Dissertations / Theses on the topic 'Psychiatry – Research'
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Gilbody, Simon Martin. "Outcomes measurement in psychiatry : a critical review of patient based outcomes measurement in psychiatric research and practice." Thesis, University of York, 2001. http://etheses.whiterose.ac.uk/9753/.
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Bjørngaard, Johan Håkon. "Patient satisfaction with outpatient mental health services - the influence of organizational factors." Doctoral thesis, Norges teknisk-naturvitenskapelige universitet, Det medisinske fakultet, 2008. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-2227.
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Pasienttilfredshet med polikliniske tilbud i det psykiske helsevernet – betydningen av organisatoriske faktorer Pasientenes opplevelse og tilfredshet med behandlingstilbudet har i økende grad blitt vektlagt ved evaluering av tjenester til mennesker med psykiske lidelser. Systematiske målinger av brukererfaringer i det psykiske helsevernet skal inngå som en av flere kvalitetsindikatorer for spesialisttjenesten. Dette skal blant annet gi brukerne beslutningsgrunnlag for å kunne velge hvor man ønsker å behandles, fagfolkene innspill til egen kvalitetsutvikling og staten nødvendig styringsinformasjon. Hensikten med avhandlingen var å undersøke i hvilken grad organisatoriske forhold har betydning for pasientenes tilfredshet med behandlingstilbudet. Resultatene i avhandlingen bygger på analyser av data fra flere større undersøkelser med spørreskjema til pasienter om deres erfaringer med det psykiske helsevernet. Samlet sett viser resultatene at misnøye eller tilfredshet med tjenestetilbudet i liten grad var avhengig av hvor behandlingen fant sted. Det vil si at pasientene var fornøyd eller misfornøyd relativt uavhengig av hvor de ble behandlet. For eksempel blant pasienter i poliklinikker for voksne kunne bare om lag to prosent av variansen i tilfredshet knyttes til hvilken behandlingsenhet som sto for behandlingen. Resultatene viste også at ulike mål på den psykiske lidelsens alvorlighet var assosiert med pasienttilfredshet, noe som vil ha betydning ved sammenlikning av behandlingsenheter med til dels ulike behandlingsoppgaver. Avhandlingen viser at aggregerte mål for pasienttilfredshet har klare begrensninger som indikator på organisatorisk kvalitet. Det er grunn til å tvile på om gjennomsnittlig tilfredshet ved for eksempel en poliklinikk er egnet som styringsinformasjon. Det synes som om metoden i liten grad er egnet til å identifisere poliklinikker med dårlig kvalitet og det er også usikkert om de poliklinikkene som metoden beskriver som dårlige, faktisk er dårlige. Kandidat: Johan Håkon Bjørngaard, Institutt for samfunnsmedisin Veiledere: Jon Magnussen, Torleif Ruud og Svein Friis Finansieringskilde: Rådet for psykisk helse og Stiftelsen Helse og Rehabilitering
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Cahill, John. "Using the concept of complexity to guide translational research in psychiatry." Thesis, University of Huddersfield, 2018. http://eprints.hud.ac.uk/id/eprint/34543/.
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The presented work unites several distinct lines of research, asserting that the broader construct of complexity (with its various connotations) may be uniquely relevant and informative to our understanding and management of psychotic disorders. Part 1 outlines the candidate’s contributions to the development of EEG methodology in clinical populations in an effort to most directly capture neural noise and complexity. The advent of oscillatory analysis facilitated the study of ongoing background activity of the EEG. Further exploration of this background activity demonstrated that increased neural noise (as quantified by Lempel-Ziv complexity) is highly correlated with, and conceptually very relevant to, positive symptoms of psychosis. Part 2 describes how considering the complexity of clinical psychosis states justifies the use of human laboratory studies using psychotomimetic drugs such as tetrahydrocannabinol and ketamine. Part 3 explains how the ideas and inferences from the work in Parts 1 and 2 can inform the environment of psychotic disorders, specifically the candidate’s work in prescribing practices and first episode psychosis service design. The thesis concludes that EEG studies of clinical populations face particular methodological challenges, however the resultant technical advancements have expanded our view of neural function to the particular benefit of our understanding of psychosis. EEG measures of complexity may be amongst the most sensitive biomarkers associated with positive symptoms, however more empirical research is called for to confirm this observation. Human laboratory studies of psychotomimetic drugs in healthy humans may continue to prove useful, in circumventing the phenomenological and patho-etiological complexity of clinically occurring psychosis. As a next step, multi-modal studies (combining biophysical signals, individual phenomenology and even population level outcomes) in combination with data mining techniques might further characterize the complexity within psychosis. Psychotic disorders, as complex problems, warrant framing and intervention informed by complexity.
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Thomas, Rhys Huw. "Phenotyping paroxysmal conditions to empower genetic research." Thesis, Cardiff University, 2012. http://orca.cf.ac.uk/44849/.
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I describe the process of preparing cohorts of individuals with two paediatric onset paroxysmal disorders – hyperekplexia and juvenile myoclonic epilepsy – for second generation sequencing. This involves: i) listening to the individual; ii) identifying subgroups; iii) using non-‐core features to create subgroups; iv) and assessing the importance of copy number variation. Using focus groups and an interpretative phenomenological approach clinicians and people with epilepsy produced 398 questions focused on epilepsy treatment. The most important themes for the professionals were – teatment pogrammes or non-‐epileptic attack disorder and concerns about side effectsinutero.For patients cognitive drug side effects and managing the consequences of drug side effects were most important. Studying ninety-‐seven individuals with hyperekplexia confirmed that all gene-‐positive cases present in the neonatal period and that clonazepam is the treatment of choice (95% found it efficacious). Patients with SLC6A5 and GLRB mutations were more likely to have developmental delay (RR1.5 p<0.01; RR1.9 p<0.03) than those with GLRA1 mutations; 92% of GLRB cases reported a mild to severe delay in speech acquisition. Juvenile myoclonic epilepsy is challenging to subdivide based on seizure and EEG features. The neuropsychological profile of limited number of patients 39) as examined in great detail including tests Q WAIS), emory TYM,WMS),executive function (BADS, DKEFS), affect (HADS). TYM was as sensitive as a full WMS for identifying cognitive errors and the zoo map and key search tests were performed particularly poorly. Personality profiling (EPQ-‐BV) identifies the cohort as having high levels of neurotic and introvert traits. Three atypical ‘hyperekplexia’ cases had alternative diagnoses suggested by copy number analysis. The juvenile myoclonic epilepsy patients had an 8% frequency of recognised pathogenic CNVs– but no recurrent variants were identified.A number of non-‐epilepsy related findings were identified including a potentially preventable cause of SUDEP.
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Rawlings, Nancy. "The role of the 5-HT2C receptor in emotional processing in healthy adults." Thesis, University of Oxford, 2010. http://ora.ox.ac.uk/objects/uuid:9bb98eb2-b753-466e-bec2-b199ad14ea34.
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Serotonin (5-HT) has long been implicated in the pathophysiology of depression and anxiety, and the therapeutic effect of treatments. Several drugs useful in treatment produce either acute or neuroadaptive changes in 5-HT2C receptor activity, and there has been growing interest in how alterations in the 5-HT2C receptor might be important in mediating antidepressant and anxiolytic activity. The neuropsychological hypothesis of drug action implies that the clinical effects of medications active in anxiety and depression are best understood through the effects of these agents on the processing of emotional information. Thus far, however, there has been no systematic attempt to identify the role of the 5-HT2C receptor in drug-induced changes in emotional processing in humans. The current research therefore investigated the effects of drug treatments with 5-HT2C blocking properties on neural and behavioural responses to emotional information in healthy volunteers. An fMRI study demonstrated that a single dose of mirtazapine, an antidepressant with action at the 5-HT2C receptor, reduces activation in regions important in emotional processing, such as the amygdala and the fusiform gyrus, to threat-relevant stimuli. A series of behavioural studies utilized drugs acting, at least in part, as 5-HT2C antagonists and agonists to show that these drugs are able to alter emotional processing, particularly emotional memory. A seven-day administration of mirtazapine was shown to increase the recall of positive versus negative personality characteristics. A single dose of agomelatine, also an antidepressant with putative action at the 5-HT2C receptor, did not increase slow wave sleep, suggesting, the drug had no effect of 5-HT2C blockade in the brain. In Chapter 4, agomelatine and mCPP, a 5-HT2C agonist, also shown to had no significant effect on emotional processing measures, but there was a statistical trend for agomelatine to increase memory for positive stimuli, and for mCPP to increase memory for negative stimuli. These findings suggest that antidepressants may work by altering the bias in emotional processing. Overall, the results of this exploration of the role of the 5-HT2C receptor in emotional processing have contributed to the understanding of antidepressant treatment, and raise new possibilities for the continuation of study in this field.
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Mugno, Diego Filadelfo Maria. "Validazione della versione italiana della Developmental Disability Child Global Assessment Scale (DD-CGAS)." Thesis, Università degli Studi di Catania, 2011. http://hdl.handle.net/10761/243.
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Obiettivo: scopo del presente lavoro è di validare la versione italiana della Developmental Disability Child Global Assessment Scale (DD-CGAS), una scala per la valutazione del funzionamento globale di bambini con diagnosi di disturbi dello spettro dell'autismo (ASD). Metodi: seguendo le procedure di validazione utilizzate per la versione in lingua inglese sono state valutate la inter-rater reliability, la stabilita' temporale e la validita' convergente in un gruppo di 48 soggetti in eta' evolutiva con diagnosi di ASD e la sensibilita' al cambiamento in un sottogruppo di 42 soggetti.
Risultati: la inter-rater reliability e la stabilita' temporale (ICC) sono risultate rispettivamente .78 e .79; l'effect size per la validita' era da moderato ad ampio; l'effect size per il cambiamento della DD-CGAS era di .59 Conclusioni: la versione italiana della DD-CGAS ha dimostrato di essere uno strumento affidabile per misurare il funzionamento globale di bambini con diagnosi di ASD.Objective: aim of this study is to validate the Italian version of the Developmental Disability Child Global Assessment Scale (DD-CGAS), a scale developed to assess global functioning in children with Autism Spectrum Disorders (ASDs) Methods: following the validation procedures used for the English version of the scale, inter- rater reliability, temporal stability and convergent validity were assessed in a group of 48 children with ASD and temporal stability in a subset of 42 subjects. Results: Inter-rater reliability and temporal stability (ICC) were respectively .78 and .79; effect size for convergent validity were moderate to large; the pre-post DD-CGAS change had an effect size of .59. Conclusions: the Italian version of the DD-CGAS is a reliable instrument for measuring global functioning of children with ASD.
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Sibeoni, Jordan. "L’apport des méthodes qualitatives dans la recherche sur les soins en psychiatrie de l’adolescent." Thesis, Université Paris-Saclay (ComUE), 2017. http://www.theses.fr/2017SACLS425/document.
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Les méthodes qualitatives visent à décrire, comprendre et approfondir un phénomène observé. Elles sont encore peu développées dans la recherche en psychiatrie de l’adolescent. Les objectifs de cette thèse sont à la fois méthodologiques et thérapeutiques. Il s'agit d'illustrer à partir de trois études qualitatives l'intérêt des méthodes qualitatives dans la recherche clinique sur les soins en psychiatrie de l'adolescent. Ces études ont en commun d'explorer la question des soins et en particulier celle de la perception des soins en psychiatrie de l'adolescent par les adolescents, leurs familles et leurs soignants, et de croiser ces perspectives. La première étude consiste en une métasynthèse -revue systématique et analyse de la littérature qualitative concernant l'anorexie mentale à l'adolescence. La deuxième étude se focalise sur l'utilisation de l'outil photographique et de son efficacité dans la recherche qualitative en psychiatrie de l'adolescent. Il s'agit d'une étude qualitative explorant le fonctionnement et les interactions familiales autour de la nourriture et du repas à l’aide de la photographie. Enfin la troisième recherche qualitative explore l'efficacité perçue des soins chez des adolescents suivis en psychiatrie dans le cadre d'un refus scolaire anxieux et chez leurs parents. Ces trois études nous permettent de discuter l’intérêt des méthodes qualitatives dans la recherche sur les soins en psychiatrie de l’adolescent et également la nécessité du développement de ces méthodes dans la recherche clinique en santé publiqueQualitative methods aim to describe, understand and deepen an observed phenomenon. Our objectives are both methodological and therapeutic. We illustrate the contribution of qualitative methods in research from three qualitative studies. These studies will jointly explore the issue of care and especially the perception of psychiatric care from adolescents, their families and caregivers. The first study is a metasynthesis - systematic review and analysis of qualitative literature- on anorexia nervosa in adolescence. The second study will focus on the use of the photographic tool and its effectiveness in qualitative research in adolescent psychiatry. This qualitative study will explore the functioning and family interactions around food and meals using Photo-elicitation. Finally, the third qualitative research will explore the perceived efficacy of care among adolescents receiving a treatment for school refusal, and their parents. These three studies enable us to discuss the contribution of qualitative methods in adolescent psychiatry care research and also the need of developing such methods in the field of clinical research in public health
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Chermá, Yeste Maria Dolores. "Therapeutic Drug Monitoring in Psychiatry : Some aspects of utility in clinical practice and research." Doctoral thesis, Linköpings universitet, Klinisk farmakologi, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-52107.
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Background and objectives: Several new psychoactive drugs for the treatment of psychiatric disorders have been introduced onto the market since the late 1980s. Basic aspects of pharmacodynamics and pharmacokinetics (PK) are investigated before approval for general prescription. Thus, a limited number of subjects are exposed to the drug before it is marketed and only sparse measurements of drug concentration are performed during phases II and III of drug development. The objective of this thesis was to provide further descriptive PK and linked patients data in naturalistic clinical settings. The PK of psychoactive drugs was also studied in the elderly and the young, major risk groups that are exposed in normal everyday clinical practice but that are underrepresented in the phases of drug development. The PK-data were to be assessed by samples sent to the Therapeutic Drug Monitoring (TDM) laboratory service. In a subset of individuals, the genotypes of the cytochrome P450 (CYP) enzymes were described. Results: Serum concentration of the parent compound and its metabolites was provided from TDM-data on antidepressant escitalopram (Paper I) and antipsychotic ziprasidone (Paper II). A large interindividual PK variability was found. The daily dose of the drug was higher than the defined daily dose (DDD) for both escitalopram and ziprasidone (median dose 20 mg and 120 mg, respectively). The median number of drugs per patient, apart from the studied drug, was 4 and 3, respectively (range 1-18). If repeated eligible TDM-data were available, change in treatment strategies could be seen between the first and second sample for the patient, and the metabolite/parent compound (M/P) ratio had lower intraindividual than interindividual variation in the escitalopram study but opposite results were found in the ziprasidone study. The prescription of antidepressant drugs (ADs) in the nursing homes studied was 38 % (Paper III). The concentration of the ADs was higher, or much higher, than could be expected from the dose administered in 73 %. The majority of the elderly people were treated with citalopram. No clear time schedule for how long the drug treatment should continue was found in the patients’ current medical record. The median number of drugs per patient apart from the AD was 11 (range 4-19), no monotherapy was found in these patients. The genetically impaired metabolic activity of CYP enzymes correlated to higher drug concentration as expected, in patients medicated with an AD that is substrate for the CYP enzyme genotype. The concentrations of ADs were as expected from the dose administered in 63 % of the children/adolescents evaluated (Paper IV). The majority of TDM samples requested sertraline. PK outcome of sertraline was similar to the results in adult populations. Monotherapy was documented in 49 % (median number of drugs apart from AD was 1 per patient, range 1-7). Changes in treatment strategies were also shown, if repeated TDM-samples were available. The median variation of the M/P ratio for sertraline between the first and the last samples within the same patient was 20 % (the interindividual variation was 37 %). The poor metabolizers (PM) for CYP2D6 medicated with a CYP2D6 substrate had a lower dose than did non-PM for the same drug. Conclusion: These studies provide reference data for the evaluation of the therapeutic response, i.e. a reference range of what is to be expected in a normal clinical setting, as well as the toxicological information concerning the psychoactive drugs studied. When available, the M/P ratio between two patients’ samples may assess patient compliance, as well as drug-drug interactions. Thus, the use of TDM can be beneficial for individual dose optimisation and drug safety, above all in the studied populations, elderly people and children/adolescents, when the selection of doses requires a consideration of PK parameters. TDM may be a tool for research, increasing knowledge of the psychoactive drug in TDM service, as well as toxicology. A more frequent clinical use of TDM and pharmacogenetic testing in clinical practice would contribute to a better quality when treating with psychoactive drugs.
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Tajika, Aran. "Replication and contradiction of highly cited research papers in psychiatry: 10-year follow-up." Kyoto University, 2016. http://hdl.handle.net/2433/215410.
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This is an author-produced electronic version of an article accepted for publication in the British Journal of Psychiatry. The definitive publisher-authenticated version is available online at http://bjp.rcpsych.org.Kyoto University (京都大学)
0048
新制・課程博士
博士(医学)
甲第19584号
医博第4091号
新制||医||1014(附属図書館)
32620
京都大学大学院医学研究科医学専攻
(主査)教授 中山 健夫, 教授 小西 靖彦, 教授 村井 俊哉
学位規則第4条第1項該当
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Abu, Ghazal Yazan. "The classification of psychoses and the detours of psychiatric research at the end of the nineteenth century." Thesis, Paris, Ecole normale supérieure, 2015. http://www.theses.fr/2015ENSU0050.
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Le présent thèse cherche à explorer le statut épistémologique de la Psychiatrie. En prenant la question de la méthode (“Methodenfrage”) comme fil directeur, nous discuterons la question de savoir dans quelle mesure la Psychiatrie, entendue comme une discipline clinique, est autorisée à emprunter les principes méthodologiques en usage dans les sciences humaines. Dans ce contexte une importance capitale sera accordée à l’analyse des développements conceptuels de la Psychopathologie de langue allemande dans la période suivant la Deuxième Guerre Mondiale. Le point de départ de ce travail sera l’analyse de la dichotomie introduite par Karl Jaspers entre “Erklären” (expliquer) et “Verstehen” (comprendre) ainsi que celle des limites épistémologiques de ces deux modes d’accès à l’anormalité psychique qu’est la schizophrénie. La deuxième partie de ce travail sera consacrée à l’analyse de l’élargissement sur le plan méthodologique des limites du “Verstehen” dans la psychopathologie de la schizophrénie. Dans ce cadre nous analyserons les conséquences de l’introduction de la “Situation analyse” et du concept d’“ordre” (comme principe organisateur de la vie psychique et sociale) pour la psychopathologie de la schizophrénie. A la lumière des résultats acquis nous analyserons les apports de ce développement conceptuel de la psychopathologie allemande pour les tentatives de conceptualisation des normes dans les théories psychiatriques sur la schizophrénieThis thesis explores the ways in which psychiatrists and researchers have developed new tools to deal with the unknown in psychiatric classifications. In the following four chaptersI seek to understand why the modes of thinking that dominated late nineteenth century psychiatry have proved to be durable and stable, and why the history of what is now called schizophrenia is the history of psychiatry itself.In this context, I situate my argument within the debates regarding the historiography of psychiatry, and more specifically the historiography of schizophrenia.My approach can be understood as an attempt to move away from common approaches to the history of psychiatric classifications.In my view, the influence of German psychiatry, from Griesinger’s unitary psychosis to Bleuler’s schizophrenia tells us more about psychiatry and its modes of conceptualization, than thus far recognized.Against the narratives that presuppose a direct line of development, I argue that the path starting with primäre Verrücktheit—one of the most commonly diagnosed psychic diseases in 1870s – leading to ”paranoia”—a term used as synonym for insanity by most authors in the1880s and 1890s – and ending in “dementia praecox” and schizophrenia was not a linear one.By tracing the detours followed by psychiatric research in the last three decades of the nineteenth century, I show how, paradoxically, the progress in the special nosology delayedconsiderably the future development in psychiatric theories
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Pedraza, Otto. "On the latent structure of cognitive malingering a multivariate taxometric analysis /." [Gainesville, Fla.] : University of Florida, 2004. http://purl.fcla.edu/fcla/etd/UFE0006261.
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Thesis (Ph.D.)--University of Florida, 2004.Typescript. Title from title page of source document. Document formatted into pages; contains 122 pages. Includes Vita. Includes bibliographical references.
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Sayal-Bennett, Anu. "A portfolio of study, practice and research exploring and theorising attempted suicide among Asian women : a qualitative investigation." Thesis, University of Surrey, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.267876.
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Muñoz, Pedro Felipe Neves de. "Degeneração atípica: uma incursão ao arquivo de Elza." reponame:Repositório Institucional da FIOCRUZ, 2010. https://www.arca.fiocruz.br/handle/icict/6099.
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Previous issue date: 2010Esta investigação histórica da teoria e prática psiquiátrica no Brasil pretende analisar os Estados Atípicos de Degeneração, um grupo de categorias diagnósticas sugerido pela Classificação Psiquiátrica da Sociedade Brasileira de Psiquiatria, Neurologia e Medicina-Legal, em 1910. Para realização deste estudo, selecionamos um caso clínico específico do Pavilhão de Observação, instituição que se localizava no complexo do antigo Hospício Nacional de Alienados, responsável pelo ensino de psiquiatria e triagem de pacientes. Este caso versa sobre uma mulher alemã, denominada em nossa pesquisa de Elza, que se envolveu em uma trama de intrigas que culminou em sua internação no Pavilhão de Observação, em junho de 1925, através da polícia e a pedido do marido, sob a alegação de abandono do lar conjugal, adultério e suspeita de loucura. No Pavilhão, Elza foi diagnosticada como portadora de um estado atípico de degeneração, com síndrome paranóide de interpretação e delírio de ciúmes , conseguindo sair de lá através de um habeas corpus. Nosso principal objetivo é analisar as relações entre gênero, prática psiquiátrica e degeneração atípica, através de uma incursão no arquivo de Elza, caracterizado por uma rede de discursos que articularam disputas por autoridade e verdade entre os diferentes protagonistas do caso. Nesse sentido, seguindo o curso das atipicidades desta história, nós iremos debater as diferenças culturais, questões de classe social, gênero e direitos civis dos homens e mulheres na legislação brasileira e alemã, nas primeiras décadas do século XX.
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Bolton, Mychal. "Perceived Barriers to Obtaining Psychiatric Treatment at Johnson City Community Health Center." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/honors/223.
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The purpose of this study was to describe the perceived barriers to obtaining psychiatric treatment at the Johnson City Community Health Center. The context of the study was a rural area in Eastern Tennessee. Five patients with confirmed DSM-IV mental health diagnoses were recruited during treatment and interviewed at the Johnson City Community Health Center after their scheduled appointments with a Mental Health Nurse Practitioner (MHNP). The semi-structured interview focused on perceived barriers to obtaining treatment, perceptions of treatment received, and perceived availability of treatment. From those interviews, two themes were identified and each of which had two sub-themes identified: Realities of Treatment with the sub-themes of Therapy-Related Realities and Logistics Realities, The Way It Is with the sub-themes of Take Care of It Myself and Don’t Want People to Know. The findings indicate that there is a duality of positive and negative aspects of treatment at Johnson City Community Health Center. Understanding the needs and perceptions of those with psychiatric diagnoses will assist all staff and mental health providers in developing programs that are better suited for those with psychiatric diagnoses receiving treatment from Johnson City Community Health Center.
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Mazzola, Carmen. "Neuropharmacology and Behaviural Animal Models." Thesis, Universita' degli Studi di Catania, 2011. http://hdl.handle.net/10761/93.
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Lo studio delle patologie umane richiede spesso l'ausilio di sperimentazioni animali. Generalmente i dati ottenuti in questi modelli permettono di ampliare le conoscenze sui meccanismi eziologici e sul trattamento delle patologie. Perche' un modello sperimentale sia considerato attendibile, deve avere specifici requisiti: face validity, construct validity and predictive validity. Rispettare tali criteri e' di enorme importanza per la ricerca in ambito fisiologico e farmacologico.The study of human disease often involves performing physiological and pharmacological experiments in animal models. Generally, experimental results obtained in these models are extrapolated to the human situation, providing new insights into disease mechanisms and treatment options. To be able to reliably extrapolate results obtained in animal experiments, it is important to consider the validity of the animal model used, i.e., the extent to which the model mimics the disease. This validity is often characterized by 1) the resemblance in symptoms (face validity), 2) shared etiology and underlying pathophysiological mechanisms (construct validity), and 3) similarity of pharmacological responses (predictive validity). Hence, the analysis of face, construct, and predictive validity of animal models constitutes a very important aspect in the study of disease physiology and pharmacology.
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Herbert, Kate. "Overcoming traumatic experiences : psychological therapy, recovery and reflections on the research process." Thesis, University of Warwick, 2008. http://wrap.warwick.ac.uk/2347/.
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This research examined therapeutic approaches to trauma and post traumatic growth and recovery as a result of brief psychological intervention. Chapter one is a critical review of current therapeutic approaches used in the treatment of trauma and post traumatic stress disorder, PTSD. The PTSD treatment literature indicates that the therapy most rigorously assessed and currently recommended by the National Institute for Clinical Excellence (NICE) is trauma-focused Cognitive Behavioural Therapy and Eye Movement Desensitization and Reprocessing. Despite this, the literature review indicated that other forms of therapy have been effective in reducing the symptoms of PTSD. The research indicated that clinicians are successfully using psychodynamic, integrative and person centred approaches in both an individual and group therapy format. Regardless of therapeutic approach used, issues of client motivation, timing of therapy and therapeutic alliance were important determinants in outcome. Chapter two is an empirical study, which focuses on the effect of brief psychological intervention on recovery from trauma. A mixed methodological design was used and five participants took part in the research. The results indicated that those participants whose trauma symptoms reduced had experienced recovery from their trauma. Participants cited underlying beliefs towards adversity, personal and contextual factors as important in facilitating recovery. Recommendations for further research and clinical implications were discussed. Chapter three provides the authors reflections upon the research process and methodological and ethical issues that arise when carrying out qualitative research with a trauma population.
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Niehaus, Daniel Jan Hendrik. "Subtyping schizophrenia." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/86221.
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Thesis (PhD)-- Stellenbosch University, 2014.ENGLISH ABSTRACT: Schizophrenia is a phenotypically heterogeneous disorder believed to have a strong genetic component. Limiting its clinical heterogeneity by means of subtyping may help to shed light on some of the genetic underpinnings of the disease. This study describes the application of factor analysis (FA), latent class analysis (LCA) and factor mixture modeling in a sample of 734 Xhosa-speaking schizophrenic subjects using factor analytically derived variables previously identified in an independent sample of this population. LCA was performed on the following 8 SANS and SAPS items identified by preliminary exploration of the data: eye contact, auditory hallucinations, global hallucinations score, global delusions score, grooming, affective non-responsiveness, spontaneous movement, and commenting voices. A four class model provided the best fit. Classes 1 and 2 were characterized by predominantly positive and predominantly negative symptoms, respectively, class 3 by both positive and negative symptoms and class 4 by few or absent symptoms. A history of cannabis use or abuse increased the probability of a subject being allocated to class 1, while being male made a person more likely to be included in class 2. Factor mixture modelling was performed by first using latent class analysis, then factor analysis and then the factor mixture analysis were done. The fit among these three types were then investigated. The results show that factor mixture modelling uncovered a heterogeneous latent variable structure that fits the data well with the latent classes capturing distinct positive symptom/behaviours and factors capturing severity variations. This study, the first to report on the latent class structure of schizophrenia in a sample of patients from a sub-Saharan African population, supports the universality of specific latent classes across ethnic boundaries. The results further support reports that gender, sibpair status and cannabis use may influence the phenomenology of schizophrenia. The identification of subgroups may represent an intermediate step in the search for endophenotypes of schizophrenia.
AFRIKAANSE OPSOMMING: Skisofrenie is „n psigiatriese steuring met „n heterogene fenotipe en „n vermoedelik sterk genetiese vatbaarheid. Ten einde die lig te werp op die genetiese onderbou van skisofrenie word gepoog om die kliniese heterogenisiteit te beperk deur middel van subgroepering. Hierdie studie beskryf die gebruik van latente klas analise (LKA) in „n groep van 734 Xhosa-sprekendes met skisofrenie. Die LKA word baseer op die gebruik van veranderlikes wat deur middel van faktor analise op simptome in „n onafhanklike studiegroep van Xhosa-sprekendes met skisofrenie verkry is. Die LKA is gedoen op die volgende 8 “SAPS” en “SANS” veranderlikes wat deur voorlopige ondersoek van die data ge-indentifiseer is: oogkontak, gehoorshallusinasies, globale hallusinasie telling, globale waantelling, selfversorging, affektiewe nie-responsiwiteit, spontane beweging en stemme wat kommentaar lewer. „n Vierklas oplossing het die beste passing getoon. Klas 1 en 2 is gekenmerk deur oorwegend positiewe en negatiewe simptome onderskeidelik, klas 3 het beide positiewe en negatiewe simptome gehad en klas 4 het baie min of geen simptome getoon nie. „n Geskiedenis van kannabis gebruik of misbruik het die kans verhoog dat die individue in klas 1 gevind sou word, terwyl manlike geslag as veranderlike die kanse verhoog het vir allokasie in klas 2. Faktor mengsel modelering is gedoen deur eers „n latent klas analise te voltooi, gevolg deur „n faktor analise, en laastens „n factor mengsel analise. Die passing tussen die drie analises is daarna evalueer. Faktor mengsel modelering toon „n heterogene latente klas struktuur wat voldoen aan die passingsvereistes. Die latente klasse blyk spesifieke positiewe simptome/gedrag te verteenwoordig, terwyl die factor grad van erns variasie aandui. Hierdie studie is die eerste om die latente klas struktuur van skisofrenie in „n subsahara-Afrika populasie, die Xhosa, te beskryf. Die resultate onderstreep die universialiteit van die latente struktuur van skisofrenie se simptome oor etniese grense heen. Verder ondersteun die resultate die moontlike rol van geslag, aangetaste sibstatus en kannabis gebruik in skisofrenie se fenomenologie. Die identifisering van die subgroepe mag „n intermediêre stap in die soektog vir endofenotipes van skisofrenie verteenwoordig.
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Stenhouse, Rosemary Clare. "Unfulfilled expectations : a narrative study of individuals' experiences of being a patient on an acute psychiatric inpatient ward in Scotland." Thesis, University of Edinburgh, 2009. http://hdl.handle.net/1842/4071.
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This study examines people’s experiences of being a patient on an acute psychiatric inpatient ward in Scotland. Within the existing research base few studies focus on the patient’s experience of acute psychiatric inpatient care, and none of these is set in Scotland. Those that do, indicate that the patient experience of acute psychiatric inpatient care is often negative. The theoretical perspective of this study conceptualises experience as represented in narrative form, thus the data take the form of narratives. Thirteen participants were recruited through the acute ward. Each participant participated in two unstructured interviews focussed on gathering narratives of their experience. Data analysis was holistic, guided by Gee’s (1991) socio-linguistic theories. This holistic analysis culminated in the presentation of each participant’s narrative in poetic form. From the holistic analysis I identified three themes - help, safety and power - that were evident in the analyses of all participants’ interviews. The theme of help represents participants’ expectations that they will receive help on the ward, and their experiences of trying to get this help. Safety represents participants’ expectations pertaining to the ward’s function in keeping them safe, their experience of threat and strategies to keep safe. The theme of power represents participants’ experiences of power relations within the acute ward. I conclude that participants’ experiences of being a patient on the ward are characterised by feelings of frustration, concerns about safety, and the perceived need to focus on self-presentation as they attempt to reach their desired goal of discharge.
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Regol, Anna. "Le Rap, un langage à la marge ?" Thesis, Aix-Marseille, 2015. http://www.theses.fr/2015AIXM3045.
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La recherche clinique conduite en psychiatrie porte sur les processus psychiques inconscients engagés pour le sujet de l’inconscient dans la création de rap. L’épistémologie psychanalytique s’appuie sur les concepts freudiens et lacaniens. Une approche transversale linguistique et sociologique permet de définir le rap comme un langage et un phénomène esthétique. La problématique s’intéresse à l’implication des processus de déplacement, de condensation, de substitution et d’association des représentants des représentations et aux processus d’identification et narcissiques en question pour le sujet individuel et la formation collective. L’hypothèse principale est que cette inventivité de langage à la marge du langage académique soutient le sujet. L’hypothèse secondaire rattachée à la première est qu’il autorise une forme de lien social. La méthodologie s’appuie sur deux axes, le premier concerne l’analyse qualitative du discours d’un corpus de textes de rappeurs connus à partir de l’outil Tropes d’analyse linguistique, sémantique et syntaxique, et l’analyse des observations et entretiens extraits du journal de bord de l’atelier-rap proposé aux patients du secteur. Le second axe concerne l’interprétation psychopathologique des résultats pour chaque auteur du corpus et la présentation de vignettes cliniques pour les rappeurs de l’atelier. L’étude comparative des résultats permet la discussion et la vérification des hypothèsesConduct clinical research in psychiatry focuses on unconscious mental processes involved in the subject of the unconscious in the creation of rap. The psychoanalytic epistemology is based on Freudian and Lacanian concepts. A linguistic and sociological approach to define rap as a language and an esthetic phenomenon. The issue focuses on the involvement of the process of displacement, condensation, substitution and association representative’s representations and identification and narcissistic in question for the individual subject and collective training process. The main hypothesis is that the inventiveness of language on the margins of academic language supports the subject. The secondary hypothesis attached to the first is that it allows a form of social relationship. The methodology is based on two axes, the first concerns the qualitative discourse analysis of a corpus of texts known rappers from Tropes tool of linguistic analysis, semantic and syntactic, and analysis of observations and excerpts from interviews logbook of the proposed patient sector workshop report. The second axis concerns the psychopathological interpretation of the results for each author of the corpus and the presentation of clinical vignettes for rappers workshop. The comparative study of the results allows the discussion and testing of hypotheses
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Zanetta, Victor Hugo. "Derecho a las prácticas sexuales de los discapacitados mentales." Master's thesis, Zanetta VH. Derecho a las prácticas sexuales de los discapacitados mentales [Internet]. Universidad Nacional de Córdoba. 2019 [citado el 5 de marzo de 2020]. Disponible en: https://rdu.unc.edu.ar/handle/11086/14974, 2019. http://hdl.handle.net/11086/14974.
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Tesis - Maestría en Bioética -Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Secretaría de Graduados en Ciencias de la Salud, 2017Hasta hace pocas décadas pasadas, bajo paradigmas propios de la Edad Media, las personas con retraso mental eran literalmente aisladas y permanecían más o menos ocultadas. Estaban predestinadas a la exclusión social. Los familiares y allegados consideraban que los disminuidos no tenían derechos afectivos y sexuales posibles. Todavía persisten algunas familias con actitudes rígidas y creencias dogmáticas. Ellas son contrarias a que sus parientes con trastornos mentales tengan derechos de otorgar y recibir naturales afectos sexuales. No es infrecuente que los padres de disminuidos intelectuales tengan el convencimiento pertinaz de que sus hijos son totalmente asexuados. Dentro de los temores hogareños frecuentes, se destaca nítidamente el miedo al despertar sexual del discapacitado. Frente a este error de apreciación de la realidad vital, se justifica la necesidad de una sensata educación afectiva de la persona con trastornos mentales. En estas personas es imperativo permitir el conocimiento de su propia sexualidad normal. Se torna necesario comprender que ellos tienen las mismas exigencias de vínculos afectivos, similares necesidades de relaciones sociales y parecidos apremios de intimidad corporal y sexual que el resto de los seres humanos. Los discapacitados mentales deben ser honrados en sus derechos a la libertad, sus derechos a la dignidad humana, en su derecho a la igualdad ante la ley y, esencialmente, respetados sus derechos a ser autónomos y tomar decisiones propias, sin injerencia de terceros. Por mandato constitucional, en la República Argentina rige un entramado legal, tanto nacional como supranacional, que ha flexibilizado las restricciones para los disminuidos intelectuales. Es preciso aplicar las leyes nuevas con vigor y de corregir aquellas normas arcaicas remanentes. Es tiempo de eliminar las limitaciones a los derechos personalísimos de las personas con trastornos mentales.
Until a few decades ago, under typical Middle Ages paradigms, people with mental retardation were literally placed in mental asylums and remained generally out of sight. They were predestined to social exclusion. Relatives and friends considered that mentally disabled people had no possible sexual or affective rights. Nowadays there still are some family members with rigid attitudes and dogmatic beliefs about that. They opposed to acknowledge their mentally disordered relatives´ rights to grant and receive natural sexual affection. It is not uncommon for parents of impaired intellectuals to have the obstinate conviction that their children are totally sexless. Within the frequent home fears, the sexual awakening of the disabled is clearly highlighted. Faced with this error of appreciation of the vital reality, the need for a sensible affective education of the mentally disordered person is justified. Nevertheless, it is imperative to allow mentally disabled people to acknowledge their own normal sexuality. It becomes necessary to understand that they have the same demands of affective bonds, similar needs of social relations and constraints of corporal and sexual intimacy than the rest of human beings. The mentally handicapped must be honored in their rights to freedom, human dignity, legal equality, but it becomes essential to respect their right to be autonomous and make their own decisions without interference from third parties. Due to constitutional command, there is a national and supranational legal framework in Argentina that has relaxed restrictions for disabled intellectuals. However, it is still necessary to vigorously enforce the new laws and to correct those archaic remaining rules. It is time to remove all limitations on the very personal rights of mentally handicapped people.
2021-04-29
Fil: Zanetta, Víctor Hugo. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Semiología; Argentina.
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Jones, Ceri. "An exploration into parents' experiences of adolescent mental health difficulties." Thesis, Canterbury Christ Church University, 2016. http://create.canterbury.ac.uk/14775/.
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Research has shown that having a child who experiences mental health difficulties can be highly stressful for parents and may lead to feelings associated with loss and grief. Currently little is known about how best to support these parents’ needs. Studies from a variety of fields suggest that the ability to find meaning in stressful life events is associated with decreased distress. The current study therefore sought to explore the ways in which a sample of parents whose adolescent children were experiencing mental health difficulties made sense of their experiences. Individual unstructured interviews were carried out with a sample of parents whose children were inpatients at an adolescent psychiatric hospital. A total of eight parents took part in the study, four male and four female. Interviews were audio recorded, transcribed verbatim and analysed using thematic and structural narrative analyses. The results suggested that parents varied in their extent and use of meaning making, with some able to find positive meaning in their child’s difficulties and others struggling to make sense of it. Four master themes emerged across participants; unpredictability and ambiguity, difficulties identifying mental health difficulties, difficulties accepting the gravity of the situation, and benefits. The findings suggest that parents would benefit from having the ambiguity of their child’s difficulties acknowledged. Interventions aimed at aiding meaning making should be offered to parents who struggle to make sense of their child’s difficulties.
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Gallici, Mirta Cecilia. "Casa de Medio Camino de Mujeres : ¿Iniciativa Innovadora en el abordaje de las problemáticas de salud mental?" Master's thesis, Gallici MC. Casa de Medio Camino de Mujeres : ¿Iniciativa Innovadora en el abordaje de las problemáticas de salud mental? [Internet]. Universidad Nacional de Córdoba; 2018 [citado el 5 de marzo de 2020]. Disponible en: https://rdu.unc.edu.ar/handle/11086/14971, 2018. http://hdl.handle.net/11086/14971.
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Tesis - Maestría en Salud Mental - Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Facultad de Psicología, 2015Objetivo: Analizar el nivel de estigma internalizado en personas que consumen sustancias psicoactivas y que realizan tratamiento de rehabilitación en Instituto de Prevención del Alcoholismo y la Drogadicción, dependiente del Hospital Neuropsiquiátrico de la provincia de Córdoba. Método: Para el presente trabajo de investigación se realizó un estudio de alcance observacional, descriptivo y de tipo transversal. Se trabajó con una muestra no probabilística, de tipo intencional dirigida a captar una cuota de 120 pacientes, con diagnóstico de abuso y dependencia de sustancias psicoactivas, de acuerdo a las clasificaciones internacionales (CIE X, DSM IV), mayores de 18 años y que se encuentren bajo tratamiento de rehabilitación por consumo de sustancias psicoactivas en una institución pública. El instrumento utilizado fue el Internalized Stigma of Mental Illness (ISMI) adaptado previamente para ser utilizado en esta población. Resultados: El 95% de los entrevistados fueron varones y el 5 % mujeres. La edad media fue de 37,3 (DE 12,6) años, no encontrándose diferencia significativa en la media de edad de mujeres y varones. Los años de educación formal tuvieron una media de 10,6 (DE 4,1) años. La edad media de inicio en el consumo de sustancias fue a los 19,4 (DE 0,83) años; mientras que el tiempo medio en tratamiento por consumo de sustancias que declararon los pacientes fue de 4 meses. La situación conyugal fue mayormente solteros 48,5%, en relación al 34,7% con estado civil casados, 14,9% separados y/o divorciados y 12,1% en estado de viudez. En cuanto al estigma internalizado de las 5 dimensiones del instrumento utilizado en su conjunto, el 26,73% experimentan un estigma internalizado de nivel leve, 41,58 % un estigma internalizado de nivel moderado, 15,84% un estigma internalizado de nivel severo y 15,84% de los sujetos no muestran estigma internalizado Además se observaron mayores indicadores de estigma en pacientes que declararon consumir sólo alcohol, que los pacientes que declararon policonsumo. Conclusiones: El estigma internalizado es una problemática frecuente entre las personas que consumen sustancias psicoactivas, aunque puede tener mayor severidad en las personas que consumen sólo alcohol siendo naturalizado dicho consumo en nuestro contexto sociocultural.
Objective: To analyze the level of internalized stigma in people who consume psychoactive substances and who are aunder rehabilitation treatment in the Institute of Prevention of Alcoholism and Drug Addiction, dependent of the Neuropsychiatric Hospital of the province of Córdoba. Methods: The study was observational, descriptive and cross-sectional. It was a non-probabilistic, intentional sample, aimed at survey a quota of 120 patients, with diagnosis of abuse and dependence on psychoactive substances, according to the IDC X and DSM IV, over 18 years old and under rehabilitation treatment for the consumption of psychoactive substances in a public institution. The assessment instrument was the Internalized Stigma of Mental Illness (ISMI) previously adapted to be used in this population. Results: 95% of the interviewees were male and 5% were female. The mean age was 37.3 (SD 12.6) years, with no significant difference in the mean age between genders. The years of formal education had a meanof 10.6 (SD 4.1) years. The mean age of onset of substance use was 19.4 (SD 0.83) years; while the mean time under treatment for substance use declared by the patients was 4 months. The marital status was mostlysingle (48.5%), 34.7% was married, 14.9% was separated or divorced, and 12.1% was widow. Regarding the internalized stigma, 26.73% experienced a mild level of internalized stigma, 41.58% a moderate level, 15.84% a severe level and 15.84% of the subjects do not showedinternalized stigma. Higher indicators of stigma were observed in patients who reported consuming only alcohol, than patients who reported polydrug use. Conclusions: Internalized stigma is a frequent problem among people who consume psychoactive substances, although it may be more severe in people who consume only alcohol, since this consumption is naturalized in this sociocultural context.
2020-08-07
Fil: Gallici, Mirta Cecilia . Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Secretaría de Salud Mental; Argentina.
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Casey, Helen. "Does emotion processing ability mediate the relationship between psychopathy and group psychotherapy engagement?" Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:2dcdd64e-357b-4bae-b6b9-b738d19485d2.
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Therapeutic engagement in psychopathy is an important area of study due to reports of poor engagement leading to poor treatment outcome for this group. One factor that may influence effective engagement is the ability to process emotional information, which has been shown to be impaired in psychopathy. The study investigated the association between engagement in group therapy and level of psychopathy and assessed whether this relationship is mediated by emotion processing ability. It was hypothesised that higher levels of psychopathy would be associated with lower levels of therapy engagement; however, this relationship would be mediated by four emotion processing indicators believed to be important for good treatment outcome. Specifically, awareness and arousal of emotion, emotion regulation ability, interpretation bias and ability to transform emotion would: i. jointly mediate the relationship between psychopathy and therapy engagement ii. each uniquely mediate the relationship between psychopathy and therapy engagement. Participants, violent offenders with varying levels of psychopathy, were interviewed in a cross-sectional design. Emotion processing ability was assessed using five computerised tasks each selected to best capture one of the cognitive mechanisms of emotion processing outlined above. Psychopathy was measured using the Psychopathy Check List-Revised. Therapy engagement was assessed by group therapists three months after interview using the Group Emotional Engagement Questionnaire (GEEQ). The GEEQ is a new measure designed, developed and tested as part of this study to measure its dependent variable accurately. Psychometric evaluation of the GEEQ demonstrated high levels of reliability (internal, inter-rater) with between good and adequate validity (convergent, discriminant) and good predictive validity. Mediation analysis revealed high Factor 1 psychopathy (the affective component) was associated with poorer therapy engagement (lower GEEQ scores). Interpretation of emotion and transforming emotion acted as suppressors on this relationship. This may suggest that those with many Factor 1 traits used positive interpretation bias as a defence against experiencing distress (schema overcompensation). This response was resistant to change and gave high Factor 1 participants the appearance of being better engaged in therapy than they were. Reaction time data suggested this phenomenon occurred as an automatic response rather than a conscious effort to impression manage.
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Sendra, Elva María. "Organización del trabajo: impacto sobre la salud mental del personal de enfermería de un centro de salud en la provincia de Chaco." Master's thesis, Sendra EM. Organización del trabajo: impacto sobre la salud mental del personal de enfermería de un centro de salud en la provincia de Chaco [Internet]. Universidad Nacional de Córdoba; 2019 [citado el 5 de marzo de 2020]. Disponible en: https://rdu.unc.edu.ar/handle/11086/14972, 2019. http://hdl.handle.net/11086/14972.
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Tesis - Maestría en Salud Mental - Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Facultad de Psicología, 2019El objetivo general del trabajo fue: analizar los sentimientos que experimentan los trabajadores en relación a la organización de su trabajo. Material y métodos: tipo de diseño: teoría fundamentada. Población: licenciados en enfermería y enfermeros de un CAPS de la provincia del Chaco. Muestreo intencional. Técnica e instrumento de obtención de la información: entrevista semi estructurada, transcriptas en un registro a 3 columnas. Criterios de Inclusión: licenciados en enfermería y enfermeros. De exclusión: auxiliares de enfermería Control de la subjetividad: triangulación de investigadores. Discusión y conclusiones: Las formas de organización taylorista basadas en la división social y técnica del trabajo están presentes en los enfermeros del CAPS. En relación a la división social: tienen clara sus funciones y pueden cambiar sólo algunas cuestiones relacionadas con la organización de la tarea. Presentan carencias de recursos humanos y de insumos. En relación a la división técnica, la mayoría coincidió en que las normas son muy rígidas y que deben cumplirla bajo presión de plazos. Modos de gestión de la fuerza de trabajo: existen trabajadores con cargos precarios, diferentes estilos de gestión de la dirección y de la jefa de enfermeras, sobrecarga laboral por falta de personal. En relación a los sentimientos en el trabajo: presentan vivencias de sufrimiento por la imposibilidad de dar respuesta a la demanda de los pacientes y el enojo de los mismos por la falta de recursos, la falta de reconocimiento, asumir roles que exceden su competencia profesional, dificultades en las relaciones interpersonales. El agotamiento parece estar relacionado a la organización y también a la imposibilidad de brindar la atención necesaria al paciente. Las fuentes de placer: buena relación con los pacientes, el reconocimiento (de pacientes, autoridades y pares), la percepción de hacer algo productivo, la relación entre compañeros de trabajo basada en la cooperación. Este estudio demuestra que los enfermeros están en situación de riesgo, que es necesario un abordaje preventivo de los mismos. Así como también, deben propiciar intervenciones orientadas al mejoramiento de las condiciones y la organización del trabajo que determinan sufrimientos laborales.
The general objective of the work was: analyze the feelings that workers experience about to the organization of their work. Material and methods: type of design: based on grounded theory. Population: graduates in nursing and nurses of a CAPS, Chaco. Technique and instrument of obtaining the information: semi structured interview, transcribed in a register with 3 columns. Inclusion Criteria: graduates in nursing and nurses. Exclusion: nursing auxiliaries Subjectivity control: triangulation of researchers. Discussion and conclusions: The forms of Taylorist organization based on the social and technical division of labor are present in the nurses of the CAPS. About to the technical division, the majority agreed that the standards are very rigid and that they must comply with time constraints.. They present deficiencies of human resources and of inputs. In relation to the technical division, everybody agreed on the rules are so strict and must be fullfilled with pressure under deadlines. Modes of management of the labor force: there are workers with precarious positions, different styles of management of the administration and the head of nurses, there is labor overload associated with the lack of personnel. Related to feelings at work: workers present suffering experience for the incompetence to respond to the patients' demands and their anger for the lack of resources, lack of recognition, assuming roles that exceed their professional competence, difficulties in interpersonal relationships. Exhaustion seems to be related to the organization and also to the impossibility of providing the necessary care to the patient. Sources of pleasure: good relationship with patients, recognition (of patients, authorities and peers), the perception of doing something productive, the relationship between co-workers based on cooperation. This study demonstrates that nurses are at risk, that a preventive approach is necessary. As well, they should promote interventions aimed at improving the conditions and organization of work that determine labor suffering
2022-10-09
Fil: Sendra, Elva María . Universidad Nacional del Nordeste. Facultad de Ciencias Médicas. Comité de Bioética en Investigaciones de Ciencias de la Salud; Argentina.
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Hörberg, Ulrica. "Att vårdas eller fostras. Det rättspsykiatriska vårdandet och traditionens grepp." Doctoral thesis, Växjö universitet, Institutionen för vårdvetenskap och socialt arbete, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:vxu:diva-1943.
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To be sentenced to care in the forensic psychiatric services can be seen as one of the most comprehensive encroachments society can make on a person's life and being, as it entails a limitation of the individual's freedom but with no time limit. The aim of this dissertation is to describe caring in forensic psychiatry based on how it is experienced by those who perform the caring and by those are cared for in a maximum secure unit. A reflective lifeworld approach, based on phenomenological philosophy, has been applied. The data has been collected in interviews that have been analyzed by use of a meaning analysis searching for the essence of the phenomenon. The results of the research are presented in two empirical studies and a general structure based on the empirical findings. The dissertation also contains an excursus, a philosophical intermediate chapter containing further analysis of the results of the studies. The results show how the forensic psychiatric care is experienced as being non-caring by the patients with only small "pockets" of good care. Caring consists of corrective techniques that are unreflected and contradictory, where the conditions are determined by the caregivers and the ward culture. The correcting takes place through the modification of the patients' behaviour with the aim of the patients having to adapt themselves to the terms of the care provision. This care results in the patients trying, by use of different strategies, to adapt them-selves to the demands of the caregivers in order to gain privileges. At the same time the patients long to get away from the care system and are lacking real, meaningful and close relationships. To be the subject of care entails struggling against an approaching overwhelming sense of resignation and to care entails experiencing both power and powerlessness in performing the care. A destructive power struggle is being waged within forensic psychiatric care that suppresses the caring potential and true caring is thus elusive. The characteristics of forensic psychiatric care, based on the results of the research, are clarified in the dissertation's excursus. These include the corrective and disciplinary nature of forensic psychiatric care, its power and how this is materialized in care situations as well as the influence of tradition on current forensic psychiatric care in the light of the work of the French philosopher Michel Foucault. The dissertation shows that if the caring potential is to be able to be developed and form a caring nucleus for forensic psychiatric care then education levels need to be further developed. A caring culture and caring environment is needed where true caring can gain a foothold. In order for this to become a possibility the current caring culture and environment must be clarified, questioned and examined. The prevalent fundamental ideas in forensic psychiatric care have to be "jeopardized" and challenged by new scientifically based ideas on what constitutes true caring in this context.
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Browning, Michael. "The mechanisms and effects of modifying attentional biases to threatening information." Thesis, University of Oxford, 2010. http://ora.ox.ac.uk/objects/uuid:26959079-8f02-4347-b398-1b8347b64a92.
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Patients with both depression and anxiety show an increased tendency to deploy attention towards negative information. Cognitive models of the illnesses predict that these negative attentional biases are causally related to the symptoms of the disorders. Consistent with this, modifying attentional bias using either antidepressant medication or simple, computer based training tasks has previously been associated with altered symptomatology in both non-clinical and clinical populations. The current thesis aimed to investigate the mechanisms by which attentional bias training tasks alter attention. The investigations were conducted within an experimental neuroscience framework which has previously been successfully deployed in studies of antidepressant medication. The thesis then sought to use these initial results to improve the basic understanding of attentional control processes and, ultimately, guide the development of novel treatment strategies. The initial studies of the thesis characterised the behavioural and neural effects of attentional bias training. Behaviourally, a high degree of generalisation of the training effect was found across a range of emotional stimuli. Neurally, training was found to alter activity in a network of prefrontal regions known to be involved in the control of attention. Further analysis, utilising a computational learning model, suggested that the attentional control systems identified in this study could be understood in terms of expectation based processes. These studies therefore indicated that, in contrast to the predominately limbic effects of antidepressant medication, training initially altered the response of frontal control circuitry. The later studies of the thesis investigated possible strategies for extending the use of attentional bias training. Firstly, combining training with antidepressant medication was found to produce an interference effect on emotional memory suggesting that administering both interventions concurrently is likely to erode their cognitive impact. Lastly, attentional bias training was found not to alter attention in patients with bipolar disorder, with the results of the study indicating that standard assessments of attentional bias in this clinical population are likely to be unreliable. Overall, these studies indicate that attentional bias training may be used to alter the top-down control of attention to emotional information and suggest that such effects may interfere with the bottom-up effects of antidepressant drugs. More generally the work demonstrates the utility of using a cognitive-neuroscientific framework to explore the mechanisms and impact of novel therapeutic strategies.
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Scary, Thomas. "American Ignominy: The Incarceration of the Mentally Ill." Master's thesis, Temple University Libraries, 2018. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/501251.
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Urban BioethicsM.A.
Prisons and jails have become the de facto psychiatric hospitals of the twenty-first century. In the wake of deinstitutionalization, as mental healthcare transitioned to a community-based model, many patients with mental illness found themselves incarcerated rather than hospitalized. Strict drug laws combined with the current opioid epidemic are now forcing the government to consider treatment over punishment, lest the prison populations continue to swell. It is time to strongly consider using the involuntary commitment for severe cases of substance abuse if the patient is unwilling to undergo rehabilitation. Refusing to wait for the federal government to act, cities and states around the nation have begun to experiment with novel solutions to these issues, working within the framework of the prison system to achieve better outcomes.
Temple University--Theses
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Domingues, Munira Penha. "Pesquisa-ação e práticas educativas do enfermeiro psiquiátrico: incentivo à educação permanente em serviço." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/22/22131/tde-09032010-163740/.
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Introdução: O reconhecimento das dificuldades vivenciadas em serviço é de fundamental importância, sobremaneira, procurando buscar saídas para resolução dessas, entre outros problemas. Por vezes, as práticas educativas fazem parte da formação do enfermeiro psiquiátrico e devem ser realizadas em serviço, concomitantemente com as ações de enfermagem rotineiras. Elas contribuem para o aprimoramento de novos conhecimentos e para o desenvolvimento de habilidades e competências essenciais, tendo em vista a execução de uma assistência de enfermagem, com qualidade ao cliente, à família e à comunidade. Sendo assim, faz-se importante que o enfermeiro tenha construído conhecimentos teórico-práticos durante o curso de graduação em enfermagem, a fim de executar as práticas educativas em serviço, com segurança e preparo para trabalhar tais ações, em Unidades Psiquiátricas. A atuação crítico-reflexiva utilizada pelo docente de enfermagem, tem, como pressuposto, construir um modelo curricular que contemple o processo de formação articulado com o mundo do trabalho, usando estratégias inovadoras, trabalhando o ensino de forma contextualizada, visando à formação de um profissional mais crítico e compromissado com as questões profissionais e sociais. Assim, de acordo com os referenciais teóricos levantados, pudemos perceber que as práticas educativas contextualizadas e dialogadas, ainda não fazem parte do planejamento das ações de enfermagem como um todo. Sob essa perspectiva, é preciso haver a conscientização dos profissionais em relação à importância dessas práticas desenvolvidas em serviço, a serem mais democráticas e humanizadas, com o intuito de garantir a melhoria da força do trabalho em saúde, revelando, assim, a importância do nosso estudo. Como objetivo, propomos levantar com os enfermeiros que atuam na enfermagem psiquiátrica o conhecimento deles sobre educação permanente, verificando se eles participam dessas atividades em serviço, identificando suas dificuldades vivenciadas, buscando seu entendimento sobre a importância da prática educativa em serviço, bem como da educação permanente, como estratégia de organização da aprendizagem e atualização profissional; e desenvolver um programa educativo visando orientação sobre as dificuldades diagnosticadas nestas práticas. Metodologia: Trabalhando a pesquisa qualitativa, humanista, mediatizada pela metodologia da pesquisa-ação. Essa permite levantar problemas e, posteriormente, propor elementos educativos. Aplicamos duas técnicas para a coleta de dados: a entrevista, com a aplicação de questionário, e a observação participante com o uso do diário de campo. A amostra do nosso estudo se constituiu de 7 enfermeiros, da Clínica de Psiquiatria de um Hospital Escola, de uma cidade do interior paulista. Adotamos como critérios de inclusão: profissionais enfermeiros do local, que manifestaram concordância em participar do estudo com a assinatura do termo de consentimento livre e esclarecido, aprovado pelo Comitê de Ética em Pesquisa, atendendo aos preceitos éticos e ao rigor científico. Análise dos dados: esses foram levantados, através das falas emitidas pelos sujeitos pesquisados. Foram trabalhados qualitativamente e, portanto, por categorização, permitindo o agrupamento de todos os elementos convergentes e/ou divergentes, apropriados e/ou ajustados às reflexões, de acordo com a discussão, associados aos achados deste estudo. Resultados: Depreendemos que a maioria dos enfermeiros pesquisados atribui significativa importância à educação permanente em serviço, relacionando a busca de conhecimento, inovação, transformação, resolução de problemas, favorecendo a qualidade da assistência/ do ensino/ da pesquisa, assim como a valorização pessoal, profissional e institucional. Alguns sujeito afirmam executar a educação permanente em serviço, mas outros relatam não ter tempo e nem recurso para realizá-la. Os sujeitos da pesquisa têm noção real das questões abordadas, revelando estar antenados sobre a educação permanente. Também realizamos a ação educativa com os enfermeiros através de folhetos informativos avaliados de modo positivo pelos mesmos. Portanto, concluímos que a educação permanente já caminha com seus primeiros passos avaliados, na clínica psiquiátrica em foco, o que contribui para o planejamento e para a organização do trabalho dos enfermeiros, possibilitando uma assistência mais humanizada ao cliente e à família.Introduction: The acceptance of difficulties experienced in services is highly important, looking for solutions for such issues and others. At some point, the educative practices are part of the psychiatric nursing education and must be executed in service concomitantly with routine nursing actions. They contribute to improvements of learning and developing abilities and considerable capacities in order to provide with assistance in nursing at good qualities for customers, families and communities. Therefore, it is important that the nurse has built theory-practical knowledge during the graduation course in order to execute educative practices in services with security and be well-prepared to work in such actions in Psychiatric Units. The critical-reflexive acting used by a nursing teacher has the purpose of building a résumé model containing the educational process connected with the job outside by using new strategies in where the teaching will be done in a contextualised way, aiming preparing a more critical professional and more compromised about the professional and social matters. Thus, in accordance with the theoretic references studied it was observed that the contextualised and dialogued educative practices are not part of the nursing action plans in general. From this perspective is needed to have a professional consciousness about the importance of these developed practices in services in order to be more democratic and humanized with the purpose of assuring the working force improvement in healthy, revealing then the importance of this study. With the purpose of raising the acknowledge of lifelong learning in psychiatric nurses by verifying whether they take part of such activities, identifying their experienced difficulties, seeking their understanding process about the importance of educative practice in service as well as lifelong learning as a organisational strategy of learning and professional upgrades and developing a educative program aiming the orientation about the detected difficulties in this practices. Methodology: Working the qualitative and humanized research, interfering with research-action methodology. This study proposes raising issues and consequently offers educative components. Two techniques were applied to collect data: the interview applying a questionnaire and the attendant observation using their daily service. The sample of our study was based in seven nurses from the Psychiatric Clinical from a School Hospital of a city located in the interior of the country. As part of the criteria were adopted: local nurses, who manifested their agreement in taking part of this study afterwards their free and cleared consent term approved by the Research Ethical Committee and considered the ethical norms and scientific strictness. Data analysis: they were raised through verbal comments from researched people. They were qualitatively analysed and therefore, by categorization allowing the converging and divergent grouping appropriated/or adjusted to the reflexion according to the arguments associated to the issues found. Results: It was deduced that most of the researched nurses attribute considerable importance to the lifelong learning in services seeking for acknowledges, innovation, changes, problems solutions in order to collaborate to the assistance quality of teaching/research as well as personal, professional and institutional improvements. Some of them confirm that they execute a lifelong learning in service, however others relate about not having time neither resources to execute them. They have a real idea of the approached questions revealing to be updated to the lifelong learning. It was also done the educative action with nurses through bulletin news, which were evaluated in a positive way. Therefore, it was concluded that the lifelong learning is taking the first step forward to the Psychiatric Clinical, which contributes to the planning and organization of the nurses, directing to a more humanized assistance to the patient and family.
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Billings, Giovanni, and Michelle Moser. "Collaboration to Change the Trajectory for Child Welfare Involved Infants, Young Children, and Their Families: Implementation of Research Informed Infant Courts." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7689.
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USA Infant Court is a multisystem, trauma-focused approach designed to address the complex needs of infants, toddlers, and their parents involved in the child welfare system and to improve outcomes. Infant mental health values and principles as well as knowledge areas such as the impact of trauma on early brain development, attachment theory, and trauma -informed care are integrated into the practice of infant courts. The core components of evidenced informed infant and early childhood courts will be reviewed. Presenters will describe two pilot infant court projects and the expansion of infant courts statewide through legislation.
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Smith, Eric G. "Comparative Effectiveness of Lithium and Valproate for Suicide Prevention and Associations With Nonsuicide Mortality: A Dissertation." eScholarship@UMMS, 2014. https://escholarship.umassmed.edu/gsbs_diss/737.
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Background: The mood stabilizer lithium has long been reported to be associated with reduced suicide risks, but many studies reporting associations between lithium and reduced suicide risks also have been nonrandomized and lacked adjustment for many potential confounders, active controls, uniform follow-up, or intent-to-treat samples. Concerns also have been raised that medications being considered as potential suicide preventative might increase risks of nonsuicide mortality while reducing risks of suicide.
Methods: Three studies of Veterans Health Administration (VHA) patients were conducted combining high-dimensional propensity score matching with intent-to-treat analyses to examine the associations between lithium and valproate and one-year suicide and nonsuicide mortality outcomes.
Results: In intention-to-treat analyses, initiation of lithium, compared to valproate, was associated with increased suicide mortality over 0-365 days among patients with bipolar disorder (Hazard Ratio (HR) 1.50 [95% Confidence Interval 1.05, 2.15]) Nonsuicide mortality among VHA patients with or without bipolar disorder was not significantly associated with the initiation of lithium compared to valproate ( HR 0.92 [0.82-1.04]). Rates of treatment discontinuation, however, were very high (≈ 92%). Longitudinal analyses revealed that the increased suicide risks associated with initiating lithium among patients with bipolar disorder occurred exclusively after discontinuation of lithium vii treatment. In secondary analyses restricted to patients still receiving their initial treatment, there was no difference in suicide risk between the initiation of lithium or valproate.
Conclusions: Significantly increased risks of suicide were observed at one year among VHA patients with bipolar disorder initiating lithium compared to valproate, related to risks observed after the discontinuation of lithium treatment Since these studies are nonrandomized, confounding may account for some or all of our findings, including the risks observed after lithium discontinuation. Nevertheless, these results suggest that health systems and providers consider steps to minimize any potential lithium discontinuation-associated risk. Approaches might include educating patients about possible risks associated with discontinuation and closely monitoring patients after discontinuation if feasible. Given the obvious importance of any substantive difference between lithium and valproate in suicide or nonsuicide mortality risk, our studies also suggest that further research is needed, especially research that can further minimize the potential for confounding.
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Ruiz, Rocío. "Consumo de sustancias psicoactivas y demanda de tratamientos en la Provincia de Córdoba." Master's thesis, Ruiz R. Consumo de sustancias psicoactivas y demanda de tratamientos en la Provincia de Córdoba [Internet]. Universidad Nacional de Córdoba; 2018 [citado el 13 de febrero de 2020]. Disponible en: https://rdu.unc.edu.ar/handle/11086/11316, 2018. http://hdl.handle.net/11086/11316.
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Tesis-Maestría en Salud Mental-Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Facultad de Psicología, 2018Fil: Ruiz, Rocío. Universidad Nacional de Córdoba. Facultad de Psicología; Argentina.
documento pdf. 93 h.
En la presente investigación se describe el consumo de sustancias psicoactivas y la demanda de tratamiento de la población de 16 a 65 años de la Provincia de Córdoba. Se realizó un estudio descriptivo de poblaciones con muestras probabilísticas mediante encuestas. Se utilizó una base de datos secundaria perteneciente a la encuesta Nacional de prevalencia de consumo de sustancias psicoactivas (Ministerio de salud de la Nación). Como resultados se encontró que la prevalencia de consumo de bebidas alcohólicas fue la más alta, seguida por el tabaco. La prevalencia de consumo de sustancias psicoactivas fue mayor en los jóvenes de 16 a 24 años y en los varones. Las mujeres registraron mayor consumo de tranquilizantes y medicamentos para adelgazar. Por otro lado, se registró bajo porcentaje de demanda de tratamiento en relación a la prevalencia de consumo de sustancias psicoactivas y al abuso de consumo. Un alto porcentaje de entrevistados demandaron tratamiento pero no lo iniciaron.La mayor demanda de tratamiento se evidenció en consultorios externos, seguido por grupos de autoayuda y hospitales generales. El lugar de menor demanda fue los centros de salud mental. Por último los entrevistados de 50 a 65 años registraron mayor demanda de tratamiento por consumo de sustancias psicoactivas.Se alerta sobre la aplicación de la nueva ley de salud mental, las altas brechas de tratamiento, la prevención y los modelos de abordaje, arribando a nuevos interrogantes para próximas investigaciones.
In the present investigation the consumption of psychoactive substances and the treatment demand of the population of 16 to 65 years of the Province of Córdoba is described. A descriptive study of populations with probabilistic samples was carried out through surveys. A secondary database belonging to the National Survey on the prevalence of psychoactive substance use (Ministry of Health of the Nation) was used. As results, it was found that the prevalence of consumption of alcoholic beverages was the highest, followed by tobacco. The prevalence of consumption was higher in young people aged 16 to 24 years and in males. The women registered greater consumption of tranquilizers and medications to lose weight. On the other hand, there was a low percentage of demand for treatment in relation to the prevalence of psychoactive substance use and abuse of consumption. A high percentage of respondents demanded treatment but did not initiate it. The greatest demand was evidenced in outpatient clinics, followed by self-help groups and general hospitals. The place of least demand was the mental health centers. Finally, respondents between 50 and 65 years of age registered a higher demand for treatment. The application of the new mental health law, the high treatment gaps, the prevention and the boarding models are alerted, arriving at new questions for future investigations.
2020-12-17
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Markström, Urban. "Den svenska psykiatrireformen : bland brukare, eldsjälar och byråkrater /." Umeå : Borea, 2003. http://publications.uu.se/umu/theses/abstract.xsql?dbid=59.
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Ulbricht, Christine M. "Latent Variable Approaches for Understanding Heterogeneity in Depression: A Dissertation." eScholarship@UMMS, 2015. http://escholarship.umassmed.edu/gsbs_diss/774.
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Background: Major depression is one of the most prevalent, disabling, and costly illnesses worldwide. Despite a 400% increase in antidepressant medication use since 1988, fewer than half of treated depression patients experience a clinically meaningful reduction in symptoms and uncertainty exists regarding how to successfully obtain symptom remission. Identifying homogenous subgroups based on clinically observable characteristics could improve the ability to efficiently predict who will benefit from which treatments.
Methods: Latent class analysis and latent transition analysis (LTA) were applied to data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study to explore how to efficiently identify subgroups comprised of the multiple dimensions of depression and examine changes in subgroup membership during treatment. The specific aims of this dissertation were to: 1) evaluate latent depression subgroups for men and women prior to antidepressant treatment; 2) examine transitions in these subgroups over 12 weeks of citalopram treatment; and 3) examine differences in functional impairment between women’s depression subgroups throughout treatment.
Results: Four subgroups of depression were identified for men and women throughout this work. Men’s subgroups were distinguished by depression severity and psychomotor agitation and retardation. Severity, appetite changes, insomnia, and psychomotor disturbances characterized women’s subgroups. Psychiatric comorbidities, especially anxiety disorders, were related to increased odds of membership in baseline moderate and severe depression subgroups for men and women. After 12 weeks of citalopram treatment, depression severity and psychomotor agitation were related to men’s chances of improving. Severity and appetite changes were related to women’s likelihood of improving during treatment. When functional impairment was incorporated in LTA models for women, baseline functional impairment levels were related to both depression subgroups at baseline and chances of moving to a different depression subgroup after treatment.
Conclusion: Depression severity, psychomotor disturbances, appetite changes, and insomnia distinguished depression subgroups in STAR*D. Gender, functional impairment, comorbid psychiatric disorders, and likelihood of transitioning to subgroups characterized by symptom improvement differed between these subgroups. The results of this work highlight how relying solely on summary symptom rating scale scores during treatment obscures changes in depression that might be informative for improving treatment response.
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Sjögren, Reet. "Att vårda på uppdrag kräver visdom : En studie om lidandet hos och vårdandet av patienter som sexuellt förgripit sig på barn." Doctoral thesis, Växjö universitet, Institutionen för vårdvetenskap och socialt arbete, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:vxu:diva-541.
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The present study focuses on the caring of patients who have sexually abused children. To do research in a field that has been considered taboo has not been without problems. The conclusive factor for the decision to carry out the research was the fascinating and interesting paradox that, in spite of the caregivers having a mandate from the judicial system to do care for these patients, they do not understand how this care is to be given. The understanding of what caring for these patients can entail is based on the perspectives of the lifeworld of both the patients and the caregivers. The theoretical perspective in this dissertation is that of the caring sciences while the epistemological framework is phenomenology. Research data consist of qualitative interviews. The aim of the first study is to describe the patients’ suffering, and the aim of the second study is to describe the caregivers’ experiences of caring for these patients. The essential meaning of the suffering felt by the patients is described in terms of the patients’ acknowledgement and then betrayal of their yearning to be part of a close human fellowship. The meaning structure of “caring”, can be understood as being lost in an obscure and unknown landscape. It challenges the caregivers and occasionally arouses strongly unpleasant but also strongly threatening feelings. However when the caregivers gain clarity on how to care they are able to find their caring courage and hope, even for these patients. The findings thus show that caring for patients who themselves do not see any opportunity of taking a place among other adults is a great challenge. The study also shows that the support that is needed to be successful in caring for these patients is a caring culture that can permeate both patients and caregivers. These patients, whose criminal acts appear to be bizarre and strange, need to learn to be able to bear their suffering without losing their humanity. The philosophical intermediate chapter shows that it is the body image of the patients that prevents them from becoming whole, i.e. existing fully, by it playing the existential drama that leads to sexual abuse. It appears from this dissertation that in order for caring to be able to relieve the suffering felt by these patients, and thus prevent them from further abuse of children, then it is important as a caregiver to be able to allow the patients just to “be”. The research also shows that in order for caregivers to be able to understand what they receive from the patients they need support from both caring science and existential reflections. Such methods can help to clarify caring and to give possibilities for a freer and more creative thinking. Encountering and understanding different lifeworlds is necessary in order to give care based on a caring perspective. The patient group in the present study have been able to demonstrate this in a clearer way than has previously been done.
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Weathers, Judah D. "Cognitive functioning in bipolar disorder." Thesis, University of Oxford, 2012. http://ora.ox.ac.uk/objects/uuid:6a73683c-0047-4285-a251-2414a0f64d0f.
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To align the neuropsychological functioning of our adult euthymic patient group with that reported in previous studies on euthymic bipolar disorder (BD), we used a neuropsychological battery that examined sustained attention (Rapid Visual Information Processing Task), verbal memory (California Verbal Learning Task), executive functioning (Intradimensional-Extradimensional Shift Task, Barrett Impulsivity Task, and Framing Task), and emotion responsiveness/regulation (Positive Affect/Negative Affect Scales, Behavioral Inhibition/Behavioral Activation Scale, and Affective Lability/Affective Intensity Scales) in patients versus healthy volunteers (HV). Our results corroborated existing evidence of reduced sustained attention, impaired verbal memory and executive functioning, and abnormal emotional responsiveness and regulation in euthymic BD relative to healthy controls (Chapter 2). To investigate how abnormal development of brain function in BD leads to deficits in decision-making, motor inhibition, and response flexibility, we examined child and adult BD using a novel risky decision-making task, and used cross-sectional (age x diagnosis) functional magnetic resonance (fMRI) designs to examine neural activation associated with motor inhibition and response flexibility in BD relative to HV. During the risky decision-making task, adult euthymic BD patients were no different from healthy controls in their proportion of risky lottery choices over a range of competing lotteries. This matched behavioral performance was associated with similar prefrontal and striatal brain activation between the patient and control groups during response, anticipation, and outcome phases of decision-making (Chapter 3). These results are different from previous studies that have shown increased risk taking during decision-making in euthymic BD. Similarly, young BD patients were no different from age-matched healthy and patient controls in their pattern of decision making during the risky choice task. This was evidenced by a similar number of risky lottery selections over the range of changing expected values between the young BD group and control groups (Chapter 4). Using a cross-sectional, fMRI analytic design during the stop signal task, we found that child and adult BD showed similar behavioral performance to child and adult HV during motor inhibition. However, this matched behavioral performance was associated with abnormal neural activation in patients relative to controls. Specifically, during unsuccessful motor inhibition, there was an age group x diagnosis interaction, with BD youth showing reduced activity in left and right ACC compared to both age-matched HV and adult BD, and adult BD showing increased activation in left ACC compared to healthy adults. During successful motor inhibition there was a main effect of diagnosis, with HV showing greater activity in left VPFC and right NAc compared to BD (Chapter 5). These neuroimaging data support existing laboratory-based evidence of motor inhibition impairments in BD relative to HV, and indicate brain dysregulation during motor control is important to BD pathophysiology. A previous behavioral study showed impaired response flexibility in young BD patients relative to age-matched controls when using the change task. Here, we used the change task during fMRI to examine response flexibility in child and adult BD compared to child and adult HV. We found that patient and control groups showed similar change signal reaction times in response to change cues. However, this matched behavioral performance was associated with abnormal age group x diagnosis activations in brain regions important in signal detection, response conflict, response inhibition, and sustained attention. Specifically, during successful change trials, child BD participants showed frontal, parietal, and temporal hyperactivation relative to healthy children and adult BD, while adult BD showed hypoactivation in these regions relative to healthy adults. These novel fMRI findings during the change task indicate impaired neural activation during response flexibility may be important to the pathophysiology of BD development.
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Capitao, Liliana. "Early effects of fluoxetine on emotional processing : implications for adolescent depression." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:c713518b-97bd-4692-99ba-288f37c97ddd.
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Depression in adolescence is a major health problem, associated with poor psychological function and key risk factors both for later illness and suicidal behaviours. The antidepressant fluoxetine is commonly used in this population and it is shown to have a favourable benefit-to-risk profile. However, controversy still exists about the use of antidepressants in young people and there is little research focusing on underlying mechanisms of wanted and unwanted actions in this group. This doctoral thesis aims to investigate, for the first time, the acute effects of fluoxetine on emotional processing, using a combination of behavioural and neuroimaging techniques. The aim is to achieve a greater understanding of the mechanisms underlying fluoxetine use in depressed adolescents, in light of differences seen in their clinical presentation and response to antidepressant drugs. In the first study (Chapter Two), a single dose of fluoxetine was shown to decrease the recognition of anger in a sample of young adult volunteers, an effect not previously seen in acute studies of older participants. This effect may be particularly relevant for the treatment of adolescent depression, in which symptoms of anger and irritability are often prominent. Beyond this, fluoxetine was shown to increase the recognition of positive vs. negative facial information, and also exerted an anxiolytic-like influence, eliminating the emotion-potentiated startle effect. However, no influence was seen in measures of attentional vigilance to threat. In an attempt to overcome methodological limitations of this study, a paradigm was developed that is particularly sensitive to the detection of automatic biases towards threatening information (Chapter Three). Chapter Four describes a neuroimaging study with depressed adolescents, in which a single dose of fluoxetine was found to reduce amygdala activity in response to anger. Early changes in amygdala activity to fear correlated with decreased symptoms of anxiety and depression in the first 7-10 days of treatment. Chapter Five explores the effects of acute fluoxetine in a sample of high trait anger males. This study replicated the finding that fluoxetine acts to increase the recognition of positive information, whilst showing preliminary evidence for a reduction in attentional vigilance to angry faces. Overall, fluoxetine was found to decrease the processing of anger across studies. This effect was seen alongside a broader influence on positive vs. negative information and anxiolytic-like properties. Together, these results indicate that fluoxetine has direct effects on processes that are especially relevant to adolescent depression and suggest a potential cognitive mechanism for the efficacy of this particular antidepressant in adolescent patients.
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Hungerford, Gabriela Marie MS. "Characterizing Community-Based Usual Mental Health Care for Infants." FIU Digital Commons, 2016. http://digitalcommons.fiu.edu/etd/2609.
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Infants who experience multiple risk factors, such as preterm birth, developmental delay, and low socioeconomic status, are at greater risk for mental health problems. Mental health interventions for infants typically target infants from high-risk groups, and there is strong evidence that some intervention programs for infants can prevent long-term negative outcomes and promote long-term positive outcomes. Despite emerging research and federal initiatives promoting early intervention, minimal research has examined community-based mental health services during infancy. Improving the effectiveness and efficiency of routine care requires close examination of current practices. The current study characterized current usual care practices in infant mental health through a survey of mental health providers. Provider, practice, and client characteristics, provider use of intervention strategies and intervention programs, and provider attitudes toward and knowledge of evidence-based practices are described. Study findings are discussed in the context of previous usual care research. Implications and directions for future research are discussed.
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Pereira, Bruce Roland. "A narrative and systemic exploration of dementia and spousal relationships : volume 1, research component and volume 2, clinical component." Thesis, University of Birmingham, 2012. http://etheses.bham.ac.uk//id/eprint/3759/.
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Volume one represents the research component of the qualification, and is comprised of a conceptual literature review and a qualitative research paper. The conceptual review analysed a small sample of the qualitative literature on couplehood and dementia. The analysis used Dialogic/Performance Analysis (Reissman, 2008) to provide critical commentary about the implications of participant voice, linguistic features and context in research papers, and how these may uncover possible narratives that are embedded in the literature. Implications of embedded narratives have been discussed. The research portion is a piece of qualitative research that used Interpretative Phenomenological Analysis. The theoretical underpinning is that of Systemic psychology. Three couples were recruited (the husbands were all diagnosed with dementia). The couples have been presented as case studies showing themes that emerged between the partners in the couples. The discussion focuses on the perceptions of continuity/discontinuity in the relationship and shared and unshared narratives. Clinical implications and directions for future research have been proposed. Volume two represents the clinical aspects of this qualification and is comprised of five clinical case reports: A case study using dual formulation, a small scale service-related research (service evaluation), single-case experimental design, case study and the abstract from an oral presentation.
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Hrádková, Jana. "Anthology of Unspoken: Surreal Complexity of Mind." Master's thesis, Vysoké učení technické v Brně. Fakulta výtvarných umění, 2021. http://www.nusl.cz/ntk/nusl-445692.
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The diploma thesis Anthology of Unspoken is a form of personal therapy, a coping mechanism in the shape of an extensive personal research presented by visually eclectic web, which maps the perception of depression and melancholy in terms of historical, artistic, and partly academic discourse. AoU takes the form of a website on the border of an archive and a research blog, which visually reminds a notebook with the use of texts in the form of notes, reader view essays, and accompanying visual material (period paintings, pop-cultural references, emoticons etc.). This diploma thesis has two main goals. Firstly, it represents a way of finding means to articulate and at least fractionally understand my own problems. Secondly, it is a way of finding answers to the following questions: Is depression really a modern matter of the 21st century? Why is it so difficult to talk about it? Where do the shame and feeling of guilt, with which it is inextricably associated with, come from? Is melancholy synonymous with depression, or do these terms differ from each other? And is depression really a disease or is it only a sign of my own failure?
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Young, Katherine S. "Adults' responses to infant vocalisations : a neurobehavioural investigation." Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:6f91f1ae-0948-4b34-b45f-ee65ae421934.
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Infant vocalisations are uniquely salient sounds in the environment. They universally attract attention and compel the listener to respond with speed and care. They provide a wealth of information to parents about their infant’s needs and affective state. There is a scientific consensus that early parenting has a profound impact on child development. In particular, the sensitivity with which parents respond to their infant’s communicative cues has been shown to affect cognitive and socio-emotional outcomes. The mechanisms underlying such sensitivity are not well understood. In this thesis, adults’ sensitivity to infant cues will be considered in terms of two components, the ‘promptness’ and ‘appropriateness’ of responses, as originally conceptualised by Bell and Ainsworth (1972). Promptness of responses is considered in terms of adults’ ability to move with speed and effort after listening to infant vocalisations. Appropriateness, on the other hand, is considered in terms of adults’ ability to differentiate between functionally significant parameters in infant vocalisations. The effect of modifiable environmental factors on the promptness and appropriateness of responses is also investigated. Finally, a focused investigation of the brain basis of responses to infant vocalisations is presented. Overall, findings demonstrated that infant vocalisations undergo privileged, specialised processing in the adult brain. After hearing an infant cry, adults with and without depression were found to move with greater coordination and effort. Adults were also found to be attuned to subtle parameters in infant cries. This sensitivity was shown to be affected by two participant-level factors, depression and previous musical training. Furthermore, this sensitivity could be enhanced through intervention, as evidenced by findings from short-term, perceptual discrimination training. The notion of privileged processing of infant vocalisations is further supported by evidence of early discrimination of infant sounds in a survival-related subcortical brain structure. Future directions for this work include directly relating current experimental measures of adults’ responses to infant cues with parental sensitivity to infant communication during dynamic interactions. Translating current findings into applied settings would require an investigation of the effects of factors such as musical and perceptual training on sensitivity to infant cues in at-risk populations, such as mothers and fathers with depression. Lastly, an increased understanding of the brain basis of adults’ sensitivity to infant cues will provide insight into our greatest challenge: parenting our young.
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Kilian, Sanja. "Interpreting practices in a psychiatric hospital : interpreters' experiences and accuracy of interpreting of key psychiatric terms." Thesis, Link to the online version, 2007. http://hdl.handle.net/10019/1067.
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Kemperman, Ramses Franciscus Jacobus. "Nutrition and biomarkers in psychiatry research on micronutrient deficiencies in schizophrenia, the role of the intestine in the hyperserotonemia of autism, and a method for nonhypothesis driven discovery of biomarkers in urine /." [S.l. : Groningen : s.n. ; University Library of Groningen] [Host], 2007. http://irs.ub.rug.nl/ppn/305278908.
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Dokter, Ditty. "Cultural variables affecting client/therapist consonance : the perception of efficacy in arts therapies group treatment." Thesis, University of Hertfordshire, 2008. http://hdl.handle.net/2299/1843.
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This thesis addresses the hypothesis “ Intragroup cultural differences between client and therapist will adversely affect client – therapist consonance in their perception of arts therapies group treatment” The literature review of intercultural psychotherapy, arts therapies and congruence research is contextualised in a discussion of the arts therapies in the UK, in particular group therapy in psychiatry. The discussion of the evolution of a multi modal research design incorporates an ethnographic perspective. The researcher shows how the setting and two pilot studies as well as the Evidence Based Practice initiative influenced the design. The main concepts in the research question are defined and the sample analysed within its local context. Helping and hindering factors in arts therapies group sessions are identified through cluster analysis of questionnaires and focus groups. The next stage of the analysis examines which client, therapist and treatment variables are shown to affect dissonance. Five case studies show the interaction of these variables for individual clients. The concluding chapter discusses the findings and critiques the methodology, as well as providing recommendations for further research. The hypothesis of the research is found invalid; cultural background variables alone do not create client-therapist dissonance. The findings show that client, therapist and treatment variables interact to create dissonance. Client diagnosis, stage of treatment and cultural background interact with their experience of the arts therapies medium. In an arts therapy group context the structuring of the group and the interpretation of the arts expression as symbol or index, will interact with client and therapist cultural background variables. The intragroup variations are migration history, nationality, religious orientation and first language spoken. Cultural difference with the therapist affecting dissonance was evident for those clients who were third generation English / British and who had grown up and were still resident in an non-urban area (small town or village in a predominantly agricultural region) with little cultural diversity. Intergroup difference affected attrition for one client, influenced more by peer than therapist dissonance. Treatment interruptions, the theoretical orientation of the therapists and peer dissonance interact with the client-therapist dissonance. Recommendations for practice are formulated from these findings. These concern adjusting practice to allow for a greater emphasis on expression and play, differing client perceptions about symbolism and the establishing of an early therapeutic alliance.
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McCabe, Patrick J. "Cannabis Use and Bipolar Disorder: Bipolar Disorder Case Identification and Cannabis Use Risk Assessment: A Dissertation." eScholarship@UMMS, 2011. https://escholarship.umassmed.edu/gsbs_diss/584.
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Bipolar disorders (BD) are characterized by symptoms of grandiosity, decreased need for sleep, pressure to keep talking, flight of ideas, distractibility, increased goal-directed activities, psychomotor agitation, and excessive involvement in pleasurable activities. Those with a bipolar disorder have a high degree of psychiatric comorbidity including substance use disorders, and they also experience increased mortality. Despite the widespread recognition of BD as an important psychiatric condition, available population-based estimates for BD prevalence differs across data sources.
Cannabis is one of the most widely-used illicit substances. Evidence supports it as a risk factor for psychotic symptoms and disorders. Because populations with psychotic disorders and populations with bipolar disorder share genetic characteristics, cannabis may increase risk for bipolar disorders through the same pathways as it does with psychotic disorders. Limited and conflicting evidence regarding the association of cannabis use and bipolar disorder is currently available. This dissertation investigates cannabis use as a risk factor for incident manic symptoms and bipolar disorders in a large nationally representative longitudinal cohort.
The first aim of this dissertation is to evaluate the implications for manic, hypomanic and major depressive episode prevalence estimates arising from the different approaches to assessing DSM-IV criterion between two national surveys. Differences in the assessment of impairment strongly influence manic or hypomanic classification within the NESARC. Compared to multiple imputation estimates (19.7% [95% CI: 19.3-20.1]) which treat depressed mood and anhedonia as separate symptoms, symptom assessment in the NESARC substantially underestimates major depressive episode prevalence (16.9% [95% CI: 16.1-17.6]).
The second research objective examined self-reported cannabis use as a risk factor for incident manic symptoms, bipolar spectrum disorders (including manic and hypomanic episodes) and SCID-based recalibrated BD I and II. Cannabis use risk was assessed in the population as a whole and in sub-populations defined by age, substance abuse/dependence status, and family history. Among those reporting no lifetime major depressive or manic symptoms at baseline, self-reported past-year cannabis use was associated with increased odds of an incident week of extremely elevated or irritable mood accompanied by at least two manic episode criterion B symptoms (adj. OR 1.69, 95% CI: 1.08-2.65, p=.02) over the three year follow-up period. Among adults (ages 26 to 45) >=1 reported use(s) of cannabis per week was associated with incident manic or hypomanic episodes (adjusted OR 2.52, 95% CI: 1.32-4.80, p=.006). Among those endorsing no major depressive symptoms, substance abuse/dependence, or anti-social traits in their first degree relatives, past year cannabis use is associated with increased risk for incident bipolar spectrum disorders (adjusted OR 2.27, 95% CI: 1.01-5.10, p=.05) and CIDI recalibrated BD I and II (adjusted OR 5.49, 95% CI: 1.38-21.9, p=.02). Past year cannabis use risk for DSM-IV manic or hypomanic episodes among those aged 26 to 45 is concentrated in those with a baseline history of a substance use disorder (adj. OR 2.00, 95% CI: 1.10-3.66, p=.02) as compared to those with no such history (adj. OR 1.87, 95% CI: 0.49-7.21, p=.36).
The third research objective of this dissertation was a sensitivity analysis using externally-predicted categorized exposures and continuous cannabis use propensities. The sensitivity analysis found evidence of exposure misclassification. Exposures defined by external propensity scores had improved cross-sectional association with bipolar spectrum disorders compared to reported use when both were compared to an external standard. No significant risk estimates were found for categorized predicted cannabis use among groups that were previously found to have significant risk from reported exposure. However, among adults 18 to 45 years of age with no manic or major depressive symptoms at baseline, past year cannabis use propensity (as a log transformed continuous measure) was associated with incident manic or hypomanic episodes (adj. OR 1.49, 95% CI: 1.10-2.03, p=.01). Elevated risk for high cannabis use propensity (>=1 use/week in the past year) was also found in this same group (adj. OR 1.33, 95% CI: 1.03-1.72, p=.03). Among those with no reported history of depression, substance abuse/dependence, or anti-social traits among their first-degree relatives, propensity for past year cannabis use (adj. OR 1.61, 95% CI: 1.11-2.32, p=.01) and propensity for >=1 use/week of cannabis in the past year (adj. OR 1.38, 95% CI: 1.03-1.85, p=.03) were associated with incident manic or hypomanic episodes. Among those without a substance use history at baseline, propensity for past year cannabis use (adj. OR 1.63, 95% CI: 1.33-1.55, p=1 use/week of cannabis in the past year (adj. OR 1.54, 95% CI: 1.26-1.88, p
The findings of the first aim support the conclusion that the AUDADIS substantially under-estimated lifetime major depressive episode prevalence compared to an imputed estimate that treated anhedonia and depressed mood as separate and concurrent MDE symptoms. The operationalization of impairment for manic disorders in both the AUDADIS and CIDI strongly influences case identification, with the CIDI having suppressed manic and hypomanic prevalence estimates. Evidence was found supporting the conclusion that self-reported cannabis use is a significant risk factor for incident bipolar spectrum outcomes within subpopulations in a nationally representative cohort. A sensitivity analysis finds evidence that supports the conclusion that increasing cannabis use propensity is associated with increased risk of bipolar spectrum outcomes within population subgroups, with the greatest increased risk among those with the lowest innate risk. Under-reporting of illicit substance use is a major limitation in this dissertation; further study is needed with improved exposure measures.
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Jensen, Bryan. "Chronic Pain Causal Attributions in an Interdisciplinary Primary Care Clinic: Patient-Provider and Provider-Provider Discrepancies." VCU Scholars Compass, 2016. http://scholarscompass.vcu.edu/etd/4100.
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The purpose of the present study was to investigate the influence of pain causal attributions on patient pain-related functioning, treatment engagement, and clinical outcomes. Additionally, the impact of discordant pain causal attributions between patients and their providers as well as between interdisciplinary providers was examined. Patients rated their pain functioning and causal pain attributions during a regular clinic visit. Following the patient’s visit both the behavioral medicine provider and internal medicine resident provided ratings of similar pain-related functioning domains and causal attributions. Follow-up data were collected from the electronic medical record three months following that clinic visit. Overall, results revealed that patients’ chronic pain attributions did influence pain-related functioning, however the impact was relatively small. There was insufficient evidence to conclude that chronic pain attributions influence a patient’s readiness to adopt self-management coping strategies and their subsequent treatment engagement. Additionally, results confirmed that different health care disciplines attribute the cause of patients’ chronic pain in distinct ways and these unique perspectives can lead to discrepant pain-related functioning assessments between providers. Discordant ratings between providers were shown to influence referring patterns for interdisciplinary services and the patient’s overall opioid dose. Similarly, discrepancies between patients and their providers influenced subsequent referral for behavioral health services, the patient’s attendance at those visits, and their overall morphine equivalent doses. Together the results indicate the important role pain attributions can play in chronic pain management and highlight the central role of the patient-provider and provider-provider relationship.
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Kaatari, Hans. "Symbolfunktion och mening : En undersökning av den psykoanalytiska psykoterapins artegna väsen." Doctoral thesis, Umeå universitet, Psykiatri, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1681.
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This work in two parts – entitled Symbolic Function and Meaning: An Investigation of the Species-Specific Essence of Psychoanalytic Psychotherapy – could be characterized as an interpretation of the above-mentioned therapy and the meaning of its particular experience. In the first part, besides a licentiate thesis, four topics are examined: the therapeutic framework, the transference – especially in neurotic form – and its interpretation, psychotherapy with borderline patients, and therapy with psychotics. This has been done by combining studies of literature with analyses of the transference meaning of a number of illuminative clinical examples or vignettes – anecdotes, i.e. narratives with a significant point – the main part of which are the outcome of the author’s own activity in the form of participant observation as a psychotherapist. The general conclusion is that promoting the symbolic function is the essential ingredient in the psychoanalytic form of therapy – its very rationality – and how it effectuates its unique therapeutic potentiality; a characterization which, despite obvious differences in the adequacy of symbolic functioning, is valid irrespective of whether the patient is diagnosed as neurotic, borderline or psychotic. In the second part – essentially of a theoretical nature in contrast to the preceding one – the study is influenced by philosophical hermeneutics, and in this process assimilates its particular conceptuality. The continued analysis of the research object shows that it is misleading, in view of its ontology, to conceptualize it in medical terms as treatment. Aimed at promoting the symbolic function by the transference being interpreted, psychoanalytic psychotherapy instead operates in an ethical dimension and is rather what Aristotle terms a praxis, on the one hand; on the other hand, it is moreover implicitly human science action research into intersubjective appropriation of meaning. In this latter respect, the investigation highlights the fact that the very special interview method in the form of free associations, with their reflexivity, gives the psychoanalytic form of psychotherapy the potential to be not only a qualitative research method but also simultaneously metaresearch. The analyses of the transference meaning of clinical anecdotes in the first part have thereby been able to be methodologically clarified retroactively as psychoanalytic metaresearch.
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Sadicario, Jaclyn S. "PREDICTORS OF EXPERIMENTAL AND CONTROL GROUP ATTENDANCE: FINDINGS FROM AN HIV/STD PREVENTION RCT WITH PREGNANT WOMEN AT RISK FOR SUBSTANCE USE." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/5703.
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Efforts to improve inclusion in research have included mandating the recruitment of ethnic minorities and women into NIH funded studies. However, little research has been completed on who attends such interventions. This is particularly worrisome in populations for which attendance to interventions can have dire consequences. HIV is a public health concern for pregnant women in substance using communities, as pregnant women are much less likely to use condoms during intercourse to prevent HIV. Group modular HIV prevention interventions have long been the standard for HIV prevention. However, little attention in research on HIV prevention interventions RCTs has been focused on attendance to these interventions. This study examined predictors of intervention and control group attendance in a randomized controlled trial comparing a 5-session Safer Sex Skill Building (SSB) intervention to a 1-session HIV education control group in a sample of pregnant women at risk for prenatal substance use. This study identified psychosocial and mental health variables associated with both 1 session control group and 5-session SSB intervention attendance as well as endeavored to identify the number of sessions necessary to attend to achieve an adequate dose in treatment. Findings include younger age and marital status as being predictive of participation in the one session HE control group and having a trade, skill, or profession as being predictive of participation in the five session SSB intervention group. Further research is needed to understand what factors may impact five-session SSB group attendance.
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Masters, Grace A. "Bipolar Disorder in the Perinatal Period: Understanding Gaps in Care to Improve Access and Patient Outcomes." eScholarship@UMMS, 2021. https://escholarship.umassmed.edu/gsbs_diss/1127.
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Background:
Bipolar disorder (BD) is a significant cause of perinatal morbidity and mortality. Because BD is hard to detect and treat, these individuals often go without care. This dissertation was designed to: (1) identify the prevalence rates of BD and bipolar-spectrum mood episodes in perinatal individuals, (2) understand pertinent barriers to mental healthcare, and (3) elucidate how to bridge healthcare gaps.
Methods:
Data sources included: primary qualitative and quantitative data from obstetric clinicians, encounter data from Massachusetts Child Psychiatry Access Program (MCPAP) for Moms, a program aimed at helping clinicians to provide mental healthcare to perinatal patients. Analyses included: descriptive statistics, systematic review and meta-analysis, qualitative data analyses, longitudinal regression analyses, and group-based trajectory modeling.
Results:
The prevalence of BD in perinatal individuals was 2.6% (95% CI: 1.2 to 4.5%). Twenty to 54.9% were found to have a bipolar-spectrum mood episode. Barriers to mental healthcare for perinatal patients with BD included the paucity of psychiatric resources, difficulties in assessing BD, and stigma towards pharmacotherapy. Obstetric clinicians reported that MCPAP for Moms has helped them feel more comfortable in treating patients with BD. Longitudinal analyses of encounter data corroborated these findings - utilization of the program predicted increased clinician capacity to treat BD.
Conclusion:
Clinicians for perinatal individuals are being called upon and stepping up to care for complex illnesses like BD. Programs like MCPAP for Moms can help them feel more confident in this role, helping to bridge gaps in perinatal mental healthcare and ensuring that individuals with BD are able to receive appropriate care.
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Coulson, Louisa Katie. "The influence of emotional stimuli on cognitive processing during transient induced mood states." Thesis, University of Oxford, 2012. http://ora.ox.ac.uk/objects/uuid:b8fc9fab-e9e0-4b3f-b78e-c76e25224972.
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Selective attention is a mechanism used to allocate resources to information processing. Both mood states and emotionally salient stimuli can influence which information is selectively attended. This information is subsequently processed in a more elaborative manner and affects task performance. The experiments presented in this thesis explore the influence of mood and emotional stimuli on selective attention and consequently task performance. Mood induction procedures were used to induce transient neutral, sad, and happy mood states in healthy volunteers. A systematic review and meta-analysis of 41 studies using sad mood induction procedures showed cognitive impairments in performance in the context of task neutral stimuli. In contrast biases in attention towards mood-congruent negative stimuli led to improved task performance. A series of three behavioural experiments with 197 participants demonstrated that participants made decisions on the basis of less information when that information was preceded by emotional but not neutral stimuli. Induced mood state did not affect performance. The behavioural and neural correlates of visual attentional processing to emotional stimuli were explored using magnetoencephalography in 24 healthy participants following sad, happy, and neutral mood induction procedures. The M300, a component associated with selective attention, had greater amplitude following presentation of negative compared with positive stimuli, which was associated with improved task performance. Reduced M300 amplitude and impairments in performance occurred following sad mood induction procedures. The experiments presented in this thesis demonstrate prioritized processing of emotional information and provide some evidence for impaired performance following sad mood induction procedures.
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Wernersbach, Brenna M. "The Impact of Study Skills Courses on Academic Self-Eficacy." DigitalCommons@USU, 2011. https://digitalcommons.usu.edu/etd/909.
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Colleges across the nation are increasingly interested in improving retention of students. Many universities have begun offering workshops and courses targeted at improving study skills in academically underprepared students with the goal of helping students succeed in higher education and continue enrollment. The impact of such courses on study skills themselves has been supported, but prior research has not examined the courses impact on students' beliefs about their ability to succeed in college - that is, their levels of academic self-efficacy. This study examined pre- and post-test levels of academic self-efficacy in college students enrolled in a study skills course in comparison to students not enrolled in such a course. Results indicated that students identified as academically underprepared did indeed have lower levels of skill and academic-self efficacy than students not enrolled in study skills courses, and students enrolled in study skills courses had greater increases in academic self-efficacy than comparison students.