Thesis (M.A. (Clinical Psychology))--University of Pretoria, 2003. / Includes bibliographical references (leaf 62-68).

Thesis--Smith College. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (M. Soc. Sc.)--University of Hong Kong, 1989.

An overview of the varied clinico-neurological features of dyskinesias in general is presented, and literature an the epidemiology af tardive dyskinesia since the introduction of antipsychotic drugs in 1950, reviewed. Furthermore reasons for the wide variations in previously published prevalence figures have been critically highlighted, and suggestions based upon the current state of clinical and experimental knowledge put forward concerning the pathogenesis of drug induced movement disorders. The type and prevalence of abnormal or purposeless involuntary movements has been surveyed among a large sample of long term White patients resident in Town Hill Hospital for a period of not less than 4 years, mast af whom were either currently receiving or had received neuroleptic medication. This sample comprised 190 men and 98 women whose ages ranged from the third to the ninth decade. Patients manifesting abnormal movements were grouped into 5 general diagnostic categories for analysis viz. schisophrenic disorders, affective disorders, organic brain disorders and syndromes, defective mental development and discrete neurological disorder. The movements were clinically classified in terms cf the areas of the body involved and semi quantitatively measured according to a standardised duration rating scale procedure. Involuntary movements were noted to be present in a total o-f 83 patients examined, most o-f which were adjudged to correspond to the syndrome currently termed 'tardive dyskinesia'. Subtype analysis o-f movement distribution indicated that 277. of cases manifested classical oro-facial dyskinesia while 527. showed body dyskinesia o-f the type designated ' pseudaakathisia'; the balance o-f the patients presented combinations o-f the two types. Schizophrenic disorders constituted the commonest diagnostic category in the dyskinesia group up to the fifth decade. Functionally obtrusive involuntary movements were observed in only some 77. of the patients with dyskinesia. Prevalence overall was equal between the sexes, and no correlations were discerned between age, sex, diagnosis or dyskinesia subtype of cases and the rating scores obtained. Prevalence rates obtained by this survey are favourably low by comparison with many results of overseas investigators, and are similar in this respect to figures reported in the very few prevalence studies carried out to date in South African institutions. / Thesis (M.Med.)-University of Natal, Durban, 1985.

The primary objective of this research was to initiate exploratory research into the challenges that trainee therapists face in the first interview. This research focused on determining what aspects of the first interview the trainee therapists found challenging and exploring what it was about these aspects which made them challenging to the trainees. Further the research sought to explore what coping mechanisms the trainees employed during the first interview in order to negotiate these challenges as well as what effect these challenges had on the experience of the trainees. The research sought to gain an understanding of what it was about these challenges which made them difficult for the trainees. The research is situated within Ronnestad and Skovholt?s (2003) model of professional therapist development whereby the difficulties faced by the novice/trainee therapist can be understood within the framework of the developmental path of the professional therapist. This framework was used to understand the nature of the difficulties encountered at this stage of training. Interpersonal Process Recall (IPR) (Kagan, 1976; Kagan, 1980; & Kagan, 1984) was employed in interviews with 8 Masters first year students following the completion of a first interview with a role play client. The data was analysed using Grounded Theory Analysis and Strauss and Corbin?s (1990, as cited in McLeod, 2001) method of qualitative analysis was employed to analyse and interpret the data. The main findings indicated the pervasive presence of anxiety in novice therapists? experiences of the first interview. In particular this anxiety was generated through a preoccupation with the evaluative component of the exercise which brought to the fore the dynamic internal conflict between the personal, private self and the professional self as the novice attempts to establish a working professional identity. This conflict is played out in the context of the first interview with specific reference to issues around self focus, management of the interview and difficulties with the role-played nature of the exercise. The difficulties encountered tended to generate further anxiety forming a negative feedback loop. Positive coping strategies were employed using „self talk? which led to an increased perception of self-efficacy. Negative coping strategies such as reverting to rigid structured processes resulted in a negative experience and escalated anxiety resulting in perceptions of poor selfefficacy. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Durban, 2010.

No description available.

This work is the result of an investigation into aspects of prolactin and dopamine in primary affective disorders. It is introduced by a discussion on the need for obtaining good scientific data on the organic and psychosocial aspects of psychiatric illness, and in particular, primary affective disorders. A short perspective of the history of depressive illness preceeds the review of relevant scientific literature on primary affective disorder. The literature survey covers aspects which indicate organic causal factors as well as viewing numerous organic studies which are thought to be relevant to this investigation. The role of dopamine in motor behaviour is considered in some detail. Psychopharmacological evidence that the mesolimbic and nigrostriatal dopaminergic systems are involved in motor regulation is reviewed. The role of dopamine receptors in motor behaviour is important to the conceptual framework of this thesis. Dopamine D 2 and D 1 receptors are considered and the opposing roles of these receptors is thought to be significant. Drugs affecting manic and depressive phases of primary affective disorders are reviewed. Emphasis is placed on dopaminergic aspects of various drugs in primary affective disorders as with pimozide as an antimanic agent, and nomifensine as an antidepressant. The possible role of noradrenaline in learning and mood regulation and in the dialogue with dopamine is looked at from an experimental and clinical point of view. Dopaminergic control of prolactin is reviewed and in particular the nature of the D4 receptor. The fact that these receptors which are on the pituitary mammotrophs have similarities to the D2 receptors is relevant. Thus considerable commonality exists between the dopaminergic regulation of motor behaviour and regulation of prolactin. Prolactin is used as an index of dopamine function in patients with primary affective disorders. Motor behaviour is strongly influenced by affective disorders.The central theme of the study itself was to indirectly evaluate dopamine function in primary affective disorder by measuring prolactin levels. As strong tonic inhibition is exerted by dopamine on prolactin, a series of challenges to the dopamine system was decided upon in order to generate a number of serum prolactin values. A dopamine agonist L-dihydroxyphenylalanine (indirect) and an antagonist, chlorpromazine, were used to stress the system mildly. The procedure was carried out under standard conditions both in the illness phase and upon significant recovery. Both these investigations were conducted in a drug-free state. The data generated was subjected to statistical analysis. The results of the analysis suggests that prolactin levels are low in depressed patients, and increase upon recovery, while manic patients have elevated levels which decrease with recovery. The pattern of the curves obtained from the challenge procedure suggests a possible supersensitivity of dopamine receptors in the manic patients. Blunting of responses of depressed patients remains a possibility but a study against normal controls is required to further assess this aspect. Evidence is therefore found for altered prolactin levels in illness phases of primary affective disorders. This is thought to be due to an abnormality in the dopamine regulation of prolactin. A discussion on the possible mechanisms and significance of these changes involves Beta-endorphin in an attempt to tie motor changes to mood regulation. Shortcomings of the study and future implications and developments are considered. / Thesis (M.D.)-University of Natal, Durban, 1986.

Schizophrenia is a lifelong disorder that affects 1% of the population worldwide and often begins in late adolescence or early adulthood. It is characterised by positive, negative and cognitive symptoms. Negative and cognitive deficits are more difficult to measure in rodents but may be a better predictor than positive symptoms of the long-term outcome following treatment of patients with schizophrenia. One of the major challenges in schizophrenia research is the development of suitable models for these aspects of the disorder. In this regard, one model we have studied in some detail is the methylazoxymethanol (MAM) neurodevelopmental model. MAM is a neurospecific antimitotic agent that prevents cells from dividing for a short time after injection. It can be administered intraperitoneally to pregnant dams on gestational day 17, theoretically causing neuroanatomical and behavioural alterations in offspring that are akin to core symptoms seen in schizophrenia. Our findings confirm that MAM model offspring exhibit several neurodevelopmental and pathological changes that bear similarities to schizophrenia. These include reductions in cortical thickness and hippocampal size,and enlargement of ventricles. Behavioural consequences of MAM, largely emergent after puberty, include increased locomotor responsiveness to NMDA antagonist administration, and also pre-pulse inhibition and cognitive flexibility deficits. However, the robust neuropathological and neurophysiological findings found in the MAM El7 model do not always translate into behavioural deficits. This is of critical consequence for model validation and use in discovery research. The variability in behaviour effects will be discussed, taking into consideration factors such as litter effects, study design and statistical analysis. Overall, our data suggests that maternal treatment with MAM on embryonic day 17 leads to persistent alterations in the adult offspring of SD-CD rats that are relevant for modelling aspects of schizophrenia - but revised methods for study design and statistical analysis are crucial to avoid misinterpretation of findings.

Disasters are events that challenge both the social and individual ability to adapt, carrying the risk of adverse mental health outcomes. High prevalence rates of Post Traumatic Stress Disorder (PTSD), anxiety, and depression have been found after disasters among affected adults and children, and PTSD is the most distinct and common disorder. However, the challenge of providing sufficient numbers of mental health professionals is the most critical issue facing health-care systems throughout the world, and especially in developing countries. The 2008 Sichuan earthquake in China had enormous destructive power and affected millions of people. Given the large number of people involved – and the shortage of resources in any major disaster – brief, pragmatic, and easily trainable interventions are needed for both adult and child survivors. In the context of the Sichuan earthquake, this thesis describes a research work aimed at: (1) investigating the extent and nature of earthquake-related distress and positive change experienced by the targeted survivor population, and exploring the factors that predict these distresses and changes, (2) examining the effectiveness of narrative exposure therapy (NET) in adult survivors, and (3) examining the effectiveness of written narrative strategies for child survivors in the school setting. To achieve these aims, a cross-sectional survey (N=120) was conducted to explore the psychological morbidities, risk, and protective factors as well as predictive models of PTSD and positive change at 1.5 years after the Sichuan earthquake. It highlights the mental health problems after the earthquake, and provides the background information for the subsequent intervention studies. Sequentially, effectiveness of the narrative exposure therapy was assessed within Chinese adult survivors and modified appropriately via two RCT studies using waiting list control. In the NET-1 study, 22 survivors with diagnosed PTSD were recruited and received the NET treatment. The results supported the effectiveness of NET for treating Chinese earthquake survivors. In the NET-2 study, NET was adapted according to the feedback and practical implications from the NET-1 study. Thirty participants with newly diagnosed PTSD were recruited. Twenty of them were treated by the NET-R, and the other 10 participants were treated by the original NET. The revised NET showed a similar intervention effect to the original NET in reducing PTSD symptoms anxiety, depression, general distress, and negative change, and promoting positive change following adversity. In the child intervention studies, a short, inexpensive and easily applied written narrative intervention called Guided Narrative Techniques (GNT) was developed and evaluated with traumatised children in the school setting through two studies. The first study was conducted with 108 sixth grade children (11-12-years old) from three classes in a single primary school, in the earthquake area. Two classes were randomly assigned to the GNT group, and one class was assigned to the expressive writing group that was given simple verbal instruction. The results indicated that if the writing instructions of the programme were fully followed through by the children, GNT might function better on reducing the posttraumatic symptoms than the expressive writing in a short time. However, a low level of writing adherence was reported, indicating that written narrative strategies may not be suitable for traumatised early adolescents. In the second child study, the GNT protocol was improved to enhance the writing adherence of children. Eighty-two Chinese fourth grade children (9-10-years-old) from three classes were recruited as participants in the writing programme. One class was randomly assigned to the GNT group; one class was assigned to the GNT condition with encouragement (GNTE group); and one class was assigned to the control group with mixed expressive writing and painting (MEWP) without specific guidelines. The results indicated that all three written narrative strategies appeared to be efficient concerning post-disaster resilience for Chinese school children. The GNTE showed most rapid, stable and extensive effects, indicating its advantages over the other two conditions. The research provides evidence for the applicability and effectiveness of narrative interventions in the Chinese earthquake survivor population. It attempted to facilitate the wider dissemination of psychological interventions to promote recovery from traumatic stress after major disasters. The findings help advance current knowledge in the management of PTSD after natural disasters in developing areas, contribute to the validation of PTSD theories, and inform future research.

No description available.