Thesis (M.A.)--Memorial University of Newfoundland, 2005. / Bibliography: leaves 150-157.

Stressrelaterad ohälsa återfinns bland de vanligaste orsakerna till sjukfrånvaro i Sverige enligt statistik 2009. För att namnge stressrelaterad ohälsa används bl a utbrändhet, utmattningssyndrom och utmattningsdepression. Den förstnämnda benämningen anses som en olämplig felaktigt förmedlande direktöversättning ifrån det engelska ordet burnout medan den andra och tredje benämningen används och fungerar som erkända begrepp. Det utmattade tillståndet innebär en mängd fysiologiska och psykiska besvär däribland den basala emotionen rädsla och komplexa emotionen ångest. Syftet med undersökningen var att djupstudera dessa emotioner i samband med utmattningssyndrom. I undersökningen deltog 8 personer med erfarenhet av fenomenet. Skriftligen beskrivna svar bearbetades och analyserades enligt metoden meningskoncentrering. I resultatet redovisas fysiologiska och psykiska upplevelser i samband med rädsla och ångest samt tankar och beteenden som upplevdes föregå och/eller förvärra rädslan och ångesten. Upplevelserna kännetecknades av mångfald och gemensamhet där djupgående beskrivningar kan bidra till en ökad kunskap och förståelse samt utgöra en grund för identifiering. Rädslan och ångesten utgör en del i en upplevd komplex problematik kring utmattningssyndrom .

Cognitive theories claim that phobias involve unconscious processing and that anxious individuals search the environment for threatening stimuli and therefore detect them more rapidly. However, evidence for this is mixed and suggests that anxious individuals do not detect threat more accurately but are more liberal to report that they detected threat even if there was no actual threat (response bias). In this study, 55 women performed a detection task with pictures of snakes, spiders, and guns. The pictures were backward masked to reduce their visibility. Participants also filled in questionnaires that assessed their fear and disgust. As found in previous studies, detection performance did not correlate with fear. However, inconsistent with previous results, disgust sensitivity correlated with lower detection performance of snakes, and response biases varied with fear of spiders or snakes. These findings provide mixed support for notions of relationships between fear and disgust in threat detection.

Synaptic plasticity, which is thought to represent the neuronal substrate for learning and memory is influenced by the degree of GABAergic inhibitory tone. In particular, γ-aminobutyric acid subtype A receptors (GABAARs), which mediate the majority of inhibitory neurotransmission in the mammalian brain regulate learning and plasticity. In these studies I examined a subpopulation of α5 subunit-containing GABAA receptors (α5GABAARs), which are preferentially expressed in the hippocampus, to determine whether they have a specific role in memory processes. I hypothesized that α5GABAAR-activity constrains hippocampus-dependent learning and CA1 synaptic plasticity. The main research objective of this thesis was to investigate the electrophysiological changes within the hippocampus that accompany genetic and pharmacological targeting of α5GABAARs and how these changes impact behaviour. I found that the general anesthetic etomidate enhanced a tonic inhibitory conductance generated by α5GABAARs, and this action correlated with an impairment of long-term potentiation (LTP) and hippocampus-dependent memory performance for fear-associated memory and spatial navigation. Mice with a genetic deletion of the α5 subunit gene (Gabra5–/–) were resistant to the LTP- and memory-impairing effects of etomidate. Additionally, the LTP- and memory-impairing effects of etomidate were rescued by pharmacologically inhibiting α5GABAARs. Genetic and pharmacological inhibition of α5GABAARs enhanced associative learning in trace fear but not contextual fear conditioning tasks. Interestingly, genetic deletion and pharmacological inhibition of α5GABAARs did not result in the common adverse side-effects associated with non-selective inhibition of GABAARs such as anxiogenesis or seizures. Further, I found that blocking the tonic inhibition generated by α5GABAARs lowered the threshold for LTP, such that lower stimulation frequencies enhanced LTP. Synaptic changes within this frequency band were modified independently of phasic GABAAR inhibition. Inhibiting the α5GABAAR-dependent membrane conductance was associated with an increase in the depolarizing envelope during 10 Hz stimulation. These experiments provide new insights into the in vitro and in vivo physiology of α5GABAARs and suggest that a tonic inhibition generated by α5GABAARs constrains learning and glutamate plasticity through regulation of the membrane’s electrical properties.

Community notification aims to warn the public when reintegrating sexual offenders represent a significant risk to public safety. However, anxiety and powerlessness are often unintentional side-effects of notification. Fear appeals are persuasive messages that arouse fear of a threat and may include recommended actions for avoiding the threat. This research applied a fear appeal theory, the Extended Parallel Processing Model (EPPM), to community notification web pages. Study 1, a systematic review of existing community notification web pages, informed the development of a traditional web page vignette for Study 2. Study 2 compared the traditional web page format to a high efficacy web page intervention, which comprised educational information on avoiding sexual victimization. The EPPM predicted positive correlations between fear and perceived threat (hypothesis 1), fear and behavioural intentions (hypothesis 2), and perceived efficacy and intentions to adopt victimization prevention behaviours (hypothesis 4) as well as negative correlations between perceived efficacy and maladaptive fear control responses (hypothesis 3). The intervention group was predicted to have higher perceived threat, higher perceived efficacy, be less likely to adopt fear control responses, and more likely to endorse behavioural intentions than the control group (hypothesis 5). Female participants were hypothesized to have higher fear, perceived threat, fear control responses, and behavioural intentions and lower perceived efficacy than male participants (hypothesis 6). The results provide preliminary support for the EPPMs ability to explain reactions to receiving a community notification. Hypotheses 1, 2, and 4 were fully supported and hypothesis 6 was partially supported as females displayed higher fear, perceived threat, and behavioural intentions; however, the intervention was ineffective in producing differences between the intervention and control groups (hypothesis 5). Exploratory regression analyses found gender, education level, previous victimization, parental status, and locus of control were related to the EPPMs variables. Future research should examine the impact of different educational materials and delivery systems (such as interpersonal sources, media, and web-based multi-media) to further examine the application of the EPPM to web-based sexual offender community notification and determine whether it is possible to increase adaptive responses to receiving a community notification by providing educational information.

Synaptic plasticity, which is thought to represent the neuronal substrate for learning and memory is influenced by the degree of GABAergic inhibitory tone. In particular, γ-aminobutyric acid subtype A receptors (GABAARs), which mediate the majority of inhibitory neurotransmission in the mammalian brain regulate learning and plasticity. In these studies I examined a subpopulation of α5 subunit-containing GABAA receptors (α5GABAARs), which are preferentially expressed in the hippocampus, to determine whether they have a specific role in memory processes. I hypothesized that α5GABAAR-activity constrains hippocampus-dependent learning and CA1 synaptic plasticity. The main research objective of this thesis was to investigate the electrophysiological changes within the hippocampus that accompany genetic and pharmacological targeting of α5GABAARs and how these changes impact behaviour. I found that the general anesthetic etomidate enhanced a tonic inhibitory conductance generated by α5GABAARs, and this action correlated with an impairment of long-term potentiation (LTP) and hippocampus-dependent memory performance for fear-associated memory and spatial navigation. Mice with a genetic deletion of the α5 subunit gene (Gabra5–/–) were resistant to the LTP- and memory-impairing effects of etomidate. Additionally, the LTP- and memory-impairing effects of etomidate were rescued by pharmacologically inhibiting α5GABAARs. Genetic and pharmacological inhibition of α5GABAARs enhanced associative learning in trace fear but not contextual fear conditioning tasks. Interestingly, genetic deletion and pharmacological inhibition of α5GABAARs did not result in the common adverse side-effects associated with non-selective inhibition of GABAARs such as anxiogenesis or seizures. Further, I found that blocking the tonic inhibition generated by α5GABAARs lowered the threshold for LTP, such that lower stimulation frequencies enhanced LTP. Synaptic changes within this frequency band were modified independently of phasic GABAAR inhibition. Inhibiting the α5GABAAR-dependent membrane conductance was associated with an increase in the depolarizing envelope during 10 Hz stimulation. These experiments provide new insights into the in vitro and in vivo physiology of α5GABAARs and suggest that a tonic inhibition generated by α5GABAARs constrains learning and glutamate plasticity through regulation of the membrane’s electrical properties.

Obsessive-compulsive disorder (OCD) is a significantly impairing anxiety disorder for which the most successful treatment, cognitive behaviour therapy, has 50-60% success rates, taking into account treatment refusals and dropout rates (Fisher & Wells, 2005). Thus, factors that contribute to the persistence of OCD and interfere with treatment are likely being overlooked. Indeed, Mancini and Gangemi (2004) have proposed that individuals with OCD have greater fear of guilt than others; that is, they dread being judged as guilty for not having done everything in their power to prevent some negative outcome. This fear of guilt fuels obsessions and compulsions as individuals attempt to prevent, avoid, or neutralise the feared guilt. However, few studies have explored fear of guilt in OCD, and no scales exist to measure this construct. The role of fear of guilt in OCD was therefore examined across two studies. Study 1 explored the core features of fear of guilt in OCD, as well as the validity and reliability of the Fear of Guilt Scale (FOGS), a measure developed specifically to assess levels of trait fear of guilt in OCD. Results indicate that the FOGS is a valid and reliable, two-factor measure, and greater FOGS scores significantly predict more severe OCD symptoms among nonclinical participants. Study 2 aimed to determine whether fear of guilt evokes caution and feelings of doubt during the decision-making process, thereby making it more difficult to know when to stop and explaining perseveratory behaviour, such as compulsions in OCD. Findings suggest that greater fear of guilt does not predict more time taken or information needed to make decisions, but higher fear of guilt predicts feelings of uncertainty when deliberating, as indicated by ratings of greater difficulty making decisions, lower confidence in having made the right decisions, and less satisfaction with decisions made. Implications of these findings and the role that fear of guilt may play in the development and persistence of OCD are discussed.

Deliberate self harm as defined pathologically as well as socially is becoming an increasing phenomenon within forensic psychiatry. Nurses working with patients who have self harm behaviour and are confined to forensic psychiatry face different challenges which affect their feelings and attitudes in different ways, in their nursing practice. Purpose: To explore nurses’ experiences of caring for patients who suffer from deliberate self harm behaviour and are confined to forensic psychiatry. Method: Qualitative semi- structured interview s from eight nurses working within the forensic psychiatric clinic. Interviews were analysed by using a qualitative content analysis. Results: They worked strategically and emphasized the importance of teamwork, good communication and urged for the need to get necessary education, staff focused tutoring and patient focused therapy. Conclusion: Need for necessary education, patient focused therapy and staff focused tutor is needed to empower staff working with patients who are confined within forensic psychiatry and suffer from deliberate self harm behaviour. / Introduktion: Självskadebeteende beskrivs vanligtvis utifrån ett patologiskt perspektiv och är allt vanligare inom rättspsykiatrisk vård. Beteendet anses ofta vara socialt oacceptabelt i samhället. Sjuksköterskor ställs ofta inför olika emotioner och synsätt i mötet med patienter med självskadebeteende. Dessa känslor och attityder påverkar både sjuksköterskan och patienter på olika sätt. Syfte: Examensarbetets syfte var att belysa sjuksköterskors erfarenheter av att vårda patienter med självskadebeteende, som vårdas inom rättspsykiatrisk vård i Sverige. Metod: Studien har genomförts med hjälp av kvalitativa semi-strukturerade intervjuer, som analyserats med innehållsanalys. Åtta sjuksköterskor deltog i studien. Resultat: Från intervjuerna framkom det att sjuksköterskorna upplevde olika känslor och reaktioner gentemot patienter med självskadebeteende. Känslorna var av frustration, hjälplöshet, ilska, ångest och rädsla. Sjuksköterskorna betonade vikten i att ha en god kommunikation i omvårdnaden med sina kollegor, samt efterlyste behovet av utbildning och handledning till personalen samt patientfokuserad terapi. Slutsats: För att stärka sjuksköterskorna i deras omvårdnadsarbete och professionella roll gentemot patienter med självskadebeteende, som vistas inom den svenska rättspsykiatriska vården, krävs det faktabaserade utbildning och handledning för att kunna ge en god vård. Deliberate self harm as defined pathologically as well as socially is becoming an increasing phenomenon within forensic psychiatry. Nurses working with patients who have self harm behaviour and are confined to forensic psychiatry face different challenges which affect their feelings and attitudes in different ways, in their nursing practice.

The Halloween ritual, trick-or-treat, has compelled suburban residents in Atlanta, Georgia to parade throughout the shared public spaces of their communities’ streets for nearly a century. In recent years, however, privatized children’s rituals beyond the realm of the neighborhood seemingly compete for trick-or-treat’s participants: trunk-or-treats in church parking lots now rise in popularity. I parse the impetuses behind the construction of these innovative ritual spaces using in-depth interviews and participant observations alongside the Christian churches who host them and the parents and guardians who participate in them. Cursorily appearing solely as privatized defangings of otherwise venomous and pagan-aligned public rites, trunk-or-treats embody social action in other ways: by actualizing and expanding faith communities’ networks of social capital, they not only afford churches the means to surmount various challenges they face in the New South, but also provide safe and attractive options for security-conscious parents and guardians in contemporary suburban Atlanta.

Home guardianship measures provide individuals with a means to enhance and ensure the safety of themselves, their family, and their property inside their homes. However, research regarding the factors considered in the decision to employ home guardianship measures as well as the means by which individuals assess this information regarding potential threats and protective responses is limited and varied in its implementation. This study attempts to provide a theoretical framework for understanding the use of home guardianship measures with the application of a modified version of Ronald Rogers’ (1983) Protection Motivation Theory (PMT) model. This model assesses factors that directly contribute to the motivation to engage in protective measures as well as cognitive processes through which an individual assesses these factors. This study finds support both for the direct relationships between sources of information about potential threats or protective responses and the use of home guardianship measures, as well as support for mediating effects of these relationships. In conclusion, this study provides suggestions for future research to further examine the application of PMT to understand the use of guardianship measures.