To date, research on the effect of depressive symptomatology on victim-witness identification is scarce even though depressive symptomatology is highly prevalent in the victim-witness experience. Furthermore, being a victim-witness often instigates the use of counselling services, which could cause a shift in affect, and applying mood dependent memory theories, any change in affect should be detrimental to eyewitness accuracy. Still, individuals suffering from subclinical depression, or dysphoria, have exhibited heightened perceptual skills, and depressed affect exhibits remarkable stability over time. Therefore, I theorized that: (1) dysphoric people’s heightened sensitivity and motivation towards accurate understanding may result in more accurate eyewitness identifications, and (2) individuals who express stable levels of dysphoria should have greater eyewitness identification accuracy than should people with stable levels of nondysphoria, with stable levels of severe depressive symptomatology, or with unstable depressive symptomatology. In Study One, 132 students were randomly assigned to one of three autobiographical mood inductions: a positive, negative, or neutral/control. Following this manipulation, participants completed 12 experimental trials each consisting of a target exposure, a 30-second distraction task, and lastly, a six-person simultaneous line-up. Higher levels of dysphoria were associated with greater overall identification accuracy and that temporary mood conferred an advantage only when participants recalled highly sad memories. In Study Two, 173 participants were exposed to 12 target faces at a first session and returned two-to-four weeks later to identify these faces from 12 six-person simultaneous line-ups. Individuals who exhibited stable levels of dysphoria from eyewitness event to the line-up task performed significantly better on the simultaneous line-ups than all of the other groups. Among those exhibiting unstable dysphoria, people whose depressive symptomatology improved were almost as accurate as those who had stable dysphoria. These results support the need for victim-witnesses to receive immediate help to stabilize or improve depressive symptomatology not just for their mental well-being but also to preserve eyewitness accuracy. / Thesis (Master, Psychology) -- Queen's University, 2010-09-23 13:11:50.153

No description available.

Antalet diagnoser av könsdysfori (KD), har ökat markant i Sverige och andra delar av västvärlden sedan 2008. Merparten av denna ökning utgörs av flickor i tonåren, vilka numera utgör den största gruppen av transpersoner. Tidigare studier av denna till synes nya population baseras på rapporter från föräldrar, som kan vara icke-representativa på flera olika sätt. För att undvika en del av dessa problem rekryterades skolpersonal, som fick besvara en enkät om antalet transidentifieradeelever som de känner till, och hur många som förekommer i samma klass eller kamratgrupp. Hypoteserna var att (1) transpersoner i åldrarna 13- 20 år är födda som flickor i högre utsträckning än som pojkar, (2) att fler än en transidentifierad elev återfinns i samma klassrum eller sociala krets inom en skola är vanligare än förväntat av slumpen, och (3) detta är vanligare bland flickor än pojkar. Enkäten annonserades via Facebooksidor och via e-post till rektorer för svenska grund- och gymnasieskolor. Den besvarades av 196 personer, som rapporterade om 176 transpersoner i 103 olika skolor. Av dessa var 103 flickor (58.5%) och 73 pojkar (41.5%), vilket är en signifikant skillnad. 12 transpersoner var samtidiga i samma klass, 24 i samma kamratgrupp, och 72 i samma skola. Som mest gick fyra transpersoner i samma skola under samma tid. I inget klassrum eller kamratgrupp rapporterades fler än två transpersoner. Utifrån dessa antal kunde inga definitiva slutsatser dras men vårt sampel indikerade att KD inte är medierad inomkamratgrupper. / A significant increase of gender dysphoria (GD) diagnosis has been reported in Sweden and the rest of the West since 2008. The majority of the increase is attributed to biological girls, 13-20 years, who have superseded biological boys in the amount of GD diagnosis. Studies of this seemingly new population were based on parentreports, which can be considered as non-representative for various reasons. To avoid some of those issues school-personnel were recruited as respondents. Three hypotheses were tested; (1) transpersons 13-20 are born as girls at a higher rate than boys, (2) more than one transidentified student in a classroom or social circle in a school is more common than expected by chance, (3) if 2 differs between the sexes it ́s more common amongst those born as girls than those born as boys. The survey posed questions regarding the quantity of transpersons respondents encountered, how many of those were in the same classroom. It was posted on Facebook- pages and emailed to principals of Swedish elementary- and upper secondary schools. 196 persons responded and reported 176 transpersons in 103 different schools. Girls were overrepresented, 103 (58.5%) versus 73 boys (41.5%). Of the 176 reported transpersons, 72 attended a schoolwith at least one other transperson. 12 were part of the same classroom, 24 of the same friendgroup. No more than 4 attended the same school. No class or friendgroup consisted of more than two. No definitive conclusions were made but our sample indicated that GD was not mediated by friendshipgroups.

Bakgrund: Könsdysfori är en beskrivande term som redogör för individens känslo- eller tankemässiga missnöje med det kön som tilldelats vid födseln vilket medför ett lidande för individen. Personer med könsdysfori har hög förekomst av samtidiga psykiatriska diagnoser. Syfte: Syftet med studien var att beskriva hur personal inom psykiatrin erfar omvårdnaden av personer med könsdysfori. Metod: Kvalitativ studie med semistrukturerade intervjuer. Urvalet bestod av tio respondenter arbetandes inom psykiatrisk öppenvård och slutenvård. Materialet har analyserats med tematisk innehållsanalys. Resultat: Det framkommer att patientgruppen kan upplevas som utmanande att möta utifrån olika aspekter. Detta är delvis kopplat till personalens vilja att ge god vård och bidra till minskat lidande för patienterna samtidigt som personalen ofta känner osäkerhet i mötena. Omvårdnadshandlingar sker främst via samtal och psykiatripersonalen visar delvis förståelse för patientens livsvärld och lidande. Utöver detta framkommer det också att personalen upplever kunskapsbrist och ser ett behov av ökad kunskap. Konklusion: Att möta patienter med könsdysfori kan upplevas komplext och svårt. Inom vården finns en okunskap som sannolikt adderar till redan befintligt stigma. Dock utförs omvårdnadshandlingar som ligger i linje med aktuell forskning samt nationella och internationella riktlinjer. / Background: Gender dysphoria is a descriptive term that describes the individual's emotional or mental dissatisfaction with the gender assigned at birth, which causes suffering for the individual. People with gender dysphoria have a high incidence of concomitant psychiatric diagnosis. Aim: The purpose of the study was to describe how staff in psychiatry experience the care of people with gender dysphoria. Method: Qualitative study with semi-structured interviews. The sample consisted of ten respondents working in psychiatry. The material has been analyzed using thematic analysis. Results: The results shows that the patient group can be experienced as challenging to meet based on different aspects. This is partly linked to the staff's willingness to provide good care and contribute to reduced suffering for the patients, while the staff often feel insecurity. Nursing actions take place mainly through conversations and the psychiatric staff show a partial understanding of the patient's lifeworld and suffering. In addition to this, it also appears that the staff experience a lack of knowledge and sees a need for increased knowledge. Conclusion: Meeting patients with gender dysphoria can be experienced as complex and difficult. Healthcare services sometimes lacks knowledge that probably adds to an already existing stigma. However, to some extent nursing actions are delivered in line with current research as well as national and international guidelines.

Transgender (TG) persons often receive, or self-treat, with cross-sex hormone (CSH) treatments as part of their treatment plans, with little known about their incidence of breast cancer. This information gap can lead to disparities in the provision of transgender health care. The purpose of the study was to examine the incidence of breast cancer in the largest North American sample of TG patients studied to date to determine their exposure to CSH, incidence of breast cancer, and to compare results with European studies in transsexual populations. We used Veterans Health Administration (VHA) data from 5,135 TG veterans in the United States from 1996 to 2013 to determine the incidence of breast cancer in this population. Chart reviews were completed on all patients who developed breast cancer. Age-standardized incidences of breast cancer from the general population were used for comparison. Person-years of exposure to known CSH treatment were calculated. Ten breast cancer cases were confirmed. Seven were in female-to-male patients, two in male-to-female patients, and one in a natal male with transvestic fetishism. Average age at diagnosis was 63.8 (SD = 8.2). 52 % received >1 dose of CSH treatment from VHA clinicians. All three males presented with late-stage disease were proved fatal. The overall incidence rate was 20.0/100,000 patient-years of VHA treatment (95 % CI 9.6–36.8), irrespective of VA CSH treatment. This rate did not differ from the expected rate in an age-standardized national sample, but exceeded that reported for smaller European studies of transsexual patients that were longer in duration. Although definitive conclusions cannot be made regarding breast cancer incidence in TG veterans who did or did not receive VA CSH due to the sample size and duration of observation, it appears that TG veterans do not display an increase in breast cancer incidence. This is consistent with European studies of longer duration that conclude that CSH treatment in gender dysphoric patients of either birth sex does not result in a greater incidence than the general population.

Bakgrund  Transperson är ett begrepp som innefattar ett flertal olika könsidentiteter, många transpersoner lider av könsdysfori. En person med könsdysfori har ofta en önskan om att korrigera sin kropp, men för att kunna göra det krävs en könsidentitetsutredning, vilket är en lång och påfrestande process. Denna väntan på behandling för att få känna sig hemma i sin egen kropp, att bryta mot normen, att inte längre ha möjligheten till biologiska barn och att ständigt behöva ställas inför situationer då det är nödvändigt att ”komma ut” kan påverka hälsan, såväl psykiskt som fysiskt. Syfte Syftet var att beskriva transpersoners upplevelse av hälsa.  Metod En litteraturöversikt har genomförts. Totalt inkluderades 16 artiklar publicerade mellan år 2012 och 2019 med både kvantitativ och kvalitativ metod. Resultat Fyra kategorier identifierades; Livskvalitet, Det allmänna hälsotillståndet, Suicid och suicidala handlingar samt Kontakt med vården. Både livskvaliteten och det allmänna hälsotillståndet är sämre hos transpersoner jämfört med övriga befolkningen. Transpersoner har även en högre suicidfrekvensen och utsätts ofta för både diskriminering och våld. Det sociala nätverket är bristande vilket har en negativ effekt på den upplevda hälsan. Kontakten med vården skjuts ofta upp på grund av bristande bemötande och okunskap bland vårdpersonalen.  Slutsats Transpersoner är en utsatt grupp nationellt såväl som internationellt och hälsan är sämre än övriga befolkningens. Kunskapen om trans är generellt låg bland vårdpersonal. Ett sätt att säkerställa kompetens och förbättrat bemötande vore att utbildning om trans och HBTQ inkluderas i läkar- och sjuksköterskeutbildningarna. Det finns även ett behov av att könsidentitetsutredningens utformning ses över. / Background Trans person is a term that encompasses multiple gender identities, many transgender people suffer from gender dysphoria. They often have a desire to undergo gender reassignment surgery, but in order to do so, a gender identity investigation is required, which is a long and stressful process. The wait for treatment to feel at home in one's own body, being deprived of the possibility of biological children, breaking the norm and constantly having to face situations when it is necessary to "come out" could affect health, both mentally and physically.  Aim The aim was to describe trans people´s experiences of health. Method A literature review has been conducted with a total of 16 included articles, using quantitative as well as qualitative method, published between the years 2012 and 2019. Results Four categories were identified; Quality of life, General health, Suicide and suicidal acts and Contact with health care. The quality of life and experienced health among transgender people is poorer than in the rest of the population. Suicide rates are higher and transgender people are often subjected to both discrimination and violence. Their social network is lacking which has a negative effect on the perceived health. Contact with health care is often postponed due to bad encounters and ignorance from the health care professionals. Conclusion Transgender people are a vulnerable group nationally as well as internationally, and the experienced health in this group is poorer than in the rest of the population. The knowledge about trans is low among healthcare professionals. One way to ensure competence of healthcare staff is to include education on trans and LGBTQ in the physician- and nurse educational programs. There is also a need for the gender identity investigation to be reviewed.

Body Integrity Dysphoria (BID) is a rare condition where a person has a desire to become disabled. This desire creates distress so intense that some request, and in a few cases have received, disabling surgery. The condition has raised debate, both concerning the BID suffers autonomy and whether the disabling surgeries conflict with the medical profession's obligations to respect patients’ autonomy, promote well-being and not do harm. In this paper, I argue that some BID sufferers plausibly possess the abilities required for medical decisionmaking, which means that they could be sufficiently autonomous to make a decision about disabling surgery. Further, I argue that if a BID sufferer is decision-making competent, and if disabling surgery is expected to have therapeutic benefits that outweigh the expected harms, and if no other treatments have proven effective for them, then it seems morally permissible for the medical profession to offer them disabling surgery as an experimental treatment.

Under de senaste 10 åren har gruppen som sökt hjälp för könsdysfori ökat. Personer med könsdysfori är särskilt utsatta för att utveckla psykisk ohälsa jämfört med befolkningen i övrigt. Det saknas dock kunskap om deras närståendes upplevelser. Den här studien är del av svenska könsdysforistudien, SKDS. Syftet med studien var att i en svensk kontext undersöka närståendes upplevelse av att leva nära en person som genomgår utredning och behandling för könsdysfori. Utifrån semistrukturerade intervjuer med elva närstående tolkades materialet genom induktiv tematisk analys. Analysen visade att de närstående upplevt att relationen fördjupats genom processen. Oavsett varierande reaktioner initialt har samtliga närstående landat i en vilja att genom fördjupad kunskap stå upp för den vårdsökande. För många har processen känts tung och ensam. Samsjuklighet och minoritetsstress har bidragit till ökad komplexitet och tyngd. Man har också hittat kraft i den gemensamma kampen. En slutsats är att den icke-dömande hållningen och oreserverade acceptansen hos de närstående, inte i samma grad återspeglats i internationella studier. En ytterligare slutsats är att de närstående utgör en viktig resurs i den vårdsökandes möjlighet till ett gynnsamt behandlingsutfall och att de närstående behöver uppmärksammas och erbjudas stöd för att själva kunna vara ett stöd. / Delstudie till Svenska könsdysforistudien (SKDS)

[pt] Este trabalho é fruto da conjunção de quatro escritos independentes, mas que guardam entre si o mesmo fio contudor, o mesmo leitmotiv: a psicopatologia da vida sexual, em geral, e o diagnóstico de disforia de gênero, em particular. Ele busca perfazer a genealogia da categoria diagnóstica no DSM, analisando os dispositivos de poder que a engendraram e a mantêm no rol dos transtornos psiquiátricos. Discutimos sua função como sustentáculo do tratamento transicionador, bem como os efeitos a longo prazo deste último. Por fim, propomos um prognóstico do diagnóstico baseados nas contingências contemporâneas e precedentes históricos. / [en] This work is the result of the conjunction of four independent writings, which maintain between them the same leitmotiv, the psychopathology of sexual life in general, and the diagnosis of gender dysphoria in particular. It seeks to make the genealogy of the diagnostic category in the DSM, analyzing the power strategies that produced and maintain it in the role of psychiatric disorders. We discuss its function as a supporter for the transitional treatment model, as well as the long-term effects of the latter. Finally, we propose a prognosis of gender dysphoria diagnosis based on contemporary contingencies and historical precedents.

Contexte: L’anhédonie, un état caractérisé par une capacité réduite d’éprouver du plaisir. Des études cliniques récentes montrent qu’un médicament antipsychotique atypique, la quétiapine, est bénéfique pour le traitement de la toxicomanie qui est supposé d’atténuer les symptômes de sevrage associés à l’usage abusif des drogues psychotropes. Le but de la présente étude était d’étudier les effets de l'administration aiguë de quétiapine sur la récompense chez des animaux en état de sevrage après un traitement chronique avec l’amphétamine. Notre hypothese est que la quetiapine va diminuer l’anhedonie causer par le sevrage. Méthodes: Les expériences ont été effectuées avec des rats mâles de la souche Sprague-Dawley entraînés à produire une réponse opérante pour obtenir une courte stimulation électrique au niveau de l'hypothalamus latéral. Des mesures du seuil de récompense ont été déterminées chez différents groupes de rats avant et pendant quatre jours après le traitement avec des doses croissantes (1 à 10 mg/kg, ip toutes les 8 heures) de d-amphétamine sulfate, ou de son véhicule, au moyen de la méthode du déplacement de la courbe. L’effet de deux doses de quétiapine a été testé 24 h après le sevrage chez des animaux traités avec l’amphétamine ou le véhicule. Résultats: Les animaux traités avec l’amphétamine ont montré une augmentation de 25% du seuil de récompense 24 h après la dernière injection, un effet qui a diminué progressivement entre le jour 1 et le jour 4, mais qui est resté significativement plus élevé en comparaison de celui du groupe contrôle. La quétiapine administrée à 2 et 10 mg/kg pendant la phase de sevrage (à 24 h) a produit une augmentation respective de 10 % et 25 % du seuil de recompense; le meme augmentation du seuil a été observe chez les animaux traitées avec le véhicule. Un augmentation de 25 % du seuil de recompense a aussi été observés chez les animaux en état de sevrage à l'amphétamine. Un test avec une faible dose d’amphétamine (1 mg/kg) avant et après le sevrage a révélé une légère tolérance à l’effet amplificateur de cette drogue sur la récompense, un phénomène qui pourrait expliquer l’effet différent de la quétiapine chez les animaux traités avec le véhicule et ceux traités avec l’amphétamine. Conclusions: Ces résultats reproduisent ceux des études précédentes montrant que la quétiapine produit une légère atténuation de la récompense. Ils montrent également que le sevrage à l’amphétamine engendre un léger état d'anhédonie et que dans cet état, une dose élevée de quetiapine et non pas une dose faible accentue l’état émotionnel négatif. Ils suggèrent qu’un traitement à faibles doses de quétiapine des symptômes de sevrage chez le toxicomane devrait ni aggraver ni améliorer son état émotionnel. / Background: Anhedonia, a condition in which the capacity of experiencing pleasure is reduced, is observed in patients that are under withdrawal from drugs of abuse. Recent clinical studies show that quetiapine may be beneficial in the treatment of substance abuse by alleviating the withdrawal-negative affect stage of addiction. This study investigated the effects of acute quetiapine on reward in animals under withdrawal from d-amphetamine. Methods: Experiments were performed on male Sprague-Dawley rats trained for intracranial self-stimulation. Measures of reward threshold were determined with the curve-shift method in different groups of rats before, and during four days after treatment with escalating doses (1 to 10 mg/kg, i.p) of d-amphetamine sulphate or its vehicle. At 24h after withdrawal, the effects of two doses of quetiapine (2 and 10 mg/kg ip) were tested in all the animals. Results: Animals treated with d-amphetamine showed 25% reward attenuation at 24h of withdrawal, an effect that decreased over the next three days. Quetiapine administered acutely at 2mg/kg and 10mg/kg on the first day of withdrawal produced 10% and 25% reward attenuation, respectively, in the vehicle-control animals, an effect also observed in the animals under withdrawal from d-amphetamine but only at the high dose. Conclusions: These results show that quetiapine produced a mild attenuation of reward in normohedonic and in anhedonic animals. They suggest that quetiapine should be used at low doses for the treatment of substance abusers under withdrawal from psychostimulant drugs to avoid enhancement of the anhedonic state.