published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

Objective: Studies in healthy individuals show that exerting self-control consumes cognitive resources, which reduces subsequent self-control performance. This is termed as the self-control depletion effect. Restoring the availability of blood glucose eliminates this impairment, which is deemed as the glucose facilitation effect. Patients with schizophrenia are found to have self-regulatory dysfunctions. This study aims to investigate whether patient’s (a) glucose facilitation effects will be impaired, and (b) will have exaggerated depletion in a self-control task, as compared with healthy population. Method: Forty patients with schizophrenia-spectrum disorders and forty normal controls were recruited. This was a two drinks (glucose vs. placebo) x two depleting phases (self-control depleted vs. non-depleted) between-groups design. We examined the blood glucose levels before and after the self-control depletion phase and the subsequent performances in two self-control tasks (handgrip and Stroop Test) after the drink condition. Results: The four groups (depleting x glucose, depleting x placebo, non-depleting x glucose and non-depleting x placebo) of both patients and normal controls were comparable on a number of characteristics. The change in blood glucose level in the depleting group was significantly different from those in the non-depleting group. Two x two between-subjects ANOVAs were carried out to test the performances in the handgrip and Stroop task. Significant interactions were found in healthy controls regarding both tasks. However, a significant interaction was only found in patients regarding the handgrip task but not the Stroop task. Conclusions: This study demonstrated an impaired glucose facilitation effect in patients during a cognitive self-control task but not physical self-control task. The findings also suggested for the first time that a self-control depletion effect is intact in patients with schizophrenia, comparing with healthy individuals. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Reward learning refers to outcome-based learning that involves selecting optimal response choices from feedback which facilitate adaptive behavior. It is believed that reward learning paradigm represents a promising translational target in schizophrenia research. Previous studies generated relatively consistent evidence of rapid learning deficits but mixed findings on gradual learning deficits. Reward learning impairments were also associated with symptoms as well as antipsychotics treatment. The current study aimed to investigate the reward learning impairments and its longitudinal change in patients with first-episode schizophrenia spectrum disorder. A total of 34 patients and 36 healthy control participants were recruited. Patients and controls were matched in terms of age, sex, and education level. All participants were assessed twice: at baseline and after one year. For each assessment time point, data were collected on demographics, clinical and treatment characteristics. Participants were asked to complete a battery of cognitive assessments and two reward learning tasks: the Gain vs. loss-avoidance task and the Go-NoGo task. Patients and controls were compared in terms of cross-sectional reward learning performance at baseline and follow-up. Correlates of reward deficits were examined, and longitudinal analyses were conducted to investigate change of reward learning performance over time. At baseline, it was found that patients had significant rapid learning deficit in win-stay (learning from positive feedback) and gradual learning deficits in learning from both positive and negative feedback. Reward-driven learning impairments were more robust. At one-year follow-up, patients continued to have significant rapid learning deficit in win-stay and gradual learning deficits in learning from negative feedback. Longitudinal analyses demonstrated that patients had significant decrease in win-stay rate in training phase and significantly lower accuracy for punishment-driven stimuli across assessment time points. No deficits in representing expected reward value of stimuli or Go response bias were demonstrated. Correlations were found between different symptom domains (negative symptoms, positive symptoms) and reward learning impairments. Current findings regarding rapid and gradual learning deficits in patients with first-episode schizophrenia spectrum disorder were partially in keeping with that of previous studies. Discrepant findings across studies may be attributable to different sample characteristics in terms of illness chronicity and symptoms severity. The current study provided valuable information regarding the longitudinal change of reward learning deficits in early psychosis patients. / published_or_final_version / Psychiatry / Master / Master of Philosophy

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

published_or_final_version / Clinical Psychology / Doctoral / Doctor of Psychology

Includes vita. / Title from PDF of title page. / Document formatted into pages; contains 114 pages. / Thesis (Ph.D.)--University of South Florida, 2003. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: The purpose of this study was to determine how to best motivate smokers with schizophrenia or schizoaffective disorder to seek treatment for tobacco dependence. Smokers with schizophrenia or schizoaffective disorder (N=78) were randomly assigned to receive a Motivational Interviewing, Psychoeducational, or Minimal Control intervention. A greater proportion of participants receiving the Motivational Interviewing intervention followed through on a referral for tobacco dependence treatment within one-week and one-month post-intervention. Mixed model Analyses of Variance found no differences between groups at one-week or at one-month with respect to tobacco use or motivation to quit. Within group analyses indicated that participants in the Motivational Interviewing and Psychoeducational groups reported significant decreases in cigarettes smoked per day. / ABSTRACT: Only participants in the Motivational Interviewing group showed significant increases in confidence in their ability to quit smoking. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.

by Chui Shu-fai, Fred. / Includes questionaire in Chinese. / Thesis (M.S.W.)--Chinese University of Hong Kong, 1995. / Includes bibliographical references (leaves [45-68] (3rd gp.)). / Chapter ONE --- INTRODUCTION --- p.1 / Chapter TWO --- THE IMPACT OF PARENTAL MENTAL ILLNESS ON CHILDREN --- p.8 / Chapter 2.1 --- Impact of parental mental illness on children --- p.8 / Chapter 2.2 --- Studies about the impact of parental affective disorder on children --- p.9 / Chapter 2.3 --- Children of schizophrenic patients --- p.12 / Chapter 2.3.1 --- Effect of psychiatric symptoms and behavioral change --- p.14 / Chapter 2.3.2 --- Impairment of interaction --- p.15 / Chapter 2.4 --- Parents with depression versus parents with schizophrenia: their differential impacts on children --- p.16 / Chapter 2.4.1 --- Parenting --- p.16 / Chapter 2.4.2 --- Children at risk --- p.18 / Chapter 2.4.3 --- Problems faced by the children --- p.20 / Chapter 2.5 --- Discussion on the above findings --- p.22 / Chapter 2.6 --- Resilience in Children / Adolescents --- p.25 / Chapter 2.7 --- Limitations of some empirical studies about children of mentally ill --- p.27 / Chapter THREE --- "STRESS, COPING RESOURCES AND MENTAL HEALTH" --- p.30 / Chapter 3.1 --- Concept of Stress --- p.30 / Chapter 3.2 --- "Life events, daily hassles and life strains" --- p.36 / Chapter 3.3 --- Objective burdens and subjective burdens arising from the mentally ill in the family --- p.37 / Chapter 3.4 --- "Stressors as management problems, psychological problems and social / economic costs faced by the children" --- p.39 / Chapter 3.4.1 --- Management problems --- p.39 / Chapter 3.4.2 --- Psychological problems --- p.41 / Chapter (a) --- Self-blame and Guilt / Chapter (b) --- Anger / Chapter (c) --- Feeling of Embarrassment and shame / Chapter (d) --- Anxieties caused by parent's hospitalization / Chapter (e) --- Sense of inferiority caused by the prejudice and rejection of community / Chapter 3.4.3 --- Social / economic costs --- p.47 / Chapter (a) --- Disruption of family functioning / Chapter (b) --- Conflict in the family / Chapter (c) --- Financial difficulties / Chapter (d) --- Reduction in social life / Chapter 3.5 --- Perceived Stress --- p.50 / Chapter 3.5.1 --- Measurement of perceived stress --- p.52 / Chapter 3.6 --- Stress and Coping in Children/Adolescents --- p.53 / Chapter 3.7 --- Coping Resources --- p.56 / Chapter 3.7.1 --- Health and energy --- p.58 / Chapter 3.7.2 --- Positive beliefs --- p.58 / Chapter 3.7.3 --- Social skills --- p.61 / Chapter 3.8 --- Coping resources being examined in this study --- p.62 / Chapter 3.8.1 --- Self-efficacy --- p.63 / Chapter (a) --- Self-efficacy as a coping resource / Chapter (b) --- Social self-efficacy / Chapter (c) --- Measurement of self-efficacy / Chapter 3.8.2 --- Self-esteem --- p.71 / Chapter (a) --- Measurement of Self-esteem / Chapter 3.8.3 --- knowledge / Information --- p.73 / Chapter (a) --- Knowledge about schizophrenia / Chapter (b) --- Measurement about mental health knowledge / Chapter 3.8.4 --- Attitude toward the ex-mental patient --- p.76 / Chapter (a) --- Mental health knowledge and attitude toward mental patient / Chapter (b) --- Adolescent's attitude toward the mentally-ill / Chapter (c) --- Measurement of attitude toward mental illness and mental patients / Chapter 3.9 --- Mental Health --- p.81 / Chapter 3.9.1 --- Concept of “Mental´ح --- p.81 / Chapter 3.9.2 --- Concept of “Health´ح --- p.81 / Chapter 3.9.3 --- Mental health as a concept --- p.82 / Chapter 3.9.4 --- Measurement of mental health --- p.84 / Chapter FOUR --- LITERATURE REVIEW ON THE RELATIONSHIPS AMONG VARIABLES UNDER STUDY --- p.85 / Chapter 4.1 --- Stress and mental health --- p.85 / Chapter 4.2 --- Coping resources and perceived stress --- p.87 / Chapter 4.2.1 --- Self-efficacy and perceived stress --- p.87 / Chapter 4.2.2 --- Self-esteem and perceived stress --- p.88 / Chapter 4.2.3 --- Knowledge and perceived stress --- p.89 / Chapter 4.2.4 --- Attitude and perceived stress --- p.89 / Chapter 4.3 --- Coping resources and mental health --- p.90 / Chapter 4.3.1 --- Self-efficacy and mental health --- p.90 / Chapter 4.3.2 --- Self-esteem and mental health --- p.92 / Chapter 4.3.3 --- Knowledge and mental health --- p.93 / Chapter 4.3.4 --- Attitude and mental health --- p.94 / Chapter 4.4 --- Conceptual framework --- p.94 / Chapter 4.5 --- Research questions and hypotheses --- p.99 / Chapter 4.6 --- Definition of concepts --- p.103 / Chapter 4.6.1 --- Definition of stressors --- p.103 / Chapter 4.6.2 --- Definition of perceived stress --- p.103 / Chapter 4.6.3 --- Definition of social self-efficacy --- p.103 / Chapter 4.6.4 --- Definition of self-esteem --- p.104 / Chapter 4.6.5 --- Definition of knowledge about schizophrenia --- p.104 / Chapter 4.6.6 --- Definition of behavioral intentions / attitude --- p.104 / Chapter 4.6.7 --- Definition of mental health --- p.105 / Chapter FIVE --- RESEARCH METHODOLOGY --- p.106 / Chapter 5.1 --- Sample Design --- p.106 / Chapter 5.2 --- Instruments for Measurement --- p.107 / Chapter 5.2.1 --- Scale measuring the stressors (ST-ALL) and Perceived Stress (PS-ALL) --- p.107 / Chapter 5.2.2 --- Rosenberg Self-esteem Scale (RSES) --- p.108 / Chapter 5.2.3 --- Adolescent Social Self-efficacy Scale (SEFF) --- p.108 / Chapter 5.2.4 --- Knowledge about Schizophrenia Scale (SKS) --- p.109 / Chapter 5.2.5 --- Behavioral Intention toward Ex-mental Patients Scale (BIEMPS) --- p.109 / Chapter 5.2.6 --- General Health Questionnaire (GHQ-30) --- p.110 / Chapter 5.2.7 --- Chinese Version of Hopelessness Scale (C-Hope) --- p.111 / Chapter 5.2.8 --- Demographic /personal data --- p.111 / Chapter SIX --- RESULTS --- p.112 / Chapter 6.1 --- Psychometric properties of the measuring instruments --- p.112 / Chapter 6.1.1 --- Measurement of stress / Chapter (a) --- Stressor Scale (ST-ALL) / Chapter (b) --- Perceived Stress Scale (PS-ALL) / Chapter 6.1.2 --- Measurement of coping resources --- p.113 / Chapter (a) --- Adolescent Social Self-efficacy Scale (SEFF) / Chapter (b) --- Rosenberg Self-esteem Scale (RSES) / Chapter (c) --- Knowledge about Schizophrenia Scale (SKS) / Chapter (d) --- Behavioral intention towards Ex-mental Patients Scale (BIEMPS) / Chapter 6.1.3 --- Measurement of mental health --- p.115 / Chapter (a) --- General health questionnaire - 30 (GHQ-30) / Chapter (b) --- Chinese-Hopelessness Scale (C-Hope) / Chapter 6.2 --- Demographic characteristics of the respondents --- p.133 / Chapter 6.2.1 --- Sex and Age of Respondents --- p.133 / Chapter 6.2.2 --- Relationship of Respondents to Their Schizophrenic Parents --- p.133 / Chapter 6.2.3 --- Education Level of Respondents --- p.133 / Chapter 6.2.4 --- No. of Siblings of the Respondents and Their Rank among siblings --- p.134 / Chapter 6.2.5 --- Religion of respondents --- p.134 / Chapter 6.2.6 --- Out-patient or in-patient status of respondents' schizophrenic parents and number of years of treatment --- p.134 / Chapter 6.2.7 --- Education Level of the Parents --- p.135 / Chapter 6.2.8 --- "Occupation of the respondents' parents, the family's income and its source" --- p.135 / Chapter 6.2.9 --- Type of accommodation and family size within the same household --- p.136 / Chapter 6.2.10 --- Marital status of respondents' parents --- p.136 / Chapter 6.2.11 --- Principal caregivers of the respondents' schizophrenic parents --- p.136 / Chapter 6.3 --- Respondents' perception of the existing services and expressed needs --- p.140 / Chapter 6.3.1 --- Number of respondents who had visited social workers in the past 6 months and their satisfaction with the service of social workers --- p.140 / Chapter 6.3.2 --- The social services which were considered by the respondents as important for their schizophrenic parents --- p.140 / Chapter 6.3.3 --- The social services which were needed by respondents --- p.141 / Chapter 6.4 --- "Findings of stress, coping and mental health of respondents" --- p.144 / Chapter 6.4.1 --- Stress --- p.144 / Chapter (a) --- Stressors faced by respondents / Chapter (b) --- Perceived stress experienced by respondents / Chapter 6.4.2 --- Coping resources --- p.148 / Chapter (a) --- Distribution of responses to the items in the Social Self-efficacy Scale / Chapter (b) --- Distribution of responses to the items in the Rosenberg Self-esteem Scale / Chapter (c) --- Distribution of responses to the items in the Knowledge about Schizophrenia Scale / Chapter (d) --- Distribution of responses to the items in the Behavioral Intention toward Ex-mental Patient Scale / Chapter 6.4.3 --- Mental health --- p.152 / Chapter (a) --- Distribution of responses to the items in the General Health Questionnaire-30 (GHQ-30) / Chapter (b) --- Distribution of responses to the items in the Chinese version of Hopelessness Scale (C-Hope) / Chapter 6.5 --- "Interrelationships amongst stress, coping and mental health of the respondents" --- p.166 / Chapter 6.5.1 --- Relationship between perceived stress and psychological well being --- p.166 / Chapter (a) --- Relationship between perceived stress and GHQ-30 / Chapter (b) --- Relationship between perceived stress and hopelessness / Chapter 6.5.2 --- Relationships between perceived stress and coping resources --- p.167 / Chapter (a) --- Relationship between perceived stress and social self-efficacy / Chapter (b) --- Relationship between perceived stress and self-esteem / Chapter (c) --- Relationship between perceived stress and knowledge about schizophrenia / Chapter (d) --- Relationship between perceived stress and behavioral intentions towards ex-mental patients / Chapter (e) --- Differential effects of coping resources on perceived stress / Chapter 6.5.3 --- Relationships amongst the various measures of coping resources and psychological well-being --- p.169 / Chapter (a) --- Relationship between social self-efficacy and psychological well-being / Chapter (b) --- Relationship between self-esteem and mental health / Chapter (c) --- Relationship between knowledge about schizophrenia and psychological well-being / Chapter (d) --- Relationship between attitude toward ex-mental patient and psychological well-being (C-Hope) / Chapter (e) --- Differential effects of coping resources on psychological well-being / Chapter SEVEN --- DISCUSSION --- p.175 / Chapter 7.1 --- Psychometric properties of the tools --- p.175 / Chapter 7.1.1 --- Measurement of stress --- p.175 / Chapter (a) --- Stressor Scale (ST-ALL) / Chapter (b) --- Perceived Stress Scale (PS-ALL) / Chapter 7.1.2 --- Measurement of coping resources --- p.178 / Chapter (a) --- Social Self-efficacy Scale (SEFF) / Chapter (b) --- Rosenberg Self-esteem Scale (RSES) / Chapter (c) --- The Knowledge about Schizophrenia Scale (SKS) / Chapter (d) --- Behavioural Intentions Toward Ex-mental Patients (C-BIEMP) / Chapter 7.1.3 --- Measurement of psychological well-being --- p.181 / Chapter (a) --- GHQ / Chapter (b) --- Chinese version of Hopelessness Scale / Chapter 7.2 --- Characteristics of respondents --- p.183 / Chapter 7.2.1 --- "Sex, age and education" --- p.183 / Chapter 7.2.2 --- "Housing condition, family size and family income" --- p.183 / Chapter 7.2.3 --- Religion --- p.184 / Chapter 7.2.4 --- Caregivng role --- p.185 / Chapter 7.3 --- Respondents' perception of the existing service and expressed concern --- p.185 / Chapter 7.3.1 --- Number of respondents who had visited social worker in the past 6 months and their satisfaction with the service of social workers --- p.185 / Chapter 7.3.2 --- The social services which were considered by respondents as important for their schizophrenic parents --- p.185 / Chapter 7.3.3 --- Social services most needed by respondents --- p.189 / Chapter 7.4 --- "Stress, coping resources and mental health of respondents" --- p.192 / Chapter 7.4.1 --- Stress --- p.192 / Chapter (a) --- Stressors faced by respondents / Chapter (b) --- Perceived Stress / Chapter 7.4.2 --- Coping Resources --- p.201 / Chapter (a) --- Social Self-efficacy / Chapter (b) --- Self-esteem / Chapter (c) --- Knowledge about schizophrenia / Chapter (d) --- Behavioral intentions toward ex-mental patients / Chapter 7.4.3 --- Mental health of respondents --- p.210 / Chapter (a) --- General Health Questionnaire / Chapter (b) --- Hopelessness Scale / Chapter 7.5 --- Findings on relationships among major variables --- p.211 / Chapter 7.5.1 --- Relationship between perceived stress and psychological well-being --- p.211 / Chapter 7.5.2 --- Relationships between perceived stress and coping resources --- p.212 / Chapter 7.5.3 --- Relationship between coping resources and mental health --- p.215 / Chapter 7.6 --- Limitations --- p.216 / Chapter 7.6.1 --- Use of variables --- p.216 / Chapter 7.6.2 --- Sampling --- p.217 / Chapter 7.6.3 --- Data Collection --- p.219 / Chapter 7.6.4 --- Measuring Instruments --- p.219 / Chapter EIGHT --- CONCLUSIONS AND RECOMMENDATIONS --- p.220 / Chapter 8.1 --- Conclusions --- p.220 / Chapter 8.2 --- Recommendations --- p.225 / Chapter 8.2.1 --- Education on management of problems arising from mental patients --- p.225 / Chapter 8.2.2 --- Training on stress management --- p.226 / Chapter 8.2.3 --- Social skills training --- p.226 / Chapter 8.2.4 --- Special counselling service --- p.227 / Chapter 8.2.5 --- Mental health education for the patients and their family members as well --- p.228 / Chapter 8.2.6 --- Public education --- p.230 / Chapter 8.2.7 --- Promotion of teamwork approach among different professionals --- p.231 / Chapter 8.2.8 --- Cooperation among different professionals and special training for them --- p.231 / Chapter 8.2.9 --- Community support service and utilitarian support --- p.233 / Chapter (a) --- Financial assistance / Chapter (b) --- Special home help /family aid service / Chapter (c) --- Outreaching psychiatric service / Community nursing service / Chapter (d) --- Volunteer service / Chapter (e) --- Aftercare service team / Chapter (f) --- Social club for ex-mental patients / Chapter (g) --- Respite service / Chapter 8.2.10 --- Concluding remarks --- p.236 / APPENDIX A QUESTIONNAIRE (English Version) / APPENDIX B QUESTIONNAIRE (Chinese Version) / APPENDIX C TABLE31 / REFERENCES

En nous référant aux théorisations de l’épistémologie psychanalytique, nous concevons la schizophrénie comme résultant d’une expérience traumatique primaire n’ayant pu être intégrée au sein de la subjectivité. Ce traumatisme, nous le rattachons moins à un évènement en tant que tel qu’à la position impensable qu’il désigne pour le sujet. Ainsi, en nous inspirant de la pensée de P. Aulagnier et de R. Roussillon, nous suggérons que le noyau traumatique conditionnant le développement d’une problématique schizophrénique se rapporte à la position d’objet pulsionnel, ou de non-désir, à laquelle se trouve identifié le sujet au sein des premiers échanges avec son environnement. <p><p>Face à l’impensable de cette position identificatoire, le sujet se voit contraint de s’extraire de la scène relationnelle avec ses objets primaires, se clivant par la même opération du capital représentatif qui lui est associé. Dans ces conditions, nous pensons que le délire, moins d’apparaître comme une production pathologique dépourvue de sens, correspond à un mode de réponse face au retour hallucinatoire de l’impensé traumatique. Aussi, à partir d’une méthodologie qualitative basée sur l’analyse d’une douzaine de cas cliniques, nous mettons en évidence trois principales fonctions du délire dans la schizophrénie. La première, conceptualisée sous le terme de « fonction contenante », procède à la mise en forme et à la transformation signifiante de ce qui ne put être symbolisé de l’expérience traumatique. La seconde, nommée « fonction localisante », tente de situer en dehors du sujet le débordement pulsionnel inhérent au traumatisme primaire. La troisième, appelée « fonction identifiante », permet à la personne délirante de s’attribuer un énoncé identificatoire qui, de manière auto-créée, supplée à l’énigme de son histoire insensée.<p><p>Enfin, l’analyse de nos données cliniques souligne que ces trois fonctions de l’activité délirante ne se réalisent pas de façon aléatoire mais qu’elles s’articulent selon une logique particulière. Ainsi, nous suggérons qu’à partir de sa triple opération le délire schizophrénique tend à se déployer en un « processus délirant », par lequel le sujet peut rendre pensable et supportable la position traumatique à laquelle il a été identifié au cours de son histoire.<p><p><p>By following theories from the psychoanalytical epistemology, we consider schizophrenia as the result of a primary trauma that has not been assimilated within the subjectivity. We connect less this traumatism with an event than with the unthinkable position the subject is identified to. Therefore, being inspired by the thought of P. Aulagnier and R. Roussillon, we suggest that the traumatic nucleus which conditions the development of schizophrenia is related to the position of instinctual object, or of non-desire, to which the subject is identified within the first exchanges with his environment. <p><p>In view of this unthinkable position, the subject is forced to remove himself from the relationship with his primary objects, splitting off from the representative capital that is associated with it. In these conditions, we think that the delusion appears less as a meaningless pathological production than as a way of answering to the hallucinatory return of the traumatic unthought. From a qualitative methodology based on the analysis of a dozen clinical cases, we highlight three main functions of the delusion in schizophrenia. The first, conceptualized under the term «containing function», carries out the shaping and the significant transformation of what could have not been symbolized of the traumatic experience. The second, called «localizing function», tries to locate outside of the subject the instinctual overflow inherent to the primary trauma. The third, named «identifying function», enables the delusional person to assume an identificatory principle which, in a self-created way, compensates for the enigma of his senseless history.<p><p>Finally, the analysis of our clinical data underlines that these three functions of the delusional activity are not randomly accomplished but are organized according to a particular logic. Thus from its triple operation, we suggest that the schizophrenic delusion tends to develop into a «delusional process», by which the subject can make thinkable and bearable the traumatic position to which he was identified during his history.<p> / Doctorat en Sciences Psychologiques et de l'éducation / info:eu-repo/semantics/nonPublished