D.Cur. / The purpose of this study was to generate an interpersonal communication skills approach for adolescents. Through this approach adolescents will be given an opportunity to formulate new stories on their interpersonal communication skills in the form of stories about constructive communication skills. This will enable adolescents to maintain their important interpersonal relationships. Adolescence is a period characterised by the occurance of many adjustments and changes. Continually higher demands are made from adolescents in terms of career choices, the choice of friends, release from parents and parental homes, development of autonomy and the successful completion of the adolescent developmental phase. The climate of reconciliation in the post apartheid South Africa pressurise adolescents even more. Sources of support is consequently of great importance to adolescents during this phase of change. Sources of support for example the families of adolescents, members of the community and especially the peer group plays a significant role. interpersonal relationships with the aforementioned groups of persons and individuals must be maintained in order to ensure continued support during and in order to successfully complete the developmental phase of adolesence. This requires constructive interpersonal communication skills. It is however evident that adolescents do not posess all of the required constructive communication skills which would enable them to maintain these important interpersonal relationships. The abovementioned lead to the following questions which were addressed in phase one, -two and -three of this research: Over which interpersonal communication skills do adolescents posess? Which specific interpersonal communication skills needs to be addressed in the interpersonal communication skills approach in order to maximise adolescent's ability to communicate interpersonally with a view to improve, maintain and restore their mental health? Which guidelines can be given for the operationalising of the interpersonal communication skills approach for adolescents? A qualitative, investigative, descriptive and contextual design was followed. The research was conducted in three phases with a pre-phase which preceeded phase one of the research. A topical scenario to be utilised in the course of the research was established in the pre-phase of the research through group interviews with adolescents. In phase one of the research role play was conducted and written dialogue was obtained based on the scenarios identified in the pre-phase. An interpersonal communication skills approach was generated in phase two of the research. In phase three of the research certain guidelines were described for the operationalising of the approach. The researcher concluded from the results obtained in phase one of the research that the interpersonal communication of adolescents included in this research were characterised by an entanglement within four repetative circular interpersonalcommunication patterns. These four repetative circular interpersonal communication patterns are initiated and maintained by certain feelings, thoughts and behaviour. The four repetative circular interpersonal communication patterns are the following: Recurrent circular interpersonal patterns of defocusing and externalizing the topic under discussion; Recurrent circular interpersonal patterns of struggling for power between the adolescent and the other conversationist; Recurrent circular interpersonal patterns of not listening to the other conversationist; and Recurrent circular interpersonal patterns of not focusing on feelings while conversating.

Indiana University-Purdue University Indianapolis (IUPUI) / Prospective epidemiologic evidence indicates that both stressful life events (SLEs) and depression are associated with an increased risk of subclinical atherosclerosis and cardiovascular disease (CVD) events. Even though stressful life events (SLEs) and depression co-occur and may act together to influence cardiovascular disease (CVD) risk, these psychosocial factors have been mainly examined in isolation. For instance, depression may moderate the relationship between SLEs and CVD outcomes. I hypothesized that depressive symptoms would potentiate the deleterious effect of SLEs on subclinical atherosclerosis. This hypothesis is plausible, given that depressed adults exhibit exaggerated and prolonged sympathetic nervous system, hypothalamic-pituitary-adrenal (HPA) axis, and inflammatory responses to stress, which in turn could promote atherosclerosis. As compared to their nondepressed counterparts, depressed individuals may also be more likely to engage in maladaptive methods to cope with SLEs (e.g., increased tobacco use, alcohol use, and consumption of low-nutrient, energy dense foods), which could also promote atherosclerosis. I examined cross-sectional data from 274 to 279 (depending on the outcome measure) older, African American adults (mean age = 66 years, 67% female) with no evidence of clinical CVD or dementia who participated in the St. Louis African American Health-Heart study (2009–2011). Number of SLEs was assessed using the Life Events Calendar, a structured interview. From this interview, a continuous SLEs variable was computed (number of adult SLEs: 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11+). Severity of depression symptoms was measured using the 17-item Hamilton Rating Scale for Depression (HAM-D). Two measures of subclinical atherosclerosis were obtained: carotid intima-media thickness (CIMT; assessed by ultrasonography) and coronary artery calcification (CAC; assessed by multi-detector computerized tomography). I conducted linear (CIMT) and logistic (CAC) regression models, first adjusted for demographics (age, sex, education) and then fully-adjusted (demographics; mean arterial pressure; low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C); hemoglobin A1c; BMI; tobacco use; diabetes diagnosis; and use of antihypertensitve, lipid lowering, antidiabetic, and antidepressant medications). No main effects of SLEs or HAM-D were found for CIMT or CAC. There were also no SLEs by HAM-D interactions for CIMT or CAC. Because the current results are largely inconsistent with prior literature and there is a paucity of studies utilizing African American samples, future research is needed to examine the independent and interactive associations of SLEs and depressive symptoms with measures of subclinical atherosclerosis. If the present results are replicated, it may suggest that SLEs, depressive symptoms, and their interactive effect are not cardiotoxic among African American adults.

Indiana University-Purdue University Indianapolis (IUPUI) / Losing a job or a significant other are examples of incentive shifts that result in negative emotional reactions. The occurrence of negative life events is associated with increased drinking, and alleviation of negative emotions has been cited as a drinking motive for individuals with problematic drinking patterns (Keyes et al., 2011; Adams et al., 2012). Further, there is evidence that certain genotypes drink alcohol in response to stressful negative life events (Blomeyer et al., 2008; Covault et al., 2007). It is possible that shared genetic factors contribute to both alcohol drinking and emotional reactivity, but there is a critical need for this relationship to be understood. The first aim of this proposal will use an incentive downshift paradigm to address whether emotional reactivity is elevated in mice predisposed to drink alcohol. The second aim of this proposal will address if reactivity to an incentive shift can result in rash action using a differential reinforcement of low rates of responding task, and whether this response is also associated with a predisposition for high drinking. The third aim of this proposal will investigate if experimenter administered ethanol reduces contrast effects, and if an incentive shift increases ethanol consumption in a high drinking line. The overall goal of this proposal is to investigate whether reactivity to incentive shift is an important mechanism underlying alcohol drinking in these mice, and the role an incentive shift may play in producing rash action and influencing ethanol consumption.

The purpose of this qualitative study is to explore how narrative therapy may facilitate not only a lessening of distressing symptoms for bereaved persons, but may also facilitate growth in identity. Five case studies are presented. The participants were chosen to illuminate different grief experiences. The case studies include a description of grieving people from different backgrounds, each with a unique relationship with the person or people who died, all of whom had different causes of death such as suicide, murder and natural causes. These differences provide an opportunity to explore the application of the therapy model with a range of grief experiences. A full and rich description of the experiences of the participants yield insight into the shared themes such as the impact of social expectations of how a grieving person should conduct him or herself, difficult physical and emotional experiences, the many losses flowing from the death, as well as an in-depth discussion of the identity growth that takes place as the bereaved person takes on different roles and tasks. Postmodern epistemology and social constructivism informed the praxis and interpretation of narrative therapy as bereavement model. Narrative therapy is shown as especially effective for grief therapy with therapeutic tenets such as deconstructing and creating richer narratives and alternative stories that enables the bereaved to explore diverse aspects of their character. The emphasis on what remains rather than what is lost, and the concept of remembering the loved one who died in the community of those who stay behind, transmute the loss-story to one of remembering and incorporating, which tends to bring significant emotional relief. This study contributes towards the field of growth through bereavement for which there seems to be a paucity in research. Furthermore, it provides additional evidence for post-traumatic growth in general, especially with the assistance of narrative therapy. / Psychology / Ph. D. (Psychology)