Dissertations / Theses on the topic 'Mental health diagnosis'
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Sanchez, Phyllis Nancy. "Psychiatric diagnosis vs medical diagnosis: Are mental health professionals aware?" Diss., The University of Arizona, 1989. http://hdl.handle.net/10150/184826.
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For years research has demonstrated a varying incidence of medical disorders manifesting with psychiatric symptoms. A relatively conservative estimate of such so called "medical masquerades" is around 10%. It is important to ascertain whether health care professionals are aware of possible medical masquerades perhaps most especially in a mental health center outpatient setting where non-medically trained clinicians are the first line therapists for treatment in the majority of cases. This study set about to find out how aware three types of health care clinicians (psychiatrists, nonpsychiatrically trained medical doctors, and non-medically trained mental health psychotherapists) are of the prevalence of medical masquerades, and whether these three types of clinicians perform differently on three types of clinical vignettes (psychiatric, somatoform, and medical masquerades). Results revealed that all health care professionals surveyed are aware that there are a percentage of medical masquerades in the clinical population. Results also revealed that the three types of clinicians performed differently on the case vignettes.
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McKeown, Margaret Mary Olive. "Dual diagnosis : a challenge for acute mental health nursing." Thesis, University of Kent, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.420833.
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Flores, Guadalupe Leon Gomez. "Dually diagnosed mental health clients: A comparative study of those receiving treatment in a dual diagnosis program and those receiving only mental health treatment." CSUSB ScholarWorks, 1997. https://scholarworks.lib.csusb.edu/etd-project/1297.
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Platt, Suzanne. "How do people with a mental health diagnosis construct an identity?" Thesis, Canterbury Christ Church University, 2016. http://create.canterbury.ac.uk/14909/.
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Psychiatric diagnosis is used to categorise and treat mental health problems in the UK yet is widely criticised for struggling to convincingly categorise the experience of distress and that it is socially constructed from the culmination of historical and cultural interactions. Service-user accounts are varied and there is a paucity of qualitative research that considers the positive and negative effects of labelling. To understand identity construction in the context of a psychiatric diagnosis, the present study recruited 16 participants from a service-user research group and five focus groups were conducted. Transcripts were studied using Foucauldian Discourse Analysis. Two major identities were detected ‘illness identity’ and ‘recovery identity’. Participants drew on multiple and competing discourses and which placed them in the position of patient and/or survivor. Medical discourses were dominant throughout the focus groups and were used in a way to convey the fluidity of the identity and how they related to their diagnosis. The study’s limitations are discussed, together with implications for clinical practice and future research.
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Montoro, Richard. "The diagnosis of depression in advanced HIV disease /." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=31274.
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Background. Diagnosing major depression in the medically ill is difficult because of the overlap of somatic symptoms between the two entities. No studies have examined this issue in advanced HIV disease. Methods. Male subjects with a CD4 count ≤200 were recruited from a specialised outpatient HIV treatment centre. They completed a 30 minute questionnaire and then participated in a diagnostic interview with an HIV psychiatrist. Results. Eight (19.0%) of 42 subjects were diagnosed with major depression. Both inclusive and exclusive approaches to the diagnosis increased the prevalence to 21.4%. Predictive items on the self-report depression scales were inserted in a logistic regression. Four items pertaining to self-worth, discouragement, crying and irritability were left in the model. All somatic items were excluded. Conclusion. This study is an important first step in devising a self-report instrument that would be useful in detecting clinical depression in patients with advanced HIV disease.
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Soar, Rod. ""Drugs on the mind" : dual diagnosis : the experience of mental health professionals." University of Ballarat, 2003. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/15384.
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Recent publicity has focused on the problems created by the usage of illicit drugs in the community. The growing use of illicit drugs throughout the Grampians region and the lack of resources and professional services available to regional and rural areas raise many questions as to treatment options and the accessibility and appropriateness of drug and alcohol and mental health services. Despite the fact that mental health professionals in rural/regional areas are expected to deliver the most appropriate care to individuals with a comorbid drug and alcohol and psychiatric disorder, a number of these rural/regional mental health professionals have limited preparation and experience in dealing with dual diagnosis issues. This phenomenological study focuses on the area of dual diagnosis, specifically the experiences of health professionals who care for clients diagnosed with a serious mental illness and a coexisting drug and alcohol disorder. Results are described in the form of four themes, which emerged from data collected during in-depth interviews with 13 mental health professionals who care for clients with a dual diagnosis. The themes captured in this research will be described using metaphors as headings. The first theme Sink or swim represents mental health professionals’ initial preparation to care for this group of complex clientele. Treading water symbolises mental health professionals’ endeavours to keep their head above water and reflects on their feelings while endeavouring to do so. Rowing against the tide describes mental health professionals’ understanding of clients’ drug misuse, which impacts greatly on the level of care.Master of Nursing
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Riley, Pamela G. "DSM-5, Asperger's Syndrome Diagnosis, and Mothers' Experiences with Mental Health Services." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6657.
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Mothers who have children with a previous Asperger's syndrome diagnosis had to go through a process to maintain or obtain services for their child when the fifth edition of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5) removed the diagnosis. Prior to and since the release of the DSM-5 in 2013, there has been an expression of concern in the literature about how this diagnostic change would affect services for children with a previous Asperger's syndrome diagnosis. Current research has not sufficiently explored the experiences mothers have had with this process. The purpose of this hermeneutical phenomenological study was to explore the experiences of mothers since this diagnostic change. Data were collected and saturation was reached at 6 participants using semistructured interviews. Interpretive phenomenological analysis was used to interpret the experiences of these mothers which produced 3 main themes related to the process of obtaining a new diagnosis, insurance-funded services, and educationally-funded services. The results included both subthemes and superordinate themes that highlighted the need for more stakeholder education, difficulty navigating systems, the need for advocacy, concerns about new diagnoses and loss of services, and the public's perception and the stigma associated with the Asperger's syndrome diagnosis both before and after this diagnostic change. Study results may assist with improving counselors and other stakeholder's knowledge about the importance of the mothers' experiences when there is a diagnostic change of this nature. Also, counselor educators can instill the importance of diagnostic accuracy and supporting all stakeholders when teaching new counselors.
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Winter, Zuzana. "Impact of the diagnosis of borderline personality disorder and its diagnostic process." Thesis, Canterbury Christ Church University, 2015. http://create.canterbury.ac.uk/14396/.
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Contrary to the long-held assumptions, borderline personality disorder (BPD) is now considered a treatable disorder. Timely assessment has been recognised as one of the key treatment enablers and basic assessment standards have been stipulated by the UK’s National Institute for Health and Clinical Excellence (NICE). The current study was the first to have specifically investigated the quality of the diagnostic process in light of the government recommendations. Interpretative phenomenological analysis was used to analyse semi-structured interviews with eight adult female service users about their lived experiences with the original diagnostic disclosure of BPD. Five master themes and several subthemes featured in the majority of the participants’ experience: a) answer with a question mark; b) if only…; c) BPD like a star sign; d) star signs are not enough; it’s what happens afterwards!; e) being at the mercy of the system. Most participants’ experiences suggested that the original diagnostic process was largely negative and did not follow the national guidelines. Nevertheless, a minority of positive views also emerged. The findings are discussed with reference to the existing literature, whilst also detailing the study’s limitations, clinical and research implications.
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Malchy, Leslie. "Dual diagnosis, the effects of substance abuse on patients with schizophrenia." Thesis, McGill University, 2000. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33426.
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Comorbidity between Axis I mental disorders and substance use disorders range from 5%--60% (Farrell, 1998; Fowler, 1998). It has been suggested that dually diagnosed patients are inadequately treated for both disorders and that they are problematic from a diagnostic, clinical management and economic perspective. Dual Diagnosis (DD) maybe associated with a number of issues including increased aggression, increased non-compliance with medication (Swartz, 1998), and exacerbated psychopathology (Tomasson, 1997). However, contradictory evidence has also been found (Leon, 1998), which suggests that patients with DD may be a higher functioning population of mentally ill patients. The objectives of the present study were to determine the prevalence and clinical characteristics of dual diagnosis patients in a chronic psychiatric population. A sample of 217 patients with schizophrenia spectrum disorders was randomly sampled from the psychiatric facilities of the Montreal General Hospital. Almost half of the sample presented with comorbid addictive disorders; the most common drugs abused were alcohol, cannabis and cocaine. Those patients who had a lifetime diagnosis of substance abuse or dependence were more likely to be male, had a more severe course of psychiatric illness, higher rates of psychiatric symptomology, were more likely to be tobacco smokers and had higher rates of non-compliance with psychiatric medications. Further analyses revealed lower levels of social support and more legal problems in patients with DD, all of which may negatively impact on the quality of care for dual diagnosis patients in the clinical setting.
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Ward, Max O. "Exploring 'dual diagnosis' treatment motivation." Thesis, Canterbury Christ Church University, 2011. http://create.canterbury.ac.uk/10459/.
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Section A reviews the clinical and risk implications of dual diagnosis along with the treatment context. The value of gathering firsthand accounts of service users to inform the planning and delivery of healthcare is touched on. The second part of the paper centres on theories of motivation and how they might be applied to help explain low rates of dual diagnosis treatment uptake and engagement. Finally, gaps in the literature are highlighted with recommendations for further research. Section B There is an emerging evidence base to support the use of integrated approaches that treat co-existing mental health and substance use disorders simultaneously. However, low rates of treatment uptake and engagement remain a concern. To address this, it would seem important to understand dual diagnosis treatment motivation and engagement, an area that has received little attention from the research community. The aim of this study was to explore service users’ and clinicians' understandings of how treatment motivation and its relationship with treatment engagement relate specifically to people with dual diagnosis. Transcripts from semi-structured interviews with four service users and four clinicians were analysed using narrative methodology. The study suggests that the factors underpinning treatment motivation and engagement among people viewed as having dual diagnosis are similar to those thought to be associated with addictions and mental health disorders generally although their relative influence and interaction effect might be different. It is suggested that negative perceptions of services, difficulties with trust, and therapeutic relationship are particularly important issues among dual diagnosis populations. Clinical and theoretical implications of the study are discussed in relation to the literature as well as recommendations for future research. Section C: Critical Appraisal. This paper provides a general overview of narrative research, including strengths and limitations as they relate to this study. With reference to the literature, clinical and theoretical implications are elaborated along with recommendations for future research. The author’s critical self-reflections regarding the process of initiating, carrying out and completing the study are highlighted. Following this, there is a section on the ethical considerations of the study. Finally, the measures taken to ensure the quality of the study and maximise internal consistency are presented.
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Wakelin, Rachel. "Mental health clinicians' perceptions of the diagnosis of bipolar disorder : a Q-study." Thesis, Staffordshire University, 2018. http://eprints.staffs.ac.uk/4905/.
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This thesis was written to fulfil the requirements of the University’s Doctorate in Clinical Psychology. The thesis is made up of three sections: a review of the research literature focused on service users’ experience of psychiatric diagnosis, an empirical paper exploring clinicians’ perceptions of the diagnosis of Bipolar Disorder and an executive summary outlining the study designed for dissemination in clinical practice. The literature review identified four important aspects of mental health diagnosis for service users: whether service users wanted to be told about their diagnosis, the communication of the diagnosis, positive aspects of being given a psychiatric diagnosis and disadvantages of receiving a psychiatric diagnosis. Accuracy, timing and communication of diagnostic feedback were all thought to be important for service users receiving a mental health diagnosis, whilst fostering hope was paramount in positive experiences. The review concluded that service users held a wide variety of different perceptions of psychiatric diagnosis and recommended that clinicians were offered specific training on feeding back a mental health diagnosis to service users. The empirical paper used Q-methodology to explore the subjective viewpoints of mental health clinicians on the diagnosis of Bipolar Disorder. This study noted the mixed literature on the use of the diagnostic label in mental health services and aimed to explore whether clinical practice mirrored the previous research. A total of 19 mental health clinicians completed Q-sorts in which they were asked to rank statements about the diagnostic label of Bipolar Disorder. Three main factors emerged: (1) Seeing the person and their experience, (2) Promoting quality through standardised processes and (3) Understanding the function of diagnostic labels. All three factors agreed that sufficient time should be taken to assess for Bipolar Disorder and that communication using purely the diagnostic label was not helpful. Holding different perspectives on the diagnosis of Bipolar Disorder is likely to make it difficult to provide consistent, high-quality care for service users and it was suggested that services may benefit from better integration of these viewpoints moving forward. The executive summary outlines an overview of the empirical paper that can be disseminated to mental health services.
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Beck, Jonathan S. ""Camouflaging" in Women with Autistic Traits: Measures, Mechanisms, and Mental Health Implications." BYU ScholarsArchive, 2019. https://scholarsarchive.byu.edu/etd/8589.
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Autistic traits are associated with frequent psychological distress and everyday functional challenges. Some individuals with autistic traits “camouflage” these traits during social interactions by effortfully engaging in “typical” social behaviors. Camouflaging seems to be especially common in autistic girls and women. Emerging evidence proposes a role for camouflaging behaviors in poorer mental health and daily functioning. Furthermore, camouflaging efforts may delay receipt of a proper diagnosis and access to appropriate mental health care. Despite their clinical significance, camouflaging efforts remain difficult to quantify, and the mechanisms and impacts of camouflaging are poorly understood. This study aimed to compare multiple methods of quantifying camouflaging, investigate potential mechanisms of camouflaging, and describe mental health implications of camouflaging behaviors.The sample included 66 women (M age = 25:2 years, SD = 6:4; M IQ = 114, SD = 11) who reported social challenges and scored high on a measure of broad autistic traits. A minority (n = 22) had previously received an autism diagnosis. A majority reported significant anxiety, depression, or suicidality. Camouflaging was quantified using three methods: one self-report questionnaire (CAT-Q), and two discrepancy-based methods that contrasted presentation of autistic traits during the ADOS-2 with measures of less-visible autistic traits (AQ, TASIT-S). Analyses showed that the discrepancy-based measures agreed with each other, but not with the self-report measure of camouflaging. Regression analyses showed camouflaging scores were poorly predicted by age, IQ, performance on executive functioning tasks, and self-reported social cognitive abilities. Regression models including clinician-rated and self-reported autistic traits showed that autistic traits on the SRS-2, and camouflaging efforts on the CAT-Q, modestly but significantly predicted psychological distress and functional challenges. Finally, clinician-administered and self-report diagnostic measures demonstrated only fair or poorer agreement with each other in this unique sample that includes women with elevated self-reported camouflaging.Results emphasize the clinical significance of the camouflaging construct, which may predict mental health difficulties in individuals with autistic traits better than conventional autism measures. Quantifying camouflaging remains challenging as various proposed measures disagree with each other. Disagreement on diagnostic classification between measures underscores the importance of comprehensive, multi-method assessment of mental health in women who report difficulties fitting into social situations and who may be camouflaging significant autistic traits.
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Holtgraves, Marnell M. "Diagnosis and schemata : counselors' perceptions and hypothesis-testing strategies." Virtual Press, 1991. http://liblink.bsu.edu/uhtbin/catkey/832991.
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The Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R) published by the American Psychiatric Association (APA) in 1987 is currently the primary tool used by counselors in clinical settings for diagnosing clients' psychological and behavioral problems. Beginning with the third edition of the manual (DSM-III; APA, 1968) a multiaxial process for diagnosis was introduced to encourage a biopsychosocial perspective of client's problems.This study was designed to investigate if alterations in diagnosis on Axis IV and V could further encourage a biopsychosocial perspective. It was designed to imitate the rapid diagnostic process that takes place in many clinical settings. In the present study, the criterion for a biopsychosocial perspective was the maintenance of neutral perceptions and unbiased hypothesis-testing strategies following diagnosis of a client.Twenty-four counseling psychology trainees participated in the study. The counselor trainees diagnosed a client after listening to approximately 20 minutes of an audio-tape of an initial assessment interview. The 12 counselor trainees in the control group diagnosed the client using the standard multiaxial format for diagnosis. The 12 counselor trainees in the experimental group diagnosed the client using an alternative format which encouraged a focus on positive aspects of the client and the client's environment.The counselor trainees completed the Impression Formation Questionnaire to assess their perceptions of the client. They then wrote 12 questions they would ask the client in the next counseling session. These questions constituted their hypothesis-testing strategies for their diagnoses on Axis I and Axis II.The counselor trainees in both groups maintained primarily neutral perceptions of the client as measured by the IFQ. The counselor trainees in both groups favored confirmatory hypothesis-testing strategies when assigned to groups based on their hypothesis-testing strategy score (p < .05).The results of this study indicated that the standard and alternative multiaxial formats for diagnosis may encourage neutral perceptions of a client when counselors must diagnose the client based on very little information. Neither format for diagnosis was successful, however, in discouraging a biased, confirmatory search for information.Department of Counseling Psychology and Guidance Services
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Davies, Karen Patricia. "Mental health diagnoses in persons with an intellectual disability : how health practitioners overcome the challenges." Thesis, University of Canterbury. Psychology, 2015. http://hdl.handle.net/10092/11261.
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Legislative changes in line with changing societal perspectives have resulted in increased service pressure on primary health practitioners to take further responsibility for the assessment and treatment of co-morbid psychiatric disorders in individuals with intellectual disability (ID) and for secondary and tertiary level services to reduce waitlists. The unique attributes of the ID population and a core lack of training for health professionals in the ID field has resulted in a large number of practitioners feeling under-trained and under-resourced to carry out this role effectively, to the potential detriment of the ID population. The challenges health practitioners experience when diagnosing co-morbid mental health disorders in individuals with ID and how they overcome these challenges was explored in this study. Participants were health practitioners of varying professions, including Psychiatrists, Clinical Psychologists and General Practitioners. Health practitioners completed an online survey and/or partook in a focus group or individual interview. The method used in this research was thematic analysis. The study found that health practitioners use holistic and contextual approaches to carry out assessments of individuals with ID, utilise ID specific tools, and liaise with experienced, specialised health practitioners as ways of dealing with the complexity of diagnosing co-morbid mental health difficulties in individuals with ID. In addition, it is recommended that more training in the ID area is provided for health practitioners, particularly for GPs in light of recent policy changes with emphasis of assessment and treatment occurring at the primary health level and for best practice guidelines to be developed. A further research project is suggested, exploring specific challenges facing GPs in this area of practice.
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Hendrickson, Edward Lee. "Characteristics of seriously mentally ill clients who benefit from outpatient dual diagnosis (substance abuse/mental health) group treatment." Thesis, This resource online, 1994. http://scholar.lib.vt.edu/theses/available/etd-01312009-063225/.
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Adeponle, Ademola. "Use of cultural consultation to resolve uncertainty of psychosis diagnosis in ethno-cultural minority and immigrant patients." Thesis, McGill University, 2010. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=95167.
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In North America, ethnic minority patients are at high risk for misdiagnosis of psychosis. A number of care models are in use for delivery of mental health services in multicultural settings, cultural consultation being one. Research on how these models address bias in diagnosis however remains sparse. We analyzed data from a cultural consultation service to determin e the frequency of re-diagnoses and associated factors, and describe the reasoning process used in resolving uncertainty of a psychosis diagnosis. Re-diagnoses occurred in 49% of cases and was more likely in recent immigrants and persons of non-Black ethnicity. A 3-step reasoning process was identified: (1) problematizing the original diagnosis; (2) explaining symptoms in terms of biomedical, psychological or social processes; (3) confirming or re-interpreting the diagnosis of a psychotic disorder. This process sheds light on psychiatric reasoning in complex cases and can be used in refining cultural competence training and service delivery.En Amérique du Nord, les patients issus de minorités ethniques sont à haut risque de diagnostic erroné de la psychose. Un certain nombre de modèles de soins sont en cours d'utilisation pour la fourniture de services de santé mentale dans un environnement multiculturel, de consultation culturelle en être un. La recherche sur la façon dont l'adresse biais de ces modèles dans le diagnostic reste cependant rare. Nous avons analysé les données d'un service de consultation culturelle de déterminer la fréquence de ré-diagnostics et les facteurs associés, et de décrire le processus de raisonnement utilisé dans la résolution de l'incertitude d'un diagnostic de psychose. Re-diagnostics eu lieu dans 49% des cas et était plus élevée chez les immigrants récents et les personnes d'origine ethnique non-Noire. Un processus de raisonnement en 3 étapes a été identifié: (1) problématiser le diagnostic initial, (2) expliquer les symptômes en termes de recherche biomédicale, les processus psychologiques ou sociaux, (3) de confirmer ou de ré-interpréter le diagnostic d'un trouble psychotique. Ce processus met en lumière le raisonnement psychiatriques dans les cas complexes et peuvent être utilisés dans le raffinage de formation des compétences culturelles et la prestation des services. fr
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Pachkowski, Katherine. "The diagnosis of madness: examining conflicting concepts of mental illness and the ethics of care in psychiatry." Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=114569.
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This thesis provides a comprehensive criticism of the current models of understanding and caring for the mentally ill in a western context. I will outline the debates surrounding the conceptualization, diagnosis and treatment of mental illness. The western, psychiatric, biologically based understanding of mental illness is the dominant model of understanding and treating mental illness, despite the evidence that it encompasses an incomplete understanding of the causation and nature of mental illness. I will outline the difficulties in the creation of a cohesive definition of mental illness, including philosophical and cultural perspectives. I will examine the impact of historical, societal and capital pressures on the creation of these definitions. I will describe the practical issues and ethical tensions inherent when a definition or diagnosis of mental illness is created and taken up by mental health practitioners, who use this definition to develop treatment plans for the mentally ill. I will conclude that these issues result in a system of conflicting values which leads to less than ideal care for a uniquely vulnerable population. In this light, I conclude that the exclusive use of the DSM diagnoses as an objective basis for the creation of treatment plans is ethically questionable. I call for a new model of professional practice based on individualized treatment and primarily I call for a reduced focus on diagnosis in the care of the mentally ill.Cette thèse propose une critique complet des modèles actuels de compréhension et d'empathie pour les malades mentaux dans un contexte occidental. Je vais chercher à décrire la compréhension actuelle de l'Ouest et débats entourant le diagnostic et le traitement de la maladie mentale. Le western, psychiatrique, la compréhension fondée sur la biologie de la maladie mentale est augmentation de la prévalence et de l'influence dans le monde. Cependant, je vais montrer que d'autres modèles et de leurs les traitements associés ont le potentiel, et le font souvent, générer améliorée résultats. Je crois que ce que j'appelle le modèle occidental medical de la maladie mentale englobe une compréhension incomplète de la causalité et le traitement de la maladie mentale. Je vais mettre en lumière les problèmes pratiques et des tensions éthiques inhérentes quand une définition ou le diagnostic de la maladie mentale est créé et utilise par les praticiens de santé mentale , qui utilisent cette définition à élaborer des plans de traitement pour les malades mentaux. Je exposer les difficultés dans la création d'une définition cohérente de la maladie mentale, y compris les perspectives philosophiques et culturels. Je vais examiner l'impact des pressions sociétales sur la création de ces définitions. Je vais conclure que le modèle occidental répandue médical, tout en étant utile en tant qu'outil, est imparfait comme une approche exclusive de soins de santé mentale. Cette faiblesse est observé lorsque l'on prend note de la variation incroyable dans le diagnostic et l'expérience de la maladie mentale chez les individus. Dans cette optique, je conclus que l'exclusivité, l'utilisation aveugle des diagnostics comme une base objective pour la création de plans de traitement est éthiquement discutable. Je suggeste à un nouveau modèle de pratique professionnelle basée sur le traitement individualisé et je demande une moindre accent sur le diagnostic dans la prise en charge des malades mentaux.
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Horton, Crystal Ann. "UNDERSTANDING THE LINK BETWEEN SUBSTANCE ABUSE AND MENTAL HEALTH." CSUSB ScholarWorks, 2017. https://scholarworks.lib.csusb.edu/etd/492.
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Treating people with co-occurring or dual diagnosis disorders requires an integrated treatment approach due to the complex health and social needs of people who suffer from mental illness and drug addiction. An integrated approach is not only necessary but crucial to treat both the drug addiction and mental illness concurrently. The aim of this study is to explore the impact that non- integrated care can have on the number of relapses that dually diagnosed people can have. The study found that there is no correlation between concurrent treatment and the number of relapses that dually diagnosed people may have. Social workers will need to be able to recognize mental illness that co-occurs with substance use in order to effectively treat clients to determine what treatment approach should be used. Social workers are trained to use a biopsychosocial approach to capture all aspects of the client’s life. This I especially important for clients that may be dually diagnosed.
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Allmon, Allison Leigh. "To tell or not to tell : disclosing mental health diagnoses to children." Diss., University of Iowa, 2014. https://ir.uiowa.edu/etd/1423.
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This online analogue study examined psychologists' current mental health diagnoses disclosure practices to children. Specifically, this dissertation investigated participants' self reported likelihood to disclose mental health diagnoses in relation to both psychologist (i.e., clinical services provided and years of clinical service) and client (culture, age, cognitive ability) characteristics. Forty-seven certified American Board of Professional Psychology (ABPP) Psychologists were recruited via email listserv for this research. Participants rated their likelihood to disclose mental health diagnoses to vignettes depicting children with varying demographic characteristics: culture, age, and cognitive ability. Participants also responded to open-ended questions exploring their current mental health diagnosis disclosure practices, including the impact of specific diagnoses on disclosure.
Analyses of open-ended questions revealed that psychologists consider the following factors in their decision to disclose diagnoses: (1) child characteristics (i.e., age, culture, cognitive ability, maturity, developmental and functioning level), (2) support (family, social, therapeutic relationship), (3) personal beliefs about disclosure, (4) diagnostic characteristics (e.g., prevalence, public familiarity, current biological evidence, stigma), (5) how to provide a supportive disclosure (e.g., kid friendly language), and (6) potential benefits. Combined open-ended and quantitative results provide empirical support suggesting that psychologists, like psychiatrists and pediatricians, are more likely to disclose diagnoses to: (a) children of an American culture than those of a Chinese-American culture, (b) older (16 years old) children rather than younger children (6 years old), and (c) children with an intellectual ability in the Superior Range rather than those with an IQ in the Borderline Range. Psychologists' years of clinical experience also significantly predicted their disclosure practice. Psychologists with between 13-31 years clinical experience reported more diagnosis disclosure to children than did participants with 32 years or more of clinical service when presented with a client who was of an American decent, 16 years old, or had an intellectual ability in the Superior Range. The services that psychologists provide (i.e., counseling, diagnostic evaluations, or both) did not significantly predict disclosure practices. Taken together, the findings of this study may be the first step to facilitate the development of evidenced based guidelines for the disclosure of mental health diagnoses to children.
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Hayward, Timothy James. "Dual diagnosis substance abuse in Vancouver mental health boarding homes : a need assessment survey." Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/28715.
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This study explores the dual diagnosis substance abuse phenomenon within the context of Vancouver area mental health boarding homes. The target population consisted of thirty-nine mental health boarding homes used by Greater Vancouver Mental Health Services, Mental Health Residental Services. An attempt was made to survey directors (n=37), staff (n=unknown), and residents (n = 422), to: estimate the prevalence of dual diagnosis substance abuse within these homes; look for associations between substance use/abuse and the demographic characteristics of staff, directors, and residents; examine boarding home policies; and to establish what, if any, services should be developed. Questionnaires were completed by twenty-nine directors (78%), twenty staff members (% unknown), and ten residents (3%), from twenty-nine boarding homes with a total resident population of 358. Results indicated that one hundred and fifteen residents (32%) consumed alcohol, and 57 residents (16%) had consumed alcohol during a specified two week period.
Only eight residents (2%) out of a potential 358 (from four different facilities) reportedly had substance related problems during the specified two week period. However, substance abuse was identified in eleven facilities (38%), without referrence to the two week time limitation. Further, staff and directors from fifteen facilities (52%) had at some time tried to get help for a resident with a substance abuse problem. Thus, while very few residents reportedly had dual diagnosis substance abuse problems, a considerably greater number of boarding homes reportedly had problems related to dual diagnosis substance abuse.
Twenty-four directors (86%) and thirteen staff (68%) were interested in receiving a workshop on dual diagnosis substance abuse. It is the recommendation of this author that a drug education program/workshop for boarding home directors and staff be developed through the Greater Vancouver Mental Health Services "dual diagnosis program."Arts, Faculty of
Social Work, School of
Graduate
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Adams, Pamela (Pamela Ann). "Bias in the Diagnosis and Treatment of Gay Males." Thesis, University of North Texas, 1996. https://digital.library.unt.edu/ark:/67531/metadc278199/.
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The purpose of this study was to explore heterosexual bias in the diagnosis and treatment of gay males. Two hundred-fifty (134 males and 116 females) mental health professionals from the Division of Psychotherapy (29) of the American Psychological Association participated in the study. Participants were randomly assigned to one of two case history conditions, which presented a 35-year-old male seeking therapy. Both conditions were equivalent with regards to the presenting problem (i.e., diagnostic symptoms) with the exception of his significant other (i.e., gay vs. non-gay condition). Potential bias was measured through a diagnostic rating Likert scale and a treatment plan questionnaire. Other independent variables that could potentially have an effect on diagnostic ratings were explored, such as gender, year of graduation, and theoretical orientation of the respondents. Results of the statistical analyses failed to confirm evidence of heterosexual bias. Implications for further research and training are discussed.
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Nuttall, L. D. "Personality disorder : no longer a diagnosis of exclusion? : law, policy and practice in Scotland." Thesis, University of Stirling, 2013. http://hdl.handle.net/1893/17417.
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Personality disorder has been and continues to be a contested diagnosis. Those who attract this form of diagnosis have been particularly vulnerable to the effects of stigma and have tended to be excluded from service provision. This thesis provides an examination of how recent developments in law, policy and practice have impacted upon the status of personality disorder as a diagnosis of exclusion in Scotland. The theoretical framework that provides this thesis with its structure is derived from the post-empiricist approach proposed by Derek Layder. This approach seeks to contextualise emergent inductive findings within a broader historical and contemporary analysis. In the case of this research the broader context consists of the interplay between mental health law, policy and practice in the field of mental health and the diagnosis of personality disorder more specifically. The empirical enquiry at the core of this thesis is based upon an analysis of the views, beliefs and expectations of front-line staff (psychiatrists and social workers qualified as mental health officers) involved in the process of assessment and service provision. In addition to front-line staff (n = 27) a range of key informants who were in a position to shed light on the strategic imperatives underpinning recent developments in law and policy were also interviewed. This analysis is contextualised within a review of key developments in law and policy that have particular significance for anyone who may attract a diagnosis of personality disorder. Despite the ostensibly inclusive approach towards those who may attract a diagnosis of personality disorder evident within the Mental Health (Care and Treatment) (Scotland) Act 2003, the reality is a highly selective and very limited inclusion of those who attract this form of diagnosis. The effective inclusion of those who may attract a diagnosis of personality disorder has been obstructed by several key impediments: 1: an insufficiently robust policy framework to drive forward the process of inclusion; 2: residual ambivalence towards the legitimacy of the diagnosis of personality disorder itself and the legitimacy of the claims made upon services by those who may attract a diagnosis of personality disorder; 3: insufficient and inadequately focused resources; 4: service structures that have not been redesigned sufficiently to engage successfully with service users who may attract a diagnosis of personality disorder. As a consequence of these impediments to inclusion, the majority of those who may attract a diagnosis of personality disorder in Scotland are likely to continue to face high levels of marginalisation and exclusion.
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Dannatt, Lisa. "The views of healthcare providers on providing a brief treatment to address methamphetamine use among patients with a dual diagnosis." Master's thesis, Faculty of Health Sciences, 2020. http://hdl.handle.net/11427/32238.
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BACKGROUND: Methamphetamine (MA) use disorder in individuals with severe mental disorders (SMDs) has significant impact on clinical presentation and care. Although treatments exist, these are met by significant challenges. Notably, brief treatments for MA use within the general population have been feasible, acceptable and effective. An individualized, integrated treatment for MA use within a psychiatric inpatient setting would allow adjustment of the treatment according to individual patient needs. It is important to understand the patient needs and potential service barriers to care before formulating a treatment. This study begins to address this gap by seeking to understand the views of healthcare providers on a brief treatment to address MA use among patients with a dual diagnosis. METHODS: Thirteen key stakeholders working with patients with mental disorders including severe mental disorders and co morbid MA use were interviewed using an open-ended semi- structured interview schedule designed to explore their views on a brief treatment for MA use among patients with a dual diagnosis. Interviews were transcribed and the framework approach was used to conduct data analysis. RESULTS: Numerous themes emerged from the data. First, there are multiple risk factors for MA use. Second, this use has a significant impact on multiple aspects of patient presentation and care including individual impacts, family impacts, and impact on care. Third, although treatments for MA use disorders exist, these have significant challenges at multiple levels. Lastly, the integration of a modified brief treatment for MA use in patients with dual diagnosis would be possible if it was adjusted to patient-specific needs within the existing system and if the team adapting the treatment were cognizant of existing and potential challenges. CONCLUSIONS: The adaptation and integration of a brief treatment for MA use among patients with severe mental disorders was considered possible and even necessary if existing and potential challenges were carefully addressed.
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Aslanyan, Alisa L. "Psycho-educational group for family members of adults with a mental health diagnosis| A grant proposal." Thesis, California State University, Long Beach, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1527676.
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The purpose of this project was to locate a potential funding source and write a grant to create a psycho-educational group for family members of adults with a mental health diagnosis. With this program, family members can receive guided and educated support. The additional support they receive will assist them in becoming more supportive to their loved ones who have mental illnesses. The group would take place at Alma Family Services in Long Beach, California. A search was conducted to locate an appropriate funder for this project. The Ralph M. Parsons Foundation had specific criteria about what type of agencies they fund, which was met by the agency and the program.
Individuals who experience mental health challenges face many difficulties during their lives. The support of knowledgeable, understanding, and caring family members may reduce some of life's challenges for individuals who experience mental illness. If funded, the program would benefit families who need psycho-education about mental illness and assistance with mental health questions. The actual submission and/or funding of this grant was not a requirement for the successful completion of the project.
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Gray, Jennie. "Living with a label: an action oriented feminist inquiry into women's mental health." Thesis, Curtin University, 2006. http://hdl.handle.net/20.500.11937/1833.
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Dorothy Smith (1987) says investigations often begin with ‘a feeling of uneasiness’. Smith’s insistence of the importance of starting with women’s standpoint, to redress the way in which women’s lives have been negated or neglected in research, informs the methodological premise of this inquiry. The unease that prompted this project emerged in conversations I had with women diagnosed with a psychiatric disorder whilst working as a practitioner at a women’s health centre. The frequency with which the discourses of biomedicine figured in these women’s narrated experiences engendered a collective commitment to make problematic ‘living with a label’. Loosely connected as mental health service recipients, the women I researched with are often positioned as ‘subject’ to an objective medical gaze. Disrupting dichotomies that these women are accustomed to in clinical settings, and destabilising notions of neutral and detached research, our investigations were contingent, reflexive and relational. Recognising that all were intrinsic to the knowledge production processes, this project was cast in the feminist ‘with’, rather than the ‘on’. Together we explored how women read and respond to a psychiatric diagnosis in their daily lives, to generate understandings that can be used by the women who joined this project. This included close consideration of social relations shaping the lived actualities these women described, and their agency in sustaining and unsettling these.Acknowledging these women’s capacity to have expertise not only as reporters, but as theorists too, experience and analysis were conflated in our explorations of ‘living with a label’. Congruent with feminist philosophy, our methodology had a praxis orientation as well, ‘to produce different knowledge and to produce knowledge differently’ as Patti Lather (2001) suggests. The attendant opportunities to research the process of researching and contemplate how we might participate in change-oriented activities were thus integral to this project. Our experience of researching together, and allowing the ‘researched’ room to know and act, produced possibilities, and also created conundrums, perhaps less frequently encountered in more conventional research – all of which gave rise to celebration!
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Libertin, Maria Nicole. "A Pediatrician's Role in Diagnosis and Treatment of Teenage Depression." NEOMED College of Graduate Studies / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=ne2gs1621946482337814.
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Dominicé, Dao Melissa. "Making sense of illness in the absence of diagnosis : patients' and physicians' narratives of medically unexplained symptoms." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=101113.
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The aim of this study was to improve medical understanding of patients' illness experience and everyday thinking about physical distress, by focusing on patients' and physicians' narratives of medically unexplained symptoms. Semi-structured interviews were held with 16 Canadian and immigrant patients from two primary care clinics in Montreal, and separately with their physician. Detailed content analysis reveals that, despite the absence of diagnosis, both patient and physicians hold complex and dynamic models of illness. Physicians' explanations rely almost exclusively on biomedical constructs, whereas patients' models of illness draw from a much wider range of sources of experience and authority. Despite regular follow-up, physicians have very limited access to the intricate networks of meaning revealed in their patients' interviews. In fact, although there is some common ground of understanding, patients and physicians show low congruence of their models, and much discrepancy in the expected outcome and management. Eliciting patients' illness narratives rather than focusing on narrow biomedical issues offers promising possibilities for physicians to negotiate meaning with their patients. The richness of patients' models provides potential avenues leading out of the clinical impasse of medically unexplained symptoms.
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Love, Patrick K. "Examining the Clinical Utility of Research Domain Criteria in an Outpatient Sample." Thesis, University of North Texas, 2018. https://digital.library.unt.edu/ark:/67531/metadc1157643/.
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This study examined the clinical utility of the recently released National Institute of Mental Health's (NIMH) research domain criteria (RDoC) by replicating and extending earlier work by using a demographically novel sample. Information retrieval and natural language processing of archival clinical records was used to achieve two main objectives: (1) estimate how well the RDoC domains match language used by clinicians by creating domain scores and (2) examine the differences between the DSM's and RDoC's ability to predict treatment outcome using these domain scores and DSM diagnoses. The social systems RDoC category was found to be the strongest predictor of treatment outcome across all diagnostic measures.
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Strohl, DeLeana D. "Differences in characteristics of success for persons with a primary diagnosis of a mental health disorder in urban and rural areas." Connect to this title online, 2005. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1110388262.
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Thesis (Ph. D.)--Ohio State University, 2005.Title from first page of PDF file. Document formatted into pages; contains xii, 168 p.; also includes graphics (some col.) Includes bibliographical references (p. 152-168). Available online via OhioLINK's ETD Center
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Gray, Jennie. "Living with a label: an action oriented feminist inquiry into women's mental health." Curtin University of Technology, School of Social Work and Social Policy, 2006. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=16963.
Full textAbstract:
Dorothy Smith (1987) says investigations often begin with ‘a feeling of uneasiness’. Smith’s insistence of the importance of starting with women’s standpoint, to redress the way in which women’s lives have been negated or neglected in research, informs the methodological premise of this inquiry. The unease that prompted this project emerged in conversations I had with women diagnosed with a psychiatric disorder whilst working as a practitioner at a women’s health centre. The frequency with which the discourses of biomedicine figured in these women’s narrated experiences engendered a collective commitment to make problematic ‘living with a label’. Loosely connected as mental health service recipients, the women I researched with are often positioned as ‘subject’ to an objective medical gaze. Disrupting dichotomies that these women are accustomed to in clinical settings, and destabilising notions of neutral and detached research, our investigations were contingent, reflexive and relational. Recognising that all were intrinsic to the knowledge production processes, this project was cast in the feminist ‘with’, rather than the ‘on’. Together we explored how women read and respond to a psychiatric diagnosis in their daily lives, to generate understandings that can be used by the women who joined this project. This included close consideration of social relations shaping the lived actualities these women described, and their agency in sustaining and unsettling these.Acknowledging these women’s capacity to have expertise not only as reporters, but as theorists too, experience and analysis were conflated in our explorations of ‘living with a label’. Congruent with feminist philosophy, our methodology had a praxis orientation as well, ‘to produce different knowledge and to produce knowledge differently’ as Patti Lather (2001) suggests. The attendant opportunities to research the process of researching and contemplate how we might participate in change-oriented activities were thus integral to this project. Our experience of researching together, and allowing the ‘researched’ room to know and act, produced possibilities, and also created conundrums, perhaps less frequently encountered in more conventional research – all of which gave rise to celebration!
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Larsen, Jack, Bruce Winegar, Jesse Gilreath, and Sarah Hewitt. "Does a Single Item Alcohol Screening Test Improve Rates of Diagnosis/Referral of Alcohol Use Disorder in a Medicare Population with Diagnosis of Depression or Anxiety?" Digital Commons @ East Tennessee State University, 2021. https://dc.etsu.edu/asrf/2021/presentations/73.
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Screening, Brief Intervention, and Referral to Treatment (SBIRT) for alcohol use has been shown to reduce rates of alcohol use across multiple clinical settings, and is routinely recommended by the United States Preventative Services Task Force (USPSTF). In 2005 the National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommended implementing a single item screening question (SISQ) for this purpose. Since then the SISQ has been well validated compared to other tools, such as the Alcohol Use Disorders Identification Test (AUDIT). It has not, however, been well studied in particular populations, such as those with comorbid anxiety and/or depressive disorders. Medicare Annual Wellness Visits present a unique opportunity to study the SISQ because while they do inquire about alcohol use, they do not routinely include a SISQ. Our study seeks to investigate the efficacy of implementation of a SISQ during Medicare Annual Wellness Visits in a residency clinic population with anxiety and/or depressive disorders. Data collection is ongoing and will measure rates of referral to treatment before and after the SISQ is implemented, as well as rates of brief interventions given.
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Gatten, Shauna L. "Clinical differentiation of mental disorders in the eldery : validation of the CAMDEX." Virtual Press, 1993. http://liblink.bsu.edu/uhtbin/catkey/862267.
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The present series of investigations examined the diagnostic accuracy of the Cognitive Examination (CAMCOG) from the Cambridge Mental Disorders of the Elderly Examination (CAMDEX) in the differential diagnosis of various dementing conditions. Specifically, this study examined: (a) the degree to which the CAMCOG would differentiate normal individuals from patients with Alzheimer's Disease (AD) and from those suffering from non-AD dementing conditions, (b) the extent to which the CAMCOG would distinguish between patients suffering from organic dementing conditions, those having functional psychiatric disorders, and normal persons, and (c) whether the CAMCOG would offer an improvement in diagnostic accuracy over a widely used screening instrument (i.e., the Mini-Mental Status Examination, MMSE) when attempting to differentially diagnose dementing patients and normal cohorts.A review of the literature was presented with an emphasis on the difficulties in establishing differential diagnosis, inaccuracies in diagnosis, the importance of improved diagnostic accuracy, and the use of neuropsychological measures in the assessment and diagnosis of patients suffering from dementing illnesses. Further, research relevant to ancillary diagnostic techniques, the various neuropsychologicalapproaches used in evaluating and diagnosing mental disorders in the elderly, and studies investigating the utility of specific cognitive/neuropsychological measures in the differential diagnosis of dementing diseases was presented.The results of these investigations revealed that the CAMCOG provides excellent diagnostic sensitivity and specificity when differentiating normal persons from clinically diagnosed AD patients and when distinguishing between individuals with an organic-dementing condition and normal adults. The CAMCOG was found to be less effective in differentiating AD and non-AD dementia patients and in distinguishing between patients suffering from organic dementia versus specified psychiatric disorders. Finally, the CAMCOG demonstrated a slight improvement in diagnostic accuracy over the Mini-Mental Status Examination. These results were discussed in terms of their support for the utility of the CAMCOG as an excellent screening measure when used to differentiate patients suffering from various dementia-producing disease states and normal persons.Department of Educational Psychology
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Cruz, Miriam E. "What's in a Name? Effects of the "Mentally Ill" Label on Autonomy." Scholarship @ Claremont, 2015. http://scholarship.claremont.edu/cmc_theses/1099.
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Over the past years, mental health has attracted increased attention throughout the world, in the form of initiatives, programs, support groups, etc. all with goals to increase awareness and support of mental health. The stark discrepancy between the vision driving this mental health movement and our reality comes from a basic misunderstanding. While there are both legislative and cultural efforts in place to reform our mental health system, the two must work hand in hand in order to affect substantial change. Rather than producing a collaborative effort, our legislators and society tend to ignore each other, resulting in isolated attempts at reform that are doomed to failure without the support of the other side.
This thesis examines the obstacles that mentally ill individuals face in the U.S. today after receiving formal “mentally ill” diagnoses. In our current system, these individuals face limited options, all of which include a number of steep costs. This thesis proposes a shift toward a more collaborative approach in order to transform the costs and fear of diagnosis into benefits and desire for diagnosis. However, an approach such as the one suggested can only be successful after a fundamental shift in the perception of mental illness occurs. Whether or not such a shift is possible – and if so, how? – is a question too large to explore in the confines of this thesis, but one that the reader should consider.
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Raghavan, Raghu. "An investigation into the needs of people with learning disabilities and mental health disorders (dual diagnosis)." Thesis, Oxford Brookes University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.325262.
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Bishop, James. "The Potential of Misdiagnosis of High IQ Youth by Practicing Mental Health Professionals: A Mixed Methods Study." Thesis, University of North Texas, 2017. https://digital.library.unt.edu/ark:/67531/metadc1062851/.
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The difficulty of distinguishing between genuine disorder and characteristics that can be attributed to high IQ increases the likelihood of diagnostic error by mental health practitioners. This mixed methods study explores the possibility of misdiagnosis of high IQ youth by mental health professionals. Participants were private practice mental health professionals who read case study vignettes illustrating high IQ youth exhibiting characteristics associated with their population. Participants then completed a survey and provided an assessment of the hypothetical client. In the study, 59% of participants were unable to recognize behavioral characteristics associated with high IQ youth unless suggested to them, and 95% of participants were unable to recognize emotional characteristics associated with high IQ youth unless suggested. The results of this study provide much-needed empirical exploration of the concern for misdiagnosis of high IQ youth and inform clinical practice and education.
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McNeil, Joy Nicole. ""I noticed something wrong"| Lived experiences of women of color who faced a protracted journey to diagnosis with lupus." Thesis, Capella University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10258862.
Full textAbstract:
Systemic Lupus Erythematosus (SLE), a systemic autoimmune disease, affects more than one million people within the United States and disproportionately impacts women of color particularly in their childbearing years, 15-44. Research on living with lupus post-diagnosis has expanded within the past decade. While research on SLE is increasing, little is known about the often-protracted journey women of color experience along the way toward diagnosis. The journey to accurate diagnosis is fraught with unexplained symptoms and uncertainty within the women?s spheres of life and influence. Therefore, the following research question arose: What are the lived experiences of women of color aged 22-44 who have experienced a protracted journey toward diagnosis with SLE? Utilizing a qualitative, phenomenological design, the researcher strove to document the lived experiences of 12 women of color who reported the experience of a protracted journey to SLE diagnosis of 6 months or more. The women were recruited from various methods of contact including message boards, lupus support groups, and social media. After recruitment and informed consent measures, interviews were conducted and transcribed. The coding and analysis of the interviews revealed the presence of various individual textural and structural themes involving aspects of the wait for answers: recurrent symptoms, significance of family, lack of answers from healthcare providers, work, uncertainty of life, desiring normalcy, and pain. Three themes overlapped throughout the interviews: Ambiguity while accessing the medical community, family matters and pushing through. The findings reveal the physical, psychological, and relational complexity surrounding the protracted journey to diagnosis and how the individual journey and collective experiences can aid healthcare professionals, lupus patients and their caregivers in timely, accurate, patient-centered care. Recommendations include further research on SLE and protracted diagnosis, the development of practical steps towards the empowerment of patients within the autoimmune community, and a call for more women in research and clinical trials that contribute toward the overall improvement of women?s healthcare.
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Stewart, Valerie Michelle. "The use of the Positive and Negative Syndrome Scale to assess psychiatric symptomatology in a mixed-diagnosis sample." Diss., The University of Arizona, 2001. http://hdl.handle.net/10150/289728.
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The Positive and Negative Syndrome Scale (PANSS) has long been widely used to assess the extent and severity of psychiatric symptomatology in research studies with samples diagnosed with schizophrenia, particularly in pharmacological studies. Recently it was used in a federally funded multisite study with a mixed-diagnosis sample of persons with serious mental illness. Though numerous factor analytic studies of the PANSS (both exploratory and confirmatory) have been undertaken in samples with schizophrenia, its use in mixed-diagnosis samples characteristic of those encountered in research on psychiatric rehabilitation has not been much studied. This paper reports on a series of confirmatory factor analyses undertaken to explore the fit of various models found in the schizophrenia literature to data from the more heterogeneous multisite sample. Two of the models tested attained marginal fit to the data (using the conventional fit criteria of CFI > .90 and RMSEA), however, both failed to represent a broad range of symptoms because they incorporated only a few PANSS items. An alternative model was developed using all 30 PANSS items and tested using parceling to improve item fit. This 5 factor model demonstrated adequate fit to the data. These findings are discussed in light of the need for a model that fits a mixed-diagnosis sample.
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Jan, Farida. "Effectiveness of recovery-focused mental health care of older people with memory problems." Thesis, University of Hertfordshire, 2015. http://hdl.handle.net/2299/15486.
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Introduction: Dementia is a syndrome due to disease of the brain, usually of a chronic nature, in which there is disturbance of multiple higher cortical functions including Memory, Comprehension, Thinking, Judgment, Orientation, language and communication skills and abstract thinking. It is one of the most challenging disorders both in terms of prevalence and economic burden. There are currently approximately 800,000 people with dementia in UK and national cost is 17 billion per year. It is estimated that in next thirty years, number of people with dementia will increase to 1.4 million and the national cost will be over 50 billion. The exceptional advances in modern medicine in terms of prolonging life expectancy do not necessarily improve the care delivered to people with dementia. Dementia is a progressive condition where clinical recovery is not possible despite the discovery of cognition enhancing drugs. This belief leads to low expectations that tend to erode hope and foster indignity. Advances in treatment of Alzheimer’s disease have, however, stimulated new thinking and methods of service delivery. At certain stage of their illness, if not from the very beginning, personal, and social recovery becomes more meaningful for service users than their clinical recovery. Objective: To investigate whether recovery-orientated psychiatric assessment and therapeutic intervention enhances the wellbeing of people with memory problems and their family carers. Method: This study was a preliminary randomised control study. Patients were randomly allocated to recovery focus group or treatment as usual group acting as the control. Participants in the recovery focus group received a recovery-focused pre-diagnostic wellbeing assessment and counselling, diagnostic consultation with written feedback and post-diagnostic support over a period of six months. Participants in both groups were assessed using the WHO Wellbeing Index (WHO-5) as the primary outcome measure. The Mini Mental State Examination, Cornell Scale for Depression in Dementia, EuroQol-5D and Zarit Burden Interview were used as secondary outcome measures. Written records of the narrative accounts of participants in the recovery focus group were also obtained. Results: 48 patients with early dementia were recruited and agreed to take part in the study. Out of these, 34 patients completed the study, of which 17 patients were in the recovery focus group and 17 patients were in the treatment as usual group (control).There was a significant difference between the groups in terms of greater improvement in wellbeing as rated by the WHO – 5 Wellbeing Index in the recovery focus group compared to the control group. The secondary outcome measures in the areas of cognition, quality of life and caregiver burden showed no differences between the groups. However, case histories from the recovery focus group identified the main areas of improvement in improved mood, increased social interaction, reduction in carer strain and/or burden and improved self-worth and/or confidence. Conclusions: This study shows that recovery focused care can enhance the wellbeing of people with mild to moderate dementia. The additional benefits perceived by the patients and their relatives /carers include improvement in mood symptoms, social interaction and confidence as well as reduction in carer burden and strain.
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Forsyth, Angus Stirling. "Community mental health team's constructions of service users with a diagnosis of borderline personality : an ethnographic study." Thesis, Northumbria University, 2011. http://nrl.northumbria.ac.uk/1623/.
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The psychiatric diagnosis of Borderline Personality Disorder (BPD) leads to service users experiencing stigmatising and disempowering attitudes from professional mental health staff. To date, a nursing theory has not been developed to understand mental health nurses’ personal and professional constructions towards service users with this diagnosis. The development of such theory may enable improved service user engagement, collaboration and recovery for this group of individuals. This study answered the questions of determining the nature of mental health nurses’ beliefs towards service users with a diagnosis of BPD and how these beliefs affect their therapeutic relationships with this service user group. An ethnographic approach was used in this study. Data was collected using a combination of observation of the patient assessment and allocation meeting within a community mental health team; and ethnographic interviews with named nurses for service users with a diagnosis of Borderline Personality Disorder. A reflective journal was also kept by the lead researcher. N-Vivo Version 7 was used to aid data analysis and this involved examining the scripts for repetitive patterns or sequences including descriptions, figures of speech, metaphors etc. in order to illuminate differences between different practices and contexts. Findings from the study elicited a model of how CPNs construct BPD categorisations and a potential pathway to alienation is described together with recommendations for the development of CMHTs and CPNs when working with BPD. Development of reflexive practice can be a vehicle for developing alternative constructions of BPD and recovery informed practice can reduce stigmatising practices experienced by service users with BPD.
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Burchett, Nicole. "Receiving a mental health diagnosis : an exploration of service users' experiences and staff responses to emergent themes." Thesis, Cardiff Metropolitan University, 2018. http://hdl.handle.net/10369/9916.
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In recent years, the personal and financial cost of mental illness has gained attention in the UK. Research indicates mental illness will affect one in four of the population at some point in their lives. This statistic is recognised in the increasing pressure on mental health services, which have historically been underfunded. Rhetoric surrounding the lack of investment, has led to a drive to ensure parity of esteem between physical and mental health services. To achieve full parity, it is essential this translates into the field of research. Although literature on mental illness is vast, the specific experience of receiving a mental health diagnosis has received little attention. This is an area of importance as it is an experience that can change people’s lives and impact on their identity. The current research, based in South Wales, gave voice to both service users and staff. Therefore it contributes to the knowledge base on the experience of receiving a diagnosis from two perspectives. This is achieved through the implementation of a novel concurrent multi-method design that incorporates a Research Advisory Panel of people with lived experience of mental illness. In-depth interviews and Interpretative Phenomenological Analysis were used to capture the experience of the service user (Study 1). Emergent themes from this analysis were taken to staff focus groups and Thematic Analysis was conducted (Study 2). Study 1 findings evidenced the ‘bitter sweet’ nature of receiving a diagnosis, where support could be accessed but diagnosis did not mean cure and was accompanied by stigma. Study 2 indicated staff were aware of the service users’ journey, however they highlight the problems in the healthcare system that led to difficulties in fulfilling their roles and supporting recovery. Synthesising these two sets of findings resulted in ‘Recommendations for practice’ which emphasised: the importance of the relationship between the service user and staff, the opportunity at diagnosis to positively ‘frame’ new knowledge and the need for a community approach to mental illness.
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Scott, Annmarie M. "COMORBIDITY OF ALCOHOL AND MENTAL HEALTH: ADDRESSING ACCESS TO DUAL DIAGNOSIS TREATMENT CENTERS AND THE PERCEIVED EFFECTIVENESS." CSUSB ScholarWorks, 2017. https://scholarworks.lib.csusb.edu/etd/531.
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The purpose of this study was to examine the comorbidity of substance
use disorders and mental illness: Addressing access to dual diagnosis treatment centers and the correlation of perceived effectiveness. The research project was conducted in collaboration with California State University, San Bernardino, (CSUSB) and the Master in Social Work Program. The study used a survey designed with items that measured the participant’s perception of availability and effectiveness of dual diagnosis treatment centers. A quantitative study was conducted using a fixed choice response and data was analyzed on an interval measurement scale. Frequencies and cross tabulations were used to present participant’s answers. 86.7% of respondents perceived that they benefited from a dual diagnosis treatment center. All respondents perceived they were better equipped to manage their alcoholism after treatment, were better equipped to manage their mental illness after treatment, and better equipped to be a contributing member of society after treatment. The findings of this research may contribute to social work's knowledge of treating comorbidity by providing insight into the factors that contribute to individual's effectiveness in regards to post dual diagnosis treatment.
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Yoder, Roger. "Evidence-Based Diagnosis of Posttraumatic Stress Disorder Using Quantitative Electroencephalography." ScholarWorks, 2020. https://scholarworks.waldenu.edu/dissertations/7779.
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Diagnosing post-traumatic stress disorder (PTSD) is challenging and is currently, diagnosis through self-administered checklists. Because a diagnosis of PTSD can open up significant benefits to compensation, education, and medical care, people can tailor their responses to the checklist to help ensure a diagnosis of PTSD. The purpose of the study was to examine the utility of the quantitative electroencephalograph for diagnosing PTSD. Frequency and presence of biomarkers and alpha brain wave symmetry in the frontal and parietal lobes were examined. Research questions involved examining the presence of alpha wave imbalance across the frontal lobe and between the right and left parietal lobes. A secondary data analysis was conducted using data from 108 subjects; these data included records from those with and without a PTSD diagnosis. The results of logistic regression showed that 63% of the clients diagnosed with PTSD were correctly identified and between 7% and 8% of the variance in PTSD was accounted for by frontal lobe asymmetry. The parietal lobe imbalance correctly classified PTSD in 59% of the patients and it identified 3.5–4.9% of the variance, suggesting that asymmetry in the frontal and parietal lobes should not be used as the primary method for diagnosing PTSD. Implications for social change include identifying an objective diagnostic tool that can potentially decrease the possibility of inaccurate diagnoses based on self-reported symptoms. This could lead to eliminating some of the shame and embarrassment veterans and first responders feel toward seeking help for PTSD.
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Bullock, Joseph Edward. "Mental Health and Substance Abuse Professionals' Attitudes Toward Dually Diagnosed Clients in a Community-Based Treatment Center." Diss., Virginia Tech, 2002. http://hdl.handle.net/10919/26713.
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Mental health and substance abuse treatment systems have a history of incompatible philosophies and conflicts that have been associated with poor treatment outcomes for persons dually diagnosed. The purpose of this study was to determine whether or not there are differences in attitudes between mental health and substance abuse professionals toward the dually diagnosed client and whether or not academic discipline, levels of training and experience, occupation, and amount of contact affect the attitudes of these professional groups. A non-experimental survey research design was used for this study, and data were collected by means of a revised Opinions About Mental Illness (OMI) survey instrument and supplemental demographic questionnaire.
The modified OMI instrument was piloted by a panel of subject matter experts experienced in the treatment of persons who are dually diagnosed in which they rated each item for favorableness to concepts of dual diagnosis. The modified OMI survey and a demographic questionnaire were administered to a sample consisting of mental health and substance abuse professionals employed at a local community mental health center. A total of 86 respondents representing 95% of the sample population completed the modified OMI survey and demographic questionnaire.
Data were analyzed using descriptive, independent sample t-test, and multiple analysis of variance (MANOVA) statistics. Results revealed no statistically significant differences in attitude between mental health and substance abuse professionals toward dually diagnosed clients. Analysis of the independent variables academic discipline, level of training and experience, occupation, and amount of contact demonstrated no significant interaction effects between mental health and substance abuse professionals. Despite the absence of statistically significant differences in attitude between the mental health and substance abuse professionals, the similarities may be significant in terms of the psychological value for building positive relationships. The atmosphere of agency culture and the significance of co-location of mental health and substance abuse professionals were also potentially important factors in the outcome of the present study.Ed. D.
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Karlsson, Lotta. ""Det värsta som finns är när folk säger att: Du kan bara du vill.." : en kvalitativ studie om hur personer med ADHD- diagnos skapar strategier för en hälsofrämjande livssituation." Thesis, Högskolan Kristianstad, Sektionen för hälsa och samhälle, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-10580.
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Den psykiska hälsan har stor betydelse för vårt välmående och ur folkhälsoperspektiv är det viktigt att plocka fram friskfaktorer som bidrar till ökad livskvalitet. ADHD, som är ett neuropsykiatriskt funktionshinder med svårigheter att reglera sitt beteende, är inget okänt fenomen och det är många som lever med det. Tidiga stödinsatser hjälper dessa individer till ett väl fungerande liv utan samsjuklighet, utanförskap, missbruk eller kriminalitet. Syftet med studien är att få en uppfattning om hur det är att leva med en ADHD- diagnos, vilka strategier som de utformat för att behålla hälsan. Detta undersöktes genom en kvalitativ studie med en semistrukturerad intervju. Intervjuguiden innehöll frågor som delades in i tillhörande teman. Materialet hanterades sedan utifrån kvalitativ innehålls analys. Sju informanter var intresserade av att ställa upp varav två senare lämnade återbud. Resultaten visade att informanterna var nöjda med en ställd diagnos som de fått genom utredning inom psykiatrin. Detta ledde till en självinsikt och strategier började utformas för att kunna hantera sin situation. Studien har påvisat att informanterna gemensamt önskade att stöd och insatser borde sättas in betydligt tidigare än vad de gör i nuläget och att en lösning på det är ökad kunskap och förståelse i omgivningen. Även genusperspektivet lyftes och informanterna var eniga om att de upplevde skillnader i beteendet mellan könen vilket ledde till att prognosen för flickorna försämrades jämfört med pojkarna. Ett samarbete mellan olika aktörer i samhället borde prioriteras för att säkerställa denna grupps förutsättningar för en god hälsa och ett fungerande liv. Ökad förståelse och kunskaper i funktionshindret är avgörande för de som har ADHD men minst lika viktigt är att omgivningen delar den.
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Lewis, Eliza Grug. "A mixed methods study of mental health and wellbeing in different UK undergraduate student populations." Thesis, Royal Veterinary College (University of London), 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.701656.
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Mohr, Caroline 1952. "Behavioural and emotional problems in adults with intellectual disability : the developmental behaviour checklist for adults." Monash University, Dept. of Psychological Medicine, 2003. http://arrow.monash.edu.au/hdl/1959.1/5588.
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Fisher, Bari S. "Development, diagnosis and treatment of post traumatic stress disorder and the Vietnam veteran population." PDXScholar, 1986. https://pdxscholar.library.pdx.edu/open_access_etds/3596.
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Over the past 15 years, mental health professionals have seen an increasing number of Vietnam combat veterans suffering from stress disorders resulting from the trauma of combat and continued exposure to life threatening situations. Prior to 1980, professional repudiation of and hostility toward Vietnam veterans and toward a clinical reality of Post Traumatic Stress Disorder was common while nondiagnosis and nontreatment was prevalent
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Fawcett, David. "Mental Health Treatment for Children and Adolescents: Cost Effectiveness, Dropout, and Recidivism by Presenting Diagnosis and Therapy Modality." BYU ScholarsArchive, 2012. https://scholarsarchive.byu.edu/etd/3860.
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As many as one in five children and adolescents may suffer from a mental health disorder, yet there are barriers that often prevent children from receiving optimal treatment. The current study explores the influence of practitioner license type, therapy modality, diagnosis, age, and gender on mental health therapy for children and adolescents. Data was provided by Cigna, a leading health care insurance provider in the United States. Participants include 106,374 boys (53.2%) and 93,753 girls (46.8%) ages 3 to 18 (M = 12.1, SD = 3.9) who were treated in outpatient facilities throughout the United States of America. Results indicate that there are differences in dropout, recidivism, cost, and treatment length by provider license, therapy modality, diagnosis, age, and gender. Specifically, results suggest that marriage and family therapists have the lowest percent recidivism and are among the lowest in terms of dropout and cost effectiveness. The results also suggest that family therapy is more cost effective than individual or mixed therapy and that mixed therapy has a much lower percent dropout than individual or family therapy. Analysis by diagnosis suggests a potential severity scale based on dropout, recidivism, and number of sessions. There are also significant differences in dropout and recidivism by age suggesting that younger children are more likely to dropout of treatment. These results provide valuable information about mental health treatment of children and adolescents. Specifically, utilizing a family based approach may help reduce the total length of treatment while utilizing a mixed mode approach to therapy may help reduce the risk of dropout from treatment. Also, some diagnoses appear to be more difficult to treat, with higher percentages of dropout and requiring more time and money for successful treatment. Limitations and future directions are discussed.
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Clyde, Matthew. "Indicators of Cessation Outcome for Treatment-Seeking Smokers with and without a Lifetime Diagnosis of Mental illness: The Impact of Cessation Self-Efficacy." Thesis, Université d'Ottawa / University of Ottawa, 2019. http://hdl.handle.net/10393/39104.
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Smoking remains a leading cause of disability and mortality worldwide. Despite declining rates of smoking in developed countries, smoking prevalence remains high, and there is evidence that it has plateaued in recent years. Individuals with a comorbid psychiatric diagnosis represent a disproportionate percentage of those who continue to smoke and are particularly at-risk given they smoke at higher rates and consume more cigarettes compared to those with no diagnosis. Moreover, these individuals are often excluded from clinical trials of smoking cessation, making it difficult to generalize results of previous intervention studies. In the general literature of smoking cessation, smoking cessation self-efficacy, or one’s confidence in their ability to abstain from smoking, is a consistent predictor of positive abstinence outcomes. The overall purpose of this dissertation was to investigate smoking cessation self-efficacy as a predictor of abstinence outcomes in a population of treatment-seeking smokers with and without a history of psychiatric illness. To accomplish this, articles 1 and 2 investigated the psychometric properties of a multi-item measure of cessation self-efficacy. This entailed comparing the measure to other indices of smoking, and conducting a confirmatory factor analysis to ensure factor invariance and equivalence of the measure regardless of psychiatric status. We found a moderate correlation between our multi-item scale to a single-item measure of confidence to quit, as well as support for both the original two-factor model as well as a three-factor model, which explained 79.3% of the variance. Our results also supported the measure as being factor invariant across psychiatric diagnoses. Next, articles 3 and 4 investigated how this measure of cessation self-efficacy predicted several smoking outcomes (10-, 22- and 52-weeks following target-quit date), and whether this relationship was mediated by concurrent smoking and other interpersonal-indices of smoking cessation (nicotine withdrawal, negative affect). In article 3, we found support for a bidirectional and reciprocal relationship between smoking cessation self-efficacy and smoking status. While changes in concurrent behavior (smoking or abstinent) did impact subsequent evaluations of self-efficacy, the inverse was also true. Moreover, both concurrent smoking and cessation self-efficacy predicted outcomes at week 10. Article 4 built on this framework and investigated this relationship at 22- and 52-weeks post-target quit-date. Our results highlight the robust association between cessation self-efficacy and abstinence. Higher cessation self-efficacy was positively associated with better abstinence outcomes, even after controlling for concurrent smoking, withdrawal, and negative affect. Further, there was evidence that cessation self-efficacy partially mediated the impact of withdrawal and negative affect. In our fully adjusted model (adjusting for demographic characteristics, baseline smoking levels, withdrawal and negative affect), cessation self-efficacy along among the interpersonal-determinants predicted abstinence outcomes (Odds ratio = 1.078, 95% confidence interval (1.068 - 1.089). This was true for those with either a current, past, or no lifetime psychiatric diagnosis, and despite the finding that individuals in the lifetime (current or past diagnosis) category experienced overall lower self-efficacy. Overall, our results support the value of cessation self-efficacy as an important indicator of abstinence outcomes, and particularly highlight its potential utility for at-risk populations of comorbid psychiatric smokers.
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Cunningham, Brian Stewart. "Treatment outcomes of the augmented board and care system for the mentally ill: Focus on post-placement and diagnosis." CSUSB ScholarWorks, 1999. https://scholarworks.lib.csusb.edu/etd-project/1807.
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