Indiana University-Purdue University Indianapolis (IUPUI) / Formal thought disorder (FTD) is a debilitating symptom of psychosis. It is linked to functional deficits and generally demonstrates poor response to interventions. Metacognition has emerged as a potential therapeutic target that may be effective in reducing FTD, as metacognitive deficits and FTD both arise from disruptions in associative thought processes. This study’s primary aim was to determine whether FTD could be reduced with metacognitive therapy. Pre-post changes in FTD severity were assessed using clinician-rated and automated measures in 20 individuals with psychotic disorders who received 12 sessions of evidence-based metacognitive therapy. We also examined whether reductions in FTD were larger when assessed with automated instruments versus clinician-rated measures. Aim two compared associations between FTD and three outcome variables (social functioning, role functioning, metacognition) across FTD-measurement approach. Results indicated that automated FTD, but not clinician-rated FTD, was significantly reduced post-intervention. This effect was more robust within a subsample exhibiting greater levels of FTD. Strength of associations between FTD and outcome variables did not differ across FTD measurement approach. These findings provide initial evidence that a targeted metacognitive intervention can reduce FTD. Effects were strongest for automated instruments, which may be more sensitive to detecting change; however, differences in measurement type did not extend to associations with selected outcome variables. This study provides preliminary support for future efforts to reduce FTD. Large-scale studies with longer intervention periods may further our understanding of the effectiveness of metacognitive intervention on FTD.

Introduction: Defensive functioning may play an important role in the development and treatment of binge-eating disorder (BED). The Defense Mechanism Rating Scale (DMRS) is a widely used observer rating measure of defensive functioning. However, there is little research on defensive functioning and the DMRS in BED. This dissertation includes three studies on defensive functioning in individuals with BED. Study one assessed the validity and reliability of the DMRS when used to rate Adult Attachment Interview (AAI) transcripts, and compared defensive functioning between women with and without BED. Study two compared change in defensive functioning in women with BED who received Group Psychodynamic-Interpersonal Psychotherapy (GPIP) versus those in a waitlist no treatment control condition. Study three assessed the impact of other group therapy members’ defensive functioning on an individual group member’s treatment outcomes (i.e., binge-eating frequency and interpersonal functioning). Thus, the overall goals of this dissertation were to better understand the role of defensive functioning in BED, the degree to which defensive functioning changes due to group therapy, and the impact in the context of the therapy group’s defensive functioning on individual outcomes. Method: Participants with for this study were recruited from three previous investigations. Two clinical trials of group psychotherapy provided data of individuals with BED: (1) a randomized trial (N = 85) in which participants were assigned to GPIP (n = 35) or a waitlist control (n = 50), and (2) an uncontrolled study in which all participants with BED (N = 101) received GPIP. A total of 17 therapy groups were formed across both studies, with each group consisting of five to 11 members. In addition, a third study provided data from two comparison groups without BED: women who were overweight/obese (body mass index [BMI] > 27 kg/m2; n = 47) and women who were normal weight (BMI = 20 to 25 kg/m2; n = 49). Participants with BED completed a battery of questionnaires and the AAI at two time-points (i.e., pre-treatment/pre-waitlist and six months post-treatment/post-waitlist). Participants without BED completed the same battery of questionnaires and the AAI at one time-point and did not receive treatment. All AAI audio recordings were transcribed and used to code defensive functioning. Results: In study one, the DMRS coded from AAI transcripts demonstrated acceptable inter-rater reliability; good convergent validity, as it was significantly correlated with other related constructs (i.e., interpersonal functioning, reflective functioning, and attachment insecurity); and acceptable predictive validity, as women with BED had significantly lower defensive functioning than normal weight women without BED. In study two, those who received GPIP had significantly greater improvements in defensive functioning from pre-treatment to six months post-treatment compared to the waitlist control group. Follow-up analyses revealed that the average number of High Adaptive defenses significantly increased from pre-treatment to six months post-treatment in the GPIP condition, but not in the waitlist control condition; and significantly more participants assigned to the waitlist control condition deteriorated in their defensive functioning from pre-waitlist to six months post-waitlist than those assigned to GPIP. In study three, individual defensive functioning scores at pre-treatment were not significantly associated with either treatment outcome (i.e., binge-eating frequency or interpersonal distress) at six months post-treatment. However, other group members’ mean defensive functioning scores at pre-treatment were significantly associated with individual interpersonal distress, but not binge-eating frequency, at six months post-treatment. Discussion: Overall, this dissertation lends further support to the role of defensive functioning in the maintenance and treatment of BED. Individuals with BED tend to use less adaptive defensive functioning, but this can be improved through GPIP. Further, context of the therapy group in terms of defensive functioning is particularly important for improving treatment outcomes in individuals with BED. These findings should be replicated across more diverse samples and other types of group psychotherapy. Group therapists can help their patients with BED confront their maladaptive defense mechanisms and binge-eating by tackling their interpersonal distress, and placing sufficient emphasis on the group’s composition in terms of defensive functioning.

Diffusion and random walks have been studied for more than 100 years. However, there are still details in the methodology that are overlooked, and more information can be extracted from the typical data that is studied. In this thesis, I simulate random walks on two dimensional lattices with immobile obstacles configured in a variety of ways: periodic, random, and "Fuzzy" (a cross intermediate state of disorder between periodic and random). The primary goal is to develop a deeper understanding of "Fuzzy" systems by designing different ways of generating tunable disorder. An example of this is the universal Fz parameter that we developed to unify the natural disorder parameters of the various disorder generation methods we developed. Often times the importance of analysing the transient/anomalous regime with more precision and consistency is overlooked. In our work, we expand on random walk dynamics by applying non-standard probabilities, and justify our choice analytically and through a comparison of results. Furthermore we discuss how the transient regime should be analyzed so that there is consistency in the field. Other than discussing semantics of algorithms and analysis, we study the connection between the transient regime and the steady-state. We introduce two measures of the width of the transient/anomalous regime, and compare them to the crossover time. Using the width of the transient/anomalous regime we are able to provide an estimate of the steady-state diffusion coefficient without access to the steady-state simulation data.

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Faculty of Health Science Degree of Master of Science in Human Genetics 9809684w / Lipoid proteinosis (LP) (OMIM 247100) is a rare autosomal recessive disorder that is caused by mutations within the extracellular matrix protein 1 gene (ECM1). The ECM1 gene has been shown to play a role in angiogenesis and connective tissue matrix generation, especially in skin and bone. The role of ECM1 in normal skin development and maintenance is further highlighted by its role in LP and in lichen sclerosis where autoantibodies are raised against ECM1. LP usually presents in the first year of life with a faint or hoarse cry and is due to a hyaline-like material deposited in the mucous membranes of the vocal cords. Gradually (over years) there is diffuse skin infiltration and general skin thickening with a yellow, waxy appearance. There is excessive scarring with scars often appearing at sites of minor injury or stress. In many cases, the eyelids show typical beaded papules. In some cases, calcification of certain aspects of the temporal lobes have been observed, and may or may not be associated with variable neurological, psychiatric and neuropsychological sequelae. Although the prevalence of LP in South Africa is unknown, the disproportionately high number of case reports originating from South Africa indicates that LP is unusually common in certain South African populations, most notably the Coloured population of Namaqualand and the Afrikaans-speaking White population. This may be due to a possible LP founder effect that occurred early during the European colonisation of South Africa. The founder effect was investigated in the South African LP patients by conducting ECM1 mutation and linked marker analysis. The data supported a LP founder effect as the Q276X mutation in exon seven of ECM1 was present in the homozygous state in all LP patients investigated. In addition, the Q276X mutation was associated with a single founder haplotype of 19-12-23-22 (ND1-D1S2343-D1S305-D1S2624). These markers were in significant linkage disequilibrium with each other and with the Q276X mutation. VI As variation within ECM1 may alter properties of skin such as healing and scar formation, ECM1 exons two through five and the first part of exon six were investigated for nucleotide variation using denaturing high performance liquid chromatography (dHPLC) and direct DNA sequencing in three different South African populations. Eight nucleotide variants were identified, of which six were cytosine to thymine transitions. Seven of the eight variants identified were either intronic or synonymous, with one variant being a missense variant, changing a methionine residue to a threonine residue (T130M).

This research aimed to determine the effect of educating parents on Regulatory Sensory Processing Disorder (RSPD) and implementing an Ayers-SI sensory diet over a two-week period. Twelve infants who met the criteria for RSPD were subdivided into two groups: 7-12 and 13-24 months. The data was obtained from a telephonic interview and completion of the Infant Toddler Symptom Checklist (ITSC). Following the two-week intervention, the ITSC was completed again and results were compared using the Wilcoxin Signed Rank Test. Although the research sample was small, findings indicate that the Ayers-SI sensory diet was effective in reducing signs of fussiness. The research group showed a significant change (p=0.0024) over the two-week period, with a greater change evident in the 7-12 month group. Selfregulation and attachment showed the most significant change. Difficulties with sensory processing for example, tactile, vestibular and auditory sensitivities appeared to persist, indicating a possible need for direct sensory integrative therapy to address them. In addition, the findings indicate that there is a lack of referral for Ayers-SI occupational therapy. This research adds value to the body of research which indicates the need for early intervention for possible prevention of later developmental difficulties.

A dissertation submitted to the Faculty of Medicine, University of the Witwatersrand, Johannesburg, in fulfilment of requirements for the degree of Medicine in Psychiatry. Johannesburg, March 1991. / In the first part of the dissertation a literature survey is done, looking at 1. An overview of dysthymic disorder. 2. An overview of serotonin and its involvement in psychiatric disorder [Abbreviated Abstract. Open document to view full version]

A review of the scholarly literature suggests that mental health struggles in Generation Z have escalated in recent years. However, there is a lack of psychological research that examines antisocial behaviors in Generation Z. This study aims to determine the prevalence rates of antisocial behaviors in Generation Z. It was hypothesized that our sample of Generation Z students would show higher prevalence rates of antisocial behaviors than previous generations. We examined the data collected from our survey, which was composed of demographic and antisocial personality disorder questions. A one-way ANOVA, revealed significant differences in the categories of age, gender, school year, and race compared to the antisocial score. A Tukey post hoc analysis revealed statistically significant differences for antisocial behaviors in Generation Z when compared to the 41-50+ age group. Significant differences between students were not found when examining the categories of sexual orientations and political affiliations.

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