Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / The purpose of this research was to determine, using the 2[14C]deoxyglucose autoradiographic method, the local cerebral metabolic rates for glucose (LCMRglu) after the administration of morphine or saline in rats escaping from acute or chronic footshock or exposed to conditioned stress. All animals were given morphine (4mg/kg, sc) or saline 7 days, 3 days and 10 minutes prior to the tracer injection. The effects of stimulation in the acute and chronic footshock studies revealed that an identical noxious stimulus may not have similar effects on functional cerebral activity if there are differences in experience with the str1xsor. The results of the conditioned stress experiment demonstrate that simply placing an animal in an environment previously associated with footshock is sufficient to elicit changes in LCMRglu. The effects of morphine in the control and acute footshock experiments were similar in that nearly all of the 73 analyzed brain regions (99% and 93%, respectively) showed decreases in LCMRg1u. Morphine, however, caused fewer decreases (56%) in the chronic footshock study. Interestingly, the percentage of structures showing decreases in the conditioned stress study (79%) was approximately halfway between the effects seen in the two footshock studies. Morphine in the presence of acute footshock, compared to acute footshock alone, caused significant decreases in elements of the limbic telencephalon, basal forebrain and thalamic midline (paraventricular and paratenial nuclei). On the other hand, morphine did not cause any significant decreases in these structures (or others) in the chronic footshock study. Rather, the combination of morphine and chronic footshock, compared to morphine alone, caused significant increases in several brainstem structures previously implicated in opioid analgesia: the locus coeruleus, gigantocellular reticular nucleus and raphe magnus. Additionally, significant effects were seen in basal ganglia structures which are normally associated with the motor system. The effects seen in these structures, along with the significant effect demonstrated in the parafasicular thalamic nucleus, suggest that morphine works to attenuate pain in animals exposed to chronic footshock via neural networks responsible for sensorimotor reactions to pain. Alternatively, animals exposed to chronic footshock may have developed tolerance to the effects of morphine. The effects of morphine, however, in the chronic footshock experiment are much different from those seen in the acute footshock study where morphine acts primarily in limbic structures and midline thalamus to attenuate the affective reaction to pain. / 2999-01-01

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2999-01-01

Thesis (Ph.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Two attitude dimensions which become highly relevant for the person who is admitted to the psychiatric ward of a hospital are acceptance of mental illness and acceptance of mental patients. It is assumed that under the impact of hospitalization acceptance of both mental illness and mental patients and rejection of both mental illness and mental patients tend to become consonant attitude combinations, and it is also assumed that rejection of mental patients and acceptance of mental illness becomes a dissonant attitude combination. Three hypotheses were derived from balance theory and subjected to test. They were first, that people realign attitudes to reduce dissonance, second that people realign attitudes to increase consonance, and third, that people maintain consonant attitude combinations more frequently than dissonant combinations. These hypotheses were tested in the following manner. Ninety-four new admissions to the open psychiatric ward of the Boston Veterans Administration Hospital were administered a questionnaire and interview at time of admission and again after a significant period of hospitalization (approximately ninety days). The questionnaire contained sixteen items measuring acceptance-rejection of mental patients, divided into four subsets each sampling from somewhat different response modes (statement agreement, statement disagreement, adjective ratings, and sentence completion). On the basis of "social distance" score summed across all sixteen items, subjects were divided into accept, neutral, and reject groups of equal frequency. The interview inquired into the patient's perception, belief, and interpretations concerning symptoms, probable cause, and preferred treatment of his own illness. Verbatim interview responses were rated for expression of acceptance and rejection of a psychiatric viewpoint. On the basis of summed ratings, subjects were divided into three groups of equal frequency representing acceptance, neutrality, and rejection at the dimension of mental illness. On the basis of the groupings on the dimension of mental patient and mental illness, subjects were assigned to nine attitude combinations representing varying degrees of consonance, dissonance, and non-consonance. Initial attitude combinations were treated as the independent variable and changes from one combination to another were treated as the dependent variable. Results: There was no special tendency for subjects with dissonant attitude combinations to shift away fran dissonance either in the direction of consonance or merely to non-dissonance. The first hypothesis was thus not confirmed. However, there did appear to be a significant tendency for subjects to shift from non-consonant to consonant attitude combinations, confirming the second hypothesis. Finally, there was no significant indication of greater stability in initially consonant attitude combinations than in non-consonant combinations. The third hypothesis, like the first, was therefore not confirmed. Theoretical Implications: There appears to be some utility in subdividing the omnibus balance hypothesis into three sub-hypotheses: namely, dissonance reduction, consonance increment, and consonance maintenance. Practical Implications: Social integration and acceptance of other mental patients may be a necessary precursor of acceptance of a psychological orientation toward illness in one's self. If psychological insight is the goal, a patient may be more receptive after he has come to perceive mental patients as potential friends and companions and people who are not too much different from himself. If social integration is the principal goal, however, there is no guarantee that acceptance of mental illness in the self will induce greater acceptance of other mental patients. Balance theory, per se, does not appear to be an effective predictor of attitude change in this setting, and it is premature to suggest direct application of the theory to ward management problems. Nevertheless, theoretical analyses are useful in clarifying and sharpening many of the issues confronting the practitioner. / 2999-01-01

No

The focus of the thesis is on violent offenders with schizophrenia and their relatives. The aims were to explore incidence of violent crimes, the extent to which family members were victims, to investigate individual background factors among violent offenders, and to identify psychotic symptoms and triggering factors associated with fatal violence. In addition, parents were interviewed to build an understanding of their experiences and emotional reactions. One study examined all 369 male individuals who had committed a violent crime (assault, homicide or attempt to any of these crimes), who in a pre-trial forensic psychiatric evaluation (FPE) during 1992-2000 were diagnosed with schizophrenia, and who were referred to forensic psychiatric treatment. Although the majority of the 615 victims was unacquainted to the offenders, family members or male acquainted were most at risk of being severely injured or killed as victims. Background factors were studied for the 207 Swedish offenders who for their first time were subjects of a FPE during the study period. There were indications that those offenders who targeted family members had an earlier onset and more severe course of their mental illness. During the study period, 48 offenders committed homicides. Of the 52 victims, 83% were family members or acquainted to the offender. Those who killed a family member had more often delusions and/or hallucinations, were less often intoxicated, had to a lesser extent committed a previous violent crime and they were younger at the time of the homicide. Parents, who were interviewed, were very emotionally involved in their adult sons, although they were not living together. Ignorance regarding the diagnosis of their son and his criminality negatively influenced the contacts, both between parent and son and between parent and professionals in psychiatry. However, the referral to forensic psychiatric treatment gave the parents hope for a positive development.

Thesis (Ph.D.)--University of Melbourne, Centre for International Mental Health and Dept. of Psychiatry, 2005. / Typescript (photocopy). Includes bibliographical references (leaves 441-472).

Submitted by Irene Nascimento (irene.kessia@ufpe.br) on 2016-09-14T17:09:11Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação_Juliano_Biblioteca.pdf: 11130689 bytes, checksum: a577f73fe7d8e20644a19bcc4ba15002 (MD5) / Made available in DSpace on 2016-09-14T17:09:11Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação_Juliano_Biblioteca.pdf: 11130689 bytes, checksum: a577f73fe7d8e20644a19bcc4ba15002 (MD5) Previous issue date: 2016-07-12 / A história da psiquiatria, em sua maior parte, confunde-se com a história dos asilos. Os Hospitais Gerais desenvolveram-se, ao longo da história da medicina, como ambientes em que não havia espaço para os loucos. A partir do século XX, começa a ocorrer uma mudança nesse paradigma, sobretudo nos EUA e na Europa, com a criação das UPHGs em diversos serviços por lá, e a consolidação da Interconsulta psiquiátrica como área de atuação da psiquiatria, que passa a estreitar o contato com o restante da medicina. Foi um movimento que rendeu diversos avanços tanto à psiquiatria quanto às outras áreas médicas. No Brasil, esse percurso começou na década de 1950 e ocorre de forma mais tímida. Apenas 1,1% dos Hospitais gerais contam com suporte da psiquiatria em nosso país atualmente. Contudo, houve espaço no Brasil para o desenvolvimento de projetos pioneiros nesse campo, cuja história não está registrada. A psiquiatria pernambucana foi protagonista na empreitada, inaugurando inclusive a integração da psiquiatria ao hospital geral no Brasil. Pernambuco também foi um dos pioneiros na introdução da clínica psicanalítica em hospitais gerais do serviço público. O presente trabalho pretende registrar a história dessas experiências. Para tanto, escolhemos os serviços da UFPE e do Hospital Barão de Lucena, sedes dos primeiros serviços de saúde mental em hospital geral de Pernambuco. Fez-se uma ampla pesquisa documental, além de serem entrevistados alguns dos principais atores da construção desses serviços. Apesar de difícil, a integração dos cuidados de saúde mental ao hospital geral na UFPE e no HBL conseguiu efetivar-se, a partir da psiquiatria na UFPE e da psicanálise no HBL. Foram espaços configurados e sustentados dentro de uma perspectiva de formação, para além da assistência, e acreditamos que sua longevidade tenha relação com isso. / The history of psychiatry, for the most part, is intertwined with the history of asylums. General Hospitals have developed mostly as environments in which there was no room for the insane. Since the early twentieth century, a paradigm shift takes place, specially in the US and Europe, with the creation of psychiatryc units in several General Hospitals there. It led to the consolidation of Consultation Liaison Psychiatry as an official sub-specialty of Psychiatry. Integration of Psychiatry and other medical specialties was a movement that yielded many advances in both psychiatry as other medical areas. In Brazil, this journey began in the 1950s and is more . Only 1.1% of brazilian general hospitals have psychiatric support nowadays. However, there was room in Brazil for the development of pioneering experiments in this field, whose history is not recorded. Pernambuco’s psychiatry had a key role in these experiments, inaugurating the integration of psychiatry to the general hospital in Brazil. Pernambuco was also one of the first places to have a psychoanalytic couch in public service facilities. This work aims to record the history of these pioneering experiences in the state of Pernambuco. Therefore, we chose the services of UFPE and the Hospital Barão de Lucena, headquarters of general Hospital Psychiatry in Pernambuco. An extensive literature research was done, along with statements collection from some of the major players in the construction of these services. Although difficult, the integration of mental health care to the general hospital at UFPE and HBL was sucessful, arising from psychiatry at UFPE and psychoanalysis at in HBL. They were configured spaces and sustained in a training perspective, and we believe that it explains their longevity.

Submitted by Rafael Santana (rafael.silvasantana@ufpe.br) on 2017-05-12T19:01:29Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação_Juliano_Biblioteca.pdf: 11109168 bytes, checksum: 1032a08c27aa11c40a06a7024ebe6551 (MD5) / Made available in DSpace on 2017-05-12T19:01:29Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação_Juliano_Biblioteca.pdf: 11109168 bytes, checksum: 1032a08c27aa11c40a06a7024ebe6551 (MD5) Previous issue date: 2016-07-12 / A história da psiquiatria, em sua maior parte, confunde-se com a história dos asilos. Os Hospitais Gerais desenvolveram-se, ao longo da história da medicina, como ambientes em que não havia espaço para os loucos. A partir do século XX, começa a ocorrer uma mudança nesse paradigma, sobretudo nos EUA e na Europa, com a criação das UPHGs em diversos serviços por lá, e a consolidação da Interconsulta psiquiátrica como área de atuação da psiquiatria, que passa a estreitar o contato com o restante da medicina. Foi um movimento que rendeu diversos avanços tanto à psiquiatria quanto às outras áreas médicas. No Brasil, esse percurso começou na década de 1950 e ocorre de forma mais tímida. Apenas 1,1% dos Hospitais gerais contam com suporte da psiquiatria em nosso país atualmente. Contudo, houve espaço no Brasil para o desenvolvimento de projetos pioneiros nesse campo, cuja história não está registrada. A psiquiatria pernambucana foi protagonista na empreitada, inaugurando inclusive a integração da psiquiatria ao hospital geral no Brasil. Pernambuco também foi um dos pioneiros na introdução da clínica psicanalítica em hospitais gerais do serviço público. O presente trabalho pretende registrar a história dessas experiências. Para tanto, escolhemos os serviços da UFPE e do Hospital Barão de Lucena, sedes dos primeiros serviços de saúde mental em hospital geral de Pernambuco. Fez-se uma ampla pesquisa documental, além de serem entrevistados alguns dos principais atores da construção desses serviços. Apesar de difícil, a integração dos cuidados de saúde mental ao hospital geral na UFPE e no HBL conseguiu efetivar-se, a partir da psiquiatria na UFPE e da psicanálise no HBL. Foram espaços configurados e sustentados dentro de uma perspectiva de formação, para além da assistência, e acreditamos que sua longevidade tenha relação com isso. / The history of psychiatry, for the most part, is intertwined with the history of asylums. General Hospitals have developed mostly as environments in which there was no room for the insane. Since the early twentieth century, a paradigm shift takes place, specially in the US and Europe, with the creation of psychiatryc units in several General Hospitals there. It led to the consolidation of Consultation Liaison Psychiatry as an official sub-specialty of Psychiatry. Integration of Psychiatry and other medical specialties was a movement that yielded many advances in both psychiatry as other medical areas. In Brazil, this journey began in the 1950s and is more . Only 1.1% of brazilian general hospitals have psychiatric support nowadays. However, there was room in Brazil for the development of pioneering experiments in this field, whose history is not recorded. Pernambuco’s psychiatry had a key role in these experiments, inaugurating the integration of psychiatry to the general hospital in Brazil. Pernambuco was also one of the first places to have a psychoanalytic couch in public service facilities. This work aims to record the history of these pioneering experiences in the state of Pernambuco. Therefore, we chose the services of UFPE and the Hospital Barão de Lucena, headquarters of general Hospital Psychiatry in Pernambuco. An extensive literature research was done, along with statements collection from some of the major players in the construction of these services. Although difficult, the integration of mental health care to the general hospital at UFPE and HBL was sucessful, arising from psychiatry at UFPE and psychoanalysis at in HBL. They were configured spaces and sustained in a training perspective, and we believe that it explains their longevity.

A literature review indicated that psychopathological symptomology must be considered within the social context of the patient. Recent research has suggested that the psychopathological symptoms of the psychotic patient function on a covert level of communication as a strategy to control the threat of interpersonal intimacy. The present investigation similarly examined the interpersonal function of another class of patient symptomology, somatic symptoms. It was hypothesized that somatic symptom verbalizations of psychiatric outpatients also can serve as covert messages to avoid the risk of interpersonal intimacy. Results indicated that only the high-somatic-symptom patients significantly increased their symptom verbalizations in response to demand. When the interviewer modeled impersonal self-disclosures, both groups showed a low rate of somatic verbalizations. The groups did not differ. When the interviewer modeled personal self-disclosures, both patient groups significantly increased their psychological symptom verbalizations compared to their counterparts in the impersonal condition. In addition, low somatic symptom patients under the demand for personal disclosure showed significantly less avoidance behavior than any other group. No differences were found among the experimental groups in terms of self-disclosure level. The results clearly lend support to Haley's (1963) intimacy-avoidance corollary; that is, symptoms of non-psychotic patients function as covert messages that avoid the formation of intimate interpersonal relationships by redefining the reciprocal role available to participants. In view of these findings, several cross-study comparisons were made. In addition, directions for future research were suggested.

<p>Current public health initiatives recognize that obesity is increasing to epidemic proportions in developed countries. In keeping with the view of obesity as a developmental, progressive condition, targeting childhood factors that predict increases in body mass index (BMI) may result in the development of more effective prevention interventions. To date, prospective studies of child-onset psychopathology and adult overweight in representative community samples are limited by short duration of follow-up into adulthood and an inability to make psychiatric diagnoses. Where available, childhood data has been analyzed together with adolescent data, such that it is difficult to disentangle the relationship between early psychological distress and adult overweight in these developmentally heterogeneous groups. The main objective of this thesis is to examine the relationship between childhood and adolescent symptoms of (i) Depression (ii) Attention Deficit Hyperactivity Disorder [ADHD] and (iii) Conduct Disorder [CD] with adult overweight, in a large, prospectively followed, community sample of Canadian children.</p> <p><strong> </strong>This thesis includes the 1,992 children aged 4-11 years and 1,302 adolescents aged 12-16 years who participated in the Ontario Child Health Survey (OCHS), a provincially funded, prospective cohort study of the psychiatric and general child health of a representative sample ofOntario community children undertaken in 1983 with follow-up assessment in 2000. Data are collected from multiple informants; psychiatric disorders are determined by a combination of parental, youth and teacher self-report and interviewer-administered measures. BMI is a derived variable determined from self-reported height and weight in 2000. Multiple regression analyses are undertaken to examine the association of child and adolescent mental illness with adult overweight, after controlling for the effects of age, sex, socioeconomic status, parental psychiatric history and, among the adolescent subgroup, cigarette smoking and alcohol use.</p> <p>Adults with a history of depression, ADHD or CD identified in childhood have increased body mass (BMI = 27.2 kg/m², 27.7 kg/m², and 27.9 kg/m², respectively) compared to their nonaffected peers (BMI= 24.8 kg/m²). Children who experienced increased depressive symptoms (among boys) and CD symptoms (boys and girls) are at greater risk for future weight gain than children with fewer symptoms. Adolescent girls with Depression or Conduct Disorder are heavier in adulthood than their psychologically healthier peers. Although ADHD was initially found to be associated with adult overweight, this relationship is accounted for by the effect of conduct disturbance, regardless of child sex.</p> <p>This thesis suggests that psychopathology in childhood and adolescence predicts increased adult body mass in a large community sample ofOntarioyouth. In childhood, boys with depressive symptoms and boys and girls with disruptive behaviour are at particular risk. Among adolescents, girls with greater depressive symptoms or conduct disturbance are at increased risk of future weight gain. Research examining the trajectories of children with depressive and externalizing disorders is needed to understand the mechanism of the relationship between these disorders in childhood and eating behaviours in adulthood.</p> / Master of Science (MSc)