Browsing by Subject "psychosis"

Filter results by typing the first few letters
Now showing 1 - 2 of 2
  • No Thumbnail Available
    ItemOpen Access
    Caregiver Perspectives on Social Support for Individuals Living with Psychotic Disorders in Tanzania
    (2021-04-20) Desjardins, Monica
    In low-resource settings like Tanzania, individuals living with psychotic disorders must rely on their families for much of their financial and social support, thus leading family members to informally become their primary caregiver. Therefore, how relatives understand, think about, and implement their caregiving roles can have a profound impact on the recovery pathways for their relatives living with mental illness. This thesis will explore how relatives describe their support roles, including their strengths and areas where they state they need additional support. Twenty semi-structured in-depth interviews were conducted with relative caregivers of adults living with psychotic disorders in Tanzania. These transcripts were coded and analyzed thematically using content analysis to distinguish their perspective surrounding the relative's role and sentiments as a caregiver. Themes of instrumental support, emotional support, informational support and appraisal for the individual living with psychosis, along with caregiver expectations from the patient, providers and greater community were identified. Analyses revealed that: 1) financial and basic needs are critical, 2) acceptance and desire for improvement in relatives’ well-being, 3) there are information/ knowledge gaps for how to promote recovery via social support, and 4) caregivers bear more responsibility than communities for care but caregivers also expect more from affected individuals, providers and the community. Despite the constant and necessary provision of social support administered by these caregivers, the support of the caregivers themselves should also be recognized and in order to fully aid those who are living with mental illnesses.
  • Thumbnail Image
    ItemOpen Access
    Neurofunctional Characterization of the At-Risk Mental State for Psychosis
    (2014) Sumner, Elizabeth Johnson

    Schizophrenia is a complex and debilitating psychiatric illness characterized by positive symptoms like hallucinations and delusions and negative symptoms like blunting of affect, avolition, and poverty of thought. This constellation of symptoms is hypothesized to result from dopaminergic dysfunction, glutamatergic dysfunction, and dysfunctional stress-reactivity. Prior to the onset of schizophrenia there is a prodromal period when individuals begin to experience sub-clinical symptoms and decreased functioning. This period is important to study not only to help elucidate biologic mechanisms of the illness but also to potentially alter the course of the illness through early treatment. The difficulty of studying this period lies in its recognizing it prospectively. To address this researchers have begun to study the at-risk mental state, a state that is associated with a high but not inevitable risk of conversion to psychosis. The studies described in this dissertation are aimed at a neurofunctional characterization of the at-risk mental state in three primary domains: reward-anticipation, hippocampus-dependent learning, and stress-reactivity. Individuals at-risk for psychosis and age-matched healthy volunteers underwent functional magnetic resonance imaging while performing tasks targeting these domains. In the reward-anticipation task, at-risk individuals showed decreased ventral tegmental area (VTA) and dorsolateral prefrontal cortex (DLPFC) responses to reward anticipation. In the hippocampus-dependent learning task, at-risk individuals showed deficits in hippocampus-dependent memory, decreased VTA engagement, and increased DLPFC activation during learning of associations between items. In the stress-reactivity task, at-risk individuals showed increased activation in the bed nucleus of the stria terminalis/basal forebrain (BNST), anterior cingulate cortex (ACC), and medial prefrontal cortex (mPFC) in response to neutral faces. Collectively, these experiments show that neurofunctional deficits in reward-anticipation, hippocampus-dependent learning, and stress-reactivity are present in the putative prodrome, prior to the onset of psychosis. Regions implicated are those that would be expected based on current models of schizophrenia and neurofunctional studies in those with frank psychosis.