The importance of early intervention for positive outcomes following a first episode of psychosis (FEP) is recognised, however, there are still delays in young people seeking help. The aim of this qualitative study was to explore beliefs about help-seeking in young people who have recently experienced a FEP. Twelve participants were interviewed and transcripts were analysed using grounded theory. Five categories of beliefs were identified which contributed to the development of a preliminary model of beliefs about a need for help-seeking. Young people’s beliefs about their experiences as normal or abnormal, and about the process and outcome of help-seeking, influenced beliefs about needing help. Existing beliefs about mental health problems, and beliefs about the impact of experiences on the self were important to the meaning young people ascribed to beliefs about help-seeking. Social networks were important in the development of these beliefs. The study identified beliefs which promoted and inhibited young people’s help-seeking beliefs for FEP. Self-stigma was present prior to help-seeking. Implications for clinical interventions include education to promote help-seeking for distress and not abnormality, and to dispel myths about the help-seeking process and outcome. Further research is needed to determine which beliefs are most important to young people’s help-seeking for FEP.

Section A is a literature review evaluating the role of Therapetuic Care Workers (TCWs) and Therapeutic Foster Carers (TFCs) working relationally with a sub-group of Looked After Children (LAC) who are highlighted as having intense emotional and behavioural needs. These LAC are thought to benefit from living in specialist, therapeutic placements where carers work relationally. However, to date, there is no known review evaluating relational residential interventions or the role of TCWs and TFCs. Therefore, literature exploring the theoretical underpinnings of the work, and the emotional impact and protective factors involved in the carer role is considered. Implications for future research and clinical practice are suggested. Section B describes a qualitative study which explores how TCWs experience their role and their perceptions of the potential benefits for LAC. A qualitative design using Interpretative Phenomenological Analysis (IPA; Smith, Flowers & Larkin, 2009) was applied. Methods. Nine TCWs currently working in one of two therapeutic communities were interviewed. Results. Five master themes were identified: ‘Therapeutic group living’; ‘Importance of carer-child relationships’; ‘Working with the unconscious’; ‘Personal meaning of professional role’, and ‘Children’s progress’. Participants considered that forums for reflection were crucial to their ability to think clearly and analytically about the children, and utilised psychodynamic concepts to gain insight into the children’s inner worlds. TCWs’ increased self-awareness was central to this process. Participants also reported experiencing their role as emotionally challenging. One focus of reflection was on the small steps of progress the children were perceived to achieve. Conclusions. Overall, the findings suggested a synergy between relevant theory, descriptive accounts of therapeutic childcare, and TCWs’ perceptions of their role. New information regarding the personal investment of TCWs and internalisation of the framework of practice was identified. Further research is needed to extend the evidence-base. The clinical implications of the findings are discussed.

This study aimed to determine the prevalence of anxiety specifically related to discharge in a group of 42 individuals who had sustained moderate to severe acquired brain injury and who were imminently due to return home following a period of inpatient neurorehabilitation. The study also aimed to explore differential relationships between psychological factors (self-efficacy and health control beliefs) alongside the relative influence of demographic (age, gender and ethnicity) and clinical (medical diagnosis and injury location) characteristics on discharge-anxiety. A cross-sectional, single-group design was employed, wherein correlational and multivariate analyses were used to explore relationships between variables. Data was obtained via self-report tools and retrospective reviews of medical files. While few participants (14%) reported markedly elevated trait-anxiety almost half (45%) of the sample reported levels of transient, state-anxiety which could be considered to be clinically significant. Notably, state-anxiety (appraised via the State-Trait Anxiety Inventory) was strongly associated with discharge-anxiety (appraised via the Patient Anxieties Questionnaire). Age, self-efficacy and internal health control beliefs made independent contributions to the level of discharge-anxiety reported, with perceived self-efficacy alone explaining 69% of the overall variance and mediating the effect of internal control beliefs. No other demographic or clinical characteristics examined were significantly related to discharge-anxiety. Although causality cannot be inferred, findings suggest that discharge-related anxiety is best predicted by poor perceptions of self-efficacy. Implications for clinical practice and directions for future research are discussed.

Section A reviews the literature from two areas: it looks first at empirical studies exploring self-stigma in psychosis and secondly at psychological flexibility in psychosis. In doing so, the review aims to consider the question as to whether the psychological flexibility model, as presented by Acceptance and Commitment Therapy, can help us to understand how and why self-stigma can have a detrimental impact on some individuals experiencing symptoms of psychosis. Section B reports on a quantitative study of self-stigma, psychological flexibility, psychological well-being and quality of life in a First Episode Psychosis population. Research suggests that individuals experiencing psychosis may self-stigmatise, whereby negative beliefs and stereotypes about mental health difficulties are internalised. This in turn has been found to impact negatively on a number of areas. The psychological flexibility model presented by Acceptance and Commitment Therapy may help us to understand this. This study aimed to explore self-stigma using both an explicit and implicit measure of self-stigma to see how these were related to psychological flexibility, quality of life and well-being. Twenty-six participants experiencing first episode psychosis were recruited. They completed self-report questionnaires pertaining to quality of life, psychological well-being, psychological flexibility and explicit self-stigma. In addition, they completed a computer based reaction-time task designed to measure implicit self-stigma. Significant relationships were found between explicit self-stigma and well-being, and between psychological flexibility, explicit self-stigma, quality of life and well-being. Explicit self-stigma was found to statistically mediate the relationship between flexibility and well-being. Implicit self-stigma was not related to any investigated variable. The findings suggest psychological inflexibility may lead to greater self-stigma, which in turn decreases psychological well-being. This implied that interventions geared towards increasing flexibility may not only improve well-being, but may also help address issues of self-stigma.

This study aimed to explore how the experience of previous mental-health problems affects clinical and counselling psychologists’ approach to practice. Semi-structured interviews were conducted with six clinical and four counselling psychologists who had experienced mental-health difficulties. Data was analysed using Interpretative Phenomenological Analysis. Analysis of the interviews highlighted five master themes: Use of the personal-self of psychologist; Ambivalence; Identity as a psychologist; Psychologists as agent of change; and Finding meaning in suffering. The results of this research showed that psychologists with a history of mental-health problems actively draw upon their experience. In managing their dual identity of service-user and professional, they reported a degree of ambivalence which influenced the way that they viewed themselves and their practice. Their personal experiences seemed to be closely tied up with their professional-identity, which either conflicted with their sense of self or complemented it through highlighting how fortunate they were compared to others. The interviews frequently highlighted how psychologists’ experiences can provide an impetus to speak out for patients’ rights to ensure that they are treated with respect and dignity. A number of psychologists with an experience of mental-health difficulties felt that they might not have pursued their career had they not had previous mental-health difficulties. There appeared to be mixed findings concerning whether the participants felt that their mental-health difficulties had helped or hindered their practice.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

This study examined the influence of social support on the relationship between posttraumatic stress disorder and comorbid psychopathology, suicidal behaviour, and mental and physical health functioning in the general population. Data came from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (N=34,653). Results showed a differential impact of posttraumatic stress disorder and social support depending on gender. For men, social support had a moderating effect, where social support had a greater influence on the prevalence of comorbid psychopathology for men with posttraumatic stress disorder compared to those without the disorder. In contrast, social support had an additive effect for women, where social support was associated with decreased psychopathology and posttraumatic stress disorder was associated with increased psychopathology. This study suggests that social support should be included in the treatment of men with posttraumatic stress disorder and encouraged among women regardless of mental disorder diagnosis.

The object of this work is the concepts of mental disorders as a social constructs and the role of the mass media in the process of their construction. The main aim of the dissertation is to analyze the representations of people with mental disorders in the Lithuanian newspapers and news websites and to examine manifestations of these depictions in the public opinion. The dissertation consists of an introduction, four main parts, conclusions and the list of references. In the first part of the dissertation the theoretical methodological presumptions of P. L. Berger’s and T. Luckmann’s theory of social constructionism are presented and the phenomenon of the social construction of mental disorders is analyzed using this theoretical framework. In the second part the influence and importance of the mass media in the process of constructing representations of social phenomena, including mental disorders is presented. The methods of the empirical research are presented in the third part of the work. Analysis and interpretations of the empirical research data are presented in the fourth part of the dissertation. At the end of the work conclusions are stated. The main aim of the dissertation was reached by conducting a three staged empirical research combining qualitative and quantitative research methods. The research methods were: the analysis of the mass media publications using methods of Discourse analysis and Content analysis; the investigation of public opinion by... [to full text] / Disertacijoje analizuojama psichikos sutrikimų kaip socialinių konstruktų samprata ir žiniasklaidos vaidmuo tokių konstruktų kūrimo procese. Pagrindinis darbo tikslas: išanalizuoti Lietuvos dienraščių bei interneto naujienų tinklalapių konstruojamus sutrikusios psichikos asmenų vaizdinius bei šių vaizdinių atspindžius visuomenės nuomonėje. Disertaciją sudaro įvadas, keturios pagrindinės dalys, darbo išvados, literatūros sąrašas ir priedai. Pirmojoje darbo dalyje pristatomos teorinės metodologinės disertacijos prielaidos: P. L. Bergerio ir T. Lukmano socialinio konstrukcionizmo teorijos pagrindinės teorinės įžvalgos ir jų taikymas analizuojant psichikos sutrikimų fenomeną. Antrojoje darbo dalyje analizuojama žiniasklaidos reikšmė ir poveikis konstruojant socialinio pasaulio fenomenų vaizdinius. Trečiojoje dalyje išsamiai pristatoma tyrimo metodika. Ketvirtojoje darbo dalyje pateikiama empirinio tyrimo duomenų analizė ir interpretacijos. Darbo pabaigoje formuluojamos darbo išvados. Siekiant pagrindinio darbo tikslo, trijų etapų empirinio tyrimo metu derinant kokybinius ir kiekybinius metodus buvo atlikta žiniasklaidos publikacijų analizė naudojant diskurso analizės ir turinio analizės metodus, anketavimo būdu atlikta reprezentatyvi visuomenės nuomonės apklausa, naudojant fokus grupės metodą atskleista sutrikusios psichikos asmenų nuomonė. Darbe konstatuojama, jog Lietuvos žiniasklaida sutrikusios psichikos asmenis vaizduoja remdamasi stereotipais, vyraujančiu medicininiu šio... [toliau žr. visą tekstą]

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common disorders of childhood. It is theorized to be caused by catecholamine dysfunction in the striatum (Str) and frontal cortex (FC). The spontaneously hypertensive rat (SHR) has been used as a model for ADHD because of its attention deficits, impulsiveness, and hyperactivity. Prior studies of dopamine (DA) in the Str and FC have revealed conflicting results in the SHR compared to control, indicative of a need for a better understanding of DA dynamics in this model. In addition to the DA hypothesis, studies have begun implicating glutamate in the etiology of ADHD. Previous evaluations of the SHR model of ADHD found that the SHR have increased α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor activity and elevated calcium levels in the FC, suggesting that altered glutamatergic neurotransmission exists in the SHR. The first set of studies presented here suggest that increased surface expression of DA transporters may exist in the SHR model of ADHD, lowering basal DA levels. Second, we discovered that the glutamate system in the FC of the SHR model of ADHD is hyperfunctional, thus raising the possibility that targeting glutamate dysfunction in the FC could lead to the development of novel therapeutics for the treatment of ADHD. The third and fourth set of studies explored glutamate signaling in the awake rodent to fully understand glutamate neurotransmission as well as the effects of methylphenidate (MPH) on glutamate signaling in the prelimbic cortex, a region heavily implicated in ADHD. The SHR displayed similar phasic glutamate signaling compared to control; however, in the SHR but not the WKY control, chronic treatment with MPH lowered phasic glutamate amplitude. Additionally, intermediate treatment with MPH increased tonic glutamate in the SHR only, whereas chronic MPH treatment increased tonic levels in both the SHR and WKY compared to saline. Taken together, this body of work characterizes DA and glutamate signaling in the anesthetized SHR model of ADHD. Additionally, glutamate dynamics and the effects of the stimulant medication MPH were explored in the awake animal, providing evidence that glutamate is a likely target for future neuropharmacology for the treatment of ADHD.

Cognitive bias and thought suppression are two maladaptive patterns of thinking that have been associated with borderline personality disorder (BPD). Negative cognitive biases related to BPD include thoughts that they are bad, powerless, or vulnerable and that the world is dangerous. Thought suppression is a maladaptive emotion regulation strategy where unwanted thoughts are intentionally pushed out of one’s consciousness. However, previous research has connected thought suppression and cognitive biases to BPD only via self-report measures. The present study examined whether a laboratory task meant to measure cognitive bias and thought suppression (Scrambled Sentences Test) would predict BPD features over and above self report measures of cognitive bias and thought suppression. A sample of 153 undergraduates completed self-report measures of BPD features, thought suppression, and negative cognitive biases, as well as the Scrambled Sentences Test (SST). Results showed that while the SST was a good predictor of cognitive biases, it did not predict thought suppression when self report measures were included. Recognizing the importance of negative cognitive bias in BPD may be useful in continued treatment development. Further research into other ways of measuring thought suppression and cognitive biases in the lab may be warranted.