Cannabinoids (CB) are compounds structurally derived from Δ(9)-THC, the main pharmacologically active component of cannabis and marijuana. CBs produce psychoactive effects by binding the cerebral CB1 receptor (CB1R). The mammalian brain also naturally produces endocannabinoids (eCBs), intrinsic ligands of CB1R. At the start of this doctoral project, the role of the eCB system in mood regulation and the interaction between CBs and monoamines remained largely unexplored. The main aim of this project was to characterize the effects of CBs and eCBs on depression-like reactivity in murids. Since serotonin (5-HT) and norepinephrine (NE) are the major monoamine neurotransmitters implicated in depression pathophysiology and in the mechanism of action of antidepressants, we employed electrophysiological techniques to assess the in vivo effect of CBs and eCBs on 5-HT neurons of the dorsal raphe, on NE neurons of the locus coeruleus, and on postsynaptic limbic areas. The direct CB1R agonist WIN55,212-2 produced a bell-shaped effect in the rat forced swim test (FST), with low doses eliciting antidepressant-like activity while high doses being inert. This behavioural pattern was congruent with electrophysiological data. Indeed, a rapid increase of 5-HT neural activity was observed at low-doses while an attenuation below basal levels was observed at high doses. The enhanced 5-HT activity was instigated by an excitatory feedback driven by CB1Rs in the ventromedial prefrontal cortex, a limbic structure involved in stress controllability. Chronic exposure to low or high doses of WIN55,212-2 in adolescence but not in adulthood precipitated depressive- and anxiety-like reactivity that persisted in adulthood. These emotional impairments were associated with 5-HT hypoactivity and NE hyperactivity. URB597 is a novel compound that inhibits fatty acid amide hydrolase (FAAH), an enzyme that degrades anandamide, one of the major eCBs. URB597 is thus able to markedly enhance brain ananda / Les cannabinoïdes (CBs) sont des composés dérivés structurellement du Δ(9)-THC, le principe actif du cannabis. Ces drogues produisent leurs effets en se liant aux récepteurs CB1 (CB1R). Le cerveau produit également des endocannabinoïdes (eCBs) naturellement, et ceux-ci constituent les ligands intrinsèques du CB1R. Le rôle du système eCB dans la régulation de l'humeur et l'interaction entre les CBs et les monoamines étaient des sujets encore largement inexplorés. L'objectif était de caractériser l'impact de la modulation du système eCB par les CBs/eCBs sur des modèles de dépression chez le rongeur. Comme la sérotonine (5-HT) et la norépinéphrine (NE) sont les neurotransmetteurs impliqués dans la pathophysiologie et le traitement de la dépression, nous avons utilisé des techniques électrophysiologiques pour isoler in vivo l'effet des CBs/eCBs sur l'activité neurones 5-HT du raphé dorsal, des neurones NE du locus coeruleus et sur les aires postsynaptiques du système limbique. L'agoniste du CB1R, le WIN55,212-2, produit un effet bi-phasique lors du test de nage forcée (FST). Les faibles doses ont entraîné une réponse de type anti-dépresseur, alors que les doses élevées sont restées sans effet. La modulation de la 5-HT a également montré une réponse bidirectionnelle, les faibles doses ayant stimulé l'activité neuronale 5-HT, et les doses élevées la réduisant sous le niveaude base. L'augmentation de l'activité 5-HT semble mettre en action une boucle excitatrice engendrée par la stimulation des CB1R du cortex préfrontal ventromédial, qui est impliqué dans le contrôle du stress. À l'adolescence, l'exposition chronique au WIN55,212-2, a engendré une perturbation semblable à la dépression et l'anxiété qui persiste à l'âge adulte. Ces troubles émotionnels semblent être associés à une hypoactivité de la 5-HT et à une hyperactivité de la NE. L'URB597 est un composé inhibant l'acide gras amide hydrolase (HAAG),

This thesis reports a qualitative ethnographic study conducted in a small sample of local informants composed of Aymara women living in El Alto, an urban-poor setting in the outskirts of La Paz, Bolivia. The aims of the study were the following: What are the local idioms of distress, main explanatory models and help-seeking, healing and coping behaviours, with regards to the experience of distress and mental illness within this specific population? Data were collected during ethnographic fieldwork, mostly through interviews using the MINI interview. Results suggest the existence of specific idioms of distress, healing and coping behaviours, which are being adapted to the cultural and urban context of the population by the process of creolization. The most common idioms of distress and illnesses are described, i.e. preocupaciones, pena, susto, and nervios. Health inequalities and accessibility to health services are discussed, and few recommendations for practice and research are made. / Ce mémoire porte sur une étude ethnographique réalisée auprès de femmes Aymara vivant à El Alto, une ville située aux limites de La Paz, en Bolivie. La question de recherche était la suivante : Quelles sont les expressions de la détresse et de la maladie mentale au sein de cette population, de même que leurs principaux modèles explicatifs, leurs mécanismes de recherche d'aide, et leurs stratégies d'adaptation et de guérison? Les données ont été majoritairement recueillies à l'aide de l'entrevue MINI. Les résultats suggèrent l'existence de comportements et de moyens d'expression spécifiques à cette population, qui ont été adaptés à son contexte urbain et culturel par le processus de créolisation. Les expressions et maladies les plus courantes sont décrites, ex. preocupaciones, pena, susto et nervios. La présence d'inégalités sociales et l'accessibilité aux soins de santé sont discutées et des recommandations pour la recherche et la pratique sont mentionnées.

Cognitive training paradigms constitute a budding field in both research and the commercial market. Engulfed in hype, computerized training programs are particularly enticing in the "Informatics Era" and have fostered the development of increasingly complex programs aiming to improve cognitive function. With the promise of enhancing skills such as attention and memory, cognitive training programs appeal particularly to atypically developing individuals as a non-pharmaceutical alternative to treatment. Such claims have led both professionals and laypersons to question the effectiveness of commercially-available products. In our critical review, we investigate the potential benefits of various cognitive training paradigms and evaluate the evidence supporting or discounting popular programs in specific populations. This investigation reveals that, while certain forms of training demonstrate benefits for improving certain cognitive skills, many programs require more rigorous scientific evaluation to validate their claims. Our experimental piece studies the effectiveness of an adaptation on one scientifically-validated form of cognitive training: computerized attention training. We seek to determine the clinical effectiveness of this type of program in children with common impulse-control disorders, including attention deficit hyperactivity disorder, oppositional defiance disorder, and conduct disorder. Findings from this study suggest that, while subjective ratings of behavior may improve as a result of training, children may require prolonged training periods to benefit on objective ratings of attention and intelligence. Future studies remain to elucidate the effectiveness and sustainability of such training programs when administered over longer periods, as well as more subtle changes detected through neuroimaging. / L'entrainement cognitif de l'attention est un domaine qui prend de plus en plus d'ampleur à la fois dans le monde de la recherche et dans le marché commercial. Couverts de publicité, des programmes informatiques d'entrainement mettent sur pieds des logiciels de plus en plus complexes ayant pour cible le développement des fonctions cognitives. Promettant d'améliorer des aptitudes telles que la capacité mnémonique ou l'attention, ces programmes d'entrainement cognitif sont particulièrement attirants pour des individus atteints de problèmes développementaux puisqu'ils semblent offrir une alternative aux traitements pharmaceutiques. Ces promesses ont cependant conduit les professionnels de la santé, ainsi que le public, à s'interroger sur l'efficacité réelle des produits disponibles sur le marché. Dans notre revue critique, nous tentons de saisir les bienfaits que divers programmes d'entrainement cognitif peuvent apporter, et nous évaluons les preuves en faveur ou en défaveur des programmes d'entrainement cognitif disponibles sur le marché. Nos recherches indiquent que, bien que certains types d'entrainement soient source de bienfaits cognitifs, plusieurs programmes promettent des effets qui ne sont pas soutenus par des preuves scientifiques suffisantes. Dans notre projet de recherche, nous étudions l'efficacité d'une adaptation d'un programme d'entrainement cognitif ayant été validé scientifiquement : l'entrainement de l'attention par programme informatisé. Nous tentons de déterminer l'efficacité clinique de ce type d'intervention chez les jeunes enfants atteints de troubles d'habitudes et d'impulsions, entre autre chez les enfants atteints du trouble de déficit de l'attention avec hyperactivité, du trouble oppositionnel avec provocation ou du trouble des conduites. Les résultats de notre étude révèlent que, bien que l'évaluation subjective du comportement de l'enfant semble s'améliorer suite à l'entrainement de l'attention, il est possible que les enfants aient besoin de séances d'entrainement prolongées afin de démontrer des bienfaits pouvant être mesurés objectivement, tels qu'une augmentation de l'intelligence ou de l'attention. Les études à venir devront évaluer l'efficacité et la stabilité à long terme des effets de ces programmes et enquêter la possibilité qu'un entrainement soutenu provoque des changements plus précis pouvant éventuellement être détectés par des techniques d'imagerie cérébrale.

As most models of psychotherapy have been developed based on Western worldviews, they may need to be adapted when applied in other cultures. One way to make psychotherapy culturally sensitive is to study the indigenous healing systems of specific cultural groups. This study focuses on dang-ki, which is a form of Chinese shamanism in Singapore. It seeks to understand whether dang-ki is perceived as helpful, and the explanations for such perception. Interviews were conducted with patients, dang-kis, and interpreters in three phases: immediately before and after the healing, and approximately one-month later. Results suggest that dang-ki healing is helpful probably due to three interrelated factors: restoration of psychosocial functioning through regulation of emotion and cognition, and mobilization of social supports; a positive patient-healer relationship; and use of culturally relevant meanings and intervention strategies. Implications for developing culture-specific psychotherapy with Chinese patients will be discussed. / Puisque la plupart des modèles de psychothérapie reposent sur des conceptions occidentales du monde, leurs applications à d'autres cultures nécessitent parfois des adaptations. Une façon d'adapter culturellement la psychothérapie est d'étudier les systèmes indigènes de guérison propres à certains groupes culturels. Cette étude porte sur le dang-ki, une forme de chamanisme chinois pratiqué à Singapour. Elle vise à déterminer si le dang-ki est perçu comme utile et à comprendre les raisons qui expliquent cette perception. Des entrevues ont été menées auprès de patients, de dang-kis et d'interprètes en trois phases successives : immédiatement avant et après la guérison, et environ un mois plus tard. Les résultats donnent à penser que l'utilité de la guérison dang-ki est sans doute attribuable à trois facteurs interdépendants : la restauration du fonctionnement psychosocial à travers la régulation de l'émotivité et de la cognition ainsi que par la mobilisation des soutiens sociaux; une relation patient-guérisseur positive; et l'utilisation de significations et de stratégies d'intervention culturellement pertinentes. On discutera des implications pour le développement d'une psychothérapie spécifique à la culture des patients chinois.

There is a 5--8% excess of winter-births among schizophrenia patients. This could be due to prenatal exposures to seasonally varying factors. Although winter-born and non-winter-born patients tend to differ in various aspects of the illness, associations between season of birth and premorbid adjustment (PMA) are unclear. Objectives. The main purpose of this study was to determine whether winter-born and non-winter-born schizophrenia patients differ in terms of PMA and to examine how family history may influence the association. A second objective was to determine which of the proposed underlying seasonal factor, and during which trimester of gestation, explains the most variance in PMA. Method. Data on four PMA dimensions (attention, internalising, externalising, and social) and family history were collected for 37 patients. Subject's prenatal exposure to sunshine, temperature, and influenza for each trimester of gestation was calculated. Results . Non-winter-birth and a positive family history of schizophrenia-spectrum disorders were associated with worse PMA. Prenatal exposure to both sunshine and temperatures during the first and third trimesters of gestation explained variance in particular PMA dimensions. Results suggest different mechanisms by which season of birth and family history interact in explaining distinct dimensions of PMA.

<p> The purpose of this project was to write a grant proposal seeking funding for a community-based mental health-educational outreach program targeting African Americans in Los Angeles County, California. This population underutilizes mental health intervention services despite their high risk of developing mental health abnormities. The California Endowment was chosen as a potential funder due to its commitment to improving the health of Californians; the host agency Alma Family Services, shares in the commitment to early prevention and intervention. The program will provide resource information to reduce barriers to treatment and to increase awareness. The actual submission and/or funding of this grant was not a requirement for the successful completion of this project.</p>

<p> The purpose of this study was to see if factors such as age, gender, and diagnoses have an effect on one's ability to recover from the symptoms of his or her mental illness. Data was collected from one of five FSP teams at MHA Village. Within the team selected, members with all necessary data were included. The research analyzed the responses of 55 MHA Village members. </p><p> The results of this study show that MORS scores do not differ by gender, Axis I diagnosis, having an Axis II diagnosis, income source, race, primary pay source, referral source, age, length of enrollment, or family income. There was, however, a positive correlation between family income and length of enrollment. Future research is needed to gain an in-depth understanding and knowledge of the diverse factors associated with mental health recovery, as well as how to more accurately measure mental health recovery in the first place.</p>

<p> Having an infant admitted to the neonatal intensive care unit (NICU) can be stressful and overwhelming for parents and families. Parents have developed anxiety and depression disorders, as a result of their experience from having their infant in the NICU. The stress and anxiety can also affect the parent-child attachment, as well as putting the infant/child at risk of abuse and neglect. A licensed clinical social worker will facilitate a support group using the strength based perspective to empower individuals and families. The support group goals are: to reduce the amount of stress that parents and/or caregivers encounter, as a result of their infant being in the NICU, to empower parents and/or caregivers to advocate for their infant who has been in the NICU, and to increase the parents and/or caregivers' ability to appropriately respond to the infant's needs. In selecting, Health Trust, as a funder, it values enhancing the well-being of individual and families in Santa Clara County. An actual submission to the funder was not a requirement of this project.</p>

<p> The purpose of this policy analysis was to analyze the Mental Health Services Act (MHSA) of 2004 using research articles and state and governmental documents. The analysis explored the expansion of mental health services and the challenges of implementation. The programs that were developed to meet the specific needs of the MHSA included early intervention, prevention, curriculum development, education, training, and community services. A thorough examination of the act provided an understanding of how the funds are distributed and how the MHSA will continue to support specialized mental health program services. The information presented in this policy analysis focused on children and youth and in detailing the services they received through the MHSA.</p>

<p> Transnational parents encounter mental health problems and emotional difficulties when they separate from their children to migrate to the United States. The purpose of this project was to locate a funding source and write a grant to develop a program for transnational parents at Maternal and Child Health Access, in Los Angeles, California. The goal of this program was to decrease depressive symptomology and other mental health problems among Latino transnational parents; as well as to address parent-child separation stressors. The proposed program was designed to be culturally competent to meet the needs of Latino immigrant parents through three support groups that utilize supportive, educational, and cognitive behavior therapy components. The Langeloth Foundation was identified as a potential funder for this proposed program. The actual submission and/or funding of this grant was not a requirement for the successful completion of the project.</p>