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Development of a test battery for assessing memory malingering in Hong Kong and its application on depressed patients. / CUHK electronic theses & dissertations collectionJanuary 2006 (has links)
The present study attempted to incorporate several tests that had specific indices for identifying memory malingering into a battery for the assessment of memory malingering. Two measures, a famous faces test and a subjective memory questionnaire were constructed originally by the author. These measures were pilot-tested on a group of demented community geriatric participants (n=10) and control geriatric participants (n = 12). Three indices indicative of memory malingering in Hong Kong List Learning Test (HKLLT) were explored. The indices of the HKLLT, the two new measures and the Test of Memory Malingering were incorporated into a battery for detection of memory malingering. Using an analogue design, the battery was tested on a group of community participants (N = 58) who were randomized into two conditions, simulated malingering (SM) condition (n = 25, one was excluded because of non-compliance to experimental instructions) and true effort (TE) condition (n = 32). Participants in the SM group were given instruction to exaggerate memory complaints after a hypothetical head injury while the TE condition instructed participants to do his/her best. The subjects were tested on 6 measures of the battery and 2 other tests. A manipulation check was also completed. The results indicated significant difference between the two conditions on all the measures. The cut-off scores of the measures attained sensitivity from .4 to .84 and specificity of .9 to 1. Using discriminant analysis, the overall hit rate was 93% and using logistic regression, the overall hit rate was 98%. The measures were then tested on a group of depressed patients (N = 39) who were randomized into SM (n = 19) and TE condition (n = 20). Manipulation check indicated that about 80% of depressed participants of SM group were unable to comply with malingering instruction. Analysis was then done to compare the performance of community SM sample (n = 25) with community TE sample (n = 32) and depressed TE sample (n = 20). Results found significant difference between simulated malingering and control and depressed sample respectively. No significant difference was found between community control and depressed sample. Using the cut-off scores obtained from the normal sample, specificity of depressed sample on 3 measures was lowered. Using discriminant analysis and logistic regression, two-group classification (simulated malingering and non-simulated malingering) reached an overall hit rate of 92% and 94% respectively. Using 4 indictors of the battery achieved sensitivity of 68%, specificity of 100 % in normal control and 100% in depressed sample. The effect of depression, base rate of malingering in affecting the classification, the issue of use of simulation in research design and future research direction was discussed. / Chang Suk Yi Sonia. / "July 2006." / Adviser: Agnes Chan. / Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1919. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 156-179). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.
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Listening to their own voices: a narrative analysis of depressed middle-aged adults in Beijing. / CUHK electronic theses & dissertations collectionJanuary 2012 (has links)
本研究是一項關於北京中年抑鬱症患者主觀經驗的敘事分析。研究的目的在於探尋患者對於自身患病歷程的主觀詮釋,他們的服務需求以及對於中國大陸精神衛生社會工作進行反思。研究的參與對象為目的性抽樣所得到的來自北京的一個抑鬱癥自助團體的八名中年抑鬱癥患者。 / 患者回顧了他們不同階段的經歷:發病期、住院期以及康復期。然後他們對於這些經歷做了詮釋。基於不同領域的社會服務需求,對於醫院、社區、大眾傳媒以及政府,他們都給出了寶貴的意見。 / 研究發現,既有的理論觀點對於關著對自身經歷的詮釋有著重要的影響,尤其是生物醫學模型。認知觀點和性別觀點也可以在患者們的敘事中找到蹤跡。精神科醫生在患者的整個經歷中都處於重要的地位,他們的觀點和行為對患者也產生了重要的影響。 / 患者還受到社會和歷史因素的影響。他們的詮釋會受到社會觀念和文化價值的影響,比如命運、面子、孝順以及性別角色等等。而歷史事件諸如文化大革命以及天安門事件也會對他們的人生經歷以及他們的主觀詮釋造成影響。而中國目前的社會情境也是另一項重要的影響因素。 / 從他們的故事中,我們可以看到,最重要的主題就是他們在患病過程中認知模式的轉變,包括對待抑鬱癥本身,所接受的服務以及自身的看法。在他們的敘述中,另外兩個主題也是非常值得注意的,那就是和抑鬱症有關的“喪失以及醫院裡非人道的治療方式。 / 他們的故事為我們對於北京中年抑鬱症患者經歷的理解提供了非常豐富詳實的材料。這些發現對於知識理論的發展、政策的制定以及針對抑鬱症患者的臨床社會工作實踐都有著很大的啟示。整個社會以及不同領域的精神衛生專業人士都應該攜起手來幫助他們,共同去創造一個更加包容和諧的社會。 / This research was a narrative analysis of the subjective experiences of the depressed middle-aged adults in Beijing, China. The purposes of the research were to explore the clients’ subjective interpretation of their lived experience of depression, their service needs and reflect on the improvement of mental health social work in Mainland China. A purposive sample of eight depressed clients from a self-help group in a mental health hospital in Beijing participated in this study. / The clients talked about their experiences at different stages: the onset, in the hospital and the rehabilitation, and interpreted their experiences. They also gave some advice to the hospital, the community, the mass media and the government based on their social service needs. / The theoretical perspectives influenced the clients’ interpretations of their experiences, especially the biomedical model. The cognitive perspective and the gender perspective could also be found in the client’s narratives. The psychiatrists were very important in the whole process of the clients’ experiences. Their perspectives and behaviors also influenced the clients. / It is found that the clients were also influenced by social and historical factors. Their interpretations were affected by social beliefs and cultural values such as fate, face, filial piety and gender roles. The historical events such as Cultural Revolution and June.4th Movement also affected their experiences and interpretations. The current social context in China was another important factor affecting them. / From their stories, we could see that the main theme was change of their cognitive styles, including view of depression, service and themselves. Another two themes were highlighted in their narratives as well: the linkage of their losses with depression and the dehumanized treatment in the hospital. / Their stories have provided comprehensive materials for an in-depth understanding of depressed middle-aged adults in Beijing. Based on the findings, recommendations are made to knowledge development, policymakers and clinical social workers in helping the depressed clients. It is necessary for our society and mental health professionals in different areas to work together to help them and build an inclusive society. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Shi, Song. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 228-245). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts and appendixes also in Chinese. / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Rationale of the study --- p.1 / Chapter 1.2 --- Background of the study --- p.2 / Chapter 1.3 --- Research Questions --- p.3 / Chapter 1.4 --- Purposes and significance of the research --- p.4 / Chapter Chapter 2 --- Literature Review --- p.7 / Chapter 2.1 --- Adult depression --- p.7 / Chapter 2.1.1 --- Definition of adults’ depression --- p.7 / Chapter 2.1.2 --- Different perspectives on “depression“ --- p.9 / Chapter 2.1.3 --- Social factors associated with adult depression --- p.24 / Chapter 2.1.4 --- Cultural influences in Chinese society --- p.32 / Chapter 2.2 --- Treatment of depressed adults --- p.36 / Chapter 2.2.1 --- Psychotherapy --- p.36 / Chapter 2.2.2 --- Medication --- p.38 / Chapter 2.3 --- Research on subjective experiences of people with mental disorders --- p.39 / Chapter 2.4 --- Research on depression in Mainland China --- p.48 / Chapter 2.5 --- The roles of social work in mental health services --- p.51 / Chapter Chapter 3 --- Research Methodology --- p.58 / Chapter 3.1 --- Paradigmatic Considerations --- p.58 / Chapter 3.1.1 --- Social constructionism --- p.58 / Chapter 3.1.2 --- Social construction and mental illness --- p.61 / Chapter 3.1.3 --- Theoretical Framework --- p.63 / Chapter 3.2 --- Research Design --- p.70 / Chapter 3.2.1 --- Qualitative research strategy --- p.70 / Chapter 3.2.2 --- Sampling strategies --- p.75 / Chapter 3.2.3 --- Data collection procedures --- p.84 / Chapter 3.2.4 --- Data analysis procedures --- p.86 / Chapter 3.2.5 --- Strategies for validating findings --- p.88 / Chapter 3.3 --- Ethical issues --- p.91 / Chapter Chapter 4 --- Research findings --- p.93 / Chapter 4.1 --- The experiences of the participants --- p.93 / Chapter 4.1.1 --- The experience during the onset of depression --- p.94 / Chapter 4.1.2 --- The experience in hospital --- p.118 / Chapter 4.1.3 --- The experience in the rehabilitation period --- p.131 / Chapter 4.2 --- The interpretation of their experiences --- p.142 / Chapter 4.2.1 --- The interpretation of the process of suffering from depression --- p.143 / Chapter 4.2.2 --- The interpretation of the process of recovery --- p.148 / Chapter 4.3 --- Advice on their needs --- p.154 / Chapter 4.3.1 --- The hospital --- p.154 / Chapter 4.3.2 --- The community --- p.159 / Chapter 4.3.3 --- Mass media --- p.161 / Chapter 4.3.4 --- The government --- p.164 / Chapter 4.4 --- Summary --- p.170 / Chapter Chapter 5 --- Discussion and Recommendation --- p.171 / Chapter 5.1 --- Characteristics of the participants in this study --- p.171 / Chapter 5.2 --- Social and historical factors affecting the clients’ interpretation of suffering from depression --- p.173 / Chapter 5.2.1 --- Social beliefs and cultural values --- p.174 / Chapter 5.2.2 --- Social context --- p.183 / Chapter 5.2.3 --- Historical events --- p.184 / Chapter 5.3 --- Themes --- p.186 / Chapter 5.3.1 --- Change of Cognitive Style --- p.187 / Chapter 5.3.2 --- The linkage of loss with depression --- p.190 / Chapter 5.3.3 --- The dehumanized treatment of hospitalization --- p.193 / Chapter 5.3.4 --- The interrelationships among the themes --- p.195 / Chapter 5.4 --- Revisiting the proposed conceptual framework --- p.197 / Chapter 5.5 --- Significance and recommendations --- p.200 / Chapter 5.5.1 --- Significance and recommendations --- p.201 / Chapter 5.5.2 --- Limitations --- p.214 / Chapter Appendix A: --- Possible Probes for interview (English Version & Chinese Version) --- p.218 / Chapter Appendix B: --- Oral Consent form (English Version & Chinese version) --- p.225 / References --- p.228
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Cross-cultural Differences in the Presentation of Depressive SymptomsTse, Pui San 05 1900 (has links)
Epidemiological studies show that China has a lower prevalence rate of major depression than that of Western countries. The disparity in prevalence is commonly attributed to the tendency of Chinese to somatize depression. Empirical evidence of Chinese somatization has yielded mixed results. The present study thus aimed to 1) examine differences in somatic and psychological symptom reporting between Chinese from Macau and Americans in America and 2) identify cultural and psychological variables that would predict somatization. Independent and interdependent self-construals, sociotropy, and emotional approach coping were hypothesized to predict somatization of depression. Participants included 353 Chinese and 491 American college students who completed self-report measures online. Contrary to prediction, results indicated that Americans endorsed a higher proportion of somatic symptoms than Chinese did. Sociotropy predicted both relative endorsement and severity of somatic symptoms for the American sample, whereas emotional expression coping was related to somatization in the Chinese sample. The findings challenge the common assumption of greater Chinese somatization and highlight the importance of context in understanding the relationships between somatization and cultural and psychological variables. Implications of the present study and future directions are discussed.
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Psychiatric morbidity of stroke in Hong Kong Chinese patients: dementia and depression. / CUHK electronic theses & dissertations collectionJanuary 2005 (has links)
PDSE are common (19.6%) in the local stroke population. Both premorbid factors as well as stroke-related factors contribute to the development of PRSD and PSDE. The application of different diagnostic criteria for PSDE will affect the frequency and the associated radiological characteristics. As regards the screening methods of PSDE, a more specific instrument should supplement the IQCODE or MDRS-IP in a two-stage screening procedure. / PSD is also common (16--17%) among local stroke survivors. Both psychosocial factors and the location of cerebrovascular lesions play an important role in the development of PSD. PSD in local Chinese seems to have a favorable short-term outcome in comparison with their Caucasian counterparts. With regard to the screening of PSD in Chinese, we found that both the GDS and HADS depression subscale have a satisfactory response rate and accuracy in detecting PSD. However, due to the relative low frequency of PSD in the local stroke population, a more specific instrument should supplement the GDS in a two-stage screening procedure. Finally, the familiarity of the rater with the subjects based on a preexisting therapeutic relationship did not influence the accuracy of screening for PSD in Chinese patients. / There has been a paucity of data on the frequency, clinical correlates and methods of screening of poststroke dementia (PSDE) and depression (PSD) in Chinese populations. The objective of this thesis is to examine the prevalence, diagnostic criteria and clinical correlates of PSDE and PSD in Chinese stroke patients in Hong Kong. A series of studies were all carried out; the author of the thesis had interviewed all the subjects 1--3 months after their index stroke and made the diagnosis of dementia and depression according to the DSM-IV criteria. / Tang Wai Kwong. / "July 2005." / Adviser: Gabor S. Ungvari. / Source: Dissertation Abstracts International, Volume: 67-01, Section: B, page: 0177. / Thesis (M.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 136-191). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / School code: 1307.
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