Wickedness in Design for People Diagnosed with Schizophrenia

With the digitisation of society, e-health technology increasingly supports new design situations that extend those traditional to Information Systems, and therefore need to be better understood. In design for complex, new and sensitive design situations, it is not possible to apply known methods and solutions without a deeper situational understanding. These design situations are fraught with wicked problems that are contradictory and complex. This paper intends to answer how the wickedness of the design situation when designing e-health technology for people diagnosed with schizophrenia can be understood and what consequences the design situation has for the design process. The paper presents a grounded theory analysis of stakeholder interviews and focus group interviews with people diagnosed with schizophrenia. Four wicked problems are identified: struggle of dependence, contradiction of social interaction, contradiction of trust and counteracting improvement behaviour. The problems are interrelated and have consequences for the design, acceptance, use and user involvement in design of e-health technology for people diagnosed with schizophrenia. The paper also shows the viability of using grounded theory for studying and describing situational wickedness

An empirical and theoretical investigation of psychodynamic psychotherapy and neuroleptic medication for the treatment of schizophrenia

Since the early 1950s, biopsychiatric conceptualizations have dominated empirical, theoretical and therapeutic efforts to understand the treatment of schizophrenia. The contemporary preeminence of biopsychiatric conceptualizations of schizophrenia have overshadowed other perspectives that might contribute fruitfully to our capacity to understand and aid individuals suffering with this devastating emotional disorder. The origin of modern biopsychiatric conceptualizations is deconstructed by illuminating the non-epistemic underpinnings of Emil Kraeplin\u27s dementia praecox concept, which is the forerunner of the modern schizophrenia construct. Two widely held assumptions of the biomedical model, namely: 1) that schizophrenia is a degenerative, organic brain disease; and 2) that neuroleptic medications are the most effective and safest treatment of schizophrenia are empirically reviewed. Psychodynamic theory and therapy alternatives are also reviewed empirically and theoretically.The comparative effectiveness of Psychodynamic Psychotherapy-only (n = 9) and Medication-only (n = 12) was investigated using an experimental design (Karon & VandenBos, 1981). All patients were administered the Thematic Apperception Test (TAT) at pre- and post-treatment (20 months). Westen\u27s (1995; Hilsenroth, Stein, & Pinsker, 2004) Social Cognition and Object Relations Scale (SCORS) was used to rate pre- and post-treatment TAT narratives in order to assess changes in the cognitive and affective aspects of patients\u27 object relations throughout treatment. Jacobson and Truax\u27 (1991) Clinical Significance methodology was used to detect clinically significant change for each individual patient. Results show the SCORS is a reliable and valid instrument for use with a schizophrenia sample.Treatment outcome results suggest that patients receiving psychodynamic psycotherapy exhibit clinically significant change in a variety of object relations domains when assessed at the group and individual levels. Comparative analyses indicated that Psychodynamic Psychotherapy-only patients outperformed Medication-only patients in regard to changes in a variety of object relations domains. Medication-only patients did not outperform Psychodynamic Psychotherapy-only patients in any domain of object relations. Significantly more Medication-only patients exhibited clinical regression compared to patients receiving psychodynamic psychotherapy. (Dr. Leonard Handler served as the chairperson of this dissertation committee.

The role of personality in posttraumatic stress disorder, trait resilience, and quality of life in people exposed to the Kiss nightclub fire

Objective To evaluate the relationship among personality (according to Cloninger’s psychobiological model), posttraumatic stress disorder (PTSD) symptoms, trait resilience and quality of life (QoL) in people who were exposed to the Kiss nightclub fire. Methods 188 participants were assessed with the Posttraumatic Checklist–civilian version (PCL-C), the Resilience Scale (RS), the Temperament and Character Inventory (TCI), the World Health Organization Quality of Life–Bref (WHOQOL-Bref), and the WHOQOL-100 Spirituality, religiousness, and personal beliefs (WHOQOL-100-SRPB). Data were analyzed in a dimensional approach, with correlation analysis, multiple linear regression and Structural Equation Modeling (SEM), with PCL-C, RS, and WHOQOL-Bref dimensions as dependent variables. Results Multiple linear regression showed that PTSD symptoms were predicted by harm avoidance (β = .34, p < .001), self-directedness (β = -.28, p < .01), and self-transcendence (β = .24, p < .01). Trait resilience was predicted by harm avoidance (β = -.38, p < .01), self-directedness (β = .20, p < .05), and self-transcendence (β = .18, p < .05). Also, PTSD symptoms had considerable negative effect on all dimensions of QoL. Self-transcendence was a positive predictor of subjective and spiritual QoL. SEM showed that QoL was predicted by PTSD symptoms (β = -.52, p < .001), trait resilience (β = .30, p < .001), cooperativeness (β = .135, p = 0.40), and self-directedness (β = .27, p < .01). The effect of self-directedness on QoL was mediated by PTSD symptoms and trait resilience. PTSD symptoms also mediated the relationship between trait resilience and QoL, and RS mediated the relationship of personality and PTSD symptoms. Conclusion The study gives insights on prediction of PTSD severity, trait resilience and QoL from temperament and character traits, in a sample of people exposed to the Kiss nightclub fire. Harm avoidance was the most influent trait on PTSD symptoms and trait resilience. Selfdirectedness was the most import trait related to QoL, still that it was more related to PTSD severity than personality traits. Self-transcendence had positive effects on both PTSD symptoms and trait resilience, indicating a coping style that may coexist with psychopathology

The portrayal of Paedophilia in the media: An analysis of themes and stigma in South African newsprint media 2013-2018.

Master of Social Science in Clinical Pyschology. University of KwaZulu-Natal, Pietermaritzburg, 2019.Child sexual offenders and paedophilic acts are highly controversial and widely debated topics, especially in the media. An assumption is made that paedophilic acts are among the most highly stigmatised and misunderstood behaviours. However, an examination of print media portrayals of paedophilic acts, potentially perpetuating the stigma attached to paedophiles, especially in a South African context, has yet to be conducted. This study aimed to address this issue by examining South African print media reports i) to identify themes concerning paedophilic acts, ii) to determine whether such themes portray paedophilic acts in accordance with scientific research on paedophilia and the media and iii) how this reporting might impact on the stigma attached to paedophilia. South African newsprint articles were located and analysed using thematic analysis to identify key themes that emerged from the data and juxtaposed with scientific literature on the topic of paedophilic acts, the media and stigmatisation. The study found nine dominant themes (and four sub-themes). These themes aligned with the scientific literature on the media, perpetuating stigma associated with paedophilia and paedophilic acts. Keywords: Paedophilic acts; Paedophilia; Child sexual offenders; Paedophiles; Mental illness; The media; Stigmatisation; Thematic analysis; Qualitative methods

AD/HD and autism spectrum disorders in adults

Background: Attention deficit/hyperactivity disorder (AD/HD) and autism spectrum disorders (ASDs) are early-onset, but often life-time impairing, neurodevelopmental disorders. They are highly overlapping and seem to carry considerable risks of negative outcomes, psychiatrically and psychosocially. Childhood hyperactivity is a known risk factor for early-onset conduct disorder (CD), but details concerning the associations between neurodevelopmental problems, aggression, and antisocial personality disorder (ASPD) in adult age are still uncertain. The current diagnostic subdivision of the ASDs is based on children, while the adult characteristics, including patterns of comorbidity and psychosocial adversities, have been less studied, especially in subjects without concomitant intellectual disability. Objectives: The overall aim of this thesis was to describe the adult outcome of AD/HD and ASDs. Specific aims were to: (1) review prospective, longitudinal studies of the adult outcome of childhood hyperactivity, equivalent to AD/HD, with special regard to ASPD, (2) investigate the relationships between AD/HD, ASDs, and different types of aggressive behaviours, (3) describe the clinical presentation, including personality development and psychosocial outcome, in normal-intelligence adult subjects with ASDs. Method: The first paper is a systematic meta-analysis of published studies. The subsequent studies are descriptive analyses of common clinical assessment protocols from consecutive groups of adults either referred for clinical evaluations of childhood-onset neuropsychiatric disorders, for forensic psychiatric investigations, or recruited to a population-based, longitudinal study of teenage-onset anorexia nervosa (AN). Results: Childhood hyperactivity increases the risk for CD, which is found in at least one-third of all hyperactive children, forming the starting point for the development of aggressive antisociality in adulthood in about half of cases with the combination of hyperactivity and CD in childhood. Support for the hypothesis that childhood hyperactivity, in the absence of early CD, carries a risk for adult ASPD, is still lacking (Paper I). Both conditions are, however, predictors of aggression in adults, together with substance-related disorders and poor development of the character trait Cooperativeness. ASD traits or symptoms did not generally predict aggression but may be associated with unique violent offences (Paper II). Among subjects with normal-intelligence ASDs, life-time psychiatric comorbidity was very high, and measures of outcome indicated low psychosocial functioning. AD/HD was common in all ASD subject categories studied with the notable exception of subjects with AN, none of whom had AD/HD. ASPD and substance-related disorders were more common in patients with an atypical ASD as compared to Asperger´s disorder or autistic disorder. Among all adults diagnosed with an ASD, less than half led an independent life and comparatively few had ever had a long-term relationship. Female subjects more often reported having been bullied at school than male subjects (Paper III and IV). Discussion and conclusions: Childhood-onset neuropsychiatric conditions such as AD/HD and ASDs are relevant for adult psychiatric phenotypes but insufficiently studied. Current classifications suffer from the hiatus between child- and adolescent psychiatry and adult psychiatry and future diagnostic concepts ought to be longitudinal with a life-time perspective on cognitive and emotional development and a patient-centred focus rather than fragmented into complex patterns of “comorbidities”

UNIQUELY GIFTED: A THEOLOGY OF MENTAL ILLNESS FOR INCLUSIVE ECCLESIOLOGY

This thesis surveys the possibility of a theology of mental illness in order to create an inclusive ecclesiology for modern churches. Mental illness is greatly stigmatized in the Church as demonic or spiritual and moral failing. In combat of such stigma and prejudice to create an inclusive atmosphere in the Church, a positive theology of mental illness understood as a unique gifting is argued for. With the elusive nature of mental illness in both definition and experience taken into account, all aspects of mental illness are considered, such as biology, psychology, and philosophy of mental disorder. The thesis understands mental illness in light of the Imago Dei and considers an adapted model of disability theology to rationalize such ideas. In addition, historical figures displaying symptoms of mental illness are compared with the uniquely gifted individuals in Scripture to see similarities. From these ideas, a theology of mental illness is positively constructed as a unique gifting. With a positive theology of mental illness given, models for practical inclusion are given for clergy and laity to implement

Three Tries

Three Tries is an interdisciplinary exhibition featuring installation, sculpture, and performance that explores the experiences of a Queer nonbinary individual growing up in the Baptist Christian South. The exhibition centers around the reclamation of the body, identity, and space, drawing parallels between the baptist christian holy trinity of father, son, and the holy ghost and Sigmund Freud\u27s Trinity of id, ego, and superego. By returning to the developmental stages of one\u27s life, the exhibition serves as a revolutionary attempt to isolate the id and disentangle the workings of the id, ego, and superego. Three Tries represents a visual framework for discovering the deepest parts of oneself and transforming into something greater than one\u27s past

Counseling and the Demonic - Full text

This is the full text of Counseling and the Demonic, by Rodger K. Bufford, PhD. Word Publishing (June 1, 1995) ‎ 978-0849936166 Table of Contents: 1. The Devil Made Me Do It 2. Satan Is Alive and Active 3. Biblical Accounts of Satanic Activity 4. Faulty Thinking: Separating the Spiritual and the Physical 5. Mental Illness 6. Mental Disorders 7. Demon Possession 8. Demonic Influence and Mental Disorders 9. Assessment and Diagnosis of Demonic Influence 10. Spiritual Interventions 11. Counseling Approaches 12. Summary and Conclusion The tendency to polarize the material and spiritual dimensions produces disagreement over whether demonic influence or mental disorders accountfor unusual human behavior. This disagreement has a long history, and continues both inside and outside the Christian church. It will be our goal to examine both sides of this issue, to suggest that mental disorders and demonic influence are related, and to recommend ways to identify and treat personsexperiencing demonic involvement

Stigma: Personality disorder and homicide in the U.K. red-top tabloid press, 2001-2012

There is evidence of stigma towards people with personality disorder from within healthcare systems, but relatively little known about other aspects of stigmatisation. This study explored the image within the red-top tabloids of people with personality disorder who have committed homicide and how this may have contributed to the processes of stigmatisation. The analysis was underpinned by a symbolic interactionist perspective on individuals and society and was informed by the modified labelling model. The role the press plays in the processes of stigmatisation is elaborated through exploration of the theoretical models and empirical evidence. The data set for the thesis was articles published by the red-top tabloids between the years 2001 and 2012 (inclusively) that made reference to personality disorder. The data set was analysed using three methods: content analysis, corpus linguistics and frame analysis. The three methods were used in a mixed methods approach with a sequential design so that the results from one stage of the analysis fed into the next stage. The content analysis of the data set identified that of the 552 articles published about people with personality disorder, 42% met the criteria for being homicide themed. Analysis identified that there was a significant reduction in the proportion of homicide themed newspaper articles in the period 2007-2012 compared to 2001-2006 ((1, n=552) = 7.38, p < .05), however, the effect size was small (φ = .12). Corpus linguistics analysis was used on articles that were homicide themed and identified 22 words that were stigmatising in their use, and were used proportionally more frequently than a comparator data set. These words were categorised as either epithets (e.g. psycho, monster), qualities (e.g. evil) or contributing to the process of labelling (e.g. branded). Comparison between 2001-2006 and 2007-2012 identified a proportional increase in the use of stigmatising descriptors, but to a level that was not considered to be significant ((1, n=114110) = 1.53, p > .05). Frame analysis of the homicide data set identified a dominant news frame in the articles, referred to as lock them up and throw away the key. This news frame was structured on a model that the problem was a failure to protect us, the public, from the risk presented by them, dangerous people with personality disorder who commit homicide. The results of the study are discussed in relation to the model elaborated in the study of the role the red-top tabloids may play in the processes of stigmatisation. Implications for practice include using personality disorder in press guidance, and training for clinicians about attitudes towards people with personality disorder to include reviewing the impact of the press