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Schizotypy and Health Promotion: the Mediating Role of Depressive Symptoms Stephen F. Austin State University SFA ScholarWorks Electronic Theses and Dissertations Spring 4-2018 Schizotypy and Health Promotion: The Mediating Role of Depressive Symptoms Michael Rice [email protected] Follow this and additional works at: https://scholarworks.sfasu.edu/etds Part of the Clinical Psychology Commons, Health Psychology Commons, and the Personality and Social Contexts Commons Tell us how this article helped you. Repository Citation Rice, Michael, "Schizotypy and Health Promotion: The Mediating Role of Depressive Symptoms" (2018). Electronic Theses and Dissertations. 160. https://scholarworks.sfasu.edu/etds/160 This Thesis is brought to you for free and open access by SFA ScholarWorks. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of SFA ScholarWorks. For more information, please contact [email protected]. Schizotypy and Health Promotion: The Mediating Role of Depressive Symptoms Creative Commons License This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License. This thesis is available at SFA ScholarWorks: https://scholarworks.sfasu.edu/etds/160 SCHIZOTYPY AND HEALTH-PROMOTION: THE MEDIATING ROLE OF DEPRESSIVE SYMPTOMS By MICHAEL RICE, Bachelor of Science Presented to the faculty of the Graduate School of Stephen F. Austin State University In Partial Fulfillment Of the Requirements For the Degree of Master of Arts in Psychology STEPHEN F. AUSTIN STATE UNIVERSITY May 2018 SCHIZOTYPY AND HEALTH-PROMOTION: THE MEDIATING ROLE OF DEPRESSIVE SYMPTOMS By MICHAEL RICE, Bachelor of Science APPROVED: Dr. Nathan Sparkman, Thesis Director Dr. Sarah C. Savoy, Committee Member Dr. Sylvia Middlebrook, Committee Member Dr. Luis Aguerrevere, Committee Member Pauline Sampson, Ph.D. Dean of Research and Graduate Studies ABSTRACT Introduction: In general populations, schizotypy and depressive symptoms may be present at sub-clinical levels. Previous research has shown that schizotypy may negatively associate with underlying factors of health promotion. Furthermore, depressive symptoms have also been shown to negatively correlate with underlying factors of health promotion. Method: Undergraduate students and Mturk users were asked to complete an online questionnaire consisting of surveys measuring schizotypy, depressive symptoms and health promotion. Results: A meditation model showed a significant negative indirect effect of schizotypy through depressive symptoms on health promotion. Additionally, schizotypy positively predicted health promotion when depressive symptoms were controlled. Discussion: Results support previous research that depressive symptoms may act to nullify positive outcomes, or worsen negative outcomes associated with schizotypy. This suggests that interventions that target depressive symptoms may be more effective on health outcomes when a person presents with high schizotypy, and may lead to a positive health promoting lifestyle. Keywords: Schizotypy, depressive symptoms, health promotion, mediation iii ACKNOWLEDGMENTS First, I would like to thank Dr. Nathan Sparkman for taking me on as a thesis student and for providing substantial guidance in a short period of time. I value his mentorship greatly and hope to keep working with him to see this project to and others come to fruition. Next, I would like to thank my committee members Dr. Sarah Savoy, Dr. Sylvia Middlebrook, and Dr. Luis Aguerrevere. They each provided quality feedback that helped guide my thesis. I would also like to thank Emily Sanchez, Neusha Khaleghi, and Tessa Thomas for sharing an office and putting up with me. Though too numerous to name individually, the rest of the (previous and current) graduate students in this program also supported me through amazing friendship over the past two years. Lastly, I would like to show my gratitude to my family. I would not have accomplished this much without them. Mom, Dad, Mark, Matthew, and, of course, Nana, you all have helped me more than you will ever know! iv TABLE OF CONTENTS Abstract iii Acknowledgments iv List of Figures viii List of Tables ix Introduction 1 Associations Between Health Promoting Behaviors and Health 2 Schizotypy and Schizophrenia 4 Depressive symptoms 9 Schizotypy and Depressive Symptoms 12 Current Study 13 Hypotheses 14 Method 14 Participants 14 Schizotypal Personality Questionnaire – Brief Revised Scale 15 Center for Epidemiology Studies Depression Scale 16 Health Promoting Lifestyle Profile – II Scale 17 Health Behaviors 17 Demographics 17 Attention Checks 18 v Procedure 18 Data Analysis 19 Results 20 Data Cleaning 20 Assumptions 21 Depressive symptoms mediate the relation of schizotypy and health promotion 22 Mediation exploring the curvilinear relationship of schizotypy and health promotion 23 Depressive symptoms mediate schizotypy’s relation to stress management. 24 Depressive symptoms predict interpersonal relationships 25 Partial correlation of schizotypy and health promotion 26 Positive schizotypy trait subscale relates to health promotion 26 Health promotion, schizotypy, depressive symptoms and health 26 Discussion 31 Depressive symptoms mediates the relationship between schizotypy and health promotion 31 Aspects of health promotion are impacted by Schizotypy and depressive symptoms 33 Positive symptoms relationship with health promotion 34 vi Health behaviors 36 Implications of Mediation 37 Future Research 38 Limitations 38 Conclusions 39 References 40 Appendix A: Informed Consent 47 Appendix B: Schizotypal Personality Questionnaire – Brief 48 Appendix C: Center for Epidemiology Studies Depression Scale 50 Appendix D: Health Promoting Life Style Profile – II 51 Appendix E: Brief Risk Factor Surveillance Survey 53 Appendix F: Demographic Questions 55 Appendix G: Debriefing Form 59 Vita 62 vii LIST OF FIGURES Figure 1: Mediation model to be tested 21 Figure 2: Scatterplot of Schizotypy and Health Promotion 27 Figure 3: Mediation model tested for hypothesis 2 28 Figure 4: Mediation model tested for exploratory analysis 28 viii LIST OF TABLES Table 1: Multiple regression of schizotypy subscales, 29 depressive symptoms and health promotion Table 2: Correlations between health and health promotion, 30 schizotypy and depressive symptoms ix SCHIZOTYPY AND HEALTHY LIFESTYLE: THE MEDIATING ROLE OF DEPRESSIVE SYMPTOMS It is becoming evident that overall health is an important mediator of neurological disease and psychological disorder progression (including neuropsychiatric disorder such as schizophrenia and depression [Herbert, 1997]). However, just as a sound body may allow one to exercise and encourage healthy lifestyle behaviors, the state of the mind and brain may be equally as important in maintaining effective health promoting behaviors. Importantly, psychiatric disease, mental states, and personality are essential determinants of behavior and habits that promote a healthy lifestyle. Schizotypy is conceptualized as the continuous form of schizophrenia and related disorders, and consists of traits indicative of behaviors that are expressed by individuals with schizophrenia and related disorders (DSM-5; American Psychological Association [APA], 2013). These traits may also be present in the general population at subclinical levels (Rado, 1953). Schizotypy traits include, but are not limited to, disorganized speech, delusions or false beliefs (e.g., superstitious or magical beliefs), lack of close relationships, and restricted affect. Expression of schizotypal traits often precedes diagnosis of schizophrenia later in life (Catts, Fox, Ward, & McConaghy, 2000). Schizophrenia has been linked to decrements in health promoting behaviors (Holmberg & 1 Kane, 1999). However, it is unknown how health promoting behaviors are affected for individuals high in schizotypy traits. Major Depressive Disorder (MDD) is a common occurrence (30-50% of patients with schizotypal personality disorder have comorbid MDD) in those with schizotypal personality disorder and other schizophrenia spectrum disorders (APA, 2013). Also, poor health promoting behaviors have been associated with MDD. In addition to MDD, subclinical depressive states are negatively correlated with positive health promoting behaviors (Gonzalez et al., 2007). Increased levels of depression have been shown to be associated with poor nutrition (Bodnar & Wisner, 2005), decreases in exercise (Byrne & Byrne, 1993), and heightened stress/anxiety (Mealey, Abbott, Gyrne, & McGillivray, 2014). Understanding the link between schizotypy, depressive symptoms and health promoting behaviors is important. Given that depressive symptoms are associated with high schizotypy trait scores and that these symptoms may affect health promoting behaviors, it is particularly important to understand how depressive symptomatology may mediate health promoting behaviors in individuals with schizotypy traits. Associations between health promoting behaviors and health Health promoting behaviors involve maintaining interpersonal relationships, managing stress, eating healthily, performing regular exercise, taking responsibility for one’s health, and striving toward self-actualization (working toward and achieving goals; Walker, Sechrist, & Pender, 1987). Overall, the individual facets of health promoting 2 behaviors are associated with factors that improve or maintain general health. For example, proper diet and exercise has been shown to reduce bad cholesterol, a known risk factor for cardiovascular disease (Stefanick et al., 1998). Also,
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