Schizotypy as a research framework for schizophrenia emphasizes a link between the symptoms of the disorder and schizotypal traits in the non-clinical population, and argues for a symptom orientated approach to the field. One such symptom area concerns that of unusual experiences, such as hallucinations and delusions that occur in both schizophrenia and in the normal population, but differ in intensity and frequency. Hallucinations and delusions are affected by the environment in which they occur, such as a perceptually ambiguous environment. However, given that both hallucinations and delusions are misinterpretations of the current environment, the content of both could also be influenced by previous experiences, where properties of previous experiences interact with the current environment to produce such experiences. One factor that could influence hallucinations and delusions in this way is time. That is, it could be that those individuals more prone to hallucinations and delusions have stronger temporal links with the properties of previous experiences that facilitate hallucinatory and delusional experiences. The current thesis explores the relationship between the influence of environmental properties on hallucinatory reports and the possibility of differences in timing between individuals scoring high or low in schizotypy through tasks that incorporate temporal elements for optimum performance, such as time based schedules of reinforcement, or measure timing more directly, such as temporal bisection tasks. Findings from the thesis show that high schizotypy scorers make more hallucinatory-like reports than low scorers and that those reports are linked to properties of the environment in which they occur. In addition, there is some evidence that high scorers differ in timing across both schedule and temporal bisection tasks, but only under very specific circumstances.

Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / O transtorno afetivo bipolar (TAB) à um transtorno psiquiÃtrico multifatorial, progressivo, que se caracteriza por uma oscilaÃÃo entre episÃdios manÃacos ou hipomanÃacos e depressivos. Estima-se que o transtorno afete cerca de 1 â 2 % da populaÃÃo mundial. O diagnÃstico definitivo e o tratamento adequado podem demorar 10 anos para se concretizar. Leva a grande prejuÃzo à qualidade de vida dos pacientes, gerando altas taxas de incapacidade funcional, comorbidades clÃnicas, como hipertensÃo e alta prevalÃncia de suicÃdio. A fisiopatologia do transtorno ainda permanece obscura, porÃm muitos esforÃos sÃo empregados em pesquisas para tentar elucidar os possÃveis mecanismos envolvidos no TAB, bem como para melhorar seu tratamento. As hipÃteses para explicar a fisiopatologia do TAB incluem: desregulaÃÃo da dopamina, alteraÃÃes mitocondriais, aumento do estresse oxidativo, reduÃÃo dos nÃveis de neurotrofinas, dentre outras. Diante deste cenÃrio, buscou-se investigar os possÃveis efeitos antimanÃacos do carvedilol (CVD), um beta-bloqueador nÃo seletivo usado amplamente no tratamento da hipertensÃo arterial com comprovada aÃÃo antioxidante e neuroprotetora. Para tanto, se utilizou um modelo animal de mania induzido por dimesilado de lisdexanfetamina (LDX), recentemente validado por nosso grupo de pesquisa. O LDX à um prÃ-fÃrmaco que se converte a D-anfetamina, a qual possui efeito psicoestimulante. O CVD foi avaliado em dois protocolos de tratamento, prevenÃÃo (simulando a fase de manutenÃÃo do TAB) e reversÃo (simulando a fase de crise do TAB), em ambos o valproato (VAL) foi utilizado como estabilizante do humor padrÃo. Foram avaliadas no presente estudo alteraÃÃes comportamentais e de estresse oxidativo. Os animais submetidos aos protocolos de prevenÃÃo (animais prÃ-tratados durante 7 dias com CVD, VAL e Salina e por mais 7 dias com LDX 10 mg/kg) e reversÃo (prÃ-tratados durante 7 dias com LDX e posteriormente tratados com CVD, VAL e Salina) tiveram os nÃveis de glutationa reduzida (GSH) e de peroxidaÃÃo lipÃdica (TBARS) determinados nas Ãreas cerebrais do cÃrtex prÃ-frontal (PFC) e corpo estriado (CE) e o fator neurotrÃfico derivado do cÃrebro (BDNF) no hipocampo (HC). Os resultados indicaram que o CVD preveniu e reverteu a hiperlocomoÃÃo e comprometimento da interaÃÃo social induzidas por LDX. Na avaliaÃÃo neuroquÃmica o CVD foi capaz de aumentar prevenir e reverter as alteraÃÃes nos nÃveis de GSH, BDNF e peroxidaÃÃo lipÃdica dos animais submetidos ao modelo de mania com resultados comparÃveis aos dos animais tratados com VAL e controles. Em conclusÃo, os resultados deste estudo revelaram que o CVD à um fÃrmaco em potencial para o tratamento da mania, sendo indicados, portanto, estudos clÃnicos que comprovem a aÃÃo deste fÃrmaco. / Bipolar disorder (BD) is a psychiatric disorder with multifactorial development and neuroprogressive characterized by oscillation between periods of manic and depressive episodes. It is estimated that the disease affects about 1 - 2% of the worldwide population and it takes about 10 years to a definitive diagnosis and appropriate treatment. BD brings many impairment of quality of life of patients, generating high rates of functional disability, comorbidities such as hypertension during the clinical course of the disease and presenting a high prevalence of suicide. The pathophysiology of the disease remains unclear, but many efforts are employed in research to try to elucidate the possible mechanisms involved in BD. The pathways hypothesized to take part of BD pathophysiology includes: dopamine deregulation, increased oxidative stress, decreased levels of neurotrophins such as BDNF, mitochondrial dysfunction among others. Based on the described above we sought to investigate the effects of carvedilol, (CVD), a nonseletive beta-blocker widely used in the treatment of hypertension with antioxidant properties, in a model of mania induced by dimesilate of lisdexamfetamine (LDX) a prodrug metabolized to D-amphetamine, in rats. The experimental design of the study consisted evaluation of CVD against behavioral changes and oxidative stress alterations in two protocols of treatment, prevention and reversal using valproate (VAL) a humor stabilizer as standard drug to assess the effectiveness of CVD. In the prevention protocol the animals were pre-treated for 7 days with CVD, saline or VAL). In the reversal protocol the animals were pre-treated for 7 days with LDX and for further 7 days received CVD, saline or VAL plus LDX. The behavioral determinations of locomotor activity and social interaction were conducted 2 h after the last administration of LDX. Reduced glutathione (GSH) and lipid peroxidation (TBARS) levels were determined in brain areas of the prefrontal cortex (PFC) and striatum (EC) and brain-derived neurotrophic factor (BDNF) in the hippocampus (HC) rats. The results indicated that CVD prevented and reversed the hyperlocomotion and deficit in social contacts induced by LDX. In the neurochemical determinations CVD significantly prevented and reversed the alterations in BDNF, GSH and MDA levels induced by LDX presenting results comparable to those of saline and VAL groups. Therefore, the results of the present study indicates that CVD prevents reverts the behavioral and neurochemical alterations induced by LDX used as an animal model of mania being, thus, a potential drug for the treatment of BD.

No description available.

Posttraumatic stress disorder (PTSD) is complex and no one theory can fully explain the development and maintenance of PTSD symptoms. In Scotland, where trauma focused care initiatives are being considered, little is known about the extent of trauma history and associated symptoms presenting in primary care services. Furthermore, subthreshold posttraumatic stress disorder (sPTSD) has recently been associated with clinically significant impairment. With PTSD symptoms often comorbid with other psychopathology such as depression, individuals potentially seek treatment for these symptoms rather than underlying trauma which therefore may go unrecognised. Studies on the effectiveness of psychological treatment for PTSD demonstrate reasonable efficacy for well developed interventions. However, up to half of individuals may not make significant clinical improvements and withdrawal rates are high. This suggests that current treatments are not acceptable to some individuals and may be ineffective for others. In light of such clinical challenges the aim of the thesis was to investigate the incidence and nature of trauma symptoms in an Adult Psychological Therapies Service. Firstly, a systematic review was conducted to appraise the current level of evidence for prevalence and impairment associated with sPTSD. Secondly, an empirical study was undertaken to review the prevalence of trauma history and symptoms in the service. This was followed by an investigation of the relationships between processes posited to underpin many forms psychological distress by a promising new treatment approach called Acceptance and Commitment Therapy (ACT). These include; cognitive fusion, experiential avoidance and valued action. A quantitative cross sectional design collecting self report questionnaire data was used and mixed statistical methodology employed. Results from the systematic review suggest that PTSD was associated with the most impairment, followed by sPTSD, then no PTSD. Subthreshold PTSD was reported to be as, or more prevalent than, PTSD. The results from the empirical study found 89 per cent reported exposure to one or more traumatic events, 51 per cent met PTSD screening criteria, whilst a further 7 per cent reached a sPTSD diagnostic cut-off. Trauma history was positively correlated with increased psychological distress at initial assessment. Cognitive fusion, experiential avoidance and valued action were all correlated with trauma symptom severity. Both cognitive fusion and experiential avoidance mediated the relationship between number of traumatic events and trauma symptom severity in a simple mediation model. However, multiple mediation analysis demonstrated that experiential avoidance, over and above cognitive fusion, explained 33 per cent of the variance. In addition, cognitive fusion and experiential avoidance jointly had a significant indirect effect on the relationship between trauma history and valued action. The implications of the findings and further directions are discussed.

M.Tech. / Attention-deficit/hyperactivity disorder (ADHD) is a commonly diagnosed childhood disorder characterised by impulsivity, inattention and hyperactivity that manifests in early childhood. The symptoms of ADHD affect cognitive, behavioural, emotional and social functioning (Sadiq, 2007). Conventional treatment of this disorder is predominantly through the use of psycho-stimulants, with methylphenidate (Ritalin® and Concerta®) often considered the drug of choice. Concerns about potential adverse effects include anxiety, anorexia, tacchycardia, cardiac arrhythmias, palpitations, increased blood pressure, dysphoria, dizziness, growth suppression and dyskinesias (Sadock and Sadock, 2007). Dreyer (1996) mentions the irritability, fatigue and melancholy, which often follows the use of these medications. Parents concerned about the side effects and long term use of medications are increasingly seeking out alternatives to pharmacologic treatment (Sadiq, 2007). Homoeopathy is a therapeutic approach of preventing and treating disease; it consists of a medical philosophy based on defined laws and principles (Eizayaga, 1991). Homoeopathy is asserted to influence disease with the use of highly diluted substances; the specific remedy is chosen to correspond according to the characteristic individual symptoms of the patient presenting with ADHD (Frei, et al., 2006). The aim of this study was, by means of case studies, to determine the effect of the homoeopathic simillimum treatment using LM potency in children with Attention Deficit/ Hyperactivity Disorder. Ten children, males and females between the ages of 5 to 10 years old who had been diagnosed with ADHD and were on a balanced, restricted sugar, high complex carbohydrate diet - low in additives, preservatives and food dyes (Rothenberg, 1997) - were recruited via advertisements (Appendix C) in the Gauteng region with permission from specific remedial and primary schools (Appendix F). In addition, an advertisement (Appendix C) was displayed on the Attention Deficit and Hyperactivity Support group of South Africa (ADHASA) website (Appendix D) and in psychologist and occupational therapist practice rooms. The study took place at the University of Johannesburg, Homoeopathy Health Centre, as well as at the participant’s and researcher’s homes.

Class of 2013 Abstract / Specific Aims: To assess the effectiveness of modafinil as an adjunct agent in the treatment of major depression and depression-related fatigue. Methods Seven databases were searched for articles that met predetermined inclusion criteria and reported sufficient data. Meta-analysis was employed to synthesize study findings, with standardized mean difference (SMD) being the primary summary measure. The I-squared statistic was used to evaluate heterogeneity among studies. Additionally, publication bias was assessed via funnel plots and Kendall’s tau.      Main Results: Ten studies (N = 848) were included in the Hamilton Depression Rating Scale (HAM-D) meta-analysis, composed of 5 RCTs and 5 pre-post studies. The pooled SMD was -0.67, a moderate effect indicating an improvement in depression scores. However, the overall SMD varied when stratified by study design; pre-post studies showed a large pooled effect (SMD = -1.54) that reached significance, whereas RCT's displayed a moderate effect (SMD = -0.41) that was not significant. Additonally, heterogeneity was substantial (I-squared = 91.54) among all studies, and publication bias was suggested by the funnel plot and Kendall's tau. Regarding modafinil and fatigue, the Epworth Sleepiness Scale (ESS) meta-analysis had a small but statistically signficant overall SMD (-0.23; p = 0.03), and the Fatigue Severity Scale (FSS) meta-analysis yielded an overall SMD which was not significant (p = 0.24). Similar to the HAM-D analysis, the overall SMD varied between study designs. Conclusion: The effect of modafinil on major depressive disorder is unclear, as the findings are largely variable and the impact of modafinil was stratified by study design.

Professionals in the mental health industry often attach a stigma to Borderline Personality Disorder (BPD). It is commonly thought of as a frustrating disorder to treat. As a result many professionals avoid dealing with BPD individuals. In an attempt to promote positive treatment outcomes, the aim of the study is to explore how the introduction of altruistic behaviours would affect the outcome of the overall treatment of individuals with BPD. Snowball sampling procedures were implemented. Data were collected through the use of semi-structured interviews with six mental health professionals and analysed through qualitative data processing and thematic analysis procedures. To the researcher’s knowledge, no research has been conducted specifically exploring the relationship between altruistic behaviour and BPD to date. The following superordinate themes emerged: treatment challenges, treatment context, treatment approach, diagnostic challenges, altruism/prosocial influences, and altruism/prosocial behaviour. It is the researcher’s hope that the findings of this study will increase awareness of this possible avenue in the treatment of BPD, so that the results of this study can then be taken to the next level of exploration in research and in clinical practice.

The classical myeloproliferative disorders (MPD), comprising essential thrombocythaemia (ET), polycythaemia vera (PV) and idiopathic myelofibrosis (IMF), are clonal premalignant haematopoietic neoplasms associated with activating mutations in signalling pathway molecules and a variable tendency to develop acute myeloid leukaemia (AML). This thesis examined genotype-phenotype associations of JAK2 and MPL mutations, the presence of clonal diversity in the MPD and the genetic events associated with progressive disease. Mutations in MPL were identified in 4% of ET and 7% of IMF but not in PV. Three different acquired MPL mutations were identified, one of which had been reported as an inherited allele. Although MPL mutations did not delineate a distinct clinical or histopathological subtype of ET, molecular testing provides an important new tool in the diagnostic armamentarium. Clones homozygous for the JAK2 V617F mutation were identified in female but not male patients with ET, suggesting that gender differences may be important in the determination of disease phenotype. In patients with two acquired genetic alterations, a signalling pathway mutation and a cytogenetic abnormality were usually present within the same clone. By contrast, coexistence of two signalling pathway mutations indicated the presence of biclonal disease that in two patients had arisen independently and not from a shared founder clone. RAS mutations were identified as potential cooperating events in patients with JAK2 or MPL mutant IMF. In patients developing AML following a JAK2 V617F-positive MPD, those with V617F-positive leukaemia had progressed via an accelerated phase of disease and harboured acquired alterations of RUNX1 or EVI1. V617F-negative leukaemias tended to follow directly from ET or PV, and loss of the JAK2 mutation by reversion to wild-type due to mitotic recombination, gene deletion or gene conversion was excluded. The thesis concludes with a discussion of how clonal heterogeneity can be integrated into current models of MPD disease pathogenesis.

A review of the construct of psychopathy suggested that procedures for assessing the disorder should take into account its two-facet structure, its chronicity, its association with criminality, and its association with deceitfulness. A review of the five most popular assessment procedures currently in use indicated that none of them was completely satisfactory; the Hare Psychopathy Checklist-Revised (PCL-R) appeared to be superior to the other measures in most respects, but it was not well-suited for use outside of forensic settings. It was therefore decided to develop anew scale, based on the PCL-R, that would be suitable for both forensic and nonforensic settings. Pilot testing resulted in a 12-item symptom construct rating scale, named the Psychopathy Checklist: Screening Version (PCL:SV). The PCL:SV was validated in 11 samples (N = 586) from forensic/nonpsychiatric, forensic/psychiatric, civil/psychiatric, and civil/nonpsychiatric settings. Results indicated that the PCL:SV had good internal consistency, interrater reliability, and temporal stability. The scale also appeared to have a two-factor structure, at least in samples with an appreciable base rate of psychopathy. The PCL:SV was highly correlated with other psychopathy-related measures, including the PCL-R, antisocial personality disorder symptom counts, and several self-report scales. It also had a pattern of convergent and discriminant validities that was consistent with both theory and previous research that used the PCL-R. It was concluded that the PCL:SV holds considerable promise as a measure of psychopathy; areas requiring further research were identified. / Arts, Faculty of / Psychology, Department of / Graduate

This ethnographic study explores the everyday experiences of recovery from an eating disorder. The fieldwork took place in Toronto and Ottawa, Ontario, Canada over a 4 month period in 2013. It involved interviews and participant observation with 12 women who were in various stages of recovery, as well as a reflexive component based on the researcher’s own experiences of recovery. The aim of the study was to uncover what it meant to recover from an eating disorder in terms of everyday eating. Specifically, “How did those in recovery learn to eat?” and “Were they learning to eat in an ‘ordered’ way?” The findings reveal there is a complex and challenging route to ‘ordered’ eating in Canadian society. Contemporary dietary practices compete for authority and popularity while simultaneously offering completely different ways of relating to and knowing food. Those in recovery are therefore lost in a maze of options telling them how to eat ‘right’ which further isolates them. The study shows however that learning to eat in recovery is not about eating in an ‘ordered’ way but more so about situating one’s self in contexts and within relationships; moving with food. It suggests that a way of moving forward in recovery is to let go of the correct ‘order’ to eating and to move forward in its continual making and unmaking.