Use of latent profile analysis to identify eating disorder phenotypes in an adult Australian twin cohort

Context: The relationships among the different eating disorders that exist in the community are poorly understood, especially for residual disorders in which bingeing or purging occurs in the absence of other behaviors. Objective: To examine a community sample for the number of mutually exclusive weight and eating profiles. Design: Data regarding lifetime eating disorder symptoms and weight range were submitted to a latent profile analysis. Profiles were compared regarding personality, current eating and weight, retrospectively reported life events, and lifetime depressive psychopathology. Setting: Longitudinal study among female twins from the Australian Twin Registry in whom eating was assessed by a telephone interview. Participants: A community sample of 1002 twins (individuals) who had participated in earlier waves of data collection. Main Outcome Measures: Number and clinical character of latent profiles. Results: The best fit was a 5-profile solution with women who were (1) of normal weight with few lifetime eating disorders (4.3%), (2) overweight (10.6% had a lifetime eating disorder), (3) underweight and generally had no eating disorders except for 5.3% who had restricting anorexia nervosa, (4) of low to normal weight (89.0% had a lifetime eating disorder), and (5) obese (37.0% had a lifetime eating disorder). Each profile contained more than 1 type of lifetime eating disorder except for the third profile. Women in the first and third profiles had the best functioning, with women in the fourth and fifth profiles having similarly poorer functioning. The women in the fourth group had a symptom profile distinctive from the other 4 groups in terms of severity; they were also more likely to have had lifetime major depression and suicidality. Conclusion: Lifetime weight ranges and the severity of eating disorder symptoms affected clustering more than the type of eating disorder symptom.

Psychotic symptom and cannabis relapse in recent-onset psychosis - Prospective study

Background: Cannabis use appears to exacerbate psychotic symptoms and increase risk of psychotic relapse. However, the relative contribution of cannabis use compared with other risk factors is unclear. The influence of psychotic symptoms on cannabis use has received little attention. Aims: To examine the influence of cannabis use on psychotic symptom relapse and the influence of psychotic symptom severity on relapse in cannabis use in the 6 months following hospital admission. Method: At baseline, 84 participants with recent-onset psychosis were assessed and 81 were followed up weekly for 6 months, using telephone and face-to-face interviews. Results: A higher frequency of cannabis use was predictive of psychotic relapse, after controlling for medication adherence, other substance use and duration of untreated psychosis. An increase in psychotic symptoms was predictive of relapse to cannabis use, and medication adherence reduced cannabis relapse risk. Conclusions: The relationship between cannabis use and psychosis may be bidirectional, highlighting the need for early intervention programmes to target cannabis use and psychotic symptom severity in this population. Declaration of interest: None. Funding detailed in Acknowledgements.

Renegotiating sexual intimacy in the context of altered embodiment:the experiences of women with breast cancer and their male partners following mastectomy and reconstruction

OBJECTIVE: Breast cancer diagnosis and treatments can have a profound impact upon women's well-being, body image, and sexual functioning, but less is known about the relational context of their coping and the impact upon their intimate partners. Our study focuses upon couples' experiences of breast cancer surgery, and its impact on body image and sexual intimacy. METHOD: Utilizing a dyadic design, we conducted 8 semistructured individual interviews, with 4 long-term heterosexual couples, after the women had undergone mastectomy with reconstruction. Interviews explored both partners' experiences of diagnosis, decision-making, and experiences of body image and sexual intimacy. Interpretative phenomenological analysis (IPA) was adopted; this is a qualitative research approach characterized by in-depth analysis of the personal meaning of experiences. RESULTS: Findings illustrate the positive acceptance that partners may express toward their wives' postsurgical bodies. They illuminate ways in which gendered coping styles and normative sexual scripts may shape couples' negotiations of intimacy around "altered embodiment." Reciprocal communication styles were important for couples' coping. The management of expectations regarding breast reconstruction may also be helpful. CONCLUSIONS: The insights from the dyadic, multiple perspective design suggest that psychologists must situate the meaning of supportive relationships and other protective factors in the context of complex life events and histories, in order to understand and support people's developing responses to distress. (PsycINFO Database Record

Is pregnancy a teachable moment for diet and physical activity behaviour change? An interpretative phenomenological analysis of the experiences of women during their first pregnancy

OBJECTIVES: Pregnancy may provide a 'teachable moment' for positive health behaviour change, as a time when women are both motivated towards health and in regular contact with health care professionals. This study aimed to investigate whether women's experiences of pregnancy indicate that they would be receptive to behaviour change during this period. DESIGN: Qualitative interview study. METHODS: Using interpretative phenomenological analysis, this study details how seven women made decisions about their physical activity and dietary behaviour during their first pregnancy. RESULTS: Two women had required fertility treatment to conceive. Their behaviour was driven by anxiety and a drive to minimize potential risks to the pregnancy. This included detailed information seeking and strict adherence to diet and physical activity recommendations. However, the majority of women described behaviour change as 'automatic', adopting a new lifestyle immediately upon discovering their pregnancy. Diet and physical activity were influenced by what these women perceived to be normal or acceptable during pregnancy (largely based on observations of others) and internal drivers, including bodily signals and a desire to retain some of their pre-pregnancy self-identity. More reasoned assessments regarding benefits for them and their baby were less prevalent and influential. CONCLUSIONS: Findings suggest that for women who conceived relatively easily, diet and physical activity behaviour during pregnancy is primarily based upon a combination of automatic judgements, physical sensations, and perceptions of what pregnant women are supposed to do. Health professionals and other credible sources appear to exert less influence. As such, pregnancy alone may not create a 'teachable moment'. Statement of contribution What is already known on this subject? Significant life events can be cues to action with relation to health behaviour change. However, much of the empirical research in this area has focused on negative health experiences such as receiving a false-positive screening result and hospitalization, and in relation to unequivocally negative behaviours such as smoking. It is often suggested that pregnancy, as a major life event, is a 'teachable moment' (TM) for lifestyle behaviour change due to an increase in motivation towards health and regular contact with health professionals. However, there is limited evidence for the utility of the TM model in predicting or promoting behaviour change. What does this study add? Two groups of women emerged from our study: the women who had experienced difficulties in conceiving and had received fertility treatment, and those who had conceived without intervention. The former group's experience of pregnancy was characterized by a sense of vulnerability and anxiety over sustaining the pregnancy which influenced every choice they made about their diet and physical activity. For the latter group, decisions about diet and physical activity were made immediately upon discovering their pregnancy, based upon a combination of automatic judgements, physical sensations, and perceptions of what is normal or 'good' for pregnancy. Among women with relatively trouble-free conception and pregnancy experiences, the necessary conditions may not be present to create a 'teachable moment'. This is due to a combination of a reliance on non-reflective decision-making, perception of low risk, and little change in affective response or self-concept.

Predicting posttraumatic stress reactions in children prior to traumatic exposure

The present study examined the relations among previously identified risk and protective variables associated with traumatic exposure and evaluated a model of resilience to traumatic events among Latino youth prior to traumatic exposure using structural equation modeling. Model tests were pursued in the context of Full Information Maximum Likelihood (FIML) methods as implemented in Mplus. The model evaluated the role of the following variables: (a) intervening life events; (b) child characteristics; (c) social support from significant others; and (d) children's coping. Data were collected from 181 Latino youth (M age = 9.22, SD = 1.38; 49.0% female) participants. Data analyses revealed that children's perceived available social support and use of coping strategies predicted low state anxiety following exposure to cues of disaster. Life events and preexisting depression symptoms did not significantly predict social support and coping, whereas preexisting anxiety was a significant predictor of perceived social support. This study represents an important initial step towards establishing and empirically evaluating a resilience model. Implications for preparedness interventions and a framework for the etiology of resilient reactions to disaster exposure are discussed.

Anxious children who received treatment grow -up: An 8-to-13 year follow-up study

This dissertation examined the long-term efficacy (8-to-13 years, M = 9.54, SD = 1.689) of exposure-based cognitive-behavioral therapy (CBT) for phobic and anxiety disorders in youths. Long-term efficacy was examined in terms of diagnostic recovery, symptom reductions, and clinically significant change. This dissertation also examined predictors of long-term efficacy (e.g., age, gender, and other clinical characteristics) as well as the relative long-term efficacy of CBT for Hispanic/Latino and European American youth. ^ Participants consisted of 67 youth (age range 15–26 years; M = 19.43, SD = 3.02 years at time of follow-up assessment), (47.8% females, 37.3% Hispanic/Latino) who had participated in one of two clinical trials (Silverman et al., 1999a, b). After providing informed consent to participate in the long term follow-up, youths completed a diagnostic interview and a battery of questionnaires. Results indicated that treatment gains were maintained about 9.5 years after treatment was completed. Maintenance of treatment gains was evident in terms of diagnostic recovery, symptom reductions, and clinically significant change. Long-term treatment gains extended to both ethnic groups and the two ethnic groups were functionally equivalent along most indices examined. Analyses of predictors of long-term outcome showed that parent self-reported pre-treatment depression, youth-reported pre-treatment depression, and youths retrospective reports of negative life events were significantly associated with less favorable long-term gains in terms of total symptoms of anxiety at long-term follow-up. In terms of long-term sequelae, youths with less successful post-treatment outcomes reported seeking-out additional treatment as well as using/abused substances and substance dependence significantly more than youths with successful post-treatment outcomes. Results are discussed in terms of the contribution of the present study to knowledge base about the long-term efficacy of exposure-based CBT procedures for phobic and anxiety disorders in youth. Findings also are discussed in terms of the need to modify CBT procedures to target youths with less successful post-treatment outcomes. Limitations and future directions are presented. ^

The Road from Emmaus

THE ROAD FROM EMMAUS is a collection of 20 personal and lyric essays that explores the narrator’s role as mother and daughter through a close look at significant life events, including her parents’ divorce, a high-risk pregnancy, the death of her father, talking to her daughter for the first time about sex, and accompanying her daughter to the DMV for a learner’s permit. Through examining familial roles and relationships, the narrator’s longing for home emerges as a unifying theme. The essays in THE ROAD FROM EMMAUS vary in style and tone, from light and funny to serious and probing. The collection is divided into five sections, each highlighting a different aspect of the narrator’s life as she evolves from a child, to a young adult, a mother, and a daughter who must help take care of her aging parents.

The Effects of Attention Bias Modification Training on Cognitive Biases Perceived Threats in Children with Anxiety

It has been found in research that children and adults with anxiety have a bias toward interpreting ambiguous situations as threatening. This bias is thought to consequently maintain many symptoms of anxiety. An emergent computer treatment system called Attention Bias Modification Training (ABMT) has been used to try to reduce this bias. It is essential to understand whether this bias can be reduced with ABMT because of its feasibility and cost effective nature of treatment. In the current study, interpretation bias is measured using the Children's Opinions of Everyday Life Events (COELE). The ABMT treatment is given to children once a week for an hour and their answers to the COELE are recorded before and after treatment. The recorded procedures are transcribed by undergraduate students working at the Child Anxiety and Phobia lab, and then scored. Each of the situations of the COELE are rated 0 being neutral or 1 threatening interpretation of the situation. The hypothesis is that ABMT will reduce the negative interpretation bias in children over the course of 4 weeks of treatment. The study is still in the collection and transcription of data phase, and will expect to have analytical conclusions in the start of spring 2015.

Vida privada e mídias sociais: impressões da pós-modernidade

This thesis starts from the proposition that postmodernity is the very cultural manifestation of Late Capitalism. The research was concerned with the publication of privacy that gives us news feeds of Facebook online social network. We used netnography, which is considered a construction method in action that combines study skills to immersion of the researcher in the investigated field. Netnography is an alternative methodology for the study of communication threads in cyber environments. We note that there is an exhibition of themselves in a related environment that reproduces the properties of the spectacle society, with an emphasis on the fact that this exhibition be made and want to be made by the individual himself, allegorically, window dresser and with spectacle. The subject is revealed by itself, shown and is induced to show and display at the same time. It is a large-scale exhibition of the private life events; it is more than spectacle, surpassing debordian sense, approaching the exhibitionism in the Freudian sense. It is a subject in a new way of existence. At the time of posting in public, the person violates their privacy. It is the desecration of stardom intimacy. We found that these new behavioral forms sharing of human experiences, under the mediation of typical technologies informationalism era, appear as a major brand of sociability, meshing the ongoing technological revolution.

Um olhar sobre “Água Suja” e o “Moleque”: tradição, fé, cultura e teatralidade

This thesis addresses two spectacles: “Moleque tão Grande Otelo” and “Água Suja”, in which both have had my participation as producer and actress. The spectacle “Moleque tão Grande Otelo” reveals the racial-ethnic questions that surrounds the play and permeates the artist’s life whose name is the same. The play deals how the actor Grande Otelo life events’ had implied in his art, the facts that marked his career and they are shown at the spectacle, the reason why to articulate: art, life, fantasy and reality. Aiming to unveil the actor, I refer it to my history as an actress and the roots’ similarity to Sebastião Bernardes de Souza Prata, who became Grande Otelo to the world. In the staging of “Água Suja”, we also expose familial and religious memories and experiences of a people that overflow faith in a real spectacle, which takes place every year, in August, in our region, more specifically in Romaria – MG. While creating “Água Suja”, we experienced the act of keeping a promise and believing in the saint’s miracle, thus this experience is told in the spectacle and investigated in this study.

The Timing of Motherhood While Earning a PhD in Engineering

In spite of tremendous efforts, women are still under-represented in the field of science. Post-graduate education and early tenure track employment are part of the academic career establish-ment in research and development during periods that usually overlap with family formation. Though women tend to leave science mainly after obtaining their PhD, and the timing of mother-hood plays a vital role in a successful research career, qualitative data on this life period are scarce. Our paper focuses on how the normative and institutional contexts shape female PhD engineering students’ family plans. The research was based on intersections of life course and risk and uncertainty theories. Using qualitative interviews we explored how contradicting social norms of childbearing cause tensions in postgraduate students’ lives, and how the different uncer-tainties and risks permeate young researchers’ decisions on early life events. We concluded that, despite the general pattern of delaying motherhood among higher educated women, these students struggle against this postponement, and they hardly have any good options to avoid risk stem-ming from uncertainties and from some characteris-tics of studying and working in engineering. Find-ings of this research may call the attention of stake-holders to possible intervention points.

Acontecimentos Traumáticos, Sentimentos de Vergonha na Relação com os Sintomas Depressivos na Adolescência: estudo longitudinal

Introdução: As experiências adversas na infância, tal como a exposição a acontecimentos traumáticos e vivências de vergonha, podem ter um contributo importante na vida dos adolescentes moldando a forma estes se percecionam a si próprios e aos outros, e como lidam com as adversidades, podendo aumentar a sua vulnerabilidade para desenvolver uma perturbação depressiva. Este estudo, de desenho longitudinal, consistiu em estudar os factores preditores (acontecimentos de vida traumáticos e sentimentos de vergonha) no desenvolvimento de psicopatologia depressiva a seis meses. Método: A amostra é constituída por 325 adolescentes, com idades compreendidas entre os 12 e os 18 anos a frequentar o 3º ciclo do ensino básico e ensino secundário. Para o estudo das variáveis referidas, foram utilizados os seguintes instrumentos de medida: o Child Depression Inventory, o Childhood Trauma Questionaire e a Escala de Vergonha Externa. Resultados: Os resultados obtidos relativamente à estabilidade absoluta das variáveis demonstram diferenças significativas entre os valores médios do 1ºmomento de avaliação e do 2º momento de avaliação (após 6 meses) para a variável vergonha. Ao longo do estudo, verificou-se uma associação positiva entre as variáveis relacionadas com o trauma e os sentimentos de vergonha avaliados no primeiro tempo (T1) e a variável sintomas depressivos (T2). O modelo de regressão linear múltipla, explicou 63% da variância dos sintomas depressivos no tempo 2, mostrando que o facto de pertencer ao sexo feminino, experienciar mais vivências de vergonha, e mais experiências traumáticas de abuso afetivo, abuso sexual e de negligência emocional permitem predizer mais sintomas depressivos na adolescência. Conclusão: Podemos concluir com a presente investigação, que o impacto de acontecimentos traumáticos, do tipo abuso/negligência, bem como de sentimentos de vergonha durante a fase da adolescência pode ser nocivo para o desenvolvimento harmonioso posterior, nomeadamente no desenvolvimento de sintomatologia depressiva. / Introduction: The adverse experiences in childhood, such as an exhibition of traumatic events and experiences of sham can have important contribution in teenager’s life shaping the way they perceive themselves and the others and how they deal with adversity, increasing their vulnerability to develop a depressive disorder. This study, longitudinal design, it was consisted in study of the predictive factors (traumatic life events and feelings of shame) in the development of depressive psychopathology in six months. Method: The sample consisted of 325 adolescents aged between 12 and 18 years attending the 3rd cycle of basic education and secondary education. To the study of the variables mentioned, the following measuring instruments were used: the Child Depression Inventory, the Childhood Trauma Questionnaire and External Shame Scale. Results: The results obtained regarding the absolute stability of the variables showed significant differences between the mean values of the evaluation 1st moment and 2nd moment of evaluation (after 6 months) for the variable shame. Throughout the study, there was a positive association between variables related to the trauma and feelings of shame evaluated at the first time (T1) and the variable depressive symptoms (T2). The multiple linear regression model explained 63% of variance in depressive symptoms at time 2 , showing that the fact of being female experience more shame experiences, and most traumatic experiences of emotional abuse, sexual abuse and emotional neglect permit predict more depressive symptoms in adolescence. Conclusion: We can conclude with this research, that the impact of traumatic events, the type abuse/neglect, as well as feelings of shame during adolescence can be harmful to the subsequent harmonious development, including the development of depressive symptoms.

Towards Empowerment: Narrative Study of Counselling Psychology Trainees and How They Make Sense of Their Personal and Professional Development in the Context of Their Past Experiences

The discipline of counselling psychology continues to grow and change in response to social, economic and political pressures. It has been argued that its quest for a coherent and distinct identity, which emphasises the possibility of the coexistence of multiple approaches, creates an inherently uncertain and dilemmatic training environment that may hinder the development of trainees’ professional identities. In order to gain a deeper understanding of the issue at hand, the aim was to explore how final year trainees and newly qualified counselling psychologists constructed and made sense of their emerging professional identities and what experiences, past and present, they drew upon in the context of their training to shape those identities. Applying narrative inquiry to analyse eight open-ended interviews, eight preliminary themes were originally identified in participants’ narratives, which with further refinements lead to stories of struggle and marginalisation, growth and discovery, and power and resilience. Participants’ stories of struggle and marginalisation emerged in reference to early family dynamics and stressful life experiences, which seemed to also foster a strong identification with the counselling psychology profession, while stories of growth and discovery focused on the importance of having supportive figures, who helped to instill a sense of security and create an atmosphere of openness. It was in this learning environment that participants felt it was possible to develop a more resilient, empowered professional self, which allowed them to shed an earlier sense of struggle and vulnerability. However, where more of an emphasis was placed on power and resilience, there seemed to be less room for participants to express other feelings that came into conflict with their preferred sense of professional self. While there seems to be a need for a ‘safer’ climate, in which trainees could voice and acknowledge anxieties, vulnerabilities and limitations, addressing concerns around power and vulnerability that may be contributing to the silencing of particular voices and identities may be equally important if trainees are to develop coherent and distinct counselling psychologist identities.

History of Premenstrual Mood Change and Postpartum Episodes are Associated with Perimenopausal Episodes in Women with Bipolar Disorder

Background and Aims: Reproductive life events are potential triggers of mood episodes in women with bipolar disorder. We aimed to establish whether a history of premenstrual mood change and postpartum episodes are associated with perimenopausal episodes in women who have bipolar disorder. Methods: Participants were 339 post-menopausal women with DSM-IV bipolar disorder recruited into the Bipolar Disorder Research Network (www.bdrn.org). Women self-reported presence (N = 200) or absence (N = 139) of an illness episode during the perimenopausal period. History of premenstrual mood change was measured using the self-report Premenstrual Symptoms Screening Tool (PSST), and history of postpartum episodes was measured via semi-structured interview (Schedules for Clinical Assessment in Neuropsychiatry, SCAN) and inspection of case-notes. Results: History of a postpartum episode within 6 months of delivery (OR = 2.13, p = 0.03) and history of moderate/severe premenstrual syndrome (OR = 6.33, p < 0.001) were significant predictors of the presence of a perimenopausal episode, even after controlling for demographic factors. When we narrowed the definition of premenstrual mood change to premenstrual dysphoric disorder, it remained significant (OR = 2.68, p = 0.007). Conclusions: Some women who have bipolar disorder may be particularly sensitive to reproductive life events. Previous mood episodes in relation to the female reproductive lifecycle may help clinicians predict individual risk for women with bipolar disorder approaching the menopause. There is a need for prospective longitudinal studies of women with bipolar disorder providing frequent contemporaneous ratings of their mood to overcome the limitations of retrospective self-report data.

Trajetórias de vida e a opção pelo sistema de suporte no concelho de Mira

Objetivos: O processo de duplo envelhecimento é universal. Em Portugal, este processo é acompanhado por um aumento e diversificação dos sistemas de suporte. Perante esta realidade, surge a necessidade de investigação acerca dos acontecimentos que influenciam na escolha do sistema de suporte. Assim, os objetivos deste estudo são perceber se as trajetórias de vida influenciam nesta escolha compreender os condicionantes e condicionadores inerentes a esta opção. Metodologias: Este é um estudo exploratório de abordagem quantitativa e qualitativa (análise estatística descritiva, correlacional e de conteúdo). A amostra é composta por 255 pessoas idosas: 130 não usufruem de qualquer resposta social e 125 frequentam uma resposta social. Aplicou-se um inquérito de questões fechadas e abertas que abrangia diversas áreas como acontecimentos de vida, envelhecimento, e equipamentos utilizados, etc. Resultados: Os resultados indicaram que as pessoas idosas preferem o cuidado familiar em detrimento das respostas sociais, em caso de necessidade. Foi possível aferir que variável “com quem vive” relaciona-se significativamente com a opção pelo cuidado em caso de necessidade. As pessoas que vivem com o cônjuge e/ou filhos optam preferencialmente pelo cuidado familiar. Conclusões: Dado os resultados apresentados considera-se importante o desenvolvimento e adaptação do sistema de suporte social nomeadamente das famílias e da rede de suporte formal. Estes devem desenvolver-se e organizar-se para que seja possível tornar exequível as preferências de cuidado da pessoa idosa seja este ou não nos seus próprios meios.