Childhood anxiety disorders are often considered gateway disorders: having an anxiety disorder in youth is associated with a higher likelihood of developing a related psychological disorder in adulthood. Successfully treating youth with anxiety disorders may reduce the likelihood of subsequent anxiety, depressive, and substance use disorders later in life. This study evaluates follow-up outcomes associated with treatment for childhood anxiety by comparing successfully and unsuccessfully treated participants 16 years after the completion of treatment. A sample of 66 youth (ages 7 to 14 at time of initial study treatment, ages 18 to 32 at present follow-up) who had been diagnosed with an anxiety disorder and randomized to treatment in a randomized clinical trial on average 16.24 (SD = 3.56) years prior participated in the present follow-up evaluation that included self-report measures and a diagnostic interview conducted to assess anxiety, depression, and substance misuse. Results indicate that, relative to those who respond successfully to CBT intervention for an anxiety disorder in childhood, those who were less responsive to CBT for childhood anxiety had higher rates of panic disorder, alcohol dependence, and drug abuse in adulthood. The present study is the first to assess the 16-year follow-up effects of CBT treatment for an anxiety disorder in youth on anxiety, depression, and substance abuse through the period of young adulthood when these disorders are often seen. / Psychology

Research supports shared neurological, cognitive, and environmental features among youth with sleep-related problems (SRPs) and anxiety. Despite overlap in interventions for SRPs and anxiety, little is known about the secondary benefit on SRPs following anxiety-focused treatment. The present study examined whether SRPs improved following cognitive-behavioral therapy (CBT) for youth with anxiety disorders. It also examined whether variables that may link anxiety and sleep problems (e.g. pre-sleep arousal, family accommodation, sleep hygiene) changed across treatment, and whether said changes predicted SRPs at posttreatment. Youth were diagnosed with anxiety at pretreatment and received weekly CBT that targeted their principal anxiety diagnosis at one of two specialty clinics (N = 69 completers, Mage = 10.86, 45% males). Youth completed a sleep diary between pretreatment and session one and again one week prior to posttreatment. All other measures were administered in the first session and at the posttreatment assessment. Results indicated that parent-reported SRPs improved from pre- to post-treatment and that treatment responders yielded greater improvement than nonresponders. Specific areas of bedtime resistance and sleep anxiety showed significant improvement. Youth reported lower rates of SRPs and no pre- to post-treatment changes. Pre-sleep arousal and parental accommodation decreased over treatment but did not predict lower SRPs at posttreatment. However, higher accommodation positively correlated with greater SRPs. Sleep hygiene evidenced no change and did not mediate accommodation and posttreatment SRPs. Clinical implications for the treatment of anxious youth are discussed and suggestions for future research are offered. / Psychology

Adolescent and young Canadians are a group with the highest rates of symptoms of anxiety and depression. Such conditions, when unaddressed, negatively impact the development of a person, restricting their chances of attaining a fulfilling future and career. Even when deciding to reach out to access care, the process can be a challenging one with many barriers along the way. Online therapies in the form of online Cognitive Behavioural Therapies, have shown to be a promising format for some, but have faced some shortcomings with low uptake and variable results. Adding guidance and support to such therapies has been shown to help address these barriers. The objective of this research is to explore how support is currently provided for online cognitive behaviour therapies for anxiety and depression, targeting adolescents and young adults. To achieve this objective a scoping review methodology was utilized to identify relevant articles. The approach taken in a scoping review methodology allows for identification of a wide range of articles, which was necessary in this case because research isolating support features from other interventions is very limited. The scoping review identified fifty articles to be reviewed, and they were analyzed using a framework created for this review. The framework covered human, delivery, and design factors. Consultations with five key informants was also used to identify more findings related to the themes identified in the framework and to complement the findings from the articles in the scoping review. The resulting picture identified the field of support for online CBT for anxiety and depression in adolescents and young adults, covering a field with a great diversity ranging from virtual guides to face-to-face support from therapists. The features were organized into groups of ‘toolkits’ that can be considered by CBT developers for different situations and needs. / Thesis / Master of Science (MSc)

Nearly 10% of college students experience chronic insomnia. Cognitive-behavioral therapy for insomnia (CBTi) is an empirically validated multi-component treatment that has been demonstrated to produce reliable and durable benefits in the general adult population. However, there have been no studies examining the effectiveness of multi-component CBTi in a college student population, even though many studies have examined the efficacy of single treatment modalities. These young adults are different from the general adult population because they are in a unique transitional developmental phase as they are maturing from adolescence into adulthood, they are sleepier than adults, they tend to have irregular sleep schedules, and their living situations are often different from the general adult population. In this study college students with chronic insomnia were randomly assigned to either six sessions of CBTi or a wait list control (WLC) group. All participants completed sleep diaries, sleep measures, and psychosocial measures. The results indicated students who received CBTi showed improvements in sleep efficiency (SE), sleep onset latency (SOL), number of awakenings (NWAK), time awake after sleep onset (WASO), and sleep quality (SQ). They also had decreased insomnia severity (ISI), dysfunctional beliefs about sleep (DBAS), and general fatigue (MFI), as well as increases in global sleep quality (PSQI).

In this study, a model of cognitive behavioural therapy (CBT) was developed, implemented and assessed. The aim of this model is to assist HIV-positive women in dealing with internalised and enacted stigma. Since much of the research about therapies developed to deal with HIV-related stigma so far has been done within a western frame of reference, in the current study a model was developed to suit the local South African situation. Women were specifically targeted as they are more vulnerable to HIV/AIDS and are disproportionately affected by the epidemic. Because of culturally determined gender roles, women are not always in a position to take control of their sexual health. Furthermore, because of the negative experiences of HIV diagnosis, the stigma has a negative impact on women’s behaviour. As a result, there is a need for a therapeutic model to assist HIV-positive women in changing the experience of internalised stigma and discrimination. A CBT approach was used in therapy to challenge the women’s dysfunctional beliefs, to change their automatic thoughts and to promote more realistic adaptive patterns of thinking. All of these aimed to assist them in dealing with stigma. Eight therapy sessions (one a week for eight weeks) were planned for each of the women. This research was conducted in two phases. In Phase 1, data was gathered about the experiences of HIV-positive women to gain an understanding of their experiences of HIV-related stigma and discrimination. Various sources of information were used to identify not only the relevant themes contributing to the individual’s experience of internalised stigma, but also possible ways to change them. These sources included a study of the available literature, the researcher's own experience and focus group discussions with other psychologists in practice, and interviews with five HIV-positive women (in the form of case studies). Five women living with HIV/AIDS, who were experiencing difficulties in dealing with stigma, were recruited at Witbank Hospital, where they were interviewed and asked to complete five psychometric instruments. The researcher scrutinised the data gained from the psychometric scales to assess the validity of the instruments to identifying the feelings of the participants the researcher observed in the interviews. Rubin and Rubin's (1995) method was used to analyse the data. The findings that emerged from Phase 1 were used to identify common themes to be addressed in the intervention, for example feelings of powerlessness, feelings of guilt, behavioural implications of stigma, the experience of the reaction of others and uncertainty about the future. These themes were used as guidelines and were adapted according to the specific needs of each of the women seen in therapy so as to address negative feelings and behaviour. Phase 2 focused on the implementation and evaluation of the cognitive behavioural model. A purposive sampling technique was used for this study. The model was tried out with ten HIV-positive women who served as the experimental group. A quasi-experimental design was used, involving a pre-and post-test and a control group consisting of ten other women identified at the same hospital. The scores that the experimental group and the control group obtained before the intervention were compared to verify that the two groups were comparable prior to the intervention. Post-test scores were compared to investigate differences between the groups after the intervention. The process notes of the therapy sessions were analysed by means of qualitative analysis to understand the reactions of the women in therapy. This contributed to the researcher’s understanding of the appropriateness and effectiveness of various therapeutic techniques used with the experimental group. Findings of this research indicate that, when compared to the control group, the experimental group not only experienced less depression, internalised stigma and negative coping, but also higher levels of self-esteem and positive coping after having participated in eight therapy sessions. The study further revealed that being HIV positive and trying to cope with stigma and discrimination involve diverse experiences for women, although there are common themes for all participants. It was recommended that the intervention be altered in future use in the following ways: Those techniques that were found to be more effective with the majority of women (positive cognitive reframing, teaching of coping strategies, homework assignments, decatastrophising and assertiveness training) could probably be used with success in similar conditions. Only the techniques that worked well should be used, and care should be taken not to use too many techniques. Each client should be given the time to question the evidence for her automatic thoughts and to draw her own conclusions about her situation, feelings or thoughts and to grasp the cognitive strategies, rather than to bombard her with many different techniques. The therapist should also relate more to the individual client and adapt the model to her context, rather than to implement the model rigorously. / Thesis (PhD)--University of Pretoria, 2009. / Psychology / unrestricted

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CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Com os recentes avanÃos da indÃstria de telecomunicaÃÃes se faz cada vez mais necessÃrio o desenvolvimento de matÃrias que apresentem altos valores de constante dielÃtrica, baixa perda dielÃtrica e uma boa estabilidade tÃrmica. Muitos materiais para rÃdio frequÃncia e microondas tÃm sido amplamente usados em uma variedade de aplicaÃÃes nestes segmentos. Destas aplicaÃÃes, as mais recentes tecnologias utilizam cerÃmicas com baixa temperatura de sinterizaÃÃo, materiais de baixo ponto de fusÃo, alÃm das caracterÃsticas citadas anteriormente. CerÃmicas dielÃtricas a base de Bismuto sÃo candidatas como materiais de baixa temperatura de sinterizaÃÃo e tÃm sido estudadas amplamente. Este trabalho apresenta o desenvolvimento e caracterizaÃÃo da sÃrie cerÃmica CaBi4Ti4O15 (CBT) com adiÃÃo em massa de triÃxido de bismuto, material conhecido por suas excelentes propriedades dielÃtricas, principalmente elevados valores de constante dielÃtrica. Esta sÃrie foi produzida a partir do mÃtodo cerÃmico convencional ou mÃtodo do estado sÃlido, com a utilizaÃÃo de moagem mecÃnica de alta energia e tratamento tÃrmico. ApÃs a sÃntese, foi adicionado o triÃxido de bismuto em diferentes concentraÃÃes para melhorar as caracterÃsticas elÃtricas desta matriz cerÃmica. A caracterizaÃÃo estrutural foi realizada por meio de DifraÃÃo de Raios-X com Refinamento de Rietveld. Um estudo da morfologia foi realizado atravÃs de Microscopia EletrÃnica de Varredura. Foram realizados experimentos para verificar o comportamento dielÃtrico das amostras, na regiÃo de rÃdio frequÃncia e microondas. No geral percebemos que esta matriz cerÃmica apresenta as caracterÃsticas desejÃveis para sua aplicaÃÃo na fabricaÃÃo de dispositivos eletrÃnicos como capacitores e antenas ressoadoras dielÃtricas. / With the recent advances in telecommunications industry, itâs increasingly required the development of materials which have high values of dielectric constant, low dielectric loss and a good thermal stability. Many materials for radio frequency and microwaves utilization have been largely used in a variety of applications in these segments. From these applications, the latest technology generally use ceramics with low sintering temperature, low melting point materials, in addition to the aforementioned characteristics. Dielectric ceramics based on Bismuth are candidates as low temperature sintering materials and have been studied extensively. This work presents the development and characterization of ceramic series CaBi4Ti4O15 (CBT) with addition of bismuth trioxide, which is currently known for its excellent dielectric properties, mostly by its high dielectric constant values. These series were produced by the use of conventional ceramic method or method of solid state, with the use of mechanical grinding of high energy and heat treatment. After the synthesis, was added the bismuth trioxide in different concentrations to improve the electrical characteristics of ceramic CBT. The Structural characterization was showed by X-ray Diffraction with Rietveld Refinement. A study of the morphology was accomplished by scanning electron microscopy (SEM). Experiments were performed to verify the behavior of dielectric samples, radio frequency and microwaves. In general we can realize that this ceramic standard mold presents desirable characteristics for its application in the manufacture of electronic devices such as capacitors and dielectric resonator antennas.

Submitted by Cristiane Chim (cristiane.chim@ucpel.edu.br) on 2018-10-23T12:03:01Z No. of bitstreams: 1 Gessyka Wnaglon Veleda.pdf: 1641786 bytes, checksum: fcc4d51b17c8f41056d82f3ec8d5cec9 (MD5) / Made available in DSpace on 2018-10-23T12:03:01Z (GMT). No. of bitstreams: 1 Gessyka Wnaglon Veleda.pdf: 1641786 bytes, checksum: fcc4d51b17c8f41056d82f3ec8d5cec9 (MD5) Previous issue date: 2018-08-09 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Behavioral Cognitive Therapy (CBT) has been indicated as first-line treatments for Major Depressive Disorder (MDD), due to its effectiveness and effectiveness. However, little is known about the maintenance of these results in the medium and long term. These findings are of particular importance in view of the high rates of relapse and recurrence of depressive episodes throughout the subjects' lives. . The objective of this study is to investigate the efficacy and effectiveness of psychotherapeutic treatment from CBT for the response of post-follow-up depressive symptoms, indicating related clinical and social aspects. From a quasi-experimental study nested to a randomized clinical study, 94 patients were evaluated through the Beck Depression Inventory (BDI-II), 6 and 12 months post intervention of 16 sessions with CBT. There were significant differences between the median depressive symptoms of the baseline with the scores of all other follow-up moments (p <0.001). There were no differences in the scores of depressive symptoms at the end of treatment when compared to 6 (p <0.486) and 12 months (p <0.098). Only the initial BDI score was associated with a decrease in depressive symptoms (p <0.001). The findings indicate that CBT significantly reduces depressive symptoms by maintaining this condition for up to 12 months after the intervention. The intensity of depressive symptoms at the beginning of the therapeutic process is associated with a decrease in post-intervention depressive symptoms. / A Terapia Cognitiva - Comportamental (TCC) tem sido indicada como tratamento de primeira linha para o Transtorno Depressivo Maior (TDM), devido sua eficácia e efetividade. Contudo, pouco se sabe sobre a manutenção desses resultados a médio e longo prazo. Esses achados têm especial importância, tendo em vista, as altas taxas de recidivas e recorrência de episódios depressivos ao longo da vida dos sujeitos. O objetivo deste estudo é pesquisar a eficácia e efetividade do tratamento psicoterápico a partir da TCC para a resposta dos sintomas depressivos um ano pós-acompanhamento, indicando aspectos clínicos e sociais relacionados. A partir de um estudo quase experimental aninhado a um clínico randomizado, 94 pacientes foram avaliados, através do Inventário Beck de Depressão (BDI- II), 6 e 12 meses pós intervenção de 16 sessões com TCC. Houve diferenças significativas entre as medianas de sintomas depressivos do baseline com os escores de todos os momentos de acompanhamento (p < 0,001). Não houve diferenças em relação aos escores de sintomas depressivos do final do tratamento quando comparados com aos 6 (p < 0,486) e 12 meses (p < 0,098). Apenas o escore de BDI inicial estava associado à diminuição dos sintomas depressivos (p < 0,001). Os achados indicam que a TCC reduz significativamente os sintomas depressivos mantendo essa condição até 12 meses após a intervenção. A intensidade dos sintomas depressivos no início do processo terapêutico está associada a uma diminuição dos sintomas depressivos pós intervenção.

The studies presented in this thesis sought to investigate a number of developmental factors that influence the efficacy of preventive intervention for child anxiety disorders. Preventive intervention has emerged as a vital step forward in clinical research following data indicating anxiety disorders are among the most common forms of psychopathology in youngsters (Kashani & Orvaschel, 1990; Mattison, 1992). Several risk and protective factors associated with childhood anxiety disorders have been identified, along with effective treatment protocols (Kendall, 1994; Howard & Kendall, 1996; Barrett, 1998, 1999; Silverman et al., 1999a, 1999b), as prerequisites to the development of preventive programs for child anxiety problems (Spence, 2001). The first objective of this research was to add to the literature on risk and protective factors by investigating the role of peer interaction in the development of child anxiety problems. Study one examined developmental differences in the influence of peer interaction on children's anxiety-related cognition and behaviour. One hundred and sixty two children enrolled in grade 6 (n = 96) aged between 9 and 10 years, and grade 9 (n = 66) aged between 14 and 16 years participated in the study. Participants were stratified into either an at risk group or to a healthy group, based on their anxiety scores on the Spence Child Anxiety Scale (SCAS; Spence, 1997), and further allocated to a peer group comprising of 3 'healthy' (non-anxious) and 3 'at risk' (high anxious) children. Prior to and following a peer discussion, participants completed a standardised self-report measure of threat interpretation and response plans to two ambiguous vignettes (Barrett, Rapee, Dadds, & Ryan, 1996; Dadds, Barrett, Rapee, & Ryan, 1996). Results showed all participants evidenced changes in threat interpretation and response plans following the discussion with peers (p < .001). Overall, findings highlight the potential importance of peer interaction in the development of anxiety-related cognition and behaviour. The findings of study one have important implications for the future development of school-based intervention programs; specifically those conducted in the classroom. Study two sought to advance the current research on preventive intervention for child anxiety by establishing the age at which youngsters benefit the most from the FRIENDS program as a classroom-based universal intervention. Study two presents the results of a longitudinal study evaluating the effects of a universal school-based intervention for child anxiety at two developmental stages. The study involved a cohort of 733 children enrolled in grade 6 (n = 336, 45.6%) aged between 9 and 10 years, and grade 9 (n = 401, 54.4%) aged between 14 and 16 years, Participants were allocated to either a school-based cognitive behavioural intervention or to a monitoring group. Participants completed standardised measures of anxiety, depression and coping style. Participants identified as 'at risk' of an anxiety disorder were assessed for a clinical diagnosis with a structured diagnostic interview. Results indicated the universal intervention effective in significantly reducing anxiety (p < .001), depression (p < .001) and behaviour avoidance in children at post- intervention and 12-month follow-up intervals. Grade 6 children reported significantly higher anxiety at pre-intervention and greater reductions in anxiety at post intervention compared with the grade 9 (p < .001), although both primary and secondary school participants showed equal reductions in anxiety at 12-month follow up. Overall, findings suggest universal intervention potentially successful in reducing symptoms of anxiety and increasing coping skills in children. Primary school children reported the greatest changes in anxiety symptoms, suggesting earlier preventive intervention potentially more advantageous than later intervention. Developmental differences in anxiety, depression and coping strategies are discussed in addition to the implications and limitations of this study and directions for future research.