Search

Lack of awareness of illness (insight) is a well recognised problem in clinical syndromes such as first episode psychosis and dementia. In healthy persons, ability to accurately rate our thoughts and behaviours is also often referred to as metacognition and there is also some debate as to whether the accuracy of our self-awareness diminishes during healthy ageing. Low mood is often noted to be associated with better insight in clinical groups, however it is not clear whether this also mediates awareness is healthy adults. Some aspects of insight are also mediated by cognitive abilities; more work is required in this area in healthy adults. Awareness and metacognition are often used interchangeably in the clinical literature, despite the methods differing drastically between healthy and clinical awareness studies. The aims of this thesis were: - to investigate the similarities and differences between insight and experimental measures of metacognitive efficiency across the adult life span and in patients experiencing their first episode of psychosis (FEP), early-stage dementia (ED) and depression. - to quantify the insight and metacognitive functional abilities and deficits in these groups. - to investigate the effect of mood and cognitive abilities on insight and metacognitive efficiency. - to run a pilot neuroimaging study aimed at investigating the structural neural correlates of both cognitive insight and metacognitive efficiency in ED patients. Both clinical measures of insight and experimentally derived metacognitive tasks were used. Results indicate age, memory and mood mediate metacognitive efficiency in healthy adults, with small associations between metacognitive efficiency and some measures of insight when controlling for age. In patients, results suggest that mood is associated with cognitive insight in FEP, but not metacognitive efficiency in either early dementia or psychosis. Further, there was an association between cognition and metacognitive efficiency in FEP, but not ED. There was no association between insight and metacognitive efficiency in either patient group. Comparing groups, FEP patients have worse metacognitive efficiency that healthy younger adults but not insight, whereas there was no difference between ED and healthy older adults. FEP patients appear to have better self-reflection on clinical scales than ED patients, whereas there was no difference between the two groups in metacognitive efficiency. The imaging study indicated that measures of cognitive insight and metacognitive efficiency have overlapping structural correlates in the cortical midline structures. Implications for these findings in both healthy adults and patients are discussed.

This dissertation investigated the effects of the intervention of the Just One Mentoring Program on student persistence in completing their career programs. The population for this study consisted of a heterogeneous group of students enrolled in the Just One Mentoring Program during summer 2003 through fall 2006 at a community college located in Milwaukee, Wisconsin. A total of 46 students (29 females and 17 males) from various ethnic backgrounds participated in the study. The study found that students who participated in the Just One Mentoring program demonstrated persistency in their career programs. Females demonstrated greater proficiency in social integration than males. Academic integration had the most compelling influence on non-persistence. Other influences were environmental with work schedule, family problems, and financial problems. Persistence was defined as: (1) returning suspended students who participated in and completed the Just One Mentoring program to the college immediately with their financial aid; (2) increasing the success rate of course completion each semester after returning to the college; (3) improving student grade point average; (4) continuing enrollment each semester; and (5) graduating from their programs, or transferring to a four-year college or university, or gaining employment. Independent variables in the study included age, gender, ethnicity, and enrollment status at the time of suspension, campus attended, graduation, transfer to other college or university, employment, social integration, academic integration, hours in class, credit hours, reason(s) for suspension, and assessment of the perceived effectiveness of the Just One Mentoring Program. This study was a descriptive methodology using a mixed method of quantitative and qualitative research. It used document materials, survey, focused group interviews, and a college database of students' records called Cosmo to triangulate the participants' responses to the research questions. Data were analyzed by calculating frequencies, counts, percentages, means and standard deviation. The t-Test was used to test for significant differences in the characteristics of persistency. The results of this study contributed to understanding the factors which influence students' decisions to persist in college. The findings of this study provide academic administrators and others in higher education information about the factors affecting students' persistence in community colleges. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]