Objective: Past research indicates that comorbid anxiety and depression in youth is associated with greater functional impairment than anxiety alone. To elucidate those factors which may increase vulnerability to depressive disorders, the current study examined several clinical correlates (i.e., feelings ratings, parental psychopathology symptoms, and family functioning) of comorbid depressive symptoms in young anxious children. Method: Sixty-eight children, aged 6 to 10 years (M = 9.06, SD = 1.10), and caregivers completed measures assessing child depressive symptoms. Furthermore, children completed self reports of anxiety symptoms, feelings ratings, and family functioning, while caregivers completed self reports of psychopathology symptoms and family functioning. Predictors of child depressive symptoms were examined separately for girls and boys. Results: In females, hierarchical regression analyses revealed that, after controlling for anxiety, higher sadness and lower positive feelings accounted for 30% of variance in child-reported depressive symptoms. Further analyses indicated that child-reported overall family dysfunction moderated the relationship between positive feelings and depressive symptoms, such that high family dysfunction increased the risk of depressive symptoms in females with low positive emotions. In males, hierarchical regression analyses revealed that, after controlling for anxiety, higher negative/hostile feelings and child-reported overall family dysfunction accounted for 19% of variance in child-reported depressive symptoms. Further analyses of family functioning in males revealed that child-reported family cohesion and conflict were negatively and positively correlated, respectively, with depressive symptoms. Family dysfunction did not moderate the relationship between feelings ratings and depressive symptoms. The only significant predictor of caregiver-reported child depressive symptoms, for males only, was caregiver self-reported overall psychopathology symptoms. Further analyses indicated that, for males, caregiver depression and hostility symptoms correlated positively with caregiver-reported child depressive symptoms. Conclusions: Different patterns of emotion and family functioning predicted self-reported depressive symptoms in males and females. Self and caregiver reports of child depressive symptoms were not related, with only caregivers’ psychopathology symptoms predicting their reports of child depressive symptoms. Results suggest the importance of assessing child-reported feelings and family dysfunction, and parental symptomatology, of clinically anxious children. To prevent future depressive disorders in these children, different targets of intervention for males and females may be warranted.

Substantial evidence indicates that maltreatment places abused children at great risk for illiteracy and damaging self-perceptions of competency and worth. Given that academic ability and self-concept are reciprocally related and mutually reinforcing, it was hypothesized that participation in an intensive literacy intervention would positively impact the reading, writing, and related self-perceptions of maltreated Struggling Readers from the Ontario Child-Welfare system. Using a mixed methods approach, 24 participants (ages 14-24) completed achievement and self-perception measures and were interviewed about their literacy experiences and views, pre and post intervention. Repeated measures analyses and pairwise comparisons measured the impact of intervention on the literacy skills and related self-evaluations of these youth and assessed how the literacy skills and related self-evaluations differed from maltreated youth without reading difficulties (n = 22). Interviews were analyzed thematically. Results converged to provide empirical support for the benefits of literacy intervention on skill and self-perception development for this high risk group of youth. Qualitative analyses further revealed unanticipated, dramatic and meaningful life changes. Participants manifested improved communication and metacognitive skills, increased autonomy and internal motivation, and amplified feelings of empowerment and hope for the future.

Gabapentin is an anticonvulsant that has become a treatment option for several indications that are not approved by Health Canada. Commonly, gabapentin is prescribed for neuropathic pain and anxiety disorders. The objective of this dissertation was to evaluate the efficacy of gabapentin for reducing pre-operative anxiety, post-operative pain and opioid consumption. The initial study examined regimens of pre-operative and post-operative gabapentin given to patients undergoing total knee arthroplasty. Patients that received gabapentin postoperatively used significantly less morphine at 24 hrs, 36 hrs and 48 hrs (p<0.05). Furthermore these patients had significantly better active-assisted knee flexion on postoperative day (POD) 2, POD 3, with a trend toward better flexion on POD 4. Next, we examined whether: 1) gabapentin administration reduces pain and opioid use after total hip arthroplasty using a multimodal analgesic regimen that included spinal anesthesia; and whether 2) preoperative administration of gabapentin is more effective than postoperative administration. Our results demonstrated that whether a 600 mg dose of gabapentin was given preoperatively or postoperatively, patients’ postoperative morphine consumption or pain scores were not reduced in hospital nor was there a reduction in pain 6 months after hip arthroplasty. The third study found that a single dose of 600 mg of gabapentin was not sufficient to reduce preoperative anxiety in patients prior to hip arthroplasty. In contrast, the final study demonstrated that 1200mg of gabapentin reduced pre-operative anxiety and pain catastrophizing in female patients with moderate to high levels of preoperative anxiety prior to major surgery, but also increased preoperative and early postoperative sedation. Our findings demonstrate the efficacy of perioperative gabapentin with respect to preoperative anxiety reduction and decreasing morphine consumption after surgery. Future studies that focus on the optimal dose and duration of perioperative gabapentin, with the aim of improving functional outcomes and decreasing the incidence and severity chronic post-surgical pain are warranted.

Although a modest body of literature has emerged to investigate the experiences of youth with Autism Spectrum Disorder (ASD), there is a need to better understand their experiences to guide developmentally appropriate interventions and supports. This exploratory mixed-methods project included two studies aimed at gathering information about the self-perceptions and lived experiences of adolescents with ASD. In study 1, 27 adolescents (ages 13-18) completed measures to examine their self-concept and self-perceived competence, self-awareness of ASD characteristics and behaviours, and the types of behavioural attributions and stigmatizing beliefs they ascribe to their problematic behaviours. Two comparison groups (adolescents with Attention Deficit Hyperactivity Disorder and typically developing adolescents) were used for self-concept and behavioural attribution comparisons. Study 2 comprised a smaller sub-set of 13 participants who participated in interviews designed to capture how ASD is perceived and experienced by those living with this disorder. Study 1 results suggested that adolescents with ASD have some awareness of the social, behavioural and adaptive challenges associated with their diagnosis and, as a group, hold some self-perceptions of competence and behavioural attributions that are different from those of adolescents without ASD. In Study 2, interviews were analyzed thematically to capture how adolescents talk about their diagnosis and psychosocial experiences, and how this may impact their self-concept and self-image. Four major categories emerged: (1) self-awareness and understanding of ASD; (2) psychosocial stress; (3) social-ecological factors; and (4) sources of support. Together, these results provide insights about how they perceive themselves and their diagnosis and some of the individual, family, and school factors related to their self-perceptions and self-awareness. Results from both studies converge to provide support for a systems approach to understanding the interactions between adolescents, families, peers, school, community, and greater society when undertaking individual assessments of needs and treatment planning for ASD. Findings from the studies are discussed with respect to the positive and negative effects of awareness and knowledge about one’s diagnosis on self-perceptions and psychological adaptation. This research has important implications for clinical and educational interventions that address the unique needs and strengths of adolescents with ASD to promote positive developmental outcomes.

This study furthers our understanding of the impact of executive dysfunction on everyday activities in stroke survivors. A classification system was developed to analyze a wide range of behaviours performed by 14 stroke survivors and 12 matched controls on the Baycrest Multiple Errands Test, a task requiring participants to buy specific items and collect certain information on the main floor of the hospital. The event recorder was used to code the occurrences and frequencies of behaviours performed by participants. Results demonstrated that participants with stroke performed significantly more task specific relevant inefficient behaviours (p < .05) and non-task specific irrelevant behaviours (p < .10) compared to controls. This study indicates the importance of performing a detailed analysis of behaviours performed to better understand the impact of ED in everyday life.

A growing body of literature is focusing on the influence of personality and emotion regulation on psychological health. Using archival data from an expressive writing project, the current study investigated the relationship between perfectionistic self-presentation and emotion regulation, and the influence of the interaction of these variables on psychological health among trauma survivors. The results indicate that both perfectionistic self-presentation and more difficulties in emotion regulation contribute to symptoms of distress. As well, higher levels of perfectionistic self-presentation were associated with more difficulties in emotion regulation. Further, emotion regulation mediated the relationship between perfectionistic self-presentation and psychological distress but not common physical complaints. More specifically, the non-acceptance subscale of emotion regulation was found to be significant in a test of multiple mediator model.

Romantic relationships are one of the most important relationships a woman will develop in her life. Women are often socialized to be compliant within their relationships, and are reminded of how a thin body type is ideal. The implications of this socialization can affect the way a woman feels about her body. The current study included 207 women who ranged in age from 18-30, were in a relationship (neither married nor engaged) for 6 months or longer, and identified as either being attracted to the same or opposite sex. Results of the study indicated a significant effect of higher levels of body dissatisfaction between both negative relationship quality, and increased engagement in unhealthy dietary behaviours. In addition, self-silencing was found to be a significant mediator in the relationship between relationship quality and both body dissatisfaction and unhealthy dietary behaviours. Limitations of the study and directions for future research are discussed.

Background. Because there have been few studies examining resilience associated with postnatal (PN) depression, this study aimed at formulating and testing a theory-based model integrating both traditional resilience paradigms and non-traditional factors including existential beliefs about life, motherhood and religion. Method. Study hypotheses addressed prediction of PN depression, stress and resilience, and the confounding influence of negative affectivity (neuroticism). Study variables included PN depression (Edinburgh PN Depression Scale, EPDS), stress, neuroticism, self-esteem, mother's distress and ambivalence, purpose/meaning, religious belief, parity, age, marital and social status. They were assessed with standardized self-report instruments and, following a pilot, administered to a probability sample of women four months postpartum in a one-wave, community, postal survey. Because the overall response rate was so low (49%) only the Europeans were included in the study (N = 225; response-rate = 78%). Statistical hypothesis-testing included linear and logistical multivariate model-twilding techniques, and principal components analysis. Results. Sixteen percent scored in the major depression range (EPDS > 12), and 14% in the minor depression range. Depression was associated with stress, neuroticism, purpose/meaning, mother's distress and (marginally) religious belief, but not with self-esteem, mother's ambivalence, age, parity or social class. Although neuroticism was strongly associated with depression, and also overlapped with most psycho-social variables, nonetheless stress, purpose/meaning, and mother's distress maintained significant relationships with depression after neuroticism was statistically controlled. Stress was associated in part with the perception of losing one's freedom in the motherhood role (neuroticism controlled). When resilience was defined as high stress coupled with low depression, it was associated with low levels of neuroticism and mother's distress. When resilience was defined in terms of high levels of maternal satisfaction, it was associated with high purpose and low ambivalence. Principal components analyses revealed that (1) stress scores reflected two dimensions suggestive of distress and self-efficacy; and (2) depression, stress, neuroticism, self-esteem and purpose were markers for the same underlying component, whereas mother's distress and ambivalence were markers for another (unrelated) component. Conclusion. This study underlines the relevance of temperament, self-efficacy, self-transcendence, existential beliefs and motherhood-related cogniitions to the understanding of PN depression and stress. / Subscription resource available via Digital Dissertations only.

Background. Because there have been few studies examining resilience associated with postnatal (PN) depression, this study aimed at formulating and testing a theory-based model integrating both traditional resilience paradigms and non-traditional factors including existential beliefs about life, motherhood and religion. Method. Study hypotheses addressed prediction of PN depression, stress and resilience, and the confounding influence of negative affectivity (neuroticism). Study variables included PN depression (Edinburgh PN Depression Scale, EPDS), stress, neuroticism, self-esteem, mother's distress and ambivalence, purpose/meaning, religious belief, parity, age, marital and social status. They were assessed with standardized self-report instruments and, following a pilot, administered to a probability sample of women four months postpartum in a one-wave, community, postal survey. Because the overall response rate was so low (49%) only the Europeans were included in the study (N = 225; response-rate = 78%). Statistical hypothesis-testing included linear and logistical multivariate model-twilding techniques, and principal components analysis. Results. Sixteen percent scored in the major depression range (EPDS > 12), and 14% in the minor depression range. Depression was associated with stress, neuroticism, purpose/meaning, mother's distress and (marginally) religious belief, but not with self-esteem, mother's ambivalence, age, parity or social class. Although neuroticism was strongly associated with depression, and also overlapped with most psycho-social variables, nonetheless stress, purpose/meaning, and mother's distress maintained significant relationships with depression after neuroticism was statistically controlled. Stress was associated in part with the perception of losing one's freedom in the motherhood role (neuroticism controlled). When resilience was defined as high stress coupled with low depression, it was associated with low levels of neuroticism and mother's distress. When resilience was defined in terms of high levels of maternal satisfaction, it was associated with high purpose and low ambivalence. Principal components analyses revealed that (1) stress scores reflected two dimensions suggestive of distress and self-efficacy; and (2) depression, stress, neuroticism, self-esteem and purpose were markers for the same underlying component, whereas mother's distress and ambivalence were markers for another (unrelated) component. Conclusion. This study underlines the relevance of temperament, self-efficacy, self-transcendence, existential beliefs and motherhood-related cogniitions to the understanding of PN depression and stress. / Subscription resource available via Digital Dissertations only.

Background. Because there have been few studies examining resilience associated with postnatal (PN) depression, this study aimed at formulating and testing a theory-based model integrating both traditional resilience paradigms and non-traditional factors including existential beliefs about life, motherhood and religion. Method. Study hypotheses addressed prediction of PN depression, stress and resilience, and the confounding influence of negative affectivity (neuroticism). Study variables included PN depression (Edinburgh PN Depression Scale, EPDS), stress, neuroticism, self-esteem, mother's distress and ambivalence, purpose/meaning, religious belief, parity, age, marital and social status. They were assessed with standardized self-report instruments and, following a pilot, administered to a probability sample of women four months postpartum in a one-wave, community, postal survey. Because the overall response rate was so low (49%) only the Europeans were included in the study (N = 225; response-rate = 78%). Statistical hypothesis-testing included linear and logistical multivariate model-twilding techniques, and principal components analysis. Results. Sixteen percent scored in the major depression range (EPDS > 12), and 14% in the minor depression range. Depression was associated with stress, neuroticism, purpose/meaning, mother's distress and (marginally) religious belief, but not with self-esteem, mother's ambivalence, age, parity or social class. Although neuroticism was strongly associated with depression, and also overlapped with most psycho-social variables, nonetheless stress, purpose/meaning, and mother's distress maintained significant relationships with depression after neuroticism was statistically controlled. Stress was associated in part with the perception of losing one's freedom in the motherhood role (neuroticism controlled). When resilience was defined as high stress coupled with low depression, it was associated with low levels of neuroticism and mother's distress. When resilience was defined in terms of high levels of maternal satisfaction, it was associated with high purpose and low ambivalence. Principal components analyses revealed that (1) stress scores reflected two dimensions suggestive of distress and self-efficacy; and (2) depression, stress, neuroticism, self-esteem and purpose were markers for the same underlying component, whereas mother's distress and ambivalence were markers for another (unrelated) component. Conclusion. This study underlines the relevance of temperament, self-efficacy, self-transcendence, existential beliefs and motherhood-related cogniitions to the understanding of PN depression and stress. / Subscription resource available via Digital Dissertations only.