Delayed sleep phase disorder (DSPD) is the most common circadian rhythm sleep disorder. Persons with DSPD have great difficulties falling asleep and waking up at conventional times. To diagnose DSPD this delayed sleep-wake rhythm should cause social impairment and distress for the individual. Evening melatonin and morning bright light are the recommended treatments. The overall aim of this thesis was to evaluate at-home treatment with Light therapy (LT) and the feasibility of adding cognitive behavior therapy (CBT) to LT in DSPD, furthermore prevalence, diagnostic aspects and associated factors were investigated. Study I included 673 randomly selected individuals aged 16–26 years. The prevalence of DSPD was 4.0%. Unemployment (defined as an absence of educational or work activities) and an elevated level of anxiety were associated with DSPD. In study II, dim light melatonin onset (DLMO) was measured in healthy adults. Time for DLMO DLMO (Mean±SD) was 20:58±55 minutes. Studies III, IV, and V present results from a randomized controlled trial examining the feasibility of CBT as an additive treatment to LT with scheduled rise times, in persons with DSPD. Sleep onset and sleep offset was significantly advanced from baseline (03:00±1:20; 10:22±2:02 respectively) to the end of LT (01:27±1:41; 08:05±1:29, p<0.001 respectively). This advancement was predicted by consistent daily usage of the LT-lamp. At the follow-ups after LT and CBT or LT alone, sleep onset remained stable, sleep offset was delayed, and sleep difficulties were further improved, but there was no significant group interaction over time. There was a significant group interaction over time in the severity of anxiety and depressive symptoms, both in favor of the LT+CBT group. Conclusively, DSPD was common among adolescents and young adults and it was associated with unemployment and elevated levels of anxiety. DLMO appeared in the expected time range in healthy working adults. At-home treatment with LT with scheduled rise times advanced sleep-wake rhythm and improved sleep difficulties in DSPD. Even though sleep-wake rhythm was not further advanced or better preserved in the participants that received LT+CBT compared to LT alone, the addition of CBT to the treatment regimen was feasible and well accepted.

The aims of this thesis were to increase the knowledge about the long-term psychological consequences in parents of children diagnosed with cancer, including parents of childhood cancer survivors (CCSs) and bereaved parents, and to take the first steps towards developing a psychological treatment for parents of CCSs. Study I was a systematic review synthesizing the literature on psychological long-term consequences in parents of CCSs. Study II had a longitudinal design assessing posttraumatic stress symptoms (PTSS) from shortly after the child’s diagnosis (T1, N=259) up to five years after end of the child’s treatment or death (T7, n=169). Study I and II concluded that while most parents show resilience in the long-term, a subgroup report high levels of general distress and/or PTSS. In Study III, interview data from the last assessment in the longitudinal project (T7, n=168) was used. Participants described particularly negative and/or positive experiences in relation to their child’s cancer, and results pointed to the wide range of such experiences involved in parenting a child with cancer. In Study IV and V, parents of CCSs reporting cancer-related psychological distress were included (N=15). In Study IV, a conceptualization of this distress was generated by aggregation of individual behavioral case formulations. The conceptualization consisted of two separate but overlapping paths describing development and maintenance of symptoms of traumatic stress and depressive symptoms. In Study V, cognitive behavior therapy (CBT) based on the individual case formulations were preliminarily evaluated in an open trial. The CBT appeared feasible, and at post-assessment participants reported significant decreases in PTSS (p<.001), depression (p<.001), and anxiety (p<.01) with medium to large effect sizes (Cohen’s d=0.65-0.92). Findings indicate that psychological long-term consequences in parents of children with cancer consist of a broad range of negative as well as positive experiences, and that while most parents show resilience in the long-term, a subgroup report high levels of psychological distress. For parents of CCSs this distress is suggested to primarily consist of symptoms of traumatic stress and depression, and a preliminary evaluation of CBT targeting hypothesized maintaining mechanisms showed promise in terms of feasibility and treatment effect. / Behandling av traumatisk stress hos föräldrar till cancerdrabbade barn med kognitiv beteendeterapi via internet / Förekomst, utveckling och behandling av posttraumatiskt stressymptom hos föräldrar till barn med cancer / Utveckling och utvärdering av ett webbaserat psykologiskt självhjälpsprogram för föräldrar till barn som tidigare behandlats mot cancer

The problem of this study is to determine the relative effectiveness of the three counseling procedures of modeling, assertive training, and modeling plus assertive training for increasing assertive behavior in low assertive junior college students.

The problem of this study was to investigate the effectiveness of systematic desensitization on test anxiety, general anxiety, and attitude toward school among fifth-grade elementary-school children.

An experiment was conducted to study the role of "positive expectancy" when utilizing anxiety-relief conditioning. Fourteen male and female undergraduate psychology students were selected as subjects (Ss), based on pre-test scores obtained on the "Snake Intimacy Test" (SIT). Ss were matched according to pre-SIT scores and randomly assigned to the "positive expectancy" or "no expectancy" groups. Anxiety relief conditioning was administered without variation. Only the rationale given each group describing what was transpiring was different. The statistical results revealed significant improvement by both groups. Also, the "positive expectancy" group improved significantly over the "no expectancy" group. Therefore, "positive expectancy" is apparently a sufficient, but not necessary, variable of anxiety-relief conditioning.

This double-blind placebo-controlled study investigated the relative efficacy of Homoeopathic similimum treatment as compared to psychological counselling (Cognitive therapy combined with Behavioural therapy), in the management of Generalized Anxiety Disorder (GAD). / Mini dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Homoeopathy, Durban Institute of Technology, 2006.

Individuals presenting with high levels of psychopathy demonstrate chronic and severe antisocial behavior and poor treatment outcomes in response to generalized rehabilitative programs. Recent research has examined the relationship between delinquency in child/adolescent populations and subsequent psychopathy. Focusing on community based/referred population of at-risk youth, this study developed and examined the effectiveness of an 18-session, psychopathy-focused, group CBT treatment program. The study incorporated treatment (n = 34) and usual-care comparison (n = 30) groups and a brief follow up period. Treatment outcomes examined measures of psychopathy, anger, impulsivity, motivation for treatment, self-reported problems, and indices of behavior. The treatment program demonstrated reductions in psychopathy on the Interpersonal (d = .55) and Affective facets (d = .24) of the PCL:YV. It also reduced overall impulsivity and improved anger suppression and treatment motivation, particularly among youth presenting with higher levels (relative to this study) of psychopathy. As a result of treatment, decreased incidents with the juvenile justice system were also observed, both during the treatment period and at six weeks follow-up. This study provides an initial empirical foundation for the ongoing development of targeted interventions for youth demonstrating psychopathic traits.

M.Ed. / Sexual molestation is a worldwide evil that affects all aspects ,of a child's humanity. It is stated that one out of every four girls and one out of every nine boys in South Africa are exposed to sexual molestation before they reach adulthood. Approximately 75 % of these molestations are committed by people who are well-known to the child and who occupy a position of trust. A disturbed educational relationship deprives a child of actively participating in his own development. It leaves him with a low sense of self-worth so that he feels negative and overwhelmed by the future. Childhood events have an influence on the developing adult and his future thought- and conduct-patterns. It is postulated that, should traumatic events disrupt the normal life cycle, destructive conduct-patterns develop that are detrimental to the individual as well as the broader community. The intervention of the educational psychologist is therefore necessary to break this destructive pattern. Consequently this research was aimed at learning about and understanding the life-world of the sexually molested child. An exploratory, descriptive, contextual and qualitative approach was followed to compile this information. In this research phenomenological interviews and projective techniques were used to involving six children, between the ages of ten and fifteen who were victims of sexual molestation. After the interviews had been recorded on audiotape and transcribed, and the drawings analyzed, the themes were identified and ordered. The results brought the following manifested experiences to light: shame due to own low self-worth; guilt due to a nagging conscience; fury due to violent conduct and humiliation; anxiety and pain due to fear of repetition and disappointment in mankind; distorted perceptions of the future due to deficient guidance by adults. Guidelines for the guidance of sexually molested children by the educational psychologist are discussed in accordance with the above mentioned themes, while Garbers' educational model is also referred to. It is clear that sexual molestation has extensive implications for its victims. It is however believed that these children can achieve personal insight, true healing and maximum inner potential, through the compassionate guidance of the educational psychologist.

Esta pesquisa teve como objetivo estudar a relação entre mudanças na competência social e no peso em dois adolescentes obesos. Os casos foram atendidos individualmente dentro do modelo de terapia comportamental e os dados obtidos foram descritos em forma de estudo de caso. Os clientes foram avaliados em relação às mudanças ocorridas através de diferentes escalas e inventários e de categorias de comportamento criadas pela pesquisadora para observação e análise do processo terapêutico. Para os dois clientes ocorreram ganhos referentes à competência social. Em relação ao peso, um cliente apresentou uma forte relação inversa com competência social no decorrer do tratamento e perdeu peso. O outro cliente precisou de um tratamento mais longo mas apresentou no final do tratamento (últimas 10 sessões) uma tendência semelhante. Os resultados também indicaram que ambos desenvolveram estratégias de comportamento para lidar com os aspectos aversivos do ambiente relacionados à obesidade, apontando para a necessidade de associar essa modalidade de tratamento que enfoca o desenvolvimento da competência social a outros procedimentos utilizados nos tratamentos de perda de peso. / This research evaluated the relationship between changes in social competence and weight loss in two obese adolescents. Both cases were treated with individual behavioral therapy and the results were presented as a case report. The clients were evaluated by changes obtained on different scales and inventories, as well as by the analysis of behavioral categories created by the therapist. In this analysis, both clients were observed to improve in terms of social competence. One of the clients demonstrated a significant inverse correlation between improvement of social competence and weight loss during treatment (16 sessions) and lost weight. The other client required longer treatment (40 sessions), but also demonstrated at the end of intervention, the same tendency of results. Based on this evaluation, it was postulated that behavioral therapy targeted to issues of social competence should be an integral part of treatment for weight loss, and should be combined with other therapeutic modalities.

A enurese é uma condição caracterizada pela perda de urina durante o sono, em crianças com mais de cinco anos sem outra condição clínica que explique os episódios. A enurese pode ser primária, no caso das crianças que nunca obtiveram controle prévio, ou secundária, em que a enurese cessou por pelo menos seis meses. Também é classificada como monossintomática, na ausência de sintomas diurnos do trato urinário inferior ou não-monossintomática, quando está associada a tais sintomas, como a urgência miccional. A enurese, cujas causas apresentam componentes hereditários ainda pouco claros, tem sua etiologia baseada na combinação de três fatores: a poliúria noturna ou a hiperatividade detrusora ligada á incapacidade de despertar em resposta aos sinais da bexiga cheia. Há tratamentos medicamentosos e psicológicos, sendo que a desmopressina, análogo sintético da vasopressina, que atua na poliúria noturna e o alarme, que atua na incapacidade de despertar, apresentam os níveis mais altos de recomendação e evidência. Embora tais tratamentos estejam consolidados, ainda não há total clareza sobre seus mecanismos de funcionamento e o porquê de não alcançarem todos os casos. Este trabalho teve como objetivo verificar se um conjunto de variáveis atuaria como moderador do resultado do tratamento com alarme, ou seja, em que medida influenciava, positiva ou negativamente, o desempenho dos participantes atendidos. As variáveis avaliadas foram: tipo de acompanhamento (presencial e à distância), frequência inicial de episódios, nível de problemas de comportamento, escolaridade dos pais, sexo e idade. Foram incluídos na amostra 61 crianças e adolescentes de 6 a 17 anos que receberam tratamento com alarme, sendo que 34 foram acompanhados à distância e 27 presencialmente. No total, 37 participantes obtiveram sucesso, caracterizado por 14 noites consecutivas sem episódios, num período de 28 semanas. Doze participantes não obtiveram sucesso e outros 12 desistiram. Caracterizaram-se como moderadoras do resultado do tratamento as seguintes variáveis: tipo de acompanhamento (grupo acompanhado à distância obteve mais sucessos), frequência inicial de episódios (participantes que obtiveram sucesso tinham menos episódios, em média, no início do tratamento) e nível de problemas de comportamento (participantes que não obtiveram sucesso tinham escores maiores de problemas de comportamento externalizantes). Os resultados indicam a efetividade do alarme e apontam para os aspectos que devem receber atenção do clínico ao administrar esse tipo de tratamento / Enuresis is a condition in which children of at least five years of age lose urine during sleep, without another clinical condition that could explain the wetting episodes. Enuresis may be primary, when the child has not obtained previous bladder control, or secondary, when such control was achieved for at least six months. It is also classified as monosymptomatic, when it is not associated with other lower urinary tract symptoms or non monosymptomatic, when these symptoms, such as urgency, are present. Enuresis etiology has unclear hereditary aspects. Its physiology is based on a combination of at least two of three malfunctioning systems: incapacity to wake in response to the full bladder signals plus nocturnal polyuria or detrusor hyperactivity. There are evidence based pharmacological and psychological treatments. Desmopressin, a synthetic version of hormone vasopressin that reduces nocturnal polyuria is the first line pharmacological treatment, whereas the alarm, which acts in the incapacity to wake is the first line psychological treatment. Both have the higher levels of evidence and recommendation by the specialized literature. However, the mechanisms underlying these treatments results and the reasons they are not successful with every enuretic children are not entirely clear. The objective of this work was to verify to what stand a series of variables are moderators of alarm treatment outcome. These variables were: type of support (face-to-face versus long distance), initial bedwetting frequency, behavior problems scores, level of parents education, gender and age. Sixty-one children with ages from 6 to 17 were included. All received full spectrum home training. Thirty-four received long distance support during treatment and 27 received face-to-face support. Success was defined by 14 consecutive dry nights within a 28 weeks treatment period. Success was obtained by 37 children, while 12 did not succeed and other 12 dropped out. Three variables were observed as moderators of treatment outcome: type of support (long distance had better results), initial bedwetting frequency (participants who succeeded had fewer initial wet nights) and behavior problem scores (participants who did not succeed had higher externalizing problems scores). Results indicate alarm effectiveness and aspects that should be focuses of attention when this kind of treatment is administered