The concept of subcortical dementia predicts higher rates of depressive symptomatology in dementia syndromes with predominant subcortical pathology. This hypothesis was evaluated by comparing the frequency and severity of depressive symptomatology in three diagnostic conditions: Alzheimer's disease (AD) (n=30) I subcortical vascular disease (SVD) (n=30), and Parkinson's disease (PD) (n=30). While AD and PD are prototypical exemplars of cortical and subcortical dementia syndromes respectively, SVD provides a test of the generality of the hypothesis as a subcortical neurodegenerative condition whose pathology is not confined to a single subcortical nucleus. A secondary aim of the study was to compare assessment methods for the ascertainment of depressive symptomatology. Assessment methods included the Hamilton Rating Scale for depression derived from interview with the patient's primary caregiver (HRSCG) and from interview with the patient (HRSEX), and the self-report Geriatric Depression Scale. The severity of current depressive symptomatology across the three neurodegenerative disorders followed a consistent pattern across each method of assessment. Specifically, scores on self-report (GDS) , examiner ratings (HRSEX), and caregiver ratings (HRSCG) of depression were most severe in patients with Parkinson's disease (PD), intermediate in subcortical vascular disease (SVD), and least severe in Alzheimer's the ascertainment of depressive symptomatology. Assessment methods included the Hamilton Rating Scale for depression derived from interview with the patient's primary caregiver (HRSCG) and from interview with the patient (HRSEX), and the self-report Geriatric Depression Scale. The severity of current depressive symptomatology across the three neurodegenerative disorders followed a consistent pattern across each method of assessment. Specifically, scores on self-report (GDS), examiner ratings (HRSEX), and caregiver ratings (HRSCG) of depression were most severe in patients with Parkinson's disease (PD) , intermediate in subcortical vascular disease (SVD), and least severe in Alzheimer's / Ph. D.

published_or_final_version / Psychiatry / Doctoral / Doctor of Philosophy

The symptomatology of depression includes affective and cognitive features. As such, depression has been associated both with maladaptive concern over emotional material, and also with general impairments in attentional control. In the current thesis, I investigated the potential influence of such depression-related dysfunctional emotional processing on a range of cognitive control abilities, using experimental paradigms containing either neutral or affective stimuli. In contrast to the hypothesis that depressive symptoms are associated with generally compromised cognitive control, depression-related impairments were not found on a range of ‘classic' measures of cognitive control, including error-processing (pre-error speeding, posterror slowing and error-related ERPs), overriding response conflict (colour-word Stroop interference, conflict adaptation) or more sustained control processes (cued-RT performance, preparatory ERPs, and maintaining long-term speed-accuracy tradeoffs). Interestingly, however, differences between groups with low and elevated levels of depressive symptoms emerged during the performance of emotionally valenced tasks. First, an elevated depressive symptom group showed a reduced ability to resolve emotional conflict arising between competing affective representations. When compared with spared performance on the classic Stroop task, this result suggests that depressive symptoms are associated with a specific impairment in the ability to regulate emotional distraction. Secondly, an ERP related to advanced preparation in cued-RT tasks (the CNV), but not those associated with early perceptual processing (P1, N170), was selectively modulated by negative, but not positive, task-irrelevant emotional distractors presented during the cue-target interval. This pattern of ERP results supports a late processing locus of affective attentional bias in depression. Together, the current results propose that control processes which facilitate the regulation of emotional material (i.e. over emotional sources of distraction) might be selectively affected by increased depressive symptoms, suggesting that future work should consider affective variables when investigating executive control processes in depression.

published_or_final_version / Anatomy / Doctoral / Doctor of Philosophy

The focus of the research study is to explore chronically ill African American, Latino, and White patients' causal attributions of symptoms of depression and factors that predict depression care treatment preferences among these groups. Research has demonstrated that perception of illness impacts what treatments a person will deem appropriate for their mental health problems and from whom they will seek treatment. Research also indicates that certain ethnic groups are more likely to seek treatment for their symptoms of depression in the primary care setting. Yet, it is unclear how they actually perceive their symptoms and what best predicts the treatments that they are likely to consider acceptable. A convenient sample of 109 HIV+ adults, 79 diabetic adults, and 3 adults with both conditions were recruited for this study. Participants had to be receiving services for either HIV, diabetes, or both conditions in one of the three central Austin facilities and be a representative from one of three racial/ethnic groups: African Americans, Latino, and White. Differences were found across ethnicity with regard to causal beliefs and treatment preferences for the symptoms of depression both among the HIV and the diabetic subgroups. Latinos in both groups were more likely than Whites to prefer counseling or a single form of treatment over combined treatment methods. Diabetic Latinos were more likely to prefer counseling for symptoms of depression. HIV seropositive individuals who reported the least number of symptoms of physical illness were more likely to attribute their symptoms of depression to stressful life events, whereas those who reported the greatest number of symptoms of physical illness were more likely to attribute their symptoms of depression to their medical illness. Additionally among the HIV subgroup, individuals who reported high stress tended to predict the preferences for treatment provided by a psychiatrist/psychologist and Whites scored highest on this factor. Finally, differences in depression scores across race/ethnicity were also revealed. The utility of assessing a patient's understanding of symptoms of depression in order to determine how personal illness models impact treatment preferences and knowledge of patient's causal attributions can aid medical social workers and physicians in collaborative management of chronic illness and depression are discussed.

Thesis (Ph. D.)--University of Texas at Austin, 2007. / Vita. Includes bibliographical references.

Thesis (M.A.)--Lancaster Bible College, 2005. / Includes bibliographical references (leaves 83-87).

Thesis (M.S.)--University of Michigan, 2002. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 32-36).

Thesis (Ph. D.)--University of Oregon, 2004. / Typescript. Includes vita and abstract. Includes bibliographical references (leaves 113-126). Also available for download via the World Wide Web; free to University of Oregon users.

Thesis (Ph. D.)--University of California, San Diego, and San Diego State University, 2005. / Vita. Includes bibliographical references (leaves 160-178).