Doctor of Philosophy in Medical Genetics (PhD)
A mixed methods evaluation of lived experiences, adaptation, and identity development in adolescents with genetic conditions
Psychiatric disorders are complex conditions that – in broad terms – arise as a result of genetic and environmental vulnerability factors acting together. Progress is now being made towards understanding the causes of these conditions more specifically, and there is an urgent need to translate this into benefit for individuals with psychiatric disorders and their families.
The overall objective of my program of research is to use a clinical genetics perspective to inform the development of novel biological and non-biological interventions to improve outcomes for individuals with psychiatric disorders and to support their families.
In honour of #GreatSupervisor week at #UBC, a huge thank you to @J9_Austin for challenging, supporting and inspiring me every day. You are an incredible mentor, not only in science and genetic counselling, but also career, life and everything in between! #GCchat
Qualities of excellent researchers, mentors, and leaders -- @JenniferLoveUBC #WHRISym18 @J9_Austin #greatsupervisor
Do I have a #GreatSupervisor at #ubc? Hell ya! @J9_Austin is not only a superstar researcher and leader, she’s a superstar supervisor! So glad I could help celebrate her with the Killam teaching prize this year! @ubcprez @UBCmedicine
Dissertations completed in 2010 or later are listed below. Please note that there is a 6-12 month delay to add the latest dissertations.
Problem: Depression during pregnancy affects 10-15% of women. Practice guidelines recommend that clinicians support women to make treatment decisions that are informed by the risks of both untreated depression and antidepressant use during pregnancy. However, there is minimal evidence regarding how women make these decisions or how clinicians can best support them. Purpose: To advance knowledge and understanding regarding women’s decision making about perinatal depression treatment through qualitative (QUAL) and quantitative (QUANT) studies. The QUAL purpose was to develop a constructivist grounded theory, within a feminist theoretical framework, of women’s perinatal depression treatment decision making. The QUANT purpose was to test the hypothesis that women with deleterious variants in the pharmacogenes CYP2D6 or CYP2C19, taking selective serotonin reuptake inhibitors (SSRIs) prenatally, would have more depression symptoms than women whose pharmacogenetic variants have been associated with normal SSRI metabolism. Methods (QUAL): Semi-structured interviews were conducted with purposively-sampled, pregnant/preconception women who had experienced depression. Iterative data collection and analysis, along with theoretical sampling, in the context of reflexive journaling, peer debriefing, and expert audit, culminated in a cohesive theoretical model. Methods (QUANT): Testing of CYP2D6 and CYP2C19 were performed as secondary analyses on two longitudinal cohorts of pregnant women taking SSRIs. The Kruskal-Wallis Test compared mean depression scores across four predicted metabolizer groups: 1) poor, 2) intermediate, 3) extensive, and 4) ultra-rapid. Results (QUAL): Participants’ (N=31) decision-making processes were complex and dynamic, and highly influenced by contextual factors - particularly stigma, patriarchy, privilege, and their emotional/cognitive environments. Participants navigated towards a decision, in a non-linear manner, between three clusters of decision-making activities: 1) seeking information, 2) making sense of information, and 3) self-soothing.Results (QUANT): There were no significant differences between mean depression scores across the four metabolizer groups (N=83; H(3)=.73, p=.87).Conclusions: The grounded theory provides insight into how women have made this decision, which can be useful both practically and emotionally. Evidence from the pharmacogenetic study clarifies the limitations of this field, which is especially vital in this era of direct-to-consumer genetic testing. Together, they can support patient-oriented decision making regarding perinatal maternal mental health.