<p> The purpose of this project was to locate a potential funding source and write a grant to create a psycho-educational group for family members of adults with a mental health diagnosis. With this program, family members can receive guided and educated support. The additional support they receive will assist them in becoming more supportive to their loved ones who have mental illnesses. The group would take place at Alma Family Services in Long Beach, California. A search was conducted to locate an appropriate funder for this project. The Ralph M. Parsons Foundation had specific criteria about what type of agencies they fund, which was met by the agency and the program. </p><p> Individuals who experience mental health challenges face many difficulties during their lives. The support of knowledgeable, understanding, and caring family members may reduce some of life's challenges for individuals who experience mental illness. If funded, the program would benefit families who need psycho-education about mental illness and assistance with mental health questions. The actual submission and/or funding of this grant was not a requirement for the successful completion of the project.</p>

<p> The purpose of this policy analysis is to critically review the Welfare and Institutions Code&sect; 369.5, which regulates the authorization of psychotropic medication to treat mental disorders among California's dependent children. While these medications have been proven effective forms of treatment, there is a growing concern about their life threatening side effects.</p><p> Research has concluded that children exposed to chronic child abuse and neglect often present with behaviors indicative of trauma. The <i>Diagnostic and Statistical Manual of Mental Disorders</i> 5th Edition has included criteria for Post-Traumatic Stress Disorder (P.T.S.D.) in children. However, the Welfare and Institutions Code&sect; 369.5 does not mandate psychiatrists and pediatricians to first rule out trauma prior to diagnosing foster children with one or more behavior, mood, or psychotic disorders.</p><p> Results support amending child welfare legislation and policies to reflect a shift toward trauma-focused services, thereby reducing the reliance on potentially dangerous pharmaceutical drugs.</p>

Cette thèse poursuit un double objectif. D’une part, mesurer et situer le niveau de la condition physique, de la performance motrice et de la participation aux activités physiques chez des enfants ayant un TDAH. D’autre part, apprécier l’impact d’un programme structuré en activité physique sur la condition physique, la performance motrice, certains comportements cibles ainsi que sur les fonctions cognitives propres à ces enfants. Pour vérifier l’atteinte de ces objectifs, trois études expérimentales ont été complétées et ont fait l’objet d’articles soumis pour publications. Dans le premier article, on évalue la condition physique et la performance motrice chez des enfants ayant un TDAH prenant ou non de la médication. Les résultats obtenus démontrent que la condition physique, comprenant ici des variables reliées à la composition corporelle, l’endurance musculaire et la flexibilité de ces enfants, ne diffèrent pas de celle des membres d’un groupe témoin. Seul l’indice de masse corporelle est significativement moins élevé chez les enfants ayant un TDAH prenant de la médication. Aucune différence n’est observée entre les groupes en ce qui a trait à la capacité aérobie telle que mesurée lors d’une épreuve de tapis roulant. Par contre, lorsqu’évaluée à partir d’un test navette, la performance aérobie de tous les participants est significativement moins élevée, d’où l’importance du choix de l’instrument de mesure. Finalement, les enfants ayant un TDAH ont significativement plus de problèmes de motricité globale que les enfants du groupe témoin. Ces difficultés sont particulièrement importantes pour la locomotion. Dans le cadre d’un programme d’activités physiques structurées et supervisées, le deuxième article porte, d’une part, sur l’évaluation de l’intensité de la participation aux exercices proposés chez des enfants ayant un TDAH. D’autre part, l’impact potentiel de facteurs comme les problèmes de poids et la présence de difficultés motrices sont également pris en considération. Les résultats obtenus suggèrent que ces enfants atteignent une intensité et une durée d’exercice qui ne diffèrent pas de celles des enfants du groupe témoin. Quant aux enfants qui ont un problème de poids ou des difficultés motrices, l’intensité et la durée de leur participation ne diffèrent pas de celles des participants témoins. Sur la base des données obtenues, les enfants ayant un TDAH peuvent parvenir à un degré de participation aux exercices qui permet de bénéficier des bienfaits de la pratique d’activités physiques. Le troisième article traite de l’impact potentiel d’un programme d’activités physiques sur la condition physique, la performance motrice, certains comportements ainsi que sur les fonctions cognitives des enfants ayant un TDAH. Sur la base des résultats obtenus, il est possible de faire valoir que la participation à un tel programme permet d’améliorer les capacités musculaires, les habiletés motrices, certains comportements observés par les parents et les enseignants ainsi que la capacité d’attention. Cela pourrait produire un impact significatif dans l’adaptation fonctionnelle de ces jeunes. Ces résultats soulignent le besoin de continuer la recherche dans les domaines de l’activité physique et du TDAH. La discussion générale présente les liens existants entre les manuscrits en fonction du modèle de l’engagement dans les activités physiques. Le déficit de la motricité globale ainsi que l’impact clinique potentiel de l’activité physique dans le traitement du TDAH sont les deux axes de recherche qui semblent le plus propices à des travaux futurs. / The first purpose of this thesis is to describe fitness and gross motor performance of children with ADHD taking medication or not, in addition with the description of their participation in structured physical activity sessions. The second objective is to evaluate the impact of a physical activity program on fitness, gross motor performance, behaviour and cognition of those children. Three manuscripts are presented. The purpose of the first study is to assess fitness and gross motor performance of children with ADHD, including users and non-users of methylphenidate medication. Fitness level of children with ADHD using medication or not, including body composition, flexibility and muscular endurance, is similar to that of a control group. The only difference is observed for body mass index, which was lower in children with ADHD using medication. Aerobic capacity is also similar when measured by a treadmill test. However, a lower performance is observed when aerobic capacity was estimated using a field shuttle test, suggesting that the methodology used is important. Finally, both groups of children with ADHD present significantly lower scores for locomotion skills. The objectives of the second manuscript are to assess the participation of children with ADHD in structured physical activity sessions and to explore the impact of variables such as weight and motor problems on this participation level. Results suggest that children with ADHD can have an intensity and duration of participation similar to children without the disorder, with a simple behavioural management system for negative behaviours. Furthermore, the intensity of participation is not different for children with ADHD having weight problems or motor skills difficulties. This highlights the fact that children with ADHD can attain effective physical activity participation when they are included in a structured supervised program. Finally, the objective of the third study is to assess the effects of a moderate- to high-intensity physical activity program on fitness, gross motor skills, cognitive functions and ADHD-related behaviour in children with ADHD. Results show that participation in a physical activity program improves muscular capacities, motor skills, behaviour reports by parents and teachers and attention capacity. The results suggest that a structured physical activity program may have clinical relevance in the functional adaptation of children with ADHD. This highlights the need for further research in the area of physical activity with this population. The general discussion presents the links between the three studies using the physical activity engagement model. Gross motor skills difficulties and the clinical impact of physical activity programs in ADHD treatment are proposed as promising research avenues.

Disordered eating is a general term that describes a wide range of behaviors from diagnosable eating disorders to subclinical patterns of behavior that do not meet criteria for diagnosis (e.g., problematic weight loss behaviors, excessive dieting, bingeing, purging). Disordered eating is prevalent and has a wide range of physical and psychological consequences. Negative self-conscious emotions such as shame and guilt have been implicated in the development and maintenance of disordered eating. Positive attitudes toward the self (i.e., self-forgiveness, self-compassion, self-acceptance) may be helpful in reducing shame, guilt, and disordered eating symptoms. In this dissertation, I explored the associations between positive attitudes toward the self, negative self-conscious emotions, and disordered eating in a sample of college students and adults (N = 477). Positive attitudes toward the self were associated with lower levels of disordered eating symptoms, and this relationship was partially mediated by lower levels of negative self-conscious emotions. I concluded by discussing areas for future research and implications for clinical practice.

Les fuseaux de sommeil sont des ondes électroencéphalographiques reflétant les mécanismes électrophysiologiques de protection du sommeil. Les adultes autistes ont un sommeil léger et moins de fuseaux de sommeil que des adultes neurotypiques. L’étude vérifie si les enfants autistes montrent également moins de fuseaux de sommeil que les enfants neurotypiques et documente leur évolution avec l’âge. Nous avons enregistré le sommeil de 34 adultes (16 autistes) et 26 enfants (13 autistes) et comparé la quantité de fuseaux de sommeil enregistrés aux électrodes préfrontales (Fp1, Fp2) et centrales (C3, C4). Les deux groupes montrent une diminution similaire des fuseaux en vieillissant. Le groupe d’enfants autistes montre moins de fuseaux que le groupe témoin aux électrodes Fp2 et C4; les adultes autistes montrent significativement moins de fuseaux que les adultes contrôles aux deux électrodes centrales. Le mauvais sommeil des autistes pourrait être causé par une faible protection du sommeil déjà présente en bas âge. / Autism is characterized by poor sleep maintenance. Sleep spindles are electroencephalographic markers representing a sleep protective mechanism. Autistic adults display less spindles than matched controls. This study investigates sleep spindle activity in children and adults with and without autism. The sleep of 34 adults (16 autistics) and 26 children (13 autistics) was recorded. Sleep spindles were counted and compared between groups at prefrontal (Fp1, Fp2) and central (C3, C4) electrodes. Both diagnostic groups showed a similar decrease in sleep spindle with age. Autistic children had significantly less spindles than controls at Fp2 and C4; adults with autism had significantly less spindles than controls at the two central electrodes. Poor sleep in children and adults with autism may be due to impaired protective mechanisms. The developmental pattern of sleep spindle topography suggests an atypical maturational course of the thalamo-cortical loop in autism.

Des études animales ont montré que l’exposition du foetus à l’adversité affecte le développement cérébral et la régulation d’émotions plus tard. Cette régulation serait reliée aux changements structurels cérébraux, particulièrement au circuit fronto-limbique. Cependant, ces résultats n’ont pas été entièrement répliqués chez l’humain. Le but de cette étude était de tester si l'adversité précoce conduit à des altérations structurelles des régions (orbitofrontal, préfrontal, cingulaire) fronto-limbiques, identifiées comme régions-clés dans la (de)régulation d’émotions. Les mesures principales de l’adversité étaient un poids léger à la naissance et l’hostilité maternelle puisqu’ils étaient parmi les plus prédictifs des résultats développementaux et comportementaux chez l’humain. Les mesures secondaires, incluant le tempérament difficile d’enfant et l’impulsivité en adolescence, étaient utilisées du à leur lien avec le développement cérébral et émotionnel. Les participants étaient des jumeaux identiques, membres de l’Étude des Jumeaux Nouveau-nés du Québec (ÉJNQ, N = 650 paires) suivis depuis 5 mois à 15 ans, leur âge actuel. Ceci a permis de mieux contrôler le facteur génétique et ainsi mieux isoler les effets d’environnement. Trente-sept paires ont été recrutées. La structure cérébrale de chacun, obtenue avec l’imagerie par résonance magnétique, a été analysée avec la régression linéaire. Le poids à la naissance n’a eu aucun effet. L’hostilité maternelle a prédit une réduction de l’aire du gyrus cingulaire postérieur. Tempérament difficile a prédit une réduction de l’aire du cortex orbitofrontal. L’impulsivité était associée avec l’aire et volume du cortex préfrontal réduits. Ces résultats soulignent l’importance des interventions précoces afin d’empêcher des altérations menant à la psychopathologie. / Animal studies have shown that fetal exposure to adversity affects brain development and emotion regulation later on. Emotion regulation would be related to a structural change in the brain, particularly the fronto-limbic circuitry. However, results have not been entirely confirmed in humans. The purpose of the present study was to test whether early adversity leads to structural changes in the fronto-limbic (prefrontal, orbitofrontal and cingulate) regions, previously identified as key areas in emotion (dys)regulation. Main measures of adversity were low birth weight and maternal hostility because these were among the best predictors of developmental and behavioral outcomes in humans. Secondary measures, including difficult child temperament and adolescent impulsivity, were used because of their link with brain and emotion development. Participants were identical twins part of Quebec Study of Newborn Twins (QSNT, N = 650 pairs), followed from 5 months to 15 years, their current age. Using identical twins allowed to better control the genetic factors and, thus, to better isolate the specific effects of early environment. Thirty-seven pairs have been recruited. Each twin’s brain structure was assessed with magnetic resonance imaging and analyzed using linear regression. Birth weight showed no effect on brain structure. Maternal hostility predicted a reduction in cortical area of posterior cingulate gyrus. Difficult child temperament predicted a reduction in cortical area of orbitofrontal cortex. Impulsivity was associated with smaller cortical area and volume in prefrontal cortex. These results highlight the importance of the early interventions in order to prevent the alterations leading to development of psychopathology.

No description available.

This research explored relationships between levels of job burnout, intrinsic spirituality and social support in women who are perinatal social workers, defined as those who were currently employed or had been employed in perinatal settings. The study population consisted of membership and active mailing list of the National Association of Perinatal Social Workers (NAPSW). Research packets mailed to this group included a cover letter, demographic survey, and three instruments including the Maslach Burnout Inventory Human Services Survey, the Intrinsic Spirituality Scale and an amended form of the Shortened Social Support Scale, amended to include support provided inside and outside the workplace. Measures were taken to insure that participation was completely voluntary and could be anonymous if desired. Demographic surveys and test instruments were statistically examined for correlations. Participants were also asked to provide comments on study topics, which were examined for key words and themes and quotations illustrative of those themes. Themes found included spirituality and social support as preventive of job burnout and stress, stresses and benefits unique to perinatal social work, identification with the specialty as social support, NAPSW as social support, stresses and benefits of working with families experiencing death and loss, other factors in stress and burnout prevention, and other sources of stress. Quantitative research yielded correlations among depersonalization (DP), emotional exhaustion (EE) and personal accomplishment (PA) subscales of the burnout instrument, and the following significant correlations: DP was negatively correlated with PA, social support, years in practice and in perinatal social work, and PA was positively correlated with social support, age, years in practice and in perinatal social work. Social support was positively correlated with marital status, as was having an organized social work department with having a supervisor who is a social worker. After recognition of personal accomplishment as a possible confounding variable, the following pairs of variables were significantly correlated: Years in perinatal social work was negatively correlated with intrinsic spirituality and positively correlated with age and years in social work. Years in social work was positively correlated with age / acase@tulane.edu

The problem of somatization in primary care medicine has received considerable attention from researchers in the past few years. Somatizing patients visit the physician frequently with a variety of physical symptoms for which no organic cause can be found. Many researchers consider the current classifications of somatization disorder and undifferentiated somatoform disorder to be arbitrary and inadequate for describing the range of somatizing patients seen in medical settings. An important clinical research goal would be to identify and describe relatively distinct homogeneous subgroups if they exist Cluster analytic techniques, which have been used for classification problems in medicine and psychiatry, have been controversial due to inadequate theoretical basis. Methods have been developed for a statistical test for the presence of cluster structure, employing an internal criterion measure and Monte Carlo simulation of a null distribution. Different clustering outcomes can be compared using bootstrapping. Although these approaches offer solid statistical credibility they have not been widely used in clinical research The purpose of this study was to investigate the efficacy of four hierarchical agglomerative clustering techniques for a clinical research problem. The use of a statistical test for cluster structure is presented. All four methods provided solutions with evidence to support the presence of distinct clusters. Five stable clusters were identified and concordance among the 'best' solutions from each method was high. Bootstrapping techniques were used for parameter estimation and comparison of the clustering methods. The group average method gave the best overall performance when all patients were to be classified. The centroid method performed well when a few outliers could remain unclassified. Ward's minimum variance and complete link methods appeared to be more seriously affected by the presence of outliers and unequal cluster size. Nevertheless, cluster analytic methods provided a reasonable means of identifying empirical subtypes of somatizers in this study / acase@tulane.edu

Thesis (Ph.D.)--Lehigh University, 2008. / Adviser: Grace I. L. Caskie.