Prospectus Extraction Template

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General Requirements:

Use the following information to ensure successful completion of the assignment:

  • Review the dissertation by Wigton in the course materials for this topic.
  • Locate and download "Prospectus Extraction Template."
  • This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
  • APA style is required for this assignment.

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Complete the "Prospectus Extraction Template" by extracting the components of the prospectus from the Wigton dissertation. Be sure to adhere to length requirements as expressed in the template. See attachments

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Evaluating 19-Channel Z-score Neurofeedback: Addressing Efficacy in a Clinical Setting Submitted by Nancy L. Wigton A Dissertation Presented in Partial Fulfillment of the Requirements for the Degree Doctorate of Philosophy Grand Canyon University Phoenix, Arizona May 15, 2014 UMI Number: 3625170 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. UMI 3625170 Published by ProQuest LLC (2014). Copyright in the Dissertation held by the Author. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, MI 48106 - 1346 © by Nancy L. Wigton, 2014 All rights reserved. Abstract Neurofeedback (NF) is gaining recognition as an evidence-based intervention grounded in learning theory, and 19-channel z-score neurofeedback (19ZNF) is a new NF model. Peer-reviewed literature is lacking regarding empirical-based evaluation of 19ZNF. The purpose of this quantitative research study was to evaluate the efficacy of 19ZNF, in a clinical setting, using archival data from a Southwest NF practice, with a retrospective one-group pretest-posttest design. Each of the outcome measures framed a group such that 19ZNF was evaluated, as it relates to the particular neuropsychological constructs of attention (n = 10), behavior (n = 14), executive function (n = 12), as well as electrocortical functioning (n = 21). The research questions asked if 19ZNF improves these constructs. One-tailed t tests performed, compared pre-post scores for included clinical assessment scales, and selected quantitative electroencephalographic (QEEG) metrics. For all pre-post comparisons, the direction of change was in the predicted direction. Moreover, for all outcome measures, the group means were beyond the clinically significant threshold before 19ZNF, and no longer clinically significant after 19ZNF. All differences were statistically significant, with results ranging from p = .000 to p = .008; and effect sizes ranging from 1.29 to 3.42. Results suggest 19ZNF improved attention, behavior, executive function, and electrocortical function. This study provides beginning evidence of 19ZNF’s efficacy, adds to what is known about 19ZNF, and offers an innovative approach for using QEEG metrics as outcome measures. These results may lead to a greater acceptance of 19ZNF, as well as foster needed additional scientific research. Keywords: Neurofeedback, QEEG, z-score neurofeedback, 19ZNF, EEG biofeedback v Dedication This dissertation is dedicated to my Lord and Savior, Jesus. From my first thoughts of considering a doctoral program being divinely inspired and directed, through to the last step I will take across a graduation stage, the Father, Son, and Holy Spirit are always the center point, the anchor. To that end, three Bible passages capture the experience of my journey. The way of God is perfect, the Lord’s word has stood the test; He is the shield of all who take refuge in Him. What god is there but the Lord? What rock but our God? – the God who girds me with strength and makes my way blameless, who makes me swift as the deer and sets me secure on the mountains (Psalms 18:3033, New English Bible). “Commit your life to the Lord; trust in Him and He will act. He will make your righteousness shine clear as the day and the justice of your cause like the sun at noon” (Psalms 37:5-6). “Not to us, O Lord, not to us, but to thy name ascribe the glory, for thy true love and for thy constancy” (Psalms 115:1). vi Acknowledgments It is only through the Lord’s strength and wisdom that this dissertation came to fruition. Next, I acknowledge the man with whom the Lord has made me one, my husband. You are truly the wind beneath my wings, and without you I would not have had the wherewithal to complete this endeavor. Thank you for all your support and sharing your perseverance for my good. I also wish to acknowledge, with unbounded gratitude, the most perfect dissertation committee possible for this journey. To my chair, Dr. Genomary Krigbaum, words are insufficient to fully express the depth and breadth of my appreciation for your support, guidance, and direction. When I first read descriptions of what the ideal chair would be, with characteristics inclusive of mentor, advocate, role model, teacher, defender, guide, supervisor, coach, encourager, and friend, I wondered if it would ever be possible to find all those elements in one person. Yet in you, I found them all, and more. Por siempre agradecida. Moreover, thank you for encouraging me to build on the methodology you started. To Dr. Daniel Smith, I am grateful that you joined my dissertation team. I knew I could count on you for your statistical expertise, and you did not disappoint. Thank you for the many conversations prior to my dissertation journey, and in helping to pave the way for the best committee possible. To Dr. Genie Bodenhamer-Davis, as a most respected neurofeedback practitioner and educator, I am humbled and honored that you were willing to assist me in my dissertation journey. Thank you, so much, for your counsel over the last 3 years. To Dr. Ron Bonnstetter, thank you for your support in being my adjunct dissertation reader. Thank you for your compliments on my writing and your assurance I have what it takes to succeed as a scholar. vii Table of Contents List of Tables ..................................................................................................................... xi List of Figures ................................................................................................................... xii Chapter 1: Introduction to the Study....................................................................................1 Introduction ....................................................................................................................1 Background of the Study ...............................................................................................2 Problem Statement .........................................................................................................4 Purpose of the Study ......................................................................................................5 Research Questions and Hypotheses .............................................................................6 Advancing Scientific Knowledge ..................................................................................8 Significance of the Study ...............................................................................................9 Rationale for Methodology ..........................................................................................10 Nature of the Research Design for the Study...............................................................11 Definition of Terms......................................................................................................13 Assumptions, Limitations, Delimitations ....................................................................19 Summary and Organization of the Remainder of the Study ........................................22 Chapter 2: Literature Review .............................................................................................23 Introduction and Background to the Problem ..............................................................23 Historical overview of EEG and QEEG. .......................................................24 Historical overview of NF .............................................................................25 How problem/gap of 19ZNF research evolved into current form .................28 Theoretical Foundations and/or Conceptual Framework .............................................31 Foundations of EEG and QEEG ....................................................................31 viii Learning theory as applied to NF...................................................................31 Traditional/amplitude-based models of NF ...................................................33 QNF model of NF ..........................................................................................35 ZNF model of NF...........................................................................................38 Review of the Literature – Key Themes ......................................................................39 QNF in the literature ......................................................................................39 4ZNF in the literature.....................................................................................47 19ZNF in the literature...................................................................................50 Outcome measures for ZNF research ............................................................53 Summary ......................................................................................................................59 Chapter 3: Methodology ....................................................................................................61 Introduction ..................................................................................................................61 Statement of the Problem .............................................................................................61 Research Questions and Hypotheses ...........................................................................62 Research Methodology ................................................................................................64 Research Design...........................................................................................................65 Population and Sample Selection.................................................................................66 Instrumentation ............................................................................................................68 Validity ........................................................................................................................72 Reliability.....................................................................................................................74 Data Collection Procedures..........................................................................................76 Data Analysis Procedures ............................................................................................78 Ethical Considerations .................................................................................................81 ix Limitations ...................................................................................................................82 Summary ......................................................................................................................84 Chapter 4: Data Analysis and Results ................................................................................86 Introduction ..................................................................................................................86 Descriptive Data...........................................................................................................86 Data Analysis Procedures ............................................................................................93 Results ..........................................................................................................................96 Summary ....................................................................................................................103 Chapter 5: Summary, Conclusions, and Recommendations ............................................105 Introduction ................................................................................................................105 Summary of the Study ...............................................................................................106 Summary of Findings and Conclusion .......................................................................107 Implications................................................................................................................113 Theoretical implications...............................................................................114 Practical implications ...................................................................................115 Future implications. .....................................................................................116 Recommendations ......................................................................................................117 Recommendations for future research. ........................................................117 Recommendations for practice. ...................................................................118 References ........................................................................................................................120 Appendix A ......................................................................................................................136 Appendix B ......................................................................................................................137 x Appendix C ......................................................................................................................138 Appendix D ......................................................................................................................139 xi List of Tables Table 1.1. Research Questions and Variables ......................................................................8 Table 4.1. Descriptive Data for All Groups ...................................................................... 91 Table 4.2. Shapiro-wilk Results for Difference Scores .................................................... 95 Table 4.3. Summary of Results - All Groups...................................................................104 xii List of Figures Figure 1.1. Formation of Sample Groups ......................................................................... 13 Figure 4.1. IVA Group Pre-Post Scores............................................................................ 97 Figure 4.2. DSMD Group Pre-Post Scores ....................................................................... 99 Figure 4.3. BRIEF Group Pre-Post Scores ..................................................................... 101 Figure 4.4. QEEG Group Pre-Post Scores ..................................................................... 102 1 Chapter 1: Introduction to the Study Introduction Neurofeedback (NF) is an operant conditioning brainwave biofeedback technique, which is also referred to as electroencephalographic (EEG) biofeedback. This modality, dating back to the 1970s (Lubar & Shouse, 1976; Sterman, LoPresti, & Fairchild, 2010), trains electrical signals of targeted frequencies and involves recording EEG data from scalp sensors with an amplifier, which is subsequently processed by computer software. The software provides visual and sound display feedback to the trainee, thereby providing a reward stimulus when the brain is functioning in the target range. This reward process generates learning such that the brain’s functioning is conditioned in the intended manner. Over the years, new models of NF have been developed, and the most current iteration is a style of NF which is termed z-score NF (ZNF). ZNF is different from more traditional NF models in that it incorporates into the NF session real-time quantitative EEG (QEEG) z-score metrics making it possible to combine operant conditioning with real-time assessment using a normative database (Collura, Thatcher, Smith, Lambos, & Stark 2009; Thatcher, 2012). In 2006, a 4-channel ZNF (4ZNF) technique was introduced, which in 2009 was expanded to include all 19 sites of the International 10-20 System (of electrode placement) to allow for a 19-channel ZNF (19ZNF). To date, case study and anecdotal clinical reports within the field indicate this new 19ZNF approach is an improvement over traditional NF models (J. L. Koberda, Moses, Koberda & Koberda, 2012a; Wigton, 2013). However the efficacy of this new model has not yet been established from empirical studies. This research is different from prior qualitative 2 studies; it has been completed as a quantitative analysis of pre-post outcome measures with group data, and thus, it is a beginning in establishing empirical evidence regarding 19ZNF. The remainder of this chapter formulates this dissertation through a review of the study background, problem statement, purpose and significance, and how this research advances the scientific knowledge. Moreover the research questions and hypotheses are presented, together with the methodology rationale and the nature of the research design. An extended Definition section is included to review the many technical terms germane to this research. Readers unfamiliar with NF or QEEGs may find it helpful to review the definitions first. Finally, to establish the scope of the study, a list of assumptions, limitations, and delimitations are included. Background of the Study In recent years NF has seen increasing acceptance as a therapeutic technique. Current literature includes reviews and meta-analyses which establish a recognition of NF as effective for the specific condition of attention deficit hyperactivity disorder (ADHD) (Arns, de Ridder, Strehl, Breteler, & Coenen 2009; Brandeis, 2011; Gevensleben, Rothenberger, Moll, & Heinrich, 2012; Lofthouse, Arnold, Hersch, Hurt, & DeBeus, 2012; Niv, 2013; Pigott, De Biase, Bodenhamer-Davis, & Davis, 2013). However, the type of NF covered in these reviews is limited to the oldest NF model (theta/beta ratio) and/or slow cortical potential NF. Yet of note are reports in the literature of a different NF model which is informed by QEEG data. This QEEG-guided NF (QNF) is reported to be used for a much wider range of conditions; not only ADHD, but also behavior disorders, cognitive dysfunction, various mood disorders, epilepsy, 3 posttraumatic stress disorder, head injuries, autism spectrum disorders, migraines, learning disorders, schizophrenia, and mental retardation (Arns, Drinkenburg, & Kenemans, 2012; Breteler, Arns, Peters, Giepmans, & Verhoeven, 2010; Coben & Myers, 2010; J. L. Koberda, Hillier, Jones, Moses, & Koberda 2012; Surmeli, Ertem, Eralp, & Kos, 2012; Surmeli & Ertem, 2009, 2010, 2011; Walker, 2009, 2010b, 2011, 2012b). Yet, all the aforementioned models are limited in their use of only one or two electrodes and they also require many sessions to achieve good clinical outcomes. For the above-cited studies the reported average number of sessions was 40.5. Moreover, Thatcher (2012, 2013) reports 40 to 80 sessions to be the accepted norm for these older style models; thus leading to a sizeable cost to access this treatment. However, one of the newest ZNF models shows promise to bring about positive clinical outcomes in significantly fewer sessions (Thatcher, 2013). With 4ZNF there have been reports of successful clinical outcomes with less than 25 sessions (Collura, Guan, Tarrant, Bailey, & Starr, 2010; Hammer, Colbert, Brown, & Ilioi, 2011; Wigton, 2008); whereas clinical reviews and recent conference reports (J. L. Koberda, Moses, Koberda, & Koberda, 2012b; Rutter, 2011; Wigton, 2009, 2010a, 2010b, 2013; Wigton & Krigbaum, 2012) suggest 19ZNF can result in positive clinical outcomes, as well as QEEG normalization, in as few as 5 to15 sessions. Therefore a NF technique which shows promise to bring clinical improvement ...
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College of Doctoral Studies
Prospectus Extraction Template

Introduction
This section briefly overviews the research focus or problem, why the study is worth conducting, and how
the study will be completed.
The recommended total length for this section is one paragraph.


Identify the dissertation topic.

Evaluating 19-Channel Z-score Neurofeedback:
Addressing Efficacy in a Clinical Setting



State whether the study is quantitative or
qualitative.

It has been completed as a quantitative analysis of
pre-post outcome measures
with group data, and thus, it is a beginning in
establishing empirical evidence regarding
19ZNF.



Describe how the study extends prior
research or fills a “need” or “defined gap”
from current literature.

Moreover, NF research needs to include
quantitative methodologies, using QEEG data as an
outcome measure, to
Learn more about the psychophysiological basis of
NF (Gevensleben, 2009). Therefore, a Quantitative
methodology was selected, as opposed to
qualitative, to address this need.
Currently, the available 19ZNF studies are in the
form of qualitative research
(Hallman, 2012; J. L. Koberda et al., 2012a).

Background of the Problem
The background section explains both the history and the present state of the problem and research focus.
The recommended total length for this section is two to three paragraphs.


Identify the “need,” or “defined gap” for
the research study.

Since many studies were based on qualitative
approach, use of quantitative approach would be
able to see if findings can be different.



Discuss how the “need” or “defined gap”
has evolved historically into the current
problem or opportunity to be addressed by
the proposed study.

However, the dearth of scientific literature
regarding 19ZNF limits the information available
to inform that decision making process. Therefore,
it is vital that both NF clinicians and clients have
empirically derived information regarding the

2
clinical value and efficacy of this new NF
technique. Consequently, the problem of this
empirical gap impacts the NF clinician and client
alike.
The goal of this research is to contribute in
providing a first step towards addressing this
research gap.

Theoretical Foundations
This section identifies the theory (-ies) or model(s) that provide the foundation for the research. This
section should present the theory (-ies) or models(s) and explain how the problem under investigation
relates to the theory (-ies) or model(s). The theory(-ies) or models(s) guide the research questions and
justify what is being measured (variables) as well as how those variables are related (quantitative) or the
phenomena being investigated (qualitative).
The recommended total length for this section is one paragraph.


Identify the theory (-ies), model(s)
relevant to the variables (quantitative
study) or phenomenon (qualitative study).

✓ Learning theory as applied to NF
✓ The ZNF theory

Note: quantitative studies should have a
theory for each variable.


Describe how the theories relate to the
research problem.

NF/EEG biofeedback is the process whereby an
individual learns how to change physiological
activity (AAPB, 2011). As Demos (2005) asserted,
biofeedback is a two-way model such that 1) the
physiologic activity of interest is recorded, and 2)
reinforcement is provided each time the activity
occurs; as a result, voluntary control of the targeted
physiologic activity becomes possible. On the
surface, this is a basic descriptor of operant
conditioning.
It is important to note that operant conditioning
relates to the learning of volitionally controlled
responses, motivation is necessary, and rewards
need to be desired or meaningful (M. Thompson &
Thompson, 2003).

Review of the Literature

This section provides a broad, balanced overview of the existing literature related to the
proposed research topic. It describes the literature in related topic areas and its relevance to the
proposed research topic findings. It provides a short one-two sentence description of each
theme/topic, and it identifies the relevance of the literature to the research topic supporting it
with at least one citation from the literature.

3...

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