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Item Open Access Exploring Opportunities to Enhance Engagement in Home-Based Stroke Rehabilitation Through the Design of Instrumented Objects(2025-04-10) Wong, Joey Shon Yue; Desai, ShitalThis thesis explores opportunities to enhance patient engagement in stroke rehabilitation through the design of an instrumented object aimed at improving fine motor skills at home. Using a Research through Design approach, the study focuses on the development of MorlensRehab, a sensor-based device that incorporates occupational therapy exercises. The prototype was used in a co-creation workshop to identify and better understand the needs and experiences of a diverse group of stakeholders, including rehabilitation patients, caregivers, healthcare providers, and technology developers. A thematic analysis of the workshop data uncovered key themes such as motivation and engagement, monitoring health and wellness, and social connectedness, highlighting factors that influence the adoption of technology in rehabilitation. Insights from the workshop also provided recommendations for more user- friendly iterations of MorlensRehab and emphasized the importance of developing an ecosystem of supporting products that can enhance patient engagement and the adoption of rehabilitative technologies.Item Open Access Developing A Non-Human Primate Model To Dissect The Neural Mechanism Of Facial Emotion Processing(2025-04-10) Shirin Taghian Alamooti; Kohitij KarFacial emotion recognition is a cornerstone of social cognition, vital for interpreting social cues and fostering communication. Despite extensive research in human subjects, the neural mechanisms underlying this process remain incompletely understood. This thesis investigates these mechanisms using a non-human primate model to provide deeper insights into the neural circuitry involved in facial emotion processing. We embarked on a comparative analysis of facial emotion recognition between humans and rhesus macaques. Using a carefully curated set of facial expression images from the Montreal Set of Facial Displays of Emotion (MSFDE), we designed a series of binary emotion discrimination tasks. Our innovative approach involved detailed behavioral metrics that revealed significant parallels in emotion recognition patterns between the two species. These findings highlight the macaques’ potential as a robust model for studying human-like facial emotion recognition. Building on these behavioral insights, the second phase of our research delved into the neural underpinnings of this cognitive process. We conducted large-scale, chronic multi-electrode recordings in the inferior temporal (IT) cortex of rhesus macaques. By mapping the neural activity associated with the classification of different facial emotions, we uncovered specific neural markers that correlate strongly with behavioral performance. These neural signatures provide compelling evidence for the role of the IT cortex in processing complex emotional cues. Our findings bridge the gap between behavioral and neural perspectives on facial emotion recognition, offering a comprehensive understanding of the underlying mechanisms. This research not only underscores the evolutionary continuity of social cognition across primate species but also sets the stage for future explorations into the neural basis of emotion processing. The integration of behavioral analysis with advanced neural recording techniques presents a powerful framework for advancing our knowledge of social cognition and its disorders.Item Open Access Mitochondrial Relationships And Contributions To Muscle Weakness And Wasting During Cancer Cachexia(2025-04-10) Luca Joseph Delfinis; Christopher PerryCancer-induced cachexia is the on-going loss of skeletal muscle mass and function throughout cancer progression. 20%-80% of cancer patients are predicted to develop cachexia depending on the type and stage of cancer, of which, there is currently no treatment. Current literature on the mechanisms of muscle loss and weakness in cancer have been limiting, especially as it relates to mitochondrial function. Moreover, several experts have suggested the use of cancer cachexia models which replicate the human disease more accurately would be of large utility towards mechanism elucidation and therapy development within this disease. The focus of this dissertation was to first determine the precise muscle-specific and time-dependent cancer-induced muscle myopathy through two different preclinical models of cancer cachexia. We first used the well-established Colon-26 (C26)-ectopic model of cancer cachexia to characterize skeletal muscle weakness, atrophy and mitochondrial function across time and muscle types. We then used a novel metastatic and orthotopic model of epithelial ovarian cancer (EOC) cachexia to further identify precise cancer-induced skeletal muscle myopathy, once again across time and different muscle types. Finally, to both establish the efficacy of a novel treatment and establish a direct link between cancer-induced skeletal muscle myopathy and mitochondrial function, we administered the mitochondrial-targeted therapeutic SkQ1 to EOC tumour bearing mice. Our findings reveal that cancer-induced skeletal muscle weakness precedes the development of skeletal muscle atrophy in both the C26-ectopic and EOC-orthotopic models of cancer cachexia. Thus, this dissertation identifies muscle atrophy-independent contributions to skeletal muscle weakness exist in cancer-induced myopathy, a phenomenon yet to be explored. Our findings also demonstrate decreases in mitochondrial respiration and increases in mitochondrial reactive oxygen species are associated with skeletal muscle weakness and atrophy across two preclinical models. Last, treatment with SkQ1 establishes a direct link between mitochondrial function and skeletal muscle weakness independent of atrophy as this mitochondrial-enhancing drug improved force production across various muscles and time. In conclusion, this dissertation identifies a direct relationship between mitochondrial function and cancer-induced weakness. This work supports the future investigation of mitochondrial targeted therapy in cancer cachexia.Item Open Access Mortality Risk In Persons With Obesity: The Role Of Cardiovascular And Metabolic Medication Use(2025-04-10) Reagan Alexander Reid; Chris ArdernPersons with obesity (PwO) are at an elevated risk of both cardiovascular and metabolic diseases as well as increased mortality risk. The effects of medication use on this relationship has not been investigated and is the focus of the current investigation. This study utilized data from 1999-2018 pooled cycles of the US NHANES. In general, death rates were higher in those taking medications. PwO aged 65 years and older who were taking cardiovascular or metabolic medications had a lower risk of mortality than those of a normal weight over 65 years of age and older without each respective medication. Conversely, PwO aged 30 to 64 years old showed a higher mortality risk than those of a normal weight, with greater risk of mortality observed in those using medication than those without.Item Open Access Brain Responses To Symmetries In Naturalistic Novel Three-Dimensional Objects(2025-04-10) Shenoa Ragavaloo; Peter KohlerHuman brains are sensitive to symmetry, especially vertical reflection, which is present in human faces and many other biological forms. However, symmetries in most visual scenes are rotated relative to the observer’s viewing location, failing to produce symmetry in the retinal image. We investigated the differences between perspective-distorted symmetry, and images that produce symmetry on the retina, and measured the association between responses to symmetry and autism spectrum disorder (ASD). We found that perspective-distorted symmetry with cues to 3D shape elicited responses, and both image-level and perspective distorted 3D symmetry elicited stronger responses than 2D symmetry. 3D image-level symmetry created stronger responses than 3D perspective-distorted symmetry. Lastly, there was no association between responses to symmetry and ASD. We conclude that symmetry processing occurs in the absence of a symmetry-related task, even for perspective-distorted symmetry. Additionally, there may not be any association between conditions that affect global processing and symmetry processing.Item Open Access Cancer Recovery Narratives Pre And Peri Covid: A Mixed Methods Comparative Analysis(2025-04-10) Lucas Gordon Scott Norton; Karen FergusThis study is the first of its kind to compare narratives from cancer survivors collected at the end of treatment both before the COVID-19 pandemic began (2017-2019) and three years following (2023-2024). Data was collected through short narrative care interviews, designed to provide a supportive way for cancer survivors to process the experience of treatment and recovery, and find ways to effectively move forward in life. Preliminary quantitative findings indicate the potential effectiveness and acceptability of the narrative interview for supporting individuals at the end of cancer treatment, with notable increases in self-reported social well-being. Emergent qualitative thematic differences include frequent reports of medical delays and experiences of loneliness during treatment in the peri-COVID cohort, as well as indications that this group was more inclined to advocate for their healthcare needs, express skepticism toward the medical system, and speak more positively about interpersonal support from loved ones than the pre-COVID cohort.Item Open Access Identifying The Ecological Interactions Of Invasive Lymantria Dispar Dispar And Agrilus Planipennis Using Metabarcoding Techniques(2025-04-10) Nicole Dorothy Borsato; Elizabeth ClareThe objectives of this thesis were to develop a standardized metabarcoding protocol to identify ecological interactions between insects and other taxa, as well as determine the impact of ecological correlates on the detection of these interactions. In Chapter 2, I evaluate target loci for the identification of Lymantria dispar dispar (spongy moth) and Agrilus planipennis (emerald ash borer) ecological interactions and develop a standardized protocol for the analysis of these interactions. I demonstrate that my metabarcoding protocol can be used to identify a wide diversity of interactions, including those with animals, plants, bacteria, and fungi. In Chapter 3, I assess how ecological factors (e.g., life stage, collection location, etc.) influence the presence or absence of ecological interactions in emerald ash borers using random forest models. I found that interactions were more likely to be detected in pupal specimens and in samples collected earlier in the year.Item Open Access Simulation Optimization Of Operating Room Schedules For Elective Orthopaedic Surgeries(2025-04-10) Daria Victorovna Maltseva; Stephen ChenThe aim of this thesis was to solve the problem of scheduling elective surgeries in a multiple operating room setting with the goal of minimizing the amount of overtime incurred. While surgical durations cannot always be perfectly estimated and vary by procedure and surgeon, we propose an approach that relies on leveraging the stochastic nature of surgical durations to simulate each operating day and understand the probability of incurring overtime under a certain schedule of surgeries. Through experimentation with three optimization techniques that strategically re-schedule surgeries, two showed promising results being able to reduce the total number of overtime surgeries by 12-15%, equivalent to approximately 1h of total monthly overtime. This approach serves as a tool for improving schedules and supporting decision makers at any hospital dealing with elective surgeries. Our contribution involves introducing the simulation optimization model and describing the data-driven approach to analyzing the scheduling problem.Item Open Access Transnational Adoptees' Identity, Belonging, And The Role Of Sport(2025-04-10) Bliss Valentina Wong; Yuka NakamuraThis study examines how, and if, sport could influence transnational adoptees’ identity formation and sense of belonging. Transnational adoptees’ identity and belonging development is complex, dynamic, and contextual. For example, some transnational national adoptees are racialized individuals within a white society and feel a lack of belonging to either group. Three facets of identity were identified: pre-adoptive identity, the adoptee identity, and ethnic identity. Each identity facet was found to develop uniquely; a singular plot can not be used to understand the development of all the facets. Sport was found to offer transnationally adoptees a space to develop essential network connections, provide opportunities for ethnic identity exploration and cultural connection, and provide a reprieve from conflicts and tensions. However, pre-existing dynamics and social exclusion were also reproduced. The stories that emerged offer insights into how the context of sport influences transnational adoptees’ navigation of belonging and identity.Item Open Access Ethical Procurement In The 2026 FIFA Men's World Cup: Toronto's Efforts In Combating Sweatshop Labour(2025-04-10) Yazan Al Horoub; Parissa SafaiThe anti-sweatshop movement has long committed to abolishing sweatshop labour and ensuring workers’ rights for all. There is an established body of literature on sport and the anti-sweatshop movement on the roles played by a range of actors concerning the mega-sporting events, which have been plagued with abuses of workers’ lives in the name of the sport spectacle. In effort to move past this troubled history, FIFA has embedded internationally recognized human and labour rights into their 2026 bid process. This study evaluates how the City of Toronto, Canada Soccer Association, and FIFA have considered ethical procurement and sweatshop labour as part of their bid for co-hosting the 2026 FIFA Men’s World Cup. Employing a critical theoretical approach, this study finds that despite the varying levels of considerations given to ethical (anti-sweatshop) procurement, the efforts remain insufficient. This is attributed to the unequal power dynamics that prioritize a discourse of (neoliberal capitalist) development for soft power.Item Open Access From Resisting to Sustaining: Exploring Skilled Migrants’ Alternative Career Pathways(2025-04-10) Soodabeh Mansoori; Jelena ZikicThis qualitative study employs a grounded theory approach to explore the lived experiences of skilled migrants in Canada who engage in alternative careers. The study investigates identity work and meaning-making processes of career actors who perceive alternative career options as “beginning again.” Through 30 semi-structured in-depth interviews, the findings identify three distinct alternative career pathways: provisional, experimental, and reformist; each characterized by a unique form of identity work and accompanying types of meaning-making. Each path provides distinctive insights into how skilled migrants cope with, and adapt to, the mismatches between their skills and new job demands, challenging and redefining their professional identities. Additionally, it highlights how each career pathway may shape migrants’ subjective well-being. This study advances the existing literature on major career transitions, specifically skilled migrant career trajectories inside local organizations, by highlighting how they reconstruct new professional identities and derive meaning in contexts that often fall below their qualifications and career aspirations. This study extends existing research on employability and career sustainability by integrating the dynamic processes of identity negotiation and meaning-making in the face of career transitions. It also builds on the existing meaning-making literature by highlighting the career narratives of those who must search for new meanings while pursuing “less than ideal” career opportunities. Finally, the findings provide practical implications related to outcomes of alternative career opportunities on migrant career success and, more broadly, for employers and policymakers.Item Open Access An Evaluation Of Acceptance And Commitment Therapy Workshops For Parents Of Autistic Children(2025-04-10) Andrea Louise Maughan; Jonathan WeissEmerging research shows that Acceptance and Commitment Therapy (ACT) may improve mental health for caregivers. This dissertation sought to understand outcomes and experiences for parents of autistic individuals following participating in a 3-day ACT group workshop. Workshops were co-led by other trained parents of autistic people and professional clinicians. In Study 1, parents (N=54) were randomly assigned to either complete a brief group- based ACT intervention or remain on the waitlist. Participants completed surveys immediately prior to randomization, and 3-, 7-, and 17-weeks post-randomization. Mixed effects linear models testing group x time interaction indicated the Treatment group demonstrated greater post- intervention improvements than the Waitlist group in parent depression and family distress. Treatment group parents also reported greater short-term gains in positive affect and personal goal attainment, compared to the Waitlist group. Although there was no significant group x time interaction for other outcomes, stress, defusion, and experiential avoidance showed improvement for the Treatment group, but not the Waitlist group, at post-intervention. All Treatment group improvements were maintained at follow-up. Results suggested that a brief ACT group intervention is efficacious for improving some aspects of mental health for parents of autistic children. In Study 2, 15 parents who had previously attended the ACT workshop participated in individual interviews, focusing on parents’ experiences in a group with a co-facilitation model, and their perspectives about who should facilitate interventions for parents of autistic people. Using a qualitative thematic analysis approach, overall themes identified included the importance of a group environment in which trust is created through establishing credibility of the program and ensuring emotional safety. This environment allowed for parents to be able to fully participate in the workshop by sharing experiences, feeling open minded and hopeful, and focusing on what is important to them. Participants discussed behaviours, knowledge, and skills that they value in facilitators, that both parent leaders and professional clinicians can contribute, as well as emphasizing the unique value that the parent leader brought to the group. Findings lend themselves to developing best practices around creating effective and supportive interventions for parents of autistic people.Item Open Access Role(s) Of Pannexin1A/B In The Physiology Of The Zebrafish Visual System(2025-04-10) Sarah Houshangi-Tabrizi; Georg R. ZoidlPanx1 proteins are glycosylated integral membrane channels with unique conduction properties, functioning as an ATP channel and non-selective ion channel in different physiological pathways. In zebrafish, the mammalian Panx1 ohnologues, Panx1a and Panx1b, have distinct tissue expression patterns. We previously demonstrated that in the retina, Panx1a is localized in the horizontal cell layer and the ON/OFF ganglion cell layer, while Panx1b protein is present in the horizontal cell layer, ganglion cell layer, and in the end-feet of the Muller glia astrocytes. Here we investigated the optic flow response in the Panx1a-/- and Panx1b-/- 6dpf larvae utilizing molecular, systems, and behavioral assays. The RNA-seq analysis revealed broad regulation of genes involved in axon guidance, retinal axon guidance, astrocytes, axons, dendrites, and synapse, confirmed by RT-qPCR in the 3dpf and 6dpf Panx1a-/- and Panx1b-/-. We demonstrate that Panx1a-/- and Panx1b-/- display an inability to make a leftward and rightward directional motion in low light contrast conditions when exposed to the left and right moving gratings. We also show how the strategic localization of Panx1a and Panx1b in the habenula region modulates visually guided behavior. Lastly, Panx1a-/- and Panx1b-/- demonstrate the inability to generate functional saccades and display ocular motor deficiencies linked to potential neurological disorders. These findings suggest that Panx1 modulates the axonal growth in axon guidance pathfinding and together are interconnected to the habenula region, leading to synaptic plasticity of the retinal neural circuitry, and regulating visually guided locomotion in the zebrafish larvae.Item Open Access "Progressive? Mothers: Feminist Eugenics And Leta S. Hollingworth(2025-04-10) Michael John Hewgill Stead; Alexandra RutherfordLeta S. Hollingworth was an early 20th century U.S. Psychologist, active during what is commonly referred to as the Progressive Era. While initial scholarship on Leta Hollingworth during the 1960s and ‘70s had celebratory aims geared towards her role as a feminist Psychologist, more recent scholarship has attempted to unpack her engagement with the eugenics movement. Using archival materials and drawing inspiration from scholars that challenge the limits of the archive, the present thesis explores Hollingworth’s scholarship and activism, fleshing out her own feminist and eugenic ideologies. I then forward the argument that Hollingworth did not hold feminist and eugenic ideologies together with tension, but reconciled them through the logic of another movement, feminist eugenics. This thesis ends with a discussion of how studying the life and scholarship of an early 20th-century feminist eugenicist serves as a cautionary tale for contemporary bioethical debate.Item Open Access A Pilot Study Using Machine Learning For Classification Of Pain-Related Versus Non-Pain-Related Electroencephalographic Activity In Preterm Infants(2025-04-10) Lojain Hamwi; Rebecca Pillai RiddellEffective pain assessment and management are crucial to mitigate both immediate and long-term consequences of prolonged NICU stays. Accurately assessing pain in premature infants is challenging due to their inability to verbally communicate their pain, the potential judgement bias by caregivers, the lack of specificity in current pain assessment tools and time constraints in a busy hospital environment. This pilot study explores a machine learning approach to support pain assessment in neonatal care using cortical activity. The current study aims to test machine learning models that autonomously distinguishes non-pain related from pain-related cortical activity. The present dataset includes 72 preterm infants (27 females), born between 24- and 36-weeks gestational age, from two NICUs: Mount Sinai Hospital (Toronto, Canada) and University College London Hospital (London, UK). The primary outcome was to assess the accuracy of various machine learning models (XGBoost, Support Vector Machines, Random Forest, Logistic Regression, Convolutional Neural Networks) in distinguishing EEG features within a one-second pre-lance epoch (non-pain related) from a one-second post-lance epoch (pain-related). Performance metrics varied across post-menstrual age groups, reflecting developmental differences in EEG patterns. Machine learning algorithms can autonomously distinguish the one-second epoch immediately following a heel lance from the one-second epoch immediately preceding the procedure in preterm infants. Moreover, the performance of these algorithms improves with increasing postmenstrual age, demonstrating greater accuracy and reliability in older infants. This study provides a foundation for developing an autonomous and accurate tool for pain assessment in neonatal patients that can improve pain management practices in NICUs.Item Open Access Effect Of Dynamic Visual Cues During Dynamic Balance On Perceived Movement And Postural Responses(2025-04-10) Kayton Yanko Jaksic; Taylor CleworthTo maintain balance, there are complex interactions that take place between one’s environment and sensory systems. Correctly perceiving one’s own movement may dictate the strategy one uses to maintain upright. While perceived movement has been studied, there is a lack of research on perceived self-motion and postural responses when visually perturbed during a dynamic balance task. Virtual reality (VR) was used to elicit visual perturbations while the support surface was translating +/- 5cm. Ground reaction forces were measured using a force plate and kinematics were collected using 3D motion capture. Perceived sway amplitude was tracked through a controller compatible with the VR head mounted display (HMD). Postural responses were significantly greater in anterior conditions. There was an observed disconnect between perceived and actual movement, where quotient amplitude measures increased in posterior conditions. Biomechanical constraints, threat-modulated behaviour and an increased conscious control of movement may explain these findings.Item Open Access Who Benefits From A Brief Online Couples Intervention? Examining Baseline Moderators Of The Effectiveness Of The Love Together, Parent Together Program(2025-04-10) Alexandra Markwell; Heather PrimeBrief relationship interventions are needed to support the relationship quality of couples parenting young children who face a heightened risk of relationship deterioration. Accordingly, the Love Together, Parent Together (L2P2) program was created as a brief online writing program for parents. The present study addresses secondary objectives of a two-arm pilot randomized control trial (RCT) of the L2P2 program, examining whether multilevel risk factors across the family system moderate the program’s effectiveness. Participants included 140 couples with children (under six years), randomized to the L2P2 intervention or control condition. They completed baseline, post-intervention, and 1- and 3-month follow-up surveys. The intervention involved three writing sessions teaching couples conflict reappraisal strategies. The current study examined couples’ baseline dyadic adjustment, COVID-19 family stress, children’s effortful control, and composite risk as multilevel risk factors. Piecewise latent growth curve modelling (LGCM), using data from four timepoints, was conducted in MPlus 8.5 to examine rates of weekly change in couples’ relationship quality scores as a function of condition (L2P2 vs. control), baseline risk, and the interaction between the two. Results revealed that none of the moderators predicted weekly change in relationship quality, nor did the interaction between each respective moderator and condition. Findings do not support the differential effectiveness of L2P2 as a function of multilevel household risk. Results contribute to a growing literature that addresses for whom and/ or in what circumstances couples’ prevention programs are most effective.Item Open Access Realism And Features Supporting Lightness Constancy In Virtual Scenes(2025-04-10) Khushbu Yogeshbhai Patel; Richard F. MurrayLighting and surface properties play an important role in visual perception. Our visual system decodes two-dimensional retinal images to discern potential three-dimensional scenes. A particular challenge in the context of achromatic lights and surfaces is lightness constancy — the ability to maintain a consistent perception of an object’s reflectance despite varying illumination conditions. Although humans are generally adept at maintaining lightness constancy, it is not perfect. This dissertation examines lightness constancy within both real-world and virtual environments, including flat-panel displays and virtual reality (VR). Chapter 2 evaluates lightness constancy through an asymmetric lightness matching task across a shadow boundary, using physical surfaces, a flat-panel display, and an immersive VR environment. While the VR condition exhibited realistic levels of lightness constancy, participants showed significantly lower levels of constancy in flat-panel display compared to the physical environment. Notably, participant variability was more pronounced in both virtual environments. In Chapter 3 the study extends to lightness matching across various 3D orientations using both physical surfaces and in VR. The findings reveal that lightness constancy is significantly weaker in VR compared to physical environments. Building on Chapter 3, Chapter 4 further evaluates lightness constancy using the same task, but incorporates more realistic and accurate rendering techniques, along with realistic materials, in VR. Contrary to expectations, the results show no notable improvement in lightness constancy, underscoring the persistent challenges in achieving realism for tasks evaluating lightness across 3D orientations in VR. Despite robust 3D shape, lighting, and depth cues available in VR, constancy is significantly worse in VR and our understanding of lightness perception fails to explain why. This discrepancy highlights a gap in our knowledge, pointing to potentially overlooked factors critical for accurate lightness perception, such as fine material details or subtle surface textures. In conclusion, the findings in this dissertation suggest that VR is a reasonable proxy for real-world scenarios in tasks when lightness is judged across a shadow boundary, but current technology falls short in replicating realistic lightness constancy when image luminance varies from one location to another due to differences in 3D orientation relative to a light source.Item Open Access Examining Eye Movements In Response To Repeated Exposure To Building Stimuli(2025-04-10) Maxym Sergiyovy Yerkeyev; Erez FreudResearch has consistently indicated a strong connection between eye movements and memory processes. This thesis explores this relationship by examining how repeated exposure to AI-generated images of buildings influences eye movements and memory. Twenty-four participants viewed 120 building images across four levels of repetition (novel, once, three, and five times), while their eye movements were recorded, and their memory assessed. The results showed significant repetition effects on both eye movements and memory. Eye movement measures revealed a decrease in fixation count and saccadic amplitude, and an increase in fixation duration, with increased repetitions. Memory measures revealed improved recognition and confidence, with increased repetitions. These repetition effects align with previous studies on faces and scenes, suggesting that the effects supersede differences in how specific object categories are processed. Overall, this thesis demonstrates that memory and oculomotor systems are associated in processing buildings, just as they are in processing faces and scenes.Item Open Access Perceived Norms About Coping-Motivated Drinking Mediate The Relations Between Social Anxiety And Alcohol Use And Related Problems(2025-04-10) Jessica Esther Newman; Matt KeoughSocial anxiety has been shown to be a risk factor for alcohol-related problems among emerging adults. Perceived norms may be a relevant cognitive factor underlying this risk; however, previous literature has focused mostly on broad norms about alcohol use in general and not on norms about specific alcohol use behaviours. The main goal of this study was to examine the mediating role of perceived approval about drinking to cope specifically, in the pathway from social anxiety to alcohol use and related problems. I hypothesized that university students with heightened social anxiety would perceive their friends (in particular) as being approving of drinking to cope with negative affect, which would lead to an increase in alcohol problems. Participants were ages 18 to 29 from six Canadian universities and completed an online cross- sectional survey measuring social anxiety levels, perceived approval of specific risky drinking behaviours, alcohol use frequency, and alcohol-related problems. Mediation analyses showed that elevated social anxiety predicted greater perceptions of friends approving of drinking to cope, which in turn, predicted elevated alcohol-related problems. This mediation effect was not seen when analyzing perceived approval from typical students, highlighting a specificity for friends increasing perceived approval of coping-related drinking behaviours. Perceived approval of sexual risk taking from friends was associated with lower alcohol-related problems, and perceived approval of heavy drinking from typical students was associated with increased alcohol outcomes. This study is the first to examine the impact of perceived approval of specific risky drinking behaviours on alcohol outcomes among students with relatively elevated social anxiety. Such research could contribute to improving the efficacy of personalized normative feedback interventions for modifying normative perceptions and alcohol outcomes.