Thesis (M.S.)--University of Wisconsin--Madison, 1965. / eContent provider-neutral record in process. Description based on print version record. Bibliography: 1 l. at end.

Thesis (M A(Psychology))--University of Pretoria, 2007. / Includes bibliographical references. Available on the Internet via the World Wide Web.

Thesis(Ph.D.)--Case Western Reserve University, 2010 / Title from PDF (viewed on 2010-01-28) Department of Social Welfare Includes abstract Includes bibliographical references and appendices Available online via the OhioLINK ETD Center

Thesis (M.D.) -- University of Adelaide, School of Medicine, Discipline of Psychiatry, 2007. / "Submitted April 2007" Bibliography: leaves 145-160. Also available in print form.

This study explored whether depression is stigmatized, and whether these perceptions of depression vary by gender, a person’s own experience with depression, or knowing other people with depression. These questions were examined through the use of an online survey, which included questions measuring demographics, personal history of depression, tolerance of depression, and stigma toward depression. Responses from 106 participants were analyzed using t-tests. The study found that depression is stigmatizing. There is also more stigma for a male with depression than a female with depression. In regards to personal history with depression and stigma, it was found that personally dealing with depression lessened the amount of stigma imposed on depressed persons. There was no significant difference between men’s ratings of stigma and women’s rating. The study also found no significant difference between knowing people with depression or coming into contact with depressed individuals and the likelihood of stigmatizing those with depression.

In any year, one in four British adults will experience a mental disorder (Singleton, Bumpstead, O’Brien, Lee, & Meltzer, 2001), but barriers to accessing treatment remain, one being fear of stigmatization. In this study perceptions of the stigma associated with mental illness were experimentally manipulated and perceived public stigma of help-seeking, attitudes to mental illness, self-stigma, and attitudes to help-seeking were measured. Results indicated that lowering perceived social stigma of mental illness reduced perceived public stigma attached to help-seeking, but also resulted in less positive attitudes to help-seeking, when compared to a neutral condition. The relationship between perceived societal stigma of mental illness and attitudes to help-seeking was mediated by perceived public stigma of seeking psychological help. This research raises questions about the effect of anti-stigma campaigns, which aim to change perceptions about stigma but may have a negative effect on attitudes to help-seeking.

Neurocognitive and functional outcome deficits have long been acknowledged in schizophrenia and are considered a core feature of the disorder. Neurocognition has been found to account for functional disability to a greater extent than psychopathology however much of the variance in functional outcome still remains unexplained. How functional outcome is measured also requires clarification. By investigating the relationship between neurocognition and functional outcome in First-Episode Psychosis (FEP), much can be learnt about the trajectory of disability and the course of illness in schizophrenia. Metacognition, or thinking about thinking, has been proposed as a mediating variable between neurocognition and functional outcome. Despite different theoretical backgrounds, authors generally converge on there being higher-order, explicit, conscious metacognitive knowledge and lower-order, implicit metacognitive processes. How these relate to each other requires clarification. The prefrontal cortex (PFC) has been implicated in higher order thought and metacognitive processing, and deficits have been observed in PFC Grey Matter (GM) volume in schizophrenia. These metacognitive deficits may contribute to the relationship between cognitive ability and community functioning. A preliminary meta-analysis demonstrated that a moderate effect size is found between neurocognition and metacognition and a moderate effect size exists between metacognition and functional outcome. The present thesis investigated whether metacognition mediates the relationship between neurocognition and functional outcome in FEP (N=80). Path models were created to investigate the different relationships between neurocognition, metacognition and both capacity to perform everyday tasks and objective functioning in the community. A secondary Voxel-based Morphometry (VBM) analysis was also conducted investigating perceptual metacognitive accuracy and its relationship to GM volume in both FEP (N=41) and a matched healthy control sample (N=21). Current findings support the model that metacognition and negative symptoms mediate the relationship between neurocognition and functional capacity in FEP. Path models also demonstrated a significant mediation effect of metacognition between neorocognition and objective function, and functional capacity and objective function. Significant group differences were found between FEP and controls in perceptual metacognitive accuracy however no significant relationship was found between metacognition and GM volume in the PFC. The present thesis suggests that metacognitive deficits are present at first episode and may account for the relationship between cognitive ability and functioning in the community. Findings also suggest that cognitive remediation programmes may wish to focus on metacognition to maximise the transfer of cognitive skills to community functioning. The findings also suggest the presence of two metacognitive processing routes; explicit, declarable, higher-order knowledge and implicit, intuition-based, lower-order experience which can be accounted for by Nelson and Narens (1990) metacognitive model.

The aim of this flexible, multi-method case-study (after Yin 1994, 2003), was to elicit the 'student perspective' on issues relating to mental well-being within the Higher Education Institution setting. It has been guided by the ideology of the health promotion model, the concept of salutogenesis and the Health Promoting University initiative. Phase One consisted of eleven focus group discussions involving fifty one self-selecting participant undergraduates and a semi-structured interview conducted with the lead medical practitioner of the Medical Centre on site. In Phase Two, a quota sample of 806 undergraduates completed a questionnaire. The three datasets were analysed according to a facilitative and complementary approach (Brannen 2004) and in keeping with assumptions of the paradigms from which they originated. The qualitative data were analysed within the framework provided by Miles and Huberman (1994) and the survey was analysed using the Statistical Package for Social Sciences (SPSS). The findings demonstrated that this multi-site university may have specific difficulties with regard to the provision of equal access to the support services. Reduced pastoral care could pose risks to the mental well-being of some students whereas the allocation of students to a personal tutor might increase levels of social capital and reduce symptoms of 'anomie'. Conclusions of the study suggest that HEIs need an understanding of the concerns of the students and their help-seeking behaviour in order to define 'health assets' and minimise 'health deficits'. Overall, the development of co-ordinated institutional support service provision - that is responsive to the needs of a diverse student body - facilitates and supports the creation of a salutogenic environment that both promotes and sustains mental well-being. Health education programmes need to address the persistence of stigma and discrimination. Attention should be focused on health protection measures so that all groups of students are treated equally and fairly in order to counter-balance a possible residual biomedical approach to health promotion from within the medical sector provision. As a case-study of one university, the findings may be theoretically generalisable to other similar multi-site HEIs in their mental health promotion provision.

Existing research and anecdotal accounts have consistently reported that Jewish people are positively inclined to seek treatment for mental health problems, including making use of psychiatric services and psychotherapy. However, much of this data has been based on samples of American Jewry and there appear to be no existing studies in the UK which have quantitatively investigated whether there are similar help seeking preferences for mental health problems amongst British Jewry. The present study investigated Jewish people’s attitudes and intentions to seek professional help for mental health problems and their experiences of seeking professional help in the UK. Using the theoretical framework of the Theory of Reasoned Action (Fishbein and Ajzen, 1975; Ajzen & Fishbein, 1980) the study also aimed to determine the strongest predictors of intentions and attempts to seek professional help, according to people’s attitudes, perceived social pressure, beliefs about the causes of mental illness and level of religiosity. The study included 126 Jewish people who were predominantly recruited from synagogues and community centres across the UK. Results indicated that a high percentage of this sample would be willing to see a mental health professional if they experienced a mental health problem. According to multiple regression analysis, attitudes towards seeking professional help and stress-related causal beliefs most strongly predicted intention to seek professional help. Despite the sample being non-clinically recruited, 63% of participants reported that they had experienced a mental health problem and the majority of these individuals had sought professional help in the past. Path analysis revealed that actual attempts to seek professional help were directly influenced by intention to seek professional help, perceived social pressure and supernatural causal beliefs. Given the high prevalence of mental health problems and use of professional mental health services amongst this sample, clinical considerations highlighted the need for preventative mental health strategies and culturally sensitive mental health services for Jewish people. Limitations of the study include the use of an opportunity sample which was unable to recruit members of the Ultra-Orthodox Jewish community.

The dementias are illnesses which have significant cultural prominence and feature in a wide range of contemporary writing, often as a trope for old age. This thesis examines how stories of dementia are told in fiction and in the clinic. To do this, the work uses Arthur Frank's socio-narratology to examine twelve selected texts in which a key protagonist has dementia. Three of the selected texts have been written by authors with direct experience of dementia within their family and form a subset of texts, memoir fiction. How stories of dementia are told is considered by examining the clinic as a storytelling venue, the creation of faux medical notes from information in the texts and a Triple Analysis of the memoir fiction using three reading templates. The templates have been created from clinical practice, using the questions posed by Frank's socio-narratological practice of Dialogical Narrative Analysis, and using the parameters of Rita Charon's version of Close Reading drill in Narrative Medicine. The work is informed by autoethnography which uses my position as a clinician and reader to examine how fiction has been used in my clinical practice and how it informs my reading of the selected texts.