Loyola University Chicago

Department of Psychology


Alexa Stern

Alexa Stern
Training Track: Clinical
Lab:  CHATS Lab
Advisor: Grayson Holmbeck, Ph.D.
Office: Coffey 302

Research Interests

promoting self-management and adjustment among youth with medical conditions, helping youth with chronic medical conditions transition to adult healthcare 

Masters Thesis Title

Depressive Symptoms, Neuropsychological Functioning, and Self-Management in Youth with Spina Bifida: Direct, Mediating, and Reciprocal Pathways

Masters Thesis Abstract

Although successful self-management of health care responsibilities is critical to meeting the developmental demands associated with the transition to adulthood in youth with spina bifida (SB), research on individual factors impacting self-management in this population is sparse. Given the increased risk for cognitive deficits and development of depressive symptoms in this population, this study aimed to examine two pathways through which depressive symptoms and neuropsychological dysfunction may be associated with self-management in youth with SB. First, it was hypothesized that neuropsychological functioning would mediate the relationship between depression and self-management. Second, an alternative model was tested whereby it was expected that depressive symptoms would mediate the relationship between neuropsychological dysfunction and self-management. Participants included 114 youth with SB (M age = 10.96 at Time 1). Data were collected at three time points, each spaced approximately two years apart. Youth, their parents, and their teachers completed questionnaires on child depressive symptoms, child neuropsychological functioning, and child self-management behaviors. Youth also completed a brief test battery assessing executive functioning. Greater deficits in attention and working memory, and more severe depressive symptoms predicted lower levels of medical responsibility over time. Unique relationships were found among depressive symptoms and individual cognitive deficits. Bootstrapped mediation analyses revealed that teacher-reported depressive symptoms significantly mediated the respective relationships between attention and working memory, and medical responsibility (all p’s < .05), but that neuropsychological dysfunction did not mediate the relationship between depressive symptoms and medical responsibility. It is hoped that this research will inform the development of evidence-based interventions aimed at improving and fostering the development of self-management in youth with SB.

Masters Thesis Committee

Grayson Holmbeck, Ph.D., Noni Gaylord-Harden, Ph.D.