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Posttraumatic stress disorder (PTSD) is associated with significant functional impairments and disruptions in cognitive functioning. Functional recovery and remediation of cognitive difficulties are oft over-looked treatment targets in this population, despite their significant contribution to the burden of PTSD to the individual and to society. Existing literature suggests that functional impairment and cognitive dysfunction may not respond to first-line treatments for PTSD. Thus, the focus of this thesis was to examine symptom dimensions associated with cognitive dysfunction and functional impairment among individuals with PTSD, and to investigate a novel approach to cognitive remediation, Goal Management Training (GMT), in this population. Study one in this thesis is a review in which we identified a strong relation between dissociative symptoms and neuropsychological functioning, transdiagnostically and among individuals with PTSD. The hypothesis that dissociative symptoms would be strongly related to functional impairment among individuals with PTSD was explored in study two. We found that dissociative symptoms mediated the relation between PTSD symptoms and functional impairment among a sample of military members, veterans, and first responders with PTSD. Study three identified that emotion regulation difficulties and dissociative symptoms most strongly predicted functional impairment among civilians with PTSD and high rates of exposure to childhood abuse and neglect. In study four we investigated the effectiveness of a cognitive training program, Goal Management Training (GMT), in improving cognitive functioning, clinical symptoms, and functional impairment among inpatients with PTSD. Participation in GMT was associated with improved cognitive functioning and increased ability to engage in goal directed behaviours when highly emotional. This thesis highlights the importance of assessing emotion regulation difficulties and dissociative symptoms in order to target functional impairment and cognitive dysfunction among individuals with PTSD. Moreover, it provides evidence for a potential treatment approach to ameliorate these difficulties. / Thesis / Doctor of Philosophy (PhD) / Posttraumatic stress disorder (PTSD) is a mental health condition that develops after exposure to a traumatic event. It is associated with reduced functioning in important areas of life, including social relationships, work performance, and self-care. PTSD is also associated with reduced cognitive functioning in areas such as memory, planning, and organization. This thesis focuses on examining variables that may be related to these difficulties, including specific symptoms such as difficulty managing emotions and difficulties remaining in the present moment (dissociation). We also investigate a treatment program, Goal Management Training (GMT), aimed at teaching skills to improve cognitive and daily functioning. By understanding what contributes to cognitive functioning and functional difficulties in individuals with PTSD and by providing evidence for a treatment that can improve these difficulties, we hope to improve the lives of individuals with PTSD.

Mild cognitive impairment (MCI) is a medical diagnosis that is conceptualized as existing on a continuum between normal cognitive aging and dementia. While a growing body of research has established the impact of this condition on family members' emotional well-being, as well as the quality of family relationships, the reciprocal impact of family dynamics and the family environment on illness course has received much less attention. Expressed emotion (EE) is a measure of the family emotional climate that has been established as being highly predictive of relapse and symptom exacerbation for a variety of mental health disorders. The recent integration of attribution theory with EE has offered new insights into the underlying attitudes and beliefs that give rise to it. This mixed methods study applied the attribution model of EE to test the validity of EE in predicting the illness course of MCI, and to identify family members' attributions regarding MCI-related behaviors and symptoms that underlie their EE status. The study sample included 57 family dyads consisting of a person with MCI and a family member providing primary care or assistance. The results of the ANCOVA did not support the hypothesis that EE status would predict changes in the non-cognitive features of MCI over time. However, methods of thematic analysis revealed four major themes, or care partner attributional stances: (a) non-blaming, (b) blaming, (c) variable, and (d) no identified. The analysis also revealed three subthemes, or attributional styles, within the variable stance: (a) ambivalent, (b) mixed, and (c) complex. These attributional stances and styles intersected with family EE status in notable ways and form the basis for future research in this area, as well as clinical interventions with these families that promote adaptation to the illness. / Ph. D.

Diets containing 5.0% excess phenylalanine; 6.0% excess protein (gelatin), and limited in tryptophan (75mg/lOOg) and/or vitamin E (O.lmg/IOOg) were fed to male rats during gestation and lactation. Addition of 5.0% phenylalanine result in a greater incidence of cataract than studies previously reported with diets limited in tryptophan and vitamin E alone, or a single supplementation of Vitamin E (40.0.mg/lOOg). Supplementation with tryptophan (500mg/lOOg) and vitamin E (40.0mg/100g) prevented cataract formation. Replacing the 5.0% excess phenylalanine and 6.0% excess protein (gelatin) with an equivalent of a balanced free amino acid mixture prevented cataract formation in the group supplemented with vitamin E alone. Addition of balanced free amino acids resulted in decreased fertility, pup survival, and increased diuresis. Supplementation with vitamin E (40.0mg/lOOg) alone prevented these effects. Urinary excretions of keto acid (phenylpyruvate), nitrogen, urea, and creatinine were examined during the 7-l4th days of gestation. Amino acid analysis were performed on plasma and soluble lens hornogenates from young progeny. Protein separations of soluble lens homogenates from young progeny were obtained. Analysis of these parameters did not indicate distinct differences between cataractous and noncataractous groups. / Master of Science

This study compared physical characteristics used when selecting comparison (healthy) watersheds for the All-Forested Load Multiplier (AllForX) Approach, and examined a quantitative watershed characteristic as a selection criterion. The AllForX Approach uses a regression relationship between Virginia Stream Condition Index (VSCI) scores and AllForX values (a unit-less multiplier that is the ratio of a modeled existing sediment load divided by a modeled all-forested load condition) for an impaired watershed and several comparison watersheds to develop sediment TMDL target loads. The Generalized Watershed Loading Function (GWLF) model was used to simulate sediment loads for 20 watersheds (four impaired and 16 comparison) in the Upper James and New River basins in Virginia's Ridge and Valley physiographic region. Results suggest that within Virginia's Ridge and Valley physiographic region it may be possible to select comparison watersheds that are of a different stream order (watershed size) and lie in different river basins from the impaired watershed. Results further indicated that the topographic index (TI) distributions were not different across the modeled watersheds, indicating the watersheds are hydrologically similar. These results support selecting comparison watersheds regardless of river basin or stream order within Virginia's Ridge and Valley physiographic region. Finally, there was no statistical difference between the AllForX regressions when using the entire period of record or the two most recent VSCI data points. Therefore, for the watersheds modeled for this study, either all of the VSCI samples or the two most recent may be used in the AllForX Approach. / Master of Science

Pathogens are the most common cause of water quality impairment in Virginia. Bacteria TMDLs (Total Maximum Daily Loads) for watersheds are typically created using a modeling approach. These models require characterization of all residential, agricultural, and wildlife sources of bacteria. Wildlife bacteria source characterization is typically conducted with estimates of population and fecal coliform production. A sensitivity analysis was performed on the bacteria TMDL development process and the HSPF (Hydrological Simulation Program-FORTRAN) model to determine how wildlife population and fecal coliform density variability impacts simulated in-stream bacteria loads. The population and fecal coliform density values for seven wildlife species were sequentially varied and run through the TMDL model to analyze the changes in bacteria loads. For population density, high, median, and low values were tested, and for fecal coliform density, high and low values were tested. The analysis was conducted on three watersheds (Abrams Creek, Upper Opequon Creek, and Happy Creek), each with a different dominant land use. The results revealed that all watersheds were sensitive to the high fecal coliform densities of deer, muskrats, and raccoons. However, Happy Creek, the watershed with majority forested land use, was additionally sensitive to the high fecal coliform densities of ducks and the high population density for all species. Using the three watersheds as surrogates for comparing different land uses, the study showed the TMDL modeling process is most sensitive to changes in wildlife in watersheds dominated by forested land use. The results also demonstrated that TMDL calibration is more efficient when adjusting wildlife fecal coliform density rather than population density to match the modeled watershed with the observed water quality data. / Master of Science

No / Person-centred care can improve the well-being of patients and is therefore a key driver in healthcare developments in the UK. The current study aims to investigate the complex relationship between cognitive impairment, dependency and well-being in people with a wide range of acquired brain and spinal injuries. Sixty-five participants, with varied acquired brain and spinal injuries, were selected by convenience sampling from six inpatient clinical neuroscience settings. Participants were observed using Dementia Care Mapping – Neurorehabilitation (DCM-NR) and categorised based on severity of cognitive impairment. A significant difference in the behaviours participants engaged in, their well-being and dependency was found between the severe cognitive impairment group and the mild, moderate or no cognitive impairment groups. Dependency and cognitive impairment accounted for 23.9% of the variance in well–ill-being scores and 17.2% of the variance in potential for positive engagement. The current study highlights the impact of severe cognitive impairment and dependency on the behaviours patients engaged in and their well-being. It also affirms the utility of DCM-NR in providing insights into patient experience. Consideration is given to developing DCM-NR as a process that may improve person-centred care in neuroscience settings.