Section A is a review of the literature on cognitive functioning difficulties in psychosis. It focuses on these difficulties as they relate to cognitive models of psychosis. After outlining relevant cognitive models, the literature on cognitive functioning is critically reviewed. The review highlights methodological limitations; gaps in our understanding; and a need for research exploring people's experiences of cognitive functioning difficulties. Section B describes a qualitative study investigating the experience of cognitive difficulties in people with psychosis. Background: An overview of research on cognitive functioning in psychosis reveals limitations in existing understandings, including the absence of a rigorous account of how people with psychosis experience cognitive functioning difficulties. Aims: This study aimed to provide an account of the experience of cognitive functioning difficulties in people with psychosis, including how these difficulties are perceived and understood, how people respond to these difficulties, and what people’s perceptions are of others’ views of these difficulties. Method: A semi-structured interview was carried out with eight participants, focusing on participants’ experience of cognitive difficulties, how they respond to these, how participants perceive others’ understandings, and available support. Interpretative Phenomenological Analysis (Smith, Flowers, & Larkin, 2009) was used. Results: Cognitive impairment was understood in terms of master themes focusing on controlled and reflective thinking; physical experiences; explaining the origins of impairment; identity; and anticipating the future with fear and hope. Conclusions: The findings had significant implications for clinical psychology, including staff and client education about cognitive difficulties, and the importance of cognitive functioning to formulation. New areas for research include interventions stimulating metacognition; managing identity changes in response to cognitive difficulties; and ascertaining staff understanding of cognitive difficulties. Section C is a critical appraisal of the qualitative study 'The experience of cognitive functioning difficulties in people with psychosis: An investigation' described in section B. It provides critical and reflective answers to four questions on the following topic areas: research skills acquired; what one would do differently if repeating the study; clinical consequences of the study; and future research projects.

Section A: A review of literature focused on African Caribbean men with diagnoses of both conduct disorder (as an indicator of antisocial behaviour) and severe mental illness. The review concludes that disorganised infant attachments appear to be predictive of conduct disorder, psychosis and poor engagement with services in a reciprocal 'vicious circle'. Section B: Empirical Paper: This study examined the relationships of African Caribbean men with severe mental illness and a history of conduct disorder, linking this to engagement with services. This was explored qualitatively using attachment theory and Lacanian discourse analysis within a psychosocial methodology. Four interviews were conducted and the texts were analysed. The findings echo the evidence base in showing that, according to this interpretation, all participants showed signs of disorganised attachment. All had had adverse encounters within mental health services although all could also cite discrete experiences which had been helpful and supportive. Each participant held different views about the interaction of ethnicity with care. Section C: A critical reflection on the research process, including: thoughts on learning experiences; retrospective changes to the study; clinical implications; and ideas for future research.

It is widely supported that participation in athletics is positively correlated with increased overall health. However, some research indicates that participation in increased levels of competition is positively correlated with higher levels of depression and anxiety. This means, that if compared, athletes competing nationally or internationally would report higher levels of both depression and anxiety than athletes competing at the intercollegiate level. Research indicates that this could be caused by increased amounts of pressure, personal cost, and expectation. This study examines potential differences between intercollegiate, intramural, and non-athletes in these areas on a college campus. The first hypothesis is that depression symptoms will be more present in intercollegiate athletes than in intramural participants. The second hypothesis states that anxiety symptoms will be more prevalent in intercollegiate athletes than in intramural participants. The third hypothesis states that life satisfaction will be greater in intramural participants than in intercollegiate athletes. Lastly, the fourth hypothesis states that perceived social support and athletic identity will mediate the relationship between level of athletic participation and psychopathology. Participants in this study gave informed consent, completed a demographics questionnaire, and scales measuring depression and anxiety, life satisfaction, athletic identity, and perceived social support. The participants were recruited from intercollegiate teams, intramural teams, and psychology courses at Western Kentucky University. The first and second hypotheses were not supported since intramural participants did not have significantly different levels of depression compared to intercollegiate athletes and non-athletes. Results revealed intramural participants are more satisfied with life than intercollegiate and non-athletes, which supports the third hypothesis. The results also revealed that life satisfaction is mediated by both athletic identity and perceived social support, which shows partial support for the fourth hypothesis. The fourth hypothesis was not supported for depression and anxiety because these factors did not have significant differences between the groups so finding a mediating factor was not possible.

L’individu est en interaction permanente avec son environnement et tente de s’y adapter sans cesse. En cas d’échec de cette relation transactionnelle (Lazarus), l’individu développe un stress qui peut s’exprimer de différentes façons.Le stress a été largement étudié en population générale, mais il existe peu de données sur les liens entre stress et psychopathologie.Nous nous sommes attachés à intégrer l’ensemble des informations qui pourraient rendre compte du stress au travers de la création d’un questionnaire intégrant à la fois les stresseurs (d’ordre personnel, professionnel et environnemental), les manifestations de stress et les cognitions inadaptées. Ce nouveau questionnaire a bénéficié d’une validité de face, d’une étude de ses validités convergente et divergente, ainsi qu’une étude de ses propriétés psychométriques.Les résultats en population générale (n=2298) montrent de façon nette une expression de stress différente selon le sexe et qu’il existerait des facteurs protecteurs (vie en couple et présence d’enfants).Ce questionnaire a été étudié sur des populations d’hommes et de femmes suivies en ambulatoire, présentant un trouble anxieux (trouble obsessionnel et compulsif, trouble panique avec agoraphobie, trouble anxiété généralisée, trouble anxiété sociale) et comparé aux populations générales.Chacune des populations présente des spécificités d’expression du stress et en particulier la population masculine souffrant d’anxiété généralisée.Les données retrouvées amènent à une réflexion sur les stratégies de coping utilisées par les patients anxieux pour rendre compte de ces différences existant à la fois entre les troubles anxieux mais aussi entre sexes. / Individuals are constantly interacting with and adapting to their environment. When the transactional model (Lazarus) is not met, stress manifests itself in a variety of different forms. While stress has been widely studied in the normal population, little is known about the relationship between stress and psychopathology. The current work attempts to evaluate stress using detailed measures of stress manifestations, daily stressors (personal, work-related, and environmental), and stress-related cognitions. The resulting questionnaire was analysed in terms of face validity followed by a larger study examining its convergent and divergent validity as well as different psychometric properties. The results from the general population (n=2298) show that males and females have significantly different experiences of stress; results also suggest that significant relationships (couple, family) can serve as protective factors. The questionnaire was then used to assess the stress experience in four ambulatory consultation samples of individuals diagnosed with anxiety disorders (obsessive-compulsive disorder, panic disorder with agoraphobia, generalised anxiety disorder, social anxiety disorder) and compared with results from the participants in the general population. Stress manifestations differed according to psychological disorder; of note was significant and meaningful differences demonstrated by the male participants suffering from generalised anxiety disorder. The data provide insight into the different types of coping strategies that seem to be used by patients suffering from anxiety disorders.

M.A.

This thesis examined the developmental differences in inhibition and theory-of-mind of 4-8 year olds as a function of the suggested presence of a supernatural agent. All children played four games designed to assess their current level of inhibition and theory-of-mind performance; Children in the experimental condition, only, were also introduced to an invisible Princess Alice and were told that she was watching during the games. Following these measures, all children engaged in a resistance-to-temptation task to determine any differences in inhibition resulting from Princess Alice's suggested presence. I found that children exhibiting a well-developed theory-of-mind were more likely to express belief in Princess Alice than were children lacking this cognitive ability. This research provided support that cognitive maturity, rather than immaturity, may be necessary for children to express belief in novel supernatural agents, and highlighted the importance of context as a mediating factor in children's behavioral inhibition. / by Ashley King. / Thesis (M.A.)--Florida Atlantic University, 2009. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2009. Mode of access: World Wide Web.

A depressão é a categoria psicopatológica que expressa, de forma privilegiada, o sofrimento psíquico na atualidade, adquirindo estatuto de epidemia. Examinamos a depressão enquanto objeto de discurso em nossa cultura, a partir de diversas ordens discursivas médica, religiosa, econômica, psicanalítica, socioantropológica e investigamos como esses discursos se singularizam produzindo efeitos clínicos e discursivos naqueles que, a seu modo, o reproduzem. Partimos da hipótese de que o discurso constitui, condiciona, altera e determina a própria experiência de sofrimento. Baseando-nos na psicanálise de Lacan e em sua acepção de sujeito, nossa proposta é a de verificar efeitos de indução e modalização sintomáticas produzidos pela exposição ao discurso da depressão. Analisamos um conjunto de sete relatos, obtidos através de entrevistas semidirigidas, nas quais a presença do significante depressão apresentava-se prevalente para a designação do sofrimento. Nossos achados apontam para a existência de marcas discursivas que se repetem nos relatos analisados, a despeito da diversidade e heterogeneidade de experiências compreendidas em cada um deles. O significante depressão se articula intradiscursivamente e interdiscursivamente, recuperando incidências históricas heterogêneas e descontínuas pelas quais efeitos transformativos são descritos. Conclui-se que há uma absorção identificatória do discurso da depressão em nossa cultura, passando a constituir, ele mesmo, uma catacrese ou seja, uma metáfora já absorvida ao uso comum da língua, de emprego tão corrente que há pouca equivocação semântica em jogo no seu uso. Nesse sentido, depressão é termo que praticamente supre a falta de palavras específicas para designar um sofrimento que resiste à nomeação e faz convergir discursos de diferentes procedências: saúde, trabalho, desejo e religião. Esse resultado é compatível com o estatuto criacionista do significante, bem como o estatuto performativo do ato diagnóstico, além dos efeitos de autoconfirmação clínica dos sintomas / Depression is the psychopathological category that expresses, in a privileged way, the psychic suffering nowadays, acquiring epidemic status. In this work, we examine depression as an object of discourse in our culture, from different discursive orders - medical, religious, economic, psychoanalytic, and social-anthropological - and we investigate how these discourses singularize themselves producing clinical and discursive effects upon those who, in their way, reproduce them. Our hypothesis is that speech constitutes, conditions, changes and determines the very experience of suffering. Based on Lacans psychoanalysis and on his conception of the subject, the proposal is to verify symptomatic induction and modalization effects produced by the exposure to the discourse of depression. We analyze a set of seven reports, obtained through semi-structured interviews, in which the presence of the significant \"depression\" became prevalent for the appointment of suffering. Our findings pointed to the existence of discursive marks that repeat themselves in the analyzed reports, despite the diversity and heterogeneity of the experiences comprised in each of them. The significant \"depression\" is articulated intra-discoursively and inter-discoursively, recovering heterogeneous and discontinuous historical incidences through which transformative effects are described. The conclusion is that there is an identificatory absorption of the discourse of depression in our culture, passing itself to constitute a catachresis that is, a metaphor already absorbed in the common use of language, an employment so current there is little semantic equivocation at stake in its use. In this sense, \"depression\" is a term that almost makes up for the lack of specific words for suffering that resists the appointment and converges speeches from different sources: health, work, desire and religion. This result is consistent with the creationist status of the signifier and the performative status of the diagnostic act, in addition to the effects of clinical auto-commitment of symptoms

The internalizing and externalizing dimensions of psychopathology have been shown to effectively identify groups that are at higher risk for experiencing certain forms of psychopathology. Many studies have shown that chronic physical health conditions are a risk factor for psychological distress, yet there has been very little research examining the association between chronic physical health conditions and dimensional models of psychopathology to date. In the present study we examined the factor structure of internalizing and externalizing symptoms in a sample of adults with postural orthostatic tachycardia syndrome (POTS; n =172) and in a sample of adults without any chronic illness diagnoses (n = 199). Confirmatory factor analyses suggested that psychological distress in individuals with POTS can be effectively characterized by an internalizing dimension composed of distress and fear subcomponents as well as an externalizing dimension. Tests of measurement invariance allowed for the examination of latent means, which showed that individuals with POTS tend to have higher scores on the internalizing dimension and lower scores on the externalizing dimension than healthy controls. Regression analyses suggested that within the sample of people with POTS, those who were more accepting of their illness and had higher health related quality of life tended to have lower scores on the internalizing dimension. Findings suggest that individuals with POTS are at heightened risk for experiencing internalizing symptoms of psychopathology. A dimensional conceptualization of psychopathology seems like an effective way to identify symptoms of psychopathology that are separate from symptoms of autonomic nervous system dysfunction.

Submitted by PPG Psicologia (psicologia-pg@pucrs.br) on 2018-03-21T13:20:05Z No. of bitstreams: 1 TES_BRENO_SANVICENTE_VIEIRA.pdf: 6222146 bytes, checksum: d1e5e710fc5ec0e52c03bb4ffe92d0f8 (MD5) / Approved for entry into archive by Tatiana Lopes (tatiana.lopes@pucrs.br) on 2018-04-03T20:11:47Z (GMT) No. of bitstreams: 1 TES_BRENO_SANVICENTE_VIEIRA.pdf: 6222146 bytes, checksum: d1e5e710fc5ec0e52c03bb4ffe92d0f8 (MD5) / Made available in DSpace on 2018-04-03T20:22:52Z (GMT). No. of bitstreams: 1 TES_BRENO_SANVICENTE_VIEIRA.pdf: 6222146 bytes, checksum: d1e5e710fc5ec0e52c03bb4ffe92d0f8 (MD5) Previous issue date: 2018-03-07 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / In Brazil, 1.4% of the population reports lifetime use of smoked cocaine (crack). The use of the drug relates to social and economic issues for society and poses serious health problems, including early death. Crack cocaine use disorder (CUD) is the medical condition which refers the pathological use of the drug. CUD relates to several negative outcomes such as higher rates of HIV and HCV infections, familiar problems and crime involvement, in addition to a higher prevalence of concurrent mental disorders. Scientific agendas promote evidence-based studies as a need for better therapeutics. In this regard, some gaps in the field require attention. In this line, distinct factors confer vulnerability for crack cocaine use in males and females: more males use the drug (a 3:1 proportion), but females show a faster transition from initial drug use to CUD. The course of the disease also show differences; females report a higher craving for the drug, while males have more frequent involvement with violent crimes. Thus, scientific commitments highlight a calling for the integration of those biopsychosocial models that consider individual characteristics in addition to those who consider addictive disorders as ?brain diseases.? A more consistent interdisciplinary integration of knowledge from classical theories in combination with advances provided for technologic methods is a promising route. Hence, the aim of this doctoral thesis was to investigate sex differences in crack cocaine users. To address the main objective, the thesis has two studies with groups of participants diagnosed with CUD and hospitalized for drug detoxification. These two groups were one of males (CK-M) and a second of females (CK-F). Study 1 had as its objective to get a picture of sex differences in the psychosocial profile. Study 2 had as its objective the identification of sex differences in brain functioning level. Study 1 had 798 CK-M and 546 CK-F. Results consistently revealed CK-M as having a more severe alcohol use history and higher rates of concurrent alcohol use disorder than CK-F. On the other hand, CK-F showed an earlier crack cocaine use onset, higher drug use severity, and more familiar and work problems along with a higher prevalence for lifetime mental disorders. Particularly, CK-F showed higher rates for trauma and stress. Study 2 had a sample of 80 participants: CK-M (n = 20), CK-F (n = 20), a group of males (HC-M, n = 20), and another of healthy female controls (HC-F, n = 20). Participants did a resting-state functional magnetic resonance imaging (rs-fMRI) scan. The method makes it possible to investigate temporal associations between nonspatially related brain areas by using as a measure fluctuations in the blood oxygen-level dependent (BOLD) level. It is an indirect measure of energy consumption, and by testing those correlations, functional connectivity (FC) can be investigated. Results supported CK-M as having an overall higher intra- and internetwork FC, while CK-F showed an overall lower FC in this regard. Taking both studies, the conclusions of this thesis point toward the existence of sex differences in all biopsychosocial domains. Thus, the interpretation of studies in crack cocaine use, particularly those testing interventions, need to resemble the possible existence of sex differences. Therefore, a hope from studies like this is that sex-specific models for crack cocaine use and CUD emerge and become tested. Similarly, possible interventions, also need to be aware of such backgrounds and consider possible sex differences when developing interventions, researches and public health policies as well. / No Brasil, cerca de 1.4% da popula??o refere j? ter feito uso de coca?na atrav?s de sua forma fumada (crack). O uso da droga gera repercuss?es sociais e econ?micas para a sociedade, al?m de ser um grave problema de sa?de relacionado, inclusive, com a morte precoce. Considerando o Transtorno por Uso de Coca?na (TUC) a manifesta??o patol?gica relacionada ao uso da droga, alguns dos desfechos desfavor?veis incluem: maiores taxas de infec??o por HIV e HCV; problemas judiciais e familiares, al?m maior preval?ncia de transtornos mentais em comorbidade. Iniciativas cient?ficas estimulam que propostas baseadas em evid?ncias sejam realizadas na tentativa de melhores resultados para o tratamento e preven??o do TUC. Neste sentido, maiores aprofundamentos em lacunas do conhecimento na ?rea s?o importantes. Assim, homens e mulheres possuem fatores de vulnerabilidade ao uso da droga distintos: Mais homens usam coca?na (propor??o de 3:1), mas mulheres apresentam uma evolu??o mais r?pida ao TUC ap?s o in?cio do uso. O curso da doen?a tamb?m ? diferente, mulheres sentem mais fissura pela droga, enquanto homens tem mais consequ?ncias relacionadas a crimes violentos. Assim sendo, iniciativas cient?ficas destacam a necessidade de integra??o de modelos biopsicossociais, que levem em conta as caracter?sticas individuais, mas que tamb?m considerem transtornos aditivos ?doen?as do c?rebro?, favorecendo a interdisciplinaridade entre antigas e robustas bases te?ricas e avan?os tecnol?gicos. Neste sentido, o objetivo desta tese foi investigar diferen?as entre homens e mulheres usu?rios de crack. Para tanto, dois estudos foram realizados com grupos de portadores de TUC internados para desintoxica??o do uso de crack, tendo sempre um grupo de homens (TUC-H) e outro de mulheres (TUC-M). No Estudo 1, o objetivo foi tra?ar um claro perfil de diferen?as psicossociais e de gravidade do uso de drogas, enquanto no Estudo 2 o objetivo foi identificar a exist?ncia de diferen?as em um n?vel de funcionamento cerebral. O Estudo 1 teve 798 TUC-H e 546 TUC-M. Resultados identificaram robustas diferen?as, com TUC-H possuindo uma hist?ria mais grave de uso de ?lcool, bem como uma maior preval?ncia para o transtorno por uso de ?lcool. Em contrapartida, TUC-M apresentam uma idade mais precoce do in?cio do uso de crack, maior severidade do uso de drogas em geral, preju?zos mais significativos nas esferas de trabalho e fam?lia, al?m taxas mais altas de preval?ncia de transtornos mentais (em especial transtornos relacionados a trauma e estresse). No Estudo 2, com 80 participantes al?m dos grupos TUC-H (n = 20) e TUC-M (n=20), participaram 20 homens saud?veis e 20 mulheres saud?veis. O m?todo utilizado foi um exame de Resson?ncia Magn?tica funcional (fMRI) em estado de repouso (rs-fMRI). Rs-fMRI permite avaliar associa??es na flutua??o do sinal BOLD (blood oxygen-level dependente, do ingl?s n?vel dependente de oxig?nio no sangue), que ? uma medida indireta de consumo energ?tico, entre ?reas cerebrais anatomicamente distintas, o que ? aceito como um dado de conectividade funcional (CF). Os resultados indicaram que de maneira geral, TUC-H apresentam um aumento na CF entre diferentes redes cerebrais, enquanto TUC-F apresentam redu??o na CF. Com base nos resultados, a tese conclui que homens e mulheres usu?rios de crack apresentam diferen?as em caracter?sticas que permeiam todos os dom?nios biopsicossociais, o que deve ser considerado ao levar em conta interpreta??es de estudos na ?rea e, principalmente, ao planejarem-se poss?veis interven??es no futuro. Portanto, espera-se que modelos sexo-espec?ficos para o uso de coca?na e do TUC sejam formulados, bem como que interven??es, pesquisas e inclusive pol?ticas de sa?de p?blica considerem poss?veis diferen?as em suas fundamenta??es.

Research on art therapy and psychosis has typically focused on individuals who have experienced psychotic symptoms for many years. This study used a grounded theory methodology to explore how service users experience art therapy following their first diagnosis of a psychotic disorder, and the possible mechanisms through which art therapy might be helpful for such individuals. Eight participants were interviewed, with two participants being interviewed twice. A preliminary theory was created and seven categories were constructed from the data, namely unpressured atmosphere, pleasure and engagement in art-making, expression and communication, connecting with others, changing emotional experience and experience of self, supporting recovery and continuation of art, and barriers. Participants reported that through the atmosphere of art therapy, art-making, and communication, they were able to build relationships, connect with others, experience a sense of commonality, absorption, sense of freedom and discover alternative perspectives and different understandings. Whilst this study suffered from some limitations, the results build on the current research base by suggesting possible processes and mechanisms through which art therapy is helpful, and focusing on a previously under-represented population. The findings are considered alongside existing research and theoretical perspectives. Clinical implications and recommendations for future research are also highlighted.