Thesis (M.S.)--The University of North Carolina at Greensboro, 2008. / Title from PDF t.p. (viewed Jun. 2, 2009). Advisor: Marion O'Brien; submitted to the School of Human Environmental Sciences. Includes bibliographical references (p. 43-48).

Thesis--Universität Giessen.

Thesis (MA(Counselling Psychology)--University of Pretoria, 2004. / Includes bibliographical references.

Thesis (Ph.D.) in Psychology--University of Maine, 2004. / Includes vita. Includes bibliographical references (leaves 117-133).

Thesis (M.S.)--University of Wisconsin--Madison, 1972. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis--University of Wisconsin--Madison. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 133-141).

Thesis (Ph. D.)--Drexel University, 2006. / Includes abstract and vita. Includes bibliographical references (leaves 103-111).

No description available.

Increasingly patients are surviving admission to intensive care units (ICUs) with life-threatening, critical illness. This has led to a growing interest in longer-term patient outcomes, including their psychological health. This thesis consists of two discrete sections: 1) a systematic review of research that evaluated emotional outcomes between 3 and 12 months post-ICU discharge, and 2) a longitudinal cohort study of emotional sequelae among adults with Type 1 diabetes during and following admission for diabetic ketoacidosis (DKA). The systematic review identified seven studies that met inclusion criteria, and highlighted weaknesses in the existing literature. From the available evidence there appears to be elevated rates of clinically significant depression (11%), anxiety (15%) and post-traumatic stress disorder (PTSD) symptoms (23%) 3 months after discharge, and these remain high 9 months later (12%; 18%, and 27%, respectively). The prospective study of DKA admissions indicated substantial rates of clinically relevant depression (25%); anxiety (37.5%), and PTSD symptoms (37.5%) prior to discharge. However, 3 months later the rates of depression and PTSD had substantially attenuated (both 8.3%) although rates of anxiety (37.5%) remained higher than that found in the general population (7%) and the local Type 1 diabetes clinical community (11.9%). Those admitted with DKA had significantly poorer HbA1c compared to the overall Type 1 clinic population (10.9% vs. 8.9%; p < 0.0001), which indicates substantial difficulties in self managing their condition. It appears that psychological problems are elevated over time following ICU discharge. PTSD is notably high and enduring in general ICU survivors, whereas was observed to fall away in the DKA sample. Anxiety seems to be elevated and this persists over time following DKA; this is pertinent given the dearth of research on the role of anxiety in the efforts of people with type 1 diabetes to manage their condition. As far as the authors’ are aware, this is the first study tracking emotional outcomes post DKA discharge. There are clearly significant psychological issues that will likely impact on staff efforts to provide ward-based care aimed at improving post-discharge diabetes control, and on the future efforts of those admitted for DKA to self-manage a complex condition. A greater awareness of the psychological issues affecting people with type 1 diabetes who experience DKA is an important first step. More specifically, a better understanding among health professionals about the ways emotional distress can impact on self-management is needed, as well as a greater understanding of how best to communicate information and educational material in light of possible information processing deficits (which may be a result of emotional distress). Larger, multi-centre, higher quality studies are required in both general ICU settings and looking at specific disease complications (such as DKA). Psychological screening for ICU survivors and implementation of a care pathway to allow access to services post-ICU may be a useful development.

Selective attention has been studied extensively and it is shown, for example, that individuals with conditions such as anxiety show attention bias to threat-related stimuli. It has been proposed that humans are predisposed or that it is naturally adaptive to selectively attend to emotional stimuli (Lang, 2000). Similarly, LeDoux (1996) and others have proposed limbic brain networks allowing for quick and automatic, but sometimes inaccurate, processing of emotion which bypasses primary cortical areas. Along these lines, automatic attention bias to subliminal image cues in an adapted Posner Covert Attention Task was examined in the current study. A sample of 64 participants was used in each of three separate experiments to examine how individuals were cued subliminally by negative or positive emotional vs. neutral images and the modulation of covert attention by emotion. Due to automatic or motivated attention to emotionally salient stimuli, participants were expected to be facilitated in task performance by negative and positive emotional image cues, relative to neutral cues. Further, state anxiety and depression were expected to impact performance on emotional cueing as well. As expected in Experiment 1, subliminal images produced significant covert attentional cueing and only negative image cues compared to neutral ones produced response time (RT) reduction by valid cueing across both cue-target delay conditions. Further, cueing differences between neutral and negative images were seen only at short delays, supporting differential subliminal processing of emotional cues in attentional paradigms and supporting previous evidence of unconscious fear processing and specialized automatic fear networks. Moreover, in Experiment 2, when delays following subliminal cues were extended further, emotional cues did not differentially modulate covert attention, suggesting that subliminal emotional cueing seems to occur more immediately. Positive subliminal imagery in Experiment 3 was largely unsuccessful in differentially modulating covert attention compared to neutral cues, suggesting that positive information is either not effective in modulating covert attention or occurs over similar immediate time durations as negative cues in Experiment 1. Finally, the presence of self-reported state anxiety and depression affected task performance, especially in Experiment 1 negative for subliminal discrimination of negative vs. neutral image cues. Overall, the current study adds to the research literature which demonstrates that emotional information, especially negative imagery processed at short intervals, can be processed below awareness to modulate attention in a different manner than less salient neutral stimuli and this modulation is further influenced by state anxiety or depressive symptomatology. Implications of these findings and future directions for research are discussed.