Browsing by Author "McMorris, Carly"
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Item Open Access Assessing Weight Stigma in Mock Jurors when Female Child Victims Testify Against Sexual Assault in Court(2024-08-29) Glazer, Melissa; Russell-Mayhew, Shelly; Nutter, Sarah; McMorris, Carly; Nesbitt, MichaelIn the psycho-legal literature, some studies have found that the body weight of female victims of sexual assault influence mock jurors’ perceptions of the victim and the testimony. The research is limited to adult victims of sexual assault and does not represent the context of the Canadian judicial system. This study investigated mock juror weight and legal-based perceptions after reviewing a vignette that was based on a legal case from the Supreme Court of Canada involving a 14-year-old female child testifying for sexual assault. A hundred and eighty-five participants acted as mock jurors and were randomly assigned to one of three artist court room sketches depicting child female victims of different body weights (underweight, average, or obese). Self- report questionnaires were completed to assess negative and positive weight-based perceptions of the child victim, general positive and negative perceptions toward the child victim, verdict decisions, and legal perceptions of the child and the accused. The current findings suggested that neither specific negative (i.e., lazy, undisciplined, self-indulgent) nor positive (i.e., friendly, outgoing, productive) weight-based perceptions or general positive (i.e., sympathy toward the complainant) or negative (i.e., anger toward the complainant) perceptions were significantly influenced by the child victim’s body weight. Nevertheless, male mock jurors indicated higher negative weight-based perceptions compared to female mock jurors. All other tested demographics of mock jurors (i.e., race, caregiver status) were not associated with weight-based perceptions. The weight of the female child victim also did not significantly influence mock jurors' legal verdict decision making. Lastly, the female child victims' body weight did not significantly influence mock jurors' legal perceptions (i.e., believability of the complainant, believability of the accused, or controllability of the complainant's behaviour). These results suggest that a female child sexual assault victim’s body weight may not significantly influence jurors' perceptions or legal decision making. Potential implications of the current study's findings are discussed concerning the Canadian judicial system, legal professionals, mental health professionals, and the field of counselling psychology.Item Open Access Brain Structure and Mental Health Symptoms in Children and Adolescents with Prenatal Alcohol Exposure(2023-06-12) Nakhid, Daphne Kristen Mitchell; Lebel, Catherine; McMorris, Carly; Gibbard, Ben; MacMaster, FrankPrenatal alcohol exposure (PAE) can impact brain development, leading to an increased risk of cognitive difficulties and mental health challenges. Mental health challenges affect many people with PAE, however, associations with brain structure remain unknown. In unexposed populations, mental health symptoms are closely linked to brain volume of subcortical structures and limbic subregions. Whether there is a similar association in individuals with PAE is unknown. Beyond brain volume, iron is a key component of healthy brain development; PAE lowers fetal brain iron and may be associated with the development of mental health symptoms. Whether increased mental health symptoms in youth with PAE are associated with alterations in brain volume or brain iron of subcortical brain structures is yet to be determined. This dissertation used quantitative susceptibility mapping (QSM) and T1-weighted magnetic resonance imaging (MRI) to assess differences in brain iron and brain volume of limbic and subcortical brain regions in youth with and without PAE. Additionally, associations between brain structure and mental health symptoms were assessed within and between groups. Multiple subcortical brain structures and limbic subregions were smaller in the PAE group, but only limbic subregion volume showed associations with mental health symptoms. I found minimal group differences in magnetic susceptibility, a marker of brain iron, but many associations between brain iron and mental health symptoms within and between groups. Furthermore, PAE moderated the association between internalizing symptoms for both brain iron and subnuclei volumes in the thalamus, suggesting that the thalamus may be a unique correlate of mental health symptoms in youth with PAE. This research provides greater insight into limbic subregions that may be affected by PAE that are not observed when looking at the whole volume of a brain region. As the first study to examine magnetic susceptibility in humans with PAE, it provides important information to help understand mental health symptoms in exposed and unexposed populations. This study highlights brain structures and regions that are uniquely associated with mental health symptoms in youth with PAE. Implications of this work include increasing awareness around mental health and promoting appropriate interventions to support youth with PAE.Item Open Access Characterizing Sleep Patterns in Youth with CP and its Impact on Mood(2024-08-24) Sanguino, Hangsel D.; McMorris, Carly; Legg, David; Fehlings, Darcy; Schulte, FionaBackground. Cerebral palsy (CP) is a lifelong neurodevelopmental condition characterized by limitations in movement and posture (Oskoui et al., 2013; Rosenbaum et al., 2007). There is a growing consensus that sleep difficulties are common and life-long in individuals with CP (Lélis et al., 2016; Newman et al., 2006; Simard-Tremblay et al., 2011). These difficulties encompass various aspects such as sleep duration, sleep quality, staying asleep, and experiencing more difficulty getting up in the morning (Lélis et al., 2016; Newman et al., 2006); however, much remains unknown about the specific sleep patterns in CP and whether they are distinct from those observed in other conditions such as autism or fetal alcohol spectrum disorder (FASD). Additionally, the link between sleep and mood in CP is not well understood (Gadie et al., 2017). While in neurotypical youth, better sleep has been linked to improvements in social, emotional, and psychological well-being (e.g., mood), the extent to which sleep may impact mood within the context of CP remains uncertain (Hamilton et al., 2007). This manuscript-based thesis aims to address these significant gaps in knowledge by examining the sleep patterns in youth with CP and investigate the subsequent temporal association between sleep and mood. Methods. For this exploratory manuscript-based thesis, we analyzed secondary data from baseline questionnaires and weekly data (accelerometers and daily sleep diaries) collected from a larger study that examined the associations between physiological factors and mental health in youth with CP. In the first study, we investigated the sleep patterns of 45 youth with CP using caregiver and youth reports, the Child/Adolescent Sleep-Wake Scale (CSWS/ASWS), Insomnia Severity Index (ISI), and measurements from actigraphs that youth wore for one week. First, the sleep characteristics were described in relation to available demographic variables (e.g., sex, age, Gross Motor Functioning Classification System level [GMFCS]), using descriptive statistics. Second, to determine the impact of the presence of a mental health diagnosis on sleep patterns and problems, a hierarchical regression analyses was conducted. In the second study, we focused on a subsample of youth (n = 32) who had sufficient daily diaries of sleep and mood. In paper 2, the impact of intraindividual variability (IIV) in sleep patterns on mood (i.e., positive and negative affect) was examined using a series of fixed-effects multi-level modelling. Analyses included age, sex, and GMFCS as covariates as these factors contribute to sleep and mood. Results. In the first study of 45 youth, the average sleep duration was 10 hours per night (SD = 0:59), ranging from 7.5 to 12.85 hours. Youth experienced an average of 14 awakenings (>5 min) per night (SD = 5.3), which is substantially higher than previous literature in youth without CP. Most youth reported poor sleep quality based on sleep quality scores from the combined CSWS and ASWS (M = 3.67, SD = 1.24). Hierarchical linear regression analysis revealed a significant positive association between mental health diagnosis and insomnia severity, even after controlling for participant demographics (age, sex, GMFCS) (p = .010). For the second study, fixed-effect models were used to examine the association between IIV sleep duration and quality and next-day negative and positive affect over a 7-day period. While controlling for covariates, higher within-subjects variability of sleep quality was related to lower next-day negative mood (b = -.03, p < .001) and increased next-day positive mood (b = .05, p = .018). To determine the directionality of this association, mood variability predicting next day sleep was examined; however, only higher within-subject variability of negative mood was related to next-day sleep quality (b = -1.12, p = .011). Conclusions. This thesis is the first of its kind to examine the group and individual characteristics of sleep patterns among youth with CP (Study 1) and the temporal impact of IIV sleep on daily positive and negative affect (Study 2). Sleep is a complex phenomenon, and further investigation is necessary to understand the influence of various other factors, which were not available for this thesis. Nevertheless, sleep timing and sleep consistency may be important characteristics of sleep health. Overall, more research is needed to help inform prevention of mental health issues in this already vulnerable population and to help inform the development of supports for sleep.Item Open Access Comparing suicidal thoughts and behaviours of youth with fetal alcohol spectrum disorder and autistic youth: Caregivers-reported suicidality, access to services and barriers in seeking support(2023-09-05) Bagshawe, Mercedes Jayne; McMorris, Carly; Bulloch, Andrew Gabriel McKay; Morton Ninomiya, MelodyBackground. Autistic individuals and individuals with fetal alcohol spectrum disorder (FASD) are at increased risk for experiencing mental health problems, including suicidality. Both groups have compounding physical and psychological challenges leading to high utilization rates of healthcare services. There is little known about the access and utility of services for suicidal neurodiverse youth and their caregivers. The present study will examine suicidality and barriers to care in neurodiverse youth (i.e., autistic youth and youth with FASD), as well as describe caregivers’ experiences with accessing healthcare services. Methods: Caregivers of neurodiverse youth (FASD n=25; autistic n=35) answered questions in an on-line modified Columbia Suicide Severity Rating Scale (CSSR-S) about their child’s experiences with suicidality, early life adversity, co-occurring mental health conditions, healthcare services, and barriers to accessing support. 12 semi-structured interviews (FASD n=6; autistic n=6) were conducted with caregivers of youth who have experienced suicidality to generate insight into experiences within the healthcare system, ability to access services and receive support and barriers to seeking help. Results: On the CSSR-S, group differences determined that autistic youth had increased suicidal ideation when compared to youth with FASD. Within each neurodivergent groups, females with FASD had increased overall suicidality compared to males. Additionally, across both sexes, as age increased, so did suicidal intensity. No sex or age differences were seen in autistic youth. Co-occurring mental health conditions were associated with increased suicidality across neurodiverse groups, and suicidality was associated with the total number of adverse early life events in only the FASD youth. Services or barriers were not associated with measures of suicidality in either diagnostic group. Both groups of caregivers reported difficulties accessing services to address their child’s suicidality, and that healthcare providers lacked the training to work with neurodiverse youth. Discussion: This is the first study to contrast suicidality, service utilization and barriers to seeking help in autistic youth and youth with FASD from a caregiver’s aspect. Prior studies generally compare neurodiverse groups to their neurotypical peers, and as such assume that neurodiverse groups face similar challenges related to suicidality, yet this has never been investigated. Overall, caregivers of neurodiverse youth are facing a lack of available services and support for helping their children and a healthcare system that is not equipped to work with neurodivergent individuals experiencing suicidality.Item Open Access Complex students: Understanding how to best supports students with a comorbid developmental or physical health need(2021-07-16) Choudhry, Muzna Ijaz; Wilcox, Gabrielle; McMorris, Carly; Prasow, CynthiaMinimal literature has investigated the supports teachers access for students with complex needs for their academic and developmental needs in a school environment. Students with complex needs, in this particular study, are those with a neurodevelopmental or medical disorder along with a comorbid disorder (e.g., epilepsy and cerebral palsy), with a focus on preschool children and those in early education. Since teachers are primarily responsible for helping students succeed in the classroom, securing resources and supports for students mostly falls on teachers. As such, the present study explored the following aims: 1) identify the supports this population is receiving within the classroom; 2) understand the challenges and potential barriers teachers experience in supporting students with complex needs; and 3) describe the profiles of children in early and elementary education. This study used a qualitative design approach. An anonymized dataset was used to generate demographic information of students with complex needs enrolled in a specialized academic setting. Five focus groups were conducted at specialized school settings in Calgary, and the focus group data was analyzed using thematic analysis in order to generate themes relevant to the research questions. Those themes were: 1) supports for students; 2) resources for teachers; 3) barriers to supporting students; 4) well-being of teachers; 5) recommendations for better assisting students. Overall, the results from the present study have future research implications and practical utility for educators and administrators.Item Open Access Contributions of Affective States and Traits to Autistic Features(2024-04) Godfrey, Kate J.; Bray, Signe; Harris, Ashley D.; McMorris, Carly; Protzner, AndreaThis thesis considered the role of affect and reward in autistic features, based on the important role affective brain systems play in emotion and motivated behaviors known to be impacted in autistic individuals. I directly tested multiple affect-based hypotheses in children with and without an autism diagnosis and aimed to inform future clinical work by exploring several methodologies for examining both inter-individual (trait) and intra-individual (state) variation in measures of affect and reward. I first examined multiple behavioral domains (reward sensitivity, anxiety symptoms, and executive function) for associations with interest intensity in early childhood autism. I report that the executive functioning domain of attention shifting associated with interest intensity in early childhood, while there was no relation with general sensitivity to reward and anxiety symptoms. I then considered how to better characterize inter-individuality in reward sensitivity during early childhood, specifically regarding social rewards. I therefore developed and validated the Social Reward Questionnaire–Early Childhood (SRQ-EC) to quantify wanting and liking of distinctly rewarding social situations in young children. I found that autistic-like traits in a community sample associated with reduced wanting and liking of social rewards, particularly for large group interactions, suggesting potential utility of the SRQ-EC for future autism research. I additionally considered a protocol for investigating brain functional connectivity for associations with intra-individual affect variation in a community sample of adults, with relevance for designing future studies to examine neurobiological mechanisms of affective disorders that commonly co-occur in autism. My work replicates recent findings that variance in functional connectivity is largely attributable to individual identity, and that variance attributable to intra-individual affect variation is 7–100x smaller than what can be attributed to viewing condition. This thesis advances methodologies for measuring and modeling both inter- and intra-individual variation in autism, specifically in relation to affective processes which are difficult to measure in a laboratory setting. The methods presented and refined here could be used in future work to better understand state- and trait-like features in autism.Item Open Access Cortisol Reactivity Elicited by Psychosocial Stress Paradigms and Suicidality: A Systematic Review and Meta-Analysis(2023-02-06) Besney, Richard Mark Anthony; McMorris, Carly; Wilcox, Gabrielle; Andrew, BullochBackground: Suicide is a leading cause of worldwide death. While our knowledge related to risk factors of suicide has grown over recent decades, our ability to predict and prevent suicide has not improved. The identification of valid and reliable biomarkers of suicidality would supplement existing screening measures by incorporating objective indicators of risk. A growing body of literature has identified altered functioning of the hypothalamic-pituitary-adrenal (HPA) axis as one potential biomarker for suicide, which can be measured using psychosocial stress paradigms to elicit cortisol reactivity. However, findings from existing literature are discrepant in terms of the directionality of cortisol reactivity, or whether hyper- or hypo-responsiveness is associated with suicidality. This thesis systematically reviewed existing studies related to cortisol reactivity and psychosocial stress paradigms, and also conducted meta-analyses to synthesize main findings of cortisol reactivity. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for the literature search. Information related to participant characteristics, methodology, and main findings were extracted from included studies. Cortisol reactivity findings were analyzed in terms of AUCi. Estimation of standardized mean differences was carried out on suicide attempters versus non-attempters, and suicidal ideators versus non-ideators. Moderation analyses were then conducted to determine if results varied as a function of age and sex. Results: Nine studies were included for review based on eligibility criteria. Mental health characteristics of participants were variable. Impulsivity/aggression, duration of suicidal ideation, recency of suicide attempt, family history of suicide attempt, and past behavioural problems impacted the association between cortisol reactivity and suicidality in the included studies. Due to availability of data/information, only six of the nine studies were included for meta-analysis. No overall group differences in cortisol reactivity between suicide attempters versus non-attempters (Cohen’s d = -0.09, 95% CI = -0.36, 0.19, p = 0.53), nor suicide ideators versus non-ideators (Cohen’s d = 0.13, 95% CI = -0.13, 0.39, p = 0.32) were found. Age and sex did not moderate analyses. Conclusion: Findings on the association between cortisol reactivity using psychosocial stress paradigms and suicidality are discrepant. Such findings may be complicated by numerous participant factors and differences in methodology across studies. Given a small number of existing studies, generalizations about the utility of cortisol reactivity as a biomarker of suicidality and associated risk cannot be made, however. The focus of future literature should include other potential biomarkers from the HPA axis, other biological systems, as well as machine learning approaches to enable integration of multiple risk factors.Item Open Access Early Influences on Brain Development in Preschool Children(2021-09) Kar, Preeti; Lebel, Catherine; Pike, Bruce; McMorris, CarlyDuring early childhood, extensive brain development takes place which underlies foundational cognitive and behavioural learning. Early environmental factors during the prenatal period and first few postnatal years can play important roles in promoting or hindering this period of brain development. Breastfeeding in infancy and alcohol use in pregnancy are both maternal behaviors with long-term impacts on children, but their downstream effects on the brain are not well-understood during early childhood. My thesis used diffusion tensor imaging to assess white matter development in young children (2-7 years) in association with 1) breastfeeding exclusivity status at 6 months of age and the total duration of any breastfeeding, as well as 2) prenatal alcohol exposure (PAE). First, I found that breastfeeding exclusivity and duration were associated with global and regional white matter microstructure, even after controlling for perinatal and sociodemographic factors, and these findings differed by sex. Second, I found that young children with PAE showed altered white matter microstructure cross-sectionally and longitudinally compared to unexposed controls. Third, measures of white matter in motor tracts were associated with motor performance in unexposed typically developing children, but these structure-function associations were not present in young children with PAE. This work highlights the dynamic and complex brain development taking place in early childhood and indicates how environmental variables during the prenatal and postnatal period, such as breastfeeding and PAE, moderate brain circuitry and behaviors in young children. This research has broad implications for clinical, policy, and health education strategies to promote breastfeeding and prevent PAE and ultimately support mothers and children.Item Open Access Effect of Remote Peer-Counsellor- delivered Behavioral Activation and Peer-support for Antenatal Depression on Gestational Age at Delivery: a single-blind, randomized control trial(2023-03-30) Chaput, Kathleen H.; Freeman, Makayla; McMorris, Carly; Metcalfe, Amy; Cameron, Emily E.; Jung, James; Tough, Suzanne; Hicks, Laurel M.; Dimidjian, Sona; Tomfohr-Madsen, Lianne M.Abstract Background Antenatal depression (AD) is the most common complication of pregnancy in developed countries and increases the risk of preterm birth (PTB). Many pregnant individuals with AD do not obtain treatment due in part to risks associated with antidepressant medications, the expense and wait times for psychological services, and perceived stigma. Accessible and timely treatment of antenatal depression is crucial to minimize foetal impacts and associated long-term child health outcomes. Previous studies show that behavioural activation and peer support are promising avenues of treatment for perinatal depression. Additionally, remote and paraprofessional counselling interventions show promise as more accessible, sustainable, and cost-effective treatment avenues than traditional psychological services. The primary aim of this trial is to test the effectiveness of a remote, behavioural activation and peer support intervention, administered by trained peer para-professionals, for increasing gestational age at delivery among those with antenatal depression. The secondary aims are to evaluate the effectiveness for treating AD prior to delivery, with persistence into the postpartum; improving anxiety symptoms; and improving parenting self-efficacy compared to controls. Methods A two-arm, single-blinded, parallel groups randomized controlled trial (RCT) with repeated measures will be conducted. Participants scoring >10 on the Edinburgh Postnatal Depression Scale will be recruited from the larger P3 cohort and invited to enroll. Assessments will be conducted prior to 27 weeks’ gestation at trial intake (T1), post-intervention, prior to delivery (T2), 5–6 months postpartum (T3), and 11–12 months postpartum (T4) and will include self-report questionnaires and linked medical records. Discussion Our remote, peer paraprofessional-delivered behavioural activation plus peer support intervention has the potential to successfully reduce symptoms of AD, which may in turn decrease the risk of PTB and subsequent health impacts. The current trial builds on previous findings and uses a patient-oriented approach to address priorities for patient care and to provide a cost-effective, accessible, and evidence-based treatment to pregnant individuals with AD. Trial registration International Standard Randomised Controlled Trial Number (ISRCTN) registry (ISRCTN51098220) ISRCTN51098220. Registered on April 7, 2022.Item Open Access Feasibility of a Virtual Mindfulness Based Intervention, for youth diagnosed with a Neurodevelopmental Disability, during the COVID-19 Pandemic(2023-01-09) O'Brien, Heidi; McMorris, Carly; Graham, Susan; Schroeder, MeadowBackground: It is well established that youth with neurodevelopmental disabilities (NDDs) experience high rates of mental health concerns (e.g., anxiety, depression, and stress), which have worsened throughout the pandemic. However, appropriate, and accessible treatments for mental health concerns for youth with disabilities are limited. Many health providers report not being adequately trained or specialized to meet the mental health needs of individuals with NDDs. Mindfulness-based interventions (MBI), offered both in person and virtually, are a promising treatment approach for youth and adults in the general population and have effectively improved symptoms of depression, anxiety, and stress. Both caregivers and autistic individuals (i.e., adults & youth) have benefited from MBI and report improvements in well-being and mindfulness skills. MBIs offered virtually have also effectively addressed mental health concerns and are feasible with autistic adults. Despite the effectiveness of MBIs in autistic adults and caregivers, it is unknown whether MBI delivered virtually, is effective in reducing the mental health concerns of neurodiverse youth. The present study addressed this gap and determined the feasibility of a virtual adapted-MBI during the COVID-19 pandemic for youth with NDDs. Methods: Twenty-three neurodiverse youth (M = 12.72, SD = 1.34) and one of their parents participated in a six-week adapted virtual adapted-MBI. Youth and their parents attended weekly group sessions and were asked to complete questionnaires at three time points (i.e., baseline, post-intervention, and 3-month follow-up). Both parent and child completed a measure of youth mental health (Strengths and Difficulties Questionnaire; [SDQ]), and the youth also completed a self-report measure of mindfulness skills (Child and Adolescent Mindfulness Measure; [CAMM]). All participants were asked to complete a semi-structured interview three months post-intervention, where they were asked questions related to their satisfaction with the intervention. Feasibility was assessed using five areas of focus: demand, implementation, efficacy, practicality, and acceptability. Paired sample t-tests and reliable change indices were used to determine the efficacy of the intervention in the immediate improvement of mental health concerns. Thematic analysis was used to identify significant themes from the participant interviews. Finally, repeated measure ANOVAs and reliable change indices were calculated to determine the long-term (3-month follow- up) impacts of MBI. Results: Overall, the virtual adapted-MBI was in demand, successfully implemented, and generally accepted. Unexpectedly, paired sample t-tests showed no significant changes in youth mental health or mindfulness skills post-intervention (i.e., all p’s <.05). The reliable change index showed clinically meaningful differences from baseline to post-intervention and baseline to follow-up time points with some youth showing improvements on mental health and mindfulness. Two main themes emerged: 1) Finding Purpose in Mindfulness, and 2) What Works for One may not Work for All. Mindfulness was perceived as a practical skill that improved youth’s ability to cope with stress and build self-awareness. The MBI seemed to work for some, but not all. There were perceived challenges with attention and focus with the virtual format. Many participants recommended more interactive and fun activities to increase participation and engagement. Conclusions: Virtual MBI is a feasible intervention that can be used to help reduce mental health symptoms for some neurodiverse youth. Although there was no significant group mean differences after the six-week intervention, the reliable change index shows immediate and long-term differences for a small number of participants at the individual level. The qualitative analysis further describes areas of strengths and weaknesses of the intervention and suggests that mindfulness might be a good tool for some but not all youth with an NDD. Further work in MBI is needed to determine age-specific adaptations. who is best suited for it, and how it can be applied within a multidisciplinary approach to improve mental health in NDDs.Item Open Access Five-year-olds’ Social Preferences and Cultural Inferences About Foreign-Accented Speakers(2022-09) Zepeda, Michelle; Graham, Susan; Curtin, Suzanne; Pexman, Penny; McMorris, Carly; White, KatherineTwo experiments investigated whether five-year-olds’ accent-based cultural inferences and social preferences varied depending on the information provided about the speakers, and whether they were associated with children’s linguistic experiences. In each experiment, 96 five-year-olds were randomly assigned to one of three between-subjects conditions. First, children were introduced to a native-accented speaker and a foreign-accented speaker and were taught limited information about both (i.e., the colours of their notebooks). Next, children in the baseline conditions proceeded to the test trials. In the differences minimized and differences maximized conditions, children were first taught cultural information about the speakers. In the differences minimized conditions, both speakers were associated with cultural items (i.e., food and clothing) that were familiar. In the differences maximized condition, the two speakers were associated with different cultural items (i.e., the native-accented speaker with the familiar object, foreign-accented with the less familiar object). In the cultural inference trials, children were asked which item matched the speaker’s voice (i.e., the voice of the native or foreign-accented speaker). In the social preference trials, children were asked to indicate which of the two speakers they wanted as a friend. Finally, parents completed a language and accent questionnaire. Methodological considerations were identified in Experiment 1 and changes to the design of the study were implemented in Experiment 2. In Experiment 1, children’s selections did not differ as a function of the information provided to them on either the cultural inference or social preference tasks. In Experiment 2, children’s cultural inferences about foreign-accented speakers varied across the differences minimized and maximized conditions (i.e., children in the differences minimized condition selected significantly more familiar cultural items). Moreover, across all conditions, children associated familiar objects more with the native-accented speaker and unfamiliar objects with the foreign-accented speaker. In the social preference task, children in the differences maximized condition preferentially selected the native-accented speaker on an initial trial. Finally, no association emerged between children’s linguistic experiences and their accent-based cultural inferences and social preferences. Together, the results of these experiments offer insight into the conditions under which children’s accent-based inferences and social preferences are modulated.Item Open Access Frequency and Predictors of Manual Use and Evidence-Based Psychological Interventions Among Clinicians Treating Eating Disorders in British Columbia(2023-09-21) Bajaj, Deepika; von Ranson, Kristin; McMorris, Carly; Exner-Cortens, Deinera; Birnie, KatieSeveral evidence-based psychological interventions (EBPIs) exist for eating disorders (EDs). Yet, these interventions and manuals are underutilised in clinical practice. This study described psychological interventions British Columbia (BC) clinicians used to treat EDs and examined factors associated with manual and EBPI use. Participants were recruited from a list of 1,530 potential participants created for this study by identifying clinicians listing online that they treat EDs, as well as through social media advertisement and snowball recruitment. One hundred and twenty-six community counsellors and psychotherapists providing psychological intervention to individuals with EDs across BC described their ED clients, psychological interventions used, and their training. To examine predictors of EBPI and manual use, these participants provided demographic information and completed measures of affect, intolerance of uncertainty, and attitudes toward treatment manuals. Overall, 8% of respondents indicated that they often used manuals in their clinical work. Use of EBPIs by clinicians for treatment of anorexia nervosa, bulimia nervosa, and binge eating disorder ranged from 2%-15%. Logistic regression analyses identified two factors associated with manual use included: negative attitudes toward manuals were associated with infrequent use of manuals, whereas positive attitudes toward manuals were associated with increased likelihood of manual use. Unexpectedly, logistic regression analyses did not identify any factors that significantly predicted of EBPI use. The low uptake of EBPIs for the treatment of EDs suggests that ED client may be receiving suboptimal care, highlighting the need for future work to address barriers to EBPI use. Future research should explore beyond clinician characteristics and investigate how external and intervention factors may impact the adoption and implementation of EBPIs and manuals in ED treatment.Item Open Access Memory Profiles of Children and Youth with Prenatal Alcohol Exposure: The Potential Role of Postnatal Risks(2021-09) Wasylyshyn, Taylor; McMorris, Carly; Climie, Emma; Sanders, JamesFetal alcohol spectrum disorder (FASD) is a neurodevelopmental condition that results from prenatal alcohol exposure (PAE). PAE is commonly associated with potential congenital disabilities and developmental delays. Cognitive domains, including those integral for memory and learning, can also be compromised following PAE. In addition to PAE, individuals with FASD tend to experience other prenatal (i.e., exposure to other substances before birth) and postnatal adversities (i.e., maltreatment following birth) that can negatively impact mental health, adaptive functioning, and neurodevelopmental outcomes. To our knowledge, no study has investigated the immediate free and cued recall abilities of children and youth with PAE compared to those without PAE. The potential influence of additional postnatal adversities on memory deficits in individuals with PAE is another research area that has been relatively overlooked. The current study first explored the short-term verbal memory profiles of children and youth with PAE (n = 26) compared to those without PAE (n = 26) and examined if distinctions in memory abilities between these groups may be better accounted for by differences in cognitive functioning (IQ). Second, this study exclusively analyzed children and youth with PAE (n = 29) to investigate if elevated exposure to postnatal adversities would be associated with more profound memory deficits. Two separate samples of exposed and unexposed children and youth between the ages of 7 and 15 were analyzed. Overall, participants with and without PAE differed significantly in their free and cued memory recall abilities, with exposed children and youth recalling significantly fewer details on a story task. However, after controlling for intellectual functioning, these group differences were no longer statistically significant. Lastly, we found that children and youth with PAE who experienced moderate-high levels of postnatal exposures had similar memory abilities as children and youth with PAE who had absent-low levels. Findings from the current study are consistent with the literature that documents verbal memory deficits within PAE populations; however, additional research on the potential associations between postnatal exposures and developmental outcomes within this population is needed. Areas for future research directions are discussed as well as study clinical implications and limitations.Item Open Access Pain in Youth with Cerebral Palsy: The Impact of Caregiver Mental Health, Parenting Style, and Protectiveness(2024-06-17) Mueri, Kendra Arina; McMorris, Carly; Racine, Nicole; Kirton, Christopher AdamBackground: Estimated to affect 2-3 in every 1000 livebirths, Cerebral palsy (CP) is one of the most common neurodevelopmental disabilities (NDDs) and causes of physical disability in childhood. One of the most common secondary conditions associated with CP is pain, which is reported to impact up to 75% of youth with CP. It is well-established that caregivers of youth with CP experience increased levels of stress due to unique caregiving responsibilities. In the general population, parenting elements such as mental health and pain-specific protectiveness have been found to influence youth chronic pain, including pain intensity, chronicity, and interference. Emerging literature in the general population also suggests that parenting style (e.g., authoritarian) may influence the development and maintenance of youth chronic pain. Although it is well known that parents have a profound impact on their children’s development and wellbeing, little is known about the role that parenting, including parenting styles, parent mental health, and pain-specific protectiveness, may have on pain outcomes in children and adolescents with CP. Understanding the associations between these parenting elements and youth pain outcomes provides valuable insight into modifiable factors that influence pain in youth with CP, which could inform targets for future psychoeducation and family-based interventions for these vulnerable youth. Objectives: The present study contributed to the literature on pain in children and adolescents with CP by 1) determining if parental mental health (i.e., depression and anxiety) was associated with child-reported pain (pain severity, pain-interference), 2) determining if parental protectiveness mediated the proposed associations between parent mental health and child pain (pain severity, pain-interference), 3) determining if parenting style (i.e., authoritarian, authoritative, permissive) was associated with child-reported pain (pain severity, pain-interference), and 4) determining if parental protective-responses mediated the proposed associations between parenting styles (i.e., authoritative, authoritarian, permissive) and child-reported pain (pain severity, pain-interference). Methods: Forty-three youth between the ages of 8 and 17 years (M = 11.51, SD = 2.63, 41.02% female) and one of their caregivers completed cross-sectional measures. Caregivers completed measures of caregiver mental health, parenting style, and pain-specific protectiveness, while youth completed measures of pain (e.g., intensity, interference). A series of linear regression analyses were conducted to determine if caregiver mental health (i.e., depression, anxiety) and parenting style (i.e., authoritarian, authoritative, permissive) predicted youth pain outcomes (i.e., pain intensity, pain interference). Lastly, mediation analyses were conducted to examine the mediating role of pain-specific protectiveness in the proposed associations. Results: Youth reported mean pain intensity levels of 3.69/10 (SD = 2.41), and a mean pain interference T-score of 51.75 (SD = 9.66). Most participants reported experiencing pain in their legs (n = 23, 58.97%) and muscles/joints (n = 11, 28.20%). Caregivers reported on the following parenting styles: authoritative parenting style (M = 110.51/135, SD = 9.95, range = 91-131), authoritarian (M = 34.70/100, SD = 6.81, range = 25-52), and permissive (M = 28.49/75, SD = 5.36, range = 18-42). Caregivers reported average anxiety symptoms of 50.60/83.1 (T-score; SD = 8.74, range = 37-67) and average depressive symptoms of 50.74/81.3 (T-score; SD = 8.33, range = 38-69). When controlling for covariates (GMFCS level, youth age, youth sex, and caregiver age), authoritarian parenting style significantly predicted youth pain interference. When controlling for covariates (GMFCS level, youth age, youth sex, and caregiver age), both caregiver anxiety and caregiver depression significantly predicted youth pain interference. The remainder of caregiver variables did not predict youth pain intensity nor pain interference. Conclusions: This study is the first of its kind to examine the influence of key parenting elements (e.g., parenting style, mental health, pain-specific protectiveness) on the pain outcomes of youth with CP. Results demonstrate that higher levels of authoritarian parenting style, caregiver depressive symptoms, and caregiver anxiety symptoms is significantly associated with higher levels of youth pain interference. The findings of this study provide valuable insights into the role that parenting has on the pain experience of youth with CP and can be used to inform psychoeducational targets for family-based interventions to continue supporting and promoting healthy functioning and wellbeing in this vulnerable population.Item Open Access Tactile cortical responses and association with tactile reactivity in young children on the autism spectrum(2021-04-01) Espenhahn, Svenja; Godfrey, Kate J; Kaur, Sakshi; Ross, Maia; Nath, Niloy; Dmitrieva, Olesya; McMorris, Carly; Cortese, Filomeno; Wright, Charlene; Murias, Kara; Dewey, Deborah; Protzner, Andrea B; McCrimmon, Adam; Bray, Signe; Harris, Ashley DAbstract Background Unusual behavioral reactions to sensory stimuli are frequently reported in individuals on the autism spectrum (AS). Despite the early emergence of sensory features (< age 3) and their potential impact on development and quality of life, little is known about the neural mechanisms underlying sensory reactivity in early childhood autism. Methods Here, we used electroencephalography (EEG) to investigate tactile cortical processing in young children aged 3–6 years with autism and in neurotypical (NT) children. Scalp EEG was recorded from 33 children with autism, including those with low cognitive and/or verbal abilities, and 45 age- and sex-matched NT children during passive tactile fingertip stimulation. We compared properties of early and later somatosensory-evoked potentials (SEPs) and their adaptation with repetitive stimulation between autistic and NT children and assessed whether these neural measures are linked to “real-world” parent-reported tactile reactivity. Results As expected, we found elevated tactile reactivity in children on the autism spectrum. Our findings indicated no differences in amplitude or latency of early and mid-latency somatosensory-evoked potentials (P50, N80, P100), nor adaptation between autistic and NT children. However, latency of later processing of tactile information (N140) was shorter in young children with autism compared to NT children, suggesting faster processing speed in young autistic children. Further, correlational analyses and exploratory analyses using tactile reactivity as a grouping variable found that enhanced early neural responses were associated with greater tactile reactivity in autism. Limitations The relatively small sample size and the inclusion of a broad range of autistic children (e.g., with low cognitive and/or verbal abilities) may have limited our power to detect subtle group differences and associations. Hence, replications are needed to verify these results. Conclusions Our findings suggest that electrophysiological somatosensory cortex processing measures may be indices of “real-world” tactile reactivity in early childhood autism. Together, these findings advance our understanding of the neurophysiological mechanisms underlying tactile reactivity in early childhood autism and, in the clinical context, may have therapeutic implications.Item Open Access The Characterization of Pain in Youth with Cerebral Palsy: A Micro-Longitudinal Analysis(2023-08) Nania, Cara; McMorris, Carly; Oberlander, Tim; Kirton, AdamBackground. Cerebral palsy (CP) is the most common cause of physical disability in children, impacting 2 to 3 in every 1000 live births. It is well-established that pain is present in up to 75% of youth with CP, making it the most prevalent secondary condition. Youth with CP also report poor mental health, quality of life, and daily functioning. Despite this, little is known about the multiple dimensions of pain (i.e., intensity, interference, chronicity), the role of mental health in the experience of pain, and the impact of pain on quality of life in youth with CP. Further, no research to date has considered how pain impacts daily functioning of youth with CP, overtime. Understanding pain in youth with CP is crucial for improving their quality of life, preventing lifelong secondary complications (i.e., functional impairments and mental health issues), and developing tailored pain management strategies. Objectives. The present study extended and replicated previous research on pain in children and youth with CP by 1) characterizing the human experience of pain (i.e., intensity, frequency, location, duration, interference, and chronicity), 2) determining the cross-sectional associations between pain outcomes (i.e., intensity and interference) and mental health (i.e., depression and anxiety), as well as pain outcomes (i.e., intensity and interference) and quality of life, and 3) investigating how pain interferes with daily functioning using an Ecological Momentary Assessment (EMA) approach. Methods. Forty-five youth with CP, between 8 and 17 years of age (58% boys; Mage = 11.6 years [SD=2.67]), along with their caregivers, completed cross-sectional measures of pain, mental health, and quality of life. Following this, youth completed seven days of daily surveys through REDCap that measured daily pain and functioning (i.e., “How much did pain interfere with your day?”). To characterize the pain experience (i.e., intensity, location, interference) of these youth, descriptive statistics were conducted. Hierarchical multiple regression analyses were also conducted to determine if pain interference predicted depression, anxiety, and quality of life. Lastly, the impact of pain on same and next day pain interference was evaluated through multi-level modelling, which accounted for variance in time (level 1) and pain (level 2). Results. Forty percent of youth reported that they experience chronic pain (i.e., pain lasting longer than 3 months), with a mean pain intensity level of 4.03/10 (SD = 1.96), and an average pain interference T-score of 49.23 (SD = 14.70). Majority of participants (59%) reported that their pain was located in their legs. Controlling for Gross Motor Function Classification Level (GMFCS), gender, and age, hierarchical multiple regression analyses demonstrated that pain interference significantly predicted poorer quality of life. Pain interference did not predict anxiety and depression over and above these covariates. Variance in pain intensity over the 7-day period was significantly associated with same and next day pain interference, such that higher pain intensity was related to higher pain interference. Discussion. This is the first study to characterize the pain experience in youth with CP and micro-longitudinally evaluate the daily impact of pain on functioning. Findings will directly inform treatment approaches to improve outcomes for these vulnerable individuals, and offset a trajectory of increased mental health issues, reduced quality of life, and poor functioning and disability into adulthood.Item Open Access The Dichotomous Portrayal of What is Written & What is Said: An Exploration into the Diverse Lives of Autistic Women and Femme Individuals(2024-05-24) Coombs, Emily; Maroney, Meredith Rose; Wada, Kaori; Brown, Heather M.; McMorris, Carly; Santinele Martino, AlanExisting research suggests that Autistic people are more likely than non-Autistic people to self-identify as sexually or gender diverse or as being on the LGBTQ+ spectrum. Moreover, research suggests that Autistic women, girls and transfeminine individuals are more likely than Autistic men and boys to identify as non-heterosexual and gender diverse. This thesis comprises two manuscripts that both focus on Autistic gender and sexuality. Manuscript 1 uses femme theory to critique the literature on the sexual and gender experiences of Autistic women and gender diverse individuals, exploring the intersection of gender norms and feminine Autistic experiences. Through critical content analysis of articles from 2019 to 2022, researchers found that identity-first language was common compared to a limited use of person-first language. Themes included inadequate examination of femininity, limitations in discussing gender diversity, and recognition of its intersectionality with other forms of oppression. The study emphasizes the importance of inclusive language, breaking gender stereotypes, and considering intersectionality. Future research should broaden its scope and incorporate diverse perspectives to represent the strengths and resilience of Autistic women and feminine individuals. Manuscript 2 explores the intersectionality of Autistic women within LGBTQ+ communities, aiming to understand how their identities and well-being intersect through femme theory. Conducting semi-structured interviews with 17 diverse participants, the study found that Autistic women in the LGBTQ+ spectrum often form micro-groups based on shared identities, such as autism, providing crucial support. Participants emphasized the interconnectedness of their identities, with varying perspectives on femininity. The research highlights the need to address disparities in diagnoses and support for Autistic women, particularly those in LGBTQ+ communities, and suggests expanding diagnostic criteria to consider gender and sexual diversity. This study fills a gap in the literature by intentionally focusing on intersectionality within the Autistic community, shedding light on systemic challenges and shared identities' strengths. The combined findings of these manuscripts reinforce the need for a nuanced conversation about gender identity, that there exists a large overlap of those who identify as feminine, Autistic and LGBTQ+ and highlight the importance of considering intersectionality in discussions of identity and diversity. Clinical and research implications are discussed.Item Open Access The Double-edged Sword of Autism in Work Teams(2023-09-26) Lieu, Erika; O'Neill, Thomas; Steel, Piers David Gareth; McMorris, CarlyAutistic workers are often drawn to science, technology, engineering, arts, and math- related fields that rely on teamwork to produce innovative solutions. Yet, autistic traits like interpersonal communication and interaction differences can make teamwork challenging. Scientists and practitioners alike have not identified the unique needs of neurodiverse teams comprised of autistic and non-autistic members. A scoping review of 29 studies dispersed through psychology, vocational training, education, management, and disability journals revealed several themes: neurodiverse teamwork is an understudied yet extant phenomenon; the ‘autism advantage’ is lauded as a benefit to organizations but ignores the health and wellness cost to the individual; interpersonal communication is a challenge that is the responsibility of all team members; the effects of disclosure are complex; coworkers, leaders, and the organization have a role to play in neuroinclusivity. Theoretical and practical implications are described, and future research directions are identified.Item Open Access The Intersection of Autism and Eating Disorders: Understanding Body Image and Eating Problems in Women and Girls(2023-07) Baraskewich, Jessica; McMorris, Carly; McCrimmon, Adam; Russell-Mayhew, ShellyThe overlap between autism and eating disorders has been increasingly noticed in clinical settings in the past decade, and researchers have highlighted several similarities between disorders (e.g., executive function difficulties, socioemotional similarities). Moreover, many autistic individuals experience significant problems related to feeding and eating, often from a young age. Despite it being widely accepted that body image disturbance is a central construct related to the development and maintenance of eating disorders, little research to date has examined body image in autistic individuals and how their experience of body image relates to eating and weight-control behaviours. This study examined whether autistic women and girls differ from their non-autistic peers in the way they perceive their bodies and aimed to understand how body image disturbances relate to eating and weight control behaviours in this population. The sample was comprised of 37 autistic women and girls (aged 16 to 24) and 37 non-autistic women and girls of the same age. Information on body image, eating, and weight-control behaviours was gathered through self-report. A multidimensional conceptualization was used to test if the two groups differ in their experience across various aspects of body image. Autistic participants had relatively high rates of body dissatisfaction, eating, and feeding problems compared to the general population. The autistic group had significantly higher attitudinal body image scores and significantly higher rates of eating problems than the non-autistic group. The results suggest that although some autistic people may experience high rates of body dissatisfaction and eating problems, these feelings and behaviours are likely motivated by different reasons than their non-autistic peers. Results of the study build on the extremely limited research in this area. Implications for clinical practice in the assessment, prevention, and treatment of eating issues in this population are discussed.Item Open Access The Relationship Between Academic Anxiety, Metacognition, and Academic Achievement(2023-10-23) Florentine, Rebecca; Wilcox, Gabrielle; McMorris, Carly; Schroeder, MeadowTransitioning into a self-regulated learning environment poses challenges for many first-year undergraduates, leading to higher anxiety and decreased academic functioning. Previous research consistently found harmful effects of anxiety on academic outcomes, while metacognition was found to increase performance. However, no consensus was found on the relationship between metacognition and anxiety. Thus, this study explores the relationships between metacognition, academic anxiety, and achievement with the aim of clarifying the role of metacognition as a mediator between academic anxiety and performance. Using the Metacognitive Awareness Inventory (MAI), Academic Anxiety Inventory (AAI), and self-reported GPA scores gathered from undergraduates (N = 128), regression analyses were conducted. Results indicate that higher general trait anxiety predicts lower academic achievement and increased metacognitive awareness, specifically declarative knowledge. Surprisingly, increased declarative knowledge also predicts lower achievement, while metacognitive strategy use does not predict performance. This unexpected finding may be attributed to students’ inaccurate and negative perceptions of their own metacognition and capabilities as a learner due to the shift to online learning during the COVID-19 pandemic. Furthermore, declarative knowledge partially mediates the relationship between trait anxiety and achievement, suggesting that metacognition acts as a secondary process to counter automatic anxious thoughts. In essence, highly anxious individuals may tend to fixate on their shortcomings, which can overwhelm their cognitive capacity and lead to a decline in their academic achievements. Therefore, improving metacognitive skills and accuracy can promote student well-being and academic success.