The present work seeks to explain the process by which anxiety was transformed from a trope of nineteenth-century existential theology into the medicalized conception we have today. The dissertation begins in the 1840s with the Danish philosopher Søren Kierkegaard. In his attempt to resolve a series of debates within German idealist philosophy regarding the nature of evil and its impact on human freedom, Kierkegaard argued that anxiety was an intermediate stage between the awakening of man's potential for freedom and its manifestation in the form of sin. On the basis of this reading, Kierkegaard concluded that anxiety was the psychological manifestation of humanity's collective guilt for original sin. Despite the psychological idiom of his account, then, anxiety remained remained for Kierkegaard an irreducibly theological category. Chapter two of the dissertation examines two very different approaches to anxiety in the early twentieth century. For Sigmund Freud, anxiety was nothing more than the expression of libidinal conflicts, especially the Oedipal complex/fear of castration. Although it is commonly believed that Freud's understanding of anxiety underwent a dramatic shift toward the end of his career, I demonstrate that little of substance changed. Martin Heidegger, by contrast, applied Kierkegaard's existential understanding of anxiety to his ontological analysis of being. For Heidegger, anxiety was a "mood" that guided human beings to authenticity. Heidegger's phenomenological approach to human being strongly influenced the Swiss-German psychiatrist Ludwig Binswanger. On the basis of his clinical experience at Bellevue, his family owned sanatorium, Binswanger came to believe that there was a somatic reality to the subjective accounts of anxiety advanced by the philosophers. More than just a mood, anxiety was a concrete medical disorder with an array of psychosomatic symptoms that required diagnosis and treatment. In this way, Binswanger played a significant role in transforming anxiety from an abstract philosophical idea into material medical reality. Chapter four examines examines the work of the German-Jewish neurologist Kurt Goldstein, whose 1935 work The Organism drew extensively on Heidegger and Binswanger to develop a fully realized medical account of anxiety. Drawing on his treatment and rehabilitation of brain-injured soldiers in World War I, Goldstein observed that severe neurological injuries were accompanied by especially acute bouts of anxiety. Alongside the traditional understanding of anxiety as "objectless," Goldstein argued that it was also a somatic process than could be observed and quantified like any other. Goldstein's conclusions placed anxiety at the heart of a comprehensive account of the meaning and significance of biological life. In the years during and immediately after World War II, anxiety became a privileged mode of expression in American medicine and culture. The final two chapters of my dissertation explain how the medical conception of anxiety proliferated across multiple disciplines in postwar America, including theology, literature, and psychotherapy. I then demonstate the way in which anxiety was co-opted into the Cold War struggle against the Soviet Union. Figures like Arthur Schlesinger, Jr., Reinhold Niebuhr, and, especially, Rollo May argued that anxiety was the price Americans had to pay for many of the values they held most dear - above all, freedom and creativity. If Americans appeared vulnerable in comparison to the Soviet Union, he asserted, that was only because Soviet society was fundamentally unfree. Rather than trying to eliminate anxiety, Americans should aim to harness its creative potentiality and channel it toward productive ends. Anxiety thus became part of the Cold War armory, another weapon in the struggle for liberty and prosperity.

This dissertation consists of three studies to assess nurses’ attitudes toward persons with mental illness. The first study was an integrative review of literature which revealed that surveyed nurses across 20 countries and three continents had mixed attitudes toward people with mental illness. While those attitudes mirrored attitudes of the general public and health providers in the United States, none of the identified studies explored nurses’ attitudes toward people with mental illness in the United States and none included a theoretical framework, showing several gaps in knowledge. Therefore, in the second paper of this dissertation two leading theories regarding stigma were analyzed and compared in order to select the best theoretical framework to guide a survey of psychiatric nurses’ attitudes toward the mentally ill, which comprises the third study of this dissertation. The Modified Labeling Theory (MLT) and the Cognitive Behavioral Models (CBM) were analyzed and evaluated. Since the MLT had strong empirical evidence, it was selected to guide the quantitative study that explored nurses’ attitudes toward people with mental illness. This exploration of 146 mental health workers and registered nurses’ attitudes in a 270-bed psychiatric hospital in New York examined three areas: it assessed respondents’ beliefs about devaluation and discrimination of people with mental illness and factors related to these beliefs; compared respondents’ expressed stigmatizing actions toward patients with schizophrenia or depression versus those with diabetes but no mental illness; and it assessed the extent to which study results were consistent with the theoretical underpinnings of the MLT. In general, respondents expressed the belief that people with mental illness would be devaluated and discriminated and expressed stronger desire for social distance from a person with schizophrenia than depression. Even though the respondents did not express a desire for social distance from a person with depression, they indicated their preference to be closer to a person with diabetes. Finally, the results of the study were consistent with the theoretical underpinnings of the MLT, confirming that the MLT is appropriate for use as a guiding theoretical framework for future research in nursing. Implications for future research, nursing education and practice are discussed.

Introduction: Impaired inhibitory control, one of the core executive functions, is common among individuals with mental illness. However, inhibitory control is essential for successful treatment and recovery. Inhibitory control is extremely vulnerable to developmental disruption during adolescence, a time when mental illness is first diagnosed. An acute bout of exercise has been shown to improve inhibitory control in healthy adolescents, however, to our knowledge there are no studies evaluating this effect in adolescents with mental illness. Purpose: The primary goal of this project was to examine the effect of an acute bout of high-intensity interval training on inhibitory control immediately, and 30 minutes following exercise in adolescents hospitalized for mental illness. The secondary goal was to assess the feasibility of using this type of exercise as an adjunct to current treatment. Methods: Participants were recruited through the inpatient mental health unit at the Children’s Hospital of Eastern Ontario. They performed exercise and control conditions in a randomized, counterbalanced manner. The Colour-Word Stroop Task was assessed pre, post, and 30-minutes-post on both days. The exercise condition included a 12 minute HIIT circuit, consisting of body weight exercises performed in a 1:1 work to rest ratio. The control condition involved reading magazines. Repeated-measures ANOVA evaluated changes in Interference Cost, the reaction time cost of responding to trials where the ink and colour do not match, and overall accuracy. Feasibility was assessed through recruitment and completion rates, as well as changes in affect and acceptability of the high-intensity interval training. Results: There was a significant interaction between condition and time for the Interference Cost measure, F(1.6,43.3)=13.6, p<.0001, η2=.34. Interference Cost was similar for both conditions at baseline (Mdiff = 12.4±11.11, p=.28). Interference Cost was significantly reduced immediately (Mdiff = 78.8±14.91, p<.001) and 30-minutes post-exercise (Mdiff = 59.6±15.14, p=.001) compared to control. Response accuracy did not differ by time, F(2,54)=.14, p<=.87, η2=.01 nor condition, F(1,27)=2.25, p=.15, η2=.08. After exercise, participants increased positive affect (mean difference = 4.3±8.09, p=.009) and were willing to perform the exercise before therapy sessions (rating = 6.4±2.75 out of 10). Conclusion: These findings suggest that high-intensity interval training could be used to improve inhibitory control in adolescents with mental illness, which has the potential to enhance the efficacy of their treatment. Future research should determine the impact of individual factors, such as diagnosis, medication, age of illness onset, length of hospitalization, and treatment history, on inhibitory control improvement after exercise.

Aim: The aim of the study has been to study how a Swedish state authority talks about mental health among children and young people. Method: The study is based on a qualitative discourse analysis in which the Public Health Authority's report was carefully studied. Results: The essay highlights how a Swedish authority presents various factors that affect a child's mental well-being. The Public Health Authority describes the discourse on health as good when healthy lifestyles are anchored at an early age as it affects health for the rest of life. Texts produced within the discourse, just as the report produced by the Public Health Authority, recommend good health habits to be introduced in an early stage of a child's life. To understand what these habits are, the authority describes social practices which govern people's experience of the current discourse. The social practices recommendations guide people to act so that they are given the conditions to create healthy habits and relationships at an early age. The analysis of the report shows two dominant categories that affect children's and young people's mental health, the school and the family. These areas are the main parts that the report describes where several identity perceptions have been identified. The identity perceptions are used to categorize the individual and create a recognition to find a place in society and to its discourses. Based on the different perceptions of identity, it is then determined how the individual's surroundings and actions are perceived.

No description available.

Canadian society continues to stigmatize individuals with mental illness, despite the prevalence of mental illness in the population, decades of advocacy to combat mental illness stigma, and known negative sequelae of experiences of stigma by people affected by a mental illness. One negative impact of stigma is internalization of negative connotations attached to mental illness. Although there is extensive research on the stigma of mental illness, there is little information specifically about how youth with mental illness perceive the stigma of mental illness and how they respond to it. The current research sought to understand how youth who self-identify as having a mental illness experienced, perceived and internalized the stereotypes, prejudice and discrimination of the stigma of mental illness. A simple content categorization method was used to identify key themes in the transcribed interviews of eleven youth in Vancouver Canada who identified as having mental illness. Qualitative analysis identified that the most frequent perpetrators of public stigma included casual acquaintances, family, friends, school staff, mental health professionals and authority figures. Youths’ accounts linked mental illness stigma with low mental health literacy, delayed mental health treatment and a low quality of life. The findings are considered with reference to implications for prevention of stigma, including enhanced mental health literacy for mental health professionals and the public aimed at increased understanding, sensitivity and empowerment of youth with mental illness and their families. / Graduate

Individuals exposed adverse childhood experiences (ACEs) are at increased risk of developing chronic illnesses in adulthood including heart disease, cancer, diabetes, and chronic pain. A relationship between ACEs and health risk factors contributing to chronic disease such as smoking, obesity, and sedentary lifestyle has also been established in prior literature. There is evidence that higher that individuals in forensic inpatient mental health samples are disproportionally exposed to ACEs, which may increase odds of chronic disease development. Despite this evidence, little research has examined the prevalence of ACEs and relationships between ACEs and chronic health conditions and risky health behaviors in this population. This study evaluated these variables using archival data collected as part of a large interdisciplinary study from a forensic psychiatric facility. A list of clients (N=182) meeting inclusion criteria was randomly generated and a comprehensive record review was used to ascertain ACE scores and rates of health-risk behaviors and chronic conditions. Findings offered support for increased rates of childhood adversity and a significant relationship between ACE scores and health-risk behaviors within a forensic inpatient mental health population. However, relationships between ACEs and chronic illnesses and health-risk behaviors and chronic illnesses failed to reach significance. The lack of significance in these relationships suggests that ACEs are less singularly predictive of chronic illness within this population and instead different factors may drive the development of chronic illness.

Since 1973, the year in which Elaine Hedges's groundbreaking edition of "The Yellow Wallpaper" was published, Charlotte Perkins Gilman's short story has been read primarily as one of America's leading feminist texts. With potent symbolism and a fragmented style of narration, it is easy to understand why many feminist scholars fashion the story's narrator into a proactive feminist, a courageous heroine who rebels against patriarchal oppression. While this trend of interpretation compellingly attempts to empower the narrator, it often overlooks her perspective of disability and projects the characteristics of a nondisabled, high-functioning feminist on a mentally ill woman. This paper reads Gilman's short story as a narrative of mental illness and applies the research of feminist disability scholars Anita Silvers, Jenny Morris, and Susan Wendell to a close reading of the story. Approaching the story from this perspective, we can identify the systems of oppression that disable the narrator and read "The Yellow Wallpaper" in a way that validates the subjective reality of depression and invites disabled voices into feminism's exploration of womanhood.

Over 43 million Americans suffer from mental illness annually with 40% seeking support from clergy (Polson & Rogers, 2007) who claim to be ineffectively prepared (Farrell & Goebert, 2008). This study investigated if mental health training administered to clergy would increase their knowledge of various mental disorders, alter their opinion regarding helpful resources, grow their self-confidence to help individuals experiencing mental health issues, and increase clergy's willingness to refer out. The theoretical basis for this research was attribution theory that attempts to explain social perceptions (Mannarini & Boffo, 2013) and the struggle individuals (i.e. clergy) have regarding the causation of mental health concerns (Locke & Pennington, 1982) and identification of mental illness symptoms (Miller, Smith & Uleman, 1981). In the within-group study, clergy completed the Mental Health Effectiveness Questionnaire pre and post training to answer the following questions: Does participation in a training workshop affect clergy's knowledge of mental disorders, opinion regarding helpful resources, self-confidence to assist an individual with mental health issues, and willingness to refer to a helpful resource? The majority of participants had experience with mental illness. Unexpected results showed mental health training positively influenced some opinions regarding helpful resources and confidence to assist someone with mental illness. The results of this research may influence positive social change by showing that faith based mental health training may do more than increase confidence to someone to assist and refer an individual experiencing mental health issues. It may also be a means of social support to family members already possessing knowledge of mental illness or indicate that family members are in search of more faith based mental health training.

This thesis is motivated by a lack of studies on the history of mental illness in South Korea. It builds upon existing studies by historians Theodore Yoo and Bang Hyun Lee, who have also used newspapers to analyze the discourse surrounding mental illness during Colonial Korea (1910-1945). Specifically, I analyze newspapers in the decades following this period to revisit three themes that both Yoo and Lee noted about the colonial period: (1) the religious practice of hitting individuals with mental illnesses, (2) the strong support for the sterilization of people with mental illnesses, and (3) the association between crime and mental illness. Because the colonial period was when people with mental illnesses were increasingly treated as social outcasts, comparing shifts or continuances from the colonial period was useful in exploring the stigma attached to mental illness in Korea. The articles surrounding the first theme revealed that despite the stigma attached to Shamanistic practices of beating during the colonial period due to a growing biomedical understanding of mental illness, they surprisingly persisted. There were also new developments, in which people with mental illnesses were beaten, chained, and isolated in “treatment” institutions across the nation for no particular reason. Articles surrounding the second theme showed that though inflamed rhetoric surrounding sterilization operations were not found post-1950, rhetoric with eugenics undertones lingered. Newspapers reported on these inhumane practices until as late as 1999. For the third theme, this study finds that the press continued to strongly associate mental illness with crime. These associations that effectively equated individuals with mental illnesses to criminals still frequently occur in newspapers today, particularly with what the media calls “Don’t Ask” crimes. Based on these findings, this study discovers that the negative treatment and perception of people with mental illnesses persisted long beyond Colonial Korea. It also stresses the importance of examining the role the press plays in contributing to the stigma attached to mental illness and shaping the way mental illness is understood.