The aetiology of bipolar disorder remains unclear and investigation to date has focussed largely on bipolar patients. Whilst ultimately of huge value, such studies may also be confounded by current mood or experience of repeated illness episodes or current or past medication; using at-risk samples may bypass some of these problems. The current research therefore assessed the efficacy of the Mood Disorder Questionnaire (MDQ) as a screening tool for vulnerability to bipolar disorder. The MDQ was used with two sets of criteria to identify two sub-groups of medication-naïve young bipolar phenotype subjects who were at risk for bipolar disorder by virtue of experience of mood elevation. Analysis of data from the Student Stress Survey was carried out to characterise the bipolar phenotype. Compared to a control group with no experience of mood elevation, the two bipolar phenotype sub-groups showed a gradient of prevalence of bipolar diagnosis and associated co-morbidity. Behavioural and functional magnetic resonance imaging (fMRI) techniques were employed to investigate emotional processing, decision-making, and sleep and circadian rhythmicity in bipolar phenotype students. Analyses revealed that positive emotional processing biases, disrupted decision-making, and increased activity during sleep were associated with the bipolar phenotype and, therefore, may represent vulnerability markers for bipolar disorder. Finally, a psychopharmacological investigation of quetiapine, which stabilises mood, was carried out in healthy volunteers. One-week quetiapine administration resulted in biases away from both positive and negative emotional stimuli (i.e. a mood-stabilising effect), reduced discrimination between different magnitudes of gains and losses during risky decision-making (consistent with an antidepressant effect), and increased sleep duration. In sum, this research has developed our understanding of vulnerability markers associated with the bipolar phenotype and provided a first step towards uncovering the psychological mechanisms through which quetiapine’s clinical effects may be mediated.

A Compra Compulsiva (CC) está atualmente classificada como um transtorno do controle dos impulsos não classificados em outro local (TCI). A prevalência das CC é estimada em cerca de 5% da população geral e é identificada com maior frequência no gênero feminino. O comportamento repetitivo e crônico do comportamento de gastar descontroladamente gera consequênias negativas ao indivíduo, além dos elevados índices de comorbidades com transtorno de humos, ansiedade e outros TCIs, o que contribui para manter a divergência existente sobre a classificação da CC. Tem sido proposto que CC deve ser classificada como um TCI, ou como uma sub-síndrome do transtorno afetivo bipolar (TAB), ou ainda como uma variante do transtorno obsessivo-compulsivo (TOC) semelhante ao armazenamento compulsivo. O objetivo deste estudo é investigar qual classificação pode ser mais adequada para a CC. Para isso, adotamos duas abordagens: a primeira abordagem é a investigação das categorias diagnósticas para identificar as comorbidades psiquiátricas; a segunda abordagem refere-se as dimensões psicopatológicas em que comparamos impulsividade, sintomas obsessivo-compulsivos, instabilidade afetiva e armazenamento em pacientes com CC, TOC e TAB. Foram selecionados 80 pacientes (24 CC, 35 TOC e 21 TAB que não estivessem em mania nem hipomania) primeiramente foram avaliados de acordo com o SCID-CV e da seção especial para TCI e depois responderam os questionários de autopreenchimento. Realizamos duas análises: categorial e dimensional. Na análise categorial houve um equilibrio de associação entre os três grupos diagnósticos, e as comorbidades psiquiátricas apresentadas pelos três grupos diagnósticos foram congruentes com as descritas na literatura. Na análise dimensional os pacientes de CC apresentaram escores significativamente mais altos em todas as medidas de impulsividade e na aquisição, mas não nas outras sub-dimensões do armazenamento compulsivo, amontoamento e dificuldade em descartar. Pacientes bipolares pontuaram mais na dimensão mania da escala SCI-MOODS. Pacientes com TOC pontuaram mais nos sintomas obsessivo-compulsivos, e principalmente nas dimensões contaminação/lavagem e checagem da escala Pádua Inventory; no entanto, eles não apresentaram maior pontuação em nenhuma dimensão do armazenamento compulsivo. Um modelo discriminante foi construído com essas variáveis e classificou corretamente os pacientes de CC (79%), TOC (77%) e TAB (71%). Considerando os resultados da análise categorial cada um dos transtornos apresentou uma agregação categorial distinta, e na análise dimensional os pacientes com CC revelaram ter aquisição impulsiva, assemelhando-se aos TCI ao invés de TOC ou TAB. Sintomas maníacos foram bem distintos nos pacientes bipolares, assim como pacientes com TOC apresentaram mais obsessão e compulsão. Sintomas de armazenamento com exceção da aquisição não foram particularmente associados a qualquer grupo diagnóstico / Compulsive Buying (CB) is currently classified as an impulse control disorder not elsewhere classified (ICD). The prevalence of CB is estimated at around 5% of the general population and is identified with greater frequency in females. The chronic repetitive behavior and the behavior of spending wildly generates negative consequences to the individual, in addition to high rates of comorbidity with mood disorder, anxiety and other ICDs, which helps to maintain the existing disagreement on the classification of CB. It has been proposed that CB should be classified as an ICD, or as a sub-syndrome of bipolar disorder (BD), or as a variant of obsessive-compulsive disorder (OCD), similar to compulsive hoarding. The aim of this study is to investigate which classification is best suited for CB. For this, we adopt two approaches: the first approach is the investigation of the diagnostic categories to identify psychiatric comorbidities, the second approach refers to the psychopathological dimensions in which we compared impulsivity, obsessive-compulsive symptoms, affective instability and hoarding in patients with CB, OCD and BD. We selected 80 patients (24 CB, 35 OCD and 21 BD who were not in mania or hypomania) were first evaluated according to the SCID-CV and the special section to TCI, then answered the self-report questionnaires. We performed two analyses: categorical and dimensional. In categorical analysis, there was a balance of association between the three diagnostic groups, and psychiatric comorbidities by the three diagnostic groups were consistent with those described in the literature. In dimensional analysis of CB patients, there were significantly higher scores in all measures of impulsivity and the acquisition, but not in other sub-dimensions of the compulsive hoarding, clutter and difficulty discarding. Bipolar patients scored higher on the mania dimension from the SCI-MOODS scale. OCD patients scored higher on obsessive-compulsive symptoms, and, particularly, higher on the contamination/washing and checking dimensions from the Padua Inventory scale; however, they did not score higher on any hoarding dimension. A discriminant model built with these variables correctly classified patients of CB (79%), OCD (77%) and BD (71%). Considering the results of categorical analysis, each of the disorders presented a distinct clustering categorical, and dimensional analysis in patients with CB reported having impulsive acquisition, resembling the TCI instead of OCD or BD. Manic symptoms were distinctive of BD patients, and patients with OCD were distinctive obsession and compulsion. Hoarding symptoms other than acquisition were not particularly associated with any diagnostic group

This investigation examined the association between Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) posttraumatic stress disorder (PTSD; American Psychological Association, 1994) symptoms as measured by the Children’s PTSD Inventory (CPTSDI; Saigh, 2003a) and the Wechsler Intelligence Scale for Children, 3rd Edition (WISC-III; Wechsler, 1991) scores of 78 traumatized children (mean age = 13.42 years, SD = 2.68 years). Child diagnostic interviews determined that the participants did not have major comorbid disorders and were not taking medications that could influence cognitive functioning. Significant inverse correlations were observed between the different symptom CPTSDI clusters and the WISC-III Verbal indices. Moreover, with the exception of the WISC-III Block Design subtest, nonsignificant correlations were observed between the WISC-III Performance measures and the CPTSDI symptom clusters. Theoretical and clinical implications are considered.

<p>Individuals afflicted with childhood and adolescent mental disorders have an increased risk for poor outcome in adulthood. The progression of psychopathology from childhood to adult life may be influenced by a multitude of interacting variables, both biological and psychosocial. There is limited information on the relationships between child psychopathology and adult personality and personality disorders. The main aim of this thesis was therefore to gain better knowledge concerning adult personality outcome in patients with early onset of mental disorders. </p><p>Former child psychiatric patients as compared to controls had a significantly higher prevalence of all DSM-IV personality disorders (38.0 vs. 10.9 percent, p<0.001) and also a considerably higher personality disorder co-morbidity. They also had more psychosocial and environmental problems. This was exaggerated in those diagnosed with a personality disorder. Major depression, disruptive disorders and substance use disorders at a young age were strong predictors for adult personality disorder.</p><p>Patients with an early onset major depression had more personality disorders and more deviant personality traits than those with a late onset. </p><p>Forensic psychiatric male patients diagnosed with a previous conduct disorder as compared to those without had more cluster B personality disorders, and more repeated violent criminality and mixed abuse. They also exhibited more deviant personality traits and higher psychopathy scores.</p><p>The instrument "Child and Adolescent Psychiatric Screening Inventory-Retrospect" had acceptable sensitivity and specificity for assessment of child psychiatric disorders. Subscales demonstrated good internal reliability (Crohnbach´s alpha = 0.76-0.93).</p><p>The results suggest that adult personality disturbances are prevalent in individuals affected with mental problems at young ages. A better understanding of the transition of psychopathology from childhood to adulthood and a better identification of those at risk will be of help in attempts to prevent permanent impact on the adult personality.</p>

Individuals afflicted with childhood and adolescent mental disorders have an increased risk for poor outcome in adulthood. The progression of psychopathology from childhood to adult life may be influenced by a multitude of interacting variables, both biological and psychosocial. There is limited information on the relationships between child psychopathology and adult personality and personality disorders. The main aim of this thesis was therefore to gain better knowledge concerning adult personality outcome in patients with early onset of mental disorders. Former child psychiatric patients as compared to controls had a significantly higher prevalence of all DSM-IV personality disorders (38.0 vs. 10.9 percent, p&lt;0.001) and also a considerably higher personality disorder co-morbidity. They also had more psychosocial and environmental problems. This was exaggerated in those diagnosed with a personality disorder. Major depression, disruptive disorders and substance use disorders at a young age were strong predictors for adult personality disorder. Patients with an early onset major depression had more personality disorders and more deviant personality traits than those with a late onset. Forensic psychiatric male patients diagnosed with a previous conduct disorder as compared to those without had more cluster B personality disorders, and more repeated violent criminality and mixed abuse. They also exhibited more deviant personality traits and higher psychopathy scores. The instrument "Child and Adolescent Psychiatric Screening Inventory-Retrospect" had acceptable sensitivity and specificity for assessment of child psychiatric disorders. Subscales demonstrated good internal reliability (Crohnbach´s alpha = 0.76-0.93). The results suggest that adult personality disturbances are prevalent in individuals affected with mental problems at young ages. A better understanding of the transition of psychopathology from childhood to adulthood and a better identification of those at risk will be of help in attempts to prevent permanent impact on the adult personality.

Arguments have been made for dimensional models over categorical for the classification of personality disorder, and for the five-factor model (FFM) in particular. A criticism of the FFM of personality disorder is the absence of measures designed to assess pathological personality. Several measures have been developed based on the FFM to assess the maladaptive personality traits included within existing personality disorders. One such example is the Five-Factor Obsessive-Compulsive Inventory (FFOCI). The current study applied item response theory analyses (IRT) to test whether scales of the FFOCI are extreme variants of respective FFM facet scales. It was predicted that both the height and slope of the item-response curves would differ for the conscientiousness-based scales, due to the bias towards assessing high conscientiousness as adaptive in general personality inventories (such as Goldberg’s International Personality Item Pool; IPIP). Alternatively, the remaining FFOCI scales and their IPIP counterparts were predicted to demonstrate no significant differences in IRCs across theta. Nine hundred and seventy-two adults each completed the FFOCI and the IPIP, including 377 undergraduate students and 595 participants recruited online. A portion of the results supported the hypotheses, with select exceptions. Fastidiousness and Workaholism demonstrated the expected trends, with the FFOCI providing higher levels of fidelity at the higher end of theta, and the IPIP demonstrating superior coverage at the lower end of theta. Other conscientiousness scales failed to demonstrate the expected differences at a statistically significant level. In this context, the suitability of IRT in the analysis of rationally-derived, polytomous scales is explored.

This study focused on trauma and seeked to demonstrate that the application of a Buberian understanding to the experience of trauma can help shed light on the impact of trauma on a sufferer's life. The aim of the study was to gain an understanding of the impact of trauma on interpersonal relationships as well as to determine components of psychotherapy found most helpful in the recovering process.

Thesis (Ph.D. in Epidemiology) -- University of Colorado Denver, 2008. / Typescript. Includes bibliographical references (leaves 103-109). Free to UCD Anschutz Medical Campus. Online version available via ProQuest Digital Dissertations;

A Compra Compulsiva (CC) está atualmente classificada como um transtorno do controle dos impulsos não classificados em outro local (TCI). A prevalência das CC é estimada em cerca de 5% da população geral e é identificada com maior frequência no gênero feminino. O comportamento repetitivo e crônico do comportamento de gastar descontroladamente gera consequênias negativas ao indivíduo, além dos elevados índices de comorbidades com transtorno de humos, ansiedade e outros TCIs, o que contribui para manter a divergência existente sobre a classificação da CC. Tem sido proposto que CC deve ser classificada como um TCI, ou como uma sub-síndrome do transtorno afetivo bipolar (TAB), ou ainda como uma variante do transtorno obsessivo-compulsivo (TOC) semelhante ao armazenamento compulsivo. O objetivo deste estudo é investigar qual classificação pode ser mais adequada para a CC. Para isso, adotamos duas abordagens: a primeira abordagem é a investigação das categorias diagnósticas para identificar as comorbidades psiquiátricas; a segunda abordagem refere-se as dimensões psicopatológicas em que comparamos impulsividade, sintomas obsessivo-compulsivos, instabilidade afetiva e armazenamento em pacientes com CC, TOC e TAB. Foram selecionados 80 pacientes (24 CC, 35 TOC e 21 TAB que não estivessem em mania nem hipomania) primeiramente foram avaliados de acordo com o SCID-CV e da seção especial para TCI e depois responderam os questionários de autopreenchimento. Realizamos duas análises: categorial e dimensional. Na análise categorial houve um equilibrio de associação entre os três grupos diagnósticos, e as comorbidades psiquiátricas apresentadas pelos três grupos diagnósticos foram congruentes com as descritas na literatura. Na análise dimensional os pacientes de CC apresentaram escores significativamente mais altos em todas as medidas de impulsividade e na aquisição, mas não nas outras sub-dimensões do armazenamento compulsivo, amontoamento e dificuldade em descartar. Pacientes bipolares pontuaram mais na dimensão mania da escala SCI-MOODS. Pacientes com TOC pontuaram mais nos sintomas obsessivo-compulsivos, e principalmente nas dimensões contaminação/lavagem e checagem da escala Pádua Inventory; no entanto, eles não apresentaram maior pontuação em nenhuma dimensão do armazenamento compulsivo. Um modelo discriminante foi construído com essas variáveis e classificou corretamente os pacientes de CC (79%), TOC (77%) e TAB (71%). Considerando os resultados da análise categorial cada um dos transtornos apresentou uma agregação categorial distinta, e na análise dimensional os pacientes com CC revelaram ter aquisição impulsiva, assemelhando-se aos TCI ao invés de TOC ou TAB. Sintomas maníacos foram bem distintos nos pacientes bipolares, assim como pacientes com TOC apresentaram mais obsessão e compulsão. Sintomas de armazenamento com exceção da aquisição não foram particularmente associados a qualquer grupo diagnóstico / Compulsive Buying (CB) is currently classified as an impulse control disorder not elsewhere classified (ICD). The prevalence of CB is estimated at around 5% of the general population and is identified with greater frequency in females. The chronic repetitive behavior and the behavior of spending wildly generates negative consequences to the individual, in addition to high rates of comorbidity with mood disorder, anxiety and other ICDs, which helps to maintain the existing disagreement on the classification of CB. It has been proposed that CB should be classified as an ICD, or as a sub-syndrome of bipolar disorder (BD), or as a variant of obsessive-compulsive disorder (OCD), similar to compulsive hoarding. The aim of this study is to investigate which classification is best suited for CB. For this, we adopt two approaches: the first approach is the investigation of the diagnostic categories to identify psychiatric comorbidities, the second approach refers to the psychopathological dimensions in which we compared impulsivity, obsessive-compulsive symptoms, affective instability and hoarding in patients with CB, OCD and BD. We selected 80 patients (24 CB, 35 OCD and 21 BD who were not in mania or hypomania) were first evaluated according to the SCID-CV and the special section to TCI, then answered the self-report questionnaires. We performed two analyses: categorical and dimensional. In categorical analysis, there was a balance of association between the three diagnostic groups, and psychiatric comorbidities by the three diagnostic groups were consistent with those described in the literature. In dimensional analysis of CB patients, there were significantly higher scores in all measures of impulsivity and the acquisition, but not in other sub-dimensions of the compulsive hoarding, clutter and difficulty discarding. Bipolar patients scored higher on the mania dimension from the SCI-MOODS scale. OCD patients scored higher on obsessive-compulsive symptoms, and, particularly, higher on the contamination/washing and checking dimensions from the Padua Inventory scale; however, they did not score higher on any hoarding dimension. A discriminant model built with these variables correctly classified patients of CB (79%), OCD (77%) and BD (71%). Considering the results of categorical analysis, each of the disorders presented a distinct clustering categorical, and dimensional analysis in patients with CB reported having impulsive acquisition, resembling the TCI instead of OCD or BD. Manic symptoms were distinctive of BD patients, and patients with OCD were distinctive obsession and compulsion. Hoarding symptoms other than acquisition were not particularly associated with any diagnostic group

Introduction: Lower extremity (LE) work-related musculoskeletal disorders (WMSDs) are known to occur with cumulative exposure to occupational and personal risks. The objective of this dissertation study was to find if creating a quantifiable risk detection model for the LE was feasible. The primary product of the literature review conducted for this study resulted in focusing the attention of the model development process onto creating the initial model of the LE for assessing knee disorder risk factors. Literature Review: LE occupational disorders affect numerous industries and thousands of people each year by affecting any one of the musculoskeletal systems deemed susceptible by the occupational and personal risk factors involved. Industries known to be affected tend to have labor intensive job descriptions. Some of the numerous industry examples include mining, manufacturing, firefighting, and carpet laying. Types of WMSDs noticed by the literature include bursitis, osteoarthritis, stress fractures, tissue inflammation, and nerve entrapment. In addition to the occupationally related disorders that may develop, occupationally related discomforts were also taken into consideration by this study. Generally, both the disorders and the discomforts can be traced to either a personal or occupational risk factor or both. Personal risk factors noted by the literature include a person's physical fitness and health history (such as past injuries). Meanwhile, occupational risks can be generalized to physical postures, activities, and even joint angles. Prevalence data over a three year interval (2003-2005) has found that LE WMSDs make up on average approximately 7.5% of all the WMSD cases reported to the US Occupational Safety and Health Administration (OSHA). When the literature is refined to the information pertaining to occupational knee disorders, the mean prevalence percentage of the same three year range is about 5%. Mean cost for knee injuries were found to be $18,495 (for the year between 2003 and 2004). Methodology: Developing a risk model for the knee meant using groups of subject matter experts for model development and task hazard analysis. Sample occupational risk data also needed to be gathered for each of a series of tasks so that the model could be validated. These sample data were collected from a sample aircraft assembly plant of a US aerospace manufacturer. Results: Based on the disorder and risk data found in the literature, a knee risk assessment model was developed to utilize observational, questionnaire, and direct measure data collection methods. The final version of this study's knee model has an inventory of 11 risk factors (8 occupational and 3 personal) each with varying degrees of risk exposure thresholds (e.g., high risk, moderate risk, or minimal risk). For the occupational risk assessment portion of the model, the results of task evaluations include both an occupational risk resultant score (risk score) and a task risk level (safe or hazardous). This set of results is also available for a cumulative (whole day) assessment. The personal risk assessment portion only produces a risk resultant score. Validation of the knee risk model reveals statistically (t (34) = 1.512, p = 0.156), that it is functioning as it should and can decide between hazardous and safe tasks. Additionally, the model is also capable of analyzing tasks as a series of cumulative daily events and providing an occupational and personal risk overview for individuals. Conclusion: While the model proved to be functional to the given sample site and hypothetical situations, further studies are needed outside of the aerospace manufacturing environment to continue testing both the model's validity and applicability to other industrial environments. The iterative adjustments generated for the occupational risk portion of the model (to reduce false positives and negatives) will need additional studies that will further evaluate professional human judgment of knee risk against this model's results. Future investigations must also make subject matter experts aware of the minimal risk levels of this knee risk assessment model so that task observational results are equally comparable. Additional studies are moreover needed to assess the intimate nature between variable interactions; especially multiple model defined minimal risks within a single task.