Doctor of Philosophy, Miami University, 2024, Psychology

Introduction: This study aims to better understand the psychosocial mechanisms by which individuals who report subjective concerns about their memory (SCI) are at a higher risk for objective cognitive impairments (OCI) over time. It also aims to identify modifiable risk factors that may disrupt this progression. Aim 1 tests if symptoms of affective disorders mediate the relationship between SCI and OCI over time. Aim 2 tests if self-perceptions of aging moderate the relationship between SCI and symptoms of affective disorders over time. Aim 3 tests if self-perceptions of aging moderate the indirect effect of symptoms of affective disorders on the relationship between SCI and OCI over time. Method: Data was sourced from the Health and Retirement Study, a national longitudinal dataset, across 8 years. 4,002 adults, 65 and older, were included in the sample. The moderation, mediation, and moderated mediation analyses were conducted using a path model in Mplus (Version 8 Plus). Relevant covariates including demographic and health variables were controlled for. Results: Analyses confirmed that symptoms of affective disorders partially mediated the relationship between SCI and OCI. For individuals with negative self-perceptions of aging, the relationship between SCI and symptoms of affective disorders strengthened over time, while for individuals with positive self-perceptions of aging, the relationship ceased to exist. Finally, positive self-perceptions of aging weakened, while negative self-perceptions of aging strengthened the indirect effect of symptoms of affective disorders on the relationship between SCI and OCI. Conclusion: Results of the current study clarify the psychosocial mechanisms involved in the progression from SCI to OCI, and add support to literature identifying positive beliefs about aging and mental health as protective factors against cognitive impairment among older adults. This study implicates the need for more interdisciplinary research studying (open full item for complete abstract)

Committee: Katherine Abbott (Committee Co-Chair); Aaron Luebbe (Committee Co-Chair); Vaishali Raval (Committee Member); Angela Curl (Committee Member) Subjects: Aging; Clinical Psychology; Psychology

Psy. D., Antioch University, 2025, Antioch New England: Clinical Psychology

Subjective Cognitive Decline (SCD), the self-perceived decline in cognitive abilities, is recognized as a preclinical marker for neurocognitive disorders (Jessen et al., 2014). Understanding the contextual factors informing SCD experience remains a research priority in this domain. At-risk older adults have heritable markers associated with dementia. Chronic exposure to embedded ageism burdens allostatic load (AL) and exacerbates epigenetic risk for cognitive decline (Levy, 2022; McEwen, 2020; Miller et al., 2021). The current qualitative study explored how ageism shapes the lived experience of SCD among at-risk older adults. Semi-structured interviews were conducted with 12 participants, all doctoral level clinical practitioners, aged 60 to 79 and analyzed using thematic analysis, guided by the Transactional Model of Stress and Coping (TMSC). Findings revealed that ageism pervades three ecological domains—intrapersonal, interpersonal, and systemic—¬contributing to emotional distress, behavioral restriction, and reduced healthcare engagement. The present study extends the current literature on this topic by identifying ageism as a socio-cultural determinant of perceived cognitive health, shaping the outcome trajectory. The findings underscore the need to address ageism through clinical interventions and systemic reforms. Such strategies to reduce AL burden, through reduction of stigma and promotion of preventive healthcare engagement, may delay or even prevent onset of dementia among at-risk older adults. This dissertation is available in open access at AURA (https://aura.antioch.edu) and Ohio LINK ETD Center (https://etd.ohiolink.edu).

Committee: Katherine Evarts PsyD (Committee Chair); Gina Pasquale PsyD (Committee Member); Casey Culligan-Benoit PsyD (Committee Member) Subjects: Clinical Psychology; Gerontology; Mental Health; Psychotherapy; Social Psychology