This is a study of military psychiatry in the Second World War. Focusing on the British Army, it recounts how the military came to employ psychiatrists to revise recruitment procedures and to treat psychiatric casualties. The research has shown that psychiatry was a valued specialty and that psychiatrists were given considerable power and independence. For example, psychiatrists reformed personnel selection and placed intelligence testing at the centre of the military selection of personnel. Psychiatrists argued that by eliminating the 'dull and backward' the tests would help improve efficiency, hygiene, discipline and morale, reduce psychiatric casualties and establish that the Army was run in a meritocratic way. However, it is probable that intelligence testing made it less likely that working-class men would receive commissions. Still, the Army had no consistent military doctrine about what the psychiatrists should be aiming for -to return as many psychiatric casualties to combatant duties as was possible or to discharge men who had found it impossible to adapt to military life. In the initial stages of the war, the majority of casualties were treated in civilian hospitals in Britain, where most were discharged. This was partly because the majority were regarded as constitutional neurotics. When psychiatrists treated soldiers near the front line most were retained in some capacity. The decision on whether to evacuate patients was influenced by multiple factors including the patients' military experience and the doctors' commitment to treatment or selection. Back in Britain, service patients were increasingly more likely to be treated in military hospitals such as Northfield -famous for the 'Northfield experiments'. These provided an alternative model of military psychiatry in which psychiatric intervention refocused away from individuals and their histories and onto social relationships, and where the psychiatrists' values were realigned with the military rather than with civilian general medicine.

Made available in DSpace on 2014-12-17T15:43:49Z (GMT). No. of bitstreams: 1 GlaudeniaAM_DISSERT.pdf: 2134728 bytes, checksum: f418d9786b3ab74e5c06ca33dab9e66a (MD5) Previous issue date: 2012-12-19 / The Psychiatric Reform has brought profound changes in assistance to people affected by mental disorders and behavior. In this context, mental health workers have played decisive roles of great impact, acting driving the process. Objective: To evaluate the impact felt by working professionals, because of the daily work with people who have psychiatric disorders. Methodology: This is a search field, a quantitative approach, sectional, descriptive and applied. Data collection occurred through the Assessment Scale Impact of Working in Mental Health Services (IMPACT-BR) applied to mental health researchers city Mossor? - RN. Results: Participants in this study 87 professionals, mostly female married, which took charge of higher education, working on a single service, working in the area for more than six years, aged between 25 and 64 years. There were a low effect of overloading the professionals surveyed. Discussion: Our results corroborate findings in other surveys conducted previously, not identifying large impact load at work among professionals of mental health teams studied. Subscales studied the highest score was observed in measuring the impact of work on team functioning. It was observed that the greater age and duration of action, reduced the emotional impact at work, suggesting that the experience enhances safety in decisions made and the possibility of greater control over the demands of work. Final Thoughts: The work presented showed that the interactive relationships between professionals and users are not the causes of greatest impact in the workplace, although it revealed overload in relation to specific aspects such as: fear of being assaulted by a patient and the feeling of physical exhaustion the end of the workday. Further investigations should be conducted on this topic in order to contribute to the implementation of psychiatric reform proposed by advances both in terms of assistance to individuals and the quality of life in the work of the professionals involved / A Reforma Psiqui?trica trouxe profundas modifica??es na assist?ncia ?s pessoas acometidas por transtornos mentais e de comportamento. Nesse contexto, os trabalhadores de sa?de mental desempenharam pap?is decisivos de grande repercuss?o, atuando de forma impulsionadora do processo. Objetivo: Avaliar o impacto laboral sentido pelos profissionais de sa?de, em virtude do trabalho di?rio com pessoas que apresentam dist?rbios psiqui?tricos. Metodologia: Trata-se de uma pesquisa de campo, numa abordagem quantitativa, seccional, descritiva e aplicada. A coleta de dados ocorreu por meio da Escala de Avalia??o do Impacto do Trabalho em Servi?os de Sa?de Mental (IMPACTO-BR), aplicada aos profissionais de Sa?de Mental da cidade de Mossor? - RN. Resultados: Participaram desse estudo 87 profissionais, em sua maioria do sexo feminino casados, que assumiam cargo de n?vel superior, trabalhando em um ?nico servi?o, atuando na ?rea h? mais de seis anos, com idade entre 25 e 64 anos. Foi observado um baixo efeito de sobrecarga nos profissionais pesquisados. Discuss?o: Os resultados encontrados corroboram com resultados encontrados em outras pesquisas realizadas anteriormente, n?o identificando grande carga de impacto no trabalho entre os profissionais das equipes de sa?de mental estudadas. Das subescalas estudadas a maior pontua??o foi observada na que mede o impacto do trabalho no funcionamento da equipe. Observou-se que quanto maiores a idade e o tempo de atua??o, menor o impacto emocional no trabalho, o que sugere que a experi?ncia aumenta a seguran?a nas decis?es tomadas e a possibilidade de um maior controle sobre as demandas de trabalho. Considera??es finais: O trabalho apresentado demonstrou que as rela??es interativas entre os profissionais e os usu?rios n?o s?o as causas de maior impacto no trabalho, embora tenha revelado sobrecarga em rela??o a aspectos pontuais como: receio de ser agredido por um paciente e a sensa??o de cansa?o f?sico ao fim do expediente. Novas investiga??es nessa tem?tica devem ser realizadas a fim de colaborar para a efetiva??o dos avan?os propostos pela Reforma Psiqui?trica tanto no que se refere ? assist?ncia aos sujeitos quanto na qualidade de vida no trabalho dos profissionais envolvidos

Thesis (M.S.P.H.)--University of Michigan, 1942.

Thesis (M.S.P.H.)--University of Michigan, 1942.

The Health Regulatory Focus Scale (HRFS) is a short scale whichmeasures an individual’s prevention and promotion focus in a health-specific context. The main objective of this study was to examine the psychometric properties of the newly translated German version of the HRFS. Reliability and item characteristics were found to be satisfactory. Validity of both subscales toward other psychological constructs including behavioral approach and avoidance, core self-evaluations, optimism, pessimism, neuroticism, as well as severalmeasures of physical andmental health was shown. In addition, invariance of the measure across age and gender groups was shown. Exploratory as well as confirmatory factor analyses clearly indicated a two-factorial structure with a moderate correlation between the two latent constructs. Differences in health promotion and prevention focus between socio-demographic groups are discussed. The HRFS is found to be a valid and reliable instrument for the assessment of regulatory focus in health-related environments.

Well-being is fundamental for health. However, health and well-being are under threat by increased prevalence of depression and physical inactivity. Interaction with the natural environment may prevent these critical health issues, as research has shown that walking outdoors contributes to better well-being than walking indoors. The aim of this thesis was to investigate outdoor group walks as a potential public health intervention to enhance positive mental and emotional well-being, reduce stress, and foster resilience. This thesis evaluated Walking for Health, a national group walking programme in England using a nonexperimental, longitudinal design. Individuals who did (Group Walkers) and did not (Non-Group Walkers) take part in outdoor group walks completed two online questionnaires about their mental and emotional well-being, and covariates. To gain a broader understanding of how outdoor group walks may contribute to positive well-being, integrations were proposed between the Attention Restoration Theory and the psycho-evolutionary model, and the theories of coping and resilience. Findings show that Group Walkers had greater mental well-being and positive affect, and less negative affect, depression and perceived stress than Non-Group Walkers. Group walking had no affect on social well-being, connectedness to nature or resiliency. Outdoor group walk participation affected positive well-being through a decrease in perceived stress, and an increase in physical activity. Group Walkers demonstrated resilience against adversity on negative affect. No evidence of resilience from outdoor group walks was found for mental well-being, positive affect or depression. Group walks in farmland and green corridor environments may further boost mental well-being, and reduce negative affect and perceived stress, when compared to group walks in the urban environment. This research suggests that outdoor group walks are effective at improving mental and emotional well-being, and could be a useful public health intervention to reduce stress and foster resilience. Implications for theory are discussed.

In Canada mental health related concerns are estimated to cost the economy $20-$50 billion annually. 500,000 Canadian each week have to take time off of work because of a mental health disability. This study explores the experiences of people living with a mental health disability in the workplace. The goal is to provide an opportunity to highlight many of the obstacles they face every day. This study relies on qualitative methodologies, using semi-structured interviews to get a more detailed understanding of their experiences. This study not only highlights the perceptions, experience and challenges of people living with a mental health disability, it highlights coping strategies and suggestions for building mentally health workplaces. The participant’s personal narratives can help by providing a chance for a community to build and be used to challenge the stigma and discrimination associated with mental health. / October 2016

The transition to parenthood involves psychological and social adjustments for men and women, with evidence of possible declines in mental health and close relationships. This thesis examined the relationship between parents' mental health (depression, anxiety, PTSD), the parent-infant relationship, couple's relationship and infant development. The five articles in this thesis were part of a prospective multi-method investigation of first-time parents. Parents completed questionnaires in late pregnancy, 3 months and 15 months postpartum (Article 3 & 4), detailed observations of parent-infant interactions 3 months postpartum (CARE-index; Article 4), in-depth interviews (Birmingham Interview of Maternal Mental Health) 5 months postpartum (Article 1 and 2), and infant development (Bayley Scales III) was examined at 17 months postpartum (Article 5). Results showed that a proportion of men and women suffered from poor mental health. Mental health problems were more common in pregnancy than postpartum. Women experienced worse mental health than men, but few other gender or within couple differences were found (Articles 2 & 3). A relatively high rate of poor parent-infant interactions was found (Article 4) and many parents reported feelings of anger towards their infant (Articles 1 & 2). Parents' perceptions of their infant's characteristics were important for the parent-infant relationship (Article 3) and infant's cognitive, language and motor development (Article 5). Additionally, women's postpartum PTSD and prenatal depression were associated with poor infant development (Article 5). Men's mental health was associated with poor interaction with their infants (Article 4), negative perceptions of the father-infant and couple's relationship (Article 3). These findings suggest that both men and women should be included in early mental health and family relationship interventions. However, the small low-risk sample limits generalizability of results. Future research would benefit from exploring the links between parental, infant and family relationship variables further, over time in larger more representative samples.

Background: Children who enter foster care usually do so because of maltreatment by their birth families. Early adversity such as this is associated with many negative outcomes, including disturbances of attachment and mental health in childhood and throughout the lifespan. Young children (under 5) are particularly at risk due to maltreatment rates being highest in this age range, and because of the vital brain development that occurs during this time. Improving the quality of existing relationships for young children is the most cost effective way to improve mental health outcomes. It is important that research investigates which relational and psychological variables that exist within the foster carer-child relationship may be protective against developing negative mental health outcomes, so as to inform carer training and future interventions for this vulnerable group. Aims: The aims of this research project were twofold. The first aim was to systematically review the existing literature on links between foster carer psychological variables (such as commitment to their foster child), and/or child psychological variables (such as their attachment style), and the mental health outcomes of children in foster care. The second aim was to investigate whether foster carer acceptance, commitment, awareness of influence and reflective functioning (RF) predict the mental health outcomes of Scottish preschool aged children who are looked after in foster care. Method: A systematic review of the existing literature was undertaken to address the first aim. The search strategy resulted in 12 quantitative studies that investigated links between child or carer psychological variables and child mental health outcomes. An empirical study of 179 pre-school aged children in foster care in Scotland was carried out to address the second aim. Participants were taking part in a wider RCT of a novel intervention to improve outcomes and permanency decisions for children in foster care. Foster carer acceptance, commitment, and awareness of influence was assessed using the This Is My Baby Interview, and scores of RF were coded from the transcripts of this interview using a computer-based algorithm. Child mental health information was gathered using the Infant Toddler Social Emotional Assessment. Data was gathered at 2 time points; baseline assessments occurred around 4 weeks after entry to care, and follow-up assessments were carried out a year later. Results: The systematic review found good evidence that foster child attachment security is linked to more positive mental health outcomes. It also found some evidence suggesting that foster carer psychological variables such as commitment and quality of caregiving also relate to child mental health outcomes, but this research is in its infancy and it is therefore difficult to draw firm conclusions around this. The results of the empirical study showed that carer commitment and awareness of influence predict child competence at baseline, and RF predicts internalising and externalising problems at follow up. No predictive relationships were found between carer variables and child mental health over time. Conclusion: The results from both studies suggest that carer psychological variables such as commitment to their foster child may relate to child mental health development. These results have implications in terms of foster carer training, and for intervention development for this vulnerable population. This research is however in its infancy, and the results suggest a complex picture with regard to carer psychological variables and child mental health. Large-scale high quality longitudinal research is needed to provide a clear understanding of these relationships.

Personality disorder has been and continues to be a contested diagnosis. Those who attract this form of diagnosis have been particularly vulnerable to the effects of stigma and have tended to be excluded from service provision. This thesis provides an examination of how recent developments in law, policy and practice have impacted upon the status of personality disorder as a diagnosis of exclusion in Scotland. The theoretical framework that provides this thesis with its structure is derived from the post-empiricist approach proposed by Derek Layder. This approach seeks to contextualise emergent inductive findings within a broader historical and contemporary analysis. In the case of this research the broader context consists of the interplay between mental health law, policy and practice in the field of mental health and the diagnosis of personality disorder more specifically. The empirical enquiry at the core of this thesis is based upon an analysis of the views, beliefs and expectations of front-line staff (psychiatrists and social workers qualified as mental health officers) involved in the process of assessment and service provision. In addition to front-line staff (n = 27) a range of key informants who were in a position to shed light on the strategic imperatives underpinning recent developments in law and policy were also interviewed. This analysis is contextualised within a review of key developments in law and policy that have particular significance for anyone who may attract a diagnosis of personality disorder. Despite the ostensibly inclusive approach towards those who may attract a diagnosis of personality disorder evident within the Mental Health (Care and Treatment) (Scotland) Act 2003, the reality is a highly selective and very limited inclusion of those who attract this form of diagnosis. The effective inclusion of those who may attract a diagnosis of personality disorder has been obstructed by several key impediments: 1: an insufficiently robust policy framework to drive forward the process of inclusion; 2: residual ambivalence towards the legitimacy of the diagnosis of personality disorder itself and the legitimacy of the claims made upon services by those who may attract a diagnosis of personality disorder; 3: insufficient and inadequately focused resources; 4: service structures that have not been redesigned sufficiently to engage successfully with service users who may attract a diagnosis of personality disorder. As a consequence of these impediments to inclusion, the majority of those who may attract a diagnosis of personality disorder in Scotland are likely to continue to face high levels of marginalisation and exclusion.