This study used a longitudinal design to investigate the relation between depression and pessimism-related cognitions about the self, world, and future in a clinical sample of psychiatric inpatients. A group of 30 inpatients diagnosed with major depressive illness was compared with a mixed-diagnostic comparison group of 28 inpatients on a measure of syndromal depression, as well as on pessimism-related cognitive measures of self-esteem, perceptions of the benevolence of the world, and hopelessness. All subjects completed the measures at two time points: within four days of admission to an psychiatric inpatient unit, and an average of 13.5 days later. It was expected that the nosologically depressed group would endorse more negative pessimism-related cognitions than the comparison group, that the pessimism-related cognitions would persist beyond remission of depressive symptoms, and that Time 1 cognitions would significantly predict Time 2 depression after controlling for depression at Time 1. Contrary to expectations, groups did not differ on the measure of syndromal depression, nor on the measures of cognitions pertaining to the self and future. Both groups exhibited a significant decline in depressive symptoms over time. Moreover, scores on the pessimism-related cognitive measures changed in concert with scores on the depression measure, and did not predict Time 2 depression. Additionally, significant interactions of group, gender, and time on the measure of syndromal depression, and interactions of group and gender on the cognitive measures, were found. These interactions revealed that men in the nosologically depressed group scored significantly lower than men in the comparison group on the measure of syndromal depression, and endorsed more positive cognitions about the self, world, and future. These findings refute major theoretical postulates regarding depressotypic cognitions, in that pessimism-related cognitions were: (1) not specific to nosological depression; (2) were mood-state dependent, with the exception of cognitions about the world; and (3) did not serve a maintenance function in syndromal depression. Exploratory analyses suggest that for the depressed group only, hopelessness may significantly predict Time 2 depression, and thus serve to prolong depression. The theoretical and clinical implications of all findings are discussed.

Thesis (Ph. D.)--Drexel University, 2006. / Includes abstract and vita. Includes bibliographical references (leaves 88-98).

Thesis (Ph.D.)--Syracuse University, 2008. / "Publication number: AAT 3323072."

People who are mentally unwell and have committed a criminal offence are cared for by forensic mental health services. Their treatment is provided in secure hospitals so that any risks to the public are minimised. The complex nature of the mental health difficulties experienced by this clinical population means that they are typically treated in secure hospitals for several years, incurring high economic and personal costs. The need for meaningful approaches to treatment and management of these individuals is therefore paramount. The first paper systematically reviewed eighteen qualitative research papers that explored stakeholder perspectives on the personal recovery approach to care in forensic contexts. Principles of personal recovery were perceived to be meaningful and applicable in forensic contexts if adaptations were made to overcome inherent barriers such as restrictions due to risk management. Methodological quality of the reviewed studies was limited by shortcomings in the transparency of study procedures. The second paper explored the experiences of a significant subpopulation of forensic service users who were discharged to the community subject to conditions including ongoing monitoring, then recalled back to a secure hospital due to a relapse in their mental state or other indicators of increased risk. Using grounded theory, a theoretical model was developed of how these individuals make sense of being recalled. This was found to be a recursive process influenced by their perceptions of events before their recall, during the recall itself, and their subsequent experiences.