Psychiatry - Theses
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ItemPsychopharmacological and psychophysiological studies in normal subjects and psychiatric patients(University of Melbourne, 1976)
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ItemThe effectiveness of three treatment regimens used in the management of neonatal abstinence syndrome( 1995-09)This study proposed a multifactorial model of development to understand the development of infants during their first 12 months of life who had been born to chemically dependent women. The impact of maternal chemical dependency on pregnancy outcome, factors associated with severity of neonatal abstinence syndrome and effectiveness of three treatments used in the management of neonatal abstinence syndrome was studied in 271 mother-infant pairs, who were managed by the Chemical Dependency Unit, Royal Women’s Hospital, Melbourne between April 1991 and May 1994. The chemically dependent mothers and their infants were grouped on the basis of their primary drug of abuse: viz methadone, heroin, non-opioid and codeine groups. Fifty two infants born to drug-free mothers were recruited from a routine antenatal clinic of the same hospital to serve as a control group. The controls were matched for maternal age, marital status, race socioeconomic status, educational level, alcohol and tobacco consumption. Patterns of maternal drug use were determined by reports from methadone treatment programs, drug rehabilitation centres, medical records, personal interviews and urine toxicologic assays performed on mothers during pregnancy and on their infants during the first 48 hours of life. Urine was assayed for metabolites of methadone, amphetamines, barbiturates, cocaine, opiates, cannabis and benzodiazepines. There were 180 heroin-dependent, one morphine-dependent and one pethidine-dependent pregnant women enrolled in methadone maintenance programs. The methadone group consisted of these 182 methadone-maintained women and their offspring. Thirty five heroin-dependent women and their offspring formed the heroin group. The non-opioid group consisted of 46 chemically dependent women who used multiple drugs but not opioid drugs during their pregnancy and their offspring. There were eight mother-infant pairs in the codeine group. The mothers in this group primarily abused medication containing codeine in pregnancy. (For complete abstract open document)
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ItemLinguistic politeness in middle childhood: its social functions, and relationships to behaviour and development( 1997-07)This research compared Brown and Levinson’s “face saving” account of linguistic politeness with the everyday or social normative account in the context of children’s requesting skills. The research also explored the relationship between children’s politeness skills and their behavioural adjustment. The subjects comprised four groups of ten-and-a-half year old children: a comparison group without behaviour problems, a hostile-aggressive group; an anxious-fearful group; and a comorbid group. All the children were selected from the Australian Temperament Project subject population based on parents’ ratings of the children on the hostile-aggressive and anxious-fearful subscales of the Rutter Child Behaviour Questionnaire. Study 1 found that all the groups of children discriminated between others on the power and distance dimensions in ways consistent with social norms, e.g. adults are judged as more powerful than children. Study 1 also showed that the hostile-aggressive and comorbid groups were significantly less likely to discriminate between others on these dimensions compared to the comparison group. Study 2 showed that for all the children studied politeness as a normative way of speaking was marked by use of please whereas face saving politeness was marked by the use of question directives and hints compared to other request forms. Further, Study 2 showed that there were no differences between children with and without behaviour problems in their use of please to mark different ways of asking.
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ItemThe history of Yarra Bend Lunatic Asylum, Melbourne( 1996-11)The thesis is in three major sections, plus a brief conclusion. The first section provides essentail background by describing the care of the mentally ill in England and New South Wales (including the Port Phillip district) in the period prior to the establishment of Yarra Bend Lunatic Asylum in 1848. The second section is a chronological history of Yarra Bend, particularly focusing on the period from its inception in 1848 until the Royal Commission of 1884; with some extension to describe the other psychiatric services within Victoria during the same period.The third section discusses at length a number of key issues identified within the chronological history.
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ItemA neuroendocrine study of chronic combat-related post-traumatic stress disorder( 1997)Descriptions of the development of psychiatric symptoms in response to traumatic experience can be found in literature dating back to some of the earliest writings found. Amongst these symptoms there have always been descriptions consistent with what we would now term Post Traumatic Stress Disorder (PTSD). Tomb (1994) describes how such symptoms historically have been most frequently described in relation to combat experience and are contained in such classical texts as Homer’s Iliad. Recognition that such symptoms also occur in association with non combat related trauma is a relatively recent event. This can be seen in description of response to traumas such as The Boston Coconut Grove Fire (Adler 1943) and the Buffalo Creek Dam collapse (Gleser et al 1981). Combined with the massive number of combat veterans with combat experience related to psychiatric disability following the World Wars, significant impetus appears to have developed for separate classification and understanding of trauma related psychiatric symptoms. Together, these forces led to the creation of the diagnostic category of PTSD for the first time in the American Psychiatric Associations DSMIII (APA 1980). In this series of studies, we are thus aiming to further the understanding of the neurobiology of Post Traumatic Stress Disorder by specifically examining a group of male Australian Vietnam veterans with current PTSD, comparing them to two control Vietnam veteran populations, one group of those veterans who previously met criteria for a diagnosis of PTSD and a third group who never have met criteria for a diagnosis of PTSD. We examined these three groups in a number of ways. Firstly, to further understand aspects of central noradrenergic receptor function we utilised a clonidine growth hormone challenge test. Consistent with previous literature on the HPA axis in PTSD from North American we utilised a modified dexamethasone suppression test to investigate feedback within the HPA axis. Finally, we investigated serotonergic receptor function peripherally with a further study of platelet paroxetine binding and performed the first large study examining central serotonergic receptor function using the d-fenfluamine prolactin challenge test. Before describing the methodology and results of these studies I will review relevant findings to these three systems from studies of animal and human models of stress, clinical populations with PTSD and their treatment and previous experimental analysis of relevant biological variables in subjects with PTSD.