Despite many proposed theories (e.g., biological, learning, evolutionary) it is still unclear how individuals develop paraphilic interests. It is not even clear from these theories why paraphilic interests are much more common in men than in women. One possible factor affecting male preponderance is anxiety. Anxiety can potentiate sexual arousal in men and deter sexual arousal in women. It has been proposed that paraphilic interests (e.g., sexual interest in children, in violence) can develop when anxious feelings are generated by unconventional sexual stimuli. According to this hypothesis, when anxiety is repeatedly elicited by an unconventional sexual stimulus, and when anxiety potentiates sexual arousal in men, over time, paraphilic interests may develop. It follows that men (but not women) with paraphilic interests may be susceptible to anxiety disorders – an anxiety disorder would facilitate the hypothesized developmental process. Part 1 of this dissertation consisted of a meta-analysis of 29 studies to determine the link between paraphilias and anxiety. Part 2 was a large-scale file review of 1,048 patients referred to a sexual behaviour clinic to investigate the link between paraphilias and anxiety. Both the meta-analysis and the file review showed a link between paraphilias and anxiety, but paraphilias were also associated with many other psychological disorders. Therefore, there does not seem to be a specific link between the paraphilias and anxiety, casting doubt on the validity of the hypothesis tested in this dissertation. The discovery of a general link between paraphilias and psychological disorders, however, opens new avenues for studying the development of paraphilic interests.

This thesis examines the excusing and exempting conditions in Strawsonian accounts of moral responsibility. More specifically, it notes some concerns for Strawsonian accounts with regards to exempting individuals on the basis of psychological abnormalities, namely that the excusing/exempting distinction is unclear, and more importantly that treating a person's brain as an entity distinct from the person suggests a dualistic picture of the self that is not consistent with neuroscientific accounts of the brain. If we redraw the distinction to be between external/internal features, and focus on brain processes as the responsible entities for any given action, we can avoid these worries and have a more empirically accurate account of responsibility. / Master of Arts

Linear mixed-effects (LME) modeling is a widely used statistical method for analyzing repeated measures or longitudinal data. Such longitudinal studies typically aim to investigate and describe the trajectory of a desired outcome. Longitudinal data have the advantage over cross-sectional data by providing more accuracy for the model. LME models allow researchers to account for random variation among individuals and between individuals. In this project, adolescent health was chosen as a topic of research due to the many changes that occur during this crucial time period as a precursor to overall well-being in adult life. Understanding the factors that influence how adolescents' mental well-being is affected may aid in interventions to reduce the risk of a negative impact. Self-esteem, in particular, has been associated with many components of physical and mental health and is a crucial focus in adolescent health. Research in self-esteem is extensive yet, sometimes inconclusive or contradictory since past research has been cross-sectional in nature. Several factors associated with self-esteem development are considered. Participation in religious services has also been an interest in research for its impact on depression. Depression development and its predictors are evaluated using LME models. Along with this line, this project will address the research problems identified through the following specific topics (i) to investigate the impact of early adolescent anxiety disorders on self-esteem development from adolescence to young adulthood; (ii) to study the role of maternal self-esteem and family socioeconomic status on adolescent self-esteem development through young adulthood; and (iii) to explore the efficacy of religious service attendance in reducing depressive symptoms. These topics present a good introduction to the LME approach and are of significant public health importance. The present study explores varying scenarios of the statistical methods and techniques employed in the analysis of longitudinal data. This thesis provides an overview of LME models and the model selection process with applications. Although this project is motivated by adolescent health study, the basic concepts of the methods introduced have generally broader applications in other fields provided that the relevant technical specifications are met.

Sexual problems or dysfunctions remain one of the prominent reasons .for marital and relationship problems, often resulting in divorce. Sexuality is however only one of many components of a marriage or of a committed relationship. Relationship problems and sexual problems are often interlinked. The fact that sexual problems are often only symptoms of deeper relationship issues, makes the social worker the ideal person to treat these sexual problems from a holistic perspective and within a relationship context. The nature of this research study evolves around the proposed lack of knowledge of social workers in private practice, and who specialise in couple therapy, regarding human sexuality and sex therapy. This research study is valuable for the social work profession as the knowledgebase of social work is extended. Social workers come into close contact with individuals seeking couple therapy. Social workers might often be required to assist individuals or couples with sexual problems, as relationship difficulties and sexual problems often co-exist. This study is further of value because the importance of the integration of sex therapy and couple therapy is shown. A qualitative research approach is used, and applied research is conducted. An exploratory research design is utilised and a self-constructed, mailed questionnaire is used as method of data collection. The following conclusions can be drawn and the following recommendations made: • The social worker is the ideal person to deal with sexual difficulties, as he or she is well trained in the dynamics of marriage and relationship therapy. • An integrative, holistic and post-modernistic approach to therapy for sexual difficulties has emerged. • There is a movement today toward the combination of sex therapy and couple/relationship therapy. • There are concerns that social workers in private practice specializing in couple therapy, may have a lack of knowledge regarding human sexuality and sex therapy. The respondents in this study answered only 58.53% of the knowledge based questions correctly. • There is a need for specialised education and training of social workers in the field of human sexuality and sex therapy. • Training in human sexuality and sex therapy should be included in the undergraduate, post-graduate and continuing education levels of social work¬training. • This research study supplies a basis for future research studies. The content of the study can aid in the development of a course in human sexuality and sex therapy aimed at social workers specifically. / Dissertation (MA (Social Work))--University of Pretoria, 2006. / Social Work and Criminology / unrestricted

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No description available.

Les patients hospitalisés en réanimation présentent fréquemment des troubles neurologiques (troubles de la vigilance, troubles du sommeil, dysfonctions cognitives multiples, confusion mentale), psychologiques (anxiété, dépression, syndromes délirants), des syndromes douloureux et de l'inconfort. Ces troubles ont en commun : la problématique de leur définition et de leur reconnaissance par l'équipe de réanimation, leur expression fréquente par un comportement d'agitation, une association avec la réponse de stress post-agressive rencontrée au cours des pathologies traitées en réanimation. La physiopathologie de ces troubles est complexe, impliquant à la fois la pathologie qui a déterminé l'hospitalisation du patient en réanimation, ses antécédents médicaux, mais aussi la réanimation elle-même par les thérapeutiques invasives qui y sont utilisées, ainsi que la sédation médicamenteuse ou le coma artificiel. En outre, ces troubles peuvent être associés dans leur expression comme dans leur détermination, certain pouvant être cause ou conséquence d'un autre. L'objectif de cette thèse était de montrer qu'une prise en charge diagnostique et thérapeutique rationalisée de la douleur, des troubles neurologiques et psychologiques était associée à un meilleur pronostic du patient en réanimation. / Patients who are hospitalized in Intensive Care Units (ICU) develop frequent neurological disorders (vigilance disorders, sleep disorders, multiple cognitive disorders, delirium), psychological disorders (anxiety, depression, delusion), pain syndrom and discomfort. These disorders have jointly the problem of their definition and recognition by the ICU team, their frequent expression by an agitated behaviour, an association with the post-aggressive stress response affecting pathologies treated in the ICU setting. The physiopathology of these disorders is complex, implying both the pathology which had determined the admission of the patient to the ICU and his/her medical history, but also either the invasive therapeutics used by the intensive medicine and the administration of sedatives or therapeutic coma. Moreover, theses disorders can be associated either in their expression and their cause, some of them able to be a cause or a consequence of another. The objective of this thesis was to show that a rationalized diagnostic and therapeutic management of pain, neurological and psychological disorders was associated with a better outcome of the patient in the ICU.

Our current knowledge about the relationship between linguistic skills and psychological disorders is somewhat diffuse. One reason is because it is difficult to investigate this relationship without including conditions that clearly influence the results in one way or another (e.g. culture, environment, socioeconomic class etc). This study aims to investigate the relationship in an attempt to highlight a potential link. By using the lens of several fields altogether; cognitive science, linguistics, neuroscience, neurocognition, this study shed light on the relationship and encourage further studies in this field to determine the role of linguistic skills in mental health in general. In the experiment, linguistic skills were measured opposed to depression as a specific disorder to quantify specific data. Linguistic skills were measured by density and diversity and PHQ-9 survey question were used to determine depression scale. Statistical analysis showed significant correlations between some measures of linguistic skills and PHQ-9. The significant statistical correlation found points towards the hypothesis that, better linguistic skills promote well-being, and psychological disorders take minor effect relative to poorer linguistic skills. This topic is large-scaled which means that background variables must be acknowledged thoroughly, which due to the extent of this thesis, were not. The results are discussed further as well as limitations of the study. Improvements for further research are proposed.

Objective: Many women experience traumatic events already prior to or during pregnancy, and delivery of a child may also be perceived as a traumatic event, especially in women with prior post-traumatic stress disorder (PTSD). Birth-related PTSD might be unique in several ways, and it seems important to distinguish between lifetime PTSD and birth-related traumatization in order to examine specific consequences for mother and child. This post-hoc analysis aims to prospectively examine the relation of both, lifetime PTSD (with/without interpersonal trauma) and birth-related traumatization (with/without postpartum depression) with specific maternal and infant outcomes. Methods: In the prospective-longitudinal Maternal in Relation to Infants’ Development (MARI) study, N = 306 women were repeatedly assessed across the peripartum period. Maternal lifetime PTSD and birth-related traumatization were assessed with the Composite International Diagnostic Interview for women. Maternal health during the peripartum period (incl. birth experience, breastfeeding, anxiety, and depression) and infant outcomes (e.g., gestational age, birth weight, neuropsychological development, and regulatory disorders) were assessed via standardized diagnostic interviews, questionnaires, medical records, and standardized observations. Results: A history of lifetime PTSD prior to or during pregnancy was reported by 25 women who indicated a less favorable psycho-social situation (lower educational level, less social support, a higher rate of nicotine consumption during pregnancy). Lifetime PTSD was associated with pregnancy-related anxieties, traumatic birth experience, and anxiety and depressive disorders after delivery (and in case of interpersonal trauma additionally associated with infant feeding disorder). Compared to the reference group, women with birth-related traumatization (N = 35) indicated numerous adverse maternal and infant outcomes (e.g., child-related fears, sexual problems, impaired bonding). Birthrelated traumatization and postpartum depression was additionally associated with infant feeding and sleeping problems. Conclusion: Findings suggest that both lifetime PTSD and birth-related traumatization are important for maternal and infant health outcomes across the peripartum period. Larger prospective studies are warranted. Implications: Women with lifetime PTSD and/or birth related traumatization should be closely monitored and supported. They may benefit from early targeted interventions to prevent traumatic birth experience, an escalation of psychopathology during the peripartum period, and adverse infant outcomes, which in turn may prevent transgenerational transmission of trauma in the long term.