Introduction: Women with bipolar disorder (BD) have higher rates of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). The primary goal of this thesis was to examine the neural correlates of bipolar disorder and comorbid PMDD and identify changes in brain structure or function that may mediate emotional and cognitive dysregulation in the late luteal phase. Results: In healthy women with no history of PMDD, absolute levels of estradiol, progesterone, allopregnanolone and dehydroepiandrosterone sulfate (DHEAS) were correlated with patterns of functional coupling in multiple regions associated with emotional and cognitive processes, in the mid-follicular and late luteal menstrual phases. A systematic review of the literature on resting state functional connectivity (Rs-FC) in BD during euthymia highlighted consistent patterns of resting state functional connectivity (Rs-FC) using ICA and SBA; including stability of the default mode network (DMN), salience network (SN) and fronto-parietal network (FPN) relative to controls. Available literature largely failed to control for sex, menstrual cycle phase or menstrual cycle disorders. Thus, we conducted the first fMRI studies to control for menstrual cycle phase in BD. During the mid-follicular phase, we found increased Rs-FC between critical nodes of the default mode and frontoparietal networks in BD compared to controls and increased functional connectivity between the somatosensory cortex and the insular cortex, inferior prefrontal gyrus and frontal orbital cortex in BD compared to controls. Voxel based morphometry analysis showed decreased gray matter in the somatosensory cortex in the same population compared to controls. Finally, women with BD and co-morbid PMDD displayed different patterns of Rs-FC using the right and left hippocampi as seed regions than women with BD without comorbid PMDD and controls with PMDD. Differences in cortical thickness between controls with and without PMDD and with and without BD were also found in regions central to emotional regulation and cognitive processing. Conclusions: Results highlight the influence of sex hormones on Rs-FC and support the need to control for menstrual phase and PMDD diagnosis. Differences in structural and functional connectivity, and the clinical profile of women with BD and those with BD and co-morbid PMDD highlights the impact of PMDD on BD and the need for future research in this area. / Thesis / Doctor of Philosophy (PhD)

Introduction: Sleep and biological rhythms have not been investigated in women with comorbid Bipolar and Premenstrual Dysphoric Disorder in the context of the menstrual cycle. We explored whether menstrual cycle phase causes increased disturbances in sleep, biological rhythms and mood symptoms. Additionally, we explored whether these women have worse illness outcome than women diagnosed with either Bipolar or Premenstrual Dysphoric Disorder, and healthy women. Methods: In this post-hoc analysis, participants were split into four groups: those with a Bipolar and comorbid Premenstrual Dysphoric Disorder diagnosis (n = 17, BDPMDD), those with a Bipolar Disorder diagnosis (n = 16, BD), those with a Premenstrual Dysphoric Disorder diagnosis (n = 19, PMDD), and women with no history of psychiatric diagnosis (n = 25, HC). The primary outcome variable was biological rhythm disruption as measured by the Biological Rhythms Interview and Assessment in Neuropsychiatry (BRIAN). The secondary outcome variables were depressive symptoms (Montgomery-Asberg Depression Scale, MADRS; Hamilton Depression Rating Scale, HAMD), manic symptoms (Young Mania Rating Scale, YMRS), and sleep quality (Pittsburgh Sleep Quality Index, PSQI). All variables were collected at both mid-follicular and late-luteal stages of the menstrual cycle. Results: The BDPMDD group did not have significantly higher disruptions in biological rhythms than the BD or PMDD groups at the luteal phase; however, there were significant disruptions and mood symptoms in comparison to the HC group, especially at the follicular stage, which point to markedly higher disruptions in these areas that seem to persist beyond the symptomatic luteal phase. Conclusion and Future Directions: Women diagnosed with a BD and PMDD comorbidity experience a higher illness burden then women diagnosed with either BD or PMDD. A relatively small sample size, not excluding for participants who were taking medications that affect sleep and relying solely on subjective measures of biological rhythms may explain some of the null results. Future studies should employ objective measures of sleep such as actigraphy to complement subjective measures like the BRIAN, as well as recruit a larger sample of participants. More importantly, more studies surrounding this topic must be done in order to create a robust body of evidence that can be used to compare results across studies and identify specific biological rhythms domains that can be targets for treatment. / Thesis / Master of Science (MSc) / Sleep disruptions are common in women diagnosed with Bipolar Disorder and in those diagnosed with Premenstrual Dysphoric Disorder. Illness burden has been shown to be greater in women diagnosed with a comorbidity of the above disorders in terms of clinical variables such as number of comorbidities, episode relapse, rapid cycling and mixed mood states. This thesis aims to investigate whether women diagnosed with Bipolar and comorbid Premenstrual Dysphoric Disorder have greater biological rhythms disruptions than women diagnosed with either disorder. Biological rhythms will be evaluated at both the follicular and late-luteal stages. The overall goal of this work is to add to the currently scant literature on the clinical presentation of a Bipolar and Premenstrual Dysphoric Disorder comorbidity.

Emerging adults who have Autism Spectrum Disorder (ASD) often encounter difficulties within the university setting. Despite an increase in the number of students with ASD enrolled in postsecondary educational institutions, there are few reports on the social, academic, and/or other needs of college students with ASD. The purpose of this study was to assess the perspectives of parents of emerging adults with ASD and ADHD, in order to inform efforts to address the poor postsecondary outcomes of students with ASD. Survey data were collected from parents who had a son or daughter in one of three educational placement groups (parents of high school students, parents of postsecondary students, and parents of individuals aged 18-25 not enrolled in education) among two disorders; ASD and ADHD. Participants were recruited nationally to participate in an online survey. Parents of emerging adults with ASD identified social interactions and daily living as primary difficulties for their son or daughter with ASD. Significant differences emerged with respect to difficulties among emerging adults with ADHD, who identified difficulties related to executive functioning and attention. Social interaction training was an identified needed service by parents of emerging adults with ASD. Additionally, independent living training was a common core service requested by parents of individuals with ASD and parents of individuals with ADHD. Results suggest that the postsecondary profile of parent-reported difficulties and needed services remains distinct for the diagnostic groups ASD and ADHD. These difficulties should be considered within the context of intervention for postsecondary students with ASD and ADHD. / Master of Science

Large family studies of complex disorders can be used to detect a genomic region linked with a particular illness. Where multiple families are found with common regions of linkage, this could be due to an ancestral mutation common to these families. In this thesis, I describe a method for studying allele sharing in families that share a linkage region, to identify a common founder mutation, thus maximising the results of replicated linkage studies. The method tests the hypothesis that the evidence for shared linkage is derived from the sharing of a common affected ancestor. By comparing the allelic similarity of haplotypes across common linkage regions, it is possible to identify any regions that are identical by descent between the families. A method of permutation analysis followed by a nested permutation technique have been developed to assess the statistical significance of allele sharing scores. Chapter 3 describes the proof of principle of the method through its application to known cystic fibrosis mutations and through simulated datasets. This provides both a real dataset and a much more diverse range of simulated conditions on which to test the method. The range of simulated data was also used to develop a set of criteria for the effective us of the method. In Chapter 4, the allele sharing method was applied to two replicated linkage regions on chromosome 4p15-16 that segregate with bipolar affective disorder. This was done over two phases, first taking in markers covering the genic regions of the shared linkage region and then followed up with a complete coverage of the region. This analysis identified a 200kb region with significant confidence within the 8Mb of the two linkage regions. The study of this region presents a clear example of how replicated linkage results that are caused by some founder effect, can be examined, and refined using this allele sharing method to vastly reduce the region under investigation.

The present research examines three central issues in the context of ADIHD. First, a theory of attribution proposing that parents' causal attributions affect ADIHD children's locus of control is assessed. Second, ADIHD children's locus of control is linked to their psychological profiles. Finally, ADIHD is looked at from a cross-cultural perspective norms, highlighting the significance of parents' knowledge versus ignorance of the disorder. The main population of interest consists of unmedicated and untreated ADIHD children in Greece whose parents had no prior knowledge of the disorder. Initially, the impact of Greek parents' causal attributions about their ADIHD children's academic performance and behaviour on those children's locus of control is examined. Qualitative and quantitative analyses of the attributions made by parents were found to be associated with specific patterns of locus of control beliefs in their children. In-depth measures of the children's psychological profiles were found to be associated with their locus of control, and a detailed discussion compares these results with other research findings linking internalising and extemalising behaviours with biases in locus of control and attributional style. Then the possible implications of knowledge and socio-cultural beliefs are discussed in relation to the findings on two socio-culturally different populations - Greek and British ADIHD children's locus of control. Finally in an attempt to compare attributional differences, the role of locus of control is examined in an experimental test of task persistence and children's self-evaluations before and after a failure experience. It is concluded that socio-cultural norms influence the ways in which parents formulate causal explanations for their children's behaviour, which, in turn, influence the locus of control, the psychological profiles, the task persistence, and the self-evaluations of ADIHD children.

No description available.

Thesis (MA)--Stellenbosch University, 2001 / ENGLISH ABSTRACT: Post-traumatic stress disorder (PTSD) is the most recognised mental disorder stemming from severe psychological trauma. One of the differential diagnoses of post-traumatic stress disorder, amongst others, is obsessive-compulsive disorder (OGD). These two disorders overlap at some point in terms of symptomatology. More specifically, both are characterized by recurrent intrusive thoughts. It has been hypothesized that trauma may also be a significant source of OGD development. OGD and PTSD are disorders that present in adulthood, as well as in childhood and adolescence. It is shown that PTSD and OGD can present comorbidly in adulthood and it is theorized that it may also be the case in childhood and adolescence. Evidence of OGD developing in the context of trauma and theories of how this might have happened are presented. It is shown how complicated it is to distinguish between OGD developing in the wake of trauma and PTSD and the importance of such a distinction. / AFRIKAANSE OPSOMMING: Post-traumatiese Stresversteurig (PTSD) is een van die mees erkende sielkundigeversteurings wat ontwikkel na die blootstelling aan sielkundige trauma. Obsessiewe-kompulsieweversteuring (OGD) is, onder andere, een van die differensiële diagnoses van PTSD. Die twee versteurings oorvleuel ten opsigte van simptomalogie. Meer spesifiek word beide gekenmerk deur herhalende indringende gedagtes. Daar word tans gehipotiseer dat trauma nie net 'n rol in die ontwikkeling van PTSD speel nie maar ook 'n oorsaaklike rol het in die ontwikkeling van OGD. OGD en PTSD is versteurings wat kan voorkom tydens volwassenheid, asook tydens die kinderjare en adolessensie. Daar word bewys gedoen van PTSD en OGD wat saam voorkom gedurende volwassenheid en daar word geteoretiseer dat dit ook die geval mag wees tydens die kinderjare en adolessensie. Bewys word gelewer van OGD wat ontwikkel na blootstelling aan trauma en teorië ten opsigte van die ontwikkeling word aangebied. Die onderskeid tussen OGD wat na trauma blootstelling ontwikkel en PTSD is ingewikkeld, dog is die onderskeid baie belangrik in vele opsigte.

published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

In this study, a promising new intervention implemented for adults with aphasia due to stroke, Multimodal Communication Treatment, was modified for its use with one child with autism spectrum disorder to identify if the child could learn and communicate new words through learning multiple modalities. Data was collected on the child’s communicative output as well to assess the frequency and types of his communication attempts. The child presented with challenging behaviors throughout the intervention period, and its potential impact on the execution of the intervention was studied. The study found that Multimodal Communication Treatment was not an effective intervention approach for this child. The majority of his output was not communicative in nature and challenging behaviors impacted the effectiveness of implementing the approach. Further research is needed to identify whether Multimodal Communication Treatment could be an effective intervention for children with more communicative intent and increased attention. / text

No description available.