This study explores the subjective catalyst influencing bulimic women to seek psychological treatment, as measured by the Subjective Factors Influencing Bulimics to Seek Treatment self report inventory. The factors addressed in the inventory designed specifically for this study were divided into five categories: Environmental, Thoughts and Behaviors, Emotional, Physical, and Spiritual. Both clinically diagnosed and self diagnosed female subjects participated in this study. The subjects voluntarily completed the anonymous self report inventory designed in a four point Likert format. Additional space was provided to write in any influencing factors on treatment seeking that were not included in the questionnaire. The data was collected, statistically analyzed, and summarized. Results were yielded through means, standard deviations and T-tests. Findings indicated that factors in the Emotional category had the greatest influence on bulimic participants to seek psychological help. The specific questionnaire item that was rated as having the strongest influence was "Hate your body".

No description available.

No description available.

No description available.

Objectives: The purpose of this thesis was to identify risk factors for the development of mental health concerns in pre-teens and adolescents with Autism Spectrum Disorder (ASD), and in particular the role of early childhood ASD symptomatology in their development. Additionally, this thesis generated prevalence estimates for mental health concerns in Canadian adolescents with ASD. Methods: The parents of 390 individuals with ASD were invited to participate in a survey, either online or by mail. Sixty-seven parents completed and returned surveys. Kendall tau b correlation coefficients were calculated for the association between age at assessment with ADI-R and score in each domain. Prevalence estimates with 95% confidence intervals were generated, and the Kappa statistic was used to determine the strength of agreement between parent-reported diagnoses and clinical CBCL scores. Finally, bivariate analysis was used to determine if childhood ASD symptomatology was associated with mental health in adolescence, followed by logistic regression modeling to evaluate the effect of other possible risk factors. Results: Scores on two domains of the ADI-R were significantly associated with age at assessment, therefore, it was necessary to control for age at assessment with the ADI-R on these domains in the analysis conducted in Chapter Four. Forty-five percent of the study sample met case criteria for a comorbid psychiatric disorder. Anxiety, mood and attention-deficit disorders were the most common disorders in this sample. Early childhood ASD symptoms were not associated with the development of mental health concerns in adolescence. Family history and female gender were associated with the development of mental health concerns in adolescence. Conclusions: Nearly half of the individuals in our sample have been diagnosed with a psychiatric disorder, or are experiencing clinically significant symptoms that may be indicative of such a disorder. Our findings of discrepancies between parent-reported diagnoses and CBCL scores, indicates that many individuals in our sample are experiencing clinically significant mental health concerns, but do not have an official diagnosis. Finally, as has been reported previously, family history of mental illness and female gender were found to be associated with the development of a mental health concern in adolescence. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2013-10-14 11:06:50.53

This project studied 108 Israeli youth of mixed gender, aged 12-16 (mean 12.8, SD 1.67), selected for risk, with a 3 to 1 ratio of boys to girls. It included a group given a sports intervention and a comparison group. It utilised a broad psychosocial approach to investigate risks for psychological disorder and the impact of an intervention, based on both an Ecological and Attachment theoretical approach to inform identification of risk and resilience factors in a society used to political conflict. Aims: i) to examine psychosocial risks for psychological disorder in both groups and (ii) to examine the impact of a sports intervention in reducing risk and symptoms and increasing resilience. Method: The two phased prospective study included 60 young people referred by social services to a cycling intervention and 48 to a comparison group. Phase 1 examined demographic characteristics and psychosocial risks in the combined groups in relation to behavioural, emotional and post traumatic symptoms. Phase 2 examined change after 9 months comparing the two groups. Standardised self-report questionnaires were used, with focus groups and qualitative interviews to establish intervention impact. Questionnaires were translated into Hebrew and Arabic, with focus groups held in the local languages and subsequently translated and interviews with coaches held in English. Results: Twenty-three percent of all the youth reported a behavioral or emotional disorder at case level, with 33% having symptomatology at borderline level. Risk factors for such disorder were deprivation, insecure attachment style, peer problems and affectionless control in childhood from mothers or fathers. Poor peer relationships mediated between childhood experience and disorder. Over half had exposure to a traumatic event and there was a high prevalence of partial Post Traumatic Stress Disorder ( PTSD): 31% and 6% with full disorder. Life events, trauma experience, ethnicity and deprivation associations provided evidence of a social and Ecological interpretation of findings. Childhood experience, insecure attachment style and peer relationships supported an Attachment perspective. Findings at follow-up showed positive effects of the cycling intervention through decreased self-esteem and symptoms for both Conduct disorder and PTSD. There was also increased support for those in the intervention. However, follow-up findings were limited by high attrition rates. Analysis of focus groups and interviews led to a descriptive model showing benefits of the intervention through agentic (skills, discipline), escapist and aesthetic (fun) aspects. Conclusion: Findings are discussed in relation to Israeli culture and post-conflict context on youth risk and disorder, and the use of similar interventions in other post-conflict zones.

No description available.

Introduction: There has been a lack of longitudinal studies on maternal and infant factors associated with feeding difficulties. Feeding difficulties are common, cause much anxiety for parents, and are associated with a range of child health and behavioural outcomes. This study aims to gain an understanding of the prevalence and type of feeding difficulties found in a community sample, the prevalence of maternal mental ill-health and identify maternal and infant factors predictive of feeding difficulties. A final aim is to identify factors associated with successful and unsuccessful feeding experiences from a maternal perspective. Method: A short questionnaire with questions about support and help-seeking was compiled, and several standardised measures were included in the pack; a measure of maternal mood (DASS-21), social support (SOS-S), and eating disorder symptomatology (EAT-26). Questionnaires were given to mothers in pregnancy, and again when infants were around 3 and 7 months old. An adapted version of the Child Feeding Assessment Questionnaire, and the food fussiness subscale from the Children’s Eating Behaviour Questionnaire examined feeding behaviour and maternal response. The Infant Temperament Questionnaire examined maternal perception of infant temperament. Content analysis was used to identify themes in mother’s narrative about factors which help feeding and barriers to a successful feeding experience. A within subjects design was employed to examine predictors of infant feeding difficulties. Results: 23% of mothers of 3 to 5 month old infants, and 13% of mothers of 7 to 10 month olds reported their child as having one or more feeding difficulties. Levels of stress remained stable across the length of the study, but prevalence of maternal anxiety and depression reduced. 47% of those mothers who breast fed found breast feeding difficult or very difficult. Maternally identified barriers to successful feeding with feeding were child illness, and painful or difficult breastfeeding. Mothers wanted an improvement in support and knowledge of health professionals, and a reduction in pressure from health professionals in relation to feeding method. Maternal depression and stress were correlated with severity of food refusal in infants, as well as maternal anxiety and food fussiness, prior to post-hoc analyses. Following post-hoc analyses these relationships were no longer significant. Discussion: Relationships between infant behaviour, maternal health and feeding difficulties are explored. The low prevalence of feeding difficulties and reasons for negative findings in relation to predictors of feeding difficulties are discussed. Implications for health services are presented in the light of maternal views about support and barriers to successfully feeding their child.

Background: High levels of dissociation have been found in recent studies involving psychiatric inpatients. Proponents of the ‘dissociative psychoses’ have found that trauma-focused intervention strategies can improve outcomes of patients with major mental illness. Despite this, levels of dissociation have not been measured in forensic inpatients in Scotland. This study investigates levels of dissociative symptoms (DES-II) within a sample of male patients in secure forensic psychiatry settings in Scotland. It explores levels of psychosis (PANSS) and self-reported childhood trauma (CTQ), current PTSD symptoms (IES-R), levels of depression (BDI-II) and broad attachment style (RQ). Four groups were arbitrarily defined based on presence or absence of psychosis and childhood trauma. It was hypothesised that levels of dissociation would be predicted by presence of childhood trauma. Methods: A quantitative cross-sectional design was used in which 56 mentally disordered offenders were interviewed across three different secure hospitals in Scotland: The State Hospital – a maximum security psychiatric hospital, and two medium secure facilities. Attempts are made to clarify the relationship of dissociation with different types of childhood trauma and psychosis symptom clusters. By splitting the data into groups the study seeks to discern whether the groups differ significantly on dissociation scores in relation to the childhood experiences they reported and presence of psychosis they are experiencing. Results: Childhood traumatic experiences were frequent where median CTQ total score = 47.0 (IQR: 42-70.5). Physical neglect was reported by 58.9% of the sample closely followed by emotional neglect (55.4%). 46.4% of the sample reported physical abuse of significant levels, 44.6% reported being emotionally abused and almost a third reported being sexually abused (28.6%). DES-II (dissociation) scores were significantly associated with delusions and hallucinatory behaviour from PANSS. Emotional abuse and sexual abuse were significantly associated with dissociation scores. Mann Whitney tests revealed that dissociation was significantly higher in the groups which reported childhood trauma. Kruskal-Wallis results indicated no significant differences between groups within the data and dissociation scores. Conclusion: Patients with clinically significant levels of dissociative symptoms were identified. This indicates that dissociation is a key characteristic, warranting further consideration in this sample. Levels and severity of reported childhood trauma were higher than expected. The findings add weight and support to the importance of dissociation and trauma in formulations of male, mentally disordered offenders. Clinical implications of these findings are considered and further directions are discussed.

Objectives. People suffering from mental health conditions, often do not seek professional help. One of the reasons for this is that they do not consider talking-therapies sufficiently effective. It has been shown that among physical health conditions the rate at which people recover by themselves from a condition, as compared to those who do not (i.e. baseline-risk), unduly influences how effective people judge respective treatments. Treatments for conditions from which many people recover by themselves are considered as more effective than they actually are, as people credit the treatments for those that have recovered by themselves; the reverse is true for conditions from which many people do not recover by themselves. People may judge talking-therapy on the basis of the baseline-risk, to the detriment of the actual treatment effect of talking-therapy, conceptualised as the absolute or relative reduction of risk. Design. A mixed factorial within-between subjects experiment. Participants. A general population sample (N=202), in which 75.8% of participants had symptoms of depression and anxiety indicating a mental health condition. Methods. Participants took part in a web-based experiment during which they were shown six vignettes about common mental health conditions and the effect of talking-therapy on these compared to no treatment. The six vignettes varied in the baseline-risk (high vs. low), the absolute risk reduction (high vs. low), and the relative risk reduction (high vs. low). The dependent variable was the perceived effectiveness of talking-therapy, measured on a visual analogue scale from 0 (ineffective) to 100 (extremely effective). Analysis of covariance was conducted to control for potential confounding variables, including numeracy and mood. Results. Talking-therapies were judged on the basis of the baseline-risk of the condition. A higher baseline-risk was associated with a lower perceived effectiveness. This impact of the baseline-risk was not moderated by numeracy or mood. Talking-therapies were also judged on the basis of the absolute risk reduction but not by the relative risk reduction. There was some evidence that those with lower numeracy were less sensitive to differences in the treatment effect, that is, their judgments of effectiveness decreased less with a decreasing treatment effect. Conclusion. The evidence suggests that the effectiveness of talking-therapy is influenced by the baseline-risk of common mental health conditions. To address people's judgement that talking-therapy is insufficiently effective may require considering the negative impact of the high baseline-risk inherent to common mental health conditions. In turn, this may increase uptake of talking-therapy for common mental health conditions.