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.

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Doctor of Philosophy / Department of Family Studies and Human Services / Anthony Jurich / Until recently, minimal research has been done regarding the impact of veterinary student stress on the student’s significant intimate relationships. In this study of 466 veterinary students enrolled in five different accredited U.S. Colleges of Veterinary Medicine, the association of five primary variables, perceived stress, self-esteem, academic satisfaction, relationship satisfaction, and general life satisfaction was investigated, utilizing McCubbin and Patterson’s (1983) Double ABCX Model as a guide. Six of the seven hypotheses were supported and further regression analysis yielded a model of variable associations that supported the Double ABCX Model, though significant gender differences were found. Specifically, female students perceived significantly more stress than did male students. With the exception of academic satisfaction and relationship satisfaction, all of the major variables were strongly correlated with each other. For the women, who comprised a significant majority of the sample, perceived stress had a significant impact on relationship satisfaction, as well as on self-esteem, which in turn significantly impacted academic satisfaction. Relationship satisfaction and academic satisfaction both significantly, and separately, impacted general life satisfaction, suggesting that relationship satisfaction and academic satisfaction are different constructs that operate independently of each other. However, both have a significant impact upon and are significantly associated with general life satisfaction, suggesting that neither can be neglected during veterinary training if a positive outcome is desired. For the men in this sample, stress impacted directly upon academic satisfaction, self-esteem, and general life satisfaction but did not have a direct impact upon relationship satisfaction. Instead, relationship satisfaction and general life satisfaction had a highly correlated relationship, with both significantly and strongly associated with the other. Although academic satisfaction and relationship satisfaction appear to be two separate entities, they are both important elements to achieving general life satisfaction during veterinary training and, therefore, should be equally attended to during the training process. These findings are interpreted and discussed in light of the implications for and importance of continued collaboration between veterinary students and programs and the field of Marriage and Family Therapy in an effort to understand and support students and their significant relationships during the veterinary training process.

Doctor of Philosophy / Department of Family Studies and Human Services / William H. Meredith / This study made use of a three round Delphi survey process to explore the influential factors in the personal clinical theory development of marriage and family therapists. The sample consisted of marriage and family therapy trainees in COAMFTE accredited masters programs around the country. The initial round began with 64 items and resulted in 94 items. The last round resulted in 94 items being rated as to their amount of influence upon the personal clinical theory development of the trainees. A core set of variables were identified that were seen to be highly influential in the theory development process. Panelists were able to reach a strong consensus on all but one of these variables. A much larger set of variables were deemed moderately high in importance and varied in the overall degree of consensus that was obtained among all panelists. The results of this study, in terms of personal clinical theory development, point to the power of the personal relationships formed in the training process. Multiple variables related to the power of personal relationships with MFT program supervisors/professors. Key graduate and undergraduate courses were identified as being highly influential. Recommendations for future study, and program emphasis are offered.

Master of Science / Department of Computing and Information Sciences / David A. Gustafson / The use of hidden Markov models in autism recognition and analysis is investigated. More specifically, we would like to be able to determine a person's level of autism (AS, HFA, MFA, LFA) using hidden Markov models trained on observations taken from a subject's behavior in an experiment. A preliminary model is described that includes the three mental states self-absorbed, attentive, and join-attentive. Futhermore, observations are included that are more or less indicative of each of these states. Two experiments are described, the first on a single subject and the second on two subjects. Data was collected from one individual in the second experiment and observations were prepared for input to hidden Markov models and the resulting hidden Markov models were studied. Several questions subsequently arose and tests, written in Java using the JaHMM hidden Markov model tool- kit, were conducted to learn more about the hidden Markov models being used as autism recognizers and the training algorithms being used to train them. The tests are described along with the corresponding results and implications. Finally, suggestions are made for future work. It turns out that we aren't yet able to produce hidden Markov models that are indicative of a persons level of autism and the problems encountered are discussed and the suggested future work is intended to further investigate the use of hidden Markov models in autism recognition.

Introduction. Les femmes autistes sans déficience intellectuelle ni retard du langage ont une meilleure motivation sociale et des capacités langagières plus typiques que leurs homologues masculins. Ceci pourrait expliquer le sous-diagnostic des femmes autistes. Paradoxalement, l’autisme pourrait être surdiagnostiqué chez des populations psychiatriques avec des difficultés sociales. En effet, les critères de diagnostic demeurent assez larges, et cette condition relativement moins stigmatisée que plusieurs troubles psychiatriques. Il existe peu de directives pour les cliniciens hésitant à attribuer les difficultés adaptatives des femmes à (1) de l’autisme, (2) une condition psychiatrique, ou (3) les deux. Les aspects qualitatifs de cette condition, absents des manuels de diagnostic, sont systématiquement identifiés par les cliniciens rompus à l’exercice du diagnostic de l’autisme. Ainsi, notre étude vise à mieux caractériser les difficultés liées à l’évaluation des femmes adultes pour un diagnostic d’autisme, ainsi que les traits, comportements et outils spécifiques utilisés pour différencier l’autisme de conditions psychiatriques. Méthodes. Des entretiens semi-dirigés ont été effectués avec 20 psychiatres et psychologues experts en diagnostic de l’autisme chez les femmes, dans 7 pays différents. La méthode Framework a permis de révéler des thèmes adressant nos objectifs de recherche. Résultats. Selon nos participants, les femmes autistes semblaient avoir appris certaines contingences sociales leur permettant de paraître plus typique, et la question du diagnostic différentiel se posait souvent. Les cliniciens effectuaient donc des entretiens flexibles et longs, et validaient les informations apportées par la personne. Plusieurs des traits cités comme indicatifs de l’autisme reflétaient une connaissance clinique de l’autisme. Le trauma, ainsi que le trouble de personnalité limite, étaient considérés comme particulièrement difficiles à départager de l’autisme. Conclusion. L’évaluation pour autisme chez les femmes adultes présente des problématiques particulières que les cliniciens adressent en utilisant des boites à outils individuelles. Chez cette population, une capacité à proposer des pistes alternatives chez les personnes non-autistes s’étant auto-identifiées au spectre est primordiale. / Introduction. Autistic women present with greater social motivation and more typical language abilities than their male counterparts, leaving them vulnerable to misdiagnosis or late diagnosis. Paradoxically, there is concern about potential overdiagnosis of autism in psychiatric populations presenting with social difficulties, as diagnostic criteria remain relatively vague and autism less stigmatizing than many psychiatric conditions. Little guidance exists to guide clinicians when deciding whether to attribute adaptative difficulties in adult women to (1) autism, (2) a psychiatric condition, or (3) both. Research suggests that autism is best reliably identified by expert clinicians having been exposed to a high number of autism cases, who notice qualitative aspects of the condition not included in diagnostic manuals. Thus, we aimed to better characterize the difficulties faced by clinicians in assessing adult women for autism, and the traits, behaviors and tools used to differentiate between autism and psychiatric conditions. Methods. Semi-structured interviews were conducted with 20 psychiatrists and psychologists from 7 different countries, experienced in autism diagnosis of adult women. The Framework Method was used to reveal themes relevant to our research goals. Results. According to participants, autistic women had learned certain social contingencies allowing them to appear more typical, which made differential diagnosis a frequent question. Clinicians recommended long, flexible assessments, and validating the information volunteered by the person. Many traits cited as indicative of autism reflected a clinical knowledge of autism. Trauma and Borderline Personality Disorder were cited as particularly difficult to differentiate from autism. Conclusion. Evaluating for autism in adult women presents with singular challenges which clinicians address using individual toolboxes. In this population, it may be crucial to have the capacity to offer alternative avenues for non-autistic people having self-identified with the spectrum.

Thèse de doctorat présenté en vue de l'obtention du doctorat en psychologie - recherche intervention, option psychologie clinique (Ph.D) / Le droit à une vie amoureuse saine et satisfaisante est indéniable pour tous les êtres humains. Pourtant, les personnes ayant vécu une psychose sont souvent confrontées à divers obstacles lorsqu'elles entrent sur la scène amoureuse. La recherche et la pratique clinique ont malheureusement pris du retard à répondre à la demande d’aide dans ce domaine. L'objectif de la présente thèse est de mieux comprendre les défis liés aux relations amoureuses et à la sexualité chez les personnes aux prises avec la psychose, ainsi que d'offrir des ressources utiles pour commencer à aborder ces difficultés. À cet fin, cette thèse a été divisée en trois parties. Le premier article visait à recueillir, évaluer et synthétiser la littérature récente sur les relations amoureuses et la sexualité dans le contexte des troubles psychotiques, les résultats soulignant un besoin pour plus d’études axées sur le consommateur ainsi qu’une plus grande accessibilité aux services adaptés. Le deuxième article a examiné les propriétés psychométriques de deux mesures liées au fonctionnement romantique et sexuel des personnes vivant avec la psychose. Nos résultats suggèrent que les deux instruments sont fiables et valides dans cette population et peuvent donc être utilisés à des fins de recherche et cliniques. Le troisième et dernier article évaluait l'impact d'une nouvelle intervention de groupe, offerte en présentiel ou à distance, pour les jeunes hommes ayant vécu une psychose et cherchant à améliorer leur vie amoureuse. Les résultats suggèrent que le programme pourrait mener à des améliorations significatives au niveau de la symptomatologie, du fonctionnement romantique et de la cognition sociale (c’est-à-dire, les habiletés de mentalisation) des participants, avec les deux modalités de traitement étant tout aussi efficaces. Nous espérons que ces résultats encourageront les chercheurs et les cliniciens à poursuivre leurs recherches sur le sujet, ainsi qu’à promouvoir le développement de ressources supplémentaires pour les personnes aux prises avec la psychose ayant des difficultés sur le plan du fonctionnement romantique. / The right to a healthy and satisfying romantic life is undeniable for all human beings. Yet, people with psychosis are often confronted with unique obstacles when entering the dating scene. Research and clinical practice have unfortunately lagged behind the demand for assistance in this area. The aim of this thesis is to better understand the challenges relating to romantic relationships and sexuality among persons with psychosis, as well as offer useful resources to begin addressing these difficulties. For this purpose, this thesis was divided into three parts. The first article sought to collect, evaluate, and synthesize the latest literature on romantic relationships and sexuality in psychotic disorders, with results highlighting a need for more consumer-oriented research and greater accessibility to tailored services. The second article examined the psychometric properties of two instruments measuring the romantic and sexual functioning of individuals with psychosis. Our findings suggest that both instruments are reliable and valid in this population and therefore can be used for research and clinical purposes. The third and final article evaluated the impact of a new group intervention, offered in-person or online, for young men with psychosis seeking to improve their dating lives. Results suggest that the program may lead to significant improvements in participants’ symptomatology, romantic functioning, and social cognition (i.e., mentalization skills), with both treatment modalities being equally effective. It is hoped that these findings will encourage researchers and clinicians to continue investigating this important topic and promote the development of additional resources for people with psychosis who struggle with romantic relationship functioning.

Mémoire de maîtrise présenté en vue de l’obtention de la maîtrise en psychoéducation, option recherche et stage (M. Sc.) / Ce mémoire examine la relation entre la consommation de cannabis et les symptômes dépressifs ainsi que l’effet modérateur de la consommation de tabac sur cette relation. Ces questions sont examinées auprès d’un échantillon de jeunes adultes vulnérables sur le plan scolaire ou social (N = 386). En tenant compte des études existantes, il était d’abord attendu que la consommation de cannabis soit liée positivement aux symptômes dépressifs au début de l’âge adulte, avec l’ajout de variables contrôles (p. ex. la consommation de cannabis et les symptômes dépressifs à l’adolescence). Ensuite, il était attendu que le tabagisme au début de l’âge adulte modère à la hausse le lien entre la consommation de cannabis et les symptômes dépressifs, avec l’ajout de ces variables contrôles. Ces hypothèses ont été testées à l’aide d’une analyse de régression linéaire multiple de type hiérarchique contrôlant pour ces variables. Les résultats obtenus démontrent notamment que la consommation de cannabis est positivement associée aux symptômes dépressifs ainsi que la consommation de tabac modère à la baisse l’association. Les résultats sont discutés en considérant leurs implications théoriques ainsi que leur signification pour le bien-être des jeunes adultes avec un profil académiquement ou socialement vulnérable. / The aim of this project is to examine the relationship between cannabis use and depressive symptoms, as well as the moderating effect of tobacco use on this relationship. These questions are examined in a sample of academically and socially vulnerable young adults (N = 386). Based on previous studies, it was first expected that cannabis use would be positively linked to depressive symptoms in young adulthood, with the addition of control variables (e.g., cannabis use and depressive symptoms in adolescence). Secondly, it was expected that tobacco use in young adulthood would upwardly moderate the link between cannabis use and depressive symptoms, with the addition of these control variables. These hypotheses were tested using a hierarchical multiple linear regression analysis controlling for these variables. The results show notably that cannabis use is positively associated with depressive symptoms, while tobacco use moderates the association downwards. The results are discussed considering their theoretical implications, as well as their significance for the well-being of young adults with an academically or socially vulnerable profile.

Accurate self-report assessment of psychopathology depends on individuals responding honestly and accurately. Some respondents, however, may respond in a manner not representative of their traits/symptoms. The MMPI-2-RF contains “validity” scales to detect elevations on over-reporting (OR) or under-reporting (UR) scales which typically correspond to elevations on MMPI-2-RF substantive scales and on instruments administered alongside the MMPI-2-RF. We examined effects of OR and UR on the Personality Inventory for DSM-5 (PID-5); a self-report instrument that assesses 25 pathological traits used with other diagnostic criteria to diagnose personality disorders (PDs) in Section III of the DSM-5. Using MMPI-2-RF validity scale scores, 908 students and 255 psychiatric outpatients were classified into OR, UR or within normal limit response groups. Significant group differences were found such that differences in the frequency of PD diagnosis emerged across response groups. We believe the PID-5 is vulnerable to OR and UR responding, which potentially compromises its validity.