Trent University                                    Dr. R. Walters

PSYC-3760-Winter-2010                  18/02/2010

Gender Identity Disorder (GID) as it is defined by the American Psychiatric Association has gained considerable attention since the late 1980’s when it was first described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) in 1987. The majority of referrals made to psychological health professionals for suspected cases of GID between 1988 and 2007 were for children. Adolescent referrals also experienced an incline in referrals during the same time, but a sharp increase in the number of referrals for adolescents did not occur until 2000. This was possibly because the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) published in 2000 removed the GID diagnosis from its previous location under Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence to the section of the DSM that concerns itself with Sexual and Gender Identity Disorders (Zucker, Bradley, & Owen-Anderson et al, 2008).

While there are surprisingly few studies that have been done to determine the prevalence of GID in any culture or at any age-range, it has been suggested by Kenneth J. Zucker – who runs the only GID-specific treatment center in North America at the Centre for Addiction & Mental Health in Toronto, ON, Canada – that medical and mental health care professionals concern themselves less with the establishment of a firm and accepted aetiology of GID but more with the best practices needed to formulate effective treatment and support plans for individuals diagnosed with GID at any age (Zucker, 2008).

Various theories regarding the aetiology of GID have been proposed since 1974 that have ranged from purely psychosocial to prenatal endocrine affects in the womb. Zucker’s suggestion that health care professionals focus on therapeutics at this time rather than aetiological concerns may, if practiced accordingly, provide indications about the actual aetiology of the disorder through the characteristics of the treatments now being provided.

There appears to be a certain level of malleability correlated with the age of the individual diagnosed with GID in which the individuals discomfort with their assigned gender and desire to transition to the opposite sex can be reversed (Zucker, 2008). This both supports and contrasts some of the more traditionally hailed etiological theories of GID and will be discussed further.

If nothing else can be demonstrated the discussion of critical literature will show that treatment implications for GID are age-sensitive and that treatment becomes more complex as the patient ages.

While currently there is no dogmatic approach to the treatment of individuals with GID, The World Professional Association for Transgender Health (WPATH) formerly known as the Harry Benjamin International Gender Dysphoria Association (HBIGDA) has formulated an unofficial Standards of Care (SOC) document that is designed to assist health care professionals formulate case-specific approaches to the care for individuals diagnosed with gender dysphoria, and if appropriately diagnosed, Gender Identity Disorder (Meyer, Bockting, & Cohen-Kettenis, 2001).

The SOC has undergone six revisions since its original publication in 1979. Currently the SOC is patient-oriented and states that the “goal of psychotherapeutic, endocrine, surgical therapy for persons with gender identity disorder is the lasting personal comfort with the gendered self in order to maximize overall psychological well-being and self-fulfillment” (Meyer, Bockting & Cohen-Kettinis, 2001, pg 1). Currently the goals of treatment for GID are concerned with the over-all quality of life of the individual, which is concurrent with the goals outlined in the SOC.

While aetiology has not yet been confirmed – which is true of most psychiatric disorders outlined in the DSM – and currently it is accepted amongst most experts in the field of gender identity that the aetiology must have to do with a discrepancy between the genetic sex of the individual and the individual’s gender. The individual’s gender is proposed by some to be a product of learning and influence (Diamond & Sigmundson, 1997) while others propose hormonal causes, such as Milton Diamond’s Organization-Activation theory which proposes that androgen levels in the womb determine sex but that infants are born gender-neutral, and that later in life a delayed hormonal activation in relation to the individuals environment designates the gender of the individual (Diamond, 2004; 2009).

Decisions about treatment for a paediatric patient presenting with gender dysphoria is often reliant upon the primary care physician to whom the individual is presented to. According to Zucker, parents of these individuals will either be advised by the physician that the Dysphoria is a phase and that the child will grow out of it, or be referred to a specialist (Stein, Zucker, & Dixon, 2001). Zucker believes that gender Dysphoria is only most likely to remit within a narrow window during early childhood, and that at this stage psychotherapeutic interventions have their best chance of helping the child to adopt the same gender as their assigned sex. Adolescents are less likely to remit, though still may change their minds, and that adults are the very least likely to remit (Zucker, 2008). Important distinctions must be made about whether a child is merely engaging in cross-gender behaviour or actually has feelings of gender-confusion or gender dysphoria and that if the behaviour has no bearing on gender internalization, the behaviour will likely cease (Möller, Schreier, Li & Romer, 2009).

Age has been shown to be an important consideration in the treatment of individuals with GID because it holds with it different levels of likelihood that the individual will change his or her mind. The treatments for GID range from the purely psychotherapeutic to the complete cosmetic and hormonal restructuring of the individuals primary and secondary sexual characteristics. Hormonal and surgical treatments have varying degrees of reversibility therefore it is important to consider the implications of the age of the patient, as it bares directly on what can be considered appropriate to relieve the patients symptoms at the time of presentation with consideration about the patient’s future feelings and life-long quality of life.

References

American Psychiatric Association. (1987). Diagnostic and Statistical Manual of Mental

Disorders (3^rd Ed. Rev.). Washing, DC.

American Psychiatric Association. (2000). Sexual and gender identity disorders. In Diagnostic

and Statistical Manual of Mental Disorders (Txt. rev.) (pp. 535-582). Washington: DC.

Diamond, M., & Sigmundson, H. K. (1997) Sex Reassignment at Birth: Long-Term Review and

Clinical Implications [Electronic version]. Archives of Pediatric and Adolescent Medicine,

151: 298-340.

Diamond, M. (2004). Sex, Gender, and Identity over the Years: A changing perspective

[Electronic version]. Child and Adolescent Psychiatric Clinics of North America, 13:

591-607. Retrieved on February 16, from the Pacific Center for Sex and Society.

http://www.hawaii.edu/PCSS/biblio/articles/2000to2004/2004-sex-gender-and-

identity.html#36.

Diamond, M. (2009). Clinical implications of the organizational and activational effects of

hormones [Electronic version]. Hormones and Behaviour, 55; 621-632.

Möller, B., Schreier, H., Li, A., & Romer, G. (2009). Gender identity disorder in children and

children and adolescents. Current Problems in Pediatric and Adolescents in Health Care, 3,

117-143.

Stein, M. T., Zucker, K. J., & Dixon, S. D. (2001). Sammy: Gender identity concerns in a

6-Year-Old boy [Electronic version]. Pediatrics, 107; (4) 850-854.

Meyer, W., Bockting, W. O., Cohen-Kettenis, P., Coleman, E., DiCeglie, D., & Devor, H. Et al.

(2001). Standards of Care for Gender Identity Disorders (6^th Ed.) [Electronic version]. The

Harry Benjamin International Gender Dysphoria Association. Retrieved February 13, 2010.

from http://wpath.org/Documents2/socv6.pdf

Zucker, K. J. (2008). Children with gender identity disorder: Is there a best practice? [Electronic

version]. K. J. Zucker (Trans.). Neuropsychiatrie de l’enfance et de l’adolescence, 56;

358-364. Retrieved February 11, 2010, from ScienceDirect database.

Zucker, K. J., Bradley, S. J., Owen-Anderson, A., Kibblewhite, S. J., & Cantor, J. M. (2008).

Is gender identity disorder in adolescents coming out of the closet?, Journal of Sex &

Marital Therapy, 34; 4, 287-290. Retrieved February 12, 2010, from Canadian Research

Knowledge Network database.

C. H. E. Anderson                        Adolescent Psychology

Trent University                          P. Franke

PSYC-351-Fall-2009                  08/12/09

The Development of Adult Identity in Individuals with Mental Illness Persisting Through Adolescence into Emerging Adulthood.

Developmental psychology has taken to partitioning the life-span into distinct temporal segments during which characteristic physical, psychological, and socio-cultural miles stones of development are expected to be achieved. Successful completion on one developmental stage indicates that the developing individual is likely capable of completing the next stage in their maturation (Erikson, 1977; Zimmerman et al, 1997).

Currently research into a mid-stage between adolescence and adulthood has been dubbed young adulthood, or emerging adulthood, and at least in western cultures young adults between the ages of eighteen to twenty-five (and sometimes older) have been profiled as a distinct sect of adults who are caught somewhere between adolescence and full independence as mature adults (Arnett, 2000). There is empirical support that young adults are a statistically independent population of their own when examined against adolescents and full-fledged adults on the MMPI in which their scores were found to be midline between the other groups, but distinct in their range (Pancoast & Archer, 1992).

This age range has now arguably become a stand-alone developmental stage of its own that is dependent upon previous development and has lasting consequences for full-fledged adulthood, particularly if psychopathologies present at an early age. (Charlotte et al, 2007; Crawford et al, 2008; Crum et al, 2008; Fontaine et al, 2008).

Freud is perhaps one of the first figureheads in psychiatry to develop a progressive model of development that demonstrated the role failed or perverted development had in the genesis of psychopathology. Freud propositioned that failure of a child to progress successfully through the stages of psychosocial development in early life would later result in fixations and repressions that lead to neuroses in adult life.

In psychiatrist John Bowlby’s theory of attachment in children, he showed that while the period in which attachment develops is brief, the consequences of negative or dysfunctional attachment tendencies had permeating effects on the likelihoods that certain children would develop healthy and secure relationships later in life, or if they would experience varying degrees of difficulty in forming and maintaining meaningful relationships, again demonstrating that unsuccessful development at pertinent points in the life-span heighten the likelihood of detrimental manifestations in related areas in later life (Hunter, 2001). Temperament was in early childhood is related to anxiety later in childhood which can contribute to more ongoing issues as the life stages progress (Grant et al, 2009).

Erik H. Erikson is generally considered to be a pioneer in the study of identity and personality and how these internal qualities evolve throughout the entire life-span. Erikson’s eight stages of development are focused on acquiring or failing to acquire certain virtues he believed to be pertinent in successful development of the self and one’s personality. Each virtue or stage has two opposing psychosocial capacities that must be resolved before the individual is capable of proceeding to the next stage of development (Erikson,1977).

While all stages in Erikson’s model bare relevance to the topic of this paper, there are two stages of particular applicability: stage five; Identity vs. Role Confusion, which occurs during adolescence, and stage six; Intimacy vs. Isolation, which occurs during young adulthood. A great number of changes occur during young adulthood in which the young adult’s personality takes a firmer shape and may change as accomplishments and failures affect hopes, ambitions, status, and senses of reality (Robins et al, 2001).

During adolescence an individual is taxed primarily with understanding their maturing body, but also with understanding and developing their abstract views of themselves. It is a time in which adolescents question who they are, and who they might like to be. The foundation for lasting identity and a sense of self are laid during Adolescence and then challenged during young adulthood when their primary concern is not only who they are as an individual, but who they are as a member of society and who they might like to develop attachments with (Doherty & Feeney, 2004).

A considerable amount of research has gone into characterizing and deciphering emerging adulthood and also in establishing what is considered successful completion of this stage and what is considered not to be successful. The mile stones that must be reached and addressed during young adulthood range from finding an acceptable mate, to completing the prerequisites for a chosen career path; deciding to attend college or university, or to merely join the work force; deciding to pursue a family or to wait and reconsider later. Many, if not all of the mile-stones in life, are in some way defined socially through the individual’s relations to others.

A great deal of pressure is placed on young adults to make decisions and to cope with new responsibilities. They are asked in so such words to prove themselves as gainful members of the community and to establish themselves as self-sufficient and satisfied adults. The pressure to figure everything out on your own and not to make any mistakes is high for young adults, particularly those attending post-secondary institutions or planning to pursue difficult career paths (Shaffer, Wood, & Willoughby, 2005)

Young adulthood is a competitive time in which young people are pitted against one another to get into the best universities, to get the best grades, to hold down the best job and date the most promising potential mate. For healthy young adults, this period of their lives can be the most stressful and challenging part of their lives, but they will emerge successfully (Shaffer, Wood, & Willoughby, 2005).

It has already been established throughout the 20^th century that individuals who suffer from psychiatric pathologies are at a gross disadvantage in life when it comes to achieving and maintaining gainful employment, healthy relationships, independence and other annals of adult life in western society.

Psychiatric patients are contraindicated in participating in one of the most respected and valued psychometric measures of human intelligence; the Wechsler Adult Intelligence Scale-III (WAIS-III) is designed to measure “and individual’s potential for purposeful and useful behaviour’, as well as their cognitive abilities and personality traits. Because certain responses on the WAIS-III may indicate psychological disturbances, those already established as psychologically are inadmissible takers of the test battery (Wechsler, 1997).

Psychiatric patients are plagued by not only the symptoms of their conditions, but also by the stigma that follows their status as a psychiatric patient. As illustrated above by the WAIS-III contraindication for psychiatric patients, science has often written the psychological disturbed off as inadmissible, unfortunate, and of little use to society. For some, the presence of a mental illnesses, whether properly managed or not, is enough to exclude the individual from occupational pursuits (Manning & White, 1995) and even dating services and social clubs (Lauber et al, 2004). Society does not follow far behind the opinions of science, and the mentally ill have been cast out as a collective by both.

The recurrent and omnipotent rejection and occlusion that follows psychiatric patients throughout their lives are, in themselves, lasting trauma’s that not only add to the stress of managing their conditions, but can also promote an escalation of symptoms in patients with anxious symptoms, depression, and fragile images of self (Markowitz, 1998).

The subjective abstract of ourselves as individual beings is secondary to our tactile and physically defined perception of ourselves. When we are physically ill our concrete self is threatened and can escalate into degradation through our tactile being. I propose that the same is true for our subjective selves; when it becomes injured, it may become infected and systemic damage may occur that both go on to consume us or severely debilitate us, making our lives just as much of a challenge to face subjectively as they can be to face when we are physically corroded or malformed.

I will rely strongly on developmental theories of psychology and psychopathology to show that like a malignancy, a psychopathology is something that we can have a predisposition to, is something that can be environmentally activated, can grow over time, and if not sufficiently irradiated, excised or eliminated, can go on to further pollute the body beyond what permanent damage it has already caused. I hope also to demonstrate why our current methods of treating psychopathology are insufficient and may only slow, or at best, lessen the degree of damage injuries to, and diseases of, the subjective self  may cause.

Under the light of this hopeless illustration of psychopathology as a systemic disease I will attempt to demonstrate via the viewing scope of developmental psychiatry how these pathologies can come to be developed, and how permanently embedded ones can be exacerbated, preventing the sufferer from developing successfully through young adulthood when psychiatric illness has persisted through adolescence, thus setting the psychiatric cadence for the individual and the rest of their lives.

Sources of Support and Relationships with Others

Adolescence is a time when emotional centers begin to shift from the immediate family to persons outside of it, though still within close proximity to themselves, such as peers at school, extracurricular clubs, neighbours, or more recently in history, online friends.

In young adulthood the emotional center remains distanced from the family but also becomes distanced from the original support network of friends formed in adolescence as each goes his own way and the strengths of their bonds diminish.

The emotional center during young adulthood becomes more abstract as affiliations are made with institutions, field of study, and characteristically-defined peer groups whom the young adult may, or may not, find friends amongst (Youniss & Smollar, 1985)

Relationships with other human beings are a requirement for survival. Upon birth we are totally dependant upon the will and skill of other around us to rear us. Through relationships with others – primarily our immediate family – we learn about the world, ourselves, how to be with other people. Support becomes an operant mechanism of our survival, whether it be gaining support for ourselves or offering it to others.

Thomas Berndt proposed in 1996 four types of support adolescents can offer to one another, but these four types of supports can be extended across many types of relationship in not only adolescence but also in young adulthood and onwards (Arnett, 2007).

Informational Support was described by Brandt to be advice, guidance, and directional mentorship that one individual can offer another. The information can be empirical, such as seeking guidance in the mechanical execution of a task, or it could be opinionated such as when one seeks information about what someone else might do in their situation and why.

Instrumental Support is composed primarily of the provision of assistance with executable tasks or the supplement of resources for use in accomplishing ones objectives.

Companionship Support is the comfort offered to one person by another through their presence in close proximity to that person. Sharing the activities of daily living, such as eat, sleeping, or entertaining oneself with someone to accompany you offers a pleasant sense of security. Having a companion accompany you to social events or to make themselves apart of your accomplishments or even to help you negotiate choices and complications encountered in life is reminiscent of the support provided by the immediate family during childhood.

Esteem/Emotional Support is the comprised of many annals of positive and negative emotional feedback that crosses bidirectionally between two individuals. Praise, encouragement and reassurance are not always self-suppliable, despite what is commonly taught in self-help material. We grew up on feedback from others and we continue to need it no matter what stage of development we are in. But unlike children, adolescents and onwards have developed abstract thinking, and with it, deduction. Esteem and Emotional support must be genuine and come from a trust source otherwise the support is empty at best.

The figureheads in our lives who become out primary emotional attachments change as we grow up from being small children attached to our mothers and fathers, to full-fledged adults attached to our romantic partners. In many ways the romantic partner replaces the parents as a source of security, support, love, and protection which may explain why there is seemingly such a prevalent preoccupation with attaining a romantic partner and such devastation when a partner fails to provide us with the positive securities we need from them. No other relationship type that we experience in life so-closely mimics that of the one we had with our parents than the ones we have with our romantic partners.

At one end of the developmental spectrum we have our parents as our primary attachment figure. Our goal from thereon is to replace them with a romantic attachment figure in adulthood with whom we can begin a family and be parents to a new individual.

It should not be surprising that a major component of human development revolves around this journey of replacing our attachment to our parents with a secure attachment to a romantic partner. This process occurs concurrently with other processes during development, and like those processes, dysfunctions experiences along the way can injure and damage the path the process takes, sometimes permanently, and sometimes even debilitating.

During adolescence and young adulthood platonic relationships with friends become great sources of support. In adolescence proximity to the parents and family is still closely available should friends fail to meet the support needs of the individual. In young adulthood however, friends may be poor sources of the kind of support needed and the family may be far away both geographically and emotionally. If the young adult develops a romantic relationship they will come to rely upon that partner more and more as the relationship progresses which fills the gap in the support network that can be experienced during young adulthood (Fraley & Shaver, 2000)

It has been shown that support and nurturance of an individual via Berndt’s four capacities from those who have a genuine vested interest in them is positively associated with increased incidence of psychological well-being (Keef & Berndt, 1996; Urberg et al, 1995, 2000)

The aetiologies for many personality disorders include dysfunctional attachments that occurred as some point or another in the patient’s life, particularly disorders that include issues with intimacy, trust, self-esteem, and the development of healthy relationships (Johnson et al, 1999).

For psychiatric young adults the period between adolescence and adulthood may be further complicated because individuals suffering from mental illnesses are heavily dependent upon their support networks, which may disappear altogether, or be altered in a manner that may not be sufficient for the young adult or may take a long time to get used to and learn to use appropriately (Mercer-McFadden & Drake, 1997).

For psychiatric patients leaving paediatric status in the provincial health care system (paediatric patients are individuals aged 0 – 18) not only will their professional circle of support change, but so will the types of professionals that will manage their care, as will the expectations for rehabilitation as an adult (College of Physicians and Surgeons of Ontario, 2007).

For isolated young adults dealing with psychiatric complications their circle of professional support may have been surrogate to the support roles members of their families or peer group were unable to provide which can cause conflict when the individual is cut off from that support group and placed in the care of, for instance, an Adult Psychiatrist, who does not have the same mannerisms, expectations and practice opinions of the Paediatric Psychiatrist that had treated the patient until thus far. This leaves the patient with a figure who was not only supposed to replace the individual’s physician, but also the surrogate support role of nurturer, advocate, and confidant. When the new Psychiatrist does not conform to this role, the patient may feel rejected, confused, and may miss their old physician and perhaps feel abandoned by him or her. This can make it difficult for the patient to form a new Doctor-Patient relationship with their new physician, which in turn makes treatment difficult (McGuire, McCabe, & Priebe, 2001)

For some young adults suffering from a psychiatric illness, their psychiatrist or other supplementary clinician may be their sole support, at least until other bonds can be made with peers, if possible. Therefore it is important that professionals provide the nurturance and guidance needed by these displaced youngsters, but also to encourage and support them to develop friendships which will make better support providers and contribute to healthier development during emerging adulthood.

Risk-Factors for Psychopathological Behaviour in Adolescents and Young Adults

Suicide is the third leading cause of mortality between ages 15-24, accounting for sixteen percent of deaths amongst adolescents and young adults in 1996 as reported by the CDC, with Accidents accounting for forty-nine percent, and homicide for twenty-four percent. Across all-ages within the range above suicides increased in the spring, and most occurred at home where the means with which to perform the suicide are kept. The attempt-to-completion ratio amongst attempters and completers of suicide are estimated to be 100-1 (Ventura et al, 1997)

Warning signs of suicidal behaviour are often missed by health-care practitioners because of the prevalent belief that adolescents and young adults are naturally in turmoil and that disturbed behaviour is normal at their age (Alexander, 2001).

This is an assumption supported by the prevalence of suicidal ideation amongst individuals not diagnosed with a major depressive disorder or a major depressive episode, though research suggests that subthreshold depression exists amongst the suicidal population that is not easily detectable which would mean that suicidal ideation amongst individuals without a diagnosis of psychopathology does not necessarily mean that they do not have one, and therefore could discount the assumption that depression and turmoil are normal in adolescents and young adults (Bethell & Rhodes, 2007). Research into the existence and prevalence of subthreshold depression remains to be undertaken.

For patients who suffer from psychotic disorders which can impair their cognitive functioning their quality of life tends to be lower due to their reports that their cognitive impairments prevent them from accomplishing tasks, being coherent, and remaining focused and can thus interfere with academic and occupational achievement (Brissos, Dias, & Kapczinski, 2008).

For a young adult with a psychotic disorder such as Bipolar Disorder they must deal with not only the cognitive difficulties associated with their disorder but also with the aggressive fluctuations of their moods from depressed to manic. Their behaviour can become a source of embarrassment which can add to the severity of the depression that follows the manic episode in which the embarrassing behaviour occurred (Howland, 2006).

The shifts in the moods of emotionally and psychotically disturbed patients can be severe enough to appear as shifts in personality and the unpredictability of their affect may make them individuals that their peers wish to distance themselves from, thus further isolating them and adding reinforcement to peer placement of stigma upon the individual. The side-effects of medications used to treat these patients can also contribute to behaviour or affects that dissuade peers from entering close physical and social proximity to the individual (Lauber et al, 2004).

Both the primary and secondary effects of psychopathology can have dire consequences for the young adult attempting to establish himself amongst his peers. The primary effects of his disorder such as his hallucinations, emotional instability, fluctuating mood, etc. Can be disruptive enough in themselves. Secondary effects of psychopathology are bidirectional causes and effects that can easily exacerbate the individuals condition and turn what was a manageable illness, into a catastrophic disability.

When an individual is identified as being mentally ill, stigma is placed upon. What kind of stigma and to what degree the stigma effects others views of the individual depends on the personal beliefs, education, and comfort level of those who have identified the mentally ill individual. How that individual will be treated in light of their identified status is also dependant upon these values and the collective view of society in regards to the mentally ill, and the specific disorder identified (Norman et al, 2008) How the identified individual deals with their illness can also be a source of stigmatization, particularly if the judgemental individuals view drug treatment as amoral, or as a sign of personal weakness.

Much misconception about pharmacotherapy in psychiatrics exists amongst the regular population and an individual who appears to be popping pills throughout the day or who has chosen to pursue chemotherapy rather than non-chemical therapies may be viewed as a weakling, a drug addict, or any other manner of undesirable individual.

Because young adults who suffer from psychiatric illnesses encounter innumerable risk factors for escalations of their symptoms, their likelihood to seek medical care rises. While no official studies have been performed on the matter, it is a commonly known fact amongst the psychiatric population (providers and receivers) that psychiatric patients believe they will be treated poorly by health care providers and are often afraid to see help during times of crisis for fear of abuse, bullying, or punishment.

For instance, psychiatric patients who are prone to self-harming behaviour such as cutting or burning themselves have reported being treated abusively when presenting at the emergency rooms of their local hospitals for suturing or wound care. They often view the treatment they received as negative and unsympathetic.

Realities for Mentally Ill Young Adults

The future of the mentally ill young adult is bleak, for the likelihood that they can successfully traverse through academic challenges, occupational goals, and form meaningful relationships is confounded extensively not just by the symptoms of their disorders, but perhaps even more so by the stigma associated with the disorders, and the gross lack of accommodation provided for mentally ill individuals.

Emotional disorders are not considered disabilities by the Ontario government, and thus mentally ill individuals suffering from mood and anxiety disorders, as well as personality disorders are not privy to government support or subsidization for accommodations granted to other Canadians with physical and learning disabilities.

Only 24% of mentally ill individuals are self-supporting and most have only been able to make marginal success in their occupational pursuits and the formation of meaningful relationships. 37% either self-medicate with prescription medication, alcohol, or illicit drugs. 42% are identified as having a high risk of suicide due to their view of their lives as hopeless and intolerable. 55% of young adults with mental illnesses received psychiatric treatment before age 18. (Pepper, Kirshner, & Ryglewicz, 2000).

The odds for an individual who fails to progress through young adulthood while coping with a mental disorder and the secondary effects of that disorder do not appear to be very good.

More information about the level of education mentally ill individuals achieve, what factors contributed to successful individuals, and more metrics on how mentally ill individuals perceive their experiences and needs are needed.

Mental Illness remains one of the only disabilities – perhaps the only disability – in western cultures which is not viewed as being possible to accommodate, and those with a mental illness are not viewed in the same optimistic, equality-favouring light that other disabled individuals are.

It would be incorrect to say that society has given up on the mentally ill, for it never had any hope for the mentally ill in the first place. Mentally ill individuals are very much aware of their socially-assigned status and identity and what their odds are of ever measuring up to their peers.

Mental Illness affects all aspects of life, and as we have established that relationships are the core of identity and self-esteem, we can now see that the mentally ill individual is unlikely to form secure relationships of any kind and therefore is very likely to have a poor sense of self which can lead to a poor quality of life.

While young adult hood has been described as an age of great possibilities and freedoms, for the young adult with mental illness, it may be a time in which the reality of how many possibilities are not open to them really becomes clear, and with the odds against them, it may be unlikely that they will get far enough to pursue any of the few possibilities left over for them, let alone anything highly ambitious

Conclusion

Failure to receive sufficient, sympathetic, and consistent support compiled with the difficulties and demands of everyday life and the pursuit of aggressive goals common during young adult hood topped with isolation and the confrontation of a societal identity that is negative (that of the mentally ill person), it is not unreasonable to understand why young adults with chronic psychopathologies perform poorly in young adulthood and can barely – if at all – compete with their peers.

The natural distancing from childhood and adolescent supports make young adulthood a particularly vulnerable time for mentally ill young adults, and without the implementation of new, secure attachments, they run a more likely risk than their peers of failing to form a positive adult identity. Failure to form a positive adult identity has consequences that are documented in the literature studying the trends of behaviour and demographics of the mentally ill adult population.

Further research into the positive or negative effects of interventions at various points in the development of identity through relations with others across the life-span might offer solutions and insights into how better assist these individuals and perhaps also add a new dimension to the current views about the development of psychopathology.

References

Alexander, E. A. (2001) Adolescents and Young Adults. In J. Noble, H. L. Greene II, W. Levinson,

G. A. Modest, C. D. Mulrow, J. E. Scherger, M. J. Young (Eds.) Textbook of Primary Care

Medicine (3^rd Ed.) (pp.62-71). St. Louis; Mosby, Inc.

Arnett, J. J. (2000) Emerging Adulthood: A Theory of Development from the Late Teens Through the

Twenties. American Psychologist, 55[5];469-480

Arnett, J. J. (2007) Friends and Peers. In Adolescence and Emerging Adulthood (3^rd Ed) (pp. 249-250)

New Jersey; Pearson Education

Bethell, J., Rhodes, A. E. (2007) Depressed Mood in the Suicidal Population. Canadian Journal of

Psychiatry, 52;744-748

Brissos, S., Dias, V. V., Kapczinski, F. (2008) Cognitive Performance and Quality of Life in Bipolar

Disorder. Canadian Journal of Psychiatry, 53[8];517-524

Charlotte, C., Bryan, R., Caldwell, T., Power, C., Stansfeld, S. (2007) Childhood and Adulthood

Psychological Ill Health as Predictors of Midlife Affective and Anxiety Disorders: the 1958

British Cohort. Archive of General Psychiatry, 64;668-678

College of Physicians and Surgeons of Ontario. (2007) Values of the Profession. In The Practice Guide:

Medical Professionalism and College Policies[Electronic Version](pp.2-12) Ontario; CPSO

Crawford, T. N., Cohen, P., First, M. B., Skodol, A. E., Johnson, J. G., Kasen, S. (2008) Comorbid Axis I

And Axis II Disorders in Early Adolescence: Outcomes 20 Year Later. Archives of General

Psychiatry, 65[6];641-648

Crum, R. M., Green, K. M., Storr, C. L., Chan, Y. F., Ialongo, N., Stuart, E. A., Anthony, J. C. (2008)

Depressed Mood in Childhood and Subsequent Alcohol Use Through Adolescence and Young

Adulthood. Archives of General Psychiatry, 65[6];702-713

Doherty, N. A., Feeney, J. A. (2004) The Composition of Attachment Networks Throughout the Adult Years.

Personal Relationships, 11;469-488

Erikson, E. H. (1977) Eight Ages of Man. In C. Jenks (Ed.) Childhood: Critical Concepts in

Sociology (2005) (Volume 1) (pp. 313-335) New York : Routledge

Fontaine, N., Carbonneau, R., Barker, E. D., Vitaro, F., Hebert, M., Cote, S. M., Nagin, D. S., Zoccolillo, M.,

Tremblay, R. E. (2008) Girls’ Hyperactivity and Physical Aggression During Childhood and

Adjustment Problems in Early Adulthood: A 15-Year Longitudinal Study. Archive of  General

Psychiatry, 65[3];320-328

Grant, V. V., Bagnell, A. L., Chambers, C. T., Stewart, S. H. (2009) Early Temperament Prospectively

Predicts Anxiety in Later Childhood. Canadian Journal of Psychiatry, 54[5];320-330

Howland, R. H. (2006) Challenges in the Diagnosis & Treatment of Bipolar Depression: Part 1: Assessment.

Journal of Psychosocial Nursing & Mental Health Services, 44[4];9-12

Hunter, J. J., Maunder, R. G. (2001) Using Attachment Theory to Understand Illness Behaviour. General

Hospital Psychiatry, 23;177-182

Johnson, J. G., Cohen, P, Brown, J., Smailes, E. M., Bernstein, D. (1999) Childhood Maltreatment Increase

Risk for Personality Disorders During Early Adulthood. Archive of General Psychiatry, 56;600-606

Keefe, K., Berndt, T. J. (1996) Relations of Friendship Quality to Self-Esteem in Early Adolescence. Journal of

Early Adolescence, 16[1];110-129

Lauber, C., Nordt, C., Falcato, L., Rössler, W. (2004) Factors Influencing Social Distance Toward People with

Mental Illness. Community Mental Health Journal, 40[3];265-274

Manning, C., White, P. D. (1995) Attitudes of Employers to the Mentally Ill. Psychiatric Bulletin, 19;151-543

Markowitz, F. E. (1998) The Effects of Stigma on the Psychological Well-Being and Life Satisfaction of Persons

with Mental Illness [Abstract]. Journal of Health and Social Behaviour, 39;335-347

Mercer-McFadden, C., Drake, R. E. (1997) The Community Support Program Demonstrations of Services for

Young Adults with Severe Mental Illness and Substance Use Disorders. Psychiatric Rehabilitation

Journal, 20[3]

Pancoast, David L.; Archer, Robert P. (1992) MMPI Response Patterns of College Students: Comparisons to

Adolescents and Adults. Journal of Clinical Psychology, 48[1];47-53

Peppar, B., Kirshner, M. C., Ryglewicz, H. (2000) The Young Adult Chronic Patient: Overview of a Population.

Psychiatric Services, 51[8];989-995

Robins, R. W., Fraley, R. C., Roberts, B. W., Trzesniewski, K. H. (2001) A Longitudinal Study of Personality

Change in Young Adulthood. Journal of Personality, 69[4];617-640

Shaffer, D. R., Wood, E., Willoughby, T. (2005) Development of the Self and Social Cognition. In Developmental

Psychology: Childhood and Adolescence (2^nd Ed.) (pp.435-461). Canada; Nelson

Urberg, K. A., Degirmencioglu, S. M., Tolson, J. M., Halliday-Scher, K. (1995) The Structure of Adolescent Peer

Networks. Developmental Psychology, 31[4];540-547

Urberg, K. A., Degirmencioglu, S. M., Tolson, J. M., Halliday-Scher, K. (2000) Adolescent Social Crowds:

Measurement and Relationship to Friendships. Journal of Adolescent Research, 15[4];427-445

Varda, K.  (2007) Identity. In R. J. R. Levesque (Ed.) Emerging and Young Adulthood: Multiple

Perspectives, Diverse Narratives. (pp. 13-15) [Electronic Version]. Springer.

Ventura, S. J., Peters, K. D., Martin, J. A., Maurer, J. D. (1997) Births and Deaths : United States 1996. Monthly

Vital Statistics Report. Atlanta; Center for Disease Control

Wechsler, D. (1997) Wechsler Adult Intelligence Scale – III (WAIS-III) Technical Manual. San Antonio; The

Psychological Corporation.

Youniss, J., Smollar, J. (1985) The Individual and Relations. In Adolescent Relations with Mothers, Fathers,

And Friends. (pp.160-174). Chicago; University of Chicago Press

Zimmerman, M. A., Copeland, L. A., Shope, J. T., Dielman, T. E. (1997) A Longitudinal Study of Self-

Esteem: Implications for Adolescent Development. Journal of Youth and Adolescence, 26[2];117-141

C. H. E. Anderson                               Inferential Statistics

Trent University                                 Prof. Wendy Kelly

PSYC-2017-Summer 2009

Spirituality, Well-Being, and Breadth of Meaning: The Influence of Baby-Boomers

Introduction

A myriad of philosophers, physicians and scientists have attempted to comprehend and present a plausible basis for answering the question regarding the meaning of life. Perhaps man’s seemingly infinite preoccupation with this topic stems not only from his desire to understand and answer his own questions, but also to strengthen the qualitative resources he has with which to relate himself to the other members of his species and the utility that such an understanding can offer him in successfully navigating the many vicissitudes of human life.

Our inherent belief that we must have a reason to engage in an activity, that we must have some inspiration to act, has been the antecedent argument in this discussion. For if a man is to do anything but expire as a result of inaction, he must have a driving force; he must have a will and it must be to go on living.

Based upon Arthur Shopenhaur’s will to live and the concurrent works by Charles Darwin on evolutionary theory Nietzsche proposed that man possesses the will to power, that he is driven by the desire to achieve goals, ambition, and the strong desire to reach the highest possible echelon of status and influence in his life.  A man’s desires in life are born of need and will to overpower others and he gains the greatest satisfaction from the pleasure he derives from this. Nietzsche was even so bold to say that the will for power was stronger than the will to live.

Freud has enjoyed a dominant position of posthumous authority in the discipline of psychology. He reasoned that man is driven by a will to pleasure; that he seeks pleasurable experiences and avoids unpleasant ones. This fundamental basis of many of Freud’s arguments is referred to as the ‘pleasure principle’.

Of particular pertenance today the theoretical perspectives of psychiatrist and neurologist Dr. Victor Frankl and his work on what he called Logotherapy. Frankl is perhaps best known for having been a survivor of the holocaust and using his experiences and realizations gained during his time in the concentration camps to propose his theory of mans will to meaning.

According to Frankl what man strives for in life is not dominance, assimilation, morality or even continued life itself, but a firm assignment of subjective meaning in his individual existence. He reasoned that when a man believes his life and his experiences, no matter how poor or intolerable, have a meaning he believes in, a purpose, that he will continue to go on sustaining his life (Frankl, 1963).

The basic principles of Frankl’s Logotherapy are that; 1) Life has meaning under all circumstances, even the most miserable ones, and 2) Our main motivation for living is to find meaning. He stated that we can find meaning for our lives in three different ways: 1) by creating a work or doing a deed, 2) by experiencing something or encountering someone we interact with, and 3)by the attitude we take towards unavoidable suffering (Frankl, 1967).

While the practice of free philosophical speculation has largely become unfashionable amongst modern minds, the desire to establish an understanding of what predisposes an individual to a successful and satisfactory life has a found a productive home nestled in the arms of the modern social sciences such as sociology and psychology, particularly in the clinical applications of these sciences.

Western society possesses a number of human institutions whose purpose is to counsel, guide, and support members of society and different communities. To do these jobs effectively and to perform in a satisfactory manner we have drawn upon a plethora of intellectual faculties in our efforts to justify our decisions when solving our macro magnanimous societal issues, but also in our efforts to assist one another in their efforts to contribute to cooperative society and to overcome the challenges we encounter in these efforts.

In recent decades a considerable amount of attention has come to be paid towards the more subtle, less concrete aspect of our experience with life. A great deal of interest and subsequent research is being done in the realm of our subjective experiences and the dispositions and vulnerabilities that these experiences have on our lives.

Clinical research into the study of the meaning that we prescribe to our lives and the activities that we believe offer us meaning has been narrowed down from its broad, philosophical roots to its application potential in the problematic areas of modern life (Reker, Peacock, and Wong, 1987). Nowhere, perhaps, has it found a greater embrace from the scientific community than in modern gerontology.

As the modern world attempts to equalize in the conclusion of the anomalous baby boomer generation (Individuals born approximately between the years 1943 to 1966) the concern of how to handle their passing and their strain upon society during their expiration has offered fruitful ground for study on the matters of the end of life and the life span as a linear whole.

True to their characteristic nature of catalyzing fast-paced innovation and technological advancement, the boomers have brought the concept of ‘successful aging’ into the clinical research area with the kind of tidal force and intensity that they are known for.  It is not surprising that the term ‘successful’ has replaced what was once considered to be normal aging, since the boomers have never been satisfied with settling for anything less than exceptional during their era. They expect to perform better even as they approach their extinction than any of their predecessors from earlier generations have.

Success in the aging process has little to do with the attainment of any specific goal, status, or well-defined standard and more to do with the maintenance of previously enjoyed functionality that an individual has come to regard as normal during the majority of their adult life.  This functionality is not limited to the physical operations and resilience that an individual associates with themselves but also with the mental functioning and baseline emotional stability that they have come to enjoy (Tate, Lah, and Cuddy, 2003).

While the human life-span may not be indefinitely extended it is a matter of popular opinion amongst health care professionals and social scientists (as well as the general public) that regardless of how long one lives their deterioration from normative function should be realistically diminishable.

Frankl’s propositions on meaning have lead the way in assisting modern researchers in their current inquiries and have lead them to begin positing new theories about the components of internal subjectivity that can either dictate and predict an individual’s potential for successfully acquiring meaning, or explain the intangible operant mechanism of cognition and perception at work in the production of meaning. A number of psychometric efforts have been made to provide researchers with the tools to quantify meaning (Debats, 1998).

Research into the aging process and the psychosocial collateral of that progression are of particular importance today. The baby boomer generation have begun to enter their senior years and for the first time in recorded history the elderly will outnumber children.  Sadly, their children and their children’s children are failing to sustain the economic standards and strengths that have defined the boomers. Now that they are beginning to lose their validity and ability to care for themselves and to contribute to society, the burden of support lays with the younger generations who will not be able to comfort and care for their parents in materialistic ways.

The baby boomer generation were a group of indulgent individuals with positive expectations for continued affluent, hedonic, and materialistic security.  They did not expect to have so many of their millennial children remain in their financial care for the length that they are currently doing so. They did not expect the fast-coming shortages of health care professionals and the current economic crisis. They are known to have been inadequately concerned with plans for their retirement and funerals (Mullins, 1998). In short there is concerned that the boomers are not prepared for infirmity during socioeconomic era that cannot sustain them in adequate care, comfort or provision.

For a generation that has drawn the most meaning and satisfaction in their lives from competition, achievement, and economic prowess they may find themselves in more destitute conditions in which they will need to ascribe meaning to their lives in different ways or run the risk of enduring an endemic of elderly depression and the associated negative consequences of such on their physical and psychological being (Bruce et al, 1994). They may go to their death beds with a higher incidence of anxiety (Wink & Scott, 2005) and their overall experience of passing may be grossly lacking in all facets.

That differences between the generations of human beings exist is generally acknowledged. The circumstances that surround a person’s life as they develop as well as the events that result from them play an important role in defining not only the individual, but the generation to which they belong. As such it is plausible to assign certain characteristics and expectations to such generations.

Given that individuals who comprise the Old age group could be said to be the pre-boomer generation, if not the parents of said boomers and that life conditions and expectations were much more austere before the mid-fifties it is expected that we will see a uniform disparity between the Old and Young age groups. The reason for this being that the Old age group has had the experience of being delivered from the circumstances preceding and lasting through the Second World War, to living their lives during the greatest innovative and economical age to date. Their children were considered to be the healthiest and the wealthiest generation to date. They have succeeded in their careers and had access to far more opportunities with far less education than current generations. In short they have not only gotten to live the majority of their adult lives in the affluent, lush upswing of the second half of the 20^th century, but so have their children (Cheung, 2007)

The Young age group, by contrast, it what is considered to be an echo generation of their parents, the boomers, ripe from a time when the boomers are retiring and the economic landscape is shifting in a negative direction towards those more similar to the beginning of the 20st century and more ethnically diverse than ever before. They are less competitive than their predecessors and are more intense in their beliefs of teamwork, rule-following, and entitlement to opportunity and achievement (Howe & Strauss).

As we near the conclusion of the first millennial decade they have also been given the disappointing title of the Boomerang Generation: named so for their high rate of failure in the transition into adulthood and independence and their tendency turn tail and return home to their parents. They’re failure to successfully sustain themselves and move through the more traditional rites of passage that their parents did has stimulated a current concern over the invalidity of the individuals who first went to post-secondary school in 2000 that characterizes them in a far less positive light than Howe and Stauss did in 2003 (France,2007)

It is the wide-spread disappointment amongst the millennial generation that should predispose them to less satisfying life circumstances. Their difficulties in establishing themselves as free agents should also prevent them from establishing families of their own, completing their educations, and achieving their highly-set goals. This should have a significant effect on their ability to find meaning in their lives.

Within the groups themselves we expect to see little variance in performance by the Old age group and considerable variance amongst the Young age group for many of the reasons stated above. We particularly expect to significant differences in the level of Spiritual Transcendence that the Young group reports given not only the broad range of religious and spiritual practices condoned today, but also the high prevalence of atheism and disbelief in the benefits of spiritual facets.

Method

Participants

Participants in the study at bar were 100 (51 females and 49 males) who were either students enrolled in an inferential statistics course Trent University or solicited associations of those students who volunteered to complete the three inventories and the personal data sheet. The two age ranges in the study were from 20 to 34(M=23.65) for the Young Group and from 70 to 85(M=77.24) for the Old Group.

Materials

Three psychometric inventories will be used in the study at bar. The first test is designed to measure the level of physical ,psychological  and general well-being that individuals believe themselves to be in possession of at the current time. The revised Perceived Well-Being Scale (PWB-R) is a 16-item, 7-point likert scale designed by G. T. Reker and P. T. P. Wong in 1984. Physical Well-Being is defined by Reker and Wong as “the presence of positive emotions such as happiness, contentment, joy and peace of mind and the absence of negative emotions such as fear, anxiety, and depression”. Physical well-being is defined as “self-rated physical health and validity coupled with perceived absence of physical discomfort.” General well-being is the composite picture rendered by juxtaposing Psychological and Physical well-being (Reker, 2002).

To measure the activities that people associate most with offering potential meaning to them the Sources of Meaning Profile – Revised (SOMP-R) by G. T. Reker in 1996 will be used. The SOMP-R is a 17-item, 7-point Likert scale measure in which high score indicates a wide variety of potential sources from which the individual can find meaning (Edwards, 2007).

Spirituality will be measured using another of G. T. Reker’s inventories, the Spiritual Transcendence Scale (STS-24) is a 24-item, 7-point Likert scale measure that measures the individuals beliefs, feelings and behaviours that pertain to their individual spiritual practices which may, or may not, exist concurrently in the context of an identifiable religion. Efforts were made in the development of the STS-24 to have ambiguous applicability across culture-specific religions (Piedmont, 2001).

Procedure

Participants who were enrolled in the statistics course were asked to complete a set of the (inventories and the data sheet which can be found in Appendix II) for themselves (if they were included in either age range) and also to solicit completed inventories and data sheets from another individual who was included in the age group opposite of their own.  The results of the inventories were scored as a group and then pooled by the instructor for subsequent statistical analysis.

The independent variable in the study at bar is the age group to which an individual falls; young or old age groups. The level of psychological well-being, spiritual transcendence, and the number of sources of meaning that the individual has in their life were the dependant variables.

Results

To test the hypothesis that the Old age group would have higher levels of perceived psychological well-being, Spiritual Transcendence, Inner Connectedness, Human Compassion and a greater Breadth of Meaning, an independent t-test was performed using a data mining program. The was no significant difference between the Young and Old age groups across all five measures. Perceived Psychological well-being, t(98) = -0.59, P > .05. Spiritual Transcendence, t(3,14) = -0.98, p > .05. Inner Connectedness, t(3,14) = -0.84, p > .50. Inner Connectedness, t(3,14) = 0.82, p > .05. Human Compassion, t(3,14) = -1.08, p > .50. Breadth of Meaning, t(3,14) = -0.41, p > .05.

Independent t-tests were used to determine whether significant differences between the means of Low and High scores on three scales existed between the two age groups revealed that significant differences between the groups exist in evaluation of Low and High Breadth of Meaning, t(48,42) = -15.29, p < .50, Low and High Perceived Psychological Well-Being, t(48,42) = -2.91, p < .05, and Low and High Spiritual Transcendence, t(48,42) = -2.80, p < .05.

Analysis of differences within the groups’ own individuals revealed that for the Young age group there were significant differences between the means of Low and High Breadth of Meaning, t(25,22) = -11.30, p < .05, and Low and High Spiritual Transcendence, t(25,22) = -2.45, p < .05.

There were significant differences between the means of Low and High Breadth of Meaning in the Old age group, t(23,20) = -11.68, p < .05, as well as Low and High Perceived Psychological Well-Being, t(23,20) = – 2.55, p < .05.

Discussion

As predicted there was a significant degree of variance between the levels of Spiritual Transcendence for the Young age group while there was amongst the Old age group.  It is perhaps interesting to take into account that it quite likely the young participants recruited the older participants from within their families and what it suggests if the Spiritual values of the older generation do not bare much sustainment in their grandchildren.

There was not, as it was predicted, a significant difference between the over-all scores between the groups on the independent t-tests for all measures. This might be explained by the convenience sampling used to obtain the data. If the individuals are related between the groups it is possible that extended upbringing and familial tradition play a role in transferring the values, practices and beliefs across the generations.

The results of this study appear to support the notion that no significant difference exists between the two age groups but that considerable differences exist in the ranges of variance within the groups and between each other, though the overall Breadth of Meaning, Perceived Well-Being, and Spiritual Transcendence is generally stable across both groups.

It must be remembered that sampling method used was not random, and that while the life-circumstances of the Older participants were quite varied, the circumstances surrounding the students in the class were not particularly variable. They were all members of socioeconomic class that has the privilege of attending post-secondary education. The terms under which they are part of that class of youths may vary, but the point is that they do not represent the general population from whence they came.

If the sampling method used was far more random and the participants used in the Young age group were not members of an exclusively privileged sub class it is possible that the originally predicted disparities between the age groups would be represented.

The coming crisis of the elderly baby boomer generation presents us with not only bleak worry for out aging loved ones, but also with a unique research opportunity to further our understanding of life after seniority. In the tradition of clinical science we will be given a great deal of information on what happens at the end of life when conditions are insufficient and disappointments dominate; when there is a wide spread deficit and dysfunction within the system of interest. We will have no shortage of elderly on which to perform our evaluations and while it is unfortunate that they cannot look forward to a pleasant expiration, we can draw from their misfortune a considerable amount of baseline data in the field of gerontology and geriatrics.

For the followers of Frankl we will see whether or not our coming elder cohort can maintain meaning and well-being amidst the very likely suffering to come.

References

Cheung, E. (2007). Baby Boomers, Generation X, and Social Cycles: North American Long Waves.

Longwave Press.

Debats, D. L. (1998). Measurement of Personal Meaning. P.T. Wong, P. S. Fry (Eds) The Human Quest

For Meaning: A Handbook of Psychological Research and Clinical Applications. Lawrence

Erlbaum. pp. 237-239.

Edwards, M. J. (2007) The Dimensionality and Construct Valid Measurement of Life Meaning: A thesis

Submitted to the Department of Psychology in conformity with the requirements for the

degree of Doctor of Philosophy. Queen’s University: Kingston. p 56.

France, A. (2007). Understanding Youth in Late Modernity. Open University Press.

Frankl, V. E. (1963). Man’s Search for Meaning: an Introduction to Logotherapy. Pocket Books: New

York.

Frankl, V. E. (1967). The Doctor and the Soul: From Psychotherapy to Logotherapy. Bantam Books:

Toronto.

Piedmont, R. L. (2001) Spiritual Transcendence and the Scientific Study of Spirituality. Journal of

Rehabilitation, Vol. 67, No.1.

Reker, G. T. (2002) Perceived Well-Being Scale – Revised. K. Talbot (Ed) What Forever Means After the

Death of a Child: Transcending the Trauma, Living with the Loss. Brunner-Routledge.

pp. 241-243.

Reker, G. T., Peacock, E. J., Wong, P. T. (1987). Meaning and Purpose in Life and Well-Being: A Life-Span

Perspective. Journal of Gerontology, No. 42, pp. 44-49.

Tate, R. B., Lah, L., Cuddy,  T. E. (2003). Definition of Successful Aging by Elderly Canadian Males: the

Manitoba Follow-Up Study. The Gerontologist, Vol. 43, No. 5, pp 735-744.

Wink, P., Scott, J. (2005) Does Religiousness Buffer Against the Fear of Death and Dying in Late

Adulthood? Findings from a Longitudinal Study. Journal of Gerontoloy, Vol.60B, No. 4,

pp. 207-214.

C. H. E. Anderson                 Development of Adolescents

Trent University                  Prof. P. Franke.

PSYC-351H-Fall 2009        09/12/2009

Standardized tests and intelligence quotients are considered to be reliable indicators of academic achievement, but there still exists enough inconsistencies between qualitative indicators of an individual’s performance and the actual level of performance achieved. For instance, a paediatric individual may be assessed as having a high IQ and as having strong psychometric indications of success in academic achievement but performs poorly in an academic setting. The reverse also occurs in which individuals with poor predictors of academic success actually perform far more successfully than their psychometric assessments predicted that they would. In some cases persons with lower IQ’s can out-perform peers of higher IQ’s. What contributes to these inconsistencies between quantitative prediction factors and actual performance in academic achievement?

It has been proposed within the literature on the subject of achievement behaviour that individual differences in achievement motivation – the willingness to succeed at challenging tasks and to pursue high standards of externally validated accomplishment- play a significant role in determining not what capacity of potential an individual may have, but how likely they are to utilize it and that the expectations they create for themselves and that are created by others affect this motivation (Rimm, 2008).

In 1959, psychoanalyst Robert White put forth his belief that human beings are inherently equipped with what he called a mastery motive: the inborn motive to explore, understand, and gain proficiency in controlling one’s environment (Shaffer, Wood, & Willoughby, 2005). The apparent pleasure that human beings gain from accomplishment is observed early in life (Mayes & Zigler, 1992), even in individuals with medically deficient intellectual functioning such as retarded children and other children who afflicted with developmental disorders (Hauser-Cram, 1996).

Achievement motivation develops in early childhood and consists of three distinct phases: the joy the child finds in mastery, the levels of approval-seeking behaviour the child exhibits, and the development of sense of performance standards that the child is capable of using to assess their level of achievement (Shaffer, Wood, & Willoughby, 2005).

Children that develop high levels of achievement motivation are considered to be more likely to perform at levels approaching optimal potential in later life in academic settings, occupational pursuits, and athletics, than peers with lower levels of achievement motivation. This predictive value of this likelihood for future performance across the life span is independent of IQ which may offer some explanation as to why very intelligent individuals can perform much more poorly in academics than persons of considerably less intellectual calibre.

While White’s mastery motivation may be considered to be an inherent characteristic of all human beings that may be purely hereditary in nature, Achievement Motivation is developed under both genetic determinants and environmental influence during maturation (Schunk & Pajares, 2002).

Factors that can have thwarting effects on the development of achievement motivation seem to have their groundwork established in childhood but become solidified as lasting characteristics of the individual during adolescence (Shaffer, Wood, & Willoughby, 2005).

Factors that have a negative influence on the development and utilization of achievement motivation have been proposed to be issues that relate to the quality of attachment that the individual has developed. Individuals with secure attachments in early childhood tend to be more self-assured and to do better in school than peers who may have less secure or more disorganized attachment styles established in early childhood (Jacobson & Hoffman, 1997).

Individuals who come have had inadequate up-bringings that are dysfunctional or abusive and were not provided with nurturing, encouraging support in their ambitions are at risk of developing learned helplessness and developing personality and behavioural characteristics are likely to develop poorer motivation to achieve goals due to a lack of skills to do so, and poor opinions of themselves (Dweck, & Leggett, 1988)

Individuals who are raised in low socioeconomic conditions such a poverty are unlikely to have expectations of their chances to succeed, which lowers their ambition levels and impairs their motivation to attempt the attainment of challenging goals. Individuals from low-income families, or family situations in which the parents and members of the community were of low socioeconomic status are unlikely to make goals beyond the status levels of the role models they have had in their life (Ryan, & Edward, 2000).

This propensity to ‘fall not far from the tree’ could be due to genetics, the environmental effects of their surroundings and the opportunities presented to them, or as a result of their higher risk for the development of psychiatric pathologies, delinquent behaviour, and the formation of identities that are negatively associated with undesirable groups such as gangs and drug-using social circle.

Low income and dysfunctional families are unlikely to be able to provide the appropriate support needed for adolescents to develop healthy in light of their disadvantages, which exacerbates the factors that lead to low achievement motivation in the first place (Owens et al, 2002).

With developmental supports that emphasize building strong achievement motivations in children and adolescents, regardless of their IQ or handicaps, would seem to be measures that would increase successful attainment of goals, and nurture achievement-seeking success in later life by mitigating factors that place them at disadvantages and also instil in them a strong desire to really utilize the potential that is indicated by their IQ, thus bridging the gap between actual performance and predicted performance. This would, however, need to be verified via scientific examination and analysis, but on first consideration, it seems reasonable to assume that this would be true.

References

Dweck, C. S.; Leggett, E. L. (1988) A Social-Cognitive Approach to Motivation and Personality. Psychological

Review, 95[2];256-273

Hauser-Cram, P. (1996) Mastery Motivation in Toddlers with Development Disabilities. Child Development,

67[1];236-248

Mayes, C. T., Zigler, E. (1992) An Observational Study on the Affective Concomitants of Mastery in Infants.

[Abstract]. Journal of Child Psychology & Psychiatry, 33[4];659-667

Owens, R. L., Hoagwood, K., Horwitz, S. M.; Leaf, P. J., Poduska, J. M.; Kellam, S. G.; Ialongo, N. S. (2002)

Barriers to Children’s Mental Health Services. Journal of the American Academy of Child & Adolescent

Psychiatry, 41[6];731-738

Rimm, S. B. (2008) The Next Three Steps: Expectations, Role Models, and Deficiencies. In Why Bright Kids Get

Poor Grades and What You Can Do About It. A Six-Step Program for Parents and Teachers (3^rd Ed) (pp.

205-206) Scotsdale: Great Potential Press.

Ryan, R. M., Deci, E. L. (2000) Self-Determination Theory and the Facilitation of Intrinsic Motivation, Social

Development, and Well-Being. American Psychologist, 55[1];68-78

Shaffer, D. R., Wood, E., Willoughby, T. (2005) Development of the Self and Social Cognition. In Developmental

Psychology: Childhood and Adolescence.(2^nd Ed.) (pp. 443-450) Toronto; Nelson.

Schunk, D. H.; Pajares, F. (2002) Social Cognitive Theory. In A. Wigfield, J. S. Eccles (Eds.) Development of

Achievement Motivation. London; Academic Press.

C. H. E. Anderson            Development of Adolescents

Trent University             Prof. P. Franke

PSYC-381H-Fall 2009   29/11/2009

The Self is a term for an abstract internalized multidimensional schematic that determines not only who and what were believe ourselves to be, but also the results of our appraisal of the Self that we conclude to be our own. Our sense of identity constitutes the internalized schematic of our traits, prospects, experiences, and believes, while our self-esteem comprises the evaluative aspect of the self that analyzes the acknowledged identity and provide a qualitative judgement about it’s perceived pedigree.

In adolescence individuals become capable of abstract cognitive analysis and begin to use more theoretical and dissociated terms to describe themselves Adolescents also begin to understand that they are not the same ‘self’ across all situations and environments, for some this may cause distress and contribute to what is colloquially referred to a teenage moodiness (Shaffer, Wood, & Willoughby, 2005).

Adjusting to fluctuating perceptions and presentations of self and the difficulties that such fluctuations can cause are not restricted to adolescence but persist through-out the life-span and the different developmental stages that an individual’s personality evolves through (Erikson, 1977).

Failure to develop a coherent and consistent sense of self has been indicated as a risk for the development of select personality disorders, in particularly borderline personality disorder in which a fluctuating sense of self is actually one of the nine elements of the listed diagnostic criteria needing to be met to make the diagnosis (Wilkinson-Ryan & Westen, 2000).

Self-esteem is the major component of the Self that compliments the internalized identity that the individual has accepted (Shaffer, Wood, & Willoughby, 2005). Self-Esteem is determined by a cumulative analysis of five different competencies or capacities which determine one’s estimate of overall self worth. The five competencies or capacities are: Scholastic Competence, Social Acceptance, Athletic Competence, Physical Appearance, and Behavioural Conduct. (Harter & Westen, 1992).

A poor self-assigned assessment of any one of these competencies or capacities can have drastic effects on the quality of self-esteem that the individual has, which in turn sets the tone by which they will evaluate their identity and may come to discontenting conclusions when discrepancies arise between the two.(Zimmerman et al). For this reason it should not be surprising that many of the psychiatric diagnoses illustrated in the DSM-IV-TR  fit into the five competencies or capacities when superimposed upon the Harter model.

For instance, the DSM-IV-TR  is divided into different categories of disorders which intern are assigned to different multidimensional axis which are used to provide a succinct but comprehensive overview of patients current mental functioning and associated factors of clinical relevance at the time of assessment.

If one reviews the nosological partitions in the DSM-IV-TR and compares them to the five aspects of self-esteem in Harter and Westen’s model, studies that report a high incidence of low-self-esteem and poor-self-concept and subsequent depression amongst psychiatric patients gain a new dimension of validity and relativity. (Mills, 2005) (Bagby, Quilty, & Ryder, 2008).

It is imperative that young individuals develop healthy senses of their unique Self. The Self and it’s associated features are linked to personality development and disordered personalities run the risk of progressing into psychiatric pathologies persistent into adulthood (Clark et al, 2007) (Cohen, 1991).

In conclusion, the Self is an abstract cognitive manifestation composed of an identity and self-esteem and is vital to development as a human being capable of higher cognitive functioning in a unique qualitative capacity.

REFERENCES

American Psychiatric Association (2000) Axis II Disorders; Cluster B: 301.83 Borderline Personality

Disorder. In Diagnostic and Statistical Manual of Mental Disorders (4^th Ed.)(Text Revision)

[Electronic]. Washington: APA

Bagby, R. M., Quilty, L. C., Ryder, A. C. (2008) Personality and Depression. Canadian Journal of

Psychiatry, 53[1];14-25

Clark, C., Rodgers, B., Caldwell, T., Power, C., Stansfeld, S. (2007) Childhood and Adulthood

Psychological Ill Health as Predictors of  Midlife Affective and Anxiety Disorders: The 1958 British Cohort. Archives of General Psychiatry, 64;668-678

Cohen, Y. (1991) Gender Identity Conflicts in Adolescents as Motivation for Suicide. Adolescence,

26;19-11

Erikson, E. H. (1977) Eight Ages of Man. In C. Jenks (Ed.) Childhood: Critical Concepts in

Sociology (2005) (Volume 1) (pp. 313-335) New York : Routledge

Harter, S., Monsour, A. (1992) Developmental Analysis of Conflict Caused by Opposing Attributes in the

Adolescent Self-Portrait. Developmental Psychology, 28[2];251-269

Mills, R. S. L. (2005) Taking Stock of Developmental Literature on Shame. Developmental Review,

25[26];26-63

Shaffer, D. R., Wood, E., Willoughby, T. (2005) Development of the Self and Social Cognition. 

Developmental Psychology: Childhood and Adolescence.(2^nd Ed.) (pp. 443-450) Toronto; Nelson.

Wilkinson-Ryan, T., Westen, D. (2000) Identity Disturbance in Borderline Personality Disorder: An

Empirical Investigation. American Journal of Psychiatry, 157:528-541

Zimmerman, M.A., Copeland, L. A., Shope, J.T., Dielman, T.E. (1997) A Longitudinal Study of Self-

Esteem; Implications for Adolescent Development. Journal of Youth and Adolescence,

26[2]117-141

C. H. E. Anderson                              Advanced Abnormal Psychology

Trent University                               Prof. M. Hogan

PSYC-341-Summer 2009

A Guilty Mind: A Matter of Capacity

“Actus non facit reum nisi mens sit rea;

The act does not make a man guilty if

The mind is not guilty also”

In Canada and many other countries of current or previous British rule a criminal act must be composed of two separate and distinct aspects. Actus reus; the voluntary action itself that took place which resulted in the offence at bar, and Mens rea; the possession of a guilty mind at the time the act occurred.

When the law and psychiatry cross paths in the court room it is often in the determination of an individual’s guilt, and further more to what extent he can be held liable and punished given his circumstances. Because the law requires than act be voluntary and comprehendible by the Accused for him to be designated as guilty the status of his mental health is a key ingredient in determining not only whether the act was committed voluntarily, but also if it was done with culpable malevolence.

Automatism is a legal term which refers to a state of absent dissociation in which the individual is unconscious of his actions and their consequences. The Supreme Court of Canada stated in R v. Parks that  automatism is ‘…a basic principle that absence of volition in respect of the act involved is always a defence to a crime. A defence that the act is involuntary entitles the accused to a complete and unqualified acquittal” (1992).

While it is generally agreed across pertinent disciplines that a man should not be held to the fullest of legal liabilities if he has committed a crime against his will there has been much discord amongst the legal and mental health professions in determining to what degree a mental disease or defect hinders an individual’s free will to not only act, but to do so in full comprehension of his actions so that he should be held responsible (Arboleda-Flórez, 2002).

This conundrum of determination is further complicated by difficulties in determining at what point an individual should be held responsible for his predispositions towards his non-culpable irresponsibility. A man with a violent history who is prone to losing his temper, so to speak, must exercise some responsibility for his inherent tendencies of which he is aware, regardless of whether they possess the potential to render him in an automatic state.

The determination of capacity to possess a guilty mind is a means on qualifying claims made in what is colloquially known as the ‘insanity defence’. In current times variations of the ‘insanity defence’, covered in Canada under the judgement of Not-Criminally-Responsible (NCR) have become significantly prevalent in criminal court proceedings amongst cases posited to the court by the defence. Paranoid and Anti-social personality disordered patients are the most likely of the abnormal personality patients to commit a violent crime (Stone, 2007). Avoidant Personality disordered patients are the least likely of the abnormal personality patients to be involved in violence of any kind (Oldha, Skodol & Bender, 2005).

Propositions of anti-social personality disorder have reached a considerable degree of popularity and it is because of propositions such as these that are plagued with subjective judgements and reliance upon inferential reasoning, which is important for the psychiatric community to devote attention to discerning the degrees of liability amongst such individuals in a sound psycho-medical context.

This report will attempt to provide reasonable evidence for the consideration of mens rea amongst individuals presenting with abnormal psychiatric pathologies in the Axis II realm of Personality Disorders. Specifically Anti-social personality. Some reference will be made to schizophrenia. Two different factor-models of human personality will be used to demonstrate and qualify the subtle difference that capacity makes in the assessment of pathologically ill defendants. Defendant dichotomies will be examined in hypothetical circumstances while utilizing the Five-Factor Model and the Personality Psychopathology Factor 5 model (PSY-5).

The Five-Factor Model (NEO PI-R) of personality traits is a set of five broad categories of temperaments, preferences, dispositions, and orientations first proposed by Goldberg in 1981. The actual model was developed by Costa and McRae in 1992 in the form of a 256-item personality inventory designed for use in the assessment of individual’s personality characteristics and the predictive value of their individual composition (McRae & John, 1992).

An alternative to the Five-Factor model was proposed by Harkness and Mcnaulty in 1994 after the Five-Factor model was criticized for its lack of applicability in psychopathy cases where it failed to provide an adequate range of coverage for the types of traits intrinsic to pathological personalities. The PSY-5 model was developed using the DSM-III-R as a resource for pathological characteristics and the Five-Factor Model as an opposing model of normality (Bagby et al, 2008) (McNulty et al, 1997).

This report will attempt to demonstrate that determining the presence of mens rea is a matter of determining an individual’s capacity to generate, maintain, and acknowledge a guilty mind in the full context of the law and its consequences. Also that an individual, who is capable of comprehending his mental disease or defect, be it acute, congenital, or transient is lesser candidate for an acquittal. An individual who is aware of his predispositions is to be held responsible for failure to placate or control them with reasonable vigilance.

It is necessary now to provide the working definitions that will be utilized to compare the hypothetical mental disturbances. Mens rea refers to possession of guilt in the mind. Guilt is understood to be acknowledgement of wrong doing and self-assignment of that wrong doing to ones person, whether or not it is accompanied by a distressing emotional affect.

The mind can be understood to be the intangible eminent of the brain organ. The mind is in essence our personality and all that contributes to it, and is produced by it; be it behaviour, perception or any other facet of cognitive function (Psychodynamic Diagnostic Manual, 2006).

In law, an act is not considered to be voluntary if it is done under the influence or as the result of a mental disease or defect. A mental disease can be defined as a psychiatric condition that is capable of improvement and deterioration. A mental defect can be defined as a psychiatric condition that is incapable of improvement or deterioration and is impervious to rehabilitative treatment. A mental defect may be incurred congenitally or through external means such as injury (Simon, 1967).

The personality disorders occupy the second axis of the Diagnostic and Statistical Manual of Mental Disorders’ (DSM-IV-TR) multiaxial assessment system and are defined as a collection of stable, long-standing characteristic and coping methods that encompass the individuals believes, values, self-identity, and relationships with others. The Psychodynamic Diagnostic Manual (PDM) furthers the definition by adding that one’s personality renders them repeatedly vulnerable to certain kinds of suffering, difficulties, achievements or relationship dynamics (PDM, 2006).

The Five-Factor model of personality traits is of much use in the examination of the Personality Disorders (Stepp & Trull, 2007). The five broad domains of human personality are identified as Conscientiousness (C; or constraint), Agreeableness (A; or antagonism), Neuroticism (N; or negative affectivity), Openness to Experience (O; unconventionality or intellect), and Extraversion (E; or positive affectivity) (Gudonis et al, 2008) (Costa & McRae, 1992). The Five-Factor Model is thought to provide reliable descriptions of individuals and also to offer predicative value for the pattern of vicissitudes the individual will likely encounter. The model is also thought to offer clues about what coping methods individuals will be most likely to employ.

The PSY-5 is composed of Aggressiveness (A; desire for power, social dominance, and grandiose thinking), Psychoticism (P; faulty perceptions of self, others, and the external world), Disconstraint (D; impulsivity and lack of anticipatory fear), Neuroticism (N; disposition to psychological suffering), and Introversion (I; lack of hedonic capacity and actively sought social experiences) (Bagby et al, 2008).

These two personality factor-models will be used to contrast normal and pathological personalities much the same way a normal anatomical chart exists for the average patient, but a modified one exists for a patient crippled by poliomyelitis; the same general landscape, but different markers.

When one thinks of the personality as an organ system in itself such as the renal or lymphatic system, and understands each component of the Five-Factor model to be an organ interconnected with that system then one can begin to understand how defects of the personality system can mirror their more tangible counterparts found in the organic systems.  The healthy conduction of systemic business is a sum of its parts; if one aspect is askew, the system will behave erratically.

Should an individual who is suffering from anti-social personality disorder commit a crime, there is a question as to whether he did so with a guilty mind. This determination could be considered when one speculates upon which component of his personality is faulty. The determination of the specific components, and to what relative strength they are abnormal, may shed light on the likelihood of a guilty mind’s presence (Daffern & Howells, 2007).

Two individuals with Anti-social personality disorder may be brought before the court on charges of murder. It has been confirmed that the act was committed by the accused and the question now lies in whether they are criminally responsible for their action.  One defendant scores quite poorly on the FFM in the areas of Openness, Constraint, and Neuroticism. The same defendant also scores highly on the PSY-5 in the areas of Psychoticism, Neuroticism, Disconstraint.

We can compose a profile of this individual using these two sets of scores. We can deduce that he is set in his ways. He has poor control over the expression of his emotions which expresses in an outward manner. His lack of curiosity and seeking of life experiences could limit his global education level. He experiences many unpleasant emotions which are distressing to him. He is unable to accurately assess his own affectivity and the affectivity of others. In conclusion of the brief assessment we might consider him to be explosive and responsive, but not particularly clever or conniving.

We can perform the same evaluation on the second individual using the factor-model tests. In example let us suppose that the second individual scores highly on the aspects of the FFM in Openness and Constraint. On the PSY-5 this individual scores highly in Aggressiveness, Psychoticism, and Disconstraint.

We can form a precursory profile of the second individual in the same manner in which we did the first. We can deduce that he is quite intelligent, if not proportionately educated. He is capable of self-discipline or impression management, he desires social superiority and perhaps sees himself as unique in his abilities or persona, something to warrant his desires for social dominance. His perceptions of himself and others are skewed. He may not see other people as worthy of empathy. His disconstraint may seem to contradict his self-control though it plausible that he is capable of channelling his impulsive desires but cannot eradicate them.

Already we can see that these two hypothetical individuals are quite obviously anti-social in their inherent characteristics. Both would satisfy the DSM-IV-TR’s criteria for anti-social personality disorder, and yet there is a subtle, but striking difference between the two. The first individual seems prone to a lack of premeditation in his reactivity, while the first seems capable of some measure of conscious control over his indulgences.

If acquittal is granted based on diagnosis alone, then the system would be deprived of addressing the gross difference between the two individuals in their capacity to not only comprehend the consequences of their actions, but also the scope of their own entities. It seems reasonable that a man with emotional or social deficits in his person should be held responsible for what those deficits predispose him towards if he can acknowledge his deficits. If he can acknowledge his deficits, then he is unlikely to be without mens rea in the commission of his crimes.

As an added example let us consider a hypothetical case of a schizophrenic individual who is plagued by command hallucinations. If he is unable to recognize the hallucinations as perceptive fallacies then he is guilty only of reacting in a manner that seemed appropriate given what his body had perceived as reality. To act in a manner that is contrary to reality would seem a more abnormal response to his perceptions.

If the man is aware of his condition and is aware that his hallucinations are not real, then acting upon them would be in violation of what he knows to be reality, even if his senses deceive him. By choosing to ignore that he has already acknowledged his propensity for command hallucinations, he is exercising some liable form of free will.

Continued study into the taxonomy and empirical measurement of personality traits, as well as their reliability as predictive factors in human behaviour would be of great benefit not only to the justice system but also those citizens who find themselves accused of a crime. Even if guilt cannot be avoided in the court, better insight into the personality of convicted criminals could offer hope in helping them to regain admission back into free society if they so choose to. Further understanding and testing reliability may also support the design and administration of more humane and effective criminal custody and rehabilitation programs.

Illness or Defect alone does not constitute a lack of liability for ones actions. It would be unwise to examine defendants with psychiatric illnesses based primarily upon their diagnoses. It would be far more prudent to place emphasis not on what the defendant is pathologically unable to do, so much as what he possesses the capacity to do. A man cannot commit a crime with a guilty mind, if he is incapable of possessing such a thing in the first place.

References

Arboleda-Flórez, J. (2002) On Automatism. Current Opinion in Psychiatry, 15:569-576. Lippincott

Williams & Wilkins.

Bagby, R. M., Sellbom, M., Cost, jr. , P.T., Widiger, T. (2008) Predicting Diagnostic and Statistical

Manual personality disorders with the five-factor model of personality and the

Personality psychopathology five. Personality and Mental Health, No.2: 55-69.

Daffern, M., Howells, K. (2007) Antecedents for aggression and the function analytic approach to

Assessment of aggression and violence in personality disordered patients within secure

Settings. Personality and Mental Health, No. 1: 125-137. Wiley Interscience.

DOI: 10.1002/pmh.16

Diagnostic and Statistical Manual of Mental Disorders (2000). American Psychiatric Association.

McNulty, J. L., Harkness, A. R., Ben-Porath, Y. S., Williams, C. L. (1997) Assessing the Personality

Psychopathology Five (PSY-5) in adolescents: new MMPI-A scales. Psychological

Assessment, No.3, pp. 250-259.

McRae, R. R., John, O. P. (1992) An introduction to the 5-Factor model and its applications.

Journal of Personality, No.2: 175-215.

Melton, G. B., Petrila, J., Poythress, N. G., Slobogin, C. (2007). Psychological Evaluation for the

Courts: A Handbook for Mental Health Professionals and Lawyers (3^rd Ed.) pp. 8. The Guilford Press.

Oldham, J. M., Skodol, A. E., Bender, D. S. (2005) The American Psychiatric Publishing Textbook

of Personality Disorders, pg. 480. American Psychiatric Publishing Inc.

Psychodynamic Diagnostic Manual (2006). Alliance of Psychoanalytic Organizations. Silver

Spring: MD.

R v Parks 1992 2 SCR 871

Simon, R. J. (1967) The Jury and The Defense of Insanity. pp. 31. Little, Brown and Company:

Boston.

This paper was written for PSYCH-341-Advanced Abnormal Psychology in August 2009 at Trent University in Peterborough Canada. Professor was Marjorie Hogan.

PSYC-240-PROF. FERGAL O’HAGAN  Winter 2009

Introductory Abnormal Psychology

TRENT UNIVERSITY – Department of Psychology – Undergraduate Studies

Anderson, Cassandra H. E.           Student ID: 0204023

Thayer et al set out to provide substantiating evidence for Thayer’s theory of Mood Adjustment and also to identify sexual differences in Mood-Adjustment behaviours as well as to ascertain which behaviours were used most often and also which behaviours were the most efficient at altering mood.

Four progressive and inter-connected study’s were administered which started with the collection of general  and uncategorized answers to open-questions in Study 1.

Study 2 sought to refine the statistical usefulness of responses by assessing the data rendered in Study 1 and formulating multiple umbrella-categories which were use in conjunction with a fixed-answer questionnaire.

Study 3 was designed to remove the personal bias factor that was suspected in Study 2. In Study 2 respondents were more likely to report the use and effectiveness of the behaviour that they personally were most likely to use. Biased answers such as this were not deemed capable of providing much substantial data in the way of efficacy since behaviours other than the most-used behaviours could in fact be more effective if tried.

Study 3 overcame the bias factor by questioning doctorate-level mental health care professionals about the success of behaviours amongst the clients in their clinical practice and not their personal experiences.

Study 4 was different from the previous studies in the sequence due to the focus being not on adjustment of negative moods, but on the efficacy of attempts to alter-mood which were considered to involve increasing one’s energy, or adjusting one’s tension level.

Review of the data rendered from the four study’s revealed that strategies in the Active Mood Management category were indicated as the most successful between the individuals participants and the mental health professionals.

The second most used and effective category of behaviours was attributed to being used most by men, rather than women and involved Direct Tension Reduction through the ingestions of volatile substances such as alcohol or through engaging in pleasant distractions such a sex.

The third most used and effective category of behaviours was reported to be most popular amongst women. Passive Mood Management strategies involve the ingestion of mild substances such as caffeine, nicotine or edible food matter. Passive Mood Management also involves the employment of sleeping as a method of reducing tension and affecting mood.

The category Pleasant Distraction was self-rated as the most effective way of reducing tension, while exertion and activity were rated as the most successful at raising energy.

Thayer’s assertion that exercise is the most effective method of mood-alteration was based on the assumption that physical states have a conjoined effect on psychological states and vice versa, however, Cognitive interventions appeared to be the most effective and reliable means across samples in effecting mood, tension and energy.

An extrapolation from this paper might be that an interesting relationship appears to exist between Passive Mood Management and Direct Tension Reduction. The relationship could be argued to be the similarity between the two in two factors; Both involved the ingestion of altering substances (nicotine, alcohol, caffeine, drugs) and both involved employing avoidant techniques that occupy two extremes of arousal (Sleep vs. Sex) (pg.922).

While these two categories were split between the sexes, one might suggest that while the volatility and the emotive-direction of the activities might be different, the core mechanisms sought are the same, therefore any conclusions made regarding drastic differences in methods employed by the sexes would need to be further differentiated if both seem to seek essentially the same thing.

Differences in efficacy between the sexes may not be related to the sex itself, but to the fact that drugs and alcohol are far more likely to effect the endocrine system as desired, than caffeine and nicotine

REFERENCES:

Thayer, R. E., Newman, J. R., McClain, T. M. (1994) Self-Regulation of Mood: Strategies for Changing a Bad Mood, Raising Energy, and Reducing Tension. Journal of Personality and Social Psychology, No.5, (pp. 910-925). American Psychological Association, Inc.

PSYC-240-PROF. FERGAL O’HAGAN  Winter 2009

Introductory Abnormal Psychology

TRENT UNIVERSITY – Department of Psychology – Undergraduate Studies

Anderson, Cassandra H. E.           Student ID: 0204023

The assigned reading material for this paper was concerned with establishing a substantial argument in favour of a ‘hyper-emotive’ theory of psychological illnesses that counters the currently held belief that psychological illness occurs as a result of faulty reasoning processes which lead to false beliefs and assessments (Beck, 1985)

A hyper-emotive theory proposes that patients whom develop anxiety disorders severe enough to validate diagnoses of pathology are suffering from anxiety caused by correctly assigned basic emotions that are obtained through well-developed reasoning processes, but that the intensity of the anxiety is incorrect. This stands in opposition to the assumption that anxiety is correctly assigned, but that the reasoning behind the assignment is incorrect which in turn leads to psychological illness (Beck).

Johnson-Laird, Mancini and Gangemi demonstrate the proposed role that their hyper-emotive theory could play in four common anxiety disorders diagnosed in western culture after establishing the premises  on which their argument is based; a) Anxiety disorders arise from the onset of a hyper-intense experience with a basic rather than a complex, emotion, b) the transition processes between the individuals cognitive assessment of a situation and the emotional and somatic products of such assessments is outside the realm of conscious awareness, and c) that a faulty process mechanism exists in the transitional phase manifestation but that the faulty mechanism is not that of logical reasoning (2006).

Through the assessment of brain-imaging studies and epidemiological surveys Johnson-Laird, Mancini and Gangemi were able to provide supporting demonstrative data for their hyper-emotive theory of psychological illnesses. One study which was administered to a group of psychiatrists was able to show the favourability of basic emotions versus complex emotions as culprits at the time of onset for patients with anxiety disorders (pg. 832). The psychiatrists were also able to show that psychiatric conditions can be differentiated in an intuitive and reliable manner based solely on demonstrations of the thought modalities present in the given disorders (pgs. 833-834).

Johnson-Laird, Mancini and Gangemi illustrated in their paper the common presence of pathological escalations of thought, in example; the real possibility of pathogen contamination can begin as a state of unease or awareness and progress through cyclical rumination to a state of pathological illness (pg. 826). Through escalation and cyclical rumination a pathological state of associated anxiety can also arise in the absence of a substantiated risk factor: the experience of spontaneous hyper-emotive episode in proximity to an object or situation to which the patient was in attention of can lead to a sudden association of the previously neutral object or situation with the state of intense anxiety (pg. 828).

The cyclical nature of escalation into pathological states falls into line with the subject of the previous assignment’s reading material which was ‘experiential avoidance’. In the previous reading material Hayes and his associates demonstrated the role of experiential avoidance and the paradoxical effects of attempts to avoid or diffuse aversive thoughts and their subsequent propagation of the associated anxiety in mental illnesses (Hayes et al, 1996).

References:

Beck, A. T. (1985) Anxiety Disorders and Phobias: a Cognitive Perspective. Basic Books: New York.

Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., Strosahl, K. (1996) Experiential Avoidance and Behavioural Disorders: A Functional Dimensional Approach to Diagnosis and Treatment. Journal of Consulting and Clinical Psychology, 6 Vol. 64. 1152-1168.

Johnson-Laird, P. N., Mancini, F., Gangemi, A. (2006) Psychological Review, 4 Vol.113, 822-841.

C. H. E. Anderson             BIOL-200-Fall 2008

Trent University              Prof. P. Frost

Human beings have been observed to exhibit a preference for which of their hands they prefer to use in the manipulation of their environment. Most human beings display a discernable difference in their preference and their performance with each of their hands and tend to maintain the use of their preferred hand throughout their life-span.  Some individuals display a similar functionality and preference for both hands and are designated ‘ambidextrous’ and are quite rare. Most individuals display a preference for the use of their right hand, while the remaining members of the population display preference for their left hand. This preference is a called ‘handedness’ and is regarded to imply which cerebral hemisphere the individual displays dominance for by the contra lateral association between hand preference and the suspected dominant hemisphere.

The human brain is a paired-organ consisting of two abundant cerebral lobes which mirror each other and are fixed atop the midbrain. While the complimentary left and right hemispheres may appear symmetrical a vast number of recorded asymmetries exist. Paul Broca is acknowledged for insisting that the hemispheres were not mirrored duplicates of one another, but complimentary, asymmetric components of the same organ. Either hemisphere is regarded as being capable of specialization for certain cognitive skills such as language and facial recognition. Most people are considered to be in possession of one hemisphere which is dominant to the other and handedness is considered to be a somewhat reliable indicator as to which hemisphere in an individual possesses dominance over the other.

It was once the practice of neurosurgeons to test for cerebral dominance through the acknowledgement of a hand-preference in their patients in hopes of determining which hemisphere was dominant for language, since most language functions are considered to be operated from the dominant hemisphere, whichever it may be. This practice was not always reliable and was replaced by the use of intracarotid sodium amobarbitol testing in the 1960’s, which served to paralyse either hemisphere and make dominance judgements much more accurate (Wada & Rasmussen, 1960).

Understanding the Etiology of handedness has been a fascinating subject for many centuries. It is considered a significant phenomena in need of understanding because the presence of left-handedness in an individual has long led to stigma, and more recently, a suspected predisposition towards a variety of cognitive and physical disorders (Elias & Saucier 2006).

Furthermore it is simply puzzling that a behavioural trait such as handedness has always existed within the same unequal relative frequencies; right handedness has always been vastly more prevalent to left-handedness and yet left-handedness has yet to succumb to extinction in favour of right-handedness. Whether left-handedness is determined to be an aberration or an advantage, its survivability amongst the species makes it a topic of much debate.

Certain explanations and hypotheses have been put forth to explain the significance and causation of handedness, particularly in respects to the prevalence of left-handedness over the span of the human species. A pre-dominant prejudice has been evident in studies against the exhibition of left-handedness. Left-handedness is often regarded as the deviancy in relation to right-handedness which is considered the normal pattern of dominance.

The Scottish essayist Thomas Carlyle (1795-1881) suggested that perhaps right-handedness was prevalent because a preference for the right hand in use of a sword and the left hand in use of a shield would provide one with an advantage in close-quarters warfare. He reasoned that holding the shield in the left hand would protect the heart and that because of this simple advantage; left-handers had simply succumbed to the disadvantage of holding their shields in the right hand and had all but died out (Carlyle 1871)

While Carlyle offers an interesting evolutionary explanation there is also evidence to suggest that he may have proposed this example in jest towards Charles Darwin whom he held in low regard at the time.  Even if he were solemnly serious about this proposition it seems unlikely that the heart’s leniency towards the left of the thoracic cavity would be significant enough to glean much more protection from the shield being held on the left arm, rather than the right. Carlyle’s statement also fails to explain why cultures who have not engaged in combat with shields also display prevalence for right-handedness.

Like behaviour itself, hand-preference has also had its cause levied between genetic and environmental factors. Neurologist John Hughlings Jackson (1835-1911) proposed that hand-preference was purely behaviour and that it was independent of physiological predisposition and wholly accountable to environmental influence (Jackson 1905).

Jackson believed that children would exhibit a hand-preference that their parents exhibited and that all human beings were inherently ambidextrous. He reasoned that children could be taught to be left-handed or right-handed and that in essence they were both. Jackson’s reasoning’s may have contributed to the expired practice of retraining left-handed children to use their right-hand in their schoolwork.

While retraining has been shown to be possible Jackson’s proposition loses credibility upon the examination of twin and adoption studies. It has been shown that children who are raised away from their parents are most likely to exhibit the same hand-preference as their biological parents, regardless of the preference of their adoptive parents. This would suggest a heritable link and yet siblings and even identical twins are not guaranteed to exhibit the same hand preference, whether or not they are raised in the same environment.

While Jackson’s explanation is appealing due to its lack of stigma it has not held against other competing theories and no systematic, controlled attempt has been made to produce fully ambidextrous children within and without a uniform environment. Children are not discouraged from experimenting with ambidexterity but neither are they encouraged to gain mastery in the use of both hands.

It is now known that the human brain exhibits a great degree of structural asymmetry long before birth. Certain asymmetries have been linked to various functions and while some gross asymmetries have been linked to abnormalities, others have been linked to exceptionalities. Certain asymmetries have tentatively been linked to handedness and the conditions under which those asymmetries occur have been extended to be likely causes of handedness itself. The confidence in physiological asymmetries as a cause for handedness is strengthened by the appearance of handedness to be hereditary and by extension, genetic.

While the probability of producing a left-handed child is assumed to be significantly greater in a parental pairing where one parent is left-handed than if both were right-handed, the probabilities of producing left-handed children are not definitively quantifiable between different types of parental pairings. While one can give a fairly accurate, quantified probability for the chances of producing a child with a certain eye-color or autosomal disease, all that can be offered regarding left-handedness is the un-quantified probability that producing left-handed offspring is likely to be higher if one or both parents are themselves left-handed. Left-handedness does not occur often enough in any documented pattern to become reliably predictable.

While there does appear to be a genetic influences upon handedness it is not yet clear how, or to what degree heritability plays a part. The proposition that handedness is a product of genetics is further hampered by the unarguable fact that genes code for proteins, not behaviours. And since handedness is not a physiological trait, but behaviour, genes alone cannot explain it’s frequencies in the population.

Perhaps the currently most-considered explanation is that proposed by Geschwind and Galaburda (1987) who proposed that handedness was a product of the chemical environment within the uterus. Geschwind and Galaburda hypothesized that, abnormally high levels of testosterone in utero lead to a higher probability of left-handedness in the offspring. They speculated that since a variety of well-established abnormalities were linked to the condition of being male that not only would males present with a higher frequency of left-handedness but that females exposed to abnormal levels of testosterone in utero would also show a higher prevalence of left-handedness against other females.

Because handedness is regarded as a physical behaviour which reliably indicates which cerebral hemisphere an individual possesses dominance for the cognitive skill of language then an individual who is cerebral dominant for their right hemisphere is likely to have an abnormal left hemisphere.

Since various learning disorders are shown to be more prevalent in males and that females are shown to be superior to males in regards to cognitive language skills it was somewhat viable to consider the effects of estrogens versus testosterone in the production of handedness in the individual. If the prevalence of testosterone in utero was considered more likely to lead to learning disorders, and left-handedness essentially indicated abnormal cognitive language skills, then testosterone itself could be blamed for cognitive and behavioural aberrations. Left-handedness has been considered an aberration that has prevailed to exist through time and perhaps elevated levels of testosterone would explain its continued survival as a human trait.

While the ideas proposed by Geschwind and Galaburda are compelling, they are far from definitive and perhaps only suggestive. For the Gecshwind and Galaburda theory to be correct, one would need to fully commit to the concept that left-handedness is pathological and that this pathology could only come to be through abnormal developmental conditions. For behaviour to be linked to physiological abnormality one must fist identify the structure whose function is considered aberrant. This has not yet been conclusively defined for either type of handedness.

Geschwind and Galaburda’s theory also succumbs to some doubt due to the fact that a myriad of developmental disorders and subsequent deviances have been linked to abnormal testosterone levels in utero and while these particular abnormalities have been widely reproducible, the production of left-handed children through the manipulation of testosterone levels has not achieved a confident level of recurrence (Gorski et al 1980).

An overall aspect of the handedness dilemma that is sometimes forgotten but is quite pertinent in placing all theories regarding its nature into the proper context is that left-handedness does not appear to bring with it any evolutionary disadvantage. Left-handedness may be less prevalent and perhaps it does correlate to some predispositions for certain abnormalities, but whatever negative attributes one can connect left-handedness to it does not appear to be enough to breed out  the trait from the population. Therefore left-handedness may offer some advantage to the individual that outweighs any disadvantage it may also signify.

The production of left-handed offspring is unreliable no matter which theory one ascribes himself to. Various theories and explanations have circulated through the human population for centuries and yet we have not determined a concrete Etiology or explanation for one preference over the other, not to mention the degree’s of preference in between. Handedness seems to give implications about neural structure and cognitive function, and yet it is not wholly reliable. Handedness may, or may not hold some as-yet unknown significance but for now all we have is speculation and more inquiries in the place of a definitive explanation and functional answers.

REFERENCES

Elias, L.J., Saucier, D.M. (2006) Neuropsychology Clinical and Experimental Foundations Pearson Education.

Geschwind, N., Galaburda, A.M., (1987)  Cerebral lateralization; biological mechanisms, associations, and pathology  MIT Press.

Gorski, R.A., Harlan, R.E., Jacobson, C.D., Shryne, J.E., Southam, A.M., (1980)  Evidence for the existence of sexually dimorphic nucleus in the pre optic area of the rat   Journal of Comparative Neurology, 193(2), 529-539

Jackson, H., (1905)  Ambidexterity  London, England. Keagan Paul.

Luria, A.R. (1966). Higher cortical functions in man. New York: Basic Books.

Sacks, O.W., (1987)  The man who mistook his wife for a hat and other clinical tales   New York: Perennial Library.

C. H. E. Anderson                      Introduction to Social Psychology

Trent University                       Prof. Rory Coughlan

PSYC-272-Winter 2009

Author Carol Tavris briefly explores the various self-defeating views that western society has held regarding the capabilities and worth of women through out various era’s of the 1900’s, in her article entitled ‘Measuring Up: Why Women Are Not Inferior to Men”.

The topic of address in this student’s discussion of Tavris’s paper is that of the relation between Western Society’s ‘Ideal Female Body Type’ and the state of the economy at various points in history. Tavris explores the different social ‘era’s’ and their relations to the ideal female body types of the times.

Tavris proposes that the ideal female body type – as established by the formal standards displayed by the models in popular women’s magazines and other media types – has fluctuated between a round, large-breasted, distinctly-feminine ideal and slim, small-breasted, more masculine ideal.

During times when maternal sentiment is held to a celebrated standard in society, the distinctly feminine body form that emphasizes its difference from the standard male body type is considered to be ideal. In contrast, when industriousness and higher degrees of education are expected by society, the ideal body type for a woman is more consistent with that of the male standard body type.

In short, when babies are important women are expected to be as much like a woman as possible. When commercial enterprise and intellectual advancement are the highlight of society, a woman is expected to as much like a man as possible.

Tavris proposes that the reasons for this cyclical rotation of standards (and the now expected ‘hybrid’ she describes) is that society has never allowed a female body type to exist that was not subject to a standard ideal. She proposes, based on several cited studies, that this is expectation to adhere to a standard of some type is harmful to women and that it arises from a more complex, socially-constructed, disparity between the sexes.

Tavris uses the work of Psychologist Brett Silverstein to demonstrate the empirical fluctuations in the female bust-waist-hip ratio’s found in possession of the women in popular magazines at different times in history.

In examination of Silverstein’s evidence one can supposedly see with mathematical clarity that during pro-maternal era’s such as the 1900’s and 1950’s, the ratios were larger. One can also see in the data that during times when maternal duties were regarded with less admiration such as the 1920’s and the 1960’s, the ratios we’re smaller than those found during opposite eras of appreciation.

Tavris raises a critical and interesting facet to consider in regards to the fluctuating body type phenomena. She notes that during times of ‘female liberation’ women have done little more than attempt to imitate the male oppressors they believe themselves to be free of.

Tavris moves on in her piece to discuss the other glaring, socially-constructed disparities between the sexes that she believes are a disservice to both. She provides a well-formulated argument that the concerns of science and society ought not to be in regards to how different males are from females, but more so why we are so concerned with separating ourselves from each other through our differences.

References

Tavris, C. (1993). Mismeasure of Women: Why Women are Not the Better Sex, the Inferior Sex, or the Opposite Sex. Touchstone.