Exhibitionism is an understudied paraphilia despite high prevalence, comorbidity and recidivism rates. 221 Exhibitionists were assessed at a University Psychiatric Hospital Outpatient Sexual Behaviors Clinic between 1983 and 1996 using a standardized assessment battery. Research data were archival, extracted from the participants' medical files, with the exception of the Psychopathy Checklist-Revised, which was administered retrospectively by the investigator. Offence data were provided by the Canadian Police Information Center. The three part study describes and compares the Exhibitionist population with both a Normal Contrast and a Rapist Contrast group on the standardized assessment battery, examines predictors of sexual, violent and criminal recidivism in this population of exhibitionists, including demographic and historical variables, psychological and phallometric measures and offence histories; and explores differences between Hands-On and Hands-Off sexual recidivists on the same variables. Exhibitionists emerged as less pathological than Rapists. They were more likely married, denied their index offence, and reported a family history of drug abuse; and were less likely to report personal histories of drug abuse, intoxication at the time of the offence, a family history of physical abuse, family violence and outside placement before 16 years. Exhibitionists and Rapists reported poorer sexual functioning and more cognitive distortions than Normals. Exhibitionists were more deviant than Normals in their phallometric responses to scenarios of children. Survival analyses indicated that over a mean follow-up time of +/-6.84 years post assessment, 11.7, 16.8 and 32.7% of Exhibitionists were charged or convicted with a sexual, violent, or criminal offence respectively. Compared to Non-Recidivists, Sexual Recidivists were less educated, more likely single and to report intoxication at the time of the index less educated, more likely single and to report intoxication at the time of the index offence; demonstrated higher Brief Psychiatric Rating Scale scores, and more prior sexual and criminal offences. Compared with Non-Recidivists, Violent Recidivists were less educated, more likely single and to report intoxication at the time of the index offence; had lower Derogatis Sexual Functioning Inventory scores, higher Psychopathy Checklist-Revised Total scores, and more prior sexual, violent and criminal offences. Compared to Non-Recidivists, Criminal Recidivists were younger, less educated, more likely single and to report intoxication at the time of the index offence. They had lower Derogatis Sexual Functioning Inventory scores, and higher Psychopathy Checklist-Revised Total scores. They demonstrated higher Pedophile Indices on phallometrics and more prior sexual, violent and criminal offences. For Sexual and Violent Recidivism respectively, the variable 'Number of Sexual Offences Prior to the Index Offence' correctly classified 89.6 and 84.6% of the original groups, representing a RIOC of 13.4 and 10.8% respectively. For Criminal Recidivism a combination of the variables Education Level and Number of Prior Criminal Offences correctly classified 71.8% of the original group, representing a RIOC of 20.5%. An exploratory comparison indicated that compared to Hands-Off Sexual Recidivists, the Hands-On Sexual Recidivists demonstrated higher Psychopathy Checklist-Revised Total scores, more deviant Pedophile and Rape Indices on phallometrics, more prior violent and criminal offences, and a trend towards more prior sexual offences. The Rape Index correctly classified 78.9% of the original group, representing a RIOC of 34%. The study is instructive in its delineation of factors placing exhibitionists at risk of reoffence, particularly hands-on sexual offences, and is valuable for court sentencing and treatment.

Attachment theory has evolved from early work on infant-caregiver relationships to exploring the role of attachment processes in close relationships in adults. Most recently, it has been investigated under conditions of threat or stress. Bowlby (1973, 1988) proposed that attachment processes should be most activated under these circumstances. Using a cross-sectional design, the present project investigated working models of attachment within the context of a threat to health. Specifically, it tested components of a model proposed by Collins and Read (1994) that attachment models affect relevant behavioural outcomes via cognitive and emotional responses. Working models of attachment, emotional distress, appraisal and coping were studied in 71 male and female colorectal cancer patients undergoing adjuvant treatment. Health-related behaviours were chosen as behavioural outcomes. Although measurement and design issues did not permit a complete test of the model, the results suggested that working models of attachment are related to distress and coping in ways that are consistent with attachment theory. Perceived threat of illness was related to negative self models. Emotional distress was found to be primarily a function of model of self and mediated the relationship between the self model and coping. Model of self also had a direct link with the degree to which patients engaged in healthful behaviours. Results for model of other were less robust. Results of this study suggest that internal working models of attachment are important constructs in situations beyond close relationships.

University administrators are becoming increasingly aware of the importance of the university experience on students' psychological well-being. Bivariate research studies have suggested that social problem solving orientation, career-decision-malting attitudes, and program commitment may be related to student's psychological well-being. Their role in psychological well-being, as suggested by the literature, may not have been investigated completely. For example, these antecedent variables may change as a function of years of university experience. Also, there may be structural relationships between these variables that are better explained by a mediational model. Accordingly, the goals of this study are threefold. First, the relationships among students' social problem solving orientation, career-decision-making attitudes, university program commitment and psychological well-being were investigated. Second, the role of years of university experience relative to social problem solving orientation and career-decision-making attitudes was explored. Third, a path analytic design was proposed to identify potential mediating relationships among the variables related to psychological well-being. Participants included 394 students from the faculties of Arts and Social Sciences at the University of Ottawa. The results confirmed that social problem solving orientation, career-decision-making attitudes, and university program commitment were all significantly positively correlated to students' psychological well-being. A one-way Anova and post-hoc analyses suggested that years of university experience was positively related to social problem solving orientation and career-decision-making attitudes. However, the hypothesized path model was not supported. Rather, the final cross-validated path design begins with years of university experience leading to social problem solving orientation and career-decision-making attitudes. Career-decision-making attitudes was, in turn, directly related to psychological well-being while social problem solving orientation's influence on psychological well-being was mediated by university program commitment and career-decision-making attitudes. These results point to two major implications. First, future research should adopt a multidimensional longitudinal strategy that takes into account the developmental sequence of variables related to students' psychological well-being. Second, university administrators, career counsellors, and academic advisors should consider ways to develop students' social problem solving orientation to facilitate their career-decision-making attitudes, program commitment, and psychological well-being.

This study examined the factors associated with subjective burden in family members or friends caring for an adult with a severe and persistent mental illness. Caregivers (N = 128) were recruited through support groups for family members or friends of a person with schizophrenia or bipolar disorder. It was hypothesized that subjective burden (Burden Assessment scale; Reinhard, Gubman, Horwitz, & Kinsky, 1994) would be predicted by coresidence status between the caregiver and the care recipient, symptomatic behaviours of the person with mental illness (Social Behavioural Assessment Schedule; Platt, Weyman, Hirsch, & Hewett, 1980), adverse effects on the caregiver's life (Burden Assessment scale; Reinhard, Gubman, Horwitz, & Kinsky, 1994), quality of the relationship between the caregiver and the person with mental illness (McMaster Family Assessment Device - General Functioning subscale; Epstein, Baldwin, & Bishop, 1983), family support (Perceived Social Support from Family scale; Procidano & Heller, I983), sense of mastery in caregiving (Mastery scale; Pearlin & Schooler, 1978) and satisfaction received from caregiving activities (Care Work Satisfaction scale; Orbell, Hopkins, & Dillies, 1993). It was also hypothesized that subjective burden would, in turn, predict caregivers' depressive symptoms (Centre for Epidemiologic Studies Depression scale; Radloff, 1977) and caregivers' satisfaction with life (Satisfaction with Life scale; Diener, Emmons, Larsen, & Griffin, 1983). Research hypotheses were tested using standard and hierarchical multiple regression analyses. Findings showed that symptomatic behaviours of the person with mental illness and sense of mastery in caregiving activities explained 25% of the variance in subjective burden. Sense of mastery and subjective burden explained 28% of the variance in caregivers' depressive symptoms. Subjective burden explained 15% of the variance in caregivers' satisfaction with life. Additional analyses suggested that coresidence status between the caregiver and the person with mental illness moderated the relationship between sense of mastery in caregiving and subjective burden. For caregivers maintaining separate living arrangements with the care recipient, sense of mastery had a stronger negative association with subjective burden than for caregivers residing with the care recipients. Additional analyses also suggested that sense of mastery in caregiving mediated the association between subjective burden and the following variables: quality of the relationship between the caregiver and the person with mental illness and satisfaction received from caregiving activities. In other words, the quality of the relationship between the caregiver and the person with mental illness and satisfaction received from caregiving activities predicted sense of mastery, which in turn predicted subjective burden.

The purpose of this thesis was to better understand when people use and neglect base rate information. In four experiments, university students made probabilistic judgements for inferential reasoning tasks that were modelled after Tversky and Kabneman's taxi-cab problem (Tversky & Kahneman, 1982). In all, four theoretical perspectives were used to test predicted outcomes with observed responses and normative expectations. Experiment 1 found no differences between the trial-by-trial (on-line) format (Baker, Mercier, Vallee-Toumngeau, Frank, & Pan, 1993) and the traditional word problem (off-line) format of Tversky and Kahneman. Here the pattern of judgements was nearly identical across conditions and yet different from normative expectations. Both formats showed a strong sensitivity to base rates and the individuating information. This was contrary to the predictions based on the heuristics and biases program (Kahneman, Slovic, & Tversky, 1982) and also contrary to the predictions made by the frequentist approach (Gigerenzer, 1998; Gigerenzer & Hoffrage, 1995). Experiments 2 and 3 were designed to test the maxims of conversational conventions (Grice, 1975; Hilton, 1995). Experiment 2 was run entirely on-line and found no differences in mean probability judgements between the different conditional (individuating) sources of information. Participants relied equally heavily on a human or non-human source and also were sensitive to the changes made in base rate information. Experiment 3 was run entirely off-line and specifically tested the attribute of ambiguity. When the individuating source of information was very ambiguous, then judgements were based almost solely on the base rate information. None of the theories tested to this point were able to accurately predict the patterns of judgements made in all these conditions. What the results of these three experiments did suggest was that how the information is presented (e.g., probabilities vs. frequencies) and the context in which it is presented (i.e., how clearly the information is presented) are both important. These two factors combined suggest that a more general cognitive mechanism, one that is a function of the complexity of the judgement task and the amount of cognitive work that is required to make the judgement could best account for the data. This was tested and supported in Experiment 4. Normative responses can be elicited in judgement tasks that present only the essential probabilistic information in a format that is clear, unambiguous, and that requires few mental operations.

Previously, models of homelessness have not described how persons dealt with the stressful experience of being homeless. This study examined the adequacy of a transient stress model, developed by the integration of Moos and Schaefer's (1993) Integrated Framework of Stress and Coping and Dohrenwend's (1978) Social Stress Model, to understand the experiences of persons who are homeless. The model illustrates what factors contribute to a person's well-being in the context of experiencing the crisis of being homeless. Specifically, personal factors (personality characteristics, sex, past experiences of homelessness, personal empowerment and approach-style and avoidance-style coping responses) and environmental factors (perceived social support and social network size) were examined in terms of their association with the occurrence of stressful life events and the appraisal of, and response to, the stress associated with being homeless. Stress appraisal and stress response were then used to predict levels of psychopathology and subjective well-being. Interviews were conducted with a sample of 200 persons who used emergency shelters and with a convenience sample of 30 persons who used community services but slept elsewhere. The final model demonstrated that personal and environmental factors played a role in the occurrence of stressful life events and stress response, but that only personal empowerment and stress response were directly associated with levels of well-being and psychopathology. The addition of qualitative responses provided more information about individuals' processes of coping with being homeless, as explained in their own words. Moreover, it allowed for the examination of differences between groups, defined by sex and age in their reporting of stressful life events, coping responses, social support, personal empowerment and stress appraisal. Unlike previous models of homelessness, this model demonstrated the importance of personal and environmental factors in the occurrence of stressful life events and the subsequent stress reaction and reports of well-being and psychopathology.

In the face of maternal illness, adolescent daughters are thought to be at risk for emotional problems (e.g., Compas et al., 1994; Compas et al., 1996). This may be due to a number of variables, including those related to the functional impact of the disease, perceptions of increased personal risk, or other individual and family influences. To date, however, adolescent daughters of ill mothers remain an understudied population and variables for predicting or explaining adjustment problems in this group have not been thoroughly investigated. The purpose of this study was to examine the disease, family, and individual psychological variables that are related to adolescent girls' adjustment following maternal breast cancer. It was expected that maternal distress and family functioning would moderate the relationship between disease variables and adolescent psychological functioning. The current study included 60 mother-daughter pairs in which the mother was at least 1 year post-treatment for non-metastatic breast cancer. The mean age of mothers in the current sample was 45.4 years, and the average age of daughters was 15.5. Predictor variables examined were: (1) maternal health-related quality of life (HQL, measured with the Short Form-36; Ware et al., 1993), and adolescent perceptions of (2) disease severity, (3) personal risk for cancer, and (4) breast cancer worries (Severity Perceptions, Risk Perceptions and Worries subscales on the Breast Cancer Survey [BCS], Cappelli et al., 1999). Proposed moderators examined were: (1) family functioning (Family Assessment Measure-III; Skinner et al., 1983), and (2) maternal psychological distress (Symptoms Checklist 90-Revised; Derogatis, 1983). Adolescent psychological adjustment was the outcome variable, and was measured in two ways: (1) adolescent reports on the Youth Self Report (YSR; Achenbach, 1991), and (2) maternal reports on the Child Behavior Checklist (CBCL; Achenbach, 1991). Some support was provided for the hypothesis that adolescent role functioning moderates the relationship between certain disease-related factors and adolescent psychological adjustment. Specifically, poorer maternal HQL in the presence of greater problems with adolescent functioning within the family was associated with adolescent reports of poorer social competence. When adolescents reported high family functioning, however, no such relationship was observed, suggesting that good family functioning can help to buffer the negative effects maternal illness on adolescent social functioning. Additional analyses suggested that maternal distress levels mediate the significant association between maternal reports of adolescent problems and maternal HQL. In contrast, the relationship between maternal HQL and adolescent self-reports of psychological problems was mediated by family functioning. Results are considered in light of existing research in this area and clinical implications are discussed.

Posttraumatic stress disorder (PTSD) is a common sequela in those individuals who survive or witness an event such as a motor vehicle accident (MVA) that may threaten personal and interpersonal integrity. Yet, not all individuals who experience MVAs develop PTSD. It was hypothesized that MVA survivors who developed PTSD would evidence dysfunctional thinking characterized by maladaptive rules, assumptions, and interpretations, or schema specific to road traffic situations. Such dysfunctional thinking patterns were thought to be associated with individuals' perceptions of increased threat in road traffic situations and with PTSD in survivors of MVAs. The study also sought to explore the possible modifying effect that social interactional influences may have on maladaptive schema. In Study 1, a Motor Vehicle-Related Schema (MVRS) questionnaire was developed as A tool to tap the content of a potential dysfunctional thought process germane to road traffic situations. In Study 2, MVA survivors who developed PTSD were compared to MVA survivors who did not develop PTSD. A group of injured workers and a community sample were used as control groups. The control groups allowed the researcher to address the question of specificity of maladaptive schema related to road traffic situations in the MVA PTSD group. Multiple measures were used to assess the presence or absence of PTSD. Participants in the MVA PTSD group endorsed significantly higher levels of dysfunctional and maladaptive cognitions specific to road traffic situations than did all other participant groups. Given that other factors might influence this type of thought process, a number of other variables were examined. The findings remained robust even after adjustment for: (a) persistent dysfunctional schemas tapping general personal and interpersonal vulnerability, (b) subjective pain, and (c) self-reported depression. In addition, MVA survivors who developed PTSD, compared to MVA survivors who did not develop PTSD, reported significantly lower levels of perceived beneficial social interactions. However, these findings became non-significant after adjustment for subjective pain and self-reported depression. Overall, the findings suggest that MVA survivors who developed PTSD organized and interpreted stimuli relevant to road traffic situations in ways that were fundamentally different from MVA survivors who did not develop PTSD, injured workers and a community sample. More specifically, participants in the MVA PTSD group tended to interpret road traffic situations as more threatening than did participants in the other groups in this study. The perception of lower levels of beneficial social interactions appear to be associated more with heightened levels of distress, pain, and depression than with PTSD. This investigation demonstrates that it is possible to tap into maladaptive schemas using a self-report measure. Consistent with cognitive-behavioral clinical protocols for MVA survivors with PTSD, these results support the notion that specific dysfunctional or maladaptive cognitions appear to characterize MVA survivors with PTSD. A better understanding of dysfunctional schemas specific to road traffic situations, gleaned through further research, may be of some benefit in attenuating or managing symptoms of PTSD in WA survivors. Although the injured workers were not the focus of this research, many of the participants in this group met the classification for PTSD or posttraumatic stress symptoms (PTSS). This finding suggests that clinical screening and further research for PTSD in injured workers might also be warranted.

Tourette Syndrome (TS) is characterized primarily by multiple motor and vocal tics. Additionally cognitive deficits, such as problems with attention, may also exist, in those both with and without co-morbid Attention Deficit/Hyperactivity Disorder (ADHD). Although neuroleptics, which block dopamine receptors, are often the treatment of choice for TS, insufficient symptomatic control often requires the use of increased doses. In addition, undesirable side effects can occur at high doses of neuroleptics, including detrimental effects on attention and concentration. Nicotine has been reported to effectively potentiate neuroleptic-induced catalepsy in rats and, when combined with neuroleptics, to reduce motor and vocal tics in TS patients. However, reported acute and sustained (i.e. up to 8 weeks) nicotine-induced improvements in tic symptomatology in TS patients have come from case reports, open and single blind studies. Nicotine alone has been shown to improve attention and cognition in both normal and neuropsychiatric populations. This double-blind, placebo-controlled, crossover design study investigated the comparative efficacy, both acute and sustained, of placebo and a single test dose of transdermal nicotine patch (TNP) on clinical symptoms of TS (i.e. tics), evaluative ratings (by parents) of attention and maladaptive behaviours, as well as event-related potential (ERP) and behavioural performance measures extracted from a degraded stimulus continuous performance task (DS-CPT) of sustained attention. Twenty-three children and adolescents with TS (with and without co-morbid ADHD), aged 8--17, who were taking conventional neuroleptics (i.e. dopamine D-2 receptor antagonists) were entered into the study. Adjunctive nicotine, relative to placebo, failed to significantly alter tic symptomatology in either the acute (i.e. 4 hours post-treatment) or follow-up (i.e. 1 week post treatment) conditions. At follow-up but not at acute assessment, parents reported non-specific improvements in attention, and performance was found to have improved on Coding, a visuomotor task measuring freedom from distractibility, following nicotine treatment. Nicotine had a limited effect on area measures of the P300 component of the ERP, by preventing area decrements seen following placebo treatment. However, other performance measures on the DS-CPT, including accuracy and speed of responding, and P300 amplitude and latency measures, failed to identify any significant effects of nicotine relative to placebo. Given the lack of initial significant effects of a single dose challenge of nicotine and the side effect profile of the TNP, the clinical use of adjunctive nicotine in neuroleptically treated children and adolescents with TS appears premature.

The purpose of this dissertation is to review research on predictors of success when students return to high school, and to investigate the power of several risk and protective factors as predictors of success of students returning to school. Research findings regarding factors associated with initial departure from high school, returning to school, and repeated departure from high school are reviewed. Theories regarding departure from school are presented. A developmental psychopathology approach to predicting repeated departure from high school programs is presented which integrates cognitive, behavioural, social, and developmental theories. Findings are presented from a study on students returning to school who responded to questionnaires about demographics, vocational identity, stress level, coping style, and perceived social support. A total of 453 students participated who were returning to four types of academic environments: alternative outreach high schools (n = 267), a school for mothers (n = 46), a fourth year high school (n = 42), and college high school upgrading and completion programs (n = 98). The participants included 288 females (79 mothers and 209 nonmothers) and 165 males. The primary analyses were focused on how vocational identity, stress, coping behaviours, and social support predicted the outcome variables of attrition, attendance, number of credits completed, and grades at the end of the students' first 4 to 6 month term back in high school programs. Age, SES, and achievement were not found to be consistently predictive of outcomes. Males were more likely to leave school again, although no specific psychological variables were found to predict their departure. Females were found to be more likely to leave school again if they had a lower level of vocational identity, and if they had experienced a greater number of stressful life events in the year prior to returning to school. Gender, vocational identity, and life stress were not found to interact as moderators on outcomes. The results of this empirical study are believed to enrich theoretical understanding of success in returning to high school and will enable teachers and other professionals to more effectively evaluate and counsel students returning to school.