Tangible User Interfaces (TUIs) offer the potential for new modes of social interaction for children with Autism Spectrum Conditions (ASC). Familiar objects that are embedded with digital technology may help children with autism understand the actions of others by providing feedback that is logical and predictable. Objects that move, playback sound or create sound – thus repeating programmed effects – offer an exciting way for children to investigate objects and their effects. This thesis presents three studies of children with autism interacting with objects augmented with digital technology. Study one looked at Topobo, a construction toy augmented with kinetic memory. Children played with Topobo in groups of three of either Typically Developing (TD) or ASC children. The children were given a construction task, and were also allowed to play with the construction sets with no task. Topobo in the task condition showed an overall significant effect for more onlooker, cooperative, parallel, and less solitary behaviour. For ASC children significantly less solitary and more parallel behaviour was recorded than other play states. In study two, an Augmented Knights Castle (AKC) playset was presented to children with ASC. The task condition was extended to allow children to configure the playset with sound. A significant effect in a small sample was found for configuration of the AKC, leading to less solitary behaviour, and more cooperative behaviour. Compared to non-digital play, the AKC showed reduction of solitary behaviour because of augmentation. Qualitative analysis showed further differences in learning phase, user content, behaviour oriented to other children, and system responsiveness. Tangible musical blocks (‘d-touch') in study three focused on the task. TD and ASC children were presented with a guided/non-guided task in pairs, to isolate effects of augmentation. Significant effects were found for an increase in cooperative symbolic play in the guided condition, and more solitary functional play was found in the unguided condition. Qualitative analysis highlighted differences in understanding blocks and block representation, exploratory and expressive play, understanding of shared space and understanding of the system. These studies suggest that the structure of the task conducted with TUIs may be an important factor for children's use. When the task is undefined, play tends to lose structure and the benefits of TUIs decline. Tangible technology needs to be used in an appropriately structured manner with close coupling (the distance between digital housing and digital effect), and works best when objects are presented in familiar form.

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The behavioral effects of nicotine on locomotor activity in a rodent model of psychosis were analyzed. This model is based on neonatal quinpriole treatment (a dopamine D2/D3 agonist) which causes increased D2 receptor sensitivity, a phenomenon known as D2 priming that is common in schizophrenia. D2-primed adolescent rats did not demonstrate nicotine-induced hypoactivity early in training, and males demonstrated more rapid sensitization to nicotine as compared to controls administered nicotine. D2-primed females administered nicotine demonstrated increased stereotypic behavior. D2-primed adult rats given nicotine demonstrated significantly more robust sensitization to nicotine than controls given nicotine. Brain-derived neurotrophic factor (BDNF) was analyzed in the nucleus accumbens. BDNF was significantly increased in nicotine treated adolescent females but was not affected in males. Nicotine alleviated BDNF deficits in D2-primed adults. These results suggest that sensitization to nicotine in D2-primed rats is age dependent, and nicotine induced changes in BDNF that is age and sexdependent.

There are many challenges that come with diagnosing attentiondeficit/ hyperactivity disorder (ADHD), including shared symptoms with many similar disorders, high comorbidity of other mental disorders, and subjective bias from informant reports. Three clinical guidelines for diagnosing ADHD currently exist, published by the American Academy of Pediatrics (AAP), the National Institute for Health and Care Excellence (NICE), and the American Academy of Child and Adolescent Psychiatry (AACAP). However, these guidelines are outdated as they are based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and do not include more recent research. This project was intended to update these guidelines by incorporating the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) as well as a selection of research on ADHD diagnosis published in the last ten years. This updated set of guidelines can be found in Appendix A of this document. Emphasis is on the evidence-based assessment model of using only psychometrically strong assessment measures and basing diagnostic decisions on posterior probabilities. Review of the literature also indicated a need to assess for differential and comorbid diagnoses in ADHD evaluations. Recommendations for doing so are discussed. Lastly, results of the review provided a strong argument against the use of continuous performance tests (CPTs) and other executive functioning measures in diagnosing ADHD, as their diagnostic accuracy is generally not acceptable.

Anxiety is a common and often stigmatized condition. Destigmatizing mental disorders can positively impact people’s interaction and communication with others and can prompt conversations in which people share their experiences with mental health, leading to improved societal understanding and perception. My design solution tackles behavioral symptoms of anxiety, specifically two conditions that fall under obsessive-compulsive behavior: Dermatillomania and Trichotillomania. By redesigning women’s jewelry to specialized accessories, my intention is for these objects to help destigmatize these conditions and relieve symptoms of maladaptive behaviors and hurtful impulses. By redirecting these irresistible urges to an external artifact, the objects are designed to help the user tactfully and harmlessly manage symptoms while at the same time satisfying the user’s impulse.

Psychiatric genetics is a basic science field that has potential for practical application and effective translation. To date, translational frameworks utilized by this field have been linear (e.g., sequential) in nature, focusing on molecular genetic information. It is proposed that non-linear (e.g., socio-ecological) frameworks are a better way to immediately translate non-molecular genetic information. This dissertation explored the translation of psychiatric genetic information in two ways. First, a survey was sent to academic stakeholders to assess the state of the science regarding the translation of genetic information to the clinical care of mental health disorders. Findings from this indicate a translation-genetic competence gap whereby genetic knowledge reinforces linear frameworks and genetic competence is needed to achieve effective translation in this content area. Second, a new risk factor model for social anxiety was created that incorporated genetic, environmental, and neurophysiological risk factors (behavioral inhibition, parental bonding, emotion reactivity). Findings indicate that genetic etiology is more informative knowledge that can influence risk factor models and possibly prevention and intervention efforts for social anxiety. Overall this dissertation paves the way for examining the translational capacity of psychiatric genetics in a clinical setting. It constitutes the first examination of barriers to and a potential solution for the most effective translation of psychiatric genetic information.

While multiple Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans suffer from mild Traumatic Brain Injury (mTBI), Post-traumatic Stress Disorder (PTSD), and co-morbid mTBI and PTSD, there remains difficulty disentangling the specific symptoms associated with each disorder using self-report and neurocognitive assessments. We propose that neurological soft signs (NSS), which are tasks associated with general neurologic compromise, may prove useful in this regard. Based on our review of the literature we hypothesized that individuals with PTSD would present with a greater number of NSS than controls or individuals with mTBI. Further, we hypothesized a synergistic effect, such that individuals with mTBI + PTSD would present with the greatest number of NSS. To test these hypotheses, we analyzed a subset of individuals (N=238) taken from a larger study of neurocognitive functioning in veterans. Participants completed a battery of neuropsychological measures, which included the Behavioral Dyscontrol Scale (BDS), the current study’s measure of NSS. A subset of other neuropsychological measures were also included to examine the utility of NSS over and above traditional neuropsychological measures. Individuals were removed from the study if they sustained a moderate/severe TBI or did not meet validity criteria on the Green’s Word Memory Test or the Negative Impression Management subscale of the Personality Assessment Inventory. Binomial logistic and multinomial logistic regression were used to examine the ability of NSS to discriminate between the study groups, first by themselves and then after the variance explained by the traditional neuropsychological measures was accounted for. Exploratory cluster analyses were performed on neuropsychological measures and NSS to identify profiles of cognitive performance in the data set. Results indicated that individuals in the mTBI and/or PTSD group had more NSS compared to controls. Of the individual NSS items only a go/no-go task of the BDS discriminated between groups, with worse performance among individuals in the mTBI, PTSD, and mTBI + PTSD group compared to controls. In contrast, the overall BDS score and individual NSS, in general, did not discriminate between the mTBI, PTSD, and mTBI + PTSD group. Overall, the current study suggests that, when eliminating participants who do not meet validity criteria, NSS do not aid in discriminating between individuals with mTBI, PTSD, and mTBI + PTSD.

The CIDI is a fully standardised diagnostic interview designed for assessing mental disorders based on the definitions and criteria of ICD-1Oand DSM-IlI-R. Field trials with the CIDI have been conducted in 18 centres around the world, to test the feasibility and reliability of the CIDI in different cultures and settings, as well as to test the inter-rater agreement for the different types of questions used. Of 590 subjects interviewed across all sites and rated by an interviewer and observer, 575 were eligible for analysis. The CIDI was judged to be acceptable for most subjects and was appropriate for use in different kinds of settings. Many subjects fulfilled criteria for more than one diagnosis (lifetime and six-month). The most frequent lifetime disorders were generalised anxiety, major depression, tobacco use disorders, and agoraphobia. Percentage agreements for all diagnoses were above 90% and the kappa values were all highly significant. No significant numbers of diagnostic disconcordances were found with lifetime, six-month, and four-week time frames.

This article reports the results of a cross-national investigation of patterns of comorbidity between substance use and psychiatric disorders in six studies participating in the International Consortium in Psychiatric Epidemiology. In general, there was a strong association between mood and anxiety disorders as well as conduct and antisocial personality disorder with substance disorders at all sites. The results also suggest that there is a continuum in the magnitude of comorbidity as a function of the spectrum of substance use category (use, problems, dependence), as well as a direct relationship between the number of comorbid disorders and increasing levels of severity of substance use disorders (which was particularly pronounced for drugs). Finally, whereas there was no specific temporal pattern of onset for mood disorders in relation to substance disorders, the onset of anxiety disorders was more likely to precede that of substance disorders in all countries. These results illustrate the contribution of cross-national data to understanding the patterns and risk factors for psychopathology and substance use disorders.

The role of comorbidity as a risk for suicide attempts is investigated in a random sample of 3021 young adults aged 14–24 years. The M-CIDI, a fully standardized and modified version of the Composite International Diagnostic Interview, was used for the assessment of various DSM-IV lifetime and 12-month diagnoses as well as suicidal ideation and suicide attempts. Of all suicide attempters, 91% had at least one mental disorder, 79% were comorbid or multimorbid respectively and 45% had four or more diagnoses (only 5% in the total sample reached such high levels of comorbidity). Suicide attempters with more than three diagnoses were 18 times more likely (OR = 18.4) to attempt suicide than subjects with no diagnosis. Regarding specific diagnoses, multivariate comorbidity analyses indicated the highest risk for suicide attempt in those suffering from anxiety disorder (OR = 4.3), particularly posttraumatic stress disorder followed by substance disorder (OR = 2.2) and depressive disorder (OR = 2.1). Comorbidity, especially when anxiety disorders are involved, increases the risk for suicide attempts considerably more than any other individual DSM-IV diagnoses.