Melbourne School of Psychological Sciences - Theses
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ItemWhat are the special characteristics of families who provide long term care for children of parents with mental illness?( 2003)This project investigated characteristics relating to family functioning and attitudes to mental illness, and caregiving, which distinguish families choosing to care for children of parents with mental illness (CPMI) from families who choose not to but do care for other children (NCPMI), and from families not involved in the adoptive care system (COMM). Welfare agencies seeking long term home based care for children of parents with mental illness (among other groups of children) report that potential caregivers are concerned about the child’s genetic risk, and the requirement that they facilitate access visits with the birth parent. Consequently it is more difficult to recruit caregivers to care for children of parents with mental illness. Previous studies found that families who adopt children with special needs had family systems that were flexible and able to adapt to changing needs, and in which family members felt close to one another. It was not known if the functioning of families who care for children of parents with mental illness would differ from other family groups. Nor was it known if these families would differ in motivation to be caregivers and attitudes to mental illness from other family groups. Forty four families completed a questionnaire providing background information, and a family functioning questionnaire which included the FACES II measure (Family Adaptability and Cohesion Evaluation Scale) and questions assessing level of altruism, and tendency to respond in a socially desirable manner. Data from the FACES II measure was used to classify families according to the Circumplex Model of Marital and Family Systems. Q-methodology was used to assess participants’ attitudes to eight issues related to the research question: mental illness, children of parents with mental illness, parents having a mental illness, family environment, motivation to be caregivers, ongoing contact between child in care and parent, approval of others when deciding to be a caregiver, and flexibility in deciding to accept a certain child for placement. The Q-method required participants to rate 42 statements (a Q-set), concerning these issues, according to a fixed distribution, from statements with which they strongly agreed to statements with which they strongly disagreed. Participants could also give open-ended responses to questions addressing the same issues in a semi-structured interview. The CPMI group were found to have a lower level of income and education than the other two groups, and were more likely to be full time caregivers. Both caregiver groups were unlikely to have children of their own. The profiles of the three groups on the cohesion and flexibility sub-scales of FACES II were similar. The classification of the family groups on the Circumplex model showed that the CPMI group were located in the balanced and mid-range levels of the model more so than the other two groups. Responses to the Q-sort and interview questions suggested that the CPMI families were more understanding of mental illness, and of the needs of the children and capacity of their parents. It is suggested that future studies increase the number of participants, and investigate in more detail the factors which motivate families who provide long term care for children of parents with mental illness.
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ItemDevelopment of executive processes in early childhood( 2003-08)Although the paediatric literature in the area of executive function has expanded significantly over the past 20 years, there is still an imbalance of knowledge when compared to the adult literature. The present project sought to redress the balance in executive function research by (1) investigating the development of a wide range of executive processes in children between the ages of 3 and 7 years, and (2) examining the effects of early frontal lobe damage on the ongoing development of these skills.
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ItemA Comparison of an internet-based and face-to-face group intervention to modify body dissatisfaction and disturbed eating in young women( 2003-01)Objective: This study compared the effectiveness of a new manual-based group intervention program, The Body Image and Eating Behaviour Program, for women with sub-clinical body dissatisfaction and disturbed eating behaviours, using two delivery modes: a traditional Face-to-Face group intervention and an Internet-based intervention with interactive on-line group sessions in synchronous time. The program was conducted weekly over an 8-session period. Predictors of a good treatment outcome for the intervention program were examined with both delivery modes combined. Methods: Participants (18-30 year old women) were recruited by advertisements on Melbourne university campuses and at community health agencies. They were randomly assigned to group (Face-to-Face group n=19, Internet-based group n=21). Body dissatisfaction, disturbed eating behaviours, psychological status, and stage of change were assessed using standardized instruments prior to and immediately after the intervention, and at two months follow. Results: A 2 (group) X 3 (testing occasions) within subjects repeated measures analysis of variance was used to examine time and between group differences. Significant improvements on all clinical outcome variables were observed at post-test and maintained at follow-up in both groups. However, there were no significant between group differences. Hierarchical multiple regression analyses were used to examine predictors of treatment outcome at follow-up. Milder depression scores predicted greater improvement in binge eating frequency while a greater improvement in bulimic pathology and self-esteem at follow-up was predicted by more severe body dissatisfaction scores. Stage of change before treatment was not a predictor of outcome. Qualitative research demonstrated that the Internet-based delivery mode was a less confronting way of seeking help and a convenient and supportive medium to disclose personal information. However, participants had more difficulty exploring deeper psychological issues in the Internet-based group and forming close bonds with each other due to the speed and flow of the discussion. Discussion: The treatment program was valuable in both delivery modes and was found to be very acceptable by participants. The Internet, with the potential to over-come obstacles of distance and provide a discrete mode of treatment delivery, showed promising results at improving body satisfaction and disturbed eating behaviours in young women. Findings demonstrated inconclusive evidence for predictors of a good treatment outcome.
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ItemThe influence of parental anxiety and child rearing factors on the outcome of the treatment of children with anxiety disorders in a mental health clinic( 2003)The aims of the current study were to identify family characteristics unique to families with children who presented to a community mental health service with an anxiety disorder, and to determine whether any such factors were predictive of the treatment outcome for these children. Parents of children with an anxiety disorder (N=28) were compared on measures of parental anxiety and depression, and parental child-rearing and disciplinary styles, to parents of children with significant learning difficulties that were non-anxiety based (N=30) and to parents of children without any apparent psychological difficulties (N=31). Parents of anxious children reported higher rates of anxiety and depression than parents of children without psychological difficulties, however, their reports did not significantly differ from parents of children with other non-anxiety related difficulties. Treatment outcome measures consisted of clinician and parent ratings at both 3-months, and 12-months following the commencement of treatment. Results generally indicated that parental difficulties with separation predicted poor treatment outcome for children at 3-month and parental anxiety predicted poor treatment outcome at the one year follow-up. This suggested that the presence of an anxious parent may, over time, increase the child’s vulnerability to relapse, and supports the need to involve parents in treatment programs.
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ItemShaping emotional competence in preschoolers with behaviour problems( 2003)This study explored differences in emotional competence, and the aspects of parenting that contributed to these skills, in a sample of preschool children with and without behaviour problems. Unregulated negative and positive emotional expression, along with problems in understanding emotions have been found to contribute to difficulties in socially relating and to oppositional behaviour. Recent research has demonstrated parents’ philosophies and approaches in responding and teaching children about emotions (emotion coaching) play an important role in shaping the emotional knowledge and regulation skills that children acquire. A sample of 4 and 5 year old children were recruited through the Melbourne Royal Children's Hospital to provide a clinical sample (N=30), and from kindergartens in metropolitan Melbourne to give a "normal" community group (N=51). Children’s emotional skills were directly assessed using a puppet-based interview to elicit emotion knowledge, with a Delay of Gratification Task and a Disappointment Task to examine emotion regulation. Children's social skills, emotional competence, and behaviour were also assessed using questionnaires administered to parents and teachers. Parenting styles were measured using the Meta-Emotion Interview to explore parent's awareness of their child's emotional life and his/her attempts to engage with and teach his/her child about emotions, along with parent self-report questionnaires. A theoretical model, which extended existing theories about the role of parenting in children's behaviour problems, was tested using path analysis. Results showed that children with behaviour problems had significantly poorer emotional regulation, less emotional knowledge, and expressed negative emotions in dysregulated ways. Weaker receptive language skills also contributed to lower levels of emotional understanding. The parents of children in the clinical sample reported more negative responses to their children's displays of emotions, frequently responding in critical and punishing ways. These parents were often unable to tolerate, support, and help their children problem solve when they were experiencing negative emotions. Model testing showed that poorer parenting skills around children's emotions contributed to less functional emotional skills and regulation in children, and these deficits were associated with problematic behavioural and social functioning. The implications of these findings for intervention were considered.
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ItemPaediatric head injury: implications for psychosocial adjustment into adulthood( 2003)Little is known about the long-term effect of head injury (HI) on psychosocial outcome. The present study examined psychosocial adjustment of a group of adults (aged between 18 and 27 years) who sustained a mild (n = 24), moderate (n = 19), or severe (n = 16) HI as children (aged between 8 and 13 years). Many parents or guardians of the head-injured adults also participated. The adults were recruited from the Royal Children's Hospital's (Melbourne, Australia) neurosurgery ward's admission records from 1983 to 1987. Questionnaires, assessments and interviews were completed during the year 2000, which was 10 to 15 years post-injury. Results generally indicated that those with severe injuries had more cognitive, educational/occupational, behavioural, and social difficulties than those with less severe injuries. Daily living skill functioning seemed to be comparable across injury severity groups. Individual case analyses revealed an additive effect of pre-injury, injury, and post-injury variables on long-term adjustment. Injury severity alone did not account for psychosocial adjustment. It was proposed that rehabilitation services need to be multidisciplinary rather than focusing on physical and cognitive sequelae and that counselling, education, and support services would be beneficial for head-injured individuals and their families for several years post-injury.