Dissertations / Theses on the topic 'Symptoms'
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Kim, Jung-Eun Esther. "Multiple symptoms and symptom clusters in patients with cancer." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3324589.
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Spengler, Peter A., and Hans-Ulrich Wittchen. "Procedural validity of standardized symptom questions for the assessment of psychotic symptoms." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-103807.
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The study examines to what degree well-documented present and life-time psychotic symptoms in a group of former psychiatric inpatients are ascertained when using the Diagnostic Interview Schedule (DIS). The Inpatient Multidimensional Psychiatric Scale (IMPS) and the Manual for the Assessment and Documentation of Psychopathology/Diagnostische Sichtlochkartei (AMDP/DiaSika) Interview-Checklist approach were used for the “clinical” evaluations of symptoms. The results indicate fair concordance between the two clinical approaches and the DIS with regard to the presence of any delusional or hallucination symptoms. Low to poor agreement was found in the assessment of many of the rather specific hallucinations and delusions. Generally, the concordance found was higher when compared to the more clinical AMDP/DiaSiKa approach than to the IMPS. More detailed comparisons with diagnostic subgroups of schizophrenic and schizoaffective patients substantiated the findings in the overall sample. Overall it was reconfirmed that the DIS approach is limited to those patients who are cooperative and at least partly remitted.
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Rattan, Arlene I. "A self-report measure of neuropsychological symptomology : the neuropsychological symptom inventory." Virtual Press, 1987. http://liblink.bsu.edu/uhtbin/catkey/558345.
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The purpose of the study was to investigate the perceived anxiety experienced by coronary care nurses working eight- and 12-hour work shifts. It was hypothesized that length of shift work affects the before- and after-shift anxiety for nurses working eight or 12-hour work shifts. Anxiety differences between the eight- and 12-hour work shifts were examined as well as differences between the before- and after-shift anxiety for each length of shift.Thirty-two (32) coronary care nurses from a general medical and surgical hospital in the Midwest volunteered to participate in the research. The sample consisted of all females (18 Registered Nurses, nine Licensed Practical Nurses, three charge nurses, a supervisory nurse, and a rehabilitation nurse). The nurses had voluntarily selected the eight- or 12-hour length of shift work and understood that they would be committed to work that shift for one year. Twelve nurses worked the eight-hour shift; 20 nurses chose the new 12-hour shift.The State Anxiety Inventory (SAI) was used to measure the nurses' before- and after-shift anxiety. Baseline data were collected from the nurses prior to the initiation of the 12-hour shift. The Box-Jenkins Time Series Analysis was used to analyze the daily before- and after-shift anxiety scores and to establish a forecasted trend for both the eight- and 12-hour shifts.The first finding was that the before-shift anxiety scores for the eight-hour workers declined, while the anxiety scores for the 12-hour workers increased, following the implementation of the 12-hour shift. The same trend was forecast for the after-shift anxiety scores. The eight-hour nurses' after-shift anxiety scores declined while the 12-hour nurses' anxiety scores increased. A transfer function was conducted for both the eight-hour and 12-hour before- and after-shift anxiety scores. No predictive trend could be established for the eight-hour anxiety scores; however, the 12-hour after-shift anxiety scores were found to be consistently higher than before-shift anxiety scores.Department of Educational Psychology
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Rijal, Sagar. "THE SYMPTOMS : STORIES." Miami University / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=miami1218083641.
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Guerreiro, da Costa Ana Paula. "The relationship among eating disorder symptoms, depressive symptoms, and attributional styles." Thesis, Keele University, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.491845.
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West, Penny L. "Neuropsychological symptoms in the learning disabled child : a symptomology inventory." Virtual Press, 1990. http://liblink.bsu.edu/uhtbin/catkey/720145.
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A predominance of symptomology related to neurological dysfunction has been reported for at least some learning disabled (LD) students. This investigation examined the self-reported neuropsychological symptoms of LD and normal students in grades 3 through 12. Determination of group membership based on the childrens' responses to items on the Neuropsychological Symptom Inventory (NSI) was made for all subjects in the study.A discriminant analysis was conducted in order to determine the degree of group separation based on the item responses and which reported symptoms add significantly to that separation. Out of 40 possible items, 19 added to the discriminant function. Prediction of group membership was accomplished with a high degree of accuracy. Nearly 80% of the total population examined were correctly classified according to actual group membership. Of the LD population, 32% were identified as normal but only 16% of the normal population were misdiagnosed as LD. Additionally, nine individual symptoms were identified as reported by a greater percentage of LD students than normals.The results of this investigation suggest that the NSI as a screening instrument may be valuable for some populations. The 80% accuracy rate with the low number of false-positives (16%) is extremely encouraging. Additional research with the NSI to validate the presence of the symptomology reported would add to the already existing data related to the neuropsychological implications related to learning disabilities.Department of Educational Psychology
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Němcová, Michaela. "Využití expertních systémů v oblasti eHealth." Master's thesis, Vysoké učení technické v Brně. Fakulta elektrotechniky a komunikačních technologií, 2016. http://www.nusl.cz/ntk/nusl-242028.
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This work focuses on the use of expert systems in engineering and medicine with the use of eHealth. The aim is the creation of an expert system that utilizes available systems for measuring physiological parameters of a patient, and helps him with the primary examination before visiting the doctor. Part of this work is a description of the problems of expert systems, descriptions of the eHealth and system testing in a doctor’s office. Work created in collaboration with Honeywell.
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Minoudis, P. G. "Malingering of cognitive symptoms." Thesis, University College London (University of London), 2007. http://discovery.ucl.ac.uk/1444848/.
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Volume 1 is divided into 3 parts as follows: Part 1 (Review Paper) discusses the admissibility of psychometric evidence of cognitive malingering in UK criminal law courts. The paper opens with a historical account of psychologists as expert witnesses, highlighting significant advances relevant to malingering. This sets the context for a discussion about current developments in policy and specifically the creation of a UK standard for the admissibility of scientific evidence. The penultimate section outlines the statistical and methodological issues which challenge the development of empirical cognitive measures of malingering. The paper closes with a discussion of future directions for research and practice in presenting psychological evidence in court. Part 2 (Empirical Paper) reports on a study testing the utility of a battery of measures to identify simulating malingerers from healthy controls and psychiatric inpatients. The battery of measures were chosen for their different approaches to detecting malingerers. An additional qualitative interview was given to the simulating malingerers to investigate the strategies they used to fake the tests. The performance of the test battery was compared to a pre-existing screening tool for malingering. The results were discussed with reference to implications for research and practice. Part 3 (Critical Appraisal) reflects on the process of undertaking the research. It discusses the generalisability of the findings when using a simulating malingering design, the utility of measuring reaction time to detect malingering, difficulties in the recruitment of inpatients, the array of choices in selecting the test battery and the clinical applications of the research.
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Wise, Anna Elizabeth. "THE DIFFERENTIAL IMPACT OF MATERNAL VERSUS PATERNAL POST-TRAUMATIC SYMPTOMS ON CHILD SYMPTOM DEVELOPMENT." Kent State University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=kent1588264051459885.
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O'Shea, Grace. "Evaluating the effectiveness of Attention Training at reducing physical symptoms in high symptom reporters." Thesis, University of Manchester, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.677749.
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This thesis is comprised of three chapters including a systematic review, an empirical paper and a critical appraisal. The systematic review explored the literature on metacognitions and components of the Cognitive Attentional Syndrome in physical illness related distress. The empirical paper was a randomized trial of Attention Training versus relaxation in the treatment of distress and somatic symptom frequency in high physical symptom reporters. The critical appraisal focused on reflecting on the empirical paper, the systematic review and the research process as a whole.
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Pinto, Thisciane Ferreira. "Night eating symptoms, sleep quality and depressive symptoms in persons seeking bariatric surgery." Universidade Federal do CearÃ, 2012. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=7400.
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FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgicoThe Night Eating syndrome (NES), is often elevated in obese but its cause has not been well established. In particular, this condition has not been investigated in Brazil. The objective of this work was investigate the frequency of NES symptoms in candidates for bariatric surgery and assess its implications in sleep quality and depressive symptoms. 100 patients from Bariatric Surgery Outpatient Clinic of a tertiary hospital in Fortaleza were selected, and these night eating symptoms were measured by the Night eating Questionnaire (NEQ), sleep quality by the Pittsburgh Sleep Quality Index (PSQI), the daytime sleepiness by the Epworth Sleepiness Scale (ESS), the depressive symptoms, by Beck Depression Inventory short form and the risk for obstructive sleep apnea by Berlin Questionnaire. It was performed a comparative analysis of the results obtained from patients with night eating symptom scores suggestive of NES. The patients included in the study were predominantly women (76%), with age between 18 and 64 (mean  SD = 34.8  9.3) years and BMI between 31.3 and 72.4 (46.9  8.5) kg/mÂ. Poor quality sleep (PSQI > 5) was observed in 56 patients, excessive daytime sleepiness (ESS > 10) in 27; depressive symptoms (Beck > 4) in 80 and high risk for obstructive sleep apnea in 73. Seventeen patients showed symptoms suggestive of NES, without difference in age, BMI, degree of daytime sleepiness and risk of sleep apnea in obese when compared to the other patients. The group with symptoms suggestive of NES had a worse sleep quality (9.3  4.9 and 6.6  3.7, p = 0.01) and more depressive symptoms (16, 7  7.6 and 9.5  7.0, p = 0.001) than the other obese. A higher proportion of patients with symptoms suggestive of NES was in use of antidepressants than other patients (29.4 and 10.8%,p = 0.04). These data show that NES symptoms are common in bariatric surgery candidates and their presence is associated with more depressive symptoms and worse quality of sleep. Also, in particular, the high frequency of severe depressive symptoms among patients with a suggestive picture of NES highlights the importance of identifying this condition in the context of specialized services to treat obesity. Further studies on the impact of the NES and its treatment are needed to allow a better approach to this problem
A sÃndrome alimentar noturna (SAN) tem freqÃÃncia elevada nos obesos, embora ainda nÃo tenha sido estabelecida uma relaÃÃo causal. De modo particular, essa condiÃÃo nÃo foi investigada no Brasil entre os candidatos a cirurgia bariÃtrica. O objetivo deste estudo foi investigar a frequÃncia de sintomas alimentares noturnos sugestivos de SAN em candidatos a cirurgia bariÃtrica, bem como avaliar sua relaÃÃo com a qualidade do sono e sintomas depressivos. Foram estudados 100 pacientes do ambulatÃrio de cirurgia bariÃtrica de um hospital terciÃrio da rede pÃblica de saÃde de Fortaleza. Os sintomas alimentares noturnos foram avaliados atravÃs da Escala de Sintomas Alimentares Noturnos (ESAN), a qualidade do sono pelo Ãndice de Qualidade do Sono de Pittsburgh (IQSP), a sonolÃncia diurna, pela Escala de SonolÃncia de Epworth (ESE), os sintomas depressivos pelo InventÃrio de DepressÃo de Beck e o risco para apneia obstrutiva do sono pelo questionÃrio de Berlim. Foi realizada uma anÃlise comparativa entre resultados obtidos de pacientes com e sem sintomas alimentares noturnos sugestivos da SAN (ESAN>25). Os indivÃduos foram predominantemente mulheres (76%), com idades entre 18 e 64 (mÃdiaÂDP = 34,8 Â9,3) anos e IMC entre 31,3 e 72,4 (46,9  8,5) kg/mÂ. MÃ-qualidade do sono (IQSP>5) foi observada em 56 pacientes; sonolÃncia excessiva diurna (ESE> 10) em 27; sintomas depressivos (Beck > 4) em 80 e o risco elevado para apneia obstrutiva do sono em 73. Dezessete pacientes apresentaram sintomas sugestivos de SAN, sem diferenÃa quanto a idade, IMC, grau de sonolÃncia diurna e risco de apneia do sono, em relaÃÃo aos demais obesos. O grupo com sintomas sugestivos de SAN, comparado aos demais, apresentou pior qualidade de sono (9,3Â4,9 e 6,6Â3,7; p= 0,01) e mais sintomas depressivos (16,7Â7,6 e 9,5Â7,0; p= 0,001). Uma proporÃÃo maior dos pacientes com sintomas sugestivos de SAN fazia uso de antidepressivos (29,4 e 10,8%; p=0,04). Nossos resultados indicam que sintomas alimentares noturnos sÃo comuns nos candidatos a cirurgia bariÃtrica e sua presenÃa està associada a mais sintomas depressivos e pior qualidade do sono. A freqÃÃncia elevada de sintomas depressivos graves entre os pacientes com quadro sugestivo de SAN destaca a importÃncia da identificaÃÃo dessa condiÃÃo no tratamento da obesidade. Estudos adicionais sobre o impacto da SAN e de seu tratamento sÃo necessÃrios para permitir uma abordagem mais adequada deste problema
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Fischer, Beth Ann. "A PROSPECTIVE EXAMINATION OF URINARY STRESS HORMONES AND PTSD SYMPTOMS FROM MOTOR VEHICLE ACCIDENT TO POST-TRAUMA RECOVERY." Kent State University / OhioLINK, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=kent1194966805.
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Thompson, James. "The role of attentional bias in medically unexplained symptoms, somatoform disorders and habitual symptom reporting." Thesis, University of Manchester, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.626964.
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This thesis focusses on the role of attentional bias for health-threat information in the production and maintenance of medically unexplained symptoms, somatoform disorders and high levels of physical symptom reporting. It is comprised of three separate papers. Paper 1 was prepared for Clinical Psychology Review as a systematic review of the evidence concerning attentional bias for health–threat information in populations presenting with somatoform/somatic symptom disorders and high levels of physical symptom reporting. From the 20 studies deemed relevant for review, it was concluded that - although limited - the evidence indicated that a relationship existed between attentional bias for health-threat information and levels of physical symptom reporting. No robust evidence was found to establish whether this relationship was a casual one. Paper 2 was prepared for Journal of Abnormal Psychology and investigated whether an exogenous cueing task could be used to reduce presumed attentional bias for health-threat information in a sample of high symptom reporting students. The results showed an unexpected attentional avoidance of health-threat information at baseline, which the study manipulation unintentionally exacerbated. No change in levels of physical symptom reporting was noted between groups (attributed to a methodological error) but a trend in relatively greater anxiety for those who received the manipulation was noted. It was concluded that avoidance may be a key factor in high symptom reporting and that this merited further research. Paper 3 provided a critical reflection of Papers 1 and 2, as well as the research process as a whole. Implications for theory and clinical practice as well as future research directions were discussed.
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Wu, Zhaowen. "Symptoms catastrophizing and symptoms-related social hypervigilance among Chinese patients with irritable bowel syndrome." Click to view the E-thesis via HKUTO, 2007. http://sunzi.lib.hku.hk/hkuto/record/B38780872.
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Wu, Zhaowen, and 吳兆文. "Symptoms catastrophizing and symptoms-related social hypervigilance among Chinese patients with irritable bowel syndrome." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B38780872.
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Jones, Luke D. "Early knee arthritis : symptoms and structure." Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:fafe8d46-9ad5-4d1e-b8f5-b2ea3757b3fb.
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Knee osteoarthritis (OA) is the commonest form of lower limb OA with a lifetime risk of over 40%. It is a disease characterised by symptoms such as pain and loss of function. In addition there are typical structural features on both radiographs and MRI. Knee OA represents a spectrum of disease, ranging from early preclinical cartilage change to established full thickness disease. Anteromedial knee OA is a particular phenotype of knee OA where disease is confined to the medial compartment. Whilst end stage arthritis is treated reliably with joint arthroplasty, those with early stage disease are treated with a variety of non- surgical interventions with varying success. This thesis is concerned with understanding the disease of patients that have early radiographic changes but symptoms not controlled by conservative measures. Up to 150 of these patients a year present to the Nuffield Orthopaedic Centre, Oxford. They have been described as being in the “Treatment Gap”. A series of validation studies were performed to determine the optimal method for diagnosing cartilage defects within the knee. The three commonest diagnostic methods were examined for their validity. Arthroscopic assessments of cartilage lesions demonstrated a moderate level of intra and inter observer reliability. In contrast, radiographs and MRI demonstrated high levels of reliability. When using MRI as a criterion standard, both radiographs and arthroscopic assessment were found to have poor accuracy. Based on the work in this thesis a formal definition of the cartilage changes exhibited in early knee OA was proposed. A cross sectional cohort of 100 patients with the symptoms and radiological features of early knee OA were identified. Their pain and function profile was compared to two comparison groups of patients at the end stage of knee OA (defined by the need for partial or total arthroplasty). In up to 78% of individual cases those with early OA had pain and function profiles as bad as those with end stage disease. The cross sectional symptoms of early knee OA demonstrate a marked discordance with their mild radiographic changes. The same cohort was extended to 125 patients. They were followed over one year with monthly PROM assessments to determine how symptoms change over time. 43% of patients experience a clinical improvement over 12 months, 31% experience a clinical deterioration and 26% remain unchanged. The range in OKS variation over 12 months was on average 12 points, with clinically relevant variation occurring on 45% of monthly measurements. Patients with early knee OA can expect to experience considerable variation in their symptoms over 12 months and this must be considered when planning interventions. A number of patients with early knee OA were noticed to demonstrate medial meniscal extrusion. Using data from the Osteo Arthritis Initiative (OAI) a nested case control study was designed to determine how the presence of meniscal extrusion in an otherwise normal knee affects the risk of developing knee OA over the next 48 months. This demonstrated an Odds Ratio of 3.5, suggesting that meniscal extrusion is a considerable risk factor for the development of OA. The presence of a knee injury or operative intervention to the index meniscus was shown to increase this risk. Many phenotypes of OA are known to demonstrate familial aggregation. In an attempt to determine where the earliest structural changes occur in medial compartment knee OA, a cohort of patients selected only for their family history of the disease were developed. This cohort was compared to spouse controls for the presence of knee OA, as well as meniscal extrusion and long leg alignment. In addition, a functional analysis of their cartilage was performed. This cohort was not shown to be at increased risk of disease compared to controls. Discussion of the possible reasons for this finding is presented. Early knee osteoarthritis is a considerable clinical problem. This thesis has aided the understanding of the condition by firstly defining the radiological description of these patients. Secondly, their cross sectional and longitudinal symptom profile have been described for the first time. In addition, the presence of an extruded meniscus has been demonstrated as a substantial risk factor for the disease. Finally, family history has not been demonstrated as a risk factor for the disease within the limits of the study described here. Future work has been proposed.
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Carson, Alan J. "Medically unexplained symptoms in neurology." Thesis, University of Edinburgh, 2001. http://hdl.handle.net/1842/27763.
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Aims- To estimate the proportion of new patients with medically unexplained symptoms (MUS) that present to neurology out-patient services and to examine the impact of such symptoms on the patients in terms of disability, distress and outcome. Methods- Historical (MUS from 2 000 BC to 1965), narrative (non-neurological MUS) and systematic (MUS in neurology 1960 - 2000) reviews of the previous literature were conducted. A prospective cohort study of 300 newly referred out-patients was carried out in the regional neurology service in Lothian, Scotland. Results- The historical review of the literature found that MUS have been described since the first written texts of medicine. The narrative review showed that MUS affected both sexes, all ages, and all cultures. The systematic review of MUS in neurology found that between 30-40% of cases in neurology had MUS and the rate of misdiagnosis was less than 5%. In the field fo neurology there was no information on disability, limited information on co-morbid anxiety and depressive disorders, and outcome studies were confined to conversion hysteria only. In the prospective cohort study 30% of new patients presenting to neurology out-patients clinics had MUS. They were as physically disabled by their symptoms as those with neurological disease were by theirs. They suffered from increased levels of pain and increased rates of anxiety of depression. At eight months follow up more than half the MUS patients were ‘just the same’ or ‘worse’. There were no cases where unexpected neurological disease was diagnosed during the follow up which explained the patient’s presenting symptoms. The patients with MUS had had multiple referrals to other specialist services as a result of MUS. Conclusions- One third of a new referrals to general neurology clinics have medically unexplained symptoms. These patients are disabled and distressed. Over half of these patients remain symptomatic at eight months follow up. They deserve more attention.
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Jansson, Mårten. "Genetic studies of depressive symptoms/." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-782-7/.
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Hunt, S. "Prodromal symptoms in skunk users." Thesis, University College London (University of London), 2008. http://discovery.ucl.ac.uk/1444239/.
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Epidemiological studies have associated cannabis use with schizophrenia for decades. In the past decade meta-analyses of this research have helped to establish a causal link between cannabis use and the onset of psychotic symptoms as a result of both acute experimental studies and longitudinal studies of recreational use. Despite this, there is limited understanding of the mechanisms by which cannabis might contribute to the symptoms of schizophrenia. This review presents research on the effects of cannabis in relation to the symptoms of those found in the prodromal phase of schizophrenia, individuals at high risk of developing full psychotic episodes. The importance of investigating the prodrome is outlined before some of the similarities of the phenomenological experiences of the prodrome and those caused by cannabis are illustrated. The paper reviews the cognitive, neurobiological and structural evidence of how cannabis might contribute to the prodrome. The review includes the vulnerability factors that have been shown to mediate these effects. Finally, the paper highlights the evidence that the psychoactive potency of cannabis in the British market has grown and the absence of research into the effects of the recreational use of "skunk," a high potency variety of cannabis which accounts for 81% of the cannabis sold in the UK today.
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Baker, Louise. "Insomnia symptoms and daytime dysfunction." Thesis, University of Southampton, 2015. https://eprints.soton.ac.uk/375529/.
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Clark, E. A., Sarah A. Job, Stacey L. Williams, and M. F. Deitz. "PTSD Symptoms and U.S. Veterans." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/8050.
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Klein, Robert S. "Posttraumatic Stress and Neurobehavioral Symptoms." Thesis, University of North Texas, 2013. https://digital.library.unt.edu/ark:/67531/metadc407833/.
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The purpose of this study is to examine the structure of neurobehavioral symptoms in service members with physical and/or psychological trauma to determine the diagnostic specificity of these symptoms. Previous literature has demonstrated that orthopedic injured, mild traumatic brain injury (MTBI), and healthy controls shared similar levels of postconcussive symptom complaints, which suggest that postconcussion-like symptoms are not unique to MTBI. To the best of my knowledge, this is the first study examining this phenomenon in a sample of recently redeployed service members. Dimensional analysis of the PCL-C and NSI using SEM did not produce a model that was consistent with previous literature and principle component analyses did not produce a simple solution for posttraumatic stress or neurobehavioral symptoms. Thus, the study does not provide evidence for construct validity for either instrument. Implications for these findings are that clinicians need to be aware that these instruments may not be measuring coherent constructs within this population as purported and should judiciously interpret and report the results of these instruments.
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Almenara, Vargas Carlos Arturo, Luca Cerniglia, Silvia Cimino, Michela Erriu, and Tambelli Sapienza Renata. "Trajectories of aggressive and depressive symptoms in male and female overweight children: Do they share a common path or do they follow different routes?" Universidad Peruana de Ciencias Aplicadas (UPC), 2017. http://hdl.handle.net/10757/624441.
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Chapman, Anna. "Attention and somatic awareness in physical symptom reporting and health anxiety : implications for medically unexplained symptoms." Thesis, University of Manchester, 2014. https://www.research.manchester.ac.uk/portal/en/theses/attention-and-somatic-awareness-in-physical-symptom-reporting-and-health-anxiety-implications-for-medically-unexplained-symptoms(f8edf8e3-7ecd-40f6-9168-064af9e6be30).html.
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The aim of the work presented in this thesis, was to investigate two general hypotheses derived from theories of the development and maintenance of medically unexplained symptoms (MUS) and health anxiety; that individual differences in attention to the body and somatic awareness contribute to the experience of physical symptoms and health anxiety. Three studies (an analogue pilot study, a prospective cohort study with primary care patients, and an analogue study involving a negative mood induction) were conducted to investigate the relationship between attention, somatic awareness, symptom reporting and health anxiety. In the pilot study, enhanced attentional disengagement from neutral material was associated with health anxiety and delayed disengagement from neutral material was associated with symptom reporting. In the primary care study, enhanced disengagement from neutral body-irrelevant material and delayed disengagement from threatening body-relevant material were independently associated with health care utilisation, but not symptom reporting or health anxiety. However, the longitudinal analysis revealed that attentional disengagement was neither a predictor of, or predicted by, health care utilisation. The tendency to experience distortions in somatic awareness was independently associated with symptom reporting, health anxiety and health care utilisation. Longitudinal analysis revealed that symptom reporting and health anxiety were independent predictors of somatic distortion, but that somatic distortion was not a predictor of symptom reporting or health anxiety. The results of a structural equation modeling analysis suggest that a model including both attentional disengagement and the tendency to experience distortions in somatic awareness improves understanding of symptom reporting, health anxiety and health care utilisation. In the negative mood induction study, however, neither attentional disengagement nor the tendency to experience distortions in somatic awareness were significantly associated with symptom reporting or health anxiety. The evidence presented here suggests that complex attentional processes may be associated with health seeking behaviours, possibly via a third unknown variable. This evidence, however, does not support the often-hypothesised general attentional bias for the body as a causative factor in the development of health anxiety or symptom reporting. This research has provided important evidence about attentional differences and how future research might extend the findings reported here. Furthermore, the findings regarding the tendency to experience distortions in somatic awareness provides empirical support for theories that suggest MUS may be associated with a tendency to place greater weight on top-down factors in the creation of somatic awareness (Brown, 2004; Edwards et al., 2013). However, whilst alterations in somatic awareness may be a maintenance factor for symptom reporting and health anxiety, somatic distortion may not be a causative factor in their development.
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Morgan, Preston Christopher. "Sexual and relationship satisfaction associated with shifts in dyadic trajectories of depressive symptoms in German couples across four years." Thesis, Kansas State University, 2017. http://hdl.handle.net/2097/35442.
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Master of ScienceSchool of Family Studies and Human Services
Jared A. Durtschi
Depression is a pervasive mental health concern; thus, it is important to identify modifiable risk factors associated with reducing depressive symptoms across time. Using 1,946 married and cohabiting German couples assessed annually across 4 years from the Panel Analysis of Intimate Relationships and Family Dynamics (Pairfam) study, we tested if shifts across time in sexual satisfaction and relationship satisfaction were linked with expected shifts in trajectories of depressive symptoms using dyadic time-varying covariate growth models. For both men and women, higher sexual and relationship satisfaction scores across time were significantly associated with decreasing their own depressive symptom trajectories across time, but only relationship satisfaction was linked with a shift in their partners’ trajectories of depressive symptoms. Potential clinical implications from these results include the treatment of depressive symptoms by making changes across time in their own relationship satisfaction and sexual satisfaction.
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Jassy, Jonathan S. "Maternal ADHD symptoms and maternal ratings of child ADHD symptoms : are more inattentive mothers less accurate?" Thesis, University of British Columbia, 2009. http://hdl.handle.net/2429/11988.
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Maternal reports are crucial in the diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) in children. While some past research has found that the presence of psychopathologies such as depression bias maternal reports of child ADHD symptoms, few studies have explored the effects of maternal ADHD symptoms on maternal ratings of child ADHD behavior. The current study examined whether maternal ADHD symptoms of inattention (IA) and hyperactivity/impulsivity (HI) are related to rating accuracy in a community sample of 97 mothers (M age = 39.7 years) of 5-12-year-old boys. Mothers completed measures of their own and their child’s functioning as well as of their family demographics; mothers and other informants also provided ratings of the mothers’ ADHD symptoms. Mothers watched videotapes of children with ADHD and then rated each child’s symptoms of ADHD. Analyses of associations between maternal ADHD symptoms and maternal rating accuracy (i.e. commission errors and omission errors) controlled for maternal and family characteristics that typically co-occur with maternal ADHD symptoms. Contrary to predictions, results revealed few significant associations overall, with neither maternal IA nor maternal HI symptoms being associated with either maternal rating commission or omission rating errors or with bias in rating videotaped child behavior, once covariates were controlled. Analysis of covariates further revealed that, while lower family SES and mothers' own sons' level of oppositional/conduct problems were each associated with mothers’ over-reporting ADHD symptoms in the videotaped children, few other significant associations between covariates and maternal ratings emerged for this sample. Overall, results may be interpreted as supporting past research in finding no associations between maternal ADHD symptoms and maternal rating accuracy or bias. Alternatively, characteristics of the current sample, especially the exclusion of mothers with clinical levels of ADHD symptoms in themselves or their sons, may have prevented significant relationships from emerging.
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Delisle, Vanessa. "The influence of somatic symptoms in assessing symptoms of depression: do physical health and gender matter?" Thesis, McGill University, 2012. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=106337.
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Major Depressive Disorder (MDD) is common among people with medical illnesses and is more common in women compared to men. In order for comparisons of MDD prevalence rates and self-reported symptom severity across groups to be valid, it is important to establish that diagnostic methods or depression symptom questionnaires that assess severity are measuring the same construct across the groups. There is relatively little research that has attempted to dissect the potential influence of somatic symptom reporting on depression symptom severity ratings, and existing research has important limitations. Thus, the objective of the studies in this thesis was to assess the degree to which differences in somatic symptom reporting might influence scores on a commonly used self-report depression symptom questionnaire, the Beck Depression Inventory (BDI), among post-myocardial infarction (MI) patients, who have a high somatic burden associated with acute cardiovascular disease, compared to psychiatry outpatients, as well as scores on the BDI-II among female compared to male psychiatry outpatients. The first study found evidence that assessing depression symptoms with the BDI post-MI may exaggerate depression symptom severity scores due to the influence of somatic symptoms that commonly occur post-MI, but which are not due to depression. These results, considered in the context of a previous study of the BDI-II that did not find any differences between post-MI and psychiatry outpatients, suggest that the BDI-II may be preferable to the BDI in epidemiological studies of depression among post-MI patients. However, more studies are needed that directly compare the influence of somatic symptoms on the BDI and BDI-II among cardiovascular disease patients. The results of the second study suggest that men and women report similar levels of cognitive/affective and somatic symptoms of depression. Previous suggestions that women report more somatic symptoms of depression than men and that this explains gender differences in depression rates and symptom severity are not supported by the evidence, and future studies should focus on alternative explanations.Le Trouble Dépressif Majeur (TDM) est fréquent chez les personnes malades et plus commun chez les femmes que chez les hommes. Afin d'assurer la validité des comparaisons du taux de prévalence de TDM et des sévérités des symptômes auto-déclarés parmi les groupes, il est important d'établir que les méthodes de diagnostic et les questionnaires sur les symptômes de dépression qui évaluent la gravité mesurent le même concept entre ces groupes. Il y a relativement peu de recherches qui ont tenté de comprendre l'influence potentielle des symptômes somatiques rapportés sur le taux de sévérité des symptômes de dépression, et les études existantes montrent des limitations importantes. Ainsi, l'objectif de la première étude de cette thèse était d'évaluer à quel point les symptômes somatiques rapportés pouvaient influencer les résultats sur un questionnaire des symptômes auto-déclarés de dépression (le "Beck Depression Inventory (BDI)") parmi les patients qui ont subi un infarctus du myocarde (IM) et qui ont des limites physiques importantes associées à cette maladie, comparés aux patients externe de psychiatrie. L'objectif de la deuxième études était aussi d'évaluer à quel point les symptômes somatiques rapportés pouvaient influencer les résultats sur un autre questionnaire des symptômes auto-déclarés de dépression (le "BDI-II") parmi les patientes externes femelles en psychiatrie par rapport aux patients externes mâles. La première étude a démontré que l'évaluation des symptômes de dépression avec le BDI parmi les patients qui ont subi un IM pouvait exagérer la gravité des symptômes dus à l'influence des symptômes somatiques qui surviennent fréquemment suite à un IM, mais qui ne seraient pas dus à la dépression. Ces résultats, considérés dans le contexte d'une étude précédente du BDI-II qui n'a pas identifié de différences entre les patients qui ont subi un IM et les patients externes de psychiatrie, suggère que le BDI-II peut-être préférable au BDI dans les études épidémiologiques de la dépression chez les patients qui ont subi un IM. Cependant, d'autres études sont nécessaires pour comparer directement l'influence des symptômes somatiques sur le BDI et le BDI-II chez les patients souffrant de maladies cardiovasculaires. Les résultats de la deuxième étude suggèrent que les hommes et les femmes présentent des niveaux similaires de symptômes cognitifs/affectifs et somatiques de dépression. Les résultats de cette deuxième étude ne supportent pas les conclusions des études précédentes qui suggèrent que les femmes rapportent plus de symptômes somatiques de dépression que les hommes et que cela expliquerait les différences entre les sexes dans les taux de dépression et la sévérité des symptômes. Les études futures devraient se concentrer sur d'autres explications.
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Iacoviello, Brian Michael. "Prodromal Symptoms of Depression: Tests of a Model of the Development and Remission of Depressive Symptoms." Diss., Temple University Libraries, 2009. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/70769.
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PsychologyPh.D.
This study examined the early course of depression by testing a conceptual model for the development and remission of depressive symptoms. In this model, prodromal symptoms emanate from the core pathological processes underlying the disorder and comprise the core syndrome as the earliest symptoms to appear, with episodes of depression representing the more pronounced peaks of symptomatology; the core symptoms would also be the last to remit. Several general hypotheses generated from this model were tested. Additionally, the hopelessness and endogenous subtypes of depression were conceptualized within this model and examined. Cognitive risk for depression and the cognitive personality modes of sociotropy and autonomy were also examined as predictors of specific prodromal and residual symptoms. Correlation and survival analyses were conducted to test the various hypotheses. Results supported the existence of a depressive prodrome as well as the general model being tested. The earliest symptoms to appear in an episode of depression were generally consistent throughout the episode and remained as the last to remit. The order of symptom onset was related to the reverse of the order of symptom remission. The durations for the prodromal and remission phases were significantly correlated. When applied to the hopelessness subtype of depression, and depressions experienced by highly sociotropic individuals, the model held. In the endogenous subtype of depression, and among cognitively high-risk and highly autonomous individuals, the model was not strongly supported.
Temple University--Theses
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Colletti, Christina. "The Association of Parental Depressive Symptoms and Child Anxiety Symptoms: the Role of Specific Parenting Behaviors." ScholarWorks @ UVM, 2009. http://scholarworks.uvm.edu/graddis/51.
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A substantial literature indicates that children and adolescents living with a depressed caregiver are at increased risk for emotional and behavioral problems. Although parental depression has been shown to have non-specific associations across child problems, researchers have begun to examine whether specific risk factors, such as parental depression, are associated with specific child outcomes, such as child anxiety. Parenting behavior has been identified as one potential mechanism for the transmission of depression and other psychopathology from parent to child. The extant literature supports this mechanism, as the parenting behaviors of mothers with and without a history of depression have been found to differ in important ways. Moreover, two separate literatures suggest that the same parenting behaviors are associated with both parental depression and child anxiety. The current study was designed to extend past research in the areas of parental depression, parenting, and child anxiety by examining parenting behavior as an explanatory mechanism for the association of parental depressive symptoms and child anxiety symptoms. Using a sample of parents with a history of depression and their 9- to 15-year old children, the current study examined four specific parenting behaviors (i.e., hostility, intrusiveness, withdrawal, and warmth), observed in the context of a stressful parent-child interaction task, as mediators of the association between parental depressive symptoms and both parent and child reports of child anxiety symptoms. Limited support was found for the meditational role of specific parenting behaviors in the association of parental depressive symptoms and child anxiety symptoms. Linear mixed-model analyses revealed an inverse and likely spurious relation between parental depressive symptoms and parent report of child anxiety symptoms. A significant positive association also emerged between parental depressive symptoms and observed parental withdrawal. No support was found for the other relations of the proposed mediation model. Possible reasons for the lack of significant findings are discussed.
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Evans, Miranda. "The Role of Individual Difference in Predicting Psychopathology Following Peer Victimization." ScholarWorks@UNO, 2019. https://scholarworks.uno.edu/td/2691.
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eer victimization is a common experience that is associated with later psychopathology. However, there is inconsistency in the strength and statistical significance of this effect. The current study used two methods to try to understand this inconsistency. First, co-occurring internalizing and externalizing symptoms were considered dimensionally. Second, the present study considered temperament as a potential moderator to explain the multifinality of outcomes that occur following peer victimization. A community sample (N = 387; 52% female) of early adolescents (11-15) from a longitudinal study of risk and resilience factors for psychopathology was utilized to test hypotheses. Cross-lagged examinations between victimization and psychopathology were examined, including the moderating effect of temperament. No longitudinal relationship between victimization and psychopathology was found. A significant interaction between victimization and effortful control predicted externalizing and co-occurring symptoms. Future researchers should consider improving the measurement of victimization and temperament to get a better understanding of the effect.
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Rees, Clare S. "Panic disorder : symptomatology, medical utilisation and treatment." Thesis, Curtin University, 1997. http://hdl.handle.net/20.500.11937/2184.
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The overall aim of this project was to investigate the nature and structure of the physiological symptoms of panic attacks and the relationship between these symptoms and use of the health care system by people with a clinical diagnosis of panic disorder. Cioffi's model of somatic interpretation was explored in relation to this issue as it had been previously applied to predominantly physiological conditions and appeared to offer a potentially useful framework for understanding the behaviour of people with panic disorder.The first study consisted of a principal components analysis of 153 panic attack symptom checklists from the Anxiety Disorders Interview Schedule - Third Edition - Revised (ADIS-III-R).Five separate physiological components emerged from the analysis which mirrored common medical conditions. A cluster analysis of the symptoms of 153 individuals indicated that the sample formed five separate groups corresponding to the five physiological components identified. The results of this study supported suggestions put forward in the literature regarding the possible clustering of the physiological symptoms of panic attacks. The study also found evidence to suggest that individuals with panic disorder can be identified in distinct sub-groups according to the most predominant physiological symptoms reported.The second study was made up of two parts. Part one investigated the health utilisation behaviour and associated costs for people with panic disorder and compared them with people with social phobia. Significantly higher costs and rates of utilisation were found for the panic disorder group compared to the group with social phobia. Part two of this study investigated the relationship between a person with panic disorder's most predominant physiological panic symptoms and the type of medical specialists consulted. Fifty three individuals with panic disorder were included in the study and the proposed relationship was analysed using a bi-partial regression analysis. The respiratory group was significantly related to the type of specialist seen.The third study was aimed at clarifying the interpretation of ambiguous symptoms in panic disorder. Thirty eight people with panic disorder completed a questionnaire requiring them to give explanations as to the cause of a number of ambiguous somatic sensations. It was hypothesised that there would be a relationship between the persons highest component score (as identified in the first study) and the interpretation of threat made in response to the items on the questionnaire. No such relationship was found although significantly more threat-interpretations were made when the individual's cognitive threat schema was activated.Study four investigated the influence of the type of panic recording measure upon the severity and number of panic symptoms reported. A secondary aim was to compare panic symptoms recorded following a panic provocation procedure in the clinic with those recorded following naturally occurring panic attacks. Thirty seven people with panic disorder recorded the symptoms of panic attacks experienced in the natural environment and those induced via hyperventilation in the clinic. It was hypothesised that there would be an effect for recording measure on the dependent variables of symptom severity and number. This hypothesis was supported with the structured recording measure producing significantly more symptoms of a greater severity than the unstructured or descriptive measure. An interaction effect was found for the neurological group of symptoms whereby the severity of symptoms was significantly higher in the clinic setting than in the natural environment with the descriptive measure resulting in significantly greater severity ratings.The final study investigated the efficacy of information-giving as an intervention for panic disorder. Forty individuals with panic disorder were randomly assigned to either receive two sessions of information-giving as well as self-monitoring of their symptoms or self-monitoring only. As hypothesised the group receiving information as well as self- monitoring had significantly lower levels of general anxiety and depression as well as anticipatory anxiety at the end of the intervention period.Several important implications emerge from these results. The finding that people with panic disorder can be identified according to the predominant set of physiological symptoms they report provides some useful information for identification of the problem in general medical settings. This project demonstrated the need for a screening measure for panic disorder in Australian medical settings as well as the potential effectiveness of the provision of information relating to anxiety and panic. In addition, Cioffi's model of somatic interpretation was found to be a useful framework with which to consider underlying processes relating to the interpretation of panic sensations.
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Lemley, Daniel Alan. "Assessing symptoms of eutrophication in estuaries." Thesis, Nelson Mandela Metropolitan University, 2015. http://hdl.handle.net/10948/3427.
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Water quality and ecological integrity of estuaries reflect activities within the entire upstream catchment. Much emphasis has been placed on the response of estuaries to anthropogenic stressors through the use of monitoring programmes. Key to the success of these programmes is the use of indicators as they transform data into useful information. The ultimate aim of this study was to identify eutrophic symptoms in selected estuaries in the Gouritz Water Management Area (WMA) using a multi-metric classification method. The study sites included the permanently open Duiwenhoks, Goukou, Gouritz, and Kaaimans estuaries, as well as the temporarily open/closed Hartenbos, Klein Brak, Great Brak, Gwaing, and Goukamma estuaries. Initially, the “pressure” associated with all the estuaries in the Gouritz WMA was determined (e.g. total daily nutrient loads and changes in river inflow affecting flushing time) using long-term flow and water quality monitoring data provided by the Department of Water Affairs (DWA). Subsequently, the “state” of the selected estuaries was assessed using a variety of indicators, including: inorganic nutrients (~ N and P), phytoplankton, epiphytes and microphytobenthos. Estuaries with longer flushing time suggested greater vulnerability to eutrophication. For example, the Gwaing (281.11 kg DIN d-1; 78.85 kg DIP d-1) and Hartenbos (38.33 kg DIN d-1; 21.51 kg DIP d-1) estuaries generally received the highest daily inorganic nutrient loads. However, at the time of sampling, the Hartenbos Estuary had a longer flushing time (i.e. weeks) compared to the Gwaing Estuary (i.e. couple of days). Field data confirmed the greater vulnerability to eutrophication associated with longer flushing times, as the indicators measured in the Hartenbos Estuary exceeded all the proposed ‘thresholds’ of a eutrophic system (~ overall ‘Poor’ condition). The Great Brak Estuary (~ overall ‘Fair’ condition) provided an interesting example where eutrophic symptoms were only detected when assessing the microalgal primary producers (i.e. high biomass and low diversity). Furthermore, the need to distinguish between naturally and anthropogenically induced symptoms was highlighted. One such scenario was noted in the Kaaimans Estuary, where its natural hydro-morphological characteristics (i.e. steep banks, low river inflow, and deep/narrow channel) led to the possible exaggeration of its overall eutrophic condition, i.e. received a ‘Fair’ rather than ‘Good’ rating, arising from ‘Poor’ ratings for dissolved oxygen and benthic diatom diversity. Overall, this study demonstrated the importance of adopting a holistic approach when assessing the condition and trophic status of estuaries. Studies such as these allow for the detection of vulnerable and degraded systems, which can provide important information with regards to the identification of management priorities.
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Graham, Janice Elizabeth. "Diagnosing dementia, signs, symptoms and meaning." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/nq26788.pdf.
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Engman, Maria. "Partial vaginismus : definition, symptoms and treatment." Doctoral thesis, Linköping : Univ, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-10036.
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Nökel, Klaus. "Temporally distributed symptoms in technical diagnosis /." Berlin [u.a.] : Springer, 1991. http://www.loc.gov/catdir/enhancements/fy0815/91223341-d.html.
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Georges, Jane Marie. "Distressing gastrointestinal symptoms in postmenopausal women /." Thesis, Connect to this title online; UW restricted, 1991. http://hdl.handle.net/1773/7275.
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Goodman, A. O. G. "Non-classical symptoms in Huntington's disease." Thesis, University of Cambridge, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.599513.
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This Ph.D. aimed to investigate some of the non-classical features in HD, focusing in detail on weight loss and metabolism by means of whole body indirect calorimetry in both early stage human patients, as well as in the R6/2 transgenic mouse model of HD. In addition, circadian rhythms and sleep disturbances were investigated in the same patient cohort using actigraphy and polysomnography. Pilot studies on zerostomia, cholesterol levels, olfaction, gestation and orthostatic hypotension were also briefly examined in order to identify further, possible non-classical symptoms. I found that patients had a trend towards elevated total energy expenditure, a finding which was significant in 14 week old R6/2 mice. I also found that patients had an overall loss of form and definition in their rest-activity actograms, suggesting a disturbed circadian rhythm. Sleep cycles were poorly consolidated, fragmented and irregular and the majority of patients had longer sleep latencies, reduced sleep efficiency, more time spent awake during the sleep period, frequent arousals and apnoeas, and reduced slow wave and rapid eye movement sleep. Pilot studies revealed that patients also have significant problems of xerostomia, olfaction and gestation. These investigations will help to define the extent and nature of non-classical abnormalities in this condition more thoroughly, thus providing a better profile of problems and deficits in HD. Future longitudinal studies involving pre-symptomatic patients will help to provide possible biomarkers for disease therapy and could ultimately contribute towards reducing morbidity and mortality in patients, as well as to provide insight into common degenerative pathways of other neurodegenerative diseases.
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Riddoch, C. J. "Exercise-induced gastrointestinal symptoms : hormonal involvement." Thesis, Queen's University Belfast, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.335621.
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Chung, Lucia P. S. "Abdominal wall hernias : symptoms and outcome." Thesis, University of Glasgow, 2014. http://theses.gla.ac.uk/5168/.
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Introduction and Aims Pain is the most common symptom associated with hernias but there is little in the literature on its effects on an individual’s physical activity or quality of life. Up to one-third of patients with an inguinal hernia have no symptoms from the hernia. Repair of a ventral hernia is a common operation and increasing in frequency. Many operations for hernia are on patients with minimal symptoms but data on outcomes are lacking. The aims of the studies are to: assess the frequency of pain and its effects on physical activity and quality of life in patients with inguinal and ventral hernias; to determine the long term outcome of patients with a painless inguinal hernia randomised to observation or operation; to assess the long term outcomes of patients with an asymptomatic ventral hernia managed by a period of observation; and to examine the incidence of umbilical hernias in a general adult population and establish the long term outcome of patients with an umbilical hernia. Patients and Methods All patients undergoing operation for an elective inguinal or ventral hernia over a 16 month period were asked to complete a questionnaire recording data on baseline characteristics, a 4-point Verbal Rating Scale (VRS) and Visual Analogue Scale (VAS) of their pain. They also completed the short form Brief Pain Inventory (BPI) to assess pain severity and interference. 160 men aged 55 years or more with an asymptomatic inguinal hernia were randomised to observation or operation. Clinical follow up was undertaken at a median of 5 years and final follow up at a minimum of 6 years from randomisation. Ventral hernia patients presenting to a surgical clinic over a one year period were identified and those who were asymptomatic were followed up either by annual clinical examination or review of their electronic case records. All new patient referrals to a general surgical clinic over a year without a previous history of abdominal surgery were examined for clinical evidence of an umbilical hernia. All general practitioner referrals with an umbilical hernia were assessed for symptoms and both groups were followed up by review of their electronic case records. Results 124 patients (72 inguinal, 52 ventral), completed the pain questionnaire and 93 (75%) registered pain on the BPI. There was good correlation between VRS, VAS and BPI scores (Correlation Coefficient >0.8). Patients with a ventral hernia had more pain (P=0.037), interference with mood (P=0.027), sleep (P=0.004), relations with other people (P=0.019), and enjoyment of life (P=0.029) than their inguinal hernia counterparts. At a median follow up of 7•5 (range 6•2–8•2) years in patients with an asymptomatic inguinal hernia randomised to observation or operation, 46 of the 80 in the observation group had converted to an operation. The estimated conversion rate for the observation group using the Kaplan–Meier method was 16% (95 % confidence interval 9 to 26%) at 1 year, and 72% (59 to 84%) at 7•5 years. The main reason for conversion was pain in 33 men, and two presented with an acute hernia. Over a one year period 112 patients were identified with 115 ventral hernias. 62 (55%) had an asymptomatic hernia, 14 of whom opted for operation. 48 patients with 50 asymptomatic hernias participated in the study. At a median follow up of 6.2 years (IQR 5.8-6.9 years) 3 (6%) patients converted to operation due to pain. The incidence of umbilical hernia in the general population was 2.4% (15 or 622 patients) and all were asymptomatic with only 2 who were aware of their hernia. 36 patients were referred by their general practitioner for assessment of an umbilical hernia and 18 were asymptomatic. 28 of the 36 underwent operation of which 3 (Kaplan-Meier estimate 10% (95% CI 3% – 30%)) required re-operation for a recurrent hernia at a median follow-up of 6.1 years (IQR 5.8 – 6.2 years). Of the 15 patients with an incidental hernia, 2 (Kaplan-Meier estimate 15% (95% CI 3% – 44%)) required an operation for pain at a median follow-up of 6.1 years (IQR 5.9 – 6.4 years). Conclusions The BPI is an easy and effective way of assessing pain and its impact on physical activity and quality of life in patients with an inguinal or ventral hernia. Most patients with a painless inguinal hernia develop symptoms over time and will require an operation therefore surgical repair is recommended for medically fit patients with a painless inguinal hernia. In contrast, a policy of non-operation is a satisfactory alternative for patients with an asymptomatic ventral hernia although further studies in this area are required to confirm these outcomes. Umbilical hernias are common in the adult population and most cause no symptoms and are unlikely to become symptomatic. Clinical trials are necessary to assess the value of operation in patients with an asymptomatic umbilical hernia.
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Martin, Matthew J. "Investigating the symptoms of airways disease." Thesis, University of Nottingham, 2017. http://eprints.nottingham.ac.uk/46745/.
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Background Airways diseases are increasingly recognised to be poorly defined phenomena with overlapping pathophysiology and symptoms. They are a significant and growing cause of morbidity, with increasing numbers of people affected globally and no improvement in key outcomes in the UK for the last decade despite ever increasing expenditure. The classification of airway diseases has changed little in the last 50 years, and may no longer be fit for purpose due to the growing appreciation of the complexity and heterogeneity of airways disease and the advent of molecular-based diagnostic techniques to target specific treatment. Aim To investigate whether strategies based on the measurement of selected phenotypic and biological characteristics of airways disease can help to improve the understanding of their pathogenesis and targeting of treatment. Methods Three characteristics of airways disease, namely (1) exhaled nitric oxide, (2) chronic productive cough of unknown cause and (3) the airway microbiota were described/measured in selected cohorts of patients in three clinical studies. Measurement of each of these characteristics was used to answer focused clinical questions regarding the pathogenesis and treatment of aspects of airways disease. Results (1) The baseline measurement of FENO in steroid naïve subjects with symptoms suggestive of asthma had a low diagnostic value for asthma but was an excellent predictor of inhaled steroid treatment response. (2) A cohort of subjects with chronic productive cough of unknown cause was described. These subjects tended to have radiological evidence of airway dilatation and chronic inflammatory changes but not significant bronchiectasis. Their cough responded well to treatment with azithromycin, with ongoing neutrophilic airway inflammation a particularly strong predictor of treatment response. (3) There were no significant differences in the abundance or community structure of the bacterial communities in the airways between subjects with mild (BTS 2) or severe (BTS 4) asthma or between severe (BTS 4) asthma patients taking inhaled fluticasone or budesonide. However a number of differences in relative abundance of certain species (including enrichment of Haemophilus parainfluenzae in the fluticasone group) were noted on comparison of the groups. Conclusions This thesis provides support for a new approach to the classification and treatment of airways disease. The recognition of pathologically important processes (treatable traits) which can be used to predict response to targeted treatment has the potential to revolutionise the management of airways disease and result in improved patient outcomes.
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Haywood, Catharina S. "Psychological therapy for medically unexplained symptoms." Thesis, University of Southampton, 2017. https://eprints.soton.ac.uk/415890/.
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The first chapter of this thesis is a systematic review of the literature into factors that influence outcomes for people with medically unexplained symptoms (MUS), treated with cognitive behavioural therapy (CBT). A total of 14 papers were identified that met the inclusion criteria and due to the heterogeneity of results, a narrative synthesis was employed. In terms of participant characteristics, neither age, gender, comorbid depression, comorbid anxiety, or comorbid personality disorder were related to therapeutic outcomes. A greater number and intensity of symptoms were related to better outcomes. Some weak evidence was found for the impact of familial status and social difficulties, however only a limited number of articles examined those variables. In terms of therapeutic factors, individual CBT was identified as having slightly superior outcomes over group CBT and certain cognitive and behavioural factors were also identified as relevant. The findings were less clear about whether clinician profession or the number of sessions offered predict better or worse outcomes. Future research should continue to identify relevant variables involved in CBT’s effectiveness in MUS and, where possible, manipulate variables experimentally. The second chapter of this thesis is an empirical research paper examining the effectiveness of CBT and cognitive analytic therapy (CAT) at improving psychosocial, physical health, and economic outcomes for people with MUS. The paper also sought to consider whether any participant or illness characteristics predicted outcomes after treatment. CBT (N = 31) and CAT (N = 17) were no different across any of the outcomes and they were therefore grouped together as Cognitive Therapy (N = 48). A treatment as usual (TAU, N = 56) group did not receive psychological treatment and were used in analyses of economic outcomes. The Cognitive Therapy group improved significantly across all measures of psychosocial and physical health outcomes at the end of therapy compared to at the start. Neither gender, ethnicity, number of symptoms, or duration of symptoms had any impact on the improvements seen. There was no reduction in inpatient, outpatient or A&E cost at either 6, 12, or 18 months after treatment ended and between those who received cognitive therapy and those who received treatment as usual. Clinical implications and avenues for future research are discussed.
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Pavlovych, L. B. "Treatment of symptoms of metabolic syndrome." Thesis, БДМУ, 2017. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/17295.
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Hazen, Rebecca Ann. "Parental rejection, temperament, and internalizing symptoms." The Ohio State University, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=osu1123821086.
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Testa, S. Marc. "DEPRESSIVE SYMPTOMS IN TEMPORAL LOBE EPILEPSY." University of Cincinnati / OhioLINK, 2001. http://rave.ohiolink.edu/etdc/view?acc_num=ucin997801556.
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Belt, Emena. "POSITIVE AND NEGATIVE SYMPTOMS QUESTIONNAIRE-REVISED." Cleveland State University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=csu1596036578434634.
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Sandt, Arthur Ralph. "Hedonic Functioning and Subthreshold Psychotic Symptoms." Diss., Temple University Libraries, 2013. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/164124.
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PsychologyPh.D.
Schizophrenia is a debilitating disorder with an array of affective, cognitive, and behavioral consequences. In addition to these impairments, research suggests that there is a distinct pattern of hedonic functioning in schizophrenia that may contribute to some of the most intractable symptoms of the disorder, the negative symptoms. Specifically, individuals with schizophrenia appear to experience deficient levels of pleasure during anticipation of a pleasurable stimulus, while experiencing typical levels of pleasure while directly engaged with a pleasurable stimulus. Despite these findings, it is unclear whether hedonic functioning deficits occur in individuals with subthreshold levels of psychotic symptoms and/or in individuals at clinical high risk for the disorder. The purpose of this study was to examine hedonic functioning in relation to the continuum of psychotic symptoms in a college undergraduate student sample, and in those at clinical risk for schizophrenia. Participants were 679 students who completed self-report measures of current psychotic-like experiences, and trait-like components of hedonic functioning (i.e., anticipatory and consummatory pleasure). Consistent with study hypotheses, deficits in anticipatory pleasure, but not in consummatory pleasure, were significantly associated with increased clinical risk for schizophrenia. However, this relation was found exclusively among women in the sample, whereas men did not show a significant relation between anticipatory pleasure deficits and clinical high-risk. Furthermore, anticipatory pleasure deficits were not significantly associated with increases in the number of positive psychotic symptoms endorsed. Moreover, consummatory pleasure was not associated with increases in the number of subthreshold positive psychotic symptoms, nor was there a relation with the number of distressing positive psychotic symptoms or clinical risk status. The present study provides the first examination of the relation between hedonic functioning and subthreshold psychotic symptoms, as well as the relation with clinical high-risk for psychosis. These findings suggest that anticipatory pleasure deficits may be more closely related to increased clinical risk for psychosis among women rather than increases in psychotic symptoms in the general population. Anticipatory pleasure deficits may be a useful target for intervention and prevention techniques among those at clinical risk for psychosis, especially in female at risk populations. Additional longitudinal studies will be essential for testing whether anticipatory pleasure deficits predict the occurrence of future psychotic disorders among those at high risk for the disorder in order to improve early identification and early intervention efforts in this population.
Temple University--Theses
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Hemberger, Helga Christine. "The neuropsychology of obsessive-compulsive symptoms." Thesis, The University of Sydney, 2007. http://hdl.handle.net/2123/1902.
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Obsessive-compulsive (OC) symptoms occur in a variety of clinical conditions, but the underlying pathogenesis of these symptoms remains elusive. Few neuropsychological investigations have compared idiopathic Obsessive-Compulsive Disorder (OCD) with patient groups where OC symptoms are acquired. The present study investigated the neuropsychological correlates of OC symptoms in OCD and frontotemporal dementia (FTD), a neurodegenerative illness in which OC symptoms are often acquired. Neuroimaging in OCD has consistently implicated the frontal-striatal-thalamic circuit, particularly the orbitofrontal cortex and basal ganglia. These areas overlap considerably with the sites of cerebral pathology found in FTD. OCD has been associated with a number of neuropsychological deficits, with most consistent findings pointing towards impaired executive function (EF), and less commonly reported deficits in visual memory and visuospatial ability. The neuropsychological hallmark of FTD is deficits in EF. However in both OCD and FTD, the relationship between cognitive deficits and OC symptoms remains unclear. Further, the extent to which OC symptoms are comparable between the groups is ambiguous. Part I of the present study compared 19 OCD subjects to 20 age, education and IQ-matched healthy controls on a battery of neuropsychological tests of all major cognitive domains with emphasis on EF. A measure of Theory of Mind (ToM) thought to be sensitive to orbitofrontal function was also administered. OCD subjects performed worse than controls on a measure of visual memory, visuospatial reasoning and on only one measure of EF. OCD symptom subtypes, as measured by the Obsessive-Compulsive Inventory (OCI), were not correlated with any cognitive deficits. No group differences in ToM were found. It is suggested that prior research has overestimated the severity and significance of EF deficits in OCD. Part II of the study compared 9 FTD participants with 10 matched healthy controls on the same neuropsychological test battery and OC symptom measures. In addition, a measure of compulsive behaviours used in neurological populations was administered to carers. While the incidence of OC symptoms was comparable to reports in previous studies (78%), the OCI was not sensitive in the detection of OC symptoms in FTD. The similarities and differences in OC symptoms between the two patient groups are discussed.
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Hemberger, Helga Christine. "The neuropsychology of obsessive-compulsive symptoms." University of Sydney, 2007. http://hdl.handle.net/2123/1902.
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Doctor of Clinical PsychologyObsessive-compulsive (OC) symptoms occur in a variety of clinical conditions, but the underlying pathogenesis of these symptoms remains elusive. Few neuropsychological investigations have compared idiopathic Obsessive-Compulsive Disorder (OCD) with patient groups where OC symptoms are acquired. The present study investigated the neuropsychological correlates of OC symptoms in OCD and frontotemporal dementia (FTD), a neurodegenerative illness in which OC symptoms are often acquired. Neuroimaging in OCD has consistently implicated the frontal-striatal-thalamic circuit, particularly the orbitofrontal cortex and basal ganglia. These areas overlap considerably with the sites of cerebral pathology found in FTD. OCD has been associated with a number of neuropsychological deficits, with most consistent findings pointing towards impaired executive function (EF), and less commonly reported deficits in visual memory and visuospatial ability. The neuropsychological hallmark of FTD is deficits in EF. However in both OCD and FTD, the relationship between cognitive deficits and OC symptoms remains unclear. Further, the extent to which OC symptoms are comparable between the groups is ambiguous. Part I of the present study compared 19 OCD subjects to 20 age, education and IQ-matched healthy controls on a battery of neuropsychological tests of all major cognitive domains with emphasis on EF. A measure of Theory of Mind (ToM) thought to be sensitive to orbitofrontal function was also administered. OCD subjects performed worse than controls on a measure of visual memory, visuospatial reasoning and on only one measure of EF. OCD symptom subtypes, as measured by the Obsessive-Compulsive Inventory (OCI), were not correlated with any cognitive deficits. No group differences in ToM were found. It is suggested that prior research has overestimated the severity and significance of EF deficits in OCD. Part II of the study compared 9 FTD participants with 10 matched healthy controls on the same neuropsychological test battery and OC symptom measures. In addition, a measure of compulsive behaviours used in neurological populations was administered to carers. While the incidence of OC symptoms was comparable to reports in previous studies (78%), the OCI was not sensitive in the detection of OC symptoms in FTD. The similarities and differences in OC symptoms between the two patient groups are discussed.
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MILLER, ELIYA. "AUTISM: SYMPTOMS, DIAGNOSIS, CAUSES, AND TREATMENT." Thesis, The University of Arizona, 2008. http://hdl.handle.net/10150/190711.
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Sheppard, Kate. "Depressive Symptoms Among Culturally Deaf Adults." Diss., The University of Arizona, 2008. http://hdl.handle.net/10150/194735.
Full textAbstract:
Aims were to describe depressive symptoms among culturally Deaf adults, describe the words in American Sign Language (ASL) that best express depressive symptoms, and describe shared meaning of depressive symptoms. Primary care providers commonly discuss depressive symptoms with clients, which can lead to earlier identification of those at risk for depression. However, providers may not discuss depressive symptoms with Deaf clients due to communication barriers. Health care providers are rarely familiar with ASL, and depression screening tools are not easily translated from English to ASL. There has been no investigation about Deaf adult's experiences with depressive symptoms or the signs used to describe those experiences. The study method employed hermeneutic interviews and analysis. Nine culturally Deaf adults were interviewed three times each, and certified interpreters were used to assist with ASL communication. After reviewing each interview with the interpreter for accuracy of translation, text was generated through word-for-word transcription and researcher observations; text was then read to obtain a broad understanding of the experience. Findings: Symptoms described by Deaf adults paralleled those of hearing adults. Four shared meanings emerged: 1) Feeling depressed, defined as the physical and emotional manifestations of depression and the ASL signs and phrases used to communicate these; 2) Emotional chaos leading to depression, defined as experiences of childhood, adolescence, and adulthood that led to feelings of depression such as feeling different, feeling isolated from family and peers, feeling excluded, and feeling limited by others; 3) Reaching out, defined as learning to walk in the Deaf world while also navigating the hearing world; 4) I am Deaf - I am not broken! Conclusions: This research provided a description of depressive symptoms as may occur among culturally Deaf adults, which may lead to increased understanding of depression as experienced by and expressed by members of the Deaf culture. In this way, improved communication and understanding between health care providers and Deaf adults can be optimized. Such knowledge may potentiate the earlier identification of culturally Deaf adults at risk for depression in the primary care setting, thereby reducing morbidity and mortality in this underserved population.