The primary objective of this study is to increase knowledge about the inter-relationship between parenting and obsessive-compulsive disorder in children and adolescents. More specifically, this study sets out to understand the impact or influence of fathers on children and adolescents with obsessive-compulsive disorder. This study further examines the changing roles of fathers and the impact these have on their children with obsessive-compulsive disorder. In an attempt to gain new insights into the father-child relationship, I have placed an emphasis on both risk and protective factors. That is, the study examines the lived experience of these fathers encompassing their interpretation of their children's obsessions and compulsions as well as their response to same, which has further consequences for themselves and their children. I was also the intent of this study to move away from "blaming" the parent or the child and instead, to examine the transactional nature of the emergence and maintenance of obsessive-compulsive disorder.

Almost all neuropsychological studies of adult bipolar disorder (BP) have failed to control for the established cognitive effects of attention deficit hyperactivity disorder (ADHD), and often other covariates. ADHD comorbidity in BP is common, and has already been shown to significantly worsen the clinical presentation of BP. This study of young adults (16 - 34 years) aimed to establish whether ADHD and BP with childhood ADHD groups had more impaired cognitive profiles (after controlling for numerous covariates) relative to BP without childhood ADHD and control groups. Using recognised structured and semi-structured clinical interviews and symptom rating scales, BP with (n = 18) or without (n = 66) childhood ADHD groups were recruited from a therapy study, and ADHD (n = 27) and control (n = 26) groups were recruited from the community. Participants completed tests (some from the Cambridge Neuropsychological Test Automated Battery) of executive functioning, memory, attention and psychomotor speed. MANCOVA results for cognitive performance indicated that the BP with childhood ADHD group did not differ significantly from the other three groups (except on a test of visual object memory, where it outperformed the ADHD group). The ADHD group was impaired relative to the BP without childhood ADHD and control groups on measures of verbal and visual memory. It was also more impaired than controls on a measure of attention. The BP without childhood ADHD group had visual memory and attention difficulties relative to controls. Compared to BP (controlling for ADHD), ADHD is associated with a more diverse range of cognitive impairment. Nevertheless, individuals with BP may independently demonstrate memory and attention difficulties which have the potential to interfere with treatment and day-to-day functioning.

Children with autism spectrum disorder (ASD) are shaped and in turn shape the people in their environment especially those closest to them, their parents and their siblings. When the sibling relationships between children with ASD and their typically developing siblings are considered, challenges and opportunities present themselves for both siblings. This study assessed the effectiveness of a sibling intervention that aimed to meet the needs of both siblings involved. It was initially hypothesised that teaching the typically developing children responsive strategy use would enhance their interactions between the children leading to increases in the quality of the sibling relationship and in the well-being of both siblings. In addition, the typically developing children were given developmentally appropriate information on their sibling’s difficulties, information on emotions, and the opportunity to play mutually enjoyable games with their sibling with ASD to enhance their motivation to persist in attempts at interacting with their sibling with ASD. Initial findings suggested that the planned intervention was not necessarily benefitting the typically developing children. The focus of the intervention changed to include a more explicit focus on the influence of the intervention on the typically developing children. Changes were made, by de-emphasising the strategy component and emphasising the other components, to enable both siblings to benefit from the intervention. Findings indicated that the typically developing children had existing skills for interacting with their siblings with ASD. Increases in the quality of the sibling interactions and the well-being of both children seemed to be most strongly related to aspects of the intervention that increased the warmth of the children’s feelings towards each other and the typically developing children’s understanding and tolerance of their sibling with ASD. Overall, the findings from this project emphasised the importance of supporting family members of children with ASD for the benefit of both the family members and the benefit of the children with ASD.

No description available.

Congenital Talipes Equinovarus is the commonest congenital musculoskeletal disorder with an incidence of 1 in 1000 live births. Although there has been much research into various aspects of the condition, there are still many unanswered questions. CTEV shows a spectrum of severity. In practice, a small percentage of cases resolve completely shortly after birth, but the remainder require further management with surgery in up to 80% of patients in some series. In children under the age of 6, soft tissue operations are often all that is required. After that age however, bony procedures are often necessary as the growing bones adapt to their abnormal environments. A number of factors have been investigated to assess the results of initial management and predict which patients will require further treatment, but there is little agreement between authors as to what variables should be studied. Outcome and the assessment of different management strategies is also contentious. This study describes the assessment of 204 families identified as having at least one child with congenital talipes. Outcome was initially assessed using a subjective scoring system. This was then used to evaluate a number of proposed objective and clinical outcome measures. On the basis of this, an objective system of assessment is proposed using measurement of foot length discrepancy, calf circumference, and range of movement at the ankle. Management was then evaluated objectively showing that in the medium term, a prolonged period of conservative management with Denis Browne splints and boots produced the best outcome. Despite a number of family studies looking at inheritance patterns in CTEV, the mode of genetic transmission remains unclear, and, while a number of environmental factors have been linked to CTEV, scientific methodology, in particular lack of a control group, limits the conclusions which can be drawn. Analysis of 176 family pedigrees demonstrates that CTEV may have an autosomal dominant mode of inheritance in a subgroup of cases. This study also presents the results of a case control study of epidemiological factors in CTEV, demonstrating a link between smoking and CTEV.

No description available.

No description available.

Interest in mental health problems in the military has been growing. However, the research to date has focused on posttraumatic stress disorder and depression. This study focuses on panic disorder and panic attacks, which are common, potentially disabling, and associated with a number of other mental health problems. This study is the first to examine panic disorder in detail in the military and extends the literature to include panic attacks, which have never been examined in this population. Using the Canadian Community Health Survey: Canadian Forces Supplement (n=8441), I investigated associations between panic disorder and panic attacks with a wide range of mental and social variables. Panic attacks and panic disorder were both positively associated with reduction of activities, two-week disability, psychological distress, mental disorders, suicidal ideation, and using self-soothing and avoidant coping strategies. These results have important implications for treatment and prevention efforts in the Canadian military.

The primary objective of this study is to increase knowledge about the inter-relationship between parenting and obsessive-compulsive disorder in children and adolescents. More specifically, this study sets out to understand the impact or influence of fathers on children and adolescents with obsessive-compulsive disorder. This study further examines the changing roles of fathers and the impact these have on their children with obsessive-compulsive disorder. In an attempt to gain new insights into the father-child relationship, I have placed an emphasis on both risk and protective factors. That is, the study examines the lived experience of these fathers encompassing their interpretation of their children's obsessions and compulsions as well as their response to same, which has further consequences for themselves and their children. I was also the intent of this study to move away from "blaming" the parent or the child and instead, to examine the transactional nature of the emergence and maintenance of obsessive-compulsive disorder.

No description available.