Coping Responses to Positive Genetic Suceptibility Test Results for Alzheimer's Disease

122 Pages·2017·0.56 MB·English

Walden University
ScholarWorks
Walden Dissertations and Doctoral Studies
Walden Dissertations and Doctoral Studies
Collection
2015
Coping Responses to Positive Genetic Suceptibility
Test Results for Alzheimer's Disease
Diana Elaine Neverson
Walden University
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Walden University

College of Social and Behavioral Sciences

This is to certify that the doctoral dissertation by

Diana Neverson

has been found to be complete and satisfactory in all respects,
and that any and all revisions required by
the review committee have been made.

Review Committee
Dr. Maureen Levine, Committee Chairperson, Psychology Faculty
Dr. Sandra Mahoney, Committee Member, Psychology Faculty
Dr. Rachel Piferi, University Reviewer, Psychology Faculty

Chief Academic Officer
Eric Riedel, Ph.D.

Walden University
2015
Abstract
Coping Responses to Positive Genetic Susceptibility
Test Results for Alzheimer’s disease
By
Diana E. Neverson

MS, Mercy College, 2006
BS, Iona College, 1996

Dissertation Submitted in Partial Fulfillment
Of the Requirements for the Degree of
Doctor of Philosophy
Psychology

Walden University
October 2015
Abstract
Genetic susceptibility test results have been found to cause differences in coping behavior
following testing for the APOE-ε4 gene, associated with Alzheimer’s disease. Coping
behaviors differ within the first 12 months of testing. Currently, no studies have been
conducted beyond the first 12 months comparing positive (P) and negative (N) groups or
how sex relates to coping behavior based on positive test results. Based on the theory of
primary and secondary control, and theory of stress, appraisal, and coping. This study
compared differences in coping strategies based on genetic test results and between sexes
with positive test results beyond the first 12 months. Participants (280) who had
undergone testing for the APOE-ε4 gene 12 or more months prior to the study and had a
relative diagnosed with AD were selected. Coping strategies were measured using the
Brief COPE scale. Using independent measures t tests, the data were analyzed, and test
results were significant, indicating there are differences in coping between P and N
groups. The P group reported significantly higher levels of cognitive and emotional
coping strategies than the N group 12 or more months after receiving test results. These
findings were consistent with previous studies that produced significances in cognitive
and emotional coping strategies between groups, in the first 12 months. The findings
were non significant for cognitive and emotional coping strategies for sex in the positive
group. This study contributes to social change by adding information and knowledge that
can impact decision making by individuals with positive test results for the APOE-ε4
gene in making financial changes, life styles changes, and family and work adjustments
affecting their community and society.
Coping Responses to Positive Genetic Susceptibility
Test Results for Alzheimer’s disease
By
Diana E. Neverson

MS, Mercy College, 2006
BS, Iona College, 1996

Dissertation Submitted in Partial Fulfillment
Of the Requirements for the Degree of
Doctor of Philosophy
Psychology

Walden University
August 2015
Dedication
This dissertation is dedicated to my family: my daughters Sharon and Lauren, my
granddaughter Sharina, my great-grandson Detrel, and our cat Stevie who sat with me
late at night when everyone else was asleep.
Acknowledgments
I give special thanks to God the Father and my Lord and Savior Jesus Christ for giving
me the strength to make this journey. To my family without whose encouragement and
understanding I would not have been able to complete this journey. I thank my committee
members Dr. Maureen Levine and Dr. Sandra Mahoney for their patience with me during
these many months. I thank Dr. Albert Manzi my statistician and mentor. I also thank Dr.
Dorthy Balancia and Dr. Eleanor Panovi for their encouragement.
Table of Contents
Chapter 1: Introduction to the Study ....................................................................................1
Introduction ....................................................................................................................1
Background of the Study ...............................................................................................3
Problem Statement .........................................................................................................6
Purpose of the Study ......................................................................................................7
Research Questions and Hypotheses .............................................................................8
Nature of the Study ........................................................................................................9
Theoretical Base...........................................................................................................10
Definition of Terms......................................................................................................11
Assumptions and Limitations ......................................................................................13
Significance of the Study .............................................................................................14
Summary ......................................................................................................................15
Chapter 2: Literature Review .............................................................................................17
Introduction ..................................................................................................................17
Literature Search ..........................................................................................................18
Alzheimer’s Disease ....................................................................................................20
Alzheimer’s Disease Studies........................................................................................22
Chronic Stress and Coping...........................................................................................26
Coping Theories ...........................................................................................................33
Primary and Secondary Control ............................................................................ 33
Stress, Appraisal and Coping ................................................................................ 40
i
Summary ......................................................................................................................48
Chapter 3: Research Method ..............................................................................................50
Introduction ..................................................................................................................50
Research Design and Approach ...................................................................................50
Research Variables.......................................................................................................51
Methodology ................................................................................................................52
Settings, Sample, and Procedure ........................................................................... 52
Power Analysis ..................................................................................................... 54
Instrumentation and Materials .............................................................................. 54
Research Questions ......................................................................................................58
Data Analysis ...............................................................................................................59
Ethical Considerations .................................................................................................60
Participants’ Protection and Rights ....................................................................... 60
Summary ......................................................................................................................61
Chapter 4: Results ..............................................................................................................62
Introduction ..................................................................................................................62
Demographic Characteristic.........................................................................................63
Assumptions of Independent-Measures T - Test .........................................................66
Hypothesis 1.......................................................................................................... 68
Hypothesis 2.......................................................................................................... 70
Summary ......................................................................................................................71
Chapter 5: Discussion, Conclusions, and Recommendations ............................................73
ii
Introduction ..................................................................................................................73
Interpretation of the Findings.......................................................................................75
Limitations of the Study...............................................................................................77
Conclusion ...................................................................................................................78
Implications for Social Change ....................................................................................80
Recommendations ........................................................................................................82
References ..........................................................................................................................84
Appendix A: ALZ Trial Match ........................................................................................101
Appendix B: Letter of Request ........................................................................................102
Appendix C: Flyer............................................................................................................103
Appendix D: IRB Approval .............................................................................................105
Appendix E: Response from Trial Match ........................................................................108
Appendix: F Demographic Information...........................................................................109
Appendix G: Carver Consent Letter ................................................................................110
Appendix H: Brief COPE Scale Coding ..........................................................................111
iii