Objective: This study examined the outcomes of patients diagnosed with borderline personality disorder (BPD) in adolescence. Neuropsychological measures of executive function and attention, as well as trait measures of impulsivity and affective lability were examined with clinical and demographic factors as predictors of outcomes of patients diagnosed with BPD in adolescence.Methods: 47 adolescent girls were assessed for a diagnosis of BPD; 31 had a past diagnosis of BPD while 16 did not meet criteria. Subjects were assessed with the SCID-I, the Diagnostic Interview for Borderlines - Revised (DIB-R), the Symptom Checklist – Revised (SCL-90-R), the Social Adjustment Scale – Self-Report (SAS-SR), the Affective Lability Scale (ALS), the Barratt Impulsivity Scale (BIS), the Continuous Performance Test (CPT), the Wisconsin Card Sorting Test (WCST), and the Attention Network Task (ANT).Results: 4.3 years after initial presentation (mean age=19.6), only 11 index patients still met criteria for BPD and no new cases developed. Those who did not remit were significantly more likely to have a current episode of major depressive disorder, lifetime substance use disorder, and self-reported childhood sexual abuse. Those who still met BPD criteria also scored higher on the ALS and the SCL-90-R. Those who remitted from the diagnosis of BPD had significantly greater impairment on measures of vigilance and overall attention. There were no differences on the BIS, SAS-SR, WCST, or ANT.Conclusions: These findings support the validity of an adolescent diagnosis of BPD and demonstrate that the majority of cases that develop in early adolescence can be expected to remit within 4 years. These findings do not support the hypothesis that there are neuropsychological findings specific to BPD. / Objectif: Cette étude a examiné les résultats des patients diagnostiqués avec un trouble de personnalité limite (TPL) à l'adolescence. Mesures neuropsychologiques de la fonction exécutive et de l'attention, mesures de traits d'impulsivité et de labilité affective, et les facteurs cliniques et démographiques, peuvent être d'importants prédicteurs de résultats chez les patients diagnostiqués avec TPL à l'adolescence.Méthodes: 47 adolescentes ont été évalués pour un diagnostic de trouble borderline, 31 avaient un diagnostic antérieur de la TPL, et 16 ne répond pas aux critères. Les sujets ont été évalués avec le SCID-I, le Diagnostic Interview for Borderline - Revised (DIB-R), la Symptom Checklist – Revised (SCL-90-R), le Social Adjustment Scale-Self-Report (SAS-SR), le Affective Lability Scale (ALS), le Barratt Impulsiveness Scale (BIS), le Continuous Performance Test (CPT), le Wisconsin Card Sorting Test (WCST), et le Attention Network Task (ANT).Résultats: 4,3 ans après la présentation initiale (âge moyen = 19,6), seulement 11 patients index encore répondaient aux critères de TPL et aucun nouveau cas développés. Ceux qui n'ont pas versé étaient significativement plus susceptibles d'avoir un épisode en cours de trouble dépressif majeur, trouble de l'utilisation à vie de substances, et abus dans l'enfance sexuelle autodéclarée. Ceux qui continuent à être remplies TPL critères aussi des scores plus élevés sur les ALS et de la SCL-90-R. Ceux qui remise du diagnostic du trouble borderline avaient une insuffisance significativement plus élevé sur les mesures de vigilance et l'attention générale. Il n'y avait aucune différence sur la BIS, SAS-SR, WCST, ou l'ANT.Conclusions: Ces résultats confirment la validité d'un diagnostic des adolescents de la DBP et de montrer que la majorité des cas qui se développent à l'adolescence au début on peut s'attendre à verser dans les 4 ans. Ces résultats ne soutiennent pas l'hypothèse selon laquelle il ya les découvertes neuropsychologiques spécifiques à la TPL.

Armed conflict, guerrilla warfare, and political violence have contributed to the burden of disease and disability, especially among civilian populations of Peru. The effects of war and political violence can be long lasting and can determine the capacity of people to reconstruct their lives long after wars have ended. The current project is a cross-sectional, qualitative, follow-up study among Quechua populations of the South Central Peruvian highlands who were exposed to twenty years of protracted violence between1980-2000. The previous study was conducted by Pedersen et al (2008) and revealed that of all respondents who had been exposed to violence, one in four (N=92) reported symptoms compatible with the DSM-III-R diagnosis of PTSD. However, due to the absence of mental health services in the province, it was virtually impossible to refer those cases for treatment and follow-up. It has been ten years since the first survey, and a subsample of the number of PTSD positive cases that were detected in 2000, were relocated and interviewed to elicit narratives on the experiences of distress, mental illness, coping and resilience for Quechua individuals of this highland region. The study was conducted in Ayacucho, Peru in four rural communities as well as one urban setting. Semi-structured interviews were carried out with 17 informants who met the compatibility of PTSD in 2000, half of whom continued to have PTSD symptoms in 2011. The findings indicate that individuals express more distress about the tremendous difficulties of surviving in the present day than about the trauma symptoms of the war. Findings suggest that although informants continued to have symptoms of distress, they found resilience in certain community resources, including social, cultural and economic resources. The data reveals that postwar psychosocial health cannot be separated from the broader political and economic structures. / Les conflits armés, la guérilla, et la violence politique ont contribué à les repensions de fléaux, la morbidité au niveau de pertes en vies humaines et les incapacités, surtout parmi les populations civiles du Pérou. Les effets de la guerre et de la violence politique peuvent languir et permet de déterminer la capacité des gens à reconstruire leur vie longtemps après la fin des guerres. Le projet en cours est une étude de suivi, transversale, qualitative chez les populations quechua des hautes terres de South Central Pérou qui ont été exposées à vingt ans de violence entre 1980-2000. Le but de l'étude était d'obtenir des récits sur les expériences de détresses, la maladie mentale, l'adaptation et la résilience des personnes quechua de cette région montagneuse. L'étude a été menée à Ayacucho, au Pérou dans quatre communautés rurales ainsi que d'un milieu urbain. Des entrevues semi-structurées ont été menées par 17 informateurs qui ont rencontré la compatibilité de stress post-traumatique en 2000, dont la moitié ont continué à avoir des symptômes de PTSD. Les résultats indiquent que les individus expriment plus de détresse due aux énormes difficultés de survie a l'époque actuelle contrairement aux symptômes de traumatisme de la guerre. Les résultats suggèrent que, bien que les informateurs ont continué à avoir des symptômes de détresse, ils ont trouvé un support morale aux niveau des ressources communautaires, sociales, culturelles et économiques mis à leur disposition. Les données révèlent que la sante psychosociale d'après-guerre ne peut pas être séparée des structures politiques et économiques.

Background. The comorbidity between psychotic illness and substance abuse is associated with negative outcomes. To better treat substance use in psychosis it is necessary to identify factors specifically promoting substance use in this population, particularly aspects of psychotic illness which may exacerbate substance use. Purpose. to identify whether early-life inattention-hyperactivity and deficits in reward processing could qualify as common factors underlying the comorbidity of psychotic illness and cannabis abuse. Methods. We conducted the following four experiments: 1. The ability of childhood symptoms of ADHD measured using retrospective parental report (Child Behavior Checklist) to predict cannabis-use outcomes in first episode psychosis (FEP). 2. Associations between self-reported anticipatory pleasure and cannabis use in psychosis patients and controls. 3. The effect of cannabis on daily activities and functional measures and on behavioural exertion for rewarding stimuli in psychosis patients and controls with cannabis use. 4. Examining physiological response to pleasant and cannabis images using event-related potentials (ERP), facial expressivity, and galvanic skin response in controls and psychosis patients with cannabis use. Results. 1. Higher levels of inattention symptoms in childhood predicted lifetime cannabis-use disorder and inability to maintain abstinence from cannabis in FEP. 2-4. Psychosis patients showed reward deficits on several measures including: self-reported reward response, engagement in effortful daily activities, behavioural exertion to seek pleasant stimuli, and sustained processing of pleasant stimuli as measured with the late positive potential (LPP) of the ERP. When comparing subjects' response to pleasant stimuli versus cannabis stimuli, control cannabis users showed a significant bias towards pleasant images on all measures, whereas patients showed similar response to both pleasant and cannabis stimuli on most measures. Reduced response on several of the measures on which patients showed a deficit was associated with greater cannabis use: self-reported reward response, behavioral exertion to seek pleasant stimuli, and LPP response to pleasant stimuli. Conclusions and significance. 1. Our finding that childhood inattention is associated with subsequent cannabis in FEP when complemented by studies showing these symptoms are more prevalent in subjects who later develop psychotic disorders is consistent with childhood inattention being a marker for shared vulnerability to develop both psychotic and substance-use disorders. 2-4. Deficits in reward processing are present in individuals with psychotic disorders and some of these deficits may predispose individuals to use cannabis more heavily. If these findings are further developed they could inform treatments targeted for substance use in populations with psychosis. / Introduction. La comorbidité entre les troubles psychotiques et l'abus de substances est associée à une évolution négative. Pour mieux traiter l'abus de substance dans la psychose, il est nécessaire d'identifier les facteurs spécifiques qui augmentent la prévalence de consommation de substances dans cette population, particulièrement les aspects du trouble psychotique qui pourraient exacerber la consommation de substances. Objectifs. Identifier si des symptômes d'hyperactivité-inattention durant l'enfance et des déficits dans les processus de récompense pourraient se qualifier comme des facteurs communs sous-jacents de la comorbidité des troubles psychotiques et de la consommation du cannabis. Méthodes. Nous avons fait les quatre expériences suivantes : 1. L'utilisation des symptômes de TDAH mesurés de façon rétrospective en utilisant un rapport des parents (Child Behavior Checklist) pour prédire la consommation de cannabis chez les premiers épisodes psychotiques (PEP). 2. L'association entre le plaisir anticipé rapporté et la consommation de cannabis chez les patients psychotiques et les contrôles. 3. L'examen de la réponse physiologique à des images plaisantes et de cannabis en utilisant les potentiels évoqués cérébraux (ERP), l'expressivité faciale et la conductivité de la peau chez les contrôles et les patients psychotiques qui consomment du cannabis. 4. L'effet du cannabis sur les activités quotidiennes, les mesures fonctionnelles et l'effortcomportemental pour des stimuli de récompense chez les patients psychotiques et les contrôles qui consomment du cannabis. Résultats. 1. Plus de symptômes d'inattention durant l'enfance prédirait un trouble de consommation du cannabis et l'inaptitude de rester abstinent pour le cannabis chez les PEP. 2-4. Les patients psychotiques démontrent des déficits de récompense sur plusieurs mesures incluant : la réponse rapportée de récompense, l'engagement dans des activités quotidiennes qui demandent de l'effort, l'effort exercé pour rechercher des stimuli plaisants et le traitement prolongé des stimuli plaisants tel que mesuré avec le potentiel retardé positif (LPP) de l'ERP. Lorsque l'on compare la réponse des sujets pour les stimuli plaisants versus les stimuli de cannabis, les consommateurs de cannabis contrôles ont démontré un biais significatif envers les images plaisantes sur toutes les mesures, alors que les patients ont démontré une réponse similaire sur les stimuli plaisants et de cannabis sur la plupart des mesures. Une réponse diminuée sur plusieurs mesures sur lesquelles les patients ont démontré un déficit était associée avec une consommation plus grande de cannabis : la réponse rapportée de récompense, l'effort comportemental pour rechercher des stimuli plaisants et la réponse LPP aux stimuli plaisants.Conclusions et signification. 1. Nos résultats concernant l'inattention durant l'enfance associée à une consommation subséquente du cannabis chez les PEP, lorsque complémentés par les études qui démontrent que ces symptômes sont plus prévalent chez les sujets qui développent plus tard des troubles psychotiques, sont consistants avec les symptômes d'inattention durant l'enfance qui sont déterminants dans la vulnérabilité à développer des troubles psychotiques et de consommation de substances. 2-4. Des déficits dans les processus de récompense sont présents chez les individus avec des troubles psychotiques et certains de ces déficits pourraient prédisposer les individus à consommer du cannabis de façon plus importante. Si ces résultats sont plus amplement développés, ils pourront donner des pistes de traitement pour la consommation de substances dans les populations psychotiques.

<p> This research introduced and studied a new response style construct, co-distraction. Co-distraction refers to diversion of attention from emotional problems to a neutral or pleasant stimulus within a dyadic relationship. It is characterized by discussing or engaging in neutral or pleasant activities, mutual encouragement to discuss or engage in neutral or pleasant activities, and a focus on positive feelings. It was hypothesized that co-distraction would serve a protective function by relating positively to friendship quality and negatively to depression and anxiety. </p><p> Participants were undergraduate college students who were recruited and tested online. They completed questionnaires measuring rumination, distraction, co-rumination, co-distraction, depression, anxiety, and friendship quality. In describing co-rumination, co-distraction, and friendship quality, participants reported on their relationship with their closest same-sex friend. Due to large differences in sample sizes between males (<i>N</i> = 40) and females (<i>N</i> = 138) as well as previously found gender differences on response style and emotional distress variables, the genders were studied separately in statistical analyses. </p><p> Results for co-distraction were as follows: (a) co-distraction scores had high reliability (alpha = .93), (b) co-distraction was positively correlated with positive friendship quality for females but not for males; (c) co-distraction was unrelated to emotional distress for both genders; and (d) it correlated positively with distraction and co-rumination for both genders. As predicted, rumination correlated positively with depression and anxiety, whereas distraction correlated negatively with anxiety for males only. Unexpectedly, co-rumination correlated negatively with one measure of depression for males and was unrelated to emotional distress for females. Distraction was positively correlated with co-rumination for males but was unrelated to co-rumination for females. All told, results were partly consistent with response styles theory. </p><p> In general, predicted gender differences were not obtained, and many results ran counter to expectation. The findings were discussed in light of the sample's highly diverse composition, and they emphasize the importance of taking into account culture when studying associations between response styles and outcomes of emotional distress and friendship quality. Implications for theory and for psychotherapy practice with depressed and anxious clients were discussed. Limitations and directions for future research were considered. </p>

No description available.

This report explores my experiences and desire to develop my clinical skills while completing an advanced practicum with the Mood and Anxiety Program through Health Sciences North. The Mood and Anxiety Program works with individuals that had been diagnosed with a mental illness and wanted to seek therapeutic assistance to learn how to manage symptoms and challenges of their mental illness. In this instance, mental illness is a health condition that is distinguished by considerable dysfunction in a person’s cognition, emotions, or behaviours that could often reveal a disturbance in the psychological, biological, or developmental processes, which could have underlying mental functioning. Through this practicum, and as shown throughout this report, I was able to create and achieve several goals that I felt would assist me in developing my clinical skills. I planned to refine my skills by working as part of a multidisciplinary team; continuously reflecting on my practice with the use of a journal and clinical supervision; completing assessments and cofacilitating group therapy sessions; and, integrating theory into practice. I was also able to critically reflect upon the theories that I used during my practicum; develop and improve my self-awareness; enhance my therapeutic presence; and develop an understanding of how stigma is present in the mental health field and could it acts as a barrier for people with a mental illness.

Objective: In this study, the effectiveness of the modified Recovery Workbook as a psychoeducational tool for facilitating recovery in persons with serious mental illness was examined. Methods: The study was a multi-center, prospective, single-blinded, randomized controlled trial. A total of 33 people receiving Assertive Community Treatment (ACT) services participated in the study. For 12 weeks, a control group continued receiving their usual treatment as determined by the ACT team, and an intervention group received the Recovery Workbook training in addition to the normal standard of care from the ACT team. Groups were compared using t-tests for continuous measures and chi-squared analyses with correction for continuity of dichotomous measures, as appropriate. The overall effects of the Recovery Workbook Training on individuals’ perceived level of hope, empowerment, knowledge, and quality of life were measured using a repeated measures analysis of variance (ANOVA). Team (PCCC-MHS/Frontenac) and group (experimental/control) were the between-subject factors, and time of testing (initial, final) was the within subject factor. Results: Participation in the Recovery Workbook was associated with significant change in participants’ perceived sense of hope, empowerment, and goal and success orientation. These associations remained significant when commensurate demographic variables were controlled for. Conclusions: This study is the first randomized controlled trial of a recovery-based psychoeducational intervention in persons with serious mental illness, and opens a new chapter of evidence-based practice for implementing recovery in mental health service delivery. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2007-08-01 11:55:02.924

No description available.

This dissertation develops a meaning oriented model of the relationship between culture and the subjective experience of psychosis, by analyzing interviews and other ethnographic data collected over the course of a 12 month fieldwork in Istanbul, Turkey. The theoretic framework for the study is introduced on the basis of detailed discussions of the notion of schizophrenia, the questions of Turkey and Turkish identity, and the basic theories of semiotics. Derived from the theoretic framework, four principles are then proposed as fundamental features of the relationship between culture, meaning systems, subjectivity and psychosis, as follows. (1) the inseparability of the notions of subject, culture, and meaning system.(2) the simultaneous synchronicity and diachnoricity of sign systems. (3) the heteroglossic nature of private associative networks and narratives. (4) the conglomerate composition of subjective autobiographical narratives. Based on these principles, an analytic approach is then developed and applied towards in-depth cultural semiotic analyses of data collected from interviews with three psychotic inpatients, their families and their clinicians. The results of the analyses demonstrate strong evidence for an interrelational model of culture, meaning, subjectivity and psychosis, as well as a fundamental presence of diachronic modality in patterns of association and networks of meaning in patients' discursive efforts to re-establish psychic wholeness and self-identity. Based on these findings and in reference to the earlier theoretical principles, the results are formalized to conclude three principal modes of 'continuity': (1) the mutual continuity of private experience and collective meaning, which reflects the importance of understanding private psychological and subjective phenomena as contextualizated processes always embedded within collective systems of meaning and power, such as culture and politics. (2) the continuity of psychotic and non-psychotic modes of subjectivity, which further highlights the embeddedness of psychotic models of experience and behavior in local systems of meaning and power. (3) the continuity of systems in time, which highlights the temporal dimension of private and collective modes of experience, and thus emphasizes the significance of considering not only private life histories, but also local historical and political trajectories in clinical and intellectual assessment of subjective and psychological experiences such as psychosis.

Mental illness is characterized by alterations in thinking, mood and behavior and is associated with significant distress and impaired functioning. Many mental illnesses and medications used in their treatment, can in some way impair fitness-to-drive. / This thesis comprises two independent but complementary articles. In the first article, the authors review the most recent literature on fitness-to-drive amongst individuals with mental illness, including those using psychotropic medications. In the second article, the authors assess current attitudes, practices, and knowledge of Canadian psychiatrists concerning driving safety amongst individuals with mental illness using a nation wide cross-sectional survey based on a random sample of practicing Canadian psychiatrists.