Disparities in mental health service use among People of Color (POC) adolescents with depression is a serious public health concern. Engaging and retaining POC adolescents in treatment is imperative to improving mental health outcomes. Parents/caregivers play a critical role in POC adolescent engagement in the therapeutic process, yet POC adolescents’ and parents’/caregivers’ preferences for parental participation engagement (PPE) in depression treatment are unknown. The goal of this dissertation was to investigate POC adolescents’ and parents’/caregivers’ preferences for PPE in adolescent depression treatment. A qualitative approach was used through individual semi-structured interviews with POC adolescents and parents/caregivers. A brief quantitative preferences questionnaire was also administered. Questionnaire data were analyzed via descriptive statistics. Qualitative data were analyzed via thematic analysis procedures. Results indicated that teen and parent/caregiver preferences for PPE included: (a) direct parental involvement, (b) indirect parental involvement, and/or (c) limited involvement. The quality of the teen-parent relationship and logistical factors informed teen and parent/caregiver preferences for PPE, with therapists having a key role in influencing these preferences and facilitating the initiation and continuation of PPE. Factors associated with the quality of the teen-parent relationship included: (a) parent mindsets and behaviors, (b) teen and parent perceptions of adolescent development, and (c) severity of teen symptoms. Themes related to the perceived outcomes of PPE included: (a) improved teen-parent communication, (b) improved parental support behaviors, (c) improved teen-parent connection and trust, (d) negative outcomes, and, (e) treatment retention. Based on these findings, implications for clinical practice and future research are discussed.

Perinatal depression (PND), depression that occurs during pregnancy or in the first year following delivery, is a common and debilitating mental health condition. In New York City, it is estimated that at least one in ten women suffer from PND. The clinicians who serve these women require training in acceptable, feasible, and effective treatments. Interpersonal psychotherapy (IPT) is a time-limited, evidence-based psychotherapy that has been found to be effective in the treatment of PND in community and primary care settings. The present study investigates the nuances of an IPT training program for licensed mental health providers who treat perinatal depression within integrated care settings in NYC. Using a qualitative-focused mixed-methods design, this study aims to systematically and comprehensively evaluate the acceptability, feasibility, sustainability, and preliminary effectiveness of the training program, and of the providers’ perceptions of IPT as a treatment for the patients they serve. To achieve these aims, five of the eight providers who participated in the training program were interviewed at two timepoints and quantitative data including demographics, use of IPT, satisfaction with training experience, and effectiveness of the training program were collected. Results indicate that providers viewed their training experience as acceptable and feasible and viewed IPT as an appropriate, relevant, and helpful treatment for their perinatal patients’ depression. Quantitative results provide preliminary support for the training model’s potential effectiveness, demonstrating that provider-trainees were able to obtain and retain knowledge of IPT and achieve certification as IPT practitioners. Overall, Patient Health Questionnaire (PHQ-9) scores show that patients who were treated by the study’s provider-trainees self-reported depression symptoms improved over the course of their IPT treatment. Recommendations for future directions and implications for future provider training programs are discussed.

The subjects were DUI probationers placed by the court system in the Virginia Alcohol Safety Action Program (VASAP). Due to their high risk level, the subjects were placed in treatment programs. An exercise program was incorporated in a VASAP treatment program to investigate the reduction in alcohol drinking frequency and quantity by implementing a weekly questionnaire as a repeated measure in an experimental vs. a control group design. Within these same groups, depression was measured through a pre-post design using the Beck Depression Inventory as a psychometric measure. The two arms of the study were evaluated by weekly ordinal data analyzed using a repeated measure ANOVA and a pre-post design using a 2x2 table with the appropriate ANOVA at a .05 level of significance. The results indicated no significant difference between the groups. There experimental group established a reduction in alcohol consumption and depression at a faster rate than the control group. / Master of Science

Text in Afrikaans / Aangesien depressie en angs hedendaags so 'n ingrypende invloed het op mense se lewens en hulle lewenskwaliteit, is daar 'n dringende behoefte aan 'n dinamiese, korttermyn en gerigte terapie om so gou as moontlik by die werklike onderliggende oorsake van die depressie en angs uit te kern. Hierdie studie het ten doel om die gebruik van hipnoterapie in die hantering van depressie en angs by adolessente en volwassenes te ondersoek. Tydens die studie word aangetoon dat die mediese hipnoanalise model 'n geskikte benadering is om as diagnostiese tegniek en terapeutiese intervensie, die oorsprong van depressie en angs aan te spreek. Emosionele probleme soos depressie en angs se oorsprong lê dikwels by foutiewe persepsies wat ontstaan tydens insidente in die kindertyd. Aangesien die persoon se breinprosesse in daardie stadium nag nie goed genoeg ontwikkel is om te besef dat die bedreiging verby is nie, word sulke persepsies nie verwyder nie. Elke persoon analiseer 'n nuwe stresvolle situasie of bedreiging vanuit sy persepsies en verwysingsraamwerk uit die verlede. Tydens 'n stresvolle insident is die depressie- en angslyer in die gewoonte om vanuit 'n depressiewe en angsvolle verwysingsraamwerk te dink en op te tree. Hierdie wyse van dink en optree is volgens sy onbewuste beter vir sy oorlewing van die stresvolle situasie, as wat denke en optrede vanuit 'n verwysingsraamwerk van die werklike onderliggende probleem sou wees. Die mediese hipnoanalise model is in staat om, tydens regressie, die ou foutiewe gedagtepatrone te verander deur die onderliggende gedagte, wat probleme veroorsaak, bloot te lê en te verwyder. Sodoende word die werklike onderliggende probleem blootgelê en verwyder. Die persoon word vry van foutiewe persepsies van die verlede en in staat om te dink en in die toekoms op te tree volgens die nuwe, akkurate persepsies. Deur hierdie meganismes, bewys mediese hipnoanalise homself as 'n geskikte terapeutiese ingreep om depressie en angs suksesvol aan te spreek. / In the light of the far-reaching effects that depression and anxiety have on the lives and the quality of people's lives, there is a need for a dynamic, short term and directed therapy in order to determine the real underlying causes of depression and anxiety as soon as possible. This study aims to examine the use of hypnotherapy in the treatment of depression and anxiety with adolescents and adults. During the course of this study, it is shown that the medical hypnoanalysis model is well suited as a diagnostic technique and therapeutic intervention for treating the origins of depression and anxiety. The origin of emotional problems like depression and anxiety, often lies in the faulty perceptions that have been formulated during childhood incidents. Since the brain processes are not yet as developed as they will become in adult life, the conscious mind does not realize that the threat ceased to exist, and can therefore not remove such perceptions. Each person analyses new stressful situations from the perspective of his own perceptions and the frame of reference of the past. A person suffering from depression and anxiety is in the habit of generating depressive and anxious ways of thinking and acting when confronted with a new stressful situation. The subconscious mind considers these ways of thinking and acting as the best way of surviving the stressful situation, better than ways of thinking and acting from the frame of reference of the underlying problem. The medical hypnoanalysis model can detect and remove the real underlying problem by regressing the person to the time of the incident, thus correcting the old patterns of thinking and acting. The person is freed from past false perceptions, and can think and act according to his new, corrected perceptions. Through use of these mechanisms, medical hypnoanalysis has shown itself to be well suited to the treatment of depression and anxiety. / Psychology of Education / D. Ed. (Sielkundige Opvoedkunde)

Text in Afrikaans / Aangesien depressie en angs hedendaags so 'n ingrypende invloed het op mense se lewens en hulle lewenskwaliteit, is daar 'n dringende behoefte aan 'n dinamiese, korttermyn en gerigte terapie om so gou as moontlik by die werklike onderliggende oorsake van die depressie en angs uit te kern. Hierdie studie het ten doel om die gebruik van hipnoterapie in die hantering van depressie en angs by adolessente en volwassenes te ondersoek. Tydens die studie word aangetoon dat die mediese hipnoanalise model 'n geskikte benadering is om as diagnostiese tegniek en terapeutiese intervensie, die oorsprong van depressie en angs aan te spreek. Emosionele probleme soos depressie en angs se oorsprong lê dikwels by foutiewe persepsies wat ontstaan tydens insidente in die kindertyd. Aangesien die persoon se breinprosesse in daardie stadium nag nie goed genoeg ontwikkel is om te besef dat die bedreiging verby is nie, word sulke persepsies nie verwyder nie. Elke persoon analiseer 'n nuwe stresvolle situasie of bedreiging vanuit sy persepsies en verwysingsraamwerk uit die verlede. Tydens 'n stresvolle insident is die depressie- en angslyer in die gewoonte om vanuit 'n depressiewe en angsvolle verwysingsraamwerk te dink en op te tree. Hierdie wyse van dink en optree is volgens sy onbewuste beter vir sy oorlewing van die stresvolle situasie, as wat denke en optrede vanuit 'n verwysingsraamwerk van die werklike onderliggende probleem sou wees. Die mediese hipnoanalise model is in staat om, tydens regressie, die ou foutiewe gedagtepatrone te verander deur die onderliggende gedagte, wat probleme veroorsaak, bloot te lê en te verwyder. Sodoende word die werklike onderliggende probleem blootgelê en verwyder. Die persoon word vry van foutiewe persepsies van die verlede en in staat om te dink en in die toekoms op te tree volgens die nuwe, akkurate persepsies. Deur hierdie meganismes, bewys mediese hipnoanalise homself as 'n geskikte terapeutiese ingreep om depressie en angs suksesvol aan te spreek. / In the light of the far-reaching effects that depression and anxiety have on the lives and the quality of people's lives, there is a need for a dynamic, short term and directed therapy in order to determine the real underlying causes of depression and anxiety as soon as possible. This study aims to examine the use of hypnotherapy in the treatment of depression and anxiety with adolescents and adults. During the course of this study, it is shown that the medical hypnoanalysis model is well suited as a diagnostic technique and therapeutic intervention for treating the origins of depression and anxiety. The origin of emotional problems like depression and anxiety, often lies in the faulty perceptions that have been formulated during childhood incidents. Since the brain processes are not yet as developed as they will become in adult life, the conscious mind does not realize that the threat ceased to exist, and can therefore not remove such perceptions. Each person analyses new stressful situations from the perspective of his own perceptions and the frame of reference of the past. A person suffering from depression and anxiety is in the habit of generating depressive and anxious ways of thinking and acting when confronted with a new stressful situation. The subconscious mind considers these ways of thinking and acting as the best way of surviving the stressful situation, better than ways of thinking and acting from the frame of reference of the underlying problem. The medical hypnoanalysis model can detect and remove the real underlying problem by regressing the person to the time of the incident, thus correcting the old patterns of thinking and acting. The person is freed from past false perceptions, and can think and act according to his new, corrected perceptions. Through use of these mechanisms, medical hypnoanalysis has shown itself to be well suited to the treatment of depression and anxiety. / Psychology of Education / D. Ed. (Sielkundige Opvoedkunde)

Utilizing an analogue research design conducted via the Internet, this study assessed athletic trainers' abilities to recognize, diagnose, and intervene with a hypothetical athlete experiencing depression, and examined the impact of their gender, athlete gender, and athlete's presenting problem on their decisions. Athletic trainers' perceived competency in using psychosocial interventions with athletes, history of referring athletes to psychology professionals, and training backgrounds in psychology also were examined. Participants (270 male and 370 female certified athletic trainers) were randomly assigned to one of six conditions (Athlete Gender X Presenting Problem). After reading the appropriate vignette, they completed questions related to the athlete's psychological symptoms and diagnosis, referral recommendations, and use of psychosocial interventions if working with the athlete. The vignettes were identical except for the athlete's gender and problem. Overall, athletic trainers accurately identified the athlete's depressive symptoms/diagnosis and need for psychological referral. They rated the athlete significantly higher in Depressive Symptoms than in Anger/Agitation Symptoms and Compulsive Behavioral Symptoms, and as more likely to be experiencing a depressive disorder compared to an adjustment disorder, anxiety disorder, sleep disorder, or substance abuse disorder. Female athletic trainers provided significantly higher ratings of Depressive Symptoms than males and the injured athlete was rated significantly higher in Anger/Agitation than the performance problem athlete. Diagnosis ratings were not influenced by athlete gender, athletic trainer gender, or type of problem. Athletic trainers were most likely to refer the athlete to a psychology professional compared to an allied health professional, treating the athlete themselves, or doing nothing. Presenting problem significantly impacted referral recommendations. If treating the athlete themselves, athletic trainers were significantly more likely to use supportive interventions than cognitive-behavioral techniques; they felt significantly more competent in providing supportive interventions. Competency in both interventions was significantly enhanced if athletic trainers completed psychology coursework. Findings suggest that athletic trainers are able to accurately identify and intervene with athletes experiencing psychological problems.

This dissertation research aims to develop systemic methods to analyze mental disorder and social media use data in young adults in a dynamic way. The first part of the dissertation is a comprehensive review on modeling methods of longitudinal data. The second part describes the methods that we used to identify symptom clusters that can characterize treatment trajectories and to predict responses of anti-depressants for depression patients. Manhattan distance and bottom-up hierarchical clustering methods were used to identify the symptom clusters. Penalized logistic regressions were conducted to identify top baseline predictors of treatment outcomes. The third part presents of Tweedie distribution application with generalized linear models and growth mixed models for analyzing association between social media use patterns and mental health status. The fourth part is future work and research directions.

Previous research has revealed heterogeneity in outcome trajectories among individuals seeking psychotherapy. However, questions remain as to the number, nature, and predictors of these trajectories. Therefore, the present study had three aims: 1) to identify heterogeneous latent groups among treatment trajectories of 212 clients with major depressive disorder (MDD) seeking psychotherapy at a community mental health training clinic; 2) to identify significant associations between clinical and demographic variables and group membership; and 3) to identify correlations between trajectory shape and positive treatment outcome. Prior to treatment, participants provided demographic information and completed symptom severity ratings. Once in treatment, participants completed a self-report of distress via the Outcome Questionnaire (OQ-45) at every session. Growth mixture modeling was utilized to identify distinct patient subgroups based on outcome trajectories among the sample. Three distinct latent classes of treatment trajectory were identified, providing evidence of heterogeneity in treatment trajectories among individuals with MDD. Baseline distress, pre-treatment work problems, and sleep difficulties were found to be predictive of an individual's membership in a specific trajectory group. Finally, specific shapes of change, namely early response and sudden gains, were associated with positive treatment outcome. Findings from this study can be used to identify patients at risk for treatment failure, allowing clinicians to intervene earlier to enhance mid-treatment feedback and prognosis.

Leung Yeuk Sin Eugenie. / "July 2004." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (p. 220-237). / 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 Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

University of Macau / Institute of Chinese Medical Sciences