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Open Access Publications from the University of California

Scholarly Works (15 results)

  • Thesis
  • Peer Reviewed
UC Berkeley Electronic Theses and Dissertations (2017)

Sleep is a vital biological function, necessary to physical and psychological health. Caregivers of patients with neurodegenerative disease suffer from chronically poor sleep. Research suggests that emotions can influence sleep quality, but little research has examined this relationship in caregivers of patients with neurodegenerative disease. In the present study, objective laboratory measures of emotion and emotion regulation, and a combination of prospectively-reported and objectively-measured sleep quality, were used to examine this important relationship. Caregivers’ physiological and expressive reactivity to emotion-eliciting films was measured in the laboratory. Caregivers’ physiological reactivity to two emotion regulation tasks (suppression, amplification) was also measured. During the week following laboratory testing, caregivers wore an actigraphy wristwatch, which recorded movement and ambient light in order to measure sleep quality, and completed a daily sleep diary. Data were analyzed to test the hypotheses that (a) greater physiological reactivity and (b) greater expressive reactivity would be associated with worse sleep quality during the following week, and to determine whether physiological reactivity to the emotion suppression and amplification tasks was associated with sleep quality.

Sleep quality in the present study was largely similar to and for some measures, better than sleep in previously published samples of non-caregiver older adults. Results partially supported the hypothesis that greater physiological reactivity to the films would be associated with worse sleep quality. Greater physiological reactivity to a film chosen to elicit distress was associated with worse sleep quality, whereas greater physiological reactivity to a film chosen to elicit sexual arousal was associated with better sleep quality. Exploratory analyses revealed that the results were reliable across caregivers for two of the three largest neurodegenerative diagnostic groups in the sample, and across caregiver sex. Neither expressive reactivity to the films, nor physiological reactivity to the emotion suppression or amplification tasks, was associated with sleep quality. These findings indicate that caregivers’ physiological reactivity to distressing and sexually arousal stimuli are associated with sleep quality. Interventions that reduce physiological reactivity to distressing stimuli, or that increase caregivers’ physiological reactivity to sexually-arousing stimuli, may improve caregiver sleep and its downstream effects.

    Cover page: Emotion, emotion regulation, and sleep quality in caregivers of patients with neurodegenerative disease
    • Thesis
    • Peer Reviewed
    UC Berkeley Electronic Theses and Dissertations (2016)

    Over the past half century, much work has been published on the theory of elastic-plastic materials undergoing large deformations. However, there is still disagreement about certain basic issues. In this dissertation, the strain-based Lagrangian theory developed by Green, Naghdi and co-workers is re-assessed. Its basic structure is found to be satisfactory. For the purpose of applications, the theory is recast in Eulerian form. Additionally, a novel three-factor multiplicative decomposition of the deformation gradient is employed to define a unique intermediate configuration. The resulting theory of finite plasticity contains an elastic strain tensor measured from the intermediate stress-free configuration. The constitutive equations involve the objective stress rate of the rotated Cauchy stress, which can be expressed in terms of the rate of deformation tensor. In their general forms, the Lagrangian theory can be converted into the Eulerian theory and vice versa. Because the Green-Naghdi theory has a strain measure that represents the difference between total strain and plastic strain, rather than representing elastic strain, it does not lend itself to a physically realistic linearization for the case of small elastic deformations accompanied by large plastic deformations. The proposed theory is well suited to describe this case as it can be linearized about the intermediate configuration while allowing the plastic deformations to be large. Differences between the linearized Green-Naghdi theory and the new theory are illustrated for uniaxial tension and compression tests.

      Cover page: Lagrangian and Eulerian Forms of Finite Plasticity
      • Article
      • Peer Reviewed
      UC San Francisco Previously Published Works (2017)
      Dementia and other neurodegenerative diseases cause profound declines in functioning; thus, many patients require caregivers for assistance with daily living. Patients differ greatly in how long they live after disease onset, with the nature and severity of the disease playing an important role. Caregiving can also be extremely stressful, and many caregivers experience declines in mental health. In this study, we investigated the role that caregiver mental health plays in patient mortality. In 176 patient-caregiver dyads, we found that worse caregiver mental health predicted greater patient mortality even when accounting for key risk factors in patients (i.e., diagnosis, age, sex, dementia severity, and patient mental health). These findings highlight the importance of caring for caregivers as well as patients when attempting to improve patients' lives.
        Cover page: Poor caregiver mental health predicts mortality of patients with neurodegenerative disease
        • Article
        • Peer Reviewed
        UC Berkeley Previously Published Works (2017)
        Dementia and other neurodegenerative diseases cause profound declines in functioning; thus, many patients require caregivers for assistance with daily living. Patients differ greatly in how long they live after disease onset, with the nature and severity of the disease playing an important role. Caregiving can also be extremely stressful, and many caregivers experience declines in mental health. In this study, we investigated the role that caregiver mental health plays in patient mortality. In 176 patient-caregiver dyads, we found that worse caregiver mental health predicted greater patient mortality even when accounting for key risk factors in patients (i.e., diagnosis, age, sex, dementia severity, and patient mental health). These findings highlight the importance of caring for caregivers as well as patients when attempting to improve patients' lives.
          Cover page: Poor caregiver mental health predicts mortality of patients with neurodegenerative disease.
          • Article
          • Peer Reviewed
          UC San Francisco Previously Published Works (2020)
          Objectives: To understand feedback from participants in Paired PLIÉ (Preventing Loss of Independence through Exercise), a novel, integrative group movement program for people with dementia and their care partners, in order to refine the intervention and study procedures.Method: Data sources included daily logs from the first Paired PLIÉ RCT group, final reflections from the second Paired PLIÉ RCT group, and responses to requests for feedback and letters of support from Paired PLIÉ community class participants. All data are reports from care partners. The qualitative coding process was iterative and conducted with a multidisciplinary team. The coding team began with a previously established framework that was modified and expanded to reflect emerging themes. Regular team meetings were held to confirm validity and to reach consensus around the coding system as it was developed and applied. Reliability was checked by having a second team member apply the coding system to a subset of the data.Results: Key themes that emerged included care partner-reported improvements in physical functioning, cognitive functioning, social/emotional functioning, and relationship quality that were attributed to participation in Paired PLIÉ. Opportunities to improve the intervention and reduce study burden were identified. Care partners who transitioned to the community class after participating in the Paired PLIÉ study reported ongoing benefits.Conclusion: These qualitative results show that people with dementia and their care partners can participate in and benefit from community-based programs like Paired PLIÉ that include both partners, and focus on building skills to maintain function and quality of life.
            Cover page: An integrative group movement program for people with dementia and care partners together (Paired PLIÉ): initial process evaluation
            • Article
            • Peer Reviewed
            UC San Francisco Previously Published Works (2023)
            OBJECTIVE: Emotional reactivity normally involves a synchronized coordination of subjective experience and facial expression. These aspects of emotional reactivity can be uncoupled by neurological illness and produce adverse consequences for patient and caregiver quality of life because of misunderstandings regarding the patients presumed internal state. Frontotemporal dementia (FTD) is often associated with altered social and emotional functioning. FTD is a heterogeneous disease, and socioemotional changes in patients could result from altered internal experience, altered facial expressive ability, altered language skills, or other factors. The authors investigated how individuals with FTD subtypes differ from a healthy control group regarding the extent to which their facial expressivity aligns with their self-reported emotional experience. METHODS: Using a compound measure of emotional reactivity to assess reactions to three emotionally provocative videos, the authors explored potential explanations for differences in alignment of facial expressivity with emotional experience, including parkinsonism, physiological reactivity, and nontarget verbal responses. RESULTS: Participants with the three main subtypes of FTD all tended to express less emotion on their faces than they did through self-report. CONCLUSIONS: Exploratory analyses suggest that reasons for this incongruence likely differ not only between but also within diagnostic subgroups.
              Cover page: Incongruences Between Facial Expression and Self-Reported Emotional Reactivity in Frontotemporal Dementia and Related Disorders.
              • Article
              • Peer Reviewed
              UC Berkeley Previously Published Works (2019)

              Objective

              Providing care for a spouse with dementia is associated with an increased risk for poor mental health. To determine whether this vulnerability in caregivers is related to the expression of positive emotion, we examined 57 patients with Alzheimer's disease and behavioral variant frontotemporal dementia and their spouses as they discussed a marital conflict.

              Method

              Facial behavior during the discussion was objectively coded to identify Duchenne (i.e., genuine) smiles and non-Duchenne (i.e., polite) smiles. Caregiver mental health was measured using the Medical Outcomes Survey.

              Results

              Greater expression of Duchenne smiles by patients was associated with better caregiver mental health, even when accounting for covariates (i.e., diagnosis, patient cognitive functioning, and caregiver marital satisfaction). Greater expression of non-Duchenne smiles by patients was associated with worse caregiver health, but only when covariates were entered in the model. Expression of Duchenne and non-Duchenne smiles by caregivers was not associated with caregiver mental health.

              Discussion

              Patients' expression of Duchenne and non-Duchenne smiles may reveal important aspects of the emotional quality of the patient-caregiver relationship that influence caregiver burden and mental health.
                Cover page: Genuine Smiles by Patients During Marital Interactions are Associated with Better Caregiver Mental Health
                • Article
                • Peer Reviewed
                UC San Francisco Previously Published Works (2022)
                Physiological linkage refers to the degree to which two individuals' central/peripheral physiological activities change in coordinated ways. Previous research has focused primarily on linkage in the autonomic nervous system in laboratory settings, particularly examining how linkage is associated with social behavior and relationship quality. In this study, we examined how linkage in couples' daily somatic activity (e.g., synchronized movement measured from wrist sensors)-another important aspect of peripheral physiology-was associated with relationship quality and mental health. We focused on persons with neurodegenerative diseases (PWNDs) and their spousal caregivers, whose linkage might have direct implications for the PWND-caregiver relationship and caregiver's health. Twenty-two PWNDs and their caregivers wore wristwatch actigraphy devices that provided continuous measurement of activity over 7 days at home. PWND-caregiver activity linkage was quantified by the degree to which activity was "in-phase" or "anti-phase" linked (i.e., coordinated changes in the same or opposite direction) during waking hours, computed by correlating minute-by-minute activity levels averaged using a 10-min rolling window. Caregivers completed well-validated surveys that assessed their mental health (including anxiety and depression) and relationship quality with the PWND. We found that lower in-phase activity linkage, but not anti-phase linkage, was associated with higher caregiver anxiety. These dyad-level effects were robust, remaining significant after adjusting for somatic activity at the individual level. No effects were found for caregiver depression or relationship quality. These findings suggest activity linkage and wearables may be useful for day-by-day monitoring of vulnerable populations such as family caregivers. We offered several possible explanations for our findings.
                  Cover page: Lower activity linkage between caregivers and persons with neurodegenerative diseases is associated with greater caregiver anxiety
                  • Article
                  • Peer Reviewed
                  UC Berkeley Previously Published Works (2019)

                  Objective

                  Providing care for a spouse with dementia is associated with an increased risk for poor mental health. To determine whether this vulnerability in caregivers is related to the expression of positive emotion, we examined 57 patients with Alzheimer's disease and behavioral variant frontotemporal dementia and their spouses as they discussed a marital conflict.

                  Method

                  Facial behavior during the discussion was objectively coded to identify Duchenne (i.e., genuine) smiles and non-Duchenne (i.e., polite) smiles. Caregiver mental health was measured using the Medical Outcomes Survey.

                  Results

                  Greater expression of Duchenne smiles by patients was associated with better caregiver mental health, even when accounting for covariates (i.e., diagnosis, patient cognitive functioning, and caregiver marital satisfaction). Greater expression of non-Duchenne smiles by patients was associated with worse caregiver health, but only when covariates were entered in the model. Expression of Duchenne and non-Duchenne smiles by caregivers was not associated with caregiver mental health.

                  Discussion

                  Patients' expression of Duchenne and non-Duchenne smiles may reveal important aspects of the emotional quality of the patient-caregiver relationship that influence caregiver burden and mental health.
                    Cover page: Genuine Smiles by Patients During Marital Interactions are Associated with Better Caregiver Mental Health
                    • Article
                    • Peer Reviewed
                    UCLA Previously Published Works (2013)
                    Why do some individuals become dissatisfied with their marriages when levels of negative emotion are high and levels of positive emotions are low, whereas others remain unaffected? Using data from a 13-year longitudinal study of middle-aged and older adults in long-term marriages, we examined whether the 5-HTTLPR polymorphism in the serotonin transporter gene moderates the association between negative and positive emotional behavior (objectively measured during marital conflict) and changes in marital satisfaction over time. For individuals with two short alleles of 5-HTTLPR, higher negative and lower positive emotional behavior at Time 1 predicted declines in marital satisfaction over time (even after controlling for depression and other covariates). For individuals with one or two long alleles, emotional behavior did not predict changes in marital satisfaction. We also found evidence for a crossover interaction (individuals with two short alleles of 5-HTTLPR and low levels of negative or high levels of positive emotion had the highest levels of marital satisfaction). These findings provide the first evidence of a specific genetic polymorphism that moderates the association between emotional behavior and changes in marital satisfaction over time and are consistent with increasing evidence that the short allele of this polymorphism serves as a susceptibility factor that amplifies sensitivity to both negative and positive emotional influences.
                      Cover page: The 5-HTTLPR Polymorphism in the Serotonin Transporter Gene Moderates the Association Between Emotional Behavior and Changes in Marital Satisfaction Over Time
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