Mona Wilhelmsson Göstas, School of Health and Medical Sciences, Örebro University, SE-701 82 Örebro, Sweden, mona.vilhelmsson gostas@orebroll.se Attachment styles are relevant to psychotherapy since they highlight the way a person handles interpersonal and emotional stress. This thesis aimed to examine how psychotherapy patients in the public mental health care system report attachment styles related to interpersonal problems and diagnosis before and after psychotherapy and to examine problems and changes and psychotherapy contract and process from patients’ experiences of cognitive behavioural oriented therapy (CBT) and psychodynamic oriented psychotherapy (PDT). The studies are based on data from patients admitted to psychotherapy within the public psychiatric services in Örebro County Council. Studies I and IV were quantitative and used self-reports to examine attachment styles and interpersonal problems before and after psychotherapy. Studies II and III were qualitative interview studies examining patients experiences of problems, changes and psychotherapy process. The patients were diagnosed with mood disorders, anxiety disorders, adjustment disorders and personality disorders and reported insecure avoidant and anxious attachment styles that correlated positively with interpersonal problems when they started therapy. Psychotherapy with CBT or PDT enabled them to turn attachment styles into more secure ones and decrease interpersonal problems Patients aged between 26 and 39, patients who attended 11-25 sessions and patients diagnosed with a personality disorder reported greater changes in secure related attachment than others. Patients described their problems as emotions that could not be regulated, as cognitive disabilities and as problematic behaviours that implied a self-centredness. During the course of psychotherapy, the patients gained abilities to handle their problems. The perceived self-centeredness changed which increased their participation in their life-context. Similarities across the therapy orientations showed that the creation of a new context was essential to pay full attention to the patient’s problems, and that the working method and cooperation with the psychotherapist made up a whole. To make the therapy effective, it is important to build up confidence in cooperation and secure base functions like offering predictability and shaping interventions according to the needs of the patient and their ability to use them.

Introduction Maternal mental health during pregnancy and its effects on offspring outcomes have received increased attention as a public health concern. Recent policies have highlighted the need for better universal perinatal services and to routinely incorporate attention to mental health into antenatal care. This thesis aimed to examine and evaluate current research into the effects of maternal antenatal depression on child psychological, development and developmental psychopathology. A research study was carried out with the aim of understanding the subjective experiences of women with antenatal depression during pregnancy and their transition to motherhood. Method Quantitative studies, exploring the relationship between antenatal depression and early child development were reviewed systematically. The empirical study employed Interpretative Phenomenological Analysis to investigate the experience of antenatal depression in pregnant women. Semi-structured interviews were conducted with six participants who were pregnant and recruited from a perinatal mental health service. Results The small number of papers considered suitable for this review highlights the lack of good quality research in this field. Twelve studies met inclusion criteria for the systematic review, demonstrating mixed results regarding whether antenatal depression effects early child development. Studies were predominantly of poor methodological quality, with inconsistent results and limited by the use of differing antenatal depression and infant development outcomes, making cross study comparisons difficult and weakening any conclusions that could be drawn. In the empirical study one super-ordinate theme, ‘The Lost Self’, and four main themes emerged. Conclusions Findings were inconsistent and of poor quality, and so we cannot say for sure whether antenatal depression itself is associated with adverse outcomes for young children. Further rigorous research on antenatal depression and adverse early child outcomes is needed in order to try and disentangle the effects of both antenatal and postnatal depression on each other and on child development. The findings from the empirical study contribute to an increased understanding of the experiences and challenges faced by women experiencing depression during pregnancy. The study highlights the need for improved awareness of depression during pregnancy to improve understanding of this disorder during the antenatal period.

Few policies carry more controversy than voter photo identification requirements. First passed in 2003, these laws require voters to present government-issued ID’s, such as a driver’s license, state identification card, military ID, or qualifying student ID. This paper examines the discursive politics in Wisconsin’s photo ID, seeking to understand how state policymakers justified the law against accusations of voter suppression. Put broadly, this paper seeks to understand the intersection of politics and policy, exploring how irrational policies are formed, implemented, and evaluated.

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