volume that abide by more traditional calculations, measured through programs such as FreeSurfer, might offer a complementary perspective on how loneliness impacts brain structure. The present study aims to examine how these measures differ and uncover the unique contributions each measure offers to research on loneliness and brain structure. Researchers used data from the Alabama Brain Study on Risk for Dementia that collected structural magnetic resonance imaging, cognition, and psychosocial questionnaires in adults aged 20-30 and 50-74, to assess loneliness across the lifespan. We examined how feelings of loneliness was differentially related to these two measures of brain structure and, in turn, how such declines in brain structure were related to cognition. We hypothesized that higher levels of loneliness will be associated with smaller brain volumes, and in turn, lower levels of cognition. Multiple regression analyses were performed in SPSS to assess the relationship between gray matter volume and loneliness in both measures. Results of our analyses supported our hypothesis in the right entorhinal cortex such that higher levels of loneliness are associated with lower levels of gray matter volume. This relationship is notable as the entorhinal cortex has been found to be associated with Alzheimer's disease in previous research and suggest that loneliness should be taken seriously as a risk factor. There was no link found between this relationship and cognitive outcomes. Across both hemispheres, the ROI values correlated moderately, leaving most of the variance unexplained between the two methods, suggesting that each method captures unique components of brain structure.
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    The Effects of Teaching About the Replication Crisis on Undergraduates' Epistemic Dependence
    (University of Alabama Libraries, 2022) Whitt, Cassie Marie; Tullett, Alexa M.; University of Alabama Tuscaloosa
    Reliance upon one's instructor for knowledge – or epistemic dependence – creates an interesting dilemma in classrooms; students need to maintain their intellectual humility and, at the same time, learn to think autonomously. In considering this challenge within the context of psychology's replication crisis, a critical inquiry seems to be this: Is it possible to train undergraduate students to become critical consumers of psychological research, without eroding their ability to find merit in empirical endeavors? Notably, the replication crisis has called into question the credibility of psychological science by highlighting the field's difficulty in reproducing findings (Open Science Collaboration, 2015), as well as the prevalence of questionable research practices amongst psychologists (e.g., p-hacking, falsifying data, incomplete reporting of measures, etc.). In the present study (n = 266), I investigated how teaching about psychology's replication crisis in either a constructive way (discussion of open science reforms as an optimistic outlook) or critical way (no discussion of reforms as a pessimistic outlook) affects undergraduate students' positive epistemic dependence, intellectual humility, and the perceived intellectual humility of their psychology instructor. While there were no differences amongst the conditions on these primary dependent measures, the present study does shed light on how students consume information about open science and replicability and has implications for how we discuss and integrate this knowledge into our undergraduate courses.
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    An Exploration of Black, Queer Grief
    (University of Alabama Libraries, 2023) Baker, Joshua; Tullett, Alexa
    As an emotional reaction to loss, grief can exist within all domains of human life. Grief literature acknowledges the importance of social and cultural context in how we express and experience grief. Still, no previous work has specifically examined how the intersection of Blackness and queerness interact in creating unique, patterned experiences of grief across the Black, queer population. The present study examines how racial-queer positionality and related identity role demands shape experiences of grief. Participants (N=10) completed semi-structured interviews and a role identity questionnaire that explored experiences of intersectional loss and meaning making. Using inductive thematic analysis, this study found that participants perceive Black, queer grief as multi-dimensional and layered, that interpersonal losses are often contextualized within safety and honor-oriented identity negotiations, and that resistance-oriented strategies aid in coping with intersectionality-related losses. This work suggests considerations for meeting the grief needs of Black, queer communities and provides insight for more inclusive research practices.
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    In Between Depression and Decline: the Role of Intra-Individual Cognitive Variation
    (University of Alabama Libraries, 2024) Lin, Shih-Hsuan; Allen, Rebecca S.
    Intra-individual cognitive variability (IICV) is defined as the variation in cognitive performance within an individual at a single assessment. In the application of neuropsychological assessment, high IICV has been found to predict cognitive decline and dementia incidence among older adults. However, the role of depression in this predictive relationship between IICV and cognitive decline has not been explored. The current proposal investigated this mediational relationship using a diverse, longitudinal, archival data set from the Rush Alzheimer's Disease Center. The hypotheses included: 1) high IICV would predict low and steep cognitive and functional decline, 2) high depression would predict low and steep cognitive and functional decline, and 3) IICV would mediate the relationship between depression and decline, both cognitively and functionally. Furthermore, reliable cognitive and functional decline was calculated with the Reliable Change Index (RCI) to mirror the dichotomous clinical diagnostic decision. Growth curve modeling and logistic regressions were employed to examine the hypotheses for the continuous and the categorical cognition and functional variables with separate models reporting results accounting for missingness, study effects, as well as non-normal data correction. While the cognitive outcome is based on a composite score summarizing performances from multiple cognitive domains, functional outcome is assessed by a self-report questionnaire inquiring multiple domains of instrumental functionality. Missingness was associated with the trajectory of cognitive decline but did not change the results. Results supported the main effect of IICV and depression on cognitive and functional decline. The hypothesized mediation in which IICV mediated the relation between depression and cognition/ functionality was not well supported by the data. On the contrary, the reverse path wherein depression mediated cognition/ functionality was statistically significant. Results from the dichotomized cognitive variable were comparable. However, applying the RCI to functionality measures did not yield clinically meaningful results, suggesting possible methodological issues. On clinical assessment and diagnosis, findings supported the clinical use of IICV. Scientifically, this study contributed to the literature on depression and dementia. Limitations of the current study were noted and ways to improve upon them for future endeavors were suggested.
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    Reframing Aesthetic Experience: the Influence of Racial Bias, Openness, and Cognition on Painting Perception
    (University of Alabama Libraries, 2023) Jackson, Barbara Larsha; Black, Sheila
    The present study explores whether executive functioning, openness to experience and implicit and explicit racial bias influence painting judgements. Black and White adults (aged 30+) and young adults (aged 18-29) evaluated paintings by Black and White artists and responded to items on like, comfort, valence, and value. Additionally, they completed a 44-item Big Factor Inventory, the Stroop task, the Implicit Association Test (IAT), and the Symbolic Racism Scale. The results yielded statistically significant interactions between Race and Art Type on the dimensions of comfort, like and value. Specifically, White participants were less comfortable with, liked and valued Black Mainstream and Black Political art less. Additionally, White participants compared to Black participants were more likely to use racialized language when describing art in the Black Mainstream and Black Political categories. These results were consistent with expectations. Moderation analyses determined that age did not moderate any of the effects. Meaning, age in this study was not a significant factor contributing to participants ratings of paintings, this was inconsistent with expectations. Additionally, a moderation analysis determined that age, explicit and implicit racial bias, inhibitory control, and openness did not moderate the effects of the Race x Art Type interaction, meaning that racism, personality, and cognitive ability were not significant contributors to ratings of art among participants. This research supports the need for future research that explores intracultural differences in art perception and the underlying factors contributing to these differences.
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    Significant Memory Concerns: the Moderating Effect on Biomarkers of Alzheimer's Disease and Learning and Memory Performance
    (University of Alabama Libraries, 2022) Letang, Sarah Katherine; McDonough, Ian M.; Allen, Rebecca S.; University of Alabama Tuscaloosa
    With Alzheimer's disease being the sixth leading cause of death in the United States, research must continue to explore possible risk factors for developing the disease. Research has explored how significant memory concerns cognitively normal older adults have could be warning signs of preclinical AD. The study explored the relationship between biomarkers and cognitive performances in learning and memory and how significant memory concerns may or may not be a moderator in the relationship between these biomarkers and cognitive tasks for older adults who meet the criteria of cognitively normal. Lastly, the study observed these findings longitudinally to explore if different cognitive changes are found years later among these biomarker groups with or without significant memory concerns. Surprisingly, there were no significant differences between biomarker groups and learning and memory. However, when adding significant memory concerns as a moderator and not controlling for covariates, a main effect was found between biomarker groups and early learning, and biomarker groups and late learning. An exploratory longitudinal analysis was also conducted and found that late learning, long-term retention, and delayed recall performance declined over time depending on the biomarker group. Lastly, contradicting my hypothesis, participants who did not report significant memory concerns at baseline had more of a decline in their delayed recall performance than participants who did report SMCs at baseline. Reasons for these unique findings are discussed.