Impulsivity and aggression have been shown to be important behavioral correlates of suicide. Neurobiological and genetic studies, mostly focusing on the serotonergic system, have demonstrated that these behaviors not only have clinical implications in suicide but also play an important biological role in increasing suicide risk. It remains unclear, however, how impulsivity and aggression might mediate suicide risk. The first study presented here was carried out to investigate clinical, behavioral and psychosocial correlates of impulsivity in suicide completers. Impulsive suicides were characterized by a greater psychiatric comorbidity as well as increased levels of aggression, and were more likely to be affected by negative life events. In a separate study, the effect of genetic variants of the 5-HT1B gene on impulsive aggressive behaviors (IABs) in suicide, as well as their contribution to overall suicide risk, was investigated. One 5-HT1B promoter variant significantly influenced levels of aggressive behaviors in suicide completers, suggesting that aggression plays a role as an intermediate phenotype that increases propensity to suicide. Both studies highlight the importance of the role of IABs in mediating suicide at both clinical and biological levels.

Schizophrenic patients have a high prevalence of smoking. It has been postulated that this may be related to the positive effect of nicotine on cognition. We evaluated the effect of nicotine on attention and eye movements, domains in which schizophrenic patients have robust deficits. Patients (n = 19) who met DSM-IV criteria for schizophrenia and Controls (n = 15) were given a Nicoderm 14 mg patch in a double-blind, placebo-controlled, crossover design, and performance on various attention tasks (Continuous Performance Task (CPT), Stroop, Treisman, Dixon-Lupien), and oculomotor tasks (fixation, smooth pursuit, saccades and antisaccade) was assessed. Nicotine significantly improved attention (CPT hit rate) in patients (p < 0.02) and not in controls. Nicotine increased pursuit gain (p < 0.01) and decreased antisaccade errors (p < 0.01) in patients and controls equally. The magnitude of the improvement on eye movement and attention tasks did not correlate with plasma nicotine concentration (measured by RIA). We conclude that nicotinic mechanisms modulate attention and oculomotor functions and that the effect of nicotine on pursuit may be mediated by attention.

The objective of this study was to develop and evaluate a non-intrusive research instrument for children who have experienced war trauma and family separation that has the capacity to elicit verbal and non-verbal representations of their experiences in their play. A related objective was to explore the relationship between the family's disclosure of traumatic events and the children's play. The research was conducted among 21 Algerian and West and Central African children. The methodology was based on both qualitative and quantitative methods. The play of children from a community and a clinical group was compared to identify play indicators that were potentially indicative of positive mental health. / Results suggest that indicators of play structure may be more important than indicators of play content in identifying children with potential mental health difficulties as a result of trauma. In particular, a flexible approach to trauma and a modulated approach to the disclosure of traumatic events may be related to positive mental health. / These results suggest that this non-intrusive directed play interview is a valid and culturally sensitive instrument for assessing the verbal and non-verbal representations of war trauma in refugee children.

Purpose. Post Traumatic Stress Disorder (PTSD) is a disorder with important prevalence, morbidity, co-morbidity as well as economic cost. This study examines the comparative efficacy and effectiveness of pharmacotherapy and psychotherapy. / Data sources. (1) MEDLINE search from 1966 to present using both McSH terms and related keywords; (2) reference lists from retrieved articles; (3) reference lists from systematic reviews and books (4) consultation with "key informants". / Study selection. All studies that examined therapeutic interventions for at least 6 subjects with PTSD were targeted for retrieval. Studies in English and French, with data enabling the calculation of a within condition effect size (ES) were retained for the analysis. A random sample of excluded studies was read to confirm that no relevant study was missed with our inclusion criteria. / Data extraction. Data on study design, study population, diagnostic method, co-morbidity, duration of illness, treatment type, outcome measure, outcome and duration of follow-up were extracted by two authors. (Abstract shortened by UMI.)

Several lines of evidence suggest an involvement of serotonin$ sb{ rm 1A}$ (5-HT$ sb{ rm 1A}$ receptors in the regulation of emotions. In order to investigate the molecular basis of recent electrophysiological findings which implicated 5-HT$ sb{ rm 1A}$ receptors in the mechanism of action of antidepressants and anxiolytics, radioligand binding and autoradiographic studies using tritiated 8-hydroxy-2-(di-N-propylamino)-tetralin ( ($ sp3$H) -8-OH-DPAT) were done in rat brain following various treatments. These included: the tricyclic antidepressant imipramine; the reuptake blockers paroxetine and indalpine; the monoamine oxidase inhibitor clorgyline; electroconvulsive shock; lithium; the classic benzodiazepine diazepam; and the 5-HT$ sb{ rm 1A}$ partial agonist gepirone. None of these treatments, nor the fluctuation in 5-HT availability provoked by the circadian cycle, gave any significant changes, with the exception of clorgyline which initially appeared to decrease the affinity of ($ sp3$H) -8-OH-DPAT for its receptor. A further series of studies in vitro and in vivo ascertained the possibility that the 5-HT$ sb{ rm 1A}$ receptors may display two interconvertible affinity states and that, in fact, clorgyline induces a shift of the high to the lower affinity state. The findings from this second series of experiments suggested that labile changes, which may possibly be disrupted during membrane preparation, in the coupling between the 5-HT$ sb{ rm 1A}$ receptor and a guanine nucleotide binding protein (G-protein) may account for the effects that certain treatments have on 5-HT$ sb{ rm 1A}$ receptor responsiveness.

This study investigates understandings and experiences of headache in two regions of Peru: a semi-rural Quechua-speaking district of the Southern Peruvian highlands and a poor urban district of Lima. In particular, it explores the personal and collective meanings constructed around women's headache experiences. Both structured and open-ended interviews were administered to patients suffering headache to elicit interpretations of headache episodes. An analysis of the collected narratives suggests that headache is often comprehended in a polysemic framework, where shifting meanings ascribed in bodily, emotional, family and social terms articulate both individual and shared notions of suffering: loss of loved ones, inter-personal conflict, and tension associated to women's roles as homemakers are among the central themes evoked, and span through past, present and future domains. In particular, strains in family relationships, in dynamic interaction with larger contexts of social violence, play a prominent role in the configuration of headache, often experienced in conditions of solitude and isolation. Overall, this study underscores the significance of patients' subjective interpretations of painful experiences and emphasizes the manner through which bodily and emotional pain are inextricably linked to distress experienced at family and social levels.

This thesis explores the phenomenon of mind-brain dualism in contemporary Western psychiatry from an anthropological and social psychological perspective. In a first chapter, it reports on an empirical study involving 127 staff psychiatrists and psychologists at McGill University who responded to a questionnaire based on clinical vignettes. Results revealed a latent process of judging patients' responsibility for illness, where the more a behavioural problem was seen as 'psychological,' the more the patients tended to be viewed as responsible and blameworthy for their symptoms, while behaviours with 'neurobiological' causes showed the opposite tendency. A second chapter reviews the history of psychosomatic medicine and argues that specific biomedical and psychological sick roles exist for patients that determine the ways in which their actions are judged, as well as how the functions of the rational mind are commonly understood. Insights from evolutionary psychology are used in a third chapter to speculate on new models of mental illness that may provide new contexts for negotiating mind-brain dualism and judgements of responsibility.

Clinical depression has been unilaterally construed as a biochemical imbalance in serotonerigic systems. The over-simplification of disease reflects economic, political, and social forces that pathologize normal behaviors to manufacture illness. This paper considers evolutionary and dynamic systems biology to advance the idea that subclinical depression is an illness within culture that manifests biologically, as opposed to being organically created and sustained. The classic medical model underestimates psychosocial elements of depression. Patient narratives show the limitations of the medical model and suggest a need for a new depression paradigm, which is the biopsychosocial model. This paper is critical of both the biological etiology of depression and the social and cultural elements that create and sustain depressive episodes.

<p> The purpose of this project was to analyze Assembly Bill 1421, known as Laura's Law, from a social work perspective of recovery-oriented care. Gil's framework was used to assess primary and secondary data from journal articles, government publications, and law reviews. A review of the literature was conducted to understand the historical background of coercive mental health treatment. Coercive treatment has been a pervasive problem generated from public fear and misconceptions about the association between mental illness and danger. Laura's Law was established as a result of the murder of 19 year-old Laura Wilcox by an individual with serious mental illness. The law's primary stated objective was to provide preventative mental health services to those identified as most in need before tragedy struck. Significant shortcomings were discovered within the analysis and alternatives to this policy are suggested as well as the implications for social work policy and practice.</p>

<p> There is estimated to be 18,000 Cambodians living in Long Beach, California. Approximately 50% of this population has suffered from depression or mental health conditions after 25 years of resettlement from the Khmer Rouge war in 1975. The researcher has found that there are various mental health related stressors such as PTSD, and depression, that Cambodians have struggle with after the post-migration. </p><p> The purpose of this proposal project was to write a grant to fund a psychoeducational group for Cambodian survivors and their family members in the City of Long Beach to address and raise awareness on mental health. The goals were to decrease mental health symptoms, provide coping skills and improve access to community resources. The grant writer identified the Weingart Foundation as a potential funding source for this program. The actual submission and funding of this grant were not a requirement for the successful completion of this project. </p>