Larry L Mullins

Larry L Mullins
Oklahoma State University - Stillwater | Oklahoma State · Department of Psychology

Ph.D. in Clinical Psychology

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243
Publications
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Publications

Publications (243)
Article
Background: Elevated depressive symptoms are observed in a significant number of youth with inflammatory bowel disease (IBD) and have been linked to illness stigma and social isolation. Body image dissatisfaction is an understudied variable in the pediatric IBD literature that may be related to both stigma and social difficulties. It is suspected...
Article
Study Objective Infants with genital development considered atypical for assigned female sex may undergo feminizing genitoplasty (clitoroplasty and/or vaginoplasty) in early life. We sought to identify factors associated with parent/caregiver decisions regarding genitoplasty for their children with genital virilization. Design Longitudinal, observ...
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Full-text available
Inflammatory bowel disease (IBD) presents physical and emotional challenges for families and imposes significant lifestyle intrusions on both youth and parents. The present study examined the effects of IBD disease activity and youth illness intrusiveness on depressive symptoms in adolescents, and the moderating influence of parent illness intrusiv...
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Emerging adults with a chronic medical condition (CMC) are at increased risk for developing health anxiety (HA). Adverse childhood experiences (ACEs) have been linked to developing HA. CMCs and ACEs frequently co-occur among emerging adults. However, no known research has examined ACEs and HA within this critical developmental period. Further, incr...
Article
Objective: The impact of parent-reported stigma due to their child's disorder/difference of sex development (DSD) on parent psychosocial adjustment is poorly understood. In other pediatric populations, perceived interference of medical conditions into daily activities (i.e., illness intrusiveness) mediates the relationship of stigma to adjustment....
Article
Stigma is a salient experience for both caregivers/parents and individuals with Disorders/Differences of Sex Development (DSD) as evidenced through qualitative and preliminary quantitative reports. However, few validated measures of associative stigma (i.e., vicarious stigma experienced through close association with someone who is socially stigmat...
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Structured Summary Introduction Caregivers of female infants with congenital adrenal hyperplasia (CAH) often confront complex medical decision-making (e.g., early feminizing genitoplasty). Objective This study aimed to evaluate the relevant medical decisions and subsequent decisional regret of caregivers following their child’s genitoplasty. Stu...
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Objective Adolescents and young adults in the college setting often report poor sleep hygiene and quality. These sleep difficulties may be related to emotion dysregulation, which is highly relevant to broader adjustment. The current study aimed to empirically identify latent groups of healthy college students with distinct subjective sleep patterns...
Article
Objective The current study examined the roles of constructive and dysfunctional problem-solving strategies in the relationships between illness uncertainty and adjustment outcomes (i.e., anxious, depressive, and posttraumatic stress symptoms) in caregivers of children newly diagnosed with cancer. Methods Two hundred thirty-eight caregivers of chi...
Article
Objective: Symptom burden of children with cancer appears to contribute to parent distress, but the mechanisms of this relationship are relatively unexplored. The current cross-sectional study examined rumination (i.e., repeated focus on negative events and experiences) as a mediator of the associations between parent-report of child (a) pain or (b...
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Objective: To examine the relative contribution of transition readiness (i.e., healthcare self-management) to health-related quality of life (HRQoL) among emerging adult (EA) college students without a chronic medical condition (CMC).Participants: College students (n = 2372; Mage = 19.32, SD = 1.26) from a Midwestern university.Methods: Participan...
Article
Purpose The stigmatizing nature of IBD symptoms may place youth at risk for being targets of peer victimization, potentially resulting in a decreased sense of social belongingness and poorer emotional adjustment. The present study tested a series of mediation and moderated mediation models examining the associations among peer victimization, thwart...
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Purpose The transition to college is associated with numerous stressors, including environmental changes, increased academic expectations, and changes in social support, all of which may be exacerbated by the added responsibility of managing a chronic medical condition. Huang (2019) proposed a model examining the relationships between coping styles...
Article
Introduction Pediatric brain tumor survivors (PBTS) are at risk for both neurocognitive impairments and psychological difficulties, yet these two domains have historically been discretely examined, with assessment of psychosocial outcomes rarely included in studies of cognitive outcomes. Taking a person‐centered approach, the current study aimed to...
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Objective: This study identifies trajectories of parent depressive symptoms after having a child born with genital atypia due to a disorder/difference of sex development (DSD) or congenital adrenal hyperplasia (CAH) and across the first year postgenitoplasty (for parents who opted for surgery) or postbaseline (for parents who elected against surge...
Article
Introduction Differences of sex development (DSD) are congenital conditions in which there is atypical chromosomal, gonadal and/or phenotypic sex. A phenotype of severe genital atypia in patients raised as male is a relatively rare occurrence and standards for management are lacking. Decision making for early surgical planning in these rare cases i...
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Objective To identify possible subgroups of health care utilization (HCU) patterns among adolescents and young adults (AYAs) with a chronic medical condition (CMC), and examine how these patterns relate to transition readiness and health-related quality of life (HRQoL). Methods Undergraduates (N = 359; Mage=19.51 years, SD = 1.31) with a self-repor...
Article
Objective Examine the indirect association between parents’ experience of stigma (i.e., associative stigma) and youth depressive symptoms through the serial effects of associative stigma on parent and youth illness intrusiveness in pediatric inflammatory bowel disease (IBD). Methods During routine clinic visits, 150 youth with well-controlled IBD (...
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Objective: A subset of parents of children with disorders/differences of sex development (DSD) including ambiguous genitalia experience clinically elevated levels of anxious and depressive symptoms. Research indicates that uncertainty about their child's DSD is associated with parent psychosocial distress; however, previous studies have been cross...
Article
Background: Youth who experience IBD-associated stigma may manifest increased worry about aversive symptoms that can intrude on their participation in routine activities (e.g., school, social events), potentially resulting in limited opportunities for reinforcement and increased depressive symptoms. The present study examined an IBD stigma → IBD w...
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Adverse childhood experiences (ACEs) are known to contribute to long-term harmful effects on mental health in young adults. Research has demonstrated that having a chronic medical condition (CMC) can also be conceptualized as being a potentially traumatic experience, and that young adults with a CMC are also at risk for negative adjustment. Emotion...
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Background Pediatric brain tumor survivors (PBTS) are at significant risk for psychological adjustment difficulties, including greater depressive and anxious symptomology. Systematic reviews have identified this heightened risk among youth with medical conditions, but these reviews have not been specific to PBTS. Therefore, the current study aimed...
Article
Extended Summary Disorders/differences of sex development (DSD) are congenital conditions in which there is atypical chromosomal, gonadal and/or phenotypic sex. While there remains controversy around the traditionally binary concept of sex, most patients with DSD are reared either male or female depending on their genetic sex, gonadal sex, genital...
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Objective: Little is known about relations between domains of psychosocial risk among pediatric cancer populations. The Psychosocial Assessment Tool 2.0 (PAT2.0) is one internationally validated screening measure that can examine these relations. This study aimed to examine risk profiles and predictors of these patterns exhibited by American and D...
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This article provides recommendations for adapting the pediatric medical home (PMH) model for health care needs of youth in foster care. Recommendations are based on key informant interviews regarding experiences at an established PMH for youth in foster care. Major clinic recommendations include expanding the PMH framework to include proficiency i...
Poster
Introduction Inflammatory bowel disease (IBD) involves invasive symptoms and embarrassing treatment side effects (e.g., weight gain/loss). Elevated levels of depressive symptoms are also observed in youth with IBD, and have been linked to perceived illness stigma and feelings of social isolation. One potential variable related to stigma that has re...
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Full-text available
Perceived illness stigma is associated with increased depressive symptoms in youth with inflammatory bowel disease (IBD), but the mechanisms by which stigma influences emotional adjustment remain unclear. It is possible that youth with IBD who are more present-focused and better able to come to terms with aspects of their disease that are less cont...
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Youth with inflammatory bowel disease (IBD) and their parents are at increased risk for psychological adjustment difficulties, potentially due to the uncertain and intrusive nature of IBD. However, empirical investigations have yet to assess the contribution of these unique disease features to adjustment outcomes. Our aim was to examine: 1) the inf...
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Objective: The current study evaluated perceived barriers to care for parents of children with cancer and the mediating effect of illness uncertainty (IU; uncertainty from the ambiguity or unpredictability of the illness) on the relationship between barriers and parental psychological distress. We hypothesized that greater barriers to care would b...
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Objective Youth with inflammatory bowel disease (IBD) often experience difficulties communicating about their disease. It is suspected that the stigmatizing nature of IBD symptoms contributes to youths’ health communication difficulties, leaving youth feeling disconnected from their social environment and potentially resulting in decreased social b...
Article
Purpose: To evaluate demographic, financial, and support predictors of distress for parents of young children with Disorders of Sex Development (DSD) including atypical genital development, and to characterize early parental experiences. This extends our previous findings to identify those parents at risk for distress. Materials and methods: Par...
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Parents of children with disorders of sex development (DSD) report significant psychological distress, including posttraumatic stress symptoms (PTSS), with mothers consistently reporting higher rates of psychological distress than fathers. However, psychological factors contributing to PTSS in both parents are not well understood. The present study...
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Objective: Parents and children affected by pediatric cancer are at risk for psychological distress, including depression, anxiety, and post-traumatic stress. A link is believed to exist between parent and child distress; however, no systematic analysis of this relationship has occurred. A meta-analysis was conducted to assess the relationship bet...
Article
Objective: The objective of this study is to examine parent and youth appraisals of illness uncertainty as potential serial mediators in the relation between disease severity and youth depressive symptoms in adolescents with inflammatory bowel disease (IBD). Methods: Participants were 85 adolescents 13-18 years of age (Mage = 15.75, SD =1.51) wi...
Article
Objective The current study examined associations between child executive functions and parenting capacities in long‐term survivors of childhood acute lymphoblastic leukemia (ALL). Methods Participants included 188 parent‐child dyads; children were at least 8 years of age, 5 years postdiagnosis of ALL, and previously treated with chemotherapy only...
Article
Purpose: Adolescents and young adults (AYAs) with chronic medical conditions are at risk for reduced health- related quality of life (HRQoL). Recent research on AYAs without chronic medical conditions found that greater health care management skills were related to higher HRQoL. In addition, grit, an intrapersonal strength, has been linked to great...
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Objective: Adolescents/Young Adults (AYAs) with a chronic illness display elevated risk for poor psychosocial outcomes, yet relatively little is known about factors that place these individuals at risk. Illness intrusiveness is a known predictor of negative psychosocial outcomes in AYAs. Illness-related stigma, an understudied concept in this popu...
Article
Adverse childhood experiences (ACEs) are consistently associated with deleterious health outcomes in adolescence and adulthood. Although research has implicated health-risk behaviors as a possible link in this relationship, the role of health care management skills has yet to be examined in this context. Transition readiness, defined as health care...
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Background/Aims: Parents of children born with a disorder of sex development (DSD) often experience anxiety, but risk factors, including parental perception of the severity of their child’s DSD, have not been examined. We hypothesized that severity of illness (SOI) ratings would relate to parental anxiety, and would be higher for parents of childre...
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Purpose Little is known about phenotypes, diagnoses and sex of rearing (SR) of infants with atypical genital development in the United States. As part of a multi-center study of these infants, we provide a baseline report from US difference/disorder of sex development (DSD) clinics describing diagnoses, anatomic features and SR. We also aim to dete...
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Objective: To examine the prevalence of adverse childhood experiences (ACEs) and their relationship with psychological distress among adolescents/young adults (AYAs) with and without pediatric chronic medical conditions (CMC). Methods: A matched sample of AYAs with and without a CMC (n = 484, Mage = 19.48, 77.7% female) completed online measures of...
Article
Objective: Caregivers of pediatric cancer patients are at risk for posttraumatic stress symptoms (PTSS). Previous literature has identified caregiver illness uncertainty as a predictor of PTSS, yet little is known about the mechanism by which illness uncertainty may affect PTSS. Rumination, or perseverations about the cause and consequences of an...
Article
Exposure to secondhand smoke (SHSe) can compound an already challenging set of health problems for youth with Sickle Cell Disease (SCD). Exposure to electronic cigarettes may also impact SCD symptomology and respiratory functioning. This study built on these previous findings by a) utilizing two objective measures of SHSe, salivary cotinine and exh...
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Objective: To identify a developmentally relevant factor structure of the Mishel Uncertainty in Illness Scale-Community form (MUIS-C) among adolescents and young adults with chronic medical conditions. Methods: Data on college students with a self-reported chronic medical condition (N = 238) were collected between November 2013 and May 2015. Par...
Article
Adverse childhood experiences (ACEs) are important public health concerns, with links to higher prevalence rates of both health-risk behaviors and physical health difficulties in adulthood. Research has demonstrated an association between early adversity and long-term health-risk behavior development. The current study assessed the role of emotion...
Article
Background How family environment and parental factors affect health status and symptoms in childhood cancer survivors is understudied. We examined the influence of family cohesion, parent distress, and overprotection on child symptom burden and health‐related quality of life (HRQOL) and family strain in survivors of childhood acute lymphoblastic l...
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Background Studies have begun to identify psychosocial factors associated with depressive symptoms in youth with IBD. However, despite considerable speculation in the literature regarding the role of perceived stigma in both social and emotional adjustment outcomes, youth appraisals of stigma have yet to receive empirical attention. The primary pur...
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Introduction: Prior studies of outcomes following genitoplasty have reported high rates of surgical complications among children with atypical genitalia. Few studies have prospectively assessed outcomes after contemporary surgical approaches. Objective: The current study reported the occurrence of early postoperative complications and of cosmeti...
Article
Objective: Adolescents and young adults (AYAs) with chronic medical conditions are at increased risk for a host of negative psychosocial outcomes, including depressive and anxious symptoms. Although studies have shown that illness appraisals (e.g., illness intrusiveness [II] and illness uncertainty [IU]) demonstrate consistent associations with su...
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Obesity is a global epidemic, yet successful interventions are rare. Up to 60% of people fail to achieve clinically meaningful, short-term weight loss (5-10% of start weight), whereas up to 72% are unsuccessful at achieving long-term weight loss (5-10% loss for ≥5years). Understanding how biological, cognitive, and self-regulatory factors work toge...
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Objective: Adolescents are not meeting the recommended guidelines for physical activity. Social support and self-regulatory skills are two factors known to impact physical activity and sedentary behaviour. The study sought to examine how targeting feedback as part of a self-regulatory process could increase physical activity, and the individual who...
Article
Objective: This preliminary study compared a DSM-IV-TR screening tool for posttraumatic stress symptoms (PTSS) with a modified DSM-5 version for parents of children diagnosed with cancer. Methods: Caregivers (n = 101) completed the Brief Symptom Inventory (BSI) and Impact of Event Scale-Revised (IES-R). Five BSI items were added to the IES-R to ass...
Article
Purpose: Provide recommendations for the development of an interdisciplinary care (IDC) clinic for the treatment of youth with disorders/differences of sex development (DSD). DSD consist of a group of complex congenital medical disorders in which the development of chromosomal, gonadal, or anatomical sex is atypical. Youth with DSD require care fr...
Article
Background: Parents of children newly diagnosed with cancer are confronted with multiple stressors that place them at risk for significant psychological distress. One strategy that has been shown to help reduce uncertainty is the provision of basic information; however, families of newly diagnosed cancer patients are often bombarded with educationa...
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The present study examined the impact of asthma-specific thought intrusion (TI) and thought suppression (TS) on two cognitive-affective variables (self-focused attention and fear of negative evaluation) among adolescents and young adults (AYAs) diagnosed with childhood-onset asthma. Participants were 290 AYAs who completed assessment questionnaires...
Article
Disorders/differences of sex development (DSD) comprise multiple congenital conditions in which chromosomal, gonadal, and/or anatomical sex are discordant. The prediction of future gender identity (i.e., self-identifying as male, female, or other) in children with DSD can be imprecise, and current knowledge about the development of gender identity...
Article
Purpose: The current study examined the psychological adjustment of parents of children born with moderate to severe genital atypia 12 months after their child underwent genitoplasty. Materials and methods: Parents were recruited longitudinally from a multi-center collaboration of 10 pediatric hospitals with specialty care for children with a Di...
Article
Objective : To examine the relationship of grit, an intrapersonal characteristic defined by perseverance and passion for long-term goals, to health care management skills and adolescent and young adult (AYA) health-related quality of life (HRQoL). Higher levels of grit were expected to relate to greater health care management skills and HRQoL, and...
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Objective: To examine predictors of psychological functioning in college students with chronic illnesses. Participants: Participants (N = 1413) included 364 students with self-reported diagnoses of asthma or allergies, 148 students with other chronic illnesses (e.g., epilepsy, type 1 diabetes), and 901 healthy students. Data were collected between...
Article
Objective: To conduct a systematic review on the construct of illness uncertainty in caregivers and youth as related to the following: demographic and illness variables, psychological functioning, illness-related distress, and reaction/coping style. Methods: A meta-analysis was conducted with articles assessing the associations between illness u...
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The current study examined the relationship between demographic variables, treatment factors, and perceived barriers-to-care to both caregiver distress and caregiver reported child health related quality of life in caregivers of children diagnosed with cancer utilizing path analysis. Parental distress is examined as a potential mediator between bar...
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Full-text available
To examine illness intrusiveness and parenting stress as potential serial mediators in the relationship between parents’ illness-specific caregiver demand and psychological distress in parents of youth with juvenile rheumatic diseases (JRDs). Sixty-eight caregivers of youth diagnosed with a JRD completed measures of illness-specific caregiver deman...
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Background The birth of a child with a disorder of sex development (DSD) and atypical genitalia can be traumatizing and isolating for families. Parents of children with DSD are at risk for increased levels of psychological distress, including depression, anxiety, illness uncertainty (IU), post-traumatic stress symptoms (PTSS), and impairments in qu...
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Full-text available
Introduction Little data exist about the surgical interventions taking place for children with disorders of sex development (DSD). Most studies that have evaluated cosmetic outcomes after genitoplasty have included retrospective ratings by a physician at a single center. Objective The present study aimed to: 1) describe frequency of sex assignment...