Background: Treatment-resistant depression (TRD) encompasses a segment of individuals with major depressive disorder who are severely ill in terms of chronicity, comorbidity, and prognosis. Although functional impairment is a prominent and costly feature of treatment-resistance, very little is known about the factors that contribute to and maintain functional impairment in TRD. Purpose: This study examined the relationships among neurocognition, symptoms, and functional impairment in TRD. Specifically, I examined the neurocognitive impairments that relate to different symptom domains and to level of symptom severity, as well as the predictors of functional outcomes and real-world behaviour in TRD. Method: Patients (N = 29) with a diagnosis of major depressive disorder were recruited from the Mood Disorders Treatment and Research Service at Providence Care Mental Health Services in Kingston, Ontario. Data were collected during a baseline assessment for a neurocognitive enhancement therapy program. Results: Individuals with TRD show mild to moderate impairments across all neurocognitive domains, with a superimposed severe impairment in verbal working memory. Verbal working memory significantly correlated with depressive symptoms and anxiety, such that increased verbal working memory capacity was related to more severe clinical symptoms. Greater response inhibition significantly correlated with less anxiety. Interpersonal competence was predicted by sustained attention and severity of depressive symptoms. Adaptive competence was significantly predicted by age at baseline and set shifting. Real-world work behaviour, interpersonal relations, and general satisfaction were predicted by the severity of depressive symptoms, whereas observed mood and anxiety predicted real-world recreational activity. Conclusions: The current study pioneered some of the first data regarding the relationships among neurocognition, symptoms, and functional outcomes in treatment-resistant depression. Verbal working memory appears to play an important role in the symptomatology of TRD. Neurocognitive variables and depressive symptoms are important in predicting functional competence (what one can do) but only depressive symptoms predict functional performance (what one actually does in the real world). There may be additional intrinsic or extrinsic factors that mediate the relationships among neurocognition, symptoms, and functioning in TRD. / Thesis (Master, Psychology) -- Queen's University, 2011-09-07 11:55:40.708

The relative strength of both neuroticism and affect in predicting common physical symptoms was tested. An event-sampling design was used to overcome methodological limitations of past research in the area. Contrary to much previous research, neuroticism was not related to reports of physical symptoms, although it was related to unpleasant affect. Unpleasant affect bore a strong concurrent relation to the frequency of reported symptoms. Temporal relations between experiences of unpleasant affect and subsequent symptoms were found for some individuals, but wide individual variability was seen in both the strength and direction of this linkage. The findings suggest that when individuals are asked to report their subjective experiences of physical illness without the necessity to retrospect over significant periods of time, unpleasant affect is more strongly related to experience of symptoms than is neuroticism.

The purpose of the study was to investigate the perceived anxiety experienced by coronary care nurses working eight- and 12-hour work shifts. It was hypothesized that length of shift work affects the before- and after-shift anxiety for nurses working eight or 12-hour work shifts. Anxiety differences between the eight- and 12-hour work shifts were examined as well as differences between the before- and after-shift anxiety for each length of shift.Thirty-two (32) coronary care nurses from a general medical and surgical hospital in the Midwest volunteered to participate in the research. The sample consisted of all females (18 Registered Nurses, nine Licensed Practical Nurses, three charge nurses, a supervisory nurse, and a rehabilitation nurse). The nurses had voluntarily selected the eight- or 12-hour length of shift work and understood that they would be committed to work that shift for one year. Twelve nurses worked the eight-hour shift; 20 nurses chose the new 12-hour shift.The State Anxiety Inventory (SAI) was used to measure the nurses' before- and after-shift anxiety. Baseline data were collected from the nurses prior to the initiation of the 12-hour shift. The Box-Jenkins Time Series Analysis was used to analyze the daily before- and after-shift anxiety scores and to establish a forecasted trend for both the eight- and 12-hour shifts.The first finding was that the before-shift anxiety scores for the eight-hour workers declined, while the anxiety scores for the 12-hour workers increased, following the implementation of the 12-hour shift. The same trend was forecast for the after-shift anxiety scores. The eight-hour nurses' after-shift anxiety scores declined while the 12-hour nurses' anxiety scores increased. A transfer function was conducted for both the eight-hour and 12-hour before- and after-shift anxiety scores. No predictive trend could be established for the eight-hour anxiety scores; however, the 12-hour after-shift anxiety scores were found to be consistently higher than before-shift anxiety scores. / Department of Educational Psychology

国立情報学研究所で電子化したコンテンツを使用している。

Thesis (Ph.D.)--University of Adelaide, Dept. of Clinical and Experimental Pharmacology, 1998? / Bibliography: leaves 1-26.

Thesis (Ph.D.)--George Mason University, 2009. / Vita: p. 118. Thesis director: Robert F. Smith. Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Psychology. Title from PDF t.p. (viewed June 10, 2009\). Includes bibliographical references (p. 101-117). Also issued in print.

Thesis (M.S.)--University of Michigan, 1987.

Thesis (Ph. D.)--University of Hong Kong, 2009. / Includes bibliographical references (leaves 241-255). Also available in print.

Thesis (Ph. D.)--Ohio University, November, 2003. / Includes bibliographical references (leaves 111-138).

Thesis (M.S.)--University of Michigan, 1987.