Emotionally triggered involuntary violent behaviour not attributed to a mental disorder: conceptual criteria and their reliability. This study conceptualised emotionally triggered involuntary violent behaviour (ETIVB), developed criteria for the identification of ETIVB, and examined their validity and reliability. South Africa criminal courts allow for a defence called “non-pathological criminal incapacity”. It refers inter alia to extreme emotional arousal triggering involuntary violent behaviour. This is usually called an “emotional storm” or a so-called “psychological blow automatism”. Psychiatrists are often called to give expert testimony in this regard, but there is no conceptual clarity or criteria upon which to base it. This difficulty is compounded by the requirement set by the criminal courts that the behaviour may not be attributed to a mental disorder (in this thesis the terms mental disorder and mental illness are used interchangeably). The first advance in obtaining clarity was afforded by focusing on the behaviour as distinct from 1) legal and jurisprudential considerations as well as 2) whether the behaviour is (not) attributed to mental disorder. The subsequent research questions driving the study were, “what counts as ETIVB?” In particular, what counts respectively as „emotional triggered‟, „involuntary‟, „violent‟, and „behaviour‟. Through conceptual methods suggested in the work of J.L. Austin, draft ETIVB-criteria were developed and then repetitively applied to a set of 28 cases. Twenty seven of these cases involved a charge of murder. The other one had behaved violently, but was not charged. The criteria were refined and their content validity derived by a repetitive to-and-fro process between comparative exploration of the concepts and their empirical application to the set of cases. The criteria were formulated into an instrument by which a psychiatrist can identify ETIVB. In addition provision was made to record whether ETIVB is, or is not, attributed to specific causes including mental disorder, but only as an attribution that follows after ETIVB has been identified. The ETIVB-instrument was subjected to reliability testing among 14 psychiatrists and 10 psychiatrists in training. They applied the ETIVB-criteria to a set of 5 externally validated case summaries. The participants had first been trained in the use of the instrument by considering other example cases. Statistical analyses of inter-rater reliability were performed. The modified kappa agreement ranged from 0.388 (fair) to 0.636 (substantial) across study cases for all criteria A.1 – H.1. The criteria for violence had exceptionally high inter-rater agreement, all being 0.947 and higher. The complexity of the ETIVB-construct transpired when inter-rater reliability analyses were compared between cases in that different cases posed different challenges for inter-rater agreement. The reliability testing across cases however, showed which less agreed-upon items would benefit from refinement. / Thesis (PhD)--University of Pretoria, 2015. / gm2015 / Psychiatry / PhD / Unrestricted

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-01-28T16:24:51Z No. of bitstreams: 1 sandramacieldecarvalho.pdf: 2854725 bytes, checksum: 38540814044484b5b6e8834780d97849 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-29T11:00:42Z (GMT) No. of bitstreams: 1 sandramacieldecarvalho.pdf: 2854725 bytes, checksum: 38540814044484b5b6e8834780d97849 (MD5) / Made available in DSpace on 2016-01-29T11:00:42Z (GMT). No. of bitstreams: 1 sandramacieldecarvalho.pdf: 2854725 bytes, checksum: 38540814044484b5b6e8834780d97849 (MD5) Previous issue date: 2014-02-14 / A pesquisa de Mestrado apresentada nesta dissertação propõe uma análise do discurso de enunciados de processos judiciais envolvendo usuários do Centro de Atenção Psicossocial (CAPS) Casa dos Amigos, de Cataguases (MG). É uma pesquisa em Psicologia Social que busca estabelecer intersecções entre o direito e a saúde mental com objetivo geral de analisar enunciados de processos judiciais civis e criminais envolvendo pessoas usuárias daquele CAPS, problematizando as posições de sujeito designadas a elas nos discursos da justiça, por meio de dispositivos de saber-poder. Investiga-se, também, como se processa a relação entre curatela, inimputabilidade e cidadania e a quais enunciados um diagnóstico de transtorno mental pode se associar e/ou se articular em um processo judicial. O método utilizado foi a pesquisa documental de processos judiciais baixados definitivamente, da comarca de Cataguases (MG). A análise das informações coletadas nos documentos foi realizada através da análise do discurso de referencial foucauldiano, podendo-se afirmar que o discurso jurídico designa posições de sujeito depreciativas para os portadores de transtorno mental, respaldando-se em dispositivos do saber-poder médicos, fundamentalmente o psiquiátrico, para enunciar verdades acerca dos mesmos. O Poder Judiciário estabelece um jogo ambíguo de proteção/subjugação com os portadores de transtorno mental, seja através da legislação, seja através das enunciações dos operadores do direito. A docilização dos corpos é um mecanismo do poder disciplinar exercido pelo Poder Judiciário, assim como a normalização é um mecanismo presente no exame médico-pericial. A cidadania, tanto no que concerne aos direitos quanto aos deveres, é negada através do processo de interdição e curatela e relativizada ao se decretar a semi-imputabilidade, em função de diagnósticos de transtorno mental. Há um distanciamento entre os códigos Civil e Penal e os códigos de Processo Civil e Processo Penal e as premissas da Reforma Psiquiátrica, presentes em legislação específica, que contribui para tal cenário. / The research presented in this Master dissertation proposes a discourse analysis of enunciations regarding judicial processes involving users of Centro de Atenção Psicossocial (CAPS) Casa dos Amigos, from Cataguases (MG). It is a Social Psychology reasearch that aims at establishing intersections between justice and mental health, with the main purpose of analyzing enunciations of civil and criminal judicial processes involving people users of that CAPS, discussing the subject position assigned to them in the discourse of justice, through dispostifs of knowledge/power. Also, the research aims at investigating how the relation among guardianship, nonimputability and citizenship is processed and to which enunciations a diagnosis of mental disorder can be associated and/or articulated in a judicial process. The method was documental research of judicial processes definitively archived belonging to the city court of Cataguases (MG). The information collected in the documents was analyzed through Michel Foucault’s discourse analyses, that allows us to affirm that legal discourse designates derogatory subjective positions to people with mental disorders, supported by medical knowledge/power dispositifs, psychiatric fundamentally, to enunciate truths about them. The Judiciary Power establishes an ambiguous game of protection/subjugation with people with mental disorders, either through legislation or through the enunciations of the operators of law. Docilization of bodies is a mechanism of the disciplinary power exercised by the Judiciary Power, as well as normalization is a mechanism present in medical-legal examinations. Citizenship, regarding as rights as duties, is denied by the process of interdiction and guardianship and also relativized when semi-inimputability is enacted, due to a mental disorder diagnosis. There is a gap between Civil and Criminal Codes and Civil Procedure and Criminal Procedure Codes and the assumptions of the “Psychiatric Reform”, present in specific legislation, which contributes to such a scenario.

Diploma thesis "System - Stigmatization of Psychically Disordered" aims the analysis of the system - stigmatization after the year 1989. As a part of the research tasks some fields related to the psychiatrical treatment/care reform in Czech Republic are discussed. Among the most important fields of disputation lie the general prerequisites of the system - stigmatization sequencing the present system of the treatment/care, the principles of the persisting psychiatrical treatment/care system that emphasizes psychiatrical institutions such as mental homes or the specific interests and acts of the people involved in compared to declared sponsions that were published in the strategical documents. As a solution by the working the problem out the people involved analysis, analysis of the legal frame and relevant strategical documents analysis. The koncept System - stigmatization is, for the purpose of that thesis, understood as an origin and a development of the stigmatization - mechanism that originated in the system of psychiatrical treatment/care and psychiatric institutions. Understood in that way, the stigmatization can be characterized as complicated web of determinants having deep history - based roots. It is also related to development of the specific culture in a way. The diploma thesis specifies...

D I S E R T A Č N Í P R Á C E Autor: Mgr. Jiří Motl Spiritualita a duševní nemoc Role spirituality v životě lidí se zkušeností s psychotickým onemocněním Spirituality and Mental Disorder: The Role of Spirituality in the Lives of People with Experience of Psychosis Abstract The dissertation investigates the relationship of mental illness and religion. It focuses on the role of spirituality in people with experience of psychosis. In the theoretical part, the problem of drawing the line between pathological and normal spirituality is discussed, stressing the importance of a functional point of view and the need for a dialogic relationship with the ill person. The theoretical part goes on with mapping the potential of spirituality in the recovery process. Spirituality often helps the afflicted to perceive their illness as a meaningful process, making it easier to cope with the illness. At the end of the theoretical part, four alternative or complementary conceptual frameworks are presented. The empirical part consists of a qualitative research of nine subjects (believers with the experience of psychosis). The data collection and analysis is based mainly in the IPA method (interpretative phenomenological analysis). The research aims to map how mental illness affected the subjects' spirituality and vice versa....

Association of education with mental illness in Czech population Abstract This master thesis aimed to study the association of education with mental disorders in the Czech population. Data were used from a nationally representative cross-sectional study - the CZEch Mental health Study (CZEMS). Mental disorders were assessed with Mini-International Neuropsychiatric Interview and divided into four groups - affective, anxiety, substance use and alcohol use. Information about the highest completed education was self-reported by participants during an interview. Binary logistic regresion examined the association of education with mental disorders, group-wise adjusting for sociodemographic, social and health-related characteristics. The analysis was conducted on 3 175 participants (54 % women, median age 49 years). Lower education (primary and vocational) was associated with higher occurrence of mental disorders, this association remained after adjustment for all characteristics. The association was strongest for alcohol use disorders and weakest for anxiety disorders and did not differ by sex. The relationship between education and alcohol use as well as substance use disorders was apparent in particular in younger individuals. The observed educational differences in the occurrence of mental disorders should be...

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The aim of this work was to explore the nature of self-efficacy construct in patients with dual diagnose in the final phase of psychiatric hospitalisation. In the theoretical part, three topics are discussed: the self-efficacy construct, hospitalisation, and specific mental disorders. In the empirical part a qualitative methodology, based on the elements of interpretative phenomenological analysis, was used. The research sample consists of 5 patients with dual diagnoses, and a psychologist treating these patients in the Department of Dual Diagnoses in Bohnice hospital. Semi-structured interviews were conducted with all participants. The presented results include a separate analysis of key topics for each participant, as well as an overall analysis of all data. A new perspective of self-efficacy is emerging, spreading through three distinct levels - intrapersonal, interpersonal, and systemic. The discussion consists of the results linked to existing literature, as well as answers to research questions. KEYWORDS Self-efficacy - dual diagnose - hospitalisation - mental disorder

Research consistently demonstrates that prison inmates are more likely than the general population to suffer from both mental disorders and substance abuse. The current study explored the relationship between diagnoses of mental disorders and maladaptive substance use among state and federal prison inmates. Linear regression analysis was used to ascertain the prevalence of comorbidity of substance abuse and mental disorder, and multiple models were constructed to determine the direction of relationship between the two disorders. Overall, mental disorders and substance use were positively related within the sample, though mixed conclusions were drawn regarding the exact nature of their relationship. Recommendations for future study and improvements to the specificity of mental disorders and substance use measures are made.

This thesis is a young adult fictional novel from the perspective of Rachel Jackson, or Rae, a seventeen year-old girl with Williams Syndrome, a rare developmental disorder caused by missing genes on chromosome 7 that causes those with it to lack logical connections, yet possess very gregarious, social, and musical personalities. Think of it as an inverted form of autism. At the genesis of the novel, Rae becomes pregnant. Upon misunderstanding her mother's sugar-coated reasoning for giving the baby up for adoption, Rae spends the novel trying to find a man to marry so that, in her understanding, she may keep her child. Along her journey, Rae meets Theo, a well-meaning Christian boy, who appears to be a possible match. Rae falls in love with Theo and gets into various kinds of trouble as she discovers how to take care of herself as well as how to accept herself, disorder and all. Along with her hardworking mother, her feisty grandmother, and her sassy little sister, Rae endeavors this bildungsroman to discover who she is and how she fits into society.

Sammanfattning: Bakgrund: Psykisk ohälsa ökar globalt och vård, omsorg och behandling kan skilja sig mellan länder. De som är sjuka har ofta behov av hjälp och stöd från familj och närstående för att kunna leva ett fullgott liv. Stödet kan vara i egenskap av medföljare till vårdbesök eller som känslomässigt eller ekonomiskt stöd i vardagen. Det i sig kan medföra ökat ansvar och press på de anhöriga. Syfte: Att beskriva anhörigas erfarenheter av att leva tillsammans med en person med psykisk ohälsa. Metod: En deskriptiv litteraturstudie med tematisk dataanalys. Sökningar gjordes i databaserna PubMed och Cinahl. Elva kvalitativa primärstudier inkluderades efter relevans- och kvalitetsgranskning och dessa analyserades sedan med tematisk analysmetod. Huvudresultat: Många anhöriga upplevde att de inte fick vara delaktiga i sin närståendes vård, behandling och omsorg. Otillräcklig information och brister i kommunikation med vårdpersonal samt ett otillräckligt stöd i den stress som uppstår i vardagslivet som anhörig framkom. Det resulterade i två huvudteman: Kommunikation med vårdpersonal samt Anhörigas stress i vardagen. Fem subteman identifierades till dessa. Slutsats: Anhöriga behöver involveras mera i vårdsituationer om och när den som är sjuk med psykisk ohälsa medger detta. Vårdpersonal behöver kontinuerlig fortbildning inom området psykisk ohälsa för att kunna ge tydlig information baserad på vetenskaplig grund. Vårdpersonal bör också våga ställa direkta frågor till de anhöriga och ta del av deras svar. Det skulle bidra till ökad känsla av sammanhang (KASAM) hos de anhöriga. / Abstract: Background: Mental illness is increasing globally. Care and treatment differ between countries. A person with mental illness often needs help from family and relatives in order to cope with their everyday life. The support can be as a companion to healthcare appointments or emotional or financial support in everyday life. This often led to increased responsibility and pressure on relatives. Aim: Relatives’ experiences of living with a person with mental illness Method: A descriptive literature review with a thematic analysis. Searches were performed in the databases PubMed and Cinahl. Eleven qualitative primary studies were included after relevance and quality review and those were then analyzed using a thematic analysis method. Result: Many relatives felt they were not allowed to participate in their loved ones care and treatment. Lack of information and communication and insufficient support in the stress that occurs in everyday life as a relative, emerged. In the result two main themes were acknowledged: Communication with healthcare staff and Relatives' stress in everyday life. Five sub themes were identified. Conclusion: Relatives need to be more involved in care situations if and when their loved ones with mental illness consents to this. Nursing staff need continuous education in the field of mental illness to be able to provide correct and science based information. Care personnel should also dare to ask direct questions to the relatives and take note of their answers. It would contribute to an increased Sense Of Coherence (SOC) among the relatives.