A thesis to be submitted in fulfilment of the requirements for the degree of Doctor of Medicine in the Department of Psychiatry and Mental Hygiene, University of the Witwatersrand. / The introduction to the problem covers mainly three sections, namely. Biblical, Historical and Psychological. Various tests are then named and described. This is followed by the section dealing with the Test Results, statistical methods used and finally a summary and conclusion. The summary and conclusion are of necessity brief, and cannot be expected to cover the whole field. Special mention must here be made of & B. Cutten whose book Speaking with Tongues is considered by the present writer to be the most scholarly and extensive account of the historical aspect of GLOSSOLALIA yet systematised. Portions relevant to the present investigation were either quoted in toto or epitomised because the writer felt they could not be improved upon. An intimate knowledge of the historical instances quoted by Cutten is essential to a complete understanding of the scope of the present work. The only originality claimed lies in the selection and presentation of the material to be found in Cutten's invaluable work. Extensive references and/or quotations have also been taken from the works of A. Schweitzer - Mysticism of St. Paul the Apostle and E.B. Tylor - Primitive Culturo, both of whom are regarded as being leaders of thought in their respective fields. / WHSLYP2017

No description available.

This study aims to determine the number of patients secluded over a specified period, provide a profile of patients that are likely to be secluded, and to ascertain the reasons for seclusion. Seclusion in the psychiatric context can be defined as the involuntary confinement of an agitated, unstable person alone in a contained, controlled environment. There are differing views on seclusion and consequently this has presented clinicians with an ethical dilemma. Significant morbidity and mortality have been associated with seclusion. In light of this, alternatives to seclusion have been explored. No data exists in South Africa on rates of seclusion for psychiatric purposes, and consequently neither the need for seclusion nor alternatives to seclusion have been explored. The study is a retrospective review of patients secluded at Sterkfontein Hospital, a tertiary psychiatric hospital, over a six month period. Data was collected from clinical records at Sterkfontein Hospital. RESULTS: 112 patients were secluded over the 6 month period. Users were secluded for a total of 59415.5 hours and on 4814 separate occasions. 84.8% of the users secluded were male. The mean age of users secluded was 29years. Just over half the users (52%) were secluded for their own safety and 40% of users were secluded for aggression (either physical or verbal). The commonest diagnosis was Schizophrenia (31.4%) followed by Cognitive Impairment (20.6%) and Bipolar Mood Disorder (13.7%). The most commonly used medication was Sodium Valproate (17%), followed by Haloperidol (11%) and Risperidone (11%). CONCLUSION: Younger male patients with psychosis were most likely to be secluded. More research should be conducted locally to compare seclusion in terms of rates and patient profiles so that we may improve seclusion practices.

The intent of this research was to investigate the relationship between a measurement of burnout and semantic differential profiles involving personal and vocational life variables. Participants were employees of a residential facility for developmentally disabled persons. The statistical analysis was to involve the use of multiple linear regression for the null hypotheses and a judgmental evaluation was to be utilized for determining levels of differences between burnout and semantic profiles. / A pilot study was completed to investigate potential problems existing in the administration and in response to two questionnaires (burnout and semantic differential profile). Corrections were made prior to administration to the primary research facility. / From the primary research administration, a total of 250 questionnaires were returned. A sample size of 169 was predetermined as adequate for use of the multiple linear regression anaylsis. However, only 81 responses were adequate in terms of completed questionnaire items. The limited responses prevented the anticipated analysis at the statistical levels prespecified. A follow-up interview with the participants revealed problems with reading comprehension and a defensive attitude about this research effort. A review of the demographic data suggested different descriptive factors between the 81 respondents and the 169 nonrespondents. / The results provided were limited to descriptive data which reflected research findings of the applicable literature review and provided impetus for this research experience; the results also offer indications for modifications in administration and future replications of this research effort. / Source: Dissertation Abstracts International, Volume: 45-08, Section: B, page: 2495. / Thesis (Ph.D.)--The Florida State University, 1984.

College student veterans may experience a variety of challenges as they transition from military life to student life, including adjusting to the academic environment, coping with mental health concerns such as depression and anxiety, redefining their identities, and balancing multiple roles (e.g., family, school, and work). In addition, research indicates that veterans may experience difficulty in finding meaning and purpose outside of the military. The purpose of the current study was to add to the career development literature related to college student veterans and explore variables which may influence meaning and purpose in their lives, specifically career thoughts and depression. The current study utilized a passive observational research design to survey 132 college student veterans attending higher education institutions across different geographic locations in the United States. Regarding demographic characteristics, participants ranged across ages, military branches, and classification levels. Career thoughts was measured using the Career Thoughts Inventory (CTI), and depression was measured using the Center for Epidemiologic Studies Depression Scale – Revised (CESD-R). Meaning in life was assessed using the presence of meaning and the search for meaning subscales of the Meaning in Life Questionnaire (MLQ). A linear multiple regression analysis was used to determine if the total scores on the CTI and the CESD-R were significant positive predictors of scores on the MLQ. In addition, Pearson correlation analyses were utilized to understand the relationship between meaning in life and depression, as well as meaning in life and career thoughts. Moreover, beyond career thoughts and depression, this study also sought to explore whether or not there were differences in meaning in life scores among particular demographic variables, including gender and ethnicity. ANOVA analyses were used to examine differences in meaning in life scores among participant gender and ethnicity. Results of the analyses revealed that both career thoughts and depression were statistically significant predictors of the presence of meaning in one’s life, with 46% of the variance in the presence of meaning in life scores accounted for by total scores on the CTI and the CESD-R. Pearson correlation results indicated that all variables were statistically significant at alpha level of .01. Furthermore, results of ANOVA procedures showed no statistically significant differences in the presence of meaning in life scores, as well as in the search for meaning in life scores, for the gender and ethnicity variables. Limitations of the study and areas for future research are discussed. Lastly, implications for practitioners working with student veteran populations are included. / A Dissertation submitted to the Department of Educational Psychology and Learning Systems in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester 2016. / April 18, 2016. / career development, career thoughts, college student veterans, depression, meaning in life, mental health / Includes bibliographical references. / Janet Lenz, Professor Directing Dissertation; Christopher Schatschneider, University Representative; Debra Osborn, Committee Member; James Sampson, Committee Member.

Referenciado nas produções teóricas em ciências sociais que informam e discutem as transformações contemporâneas no modo produção capitalista e suas repercussões nos modos de reprodução da vida, organização social, e nos campos de mediações sociais, políticos, simbólicos, culturais, jurídicos e científicos; o presente trabalho visa refletir sobre O que é o Centro de Atenção Psicossocial - CAPS - campo de construção de um saber-fazer em saúde mental - no contexto sócio histórico contemporâneo, com base na leitura crítica de textos oficiais (legislação e cartilha) concernentes ao campo, produzidos em âmbito federal a partir da década de 1990, pautada no materialismo histórico e dialético e na concepção de discurso formulada pela Teoria Semiótica Discursiva. Dito de outra forma, objetiva examinar o campo conceitual e interdiscursivo que figura nas leis, portarias e documentos de referência que regulam a implementação e funcionamento destes dispositivos assistenciais, e seus possíveis elos e nexos com as profundas e significativas mudanças engendradas pelas mutações no modo de produção capitalista nas mais diversas instâncias de reprodução da vida social. Trata-se de um estudo qualitativo de caráter exploratório que pretende contribuir para o mapeamento do campo das práticas em saúde mental, acrescentando elementos às discussões em curso, de modo a favorecer a proposição de ações capazes de operar mudanças nas condições concretas de produção destas mesmas práticas. O referencial teórico adotado para tanto foi o materialismo histórico e dialético e as categorias de análise eleitas: práxis e ideologia. A análise dos dados foi orientada para a depreensão das diretrizes conceituais, valores e visão de mundo, presentes no discurso oficial, que prescrevem e regulamentam as ações de atenção psicossocial, buscando refletir sobre as contradições presentes no discurso e seus nexos com campos discursivos relativos a outras esferas de regulação e organização social e com o contexto sócio histórico atual. Os resultados apontam as mesmas contradições e os reflexos dos mesmos percalços que as diversas esferas de regulação social e reprodução da vida vem enfrentando em tempos atuais, ou seja, as marcas contra hegemônicas e críticas que caracterizaram o início do processo de implantação dos primeiros CAPS filiado à Reforma Psiquiátrica e impulsionado pelo Movimento da Luta Anti-Manicomial, se fazem presentes nos discursos oficiais analisados. No entanto, aspectos depreendidos levam a crer que a lógica segundo a qual operam os dispositivos CAPS, e a favor da qual são postos a funcionar, é oposta ao que aparece na sua superfície discursiva. Se no nível aparente do enunciado o que prevalece são referências à filiação democrática de seus conceitos ao caráter inovador e alternativo de suas práticas que tem como foco os sujeitos e a produção de respostas às suas necessidades; no nível abaixo localizado e por ele encoberto, encontram-se as contradições características do modo de produção capitalista alimentando o maquinário que trabalha a favor da satisfação dos interesses do capital. Esmiuçando estes discursos, nota-se os mesmos mecanismos de manutenção dos modos de reprodução da vida que favorecem e dão sustentação ao capitalismo, e ao mesmo tempo, as mesmas artimanhas na intenção de apagar estes processos, de ocultá-los / Mentioned in the theorical productions in social science that inform and discuss the contemporary transformation in the way of capitalist production and its repercussion in the way of reproduction of life, social organization, and in the fields of social political, symbolic, cultural, juridical and scientific; the present work aim to reflect about What Psychosocial Attention Center– CAPS is – construction field of a know-how in mental health – in the contemporary socio-historical context, based on the critical reading of official texts (legislation and elementary treatise) refeering to the field, produced in Federal ambit since 1990’s, rueld in the historical and dialectical materialism and in the conception of speech formulated by the Discursive Semiotic Theory. Said in other words, the objective is to examine the conceptical and interdiscursive field that figures in laws, judicial directive and documents of reference that rule the implementation and functioning of these attendance dispositives, and its possible links and coherency with the profound and significative changes engendered by the mutation in the way of capitalist production in the most various entreaties of reproduction of social life. This work is about a qualitative study of exploratory character that intends to contribute to map out the field of practice in mental health, adding elements to the current discussion, in order to favor the proposal of actions capable of making changes in the concrete conditions of production of these same practices. The theorical reference used for that was historical and dialectical materialism and the elected categories of analysis: praxis and ideology. The data analysis was oriented for the deduction of the conceptual directrix, value and vision of the world, present in the official speech, that prescribe and regulate the action of psychosocial attention, looking for reflection about the contradiction present in the speech and its coherence with discursive field related to other spheres of social regulation and organization and with the current socio-historical context. The results point to the same contradictions and the reflex of the same disadvantages as the various spheres of social regulation and reproduction have been facing nowadays, in other words, the signs against hegemony and critics that characterize the beginning of the implantation of the first CAPS affiliated to the Psychiatric Reform and propelled by the Anti-madhouse Fight, are present in the official speech analyzed. Nevethless, the aspects infered make us believe that the logic in which the CAPS dispositives operate on and in favor of what they are put to operate on, it’s opposed to what appears in the discursive surface. If in the apparent level of the stated what prevails ire references to the democratic filiations of its concepts to the innovative and alternative character of its practices that has as focus the subjects and the production of answers to its necessity; on the localized level below and covered by itself, it has been found the characteristic contradictions of the way of capitalism production feeding the machinery that works for the satisfaction of the capital interests. Scrutinizing these speeches, we can notice the same mechanism of maintenance of the way of reproduction of life that favor and give sustainment to capitalism, and at the same time, the same artifice with the intention of erasing these processes, to hide them

Introdução: O atual modelo de saúde mental infantojuvenil tem como um dos seus pilares a transformação da postura dos profissionais da área. Espera-se que eles se coloquem de corpo inteiro e se impliquem subjetivamente no trabalho. Esses profissionais têm papel fundamental nas direções tomadas ao longo dos anos, contudo são historicamente desvalorizados e pouco estudados. Objetivo: Descrever e analisar a subjetividade, as experiências de formação e a trajetória de vida de trabalhadores de Centros de Atenção Psicossocial Infantojuvenis (CAPSi) e suas relações com o processo de inserção e prática nesse campo. Método: Foi realizado um questionário com perguntas semi abertas e entrevistas narrativas com 8 trabalhadores de diferentes categorias profissionais lotados em 2 CAPSis do Município de São Paulo, um deles gerenciado diretamente pela Prefeitura e outro por Organização Social de Saúde (OSS). Para análise das entrevistas narrativas foi utilizada a proposta de Shutze. O Referencial Teórico foi construído a partir de diferentes autores que dialogam entre si, dentre eles Dejours e Schwartz. Resultados: Constaram-se importantes diferenças entre os trabalhadores do CAPSi gerenciado por OSS e pela Prefeitura no que se refere ao perfil profissional, às motivações para o trabalho, ao tipo de formação que buscam e aos sentidos atribuídos ao trabalho. No entanto, todos os trabalhadores revelam características comuns: impacto recíproco que a vida pessoal e o trabalho na saúde mental exercem entre si; passagem prévia por hospital, escola ou consultório, de forma que essas instituições marcam sua atuação profissional; carência de capacitação oferecida pelos serviços e grande distância entre as necessidades reais do serviço e os treinamentos oferecidos. Conclusão: A tendência atual do mundo do trabalho caminha em sentido oposto às propostas da Reforma Psiquiátrica, fazendo com que os profissionais mais antigos encontrem dificuldades e os mais jovens se afastem dos pressupostos da Reforma Psiquiátrica. Junto a isso, a complexidade das propostas de tratamento nos CAPSis e a falta de espaços de discussão e potencialização do trabalho, que deviam ser oferecidos pelas instituições, faz com que ambos os grupos de profissionais sintam-se perdidos e sozinhos. A formação transcende o espaço técnico no qual ela se delimita inicialmente e se espraia para diversos setores da vida do indivíduo / Introduction: The current model of child and adolescents Mental Health Care are in transformation concerning the professionals approach. It is expected that they get deeply involved in a subjective way in their work. These professionals are very important in the directions taken in that field over the years, however, they are historically unevaluated and understudied. Objective: Describe and analyze subjectivity, as well as training experiences and life trajectories of employees of Psychosocial Care Centers for Children and Adolescents (CAPSi) and their relation to the process of professional insertion and practice in this field. Method: A semi-structured questionnaire and narratives interviews were conducted with 8 workers from 2 CAPSi from São Paulo City, Brazil; one managed directly by the City and one managed by Social Health Organizations- OSS. The narratives interviews have been subjected to Shutze analysis techniques. The Theoretical Framework was built from different authors who interact with each other, including Dejours and Schwartz. Results: It was found important differences between work team from CAPSi managed by the OSS and CAPSi managed directly by the City concerning professional profile, motivations for work, type of training searched and meanings attributed to work. However, all employees reveal common features: reciprocal impact that personal life and work in mental health influences on each other; previous works in hospitals, schools and office, so these institutions marked their professional performance; lack of training services and large distance between the real needs of the service and the training offered. Conclusion: It was found that the current trend in the field goes in opposite direction to the proposals of the Psychiatric Reform, causing the older professionals do not fit in and younger professional deviate from the Psychiatric Reform proposed. Along with this, the complexity of treatment proposed in CAPSi and lack of opportunities for discussion and empowerment work team of labor, which should be offered by institutions, makes both groups of professionals feel lost and alone. The technical training transcends space in which it delimits initially and spreads to various sectors of the life of the individual

<p> Home and community based counseling services have become instrumental to the treatment of children and adolescents struggling with mental illness. Counselors working in these systems of care face significant challenges in this unique setting. Most home and community based counselors (HCBCs) face these challenges as recent graduates, not having adequate preparation for the home setting, while receiving little supervision. HCBCs have reported feeling isolated and unsupported and question their effectiveness as counselors. Macchi, Johnson, and Durtschi&rsquo;s (2014) results point to the importance of self-care to HCBC wellness, especially when the HCBC is lacking supervision. Yet, we are unable to glean from prior research which self-care strategies may benefit the HCBC. It is also unclear how systemic factors may affect HCBC wellness. A broad review of the literature revealed that studies examining the individual and organizational factors that may influence counselor wellness have yielded inconclusive results. Individual interviews were conducted with eight HCBCs and four supervisors working for three different home and community counseling agencies and data were analyzed using constructivist grounded theory. Out of the grounded analysis, this researcher identified seven concepts: helping others, confronting the realities of the work, taking care of yourself, finding support, striving for work-life balance, and moving forward. The experiences shared by the HCBCs and supervisors make it clear that it is not just the individual practices that matter, organizational and supervision practices impact wellness as well. Recommendations for supervisors, HCBCs, and agencies are provided.</p><p>

Many clients with severe mental health problem, live in the community with their relatives. Research in the area has indicated that exacerbation of psychotic symptoms in clients is strongly associated with the emotional atmosphere in the family. The presence of high expressed emotion has been linked with relapse. However, recent research suggests that it is the causal attributions which relatives make to explain the illness symptomatology, which is most predictive of relapse. Relatives viewing clients' symptoms as being controllable by the client has been associated with hostility in relatives. Little has been said in the literature about the subjective experiences of clients. The present study investigated the causal attributions which clients and relatives made to explain the manifestation of the illness. Causal attributions made to explain positive symptoms, negative symptoms and behavioural problems were examined and compared. Clients! perception of their relationship with a key relative and their affective state was measured. Participants knowledge about schizophrenia, and relatives levels of distress were also examined. The clients in the present study were men under fifty with a diagnosis of schizophrenia. Key relatives also participated. A cross sectional correlational and comparative methodology was employed. A mixture of quantitative data and qualitative information was generated. A key finding was that the nature of attributions made was determined by symptom category. Positive Symptoms were deemed to be the least controllable symptom and Behavioural Problems were considered the most controllable. Relationships existed between the attributions made by clients and relatives. Depression in clients was related to them attributing their illness to personal factors, and a reporting negative feelings about there relationship with a key relative. Findings are discussed in relation to literature, research and clinical practice.

Made available in DSpace on 2019-03-30T00:06:40Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-04-20 / The aging is characterized by a number of morphophysiological and functional changes that are adverse to the organism, especially the decline of cognitive functions, which can have a direct consequence on the quality of life. Therefore, this study aimed to analyze the cognitive performance of older people living in the Municipality of Fortaleza, Ceará. A quantitative and analytical cross-sectional study was conducted using a questionnaire on demographics, socioeconomic status and self-reported health. Cognitive performance and the domains of its function were assessed by the Mini Mental State Examination (MMSE). The cutoff points used were differentiated by education, as established by Bertolucci (1994). Data were statistically analyzed using SPSS version 20.0. The 297 patients included were aged 60-97 years, with a mean age of 71.7 years (SD ± 9.0). They were interviewed at the Primary Care Centers of the Regional Executive Secretariats of the Municipality of Fortaleza. There was a prevalence of: age group 60-69 years; women; married participants; monthly income of up to two minimum wages; and low education level. The most common self-reported diseases were: hypertension, rheumatism and diabetes mellitus. With regard to the MMSE, 24.9% of the participants (N=74) presented cognitive impairment, with MMSE scores ranging 8-30 points and mean value of right answers (24.4; ± 4.3). Significant association was found between and cognitive impairment and: Sociodemographic variables concerning age, income; education level; General health with hearing and speech problems; and referred to oral discomfort in dry mouth sensation, difficulty chewing, problems with taste and burning mouth sensation. The most severe impairment was in the calculation domain, and the best performance was in immediate memory. Statistical significance was obtained between the average scores in each of the following domains: temporal orientation about age group, race, work, income nd education level; only in the space age group; calculation about age group, marital status, race, work, income and education level; in recall in relation only age group; in the language in relation to age group, race, income and education level; and visual-constructive function about age group, work, income and education level. Regarding the total MMSE scores and sociodemographic variables, statistical significance was obtained for age group, marital status, race, work, income, education level. The findings demonstrate a reasonably high prevalence (24.9%) of older patients with a deficit in cognitive performance, but that is in agreement with the findings of other researchers. The MMSE presented as an important tool for screening cognitive function because it identified the most compromised domains. Therefore, it is effective in preventing possible cases of cognitive impairment that may be precursors of dementia with consequences for the individual, the family and society. / O envelhecimento é caracterizado por um conjunto de alterações morfofisiológicas e funcionais desfavoráveis ao organismo, destacando-se o declínio das funções cognitivas, que pode ter consequência direta sobre a qualidade de vida. Assim sendo, este estudo teve por objetivo analisar o desempenho cognitivo de pessoas idosas e sua relação com o Estado geral de Saúde no Município de Fortaleza-Ceará. Trata-se de um estudo transversal, quantitativo e analítico, realizado por meio de um questionário contendo questões demográfica, socioeconômica e do estado geral de saúde. Para avaliar o desempenho cognitivo e os domínios de sua função, foi utilizado o instrumento Mini Exame do Estado Mental (MEEM). Os pontos de corte utilizados foram diferenciados pela escolaridade, segundo Bertolucci (1994). Os dados foram analisados estatisticamente por meio do software SPSS versão 20.0. Os 297 idosos avaliados tiveram idade de 60 a 97 anos, com média 71,7 anos (DP±9,0). Estes foram entrevistados nas unidades básicas de saúde das Secretarias Executivas Regionais do Município de Fortaleza. Prevaleceram faixa etária de 60 a 69 anos; sexo feminino; casados; renda mensal de até dois salários-mínimos e baixa escolaridade. Sobressaíram as doenças: hipertensão arterial, reumatismo e Diabetes Mellitus. Quanto ao teste do MEEM, 24,9% dos idosos (N=74) apresentaram comprometimento cognitivo, com pontuação do MEEM ,variando 8-30 pontos, e média de acertos (24,4;±4,3).Houve associação significativa entre ter défice cognitivo e: Variável sócio demográfica com relação a faixa etária, renda e escolaridade; Estado de saúde geral com problema de audição e de fala; e no que se refere a desconforto oral em sente boca seca, dificuldade de mastigar, problema com o gosto dos alimentos e sensação de queimação na boca. O maior comprometimento se deu no domínio do cálculo e melhor desempenho no da memória imediata. Obtiveram significância estatística entre a média de pontuação nos domínios: temporal em relação a faixa etária, raça, trabalha, renda e escolaridade; no espacial apenas na faixa etária; no cálculo em relação a faixa etária, estado civil, raça, trabalha, renda e escolaridade; na memória evocada em relação apenas na faixa etária; no da linguagem em relação a faixa etária, raça, renda e escolaridade; e no construtivo visual em relação a faixa etária, trabalha, renda e escolaridade. Quanto ao total de escores do MEEM e às variáveis sociodemográficas, observou-se significância estatística entre faixa etária, estado civil, raça, trabalha, renda e escolaridade. Os achados demonstram prevalência razoavelmente alta (24,9%) de idosos com défice no desempenho cognitivo, entretanto compatível com os achados de outros pesquisadores. O instrumento MEEM mostrou-se importante na triagem da função cognitiva, identificando domínios mais comprometidos, portanto, eficaz na prevenção de possíveis casos de défice cognitivo que possa ser precursor de demência, trazendo consequência para a pessoa, a família e a sociedade.