Thesis (Ph. D.)--University of Missouri-Columbia, 1996. / Typescript. Vita. Includes bibliographical references (leaves 141-152). Also available on the Internet.

Thesis (M.A.)--York University, 2008. Graduate Programme in Psychology. / Typescript. Includes bibliographical references (leaves 78-95). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:MR51611

Objective: To examine the association between separation anxiety disorder (SAD) and mental disorders in a community sample and to evaluate whether separation anxiety is specifically related to panic disorder with and without agoraphobia. Method: The data come from a 4-year, prospective longitudinal study of a representative cohort of adolescents and young adults aged 14–24 years at baseline in Munich, Germany. The present analyses are based on a subsample of the younger cohort that completed baseline and two follow-up investigations (n = 1,090). DSM-IV diagnoses were made using the Munich Composite International Diagnostic Interview. Cox regressions with time-dependent covariates were used to examine whether prior SAD is associated with an increased risk for subsequent mental disorders. Results: Participants meeting DSM-IV criteria for SAD were at an increased risk of developing subsequent panic disorder with agoraphobia (PDAG) (HR = 18.1, 95% CI = 5.6–58.7), specific phobia (HR = 2.7, 95% CI = 1.001–7.6), generalized anxiety disorder (HR = 9.4, 95% CI = 1.8–48.7), obsessive-compulsive disorder (HR = 10.7, 95% CI = 1.7–66.1), bipolar disorder (HR = 7.7, 95% CI = 2.8–20.8), pain disorder (HR = 3.5, 95% CI = 1.3–9.1), and alcohol dependence (HR = 4.7, 95% CI = 1.7–12.4). Increased hazard rates for PDAG (HR = 4.2, 95% CI = 1.4–12.1), bipolar disorder type II (HR = 8.1, 95% CI = 2.3–27.4), pain disorder (HR = 1.9, 95% CI = 1.01–3.5), and alcohol dependence (HR = 2.1, 95% CI = 1.1–4.) were also found for subjects fulfilling subthreshold SAD. Conclusions: Although revealing a strong association between SAD and PDAG, our results argue against a specific SAD-PDAG relationship. PDAG was neither a specific outcome nor a complete mediator variable of SAD.

The purpose of this study was to examine the origins of the Multicultural Relational Model of therapy and demonstrate the application of this model in the clinical setting. Subjects were two ethnic minority children, a Hispanic boy, age nine, and a mixed-race boy, age 10, who was adopted by an African American family.

Objective: To examine the association between separation anxiety disorder (SAD) and mental disorders in a community sample and to evaluate whether separation anxiety is specifically related to panic disorder with and without agoraphobia. Method: The data come from a 4-year, prospective longitudinal study of a representative cohort of adolescents and young adults aged 14–24 years at baseline in Munich, Germany. The present analyses are based on a subsample of the younger cohort that completed baseline and two follow-up investigations (n = 1,090). DSM-IV diagnoses were made using the Munich Composite International Diagnostic Interview. Cox regressions with time-dependent covariates were used to examine whether prior SAD is associated with an increased risk for subsequent mental disorders. Results: Participants meeting DSM-IV criteria for SAD were at an increased risk of developing subsequent panic disorder with agoraphobia (PDAG) (HR = 18.1, 95% CI = 5.6–58.7), specific phobia (HR = 2.7, 95% CI = 1.001–7.6), generalized anxiety disorder (HR = 9.4, 95% CI = 1.8–48.7), obsessive-compulsive disorder (HR = 10.7, 95% CI = 1.7–66.1), bipolar disorder (HR = 7.7, 95% CI = 2.8–20.8), pain disorder (HR = 3.5, 95% CI = 1.3–9.1), and alcohol dependence (HR = 4.7, 95% CI = 1.7–12.4). Increased hazard rates for PDAG (HR = 4.2, 95% CI = 1.4–12.1), bipolar disorder type II (HR = 8.1, 95% CI = 2.3–27.4), pain disorder (HR = 1.9, 95% CI = 1.01–3.5), and alcohol dependence (HR = 2.1, 95% CI = 1.1–4.) were also found for subjects fulfilling subthreshold SAD. Conclusions: Although revealing a strong association between SAD and PDAG, our results argue against a specific SAD-PDAG relationship. PDAG was neither a specific outcome nor a complete mediator variable of SAD.

Separation anxiety is highly prevalent among intellectually and visually impaired individuals, yet little research has been done into its treatment in this population. Due to delayed cognitive skills, these individuals struggle to develop the abstract concept of person permanence, which is necessary to diminish separation anxiety. The first aim of this study was to investigate whether using technology alone or including caregivers was the most beneficial approach to developing person permanence using technology-assisted therapy. The caregivers received training in advance in an attachment-based protocol about securing attachment relationships with the participant. It was hypothesised that the inclusion of attachment figures in technology-assisted therapy would enhance the acquisition of the person permanence concept. The second aim of this study was to determine whether technology-assisted therapy in tandem with the participation of caregivers consequently decreased separation anxiety and challenging behaviour in an adult with intellectual and visual impairment. It was hypothesised that the subject’s anxiety and challenging behaviour levels would significantly decrease due to the intervention. The final aim was to determine how the caregivers and the participant experienced this intervention. It was hypothesised that they would regard it as a positive experience. This single-subject design used a pre-experimental quantitative approach. It was based on the familiar ABAB design and comprised six phases. Phase A served as baseline, giving the participants time to become acquainted with the technology. Phase B consisted of automated responses to the participant’s messages. In phase C caregivers directed the active reply. The daily messages were discussed when the participant and caregiver reunited, incorporating the attachment-based protocol. Phase B and C were repeated. Phase D followed after the devices were handed in. The technology was a specially adapted touch iPhone with an application comprising coloured emoticons. When the participant was physically separated from the caregiver, he could send happy, sad, angry or scared emoticons, or request help. The caregiver, who had a similar device, responded by sending a pre-determined response such as acknowledging the participant’s “I am angry” message with a “You are angry” message. Due to the association between anxiety and challenging behaviour in this population, standardised instruments were used to measure changes in these behaviours. Repeated measure ANOVA and a non-parametric Friedman test were used to analyse the data, specifically comparing phase B and C. Overall, the results showed that behaviour did significantly change over the course of the intervention. The frequency of the various iPhone messages sent by the participant was recorded daily. ANOVA contracts results demonstrated significantly fewer anxious and angry messages sent during the C phases compared with the B phases. The professional caregivers recorded the frequency and intensity of anxiety and challenging behaviours. The ANOVA contrast results showed a significantly lower frequency and intensity of these behaviours in the C phases compared with the B phases. A questionnaire was developed to evaluate the social validity of the intervention. The independent samples t-test demonstrated a significant difference between the mean scores rated by the caregivers at the beginning and the end of the invention. The participant and caregivers were positive about the intervention. Although the results cannot be generalised, it can be concluded that the inclusion of caregivers in technology-assisted therapy can serve as an invaluable aid to developing the person permanence concept. The findings also indicate that the anxiety and challenging behaviour levels shown by the adult with ID and visual impairment decreased due to technology-assisted therapy applied by caregivers, while responses to the social validity of the intervention were positive. / MSc (Research Psychology), North-West University, Potchefstroom Campus, 2015

Separation anxiety is highly prevalent among intellectually and visually impaired individuals, yet little research has been done into its treatment in this population. Due to delayed cognitive skills, these individuals struggle to develop the abstract concept of person permanence, which is necessary to diminish separation anxiety. The first aim of this study was to investigate whether using technology alone or including caregivers was the most beneficial approach to developing person permanence using technology-assisted therapy. The caregivers received training in advance in an attachment-based protocol about securing attachment relationships with the participant. It was hypothesised that the inclusion of attachment figures in technology-assisted therapy would enhance the acquisition of the person permanence concept. The second aim of this study was to determine whether technology-assisted therapy in tandem with the participation of caregivers consequently decreased separation anxiety and challenging behaviour in an adult with intellectual and visual impairment. It was hypothesised that the subject’s anxiety and challenging behaviour levels would significantly decrease due to the intervention. The final aim was to determine how the caregivers and the participant experienced this intervention. It was hypothesised that they would regard it as a positive experience. This single-subject design used a pre-experimental quantitative approach. It was based on the familiar ABAB design and comprised six phases. Phase A served as baseline, giving the participants time to become acquainted with the technology. Phase B consisted of automated responses to the participant’s messages. In phase C caregivers directed the active reply. The daily messages were discussed when the participant and caregiver reunited, incorporating the attachment-based protocol. Phase B and C were repeated. Phase D followed after the devices were handed in. The technology was a specially adapted touch iPhone with an application comprising coloured emoticons. When the participant was physically separated from the caregiver, he could send happy, sad, angry or scared emoticons, or request help. The caregiver, who had a similar device, responded by sending a pre-determined response such as acknowledging the participant’s “I am angry” message with a “You are angry” message. Due to the association between anxiety and challenging behaviour in this population, standardised instruments were used to measure changes in these behaviours. Repeated measure ANOVA and a non-parametric Friedman test were used to analyse the data, specifically comparing phase B and C. Overall, the results showed that behaviour did significantly change over the course of the intervention. The frequency of the various iPhone messages sent by the participant was recorded daily. ANOVA contracts results demonstrated significantly fewer anxious and angry messages sent during the C phases compared with the B phases. The professional caregivers recorded the frequency and intensity of anxiety and challenging behaviours. The ANOVA contrast results showed a significantly lower frequency and intensity of these behaviours in the C phases compared with the B phases. A questionnaire was developed to evaluate the social validity of the intervention. The independent samples t-test demonstrated a significant difference between the mean scores rated by the caregivers at the beginning and the end of the invention. The participant and caregivers were positive about the intervention. Although the results cannot be generalised, it can be concluded that the inclusion of caregivers in technology-assisted therapy can serve as an invaluable aid to developing the person permanence concept. The findings also indicate that the anxiety and challenging behaviour levels shown by the adult with ID and visual impairment decreased due to technology-assisted therapy applied by caregivers, while responses to the social validity of the intervention were positive. / MSc (Research Psychology), North-West University, Potchefstroom Campus, 2015

The transition from home to preschool is a very emotional and sometimes distressing period for both parent and child. The teacher plays a significant role, in that they are entrusted with the distressed and separation anxious child, and assist in helping both parent and child to adjust to the change. Research in the field of early childhood separation anxiety has suggested that, when the child has difficulty managing their anxiety, maladjustment can potentially predispose them to various other forms of pathology later in life. Thus, the potential implications of maladjustment simultaneously imply the importance of understanding and helping anxious and struggling preschoolers to adjust to developmental demands. This study qualitatively explored the perspectives and experiences of teachers, and how they have come to make sense of and respond to separation anxiety in children. Four private preschools in the Johannesburg area participated in the study and a sample of thirteen teachers were interviewed. The data was collected through semi-structured interviews which were audio-recorded. A thematic content analysis of the collected data revealed two core themes concerning teachers’ views on separation anxiety. The first theme addressed the ‘challenges encountered’ during the transitional period, which focused primarily on the presentation, impacts and predisposing factors of separation anxiety. The second major theme addressed ‘helpful qualities in the caregiver role’, which discussed useful qualities to be considered when engaging with a separation anxious child. Collectively, these findings presented an understanding of the various ways in which teachers make sense of and respond to separation anxiety during the transitional process. These qualitative insights also add to the existing body of literature, highlight areas for future research and attempt to offer thoughts on how separation anxiety can be managed, as to avoid further exacerbation and implications on later development.

Separation anxiety disorder (SAD) is rarely considered in adults presenting with anxious symptomatology, but a growing body of evidence suggests that its symptoms are experienced by a significant number of adults. Early parent-child relationships are an especially important area of study for understanding SAD. Moreover, the attachment style that is formed through early parent-child interactions may serve as a mediator to later expression of symptoms of adult separation anxiety (ASA). Studying the early parent-child relationship and perceived parenting styles in conjunction with individual attachment styles will allow for a more systemic approach to understanding potential risk factors for the development of ASA. Young adult college students may be particularly vulnerable to ASA as they transition into college and away from primary caregivers. This study investigates a mediational model with individual attachment style serving as a mediator between perceived early parenting styles and symptoms of ASA in 170 first-year college students between the ages of 18-20. As anticipated a large percent of the sample endorsed clinically significant levels of symptoms of ASA (47%). In addition, results utilizing bootstrapping analyses demonstrated that a perceived indifferent parenting style had an indirect effect on symptoms of ASA, with the effect occurring through an anxious attachment style. Support for the mediation model was obtained when statistically controlling for perceived parenting styles of overcontrol and abuse as well as confounding variables including age, sex, number of different families lived with and emotionality domains of temperament (distress, anger, and fearfulness). Highlighting the role of perceived parenting styles and attachment styles in the development of symptoms of ASA will serve to establish potential family-based interventions and help in the development of prevention programs. Examining symptoms of ASA in young adult college students may result in the development of university-based psycho-educational programs to help these students master a challenging transitional period. This study is one of the first to explore a model that can help to explain the developmental trajectory of symptoms of ASA. Future studies are encouraged to consider symptoms of ASA when investigating anxious symptomatology in adult populations.

Background: Research exploring the developmental of adolescent antisocial behaviour suggests that a secure attachment style is a protective factor against problem behaviour (Bowlby, 1969). It is theorised that disruptions in the attachment relationship can increase the likelihood of adjustment difficulties in adolescence, including antisocial behaviour (MacDonald, 1985). Such relationships have been inferred by cross-sectional research studies, but have yet to be tested in a longitudinal sample. Aims: This research is a secondary data analysis, using data from the Avon Longitudinal Study of Parents and Children cohort study, to explore the relationship between attachment and adolescent antisocial behaviour at age 15.5 years. Attachment was measured using three component measures; maternal sensitivity in infancy (sample 1), separations from main caregiver in early childhood, age 3-5 years (sample 2) and the presence of separation anxiety in middle childhood, age 81 months, 6.75 years (sample 3). Results: Logistic regression analyses were used to explore the relationships. Using available data, in sample 1 (n=456 complete cases) no evidence was found to support an association between non-positive maternal sensitivity in infancy and an increased incidence of adolescent antisocial behaviour (OR=0.79 [CI=0.42-1.48], p=0.46). In sample two (n=3,961), the number of separations in infancy were not found to significantly increase the risk of adolescent antisocial behaviour (OR=1.26 [CI=0.94-1.71], p=0.17). Separation anxiety in middle childhood was not found to have an effect on adolescent antisocial behaviour (OR=1.01 [CI=0.80-1.26], p=0.96). Conclusions: The findings suggest that although components of attachment, as measured in this study, were hypothesised to be associated with an increased risk of adolescent antisocial behaviour, this was not statistically supported in this study. In this study effects may be limited due to attrition, leading to the loss of antisocial adolescents from the study, creating a bias in the sample studied.