Concussion-Related Symptomatology And Outcomes In Individuals With Mental Health Conditions: Symptom Number And Severity, Balance Performance, And Time Course To Discharge, Kathryn J. Schulze

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Symptomatology can overlap between concussions and common mental health conditions (MHCs) – such as anxiety, depression, and attention-deficit/hyperactivity disorder. Research determined that there can be an onset of new or worsening symptoms related to pre-existing MHCs in individuals post-concussion. Pre-existing MHCs may affect concussion outcomes. Therefore, the relationship between pre-existing MHCs and concussions was further examined. Study One examined the difference in symptom severity and number of symptoms reported at the initial clinical assessment for concussion for individuals with and without a pre-existing MHC. A chart review determined that individuals with anxiety or multiple MHCs had significantly more concussion symptoms …

Antidepressants Versus Placebo For Generalized Anxiety Disorder: A Systematic Review And Meta-Analysis, Katarina Kopcalic

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Objectives: To assess the efficacy and acceptability of antidepressants compared to placebo among adults with a primary diagnosis of generalized anxiety disorder (GAD). Methods: Five electronic databases and 2 trial registries were searched to identify studies for inclusion. The risk of bias version 1 tool was used to assess the risk of bias. A random-effects meta-analysis was conducted using RevMan web. Results were presented using forest plots. Results: 38 studies (12,570 participants) were included. Very low-quality evidence showed a benefit for antidepressants over placebo in the rate of treatment response (RR, 1.39: 95% CI: 1.27, 1.52) and no differences in …

Data-Driven Neuroanatomical Subtypes In Various Stages Of Schizophrenia: Linking Cortical Thickness, Glutamate, And Language Functioning, Liangbing Liang

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The considerable variation in the spatial distribution of cortical thickness changes has been used to parse heterogeneity in schizophrenia. We aimed to recover a ‘cortical impoverishment’ subgroup with widespread cortical thinning. We applied hierarchical cluster analysis to cortical thickness data of three datasets in different stages of psychosis and studied the cognitive, functional, neurochemical, language and symptom profiles of the observed subgroups. Our consensus-based clustering procedure consistently produced a subgroup characterized by significantly lower cortical thickness. This ‘cortical impoverishment’ subgroup was associated with a higher symptom burden in a clinically stable sample and higher glutamate levels with language impairments in …

The Functional And Structural Consequences Of Aberrant Microglial Activity In Major Depressive Disorder, Jasmine D. Cakmak

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Major depressive disorder (MDD) is a highly debilitating neuropsychiatric illness which has been linked with increases in both peripheral and central inflammation, as well as with changes in connectivity. Although countless studies have investigated these two topics, the relationship between neuroinflammation and functional/structural connectivity has not been explored. Using [¹⁸F]FEPPA PET imaging, we measured translocator protein-related (TSPO) microglial activity in the subgenual anterior cingulate cortex (sgACC) and insula and confirmed significantly increased [¹⁸F]FEPPA uptake in depressed patients (N=12) compared to healthy controls (N=23). Using a seed-based ROI analysis of fMRI data, we found that patients show …

Why Do People Engage In Eating Disorder Behaviours?, Abbigail Kinnear

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Eating disorders (EDs) are serious mental illnesses often with poor prognosis. Personalizing evidence-based treatments based on an individual’s reasons for engaging in ED behaviours – or the functions of EDs – may improve treatment outcomes; however, no validated measures assessing these functions exist. The goal of this study was to complete the initial steps in developing a measure of ED functions. Individuals who engage in ED behaviours (n = 16) and clinicians who treat EDs (n = 14) were interviewed, and a thematic analysis was conducted to determine key functions of EDs. Four main functions of EDs were …

Exploring The Mental Health Experiences Of African, Caribbean, And Black Youth In London, Ontario, Lily Yosieph

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This qualitative study explores the mental health experiences of African, Caribbean, and Black (ACB) youth in London, Ontario, investigating how the factors of race, gender, culture, and place have shaped their perceptions and experiences of mental health. The data collection and analysis were conducted using a phenomenological approach and a critical lens informed by feminist, intersectionality, and critical race theories. These data illuminate the ways in which these young people’s attitudes toward mental health and help-seeking strategies are impacted by broader social constructs and community expectations, which they navigate and often resist in their everyday lives. Their insights can provide …

The Experiences Of Iraqi Refugees In Canada: A Life History Study Of War And Resilience In The Aftermath Of Migration, Nada Nessan

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This thesis reports on a life history narrative on the experiences of Iraqi refugees who resettled in Canada after living through war. The aim of this study is to help change the narrow perspectives on the mental health of war affected populations to a broader perception shaped by cultural and social aspects and to inform the development of meaningful and cultural relevant programs and policies with a particular attention to the concept of resilience.

The first part of the study presents the chronological narratives, or profiles. of eight participants. The second part of the study is a thematic discussion of …

Mood And Anxiety Disorders, Measurement, And Migrant Groups In Ontario, Jordan Edwards

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Our objectives were to: (1) evaluate the current literature on the epidemiology of mood or anxiety disorders among migrant groups; (2) assess how current tools for measuring mood or anxiety disorders at the population level influence our understanding of the epidemiology by a) analyzing the concordance between two commonly used population measures, and b) using a Bayesian analysis to create a combined estimate using both measures; (3) estimate the prevalence and effects of potential risk factors on the prevalence of mood or anxiety disorders among first-generation migrant groups compared to the general population in Ontario. We conducted a systematic review …

The Experiences Of Female Adolescents Who Have Sustained A Concussion Through Sport Participation: A Consideration Of An Occupational Perspective During Recovery, Annalise Michelle Tichenoff

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Adolescence is a time of rapid and tumultuous development in the physical, cognitive and psychosocial domains. Sustaining a concussion during this time period may complicate this development, particularly when symptoms are prolonged. Of particular importance is the study of adolescent females, as this population has been under-evaluated within the literature. This is especially troubling due to the number of concussions that occur among adolescent females, as concussions within this population reportedly occur at twice the frequency of adolescent males. This dissertation presents a qualitative case study investigation that explores the recovery experiences of adolescent female athletes who have sustained a …

Effects Of A Pregnancy Lifestyle Intervention On Emotion Regulation In Infants Responding To A Toy Removal Task At One-Year Of Age, Mollie Manley

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Poor infant emotion regulation (ER) has been linked with increased psychopathological risk in infancy and childhood. The Developmental Origins of Health and Disease Hypothesis suggests the prenatal period as the earliest point of intervention, where fetal exposure to healthy lifestyle changes can promote optimal ER in infancy. Infant electroencephalography (EEG; n=13) and heart rate variability (HRV; n=18) were measured at rest and in response to a toy removal task, to determine the ER of infants whose mothers participated in a nutrition and exercise intervention during pregnancy. Results demonstrated positive left frontal alpha asymmetry at rest (0.08± 0.66) and in response …

In Search Of Psychiatric Kinds: Natural Kinds And Natural Classification In Psychiatry, Nicholas Slothouber

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In recent years both philosophers and scientists have asked whether or not our current kinds of mental disorder—e.g., schizophrenia, depression, bipolar disorder—are natural kinds; and, moreover, whether or not the search for natural kinds of mental disorder is a realistic desideratum for psychiatry. In this dissertation I clarify the sense in which a kind can be said to be “natural” or “real” and argue that, despite a few notable exceptions, kinds of mental disorder cannot be considered natural kinds. Furthermore, I contend that psychopathological phenomena do not cluster together into kinds in the way that paradigmatic natural kinds (e.g., chemical …

Prevalence Of Moral Injury In Canadian Forces Members Deployed To Afghanistan, Kevin T. Hansen

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Moral injury is a relatively new area of study within military mental health care, as such, prevalence estimates for both moral injury and exposure to potentially morally injurious events (PMIE; a moral injury precursor) are unknown for many of the world’s militaries. PMIE is commonly defined as the perpetrating, failing to prevent, witnessing, or learning about acts or events that transgress an individual’s deeply held moral belief(s). The primary purpose of this study was to estimate the prevalence of PMIE in a population of Canadian Armed Forces (CF) members who served in support of the recent mission to Afghanistan. How …

The Association Between Child And Youth Mental Health Service Urgency And Exposure To Childhood Interpersonal Trauma, Catherine Marshall

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Children/youth with a history of maltreatment experience a variety of different developmental, psychiatric and health problems and ensuring there is streamline access to services is imperative to their recovery. Yet, there are few reports of standardized methods for directing and prioritizing risk for children seeking services. The current study,utilizingretrospective data collected from theinterRAIChild and Youth Mental Health Screener (ChYMH-S), aimed to address this gap and explore the relationship between childhood maltreatment and mental health screening outcomes. A sample of 4-18-year-olds (N= 19,645) was studied to explore how differences in maltreatment history, gender, and legal guardianship impacted service prioritization. The findings …

White Matter Inflammation And Executive Dysfunction: Implications For Alzheimer Disease And Vascular Cognitive Impairment, Alexander Levit

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White matter integrity is crucial to healthy executive function, the cognitive domain that enables functional independence. However, in the ageing brain, white matter is highly vulnerable. White matter inflammation increases with age and Alzheimer disease (AD), which disrupts the normal function of white matter. This may contribute to executive dysfunction, but the relationship between white matter inflammation and executive function has not been directly evaluated in ageing nor AD. White matter is also particularly vulnerable to cerebrovascular disease, corresponding with the common presentation of executive dysfunction in vascular cognitive impairment (VCI). Thus, white matter may be an important substrate by …

Searching For Wisdom: A Phenomenological Investigation Of Women's Perspectives Following Participation In An Ovarian Cancer Supportive Care Group, Helen Butlin

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This study used a novel methodology of hermeneutic-poetic-phenomenology to explore perspectives of women living with ovarian cancer. Each had participated in a supportive care group process Soul-Medicine prior to volunteering. Three women, Beth, Carrie, and Denise contributed to this study. The methodology was grounded in Gaston Bachelard’s philosophy of poetic-phenomenology. Data was analyzed with attention to image-centred knowledge; material imagination; reverie; and horizons of hope to elucidate their implicated aspects of wisdom and the ways participant’s formed their personal wisdom integrating feminist theories of embodiment and bioethics.

Findings are framed through three images of a uniquely formed inner ‘wisdom-compass’, an …

Neuronal Correlates For Neuroendocrine Habituation To Repeated Stress, Sara Matovic

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One way that the body actively responds to an impending stressor is by increasing systemic glucocorticoids through the activation of the hypothalamic-pituitary-adrenal (HPA) axis. While it is essential for short-term adaptation to stress, the sustained activation of the HPA axis during chronic stress can be detrimental and is linked to stress-related psychiatric conditions such as anxiety and depression. Therefore, it is important that the HPA axis adapts, or habituates, during chronic stress to minimize the negative consequences. Corticotropin releasing hormone (CRH) neurons in the paraventricular nucleus of the hypothalamus (PVN) function to assimilate incoming information from the stress circuitry and …

Cal And Magi Pdz Protein Regulation Of Crfr1 And 5-Ht2ar Trafficking And Signaling, Maha Mahmoud Hammad

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PDZ (PSD95/Disc Large/Zona Occludens) domain-containing proteins are scaffolding proteins that play important roles in regulating the activity of G protein-coupled receptors. Corticotropin Releasing Factor Receptor 1 (CRFR1) and Serotonin 2A Receptor (5-HT_2AR) are two GPCRs that are commonly associated with mental disorders. Both receptors also contain a class I PDZ-binding motif at the carboxyl terminal tail. In the first chapter, we investigate the effects of CAL (CFTR-associated ligand) on regulating the trafficking and signaling of CRFR1. We demonstrate a role for CAL in inhibiting CRFR1 endocytosis, cell surface expression, and CRF-mediated ERK1/2 signaling via the CRFR1 PDZ-binding motif. …

Domestic Homicide And Homicide-Suicide In The Older Population, Brianna L. O'Neil

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Extensive research has been conducted on domestic homicide in younger populations; however, very little is known about such incidents in the older population. It is vital that this gap in the literature be filled as Canada’s older population has been increasing. Data for this study was provided by the Ontario Domestic Violence Death Review Committee. Ninety-two domestic homicide and suicide cases were examined to determine whether there were differences between younger age groups (30 to 50 years of age) and older age groups (55 years of age and older). Information was gathered on prominent characteristics and risk factors within cases …

Testing The Interpersonal Theory Of Suicide In Community - Residing Older Adults, Dorian Murariu

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Suicide rates among older adults are high in Canada and around the world. Evidence-informed and theory-driven research on late life suicide may help to devise effective interventions to reduce suicide rates among older adults. In this thesis, I tested the Interpersonal Theory of Suicide (IPTS: Joiner, 2005; Van Orden et al, 2010) using data collected from a community-based sample of older adults recruited for a larger study designed to assess risk and resiliency factors for late life suicide (Dr. Marnin Heisel, PI). According to the IPTS, (Hypothesis 1) the interpersonal constructs of perceived burdensomeness (PB) and thwarted belongingness (TB) can …

Smoking And Exercise: Mechanisms And Effects During Simulated And Genuine Quit Attempts, Stefanie De Jesus

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Cigarette smoking is a leading agent for premature morbidity and mortality among the global community. Most individuals surrender to tobacco use disorder due to the inability to cope with cravings and withdrawal symptoms. Exercise appears to provide acute relief. Currently, it is unclear how exercise attenuates these reductions. Furthermore, the available evidence has focused on acute outcomes besides smoking behaviour and is limited to simulated quit attempts. Three experimental studies were designed to address these outstanding issues. Not surprisingly, a bout of moderate intensity exercise was found in study 1 (chapter 2) to reduce cravings associated with a temporary period …

Psychotherapy In Family Medicine, Saadia N. Hameed

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Abstract

Aim: To explore the perspectives and practice of psychotherapy of family physicians, and analyze Ontario’s mental health policy documents within the context of psychotherapy.

Methods: In the first study descriptive qualitative methodology was used. Eighteen family physicians were interviewed and the results were presented thematically. In the second study, a policy analysis of Ontario’s mental health policy documents was conducted. The qualitative policy analytic methodology of Peter et al. was used.

Findings: Psychotherapy is an effective treatment of mental illness and is practiced by family physicians. Lack of training and time are barriers, while patient needs and …

Pearl Harvesting Autism, Mariya Gruntovskaya

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This thesis addresses the difficulties of on-line information searching as it relates to the topic of autism. A review of existing search strategies is presented and their limitations are discussed. A new method for deriving a set of search-terms for comprehensive searching, Pearl Harvesting, was tested here to determine the necessary search terms (i.e., synonym ring) for ERIC and PsycINFO databases. Once discovered and validated, a synonym ring can be copied and pasted directly into the search box of the database, providing a simple, thorough and time saving way of conducting on-line research in the field. This easily used method …

Resilience As Health Promotion In Action: University Students Who Grew Up Amid Violence Directed Towards Their Mothers, Tatiana Murkin (Zdyb)

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Abstract

Violence against women is among the greatest threats to the health of our population. An estimated three hundred and sixty thousand children in Canada, and over two million worldwide are exposed to violence in their homes (UNICEF, 2006). Growing up amidst such violence seriously compromises children’s capacities for healthy development. Violence against women is not limited by culture, geography or socioeconomic status. It constitutes one of the most pervasive and yet least openly discussed human rights violations and public health issues known today.

Researchers and allied health professionals generally agree that children whose development has been interfered with by …

Measuring The Sixth Vital Sign: A Descriptive Analysis Of Distress In Individuals With Head And Neck Cancer And Their Caregivers, Catherine C. Bornbaum

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Introduction: Distress has become so problematic in oncology that it has been recognized as the “sixth vital sign” implying that distress monitoring should occur as routinely as the monitoring of one’s temperature or blood pressure. The research reported herein investigated the impact of head and neck cancer on levels of distress, commonly reported problems, and perceptions of quality of life in individuals with head and neck cancer and their caregivers.

Method: Two distinct studies were conducted; the first explored the patient experience of distress and quality of life while the second assessed the caregiver experience of these same constructs. A …