The purpose of this study was to explore the role of peers in women's lived experiences in their bodies from childhood to young adulthood. The present study used a qualitative life history methodology to delineate the range of peer processes, both adverse and protective, that affect women's connection to their bodies over time, as well as the meaning women make of these processes, and their internalized reactions to peer influences across a developmental trajectory. In-depth interviews were conducted among fourteen women between the ages of 25 and 35, representing diverse social and cultural backgrounds, as well as current and past eating and body image problems. Women participated in open-ended interviews, using a series of guided questions about their experiences with peers that affected their lived experiences in their bodies, from childhood through to adulthood. Interviews were transcribed and analyzed for themes using a grounded theory methodology. Two interrelated models emerged from the data that clarified ways in which relationships with peers shaped interviewed women's lived experiences in their bodies over time. The Peer Processes Related to Dominant and Alternative Norms, Ideals and Expectations Model addresses peer processes related to the promotion of dominant and alternative norms, ideals and expectations regarding appearance and ways of inhabiting the body as girls and women. The Implications of Peer Processes on Social Power and Acceptance model delineates the ways in which widely sanctioned norms, ideals and expectations pertaining to participants' bodies and appearances, are expressed and internalized through concerns for peer status, power, belonging and acceptance. The research has both clinical and research implications, shedding important light on the ways in which peers enhance, maintain and disrupt girls' and women's connection to their bodies over time.

This study examined the impact of working memory deficits (WMD) on the academic achievement of adolescents with ADHD. Adolescents (n=79) aged 13 to 17 years with a clinical diagnosis of ADHD were subtyped into those with and without WMD based on impairment in at least two measures, and then compared on their academic achievement and clinical profile. Results indicated that adolescents with ADHD plus WMD (23%) manifest significantly lower academic achievement than those with adequate WM. By contrast, there were no group differences in psychiatric comorbidity, severity of ADHD symptoms and psychological adjustment. We also found a unique contribution of WM to academic achievement over and above that of other clinical features. These findings suggest that WMD compromise the educational attainment of a subgroup of individuals with ADHD. Individuals with ADHD should be screened for WMD to prevent academic failure and WM should be considered as a treatment target.

The present research explores a promising therapy – Supportive Expressive Therapy (SET; Luborsky, 1984) – for adolescents with mood and/or anxiety disorders. It has been proposed that therapist expressive techniques (e.g., challenges and interpretations) and client interpersonal mastery (i.e., self-understanding and self-control in relationships) are two elements central to the success of SET (Luborsky, 1984; Grenyer & Luborsky, 1996). The current thesis employs a microprocess approach to examine expressive techniques and interpersonal mastery as potential mechanisms of change in SET. The study first provides preliminary evidence that SET is effective in helping adolescents suffering from internalizing disorders. Clients (N = 10) reported significantly fewer symptoms of depression and anxiety post-therapy. The body of the study then focuses on two research questions pertaining to the microprocesses occurring during SET. First, employing graphical and statistical analyses, the study investigates the notion that SET helps clients develop greater interpersonal mastery. Ten clients’ levels of interpersonal mastery were assessed at four points throughout therapy to determine whether clients demonstrated higher levels of interpersonal mastery over time. Secondly, this dissertation explores the impact of therapist expressive statements on clients' narratives, using a lag sequential analysis. Clients' statements were examined to determine whether higher levels of interpersonal mastery were exhibited following higher-level expressive techniques versus other therapist statements (i.e., supportive statements). Statistical analyses pertaining to the first research question did not reveal significant changes in interpersonal mastery over the course of therapy. However, graphical analyses suggested specific patterns of gains in interpersonal mastery during SET. With respect to the second research question, results demonstrated therapists employed significantly more higher-level expressive techniques in the later stages of SET, in accordance with the guidelines provided in SET manuals. Lag sequential analyses did not, however, provide substantial evidence of gains in interpersonal mastery following higher-level therapist techniques. Despite a lack of evidence supporting a general link between higher-level techniques and increased client mastery, exploratory analyses suggested change-focused expressive statements were linked to fewer client statements reflecting low interpersonal mastery. Future research should examine (1) change-focused statements as potentially important variables fostering improvement, and (2) moderators of client responses to higher-level techniques.

Adolescence is marked with significant changes in how girls feel and act within their bodies, and is considered a special risk period for body image disruptions. Cross sectional quantitative research within this area suggests that parents represent an important contextual and developmental contributor to body image. The present study aimed to address gaps in previous research by investigating parental influences, including both protective and risk factors, on girls’ embodied experiences through utilizing a prospective qualitative design with a diverse sample of twelve girls, ages 9-18, interviewed annually over four years. Results revealed the presence of both protective and risk factors related to embodiment experiences within the parental relationships, including aspects of relational qualities, self-care, evaluative gaze and social location. Results are discussed in relation to Bronfenbrenner’s Ecological Systems Theory and to previous research. The implications for future research are also discussed.

Introduction: This thesis evaluated the effectiveness of an educational intervention for Toronto Transit Commission (TTC) employees exposed to a traumatic event at work. Methods: This study used a sequential mixed methods design. The primary outcome was the proportion seeking mental health treatment after an educational intervention (BPI) compared to a group not receiving an educational intervention (TAU). Qualitative interviews aimed to understand what compelled participants to seek help and perceptions of the educational intervention. Results: 60 TAU and 50 BPI participants were recruited. A larger proportion of BPI participants sought specialty mental health treatment compared to the TAU (p=0.034). Reasons for seeking treatment were varied and we found overall positive responses to the educational intervention, particularly normalization of reactions. Conclusions: A greater proportion of those receiving the educational intervention sought help. However, the interviews showed that although the educational intervention was helpful, it was not central to this decision.

The purpose of this study was to explore the role of peers in women's lived experiences in their bodies from childhood to young adulthood. The present study used a qualitative life history methodology to delineate the range of peer processes, both adverse and protective, that affect women's connection to their bodies over time, as well as the meaning women make of these processes, and their internalized reactions to peer influences across a developmental trajectory. In-depth interviews were conducted among fourteen women between the ages of 25 and 35, representing diverse social and cultural backgrounds, as well as current and past eating and body image problems. Women participated in open-ended interviews, using a series of guided questions about their experiences with peers that affected their lived experiences in their bodies, from childhood through to adulthood. Interviews were transcribed and analyzed for themes using a grounded theory methodology. Two interrelated models emerged from the data that clarified ways in which relationships with peers shaped interviewed women's lived experiences in their bodies over time. The Peer Processes Related to Dominant and Alternative Norms, Ideals and Expectations Model addresses peer processes related to the promotion of dominant and alternative norms, ideals and expectations regarding appearance and ways of inhabiting the body as girls and women. The Implications of Peer Processes on Social Power and Acceptance model delineates the ways in which widely sanctioned norms, ideals and expectations pertaining to participants' bodies and appearances, are expressed and internalized through concerns for peer status, power, belonging and acceptance. The research has both clinical and research implications, shedding important light on the ways in which peers enhance, maintain and disrupt girls' and women's connection to their bodies over time.

Introduction – Dissocié un trouble psychiatrique primaire (TPP) concomitant à un problème d’abus de substances d’une psychose induite par consommation de substance (PICS) peut être une tâche difficile puisque plusieurs symptômes sont similaires. La dichotomie entre les symptômes négatifs et les symptômes positifs de la schizophrénie a été suggéré comme étant un indicateur puisque les symptômes négatifs ne sont pas caractéristiques d’un double diagnostic (Potvin, Sepehry, & Stip, 2006). Objectif – Cette étude explore la possibilité de distinguer des sous-groupes au sein de notre échantillon en utilisant le fonctionnement cognitif en vue d’identifier des facteurs qui permettraient un meilleur défférentiel entre un TPP concomitant à un problème d’abus de substance d’une psychose induite par consommation de méthamphétamines (MA). L’hypothèse stipule que les individus avec un TPP présenteraient des déficits cognitifs différents comparativement aux individus avec une PICS. Méthode – Les données utilisés font parties d’une étude longitudinale qui s’est déroulée à Vancouver, CB, Canada. 172 utilsateurs de MA et présentant une psychose ont été recruté. L’utilisation de substances, la sévérité des symptômes et des déficits cognitifs ont été évalué. Résultats – Des analyses par regroupement ont révélé deux profiles: les individus du Groupe 1 ont une performance inférieure au score total du Gambling task (M=-28,1) ainsi qu’un pourcentage de rétention inférieur au Hopkins Verbal Learning Test – Revised (HVLT- R; M=63) comparativement à ceux du Groupe 2. Les individus du Groupe 1 ont plus de symptômes négatifs, t=2,29, p<0.05 et ont plus tendance à avoir reçu un diagnostic psychiatrique, X2(3) = 16.26, p< 0.001. Conclusion – Les résultats suggèrent que des facteurs cognitifs pourraient aider à identifier un TPP concomitant à l’abus de MA. / Introduction - Dissociating a primary psychotic disorder (PPD) with concurrent substance use from substance-induced psychosis (SIP) can be a difficult task since several symptoms are similar. The dichotomy between negative and positive symptoms in schizophrenia has been hypothesized as a predictor, as the former is not typically a feature of a dual disorder (Potvin, Sepehry, & Stip, 2006). Objective - This study explored the possibility of distinguishing subgroups within our sample using cognitive functioning to further identify factors that could help the differential diagnosis between a PPD co-occurring with substance-use and a methamphetamine (MA) induced psychosis. The hypothesis stipulates that individuals with a PPD should present with different cognitive deficits compared to individuals with SIP. Methods - This study used the data collected as part of a longitudinal study (the MAPS project) that took place in Vancouver BC, Canada. 172 individuals presenting with psychosis and MA abuse were recruited. Substance use, symptoms severity and cognitive deficits were assessed. Results - Cluster analyses revealed two profiles: individuals in Cluster 1 had a poorer performance on the Gambling task net score (M=-28,1) as well as on the Hopkins Verbal Learning Test - Revised (HVLT-R; M=63) % of retention score compared to those in Cluster 2. Individuals in Cluster 1 also had more negative symptoms than individuals in Cluster 2, t=2,29, p<0.05 and were more likely to have had a psychiatric diagnosis, X2(3) = 16.26, p< 0.001. Conclusion - Results suggest that cognitive predictors might help identify PPD that co-occur with MA abuse.

Introduction: This thesis evaluated the effectiveness of an educational intervention for Toronto Transit Commission (TTC) employees exposed to a traumatic event at work. Methods: This study used a sequential mixed methods design. The primary outcome was the proportion seeking mental health treatment after an educational intervention (BPI) compared to a group not receiving an educational intervention (TAU). Qualitative interviews aimed to understand what compelled participants to seek help and perceptions of the educational intervention. Results: 60 TAU and 50 BPI participants were recruited. A larger proportion of BPI participants sought specialty mental health treatment compared to the TAU (p=0.034). Reasons for seeking treatment were varied and we found overall positive responses to the educational intervention, particularly normalization of reactions. Conclusions: A greater proportion of those receiving the educational intervention sought help. However, the interviews showed that although the educational intervention was helpful, it was not central to this decision.

The present research explores a promising therapy – Supportive Expressive Therapy (SET; Luborsky, 1984) – for adolescents with mood and/or anxiety disorders. It has been proposed that therapist expressive techniques (e.g., challenges and interpretations) and client interpersonal mastery (i.e., self-understanding and self-control in relationships) are two elements central to the success of SET (Luborsky, 1984; Grenyer & Luborsky, 1996). The current thesis employs a microprocess approach to examine expressive techniques and interpersonal mastery as potential mechanisms of change in SET. The study first provides preliminary evidence that SET is effective in helping adolescents suffering from internalizing disorders. Clients (N = 10) reported significantly fewer symptoms of depression and anxiety post-therapy. The body of the study then focuses on two research questions pertaining to the microprocesses occurring during SET. First, employing graphical and statistical analyses, the study investigates the notion that SET helps clients develop greater interpersonal mastery. Ten clients’ levels of interpersonal mastery were assessed at four points throughout therapy to determine whether clients demonstrated higher levels of interpersonal mastery over time. Secondly, this dissertation explores the impact of therapist expressive statements on clients' narratives, using a lag sequential analysis. Clients' statements were examined to determine whether higher levels of interpersonal mastery were exhibited following higher-level expressive techniques versus other therapist statements (i.e., supportive statements). Statistical analyses pertaining to the first research question did not reveal significant changes in interpersonal mastery over the course of therapy. However, graphical analyses suggested specific patterns of gains in interpersonal mastery during SET. With respect to the second research question, results demonstrated therapists employed significantly more higher-level expressive techniques in the later stages of SET, in accordance with the guidelines provided in SET manuals. Lag sequential analyses did not, however, provide substantial evidence of gains in interpersonal mastery following higher-level therapist techniques. Despite a lack of evidence supporting a general link between higher-level techniques and increased client mastery, exploratory analyses suggested change-focused expressive statements were linked to fewer client statements reflecting low interpersonal mastery. Future research should examine (1) change-focused statements as potentially important variables fostering improvement, and (2) moderators of client responses to higher-level techniques.

This study examined the impact of working memory deficits (WMD) on the academic achievement of adolescents with ADHD. Adolescents (n=79) aged 13 to 17 years with a clinical diagnosis of ADHD were subtyped into those with and without WMD based on impairment in at least two measures, and then compared on their academic achievement and clinical profile. Results indicated that adolescents with ADHD plus WMD (23%) manifest significantly lower academic achievement than those with adequate WM. By contrast, there were no group differences in psychiatric comorbidity, severity of ADHD symptoms and psychological adjustment. We also found a unique contribution of WM to academic achievement over and above that of other clinical features. These findings suggest that WMD compromise the educational attainment of a subgroup of individuals with ADHD. Individuals with ADHD should be screened for WMD to prevent academic failure and WM should be considered as a treatment target.