This dissertation describes the development of the Victoria Symptom Validity Test (VSVT). The VSVT was designed to assist in screening for non-optimal performance during neuropsychological evaluation due to malingering, psychiatric disturbance, or other environmental or dispositional factors. Specifically, the VSVT is a test of recognition memory that uses the forced-choice paradigm for detecting biased or random responding. Response latency is also recorded. Results from pilot and follow-up normative studies with experimental and clinical populations are presented. The VSVT was found to have excellent divergent and adequate convergent validity in samples of compensation-seeking and noncompensation-seeking patients. Classifications of experimental participants using below chance performance as a cutoff were consistent with the majority of previous studies in finding 100% specificity but poor sensitivity. A new system wherein a third category is added for questionable (at chance) performance showed greatly increased sensitivity, with no decrement in specificity. Although scores in the questionable range are not unequivocal indicators of malingering, findings suggest good utility for screening or corroborative purposes. A Bayesian diagnostic probability matrix that takes base-rates into account was also provided as a more flexible alternative to absolute cutoff scores. Response latency as a measure of symptom validity was shown to have adequate sensitivity for screening, but less acceptable discriminant validity and lower specificity. Limitations of experimental results and clinical applications of symptom validity tests are discussed. / Graduate

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Occupational skin and respiratory symptoms, and disease, are common problems. Workers can develop new disease or aggravate existing disease as a result of exposures at work. Many workers are exposed to chemicals that can cause both respiratory and skin responses and there is evidence that some workers experience symptoms in both systems. There is also evidence that skin exposure may lead to sensitization and the development of respiratory disease. There is very little research that has examined both airborne and skin exposures together with lung and skin outcomes. The purpose of this thesis was to further investigate the relationships between occupational exposures, skin symptoms and disease, and respiratory symptoms and disease. Four studies were undertaken to improve our understanding of these complex relationships. Results from a study of clinical patch test data determined that seven of the ten most common occupational contact allergens are also capable of causing occupational asthma and that these common occupational exposures may not be recognized as sensitizers in common reference materials. Exposure-response relationships for skin symptoms were modeled in bakery workers and auto body shop workers using historical data; significant exposure-response relationships were found for auto body workers. In two separate studies of concurrent skin and respiratory symptoms, workers did report concurrent skin and respiratory symptoms. In predictive models, subjects reporting a history of eczema were more likely to report concurrent skin and respiratory symptoms. Overall, the results from this thesis provide more evidence that the skin and respiratory systems are associated. This body of work suggests that: (1) several common occupational exposures can cause disease in both the skin and respiratory system; (2) a portion of workers report both skin and respiratory symptoms; and (3) exposure-response relationships do exist for skin symptoms, both work-related and non-work-related. Future studies need to gather detailed information about exposure and response in both systems in order to better determine the role of exposure(s) in the development of skin and respiratory symptoms. Improved understanding of these relationships will allow for more targeted and effective exposure prevention strategies and will ultimately reduce the burden of occupational disease.

The aim of this study was to examine three distinct parenting styles and their effect on children’s behavioural patterns, as perceived by the child. The parenting styles, based on Baumrind’s typologies of authoritative, authoritarian and permissive parenting, were measured as well as the children’s self-rated internal and external symptoms. Results indicated that there was a relationship between authoritarian parenting and all aspects of internal symptoms (depression, loneliness and self-esteem) as well as delinquency and aggression (external symptoms). Gender had an effect on depression and loneliness with females displaying higher levels. Permissive parenting was the largest contributor to drug use and an effect of age on drug use was also found. In conclusion, the results from this study shows that authoritarian parenting has a detrimental effect on a host of mental health issues and behavioural problems. However, authoritative parenting was shown to have the most positive outcome across the study. Implications for positive parenting style interventions are discussed. In addition, further studies examining parent-child relations from the child’s perspective are suggested.

Occupational skin and respiratory symptoms, and disease, are common problems. Workers can develop new disease or aggravate existing disease as a result of exposures at work. Many workers are exposed to chemicals that can cause both respiratory and skin responses and there is evidence that some workers experience symptoms in both systems. There is also evidence that skin exposure may lead to sensitization and the development of respiratory disease. There is very little research that has examined both airborne and skin exposures together with lung and skin outcomes. The purpose of this thesis was to further investigate the relationships between occupational exposures, skin symptoms and disease, and respiratory symptoms and disease. Four studies were undertaken to improve our understanding of these complex relationships. Results from a study of clinical patch test data determined that seven of the ten most common occupational contact allergens are also capable of causing occupational asthma and that these common occupational exposures may not be recognized as sensitizers in common reference materials. Exposure-response relationships for skin symptoms were modeled in bakery workers and auto body shop workers using historical data; significant exposure-response relationships were found for auto body workers. In two separate studies of concurrent skin and respiratory symptoms, workers did report concurrent skin and respiratory symptoms. In predictive models, subjects reporting a history of eczema were more likely to report concurrent skin and respiratory symptoms. Overall, the results from this thesis provide more evidence that the skin and respiratory systems are associated. This body of work suggests that: (1) several common occupational exposures can cause disease in both the skin and respiratory system; (2) a portion of workers report both skin and respiratory symptoms; and (3) exposure-response relationships do exist for skin symptoms, both work-related and non-work-related. Future studies need to gather detailed information about exposure and response in both systems in order to better determine the role of exposure(s) in the development of skin and respiratory symptoms. Improved understanding of these relationships will allow for more targeted and effective exposure prevention strategies and will ultimately reduce the burden of occupational disease.

The purpose of this study is to find out what effect and meaning the youths’ describe that  music has for their wellbeing. The idea is to examine how students studying music at the esthetic program describe that they perceive that practicing music and listening to different types of music affect their wellbeing, with focus on psychosomatic and psychic symptoms. The point is also to examine why the youths think that music can affect their feelings and wellbeing and why they perceive that music is important to them. The study is qualitative and starts from a life world phenomenological perspective. Music is regarded as a phenomenon in this study. The study’s data was collected through a survey which was performed at three different gymnasiums in southern Sweden. The result presents that music listening and music practicing can reduce many of the youths’ psychosomatic and psychic symptoms – mainly by music affecting the youths’ feelings in different ways, making them feel good, creating fellowship and acting as an escape route from reality. Two types of music that can make the youths feel better is calm music and happy music. It also appears that music can increase psychic and psychosomatic symptoms in a way that different types of music can increase symptoms such as anxiety, worry, sleep difficulties and stress. Music described as sad is a type of music that is mentioned making these symptoms worse. The music is important for the youths in different ways. Examples given are that it’s a part of them as individuals, that it works as a support and that it can affect their wellbeing and feelings. The result also presents why the youths think that music can­­­ affect their wellbeing and feelings. The primary point that emerges is that they describe that there is a connection between humans, memories and feelings; that music can affect and amplify peoples’ feelings and memories. In the discussion it appears that music could be used in order to decrease the youths’ psychosomatic and psychic symptoms.

Systematic review Background: Bipolar disorder is associated with a higher rate of physical health problems and lower levels of physical activity than other clinical and general populations. Despite the potential benefits of physical activity to people with bipolar disorder, little research has been published around this and no recent review of this topic is available. Due to the clinical utility of summarising the available research evidence on this topic, this review aimed to answer the question “Is physical activity associated with manic and depressive symptoms in people with bipolar disorder?”. Methods: Seven electronic databases were searched using a range of search terms to reflect physical activity and bipolar disorder variables. Results: Ten studies were identified that reported associations between physical activity and mood symptoms of bipolar disorder. There were inconsistent findings on the relationship between physical activity and mood, in particular with relation to manic symptoms, with reports of physical activity being both helpful and harmful to manic symptoms. Findings were more consistent with regards to the association between physical activity and depressive symptoms, with most showing that higher levels of physical activity are associated with lower depressive symptoms. Limitations: Many studies had small sample sizes and very few manipulated physical activity and included a control group. Measures and diagnosis method were heterogeneous. Four studies lacked a direct measure of manic symptoms. Conclusions: Results showed inconsistent findings with regards to the relationship between physical activity and mood symptoms and further research is needed to inform any guidelines developed for this client group. Empirical paper: Background: Despite the published evidence for the benefits of physical activity on mood in the general population and in people with mental illness, there is a lack of research into the associations between physical activity and mood in people with bipolar disorder. The current study therefore aimed to investigate the relationship between symptoms of mania and depression and different intensities, regularity, and total duration of physical activity per day and across the week. Methods: People with a diagnosis of bipolar disorder (N = 29) completed daily diaries on physical activity and manic and depressive symptoms over 14 days. Analysis included multilevel modelling, t-tests and correlation analysis. Results: No association was found between manic symptoms and physical activity, either at the within- or the between-person level. An association was found at the within-person level between higher duration of physical activity and lower depression symptoms, however no association was found at the between-person level. Limitations: The small sample size was adequate only to detect large-sized effects for between-person hypotheses. Participants were highly active and may not be representative of the wider BD population. Physical activity levels were assessed via self-report. Conclusions: The relationship between physical activity and manic symptoms in BD remains inconclusive, but a significant within-person association indicates that physical activity may reduce depressive symptoms in the short term. Given previous research on physical activity and manic symptoms, people with BD and professionals working with them may need to remain cautious, modifying any PA engagement depending on mood state.

A sizeable proportion of adults suffer from an anxiety disorder and many of those adults are parents. Parental anxiety, as well as dysfunctional family environment, contributes to both internalizing and externalizing problems in children. Specifically, family control, conflict, and cohesion have been shown to predict child internalizing and externalizing symptoms to varying degrees. However, few studies have examined the association between all three components in the same study: parental psychopathology, family environment, and child outcomes. The current study tested the relationships among these variables in a sample of 189 children (66% male, 93% Caucasian, mean age = 10.34 years). Family conflict predicted child externalizing symptoms for both mothers and fathers, and mediated the relationship between maternal anxiety and child externalizing symptoms. Family cohesion predicted child externalizing problems based on maternal report and mediated the relationship between maternal anxiety and child externalizing symptoms. Furthermore, family cohesion moderated the relationship between maternal anxiety and child internalizing symptoms. These findings provide preliminary support for the role of the family environment in the relationship between parental anxiety and child psychopathology, and these environmental variables may be important targets of intervention in families with elevated parental anxiety. / Master of Science

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