Borderline personality disorder (BPD) is a serious mental illness characterized by emotion dysregulation. Symptoms related to emotion are thought to contribute to difficulties in perceiving emotional expressions. Individuals with BPD and demographically matched healthy controls completed a task assessing the recognition of happy, sad, and neutral facial expressions at two intensities. Patients with BPD demonstrated comparable performance on the recognition of very happy and very sad facial expression but were significantly less accurate on neutral expressions. Patients with BPD were also significantly worse in recognizing mildly happy facial expressions, however the severity of current depressive symptoms intervened this relationship. There was evidence that perceptual biases within BPD are unique from mood-congruent biases typically found in major depressive disorder. The findings advance research on the topic of emotion perception in BPD and suggest important new lines of investigation that may be useful for delineating the nature of emotion dysregulation in BPD.

Borderline personality disorder (BPD) is a serious mental illness characterized by emotion dysregulation. Symptoms related to emotion are thought to contribute to difficulties in perceiving emotional expressions. Individuals with BPD and demographically matched healthy controls completed a task assessing the recognition of happy, sad, and neutral facial expressions at two intensities. Patients with BPD demonstrated comparable performance on the recognition of very happy and very sad facial expression but were significantly less accurate on neutral expressions. Patients with BPD were also significantly worse in recognizing mildly happy facial expressions, however the severity of current depressive symptoms intervened this relationship. There was evidence that perceptual biases within BPD are unique from mood-congruent biases typically found in major depressive disorder. The findings advance research on the topic of emotion perception in BPD and suggest important new lines of investigation that may be useful for delineating the nature of emotion dysregulation in BPD.

Occupation provides valuable information on premorbid ability in dementia. Not only is occupation related to cognitive and brain reserve, but premorbid sub-symptomatic impairment may influence prospective career choice. Frontotemporal lobar degeneration (FTLD) patients with professions dependent upon one hemisphere have demonstrated contralateral degeneration. The present work was the first group study to examine the relationship between atrophy in FTLD and occupation. Chapter one reviews methods for quantifying occupations and introduces the Occupational Information Network database. This database provided quantified occupation attribute data and enabled subsequent multivariate analyses. A principal component analysis yielded five factors that parsimoniously summarized verbal, physical, mechanical, mathematical and visuospatial occupational demands, some with hypothesized neuroanatomical substrates. Chapters two and three tested the hypothesis that occupation characteristics systematically relate to origin of atrophy in FTLD. In a multi-centre chart review of 588 patients, occupation information was related to location of atrophy. Patients with unilateral right atrophy had higher verbal scores than patients with unilateral left or bilateral atrophy. Thus, occupation selection occurring in early adulthood is related to lateralized brain damage in patients who develop FTLD decades later. The finding suggests that verbal occupations may have been pursued due to incipient right-hemisphere functional impairment. Alternatively, long-term engagement of verbal processes contributed to left-hemisphere reserve, right-hemisphere dysfunction, or both. In a subgroup of well-characterized patients with quantified brain imaging data, chapter three replicated and extended these findings. The lateralization effect was limited to the temporal lobes and included both verbal and mathematical ability. This pattern may reflect shared attributes between mathematics and language processing, which are mediated by left-temporal lobe structures. Patients whose professions placed high demands on language had relatively preserved left temporal lobes and atrophy originating in the right temporal lobes at disease onset whereas patients with less challenging linguistic occupations were more susceptible to the onset of atrophy in the left-temporal lobe. In chapter four, the hypothesized relationship between occupational attainment and global degeneration was supported. Patients with highly skilled occupations had less atrophy than patients with lower-skilled occupations. Notably, specific occupational attributes were predictive of brain volume after controlling for demography and disease progression. Overall, a relationship between occupation and FTLD is supported.

This study examines the childhood and social experiences of 10 women with trichotillomania (compulsive hair pulling) and the various pathways that led them to the discovery of trichotillomania. Trichotillomania is a chronic and devastating condition that affects a significant number of women, which has long-term consequences that can be debilitating and psychologically and emotionally scarring. The 10 women participated in semi-structured interviews during which they were asked to describe their childhood and social experiences. This is the first study that has attempted to understand childhood and social experiences from the perspective of women living with trichotillomania. Utilizing a grounded theory approach (Strauss & Corbin, 1998), the interviews were transcribed, coded, and analyzed. A model, based on the core category, The Road to Discovering Trichotillomania: The Issue of Control, was developed to reflect the experiences of these women. The model is constructed on five major themes: Looking Back: How It All Began; Childhood Environment; Relationship Between Specific Experiences and the Discovery of Hair Pulling; The Role of Hair Pulling; and The Journey of Hair Pulling. The women identified the events (both internal and external) that precipitated the first episode of hair pulling. The underlying theme of these events was the perception that things were out of their control. The discovery of trichotillomania came about as a result of the women’s attempts to regain control of their experiences and environment. The findings of this study make an important contribution to the current literature on trichotillomania by attempting to understand the complexities of the factors involved in the discovery of this condition. In presenting the lived experiences of these 10 women, this study moves the discussion beyond the pathology and towards a richer understanding of trichotillomania. The study’s limitations, implications for future research, and final thoughts are also discussed.

This dissertation consists of two studies that investigated predictors of parenting stress as they relate to child ADHD. Two main questions were explored: what is the magnitude of the association between child ADHD and parenting stress, and what are the parent and contextual predictors of parenting stress? In Study 1, meta-analyses were conducted on the association between parenting stress and ADHD. Predictors comprising child, parent, and contextual factors, and methodological and demographic moderators of the relationship between parenting stress and ADHD were examined. Findings from 44 studies were included. In Study 2, I examined parent and contextual (parental ADHD symptoms, parental education, social support, and marital status) predictors of parent domain parenting stress (parental distress) as a function of teacher-reported child ADHD symptoms. Results confirmed that parents of children with ADHD experience more parenting stress than parents of nonclinical control children, and that severity of child ADHD symptoms are associated with parenting stress. Child oppositionality was only predictive of parental distress when reported by parents (not teachers). A post-hoc analysis in Study 2 showed that child factors did not predict parental distress over and above parent and contextual factors. In Study 1, children’s co-occurring conduct problems and parental depressive symptomatology predicted parenting stress. Little difference in parenting stress was found between mothers and fathers, but lower parenting stress levels were found in samples with higher proportions of girls. Parental ADHD symptomatology was the strongest predictor of parental distress considered in Study 2. Social support was inversely related to parental distress in Study 2, whereas parental age and education were unrelated to parental distress. In Study 2, marital status was significantly correlated with parental distress, but was not a significant predictor in the regression. Marital quality was not a significant predictor of parenting stress in Study 1. The large effects observed for parent level predictors suggests that parent factors (i.e., ADHD and depressive symptoms) are critically important in parenting stress and play a primary role in the experience of elevated parenting stress. Future research should give greater consideration to factors outside of the child in increasing parenting stress.

This study provided information on the long term psychosexual and psychiatric outcomes of 139 boys with gender identity disorder (GID). Standardized assessment data in childhood (mean age, 7.49 years; range, 3–12 years) and at follow-up (mean age, 20.58 years; range, 13–39 years) were used to evaluate gender identity and sexual orientation outcome. At follow-up, 17 participants (12.2%) were judged to have persistent gender dysphoria. Regarding sexual orientation, 82 (63.6%) participants were classified as bisexual/ homosexual in fantasy and 51 (47.2%) participants were classified as bisexual/homosexual in behavior. The remaining participants were classified as either heterosexual or asexual. With gender identity and sexual orientation combined, the most common long-term outcome was desistence of GID with a bisexual/homosexual sexual orientation followed by desistence of GID with a heterosexual sexual orientation. The rates of persistent gender dysphoria and bisexual/homosexual sexual orientation were substantially higher than the base rates in the general male population. Childhood assessment data were used to identify within-group predictors of variation in gender identity and sexual orientation outcome. Social class and severity of cross-gender behavior in childhood were significant predictors of gender identity outcome. Severity of childhood cross-gender behavior was a significant predictor of sexual orientation at follow-up. Regarding psychiatric functioning, the heterosexual desisters reported significantly less behavioral and psychiatric difficulties compared to the bisexual/homosexual persisters and, to a lesser extent, the bisexual/ homosexual desisters. Clinical and theoretical implications of these follow-up data are discussed.

Peer relationships encompass an important developmental context for young girls’ understanding of normative social behavior and appearances. In early adolescence, concern for peer acceptance intensifies, as do the rigid standards peers regulate and command for physical appearance. Pressure to conform to group norms of attractiveness leaves girls vulnerable to reduced self-esteem and body dissatisfaction. Based on the life history narratives of 10 pre- and post-pubertal girls of diverse backgrounds, experiences with peers as they relate to pressures and resistances towards appearance conformity are documented through a prospective design. Results support the presence of two highly integrated domains of the peer environment which promote the pervasiveness of appearance-related pressure and body-consciousness for girls transitioning into adolescence: the evaluative external gaze and concerns for peer acceptance. Protective factors are discussed in the context of girls’ friendships and their ability to distance themselves from peer appearance pressure.

Literature addressing Canada’s immigrant professionals has primarily focused on the negative aspects of life-career transition. Research themes have centered on discouraging features of migration such as barriers, discrimination, underemployment and unemployment. Surprisingly few studies have explored how, in spite of personal and environmental barriers, some new Canadians have found they have flourished in their new country. The purpose of this study is to explore the lived experiences of a group of immigrant professionals who believe they have successfully transitioned in the life-career domains. Using a grounded theory approach, 20 individuals were interviewed about their experiences. Analysis revealed that a combination of internal and external factors contributed or hindered their life-career trajectories. Meaning making, social support and behavioural coping emerged as primary coping strategies. Issues with language and accreditation emerged as significant barriers to life-career development. Practical and theoretical implications are discussed.

Negative affect and emotions such as anger and anxiety, are risk factors related to sexual offending (Howells, Day, & Wright, 2004; Serran & Marshall, 2006). Consequently, most sexual offender treatment programs teach offenders how to cope with situations that produce negative emotionality (Pithers et al., 1989; Marshall, Marshall, Serran, 2006). A review of mindfulness meditation, a positive therapeutic approach, has demonstrated utility in improving emotional management skills (Baer, 2003), however meditation has yet to be considered as a treatment for sexual offenders. The present study is a pilot attempt at exploring the feasibility of using meditation in working with sexual offenders. Results show that participants were receptive to meditation, thought it may be beneficial, and were able to concentrate and relax during an experiential session. The potential benefits of mindfulness for improving emotional management in sexual offenders will be discussed and directions for future research will be explored.

Currently, few intervention programs for maltreating fathers exist and even fewer of them have been evaluated for effectiveness. The current study examined the effectiveness of a community-based group treatment program for domestically violent and child abusing fathers by looking at reliability, magnitude, and clinical significance of changes in variables associated with maltreatment risk mechanisms in a group of 98 participants. The intervention was found to be largely successful in producing statistically significant changes in fathers’ overreactivity to children’s misbehaviour, ability to co-parent with children’s mothers, and their ability to prioritize their children’s needs. However, a closer look at individual change (using measures of clinical significance), showed variability in fathers’ responses to treatment, with some men making changes across measures and some remaining in the clinically concerning range despite treatment efforts. The implications of these findings for intervention and maltreatment prevention are discussed.