The difficulty of distinguishing between genuine disorder and characteristics that can be attributed to high IQ increases the likelihood of diagnostic error by mental health practitioners. This mixed methods study explores the possibility of misdiagnosis of high IQ youth by mental health professionals. Participants were private practice mental health professionals who read case study vignettes illustrating high IQ youth exhibiting characteristics associated with their population. Participants then completed a survey and provided an assessment of the hypothetical client. In the study, 59% of participants were unable to recognize behavioral characteristics associated with high IQ youth unless suggested to them, and 95% of participants were unable to recognize emotional characteristics associated with high IQ youth unless suggested. The results of this study provide much-needed empirical exploration of the concern for misdiagnosis of high IQ youth and inform clinical practice and education.

Background: There is a strong association between exposure to intimate partner violence (IPV) and the development of negative mental health (MH) outcomes among women and their children. Given the high prevalence of IPV in low and lower-middle income countries (LLMICs) and its relationship with varying MH issues, it is essential to identify evidence-based interventions that reduce MH challenges, including interventions that remain effective under LLMIC resource, implementation, and scalability constraints. Objective: The proposed study involves a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating psychosocial interventions compared to a) no intervention, b) alternatively specified interventions, or c) waitlisted services to reduce MH impairment among women and children with IPV exposure and who live in LLMICs relative to those living in high income countries (HICs). Methods: Our methods and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We systematically searched eight electronic databases for RCTs reporting the effects of psychosocial interventions on the well-being of women, and/or their children, who were exposed to IPV and who were living in LLMICs or HICs. Searches were completed on April 10, 2022. We implemented forward citation searching on February 19th, 2023, of the included studies to capture any missed or recently published papers. Title, abstract, full-text screening, and data extraction were completed independently, using Covidence. Primary and secondary outcome data extracted and analyzed from the included studies were: (a) MH disorder (depressive disorder, anxiety disorder, post-traumatic stress disorder (PTSD)), (b) clinical symptoms of mental illness (stress, emotion dysregulation, self-efficacy, self-esteem, externalizing symptoms, and suicidal thoughts and ideation) and (c) parent and child relationship and quality of life. Pooled effect estimates of the outcomes were synthesized on Comprehensive Meta-Analysis (CMA) and were reported using Hedge’s g. Risk of bias was also assessed, in duplicate, using the Clarity Risk of Bias Tool and the certainty of the available evidence was classified according to the Grading of Recommendations Assessment, Development and Evaluation Tool (GRADE). Where at least five studies were available for an outcome, three a priori subgroup analyses were completed for women and children on the basis of : 1) psychosocial intervention type (empowerment and advocacy, trauma-focused therapy, non-trauma focused therapy, counselling, and cognitive behavioural therapy (CBT), and parenting), income setting (LLMIC and HIC), and 3) length of follow-up (post-intervention, < 12-months follow-up, and ≥ 12-months follow-up). Lastly, sensitivity analyses explored the impact of the following on the outcomes (1) high-risk of bias ratings; (2) missing data, and (3) reporting on feasibility and pilot data. Results: A total of 33,257 articles were identified via database searches; 12,057 were removed using deduplication, resulting in 21, 200 articles for title and abstract screening. A total of 581 articles underwent full-text screening, of which 55 unique studies were included in the review. Across the included studies, enough data was available to analyze seven outcomes within the meta-analysis; this included the primary outcomes of depressive disorder, anxiety disorder, PTSD, and the secondary outcomes, stress, self-esteem, self-efficacy, and quality of life. Thirteen studies were completed in LLMIC settings, with 42 studies focused on HICs. Ten studies focused on women and children exposed to IPV, 43 studies focused strictly on women, and two studies focused strictly on children. With respect to the outcomes, the majority of studies examined intervention impacts on depression (k = 33, 60%), anxiety (k = 11, 20%), and PTSD (k = 26, 47%). After performing the meta-analyses, very uncertain evidence suggests that psychosocial interventions may lead to reductions in maternal depression (g = -0.222; 95% CI -0.353 to -0.090) maternal anxiety (g = -0.541; 95% CI -0.953 to -0.129), and child PTSD (g = -0.314; 95% CI -0.602 to -0.026). Additionally, very uncertain evidence suggests that psychosocial interventions may have little to no effect on child depression (g = 0.085; 95% CI -0.519 to 0.690), maternal PTSD (g = -0.193; 95% CI -0.339 to -0.047), maternal stress (g = -0.188; 95% CI -0.454 to 0.078), and maternal self-efficacy (g = 0.187; 95% CI -0.096, 0.469). As well, moderate certainty of evidence indicates that psychosocial interventions are likely to result in little to no difference in self-esteem (g = 0.196; 95% CI -0.009 to 0.401), and a low certainty of evidence indicates that psychosocial interventions may result in little to no difference in maternal quality of life (g = 0.121; 95% CI -0.090, 0.332), relative to controls. However, when considering these outcomes, trauma-focused therapy showed significant improvements in maternal depression in HICs and LLMICs, while maternal anxiety and PTSD showed significant improvements in LLMICs. Non-trauma focused therapy resulted in significant improvements in maternal stress specifically in LLMICs. Parenting psychosocial interventions were also effective in significantly improving child PTSD in LLMICs. Conclusion: The systematic review and meta-analysis found that psychosocial interventions may not be more beneficial compared to control groups for addressing MH outcomes amongst women and children exposed to IPV within LLMICs and HICs. While trauma-focused therapy, non-trauma focused therapy, and parenting interventions demonstrated significant positive impacts for maternal depression, anxiety, PTSD, stress and child PTSD, the evidence available was deemed to be uncertain. This review underscores the importance of equal resource distribution, fair research practices, investing in longer follow-up studies, comprehensive data analysis, and clear reporting. Future research should prioritize well-designed trials to understand the effects of specific psychosocial interventions. / Thesis / Master of Science (MSc) / Women's exposure to intimate partner violence (IPV) is a serious public health problem that often occurs in the presence of children and is linked to poor mental health; this is especially true among women and children living in low and lower-middle income countries (LLMIC) (Barada et al., 2021; García-Moreno et al., 2013; Silva et al., 2019). Given that intervening early can help reduce the mental health (MH) impacts of IPV exposure, there is an urgency to identify and disseminate evidence-based interventions in LLMIC settings. Here, we systematically review the literature evaluating psychosocial interventions that aim to reduce MH impairment among women and children exposed to IPV in LLMIC settings and examine how these findings compare to psychosocial interventions that reduce MH impairment among those living in high-income country (HIC) settings. In total, 55 unique studies were included in the systematic review. Findings are varied; however, overall, trauma-focused therapy, non-trauma focused therapy, and parenting psychosocial interventions significantly improved specific mental health outcomes within specific settings. In HICs, trauma-focused therapy demonstrated improvements in maternal depression. In LLMICs, trauma-focused therapy was effective in reducing maternal depression, anxiety, and post-traumatic stress disorder (PTSD). In addition, in LLMICs, only, non-trauma focused therapy improved maternal stress and parenting interventions improved child PTSD. We also narratively and statistically discuss factors specific to the psychosocial interventions that may improve MH following IPV exposure. Intervention factors include mechanism, type, delivery, setting, and modality, which should be targets for future evaluation. In sum, our review emphasizes the importance of tailoring interventions to address the unique needs of survivors in particular settings and calls for balanced, larger, and well-designed trials to better understand the effects of psychosocial interventions within and across contexts.

Educational Studies / (M.Tech. (Inclusive Education))

Made available in DSpace on 2016-04-28T20:40:14Z (GMT). No. of bitstreams: 1 Ana Cristina Delgado Lopergolo.pdf: 3462553 bytes, checksum: 6a446430af6904675330d75f2d9dd909 (MD5) Previous issue date: 2009-12-18 / The present thesis has constituted itself from the survey of many practical possibilities in the dealings with a particular set of issues raised from the encounters of a psy as related to certain varieties of therapeutic initiatives. Under the inspiration of one of such initiatives the work carried out at the Peri-Peri Local Psychology Care Unit with babies and their parents this report´s chapters are structured using pregnancy as a metaphor. In the chapter named The Thesis Pre-history , there is a report about the author´s beginning professional path, before she started at the Ambulatório de Especialidades do Jardim Peri-Peri, when a certain design, a certain reference had constituted her as a therapist. In Part 1, or The First Trimester referring to the period when the author´s had already joined the Unit s children´s mental health care team the thesis maps the constitution of such clinical practice, from the viewpoint of both children psychiatry and psychoanalysis, and, still, it tries and approaches some issues as posed by this same practice at present. In Part 2, or The Second Trimester , the thesis explores the work carried out with the team in charge with the babies; maps some of the possible intervention strategies, charged with the effort of hearing the sufferings of such young patients the babies as well as the dealings with the sufferings of both parents and members of the rest of the team. Some therapeutic initiatives in which this psy took part are discussed. Such initiatives are based on a clinical practice which is politically prone to view the care unit in such a way so as to incite changes, resist to the processes which oppress subjectivities and to promote differences. After the third trimester, a baby is ready to be born. It is in The Third Trimester , that the Final Considerations are presented, stressing that the preparing of a psy is a never ending process, because of the impossibility of dissociation between practice and theory. The thesis is born ! / Essa tese de doutorado constitui-se num traçado de possibilidades práticas no trato de uma problemática dos encontros de um psi envolvido com determinadas variedades de iniciativas terapêuticas. Inspirada em uma dessas iniciativas - o trabalho com os bebês e seus pais desenvolvido no Ambulatório do Peri-Peri - essa tese utilizou-se da gravidez como metáfora para a construção dos seus capítulos. No capítulo intitulado A Pré- História da Tese , faz um recorte do percurso profissional da autora, anterior à sua inserção no Ambulatório de Especialidades do Jardim Peri-Peri, apresentando um certo esquema, uma certa referência que a constitui enquanto terapeuta. Na Parte 1, ou O Primeiro Trimestre , a partir da inserção da autora na equipe de saúde mental infantil do ambulatório, a tese se propõe a mapear a constituição dessa clínica, tanto pelo viés da psiquiatria infantil, quanto pelas contribuições da psicanálise e, ainda, abordar algumas questões colocadas por essa clínica na atualidade. Na Parte 2, ou O Segundo Trimestre , a tese explora o trabalho realizado na equipe de bebês, mapeia algumas estratégias de intervenções possíveis, tanto na escuta do sofrimento de alguém tão pequeno o bebê , quanto no acolhimento do sofrimento de seus pais e também da equipe. Também são apresentadas algumas das iniciativas terapêuticas que envolveram esse psi . Iniciativas, essas, caudatárias de uma posição clínico-política, que investe na clínica como ocasião de produzir mudanças, produzir resistência aos processos de massacre das subjetividades e incitar diferenças. O Terceiro Trimestre , do ponto de vista de uma gravidez, é considerado como aquele em que o bebê é viável; é nesse capítulo que a autora tece as Considerações Finais da tese, ressaltando o caráter interminável da formação psi , pela indissociabilidade que há entre a teoria e a prática. A tese nasceu !

Families of children with a mental disorder typically have many stressors due to their children's behavioral functioning. These families do not always choose to receive community-based services that are intended to decrease the stressors within the families and prevent the children from being placed out of the families' homes. This study investigated the relationship between clients' functioning during their initial assessment provided by the Victor Community Support Services (VCSS), compared to their functioning when they were discharged from VCSS based on the families utilization of community-based services.

Child sexual abuse and its potentially traumatizing consequences, over both the short- and longer term, has been increasingly recognized in the literature as a possible pathway to the development of intra- and interpersonal maladjustment, affecting the mental well-being of those affected. There is a paucity of local research investigating the systemic impact of a child's sexual abuse upon the caregiving and family systems in which the child is integrally embedded. The current research was conducted primarily in response to this, with the intention of illuminating the experiences of caregivers and families managing their child's experience of sexual abuse. More specifically, the research was interested in the experiences and perceptions of caregivers of children who had been sexually abused by an extrafamilial person. The phenomenological approach informed the planning, implementation, analysis and interpretation phases of the research. The sample included six mothers / female caregivers who had discovered their child's sexual abuse no less than three months and no longer than twelve months prior to the research being conducted. Maternal caregivers were the primary source of information regarding their own experiences, as well as spokespersons for the caregiving family unit and its members. Two semistructured interviews were planned for each respondent, the first interview aimed at eliciting their experiences and perceptions, and the second interview aimed primarily at providing debriefing and feedback. In view of the highly sensitive nature of the interview topic, the second interview was structured primarily out of ethical concerns for the respondent's well-being as a consequence of the interviewing. Results of the interviews suggest that these caregivers were faced with a host of complex experiences related to three broad thematic areas, namely: their involvement with the criminal justice system; managing the child's and family's distress; and themes around coping and support. A number of sub-themes were identified within and across these three broad thematic areas, representing a complex interaction between dominant experiences. Caregivers were typically faced with a series of dilemmas and decisions in their interactions with their child, family, and the criminal justice system. Based upon the findings, a number of suggestions have been made in terms of policy and protocol development for intervening with such families and their children. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2005.

Mental health reflects an array of causal influences that span biological, psychological, and social circumstances, with resultant underlying causal pathways to poor mental health outcomes in childhood that are complex. Key features of this complexity are reciprocal interactions between person and environment that take place over time. The core of this thesis seeks to attend to the complexity of development to move the field of developmental health forward toward greater explanation, and more successful prediction and prevention. The focal point of the thesis is the psychosocial determinants of childhood mental health, the resource domain of the developing child, and the interplay between characteristics of the individual child, the family, and the community. The eventual goal is to better understand why and how socioeconomic circumstances impact on developmental health. One component of this thesis focuses on the expansion of extant developmental theory. The other component focuses on the development of an analytic strategy that more appropriately reflects the intricacies of this theoretical expansion. In the process, data are analysed, principally as a heuristic strategy, to illustrate the analytical approach needed to support the theoretical framework. The specification of a bioecological conceptual framework suitable to guide research and policy in developmental health is the first principal objective of the thesis. A critical examination of the resource framework proposed by Brooks-Gunn, Brown, Duncan, and Anderson Moore (1995) reveals it to be centred on family and community resources, but otherwise silent with respect to the physical and psychological resources of the child. The quintessential point of this thesis is that theory in developmental health must be able to account for the contribution individuals make to their own development. A modified resource framework is proposed that acknowledges financial, physical, human, and social capital, within the domains of the individual child, the family, and the community. The second principal objective of the thesis, the development of analytical methods that focus on the individual child and the complexity of data generated by this theoretical approach, is then introduced. Theory and method are thus integrated when comprehensive measures of characteristics in multiple domains across developmental periods are modeled using longitudinal data from the Western Australian Pregnancy Cohort (Raine) Study (Newnham, Evans, Michael, Stanley, & Landau, 1993). The mothers of 2,860 children were enrolled at 18 weeks in pregnancy and the children have been followed at birth, one, two, three, five, and eight years of age. Eighty-nine per cent (2,537 /2,860) of families were available for follow-up at eight and 74 per cent (2,126/2,860) of families responded. Extensive demographic, psychological, and developmental data were available for the children and their families and a limited amount of data were available for the communities in which they reside. A measure of mental health morbidity, the Child Behaviour Checklist (Achenbach, 1991), was available for the children at two, five, and eight years of age. In the first instance, dichotomous summary variables are derived for the demographic, psychological, and developmental variables of interest. Variables are then selected for inclusion in one of several explanatory models. To create a mathematical representation of resource characteristics, the information for each child is concatenated as a series of binary strings. Frequency tabulation is then used to aggregate the data and odds ratios are calculated to determine the degree of risk associated with each string of code, or pattern of factors relative to a nominated mental health outcome. The results provided a scaffold from which this theoretical and analytical approach is compared and contrasted with the reviewed literature. Two principal themes of investigation are pursued. The first theme to be examined is the interplay between characteristics of the child, family, and community and the contribution children make to their own development. The specific approach models the interaction between selected characteristics of the child, family and community in each of four developmentally significant time periods. The theoretical position adopted in the present study suggests that the effect of any personal or contextual factor on later development, if a relationship does truly exist, is most likely to be differential. That is, it is a combination of influences that determines developmental outcomes for children, not any single factor acting independently. The modelling process demonstrates that, for the children involved, personal and contextual factors impact mental health differentially depending on various other individual, family and/or community characteristics. The modelling process identifies patterns of factors that impact relatively small, but significant, numbers of children because the models focus on the effect for individual children rather than the effect for the group. For example, one model suggests that the effect of intra-uterine growth restriction for the group as a whole may be minimal, but the impact for some children could be critical depending on the combination of family and community influences, such as the mothers level of education, the family’s experience of significant life stress, and residence in a relatively disadvantaged community. The second theme to be examined is the possibility that the accumulation of resource deficits or risk characteristics, over time, amplifies the likelihood of mental health problems in childhood. The approach models selected characteristics of the child in each of the four periods of development collectively, and it also models selected characteristics spanning each of the four time periods discretely. The results suggest that latency, pathway, and recency effects may operate simultaneously, and that timing and accumulated burden may both be important determinants of risk. For example, with regard to children whose family experienced life stress, these three effects operated in a systematic way to increase the degree of risk of a mental health problem. In summary, the aggregation of data at the individual level is a productive approach in seeking to explain population level social phenomena. While seemingly paradoxical, the identification of the joint, interactive effects between individual, family, and community characteristics, better allows for the quantification of family and community characteristics operating through multiple causal pathways.

Educational Studies / (M.Tech. (Inclusive Education))

Although the profession of occupational therapy had its origins in the treatment of the mentally ill, and was among the pioneers in developing community-based programs to meet the social and emotional needs of children, a study of 28 therapists practicing in the public schools revealed that these occupational therapists did not serve students with behavioral disorders unless they also exhibited a neurological disorder. The results of this study revealed that occupational therapy is not recognized by the educational sector as an essential related service for students with behavioral disorders. Occupational therapy is viewed as a modality much akin to physical therapy in which the focus is on motor skill development.

Text in Afrikaans / Practical research has shown that children experiencing learning restraints may suffer from high stress levels. These children encounter difficulty adapting to normal scholastic challenges and their performance often appear marginalised. The objective of this study is to explore the phenomenon of stress experienced by three eleven year old learners with learning restraints in the intermediate phase. The literature study on this topic has shown that learning restraints not only affect a child scholastically, but in his entire being. Based on this understanding, learning restraints may cause stress due to habitual underachievement in the learning environment. These learners might not necessarily have extremely poor cognitive abilities, but perceive themselves as incompetent or "dumb". In the empirical study, projection techniques were mainly utilised to determine stress levels experienced by learning restrained learners, from their internal frame of reference. From these findings, certain recommendations are proposed for psychotherapy. / Educational Studies / M. Ed. (Guidance and Counseling)