In this thesis I investigate the social and cultural dimensions of the self through an examination of the psychiatric disorder of depersonalization. Specifically, I apply Thagard's Multilevel Interacting Mechanisms framework to depersonalization, which reveals the complex interaction between the phenomenal nature of the illness, and the (culturally construed) conception of the self. I argue that in addition to being a factor for this particular mental illness, the Western independent conception of the self is descriptively incomplete. These conclusions have both bioethical implications for the optimal treatment of depersonalization, and conceptual implications as to our understanding of the self. In the former case, I advocate for greater recognition of the social and cultural contributions to depersonalization, and a more pro-active response to potentially unhealthy self-concepts. With respect to the self, I argue that despite the lack of a 'single monolithic self-concept', the self can be understood as unified both phenomenally, and more broadly by taking a multilevel approach. Depersonalization has been chosen for this project as it is challenging (and ultimately revealing) on two fronts; first it is an incredibly subtle yet disturbing phenomenal experience that affects approximately 2.5 percent of the Canadian population, making it an ideal subject for fostering an understanding of the phenomenal subtleties of selfhood. Secondly, the rates of depersonalization vary dramatically across cultures, and I shall argue that this is largely a result of divergent conceptions of the self. An integrative multilevel account of depersonalization will help explain how these phenomenal and social components operate within the larger phenomena of selfhood.

In this thesis I investigate the social and cultural dimensions of the self through an examination of the psychiatric disorder of depersonalization. Specifically, I apply Thagard's Multilevel Interacting Mechanisms framework to depersonalization, which reveals the complex interaction between the phenomenal nature of the illness, and the (culturally construed) conception of the self. I argue that in addition to being a factor for this particular mental illness, the Western independent conception of the self is descriptively incomplete. These conclusions have both bioethical implications for the optimal treatment of depersonalization, and conceptual implications as to our understanding of the self. In the former case, I advocate for greater recognition of the social and cultural contributions to depersonalization, and a more pro-active response to potentially unhealthy self-concepts. With respect to the self, I argue that despite the lack of a 'single monolithic self-concept', the self can be understood as unified both phenomenally, and more broadly by taking a multilevel approach. Depersonalization has been chosen for this project as it is challenging (and ultimately revealing) on two fronts; first it is an incredibly subtle yet disturbing phenomenal experience that affects approximately 2.5 percent of the Canadian population, making it an ideal subject for fostering an understanding of the phenomenal subtleties of selfhood. Secondly, the rates of depersonalization vary dramatically across cultures, and I shall argue that this is largely a result of divergent conceptions of the self. An integrative multilevel account of depersonalization will help explain how these phenomenal and social components operate within the larger phenomena of selfhood.

This thesis examined a topic from the field of intergroup relations, namely the consequences of the process of depersonalization. According to Turner, depersonalization is that process whereby people come to perceive themselves and others more as interchangeable exemplars of a social category than as unique personalities defined by their differences from others. Based on research involving simple or unstructured groups, he formulated the consequences of depersonalization in his Assimilation-Contrast Model as the enhancement of intragroup similarities (assimilation) and intergroup differences (contrast) with a pro-ingroup bias. The generality of the Assimilation-Contrast Model has recently been challenged by Smith's Person-Situation Model of depersonalization, on the grounds that the assimilation-contrast effect may not be observed in complex or structured groups. The present work derived and tested the validity of three sets of predictions on the behavior of structured and unstructured groups under depersonalized conditions based on the Assimilation-Contrast and Person-Situation Models. To this end, structured and unstructured groups were studied under two levels of depersonalization, one level of non-explicit outgroup comparison and a second level of explicit outgroup comparison. This resulted in four experimental conditions. A fifth condition of non-categorized individuals functioned as a control group. Fifty-eight college aged males participated in the experiment which consisted of a game-like procedure (brainstorming task). Subjects participated in a group (experimental conditions) or alone (control condition). The assimilation-contrast effect was assessed in three ways. Subjects were asked about their overall impressions regarding the group and the individual ingroup members ('global questionnaire items'), they were asked to rate other ingroup members on a number of personal attributes ('personal attribute ratings'), and thirdly, they were asked to rate the products of the ingroup as well as those of the outgroup ('product ratings'). There were four major Findings: (a) in unstructured groups, ingroup assimilation was more pronounced under higher levels of depersonalization than under lower levels. This was in line with previous research findings involving the Assimilation-Contrast Model (b) In structured groups, ingroup assimilation was less under higher levels of depersonalization than it was under lower levels. This was predicted by the Person-Situation Model (c) Structured groups expressed more assimilation-contrast behavior than unstructured groups. This finding was not predicted by either model, (d) In structured as well as unstructured groups, more outgroup contrast was observed under high levels of depersonalization than under low levels. This was in line with the predictions of the Assimilation-Contrast Model. The findings showed that all three sets of predictions were found to be useful in describing a certain component of the behavior of the groups under study. It was concluded that the assimilation-contrast effect may constitute less monolithic a phenomenon than originally suggested by Turner. / Arts, Faculty of / Psychology, Department of / Graduate

Magister Public Health - MPH / Burnout is a condition of emotional exhaustion (EE), depersonalization (DP), and a reduced sense of personal accomplishment (PA) that can occur among individuals who work with people in some capacity. Burnout is more prevalent in the helping professions, and high levels of burnout have been documented in all categories of nurses. A descriptive and analytical quantitative cross-sectional study was conducted to measure the level of burnout and its possible associated factors among nurses of two district hospitals in Kigali City. All 126 nurses working in the maternity and paediatric sections of Muhima and Kibagabaga District Hospitals were included in the study. A self-administered questionnaire was used to collect socio-demographic and workplace information as well as responses to 22 questions in the Maslach Burnout Inventory (MBI), which assesses burnout along its three dimensions of emotional exhaustion, depersonalisation and reduced personal accomplishment. Descriptive statistics such as percentage, mean score, and standard deviation were computed for each burnout category and Chi-square test statistic was performed to test the relationship between burnout (dependent variable) and personal factors, workplace demands, and access to resources (independent variables); and between burnout and hospital and service (paediatric or maternity). Of the 126 questionnaires distributed, 102 (81%) were returned and useable for analysis. The average age of respondents was 29.7 years and female nurses represented the majority (88.2%) of our sample. Just over half (52.9%) were married and 53.9% had at least on child. The average years of experience as a nurse was 5.6 years, while the average years of experience in the hospital was 4 years. High burnout was found with high levels of EE in 43.1% of respondents, high levels of DP in 48.0%, and low level of PA in 34.3%. Burnout was associated with being young and inexperienced, having less training, having at least one child, working longer hours, experiencing workloads as demanding, poor perceived control of the work, perceived staff shortages and workplace conflicts. However, good communication, job satisfaction and trust in colleagues and in hospital management, appeared to be protective for all three dimensions of burnout. In conclusion, burnout was found to be associated with personal, workplace demands and environmental factors. Improvement of nursing work conditions, conflict prevention and improved communication between hospital managers and staff would be expected to prevent burnout among nurses working in paediatric and maternity wards of Muhima and Kibagabaga District Hospitals.

Background: Burnout and physician wellness are becoming increasingly topical. While some surveys have been performed with South African anaesthesiologists, these have been conducted in limited samples. While Burnout is often measured, there is a paucity of research on contributory risk and protective factors. Method: A contextual, prospective, cross-sectional study was conducted. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and the Areas of Work-Life Survey (AWS) were used to assess Burnout and contributory organizational risk factors amongst state-employed anaesthesiologists working at Groote Schuur Hospital. Results: Out of a possible 127 members of staff (Medical officers, Registrars and Consultants), 81 responded with 75 completing the full survey (59% response rate). Only 4% of respondents were classified as “burnt out”, defined as scoring 8 high in all three domains of Burnout: High Emotional Exhaustion and Depersonalization and Low Personal Accomplishment. However, 67% of respondents scored high for at least one of the components of Burnout, indicating the majority of the respondents are at risk for developing clinically significant Burnout. The Areas of Work-Life survey showed that respondents found their workload inappropriate. However, responses for the categories of Control, Reward, Community, Fairness and Values were all in the acceptable range. Conclusion: While the overall rate of Burnout was low, the majority of respondents were at risk of developing Burnout. High perceived workload appeared to be a particular contributory factor. Protection against Burnout in this group may be provided by a combination of few organisational risk factors together with feelings of personal accomplishment.

Mr. B, a 22-year-old Caucasian male nursing student, ingested oral marijuana 100mg Pretzel for the first time under peer pressure.  Within 30 min he felt trippy with out of body experiences. He slept for 24 hours and woke feeling still as if out of his body looking at himself with disconnected, numb hands and feet; everyone and everything appeared cartoonish; and his voice was like an echo. He felt anxious with panic attacks, experienced eye floaters and could not tolerate sunlight so covered his bedroom windows with blankets and isolated himself from usual activities. His friends, who were not novice users, felt high for 24 hours but had no dissociative symptoms. The patient saw his PCP where UDS was positive only for tetrahydrocannabinol and all other lab tests were normal. He was treated with paroxetine 10mg, buspirone 15mg bid, and prn hydroxyzine 50mg for insomnia for 3 weeks but experienced nausea, vomiting, diarrhea, drowsiness and suicidal ideation. He was switched to escitalopram 5mg daily and lorazepam 0.5mg prn for anxiety for 2 weeks which resulted in 90% improvement in symptoms but when escitalopram was increased to 10mg he felt worse. When presenting to psychiatry he reported daily persistent anxiety worrying about having these symptoms for life and panic attacks every 3days relieved with lorazepam. He had a history of anxiety and panic attacks at the age of 8 around parental divorce with therapy for 6 months. There was a family history of anxiety and panic disorder. At 2, 4, 6-month follow-ups the patient reported thrice a week anxiety lasting 5 min but no panic attacks. He also had rare episodes of 2 min duration when everything around him seemed in high definition imagery. He felt stable on daily escitalopram and thrice a week lorazepam. Transient or prolonged cannabis induced Depersonalization-Derealization Disorder (DDD) is typically reported to occur after repeated use of inhaled cannabis with improvement with avoidance of the offending agent or use of SSRI, benzodiazepine, or rarely anti-psychotics. Cannabis’s psychoactive properties are primarily due to delta-9-tetrahydrocannabinol (Δ9-THC) which is the primary inhaled component, but metabolism by the liver after ingestion results in the more psychoactive 11 hydroxy-THC that has a slower onset but longer lasting effect. Cannabis’ potency has been increasing in recent years with current edible forms containing an average of 50% up to 90% THC. Our case emphasizes the importance of recognizing that even single use de novo marijuana can induce a protracted Depersonalization-Derealization Disorder. In this poster, we elaborate on the typical risk factors for DDD that include chronic use, adolescent age, cannabis potency, prior history of anxiety and panic attacks, precipitating stress, genetic vulnerability, and family history of anxiety/panic disorder. We also address the hypothesized neurochemistry underlying the association between dissociative states and cannabis use.

This study examined the prevalence of undiagnosed dissociative disorders in a sample of 201 adult patients admitted to a private psychiatric hospital in a major metropolitan city in the south-central United States, over an eight-month period. A screening measure, two blind structured interviews, and a blind clinical interview were employed. The lifetime prevalence of dissociate disorders among the interviewed subjects was 40.8%. More specifically, 7.5% were diagnosed with dissociative identity disorder, 15.4% with dissociative disorder not otherwise specified, 13.4% with dissociative amnesia, and 4.5% with depersonalization disorder. Dissociative fugue was not found in this sample. Cohen's kappa reliability coefficients were computed between the three interview measures, resulting in significant findings for the presence of dissociative identity disorder and dissociative disorder not otherwise specified versus no dissociative disorder. The Cohen's kappa reliability coefficients were as follows: DDIS-DES-T = 0.81; SCID-D-DES-T = 0.76; Clinician-DES-T = 0.74, DDIS-SCID-D = 0.74; DDIS-Clinician = 0.71, and SCID-D-Clinician = 0.56. A meeting was conducted at the end of all subject interviews to discuss discrepant findings between measures. Four additional sub-analyses were performed between dissociative and non-dissociative subjects on DSM-IV variables. Patients diagnosed with a dissociative disorder had higher rates of comorbid major depressive disorder, borderline personality disorder, somatization disorder, and childhood history of physical and/or sexual abuse. Theoretical and methodological issues were discussed as they relate to these findings.

No description available.

Burnout is a topic that is drawing an increasing amount of attention in the social work field. The compassion and emotional energy that is used daily by these service providers can cause them to experience emotional exhaustion, depersonalization, and reduced personal accomplishment. The effects of burnout are detrimental on several levels. Staff will experience decreased interest and efficiency in their work and may even leave their place of employment. Clients will not receive the help that they require and agencies will suffer from staff turnover and lowered productivity. Utilizing a survey including a burnout inventory and spirituality inventory, data was gathered regarding burnout and the spiritual attitudes and practices of 133 service providers. Results show that there is a negative significant relationship between depersonalization and spirituality. There was a positive significant relationship between personal accomplishment and spirituality. The correlation showed that personal accomplishment was negatively related to emotional exhaustion as well as depersonalization. These results are consistent with the literature in the way that it demonstrates that the use of spiritual beliefs and practices can reduce the effects of burnout on social workers.

No description available.