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Introduction: The Adverse Childhood Experiences (ACE) study demonstrated that childhood maltreatment has a profound impact on adult health, leading to psychopathology, continued victimization, risky behaviors, chronic disease, suicide, and premature death. Persons involved in the forensic mental health system are characterized by a greater degree of cumulative risk – exposed to greater and more prolonged ACEs during critical developmental periods who also face disproportionate exposure to psychosocial and economic deprivation, limited health care access, and other such factors that compound lifetime health concerns. In the current study, we seek to build upon emerging knowledge of ACEs in forensic mental health consumers by examining clusters of persons differentially exposed to ACEs in relation to a range of health and behavioral outcomes. Method: Archival data were used; participants were randomly sampled who had been admitted to the facility and released between 2005 and 2013. Of 250 possible participants identified by the facility’s Quality Management team, data were collected and coded for the resulting 180 persons. Records included admission and discharge summaries, criminal background records and associated pre-sentencing reports, and annual medical, social services, and psychiatric evaluations. Data pertaining to ACEs and characteristics of the early environment, mental and physical health, and criminality and aggression were coded for each participant. For this presentation, we examined outcomes related to adult physical health (e.g., chronic disease conditions, head injuries), mental health (e.g., suicidality, psychiatric admission history, psychiatric diagnoses), and criminogenic behavior (e.g., characteristics of arrest history, onset of aggression) using a series of logistic regression analyses, with differing ACE risk bands as ordinal predictors of our outcome variables. These include persons with an ACE score of 0-1 (40.6%, n = 73), 2-3 (27.2%, n = 49), 4-5 (16.1%, n = 29), and 6+ (16.1%, n = 29). Results & discussion: None of the outcomes for medical history were significantly different across the risk bands, potentially due to high occurrences among the sample, with over 79% reporting a chronic disease. The relationship between risk band and sexual arrest history was significant (p = .045), with those in lower risk bands more likely to be arrested for a sexual offense. This may be due to the additional planning and executive functioning required to engage in these types of crime. There was a significant relationship between risk bands and age at first arrest (p = .032), with the highest risk band arrested at younger ages. There was also a significant relationship for age at first aggression (p < .001) and age at first psychiatric hospitalization (p < .001) with highest risk bands demonstrating aggressive behaviors and being hospitalized at earlier ages. Relationships between self-harm history (p < .001), PTSD diagnosis (p < .001), and BPD diagnosis (p < .001) were significantly related to ACE risk bands. Implications and future directions will be discussed.

Thesis (M.S.)--Boston University

There has been much debate in the history of philosophy aimed at determining what it is, exactly, that makes a person who and what she is. Varying theories have offered a wide range of concepts in pursuit of the answer to this question. Some thinkers, such as B.F. Skinner, have claimed that it is observable behavior patterns that determine who and what a person is. Yet other thinkers, such as Carl Jung, have attributed unconscious motivators as being determinative in deciphering who and what a person is. Jung claims that it is the conscious and unconscious working together that determines who and what a person is. The purpose of this thesis is to discover evidence that supports or disproves the theory of self in which the unconscious and conscious work together to determine who and/or what a person is. This is done by semiotically analyzing the Visual Products (VP) of Visual Product Producers (VPP) who were or are afflicted with Bipolar Disorder. This thesis consists of the semiotic analysis of selected works by Jackson Pollock, Virginia Woolf, Vincent Van Gogh, and myself (Michael Main). Semiotic analysis studies how meanings are generated as opposed to what meanings are generated. It should be noted that semiotics was used strictly as a method of analysis and not as a guiding philosophy. In examining how the works of the selected VPPs generate meaning, it is hoped that evidence is produced that proves or disproves the theory of who or what a person is as determined by the interaction of the conscious and unconscious.

Post-Traumatic Stress Disorder (PTSD) is a mental illness resulting from exposure to a traumatic event. Symptoms of PTSD vary, but those affected commonly experience nightmares, flashbacks, hypervigilance, and trouble sleeping; they may also avoid people or situations that trigger traumatic memories. It is estimated that PTSD affects about 10-30% of all United States veterans. Additionally, traditional treatment methods have an average dropout rate of 25% among military personnel. Inadequate PTSD symptom management may lead to depression, anxiety, suicidality, isolation, unstable relationships, and substance misuse. The purpose of this review is to examine the current research concerning the use of service dogs as a treatment option for the management of PTSD and its associated symptoms among veterans with PTSD. A database search was done using CINAHL, APA PsycInfo, and MEDLINE. Limited research has been done on the effects service dogs have on American veterans' management of PTSD. A total of eight studies met all inclusion criteria and were analyzed as part of this literature review. The results of this review of the current literature suggest that psychiatric service dogs have a positive influence on the management of PTSD among veterans. The studies analyzed suggest that the acquisition of a service dog contributes to lower PTSD scores and sequelae among veterans.

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In this thesis, Giddens' theory of structuration is employed in an analysis of the ghetto of ex-psychiatric patients in Hamilton, Ontario. A review of the main concepts of of structuration theory forms the basis for a theoretical model of the structuration of urban space that considers both the individual agent and the social system as equal partners in the production and reproduction of the urban built environment. From this general model, methodologies are developed for institutional analysis and an analysis of strategic conduct. The institutional analysis enables an understanding of the ghetto as the unintended outcome of deinstitutionalization policy. An examination of the city of Hamilton's attempt to dismantle the ghetto focuses on the strategic conduct of the actors in the policy-making process, and provides insight as to why the city's attempt has thus far proved unsuccessful in halting the ghettoization of ex-patients. The study demonstrates the theoretical and empirical utility of structuration theory in providing an analysis that considers the complex interrelationships of system, structure, agency, time and space. / Thesis / Master of Arts (MA)