Melbourne School of Psychological Sciences - Theses
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ItemGlobal meaning and its implications for emotional adjustment following a cancer diagnosis( 2007)This thesis examined the course of global meaning following diagnosis with cancer and explored its role in emotional adjustment using Janoff-Bulman’s (1992) assumptive world model. The study aimed to find evidence that there is a normative tendency to hold unrealistically positive global meanings which are contradicted by an adverse life event and the resultant emotional distress is resolved either through reinterpreting the event in a more positive light (assimilation) or revising meanings to be more realistic (accommodation). Assimilation is thought to be associated with favorable emotional functioning while accommodation has been linked to worse emotional outcomes (Janoff-Bulman, 1992). Using a longitudinal design, 86 adults with a hematologic cancer were assessed three times: following diagnosis; after primary treatment and: one year postdiagnosis (N=63). Data collected included six indices of emotional adjustment (depression, anxiety, traumatic stress, joviality, self-assurance and serenity); a measure of global meaning, the World Assumptions Scale (Janoff-Bulman, 1992) and, demographic and medical information. Three sets of analyses were conducted. The first set of analyses examined the course of emotional outcomes and global meaning over the year-long study period. Anxiety was the only emotional outcome showing overall change (decrease) while randomness was the only meaning displaying change (increase) over time. The study samples’ world assumptions were also compared with those of general community groups and motor vehicle accident survivors. At study entry, the sample displayed more positive bias in self and benevolence meanings than the other groups. By study exit, they showed less positive bias in contingency assumptions than the comparison groups, a pattern consistent with accommodation. The second set of analyses assessed whether global meaning predicted emotional outcomes when effects of demographic and medical factors had been accounted for. Meaning was implicated in all six emotional outcomes, with variability in their predictive power relative to the outcome measure and time of assessment. Self-worth and luck assumptions were the strongest predictors with justice and randomness also showing some predictive power. The final set of analyses used longitudinal data to focus on the association between global meaning and trajectories of emotional adjustment over time. The findings indicated that self-worth was associated with better outcomes for anxiety and TSS; luck was associated with depression while people benevolence was associated with anxiety. The directions of associations for all but people benevolence were consistent with the expectation that more positive bias in meanings is related to more favorable outcomes. The finding of a significant increase in randomness provides some support for the hypothesis that positively biased global meanings are challenged by the cancer experience and accommodate to become more realistic, although randomness did not predict worse emotional outcomes over time. Self-worth and luck, which were relatively high compared to other groups and stayed stable over the study period, were most strongly implicated in adjustment. The results also provide some impetus for a reconceptualization of the meaning in adversity models to take into account state-like variability in global meaning constructs.
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ItemAssessing the relationship between executive function, coping, stress, depression, anxiety and quality of life in multiple sclerosis( 2014)Background: Compared to healthy controls, people with multiple sclerosis (PwMS) use fewer adaptive and more maladaptive coping strategies when managing stressors and they experience higher rates of depression, anxiety and adjustment disorders. In addition, PwMS experience a high prevalence of cognitive impairment, including executive dysfunction, which has been linked to depression and anxiety. Aims: The current study examined the relationship between executive function, coping strategy use and psychosocial adjustment outcomes including stress, depression, anxiety and quality of life (QoL) in PwMS. The research assessed i) the ability of coping strategies and executive function to predict maladaptive and adaptive adjustment outcomes, and ii) the relationship between executive function and coping and whether there is a moderating and mediating relationship of different coping strategies between executive function and psychosocial adjustment in PwMS. Methods: Participants (N=107) with relapsing remitting or secondary progressive multiple sclerosis were administered tasks of executive function and completed self-report measures of stress, depression, anxiety, QoL and coping. Results: Consistent with expectations, stress, depression, anxiety and QoL were predicted by adaptive and maladaptive coping styles. Similarly, coping strategies, total coping and an adaptive coping index were predicted by tasks of executive function. Lower scores on tasks of executive function best predicted higher use of maladaptive strategies, but also adaptive strategies, while higher scores were limited in their ability to predict adaptive coping strategies. Tasks of executive function that most often predicted coping strategies included tasks of working memory, cognitive flexibility, information processing and attention. However, contrary to expectations, there was limited support for a relationship between tasks of executive function and psychosocial adjustment outcomes. An indirect relationship was found between executive function performance and adjustment through individual maladaptive coping strategies and adaptive coping strategies, as well as for an index of adaptive coping. Higher executive function performance was related to better adjustment via lower venting and behavioral disengagement, as well as higher scores on the adaptive coping index, whereas lower executive function performance was related to better adjustment via higher growth and acceptance. In general, better executive function and psychosocial adjustment was associated with minimal use of adaptive coping strategies, or greater use of maladaptive coping strategies. Conclusion: Executive function and psychosocial adjustment is mediated and moderated by coping strategies used by PwMS. Well-preserved executive function provides relative protection from poorer adjustment in the presence of high maladaptive or low adaptive coping. PwMS who perform poorly on tasks of executive function benefit from using less cognitively demanding coping strategies to enhance adjustment outcomes and this area that would benefit from further research to underpin effective intervention strategies. Findings from this study will assist with development of patient resources and patient management aimed at enhancing adaptive psychosocial adjustment in PwMS.
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ItemInterpersonal functioning and empathy in females with Borderline Personality Disorder: the role of social perspective coordination( 2014)Empathy is a construct that might play a key role in understanding the interpersonal dysfunction found in Borderline Personality Disorder (BPD). However, empathy in BPD has been relatively under-explored and research has produced inconsistent findings, with results regarding its contribution to interpersonal dysfunction being inconclusive. These inconsistent findings might partly be due to a lack of consensus in the definitions of empathy, perspective taking, mentalisation and Theory of Mind (ToM). They might also be due to the broad range of instruments used to measure these concepts. The present study aimed to further investigate the role of empathy in BPD, including any impairments in the development of mature empathy (which is essentially both cognitive and affective empathy) that are unique to BPD, through incorporating the developmentally-based and ecologically-valid Interpersonal Negotiation Strategies (INS) interview. Additionally, the present study aimed to provide phenomenological data regarding the development of empathy in BPD by comparing 41 females (aged 15-24 years) with BPD to 31 females (aged 15-24 years) with Major Depressive Disorder (MDD). More specifically, the present study used the INS to measure Social Perspective Coordination (SPC) skills following the presentation of four video clips that were designed to either induce affective arousal in the BPD group (BPD-specific clips) or to induce no or limited affective arousal in both groups (neutral clips). The INS was used alongside self-report measures to investigate potential developmental deficiences in empathy in BPD and the relationship between empathy, interpersonal functioning and negative arousal in the disorder. The results indicated that the BPD participants responded to all film clips at a lower developmental level of SPC than did the MDD participants and, based on self-reports, they were also found to have lower levels of cognitive empathy, in particular, perspective taking, and the same levels of affective empathy as the MDD group. Finally, interpersonal functioning was found to be more impaired in the BPD group than the MDD group. However, higher levels of BPD criteria were only weakly associated with poorer social functioning and lower SPC scores were not found to be predictive of less adaptive interpersonal functioning. The present study has confirmed some key research findings that have suggested a deficit in mature empathy, high levels of interpersonal dysfunction and high levels of negative arousal in BPD. It has also extended this literature by assessing developmental levels of mature empathy. It is hoped that the results of this study will help with early identification of the significant problems associated with social interactions in BPD and enhance treatment programs.
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ItemBuilding climate change knowledge: effects of analogical reasoning and cognitive elaboration on beliefs and policy support( 2014)In recent years, the theory of anthropogenic climate change has attained an exceedingly high level of consensus within the scientific community (Cook et al., 2013). At the same time, public engagement as well as government action on the issue has wavered, remaining considerably weak in comparison. Social scientists have argued that conceptualising this lack of engagement as a knowledge-deficit problem is to misunderstand the complex interplay of social, cultural, and economic dynamics that characterise responses to global climate change (Kahan et al., 2012; Malka, Krosnick, & Langer, 2009; Whitmarsh & O'Neill, 2011). Nonetheless, understanding of the issue remains an essential ingredient of engagement and subsequent mitigation and adaptation. Whether it is policy-makers developing policy instruments to reduce national CO2 and other greenhouse gas emissions, or local communities developing strategies to respond to bushfires, the people involved in these decision-making scenarios would require a depth of understanding of the relevant issues. Moreover, the relationship between specific climate change knowledge and people’s beliefs about climate change has not been clearly established. Research that has been used to argue that knowledge is not related to climate change attitudes has been based on proxy measures of knowledge (e.g., general scientific literacy) rather than specific climate change knowledge. This research examined the role of knowledge in climate change cognition to better understand how it relates to people’s beliefs about climate change and policy support. There were three components to realising this goal. First, an intervention to build knowledge about climate change through analogical processing was tested. Second, the effects of analogical processing (Studies 1 and 2) plus cognitive elaboration (Studies 3 and 4) on climate change beliefs and policy support were investigated. Third, the relationships between climate change knowledge, ideology, and climate change beliefs were examined. In Study 1, analogical processing significantly improved task performance when information about emission rates was presented in text but not when presented in graph format. It was also associated with greater preference for strong action on climate change. When tested with the public in Study 2, analogy and information format independently influenced task performance. Furthermore, there was a marginal effect of education such that the analogy was especially effective among those who completed secondary school. Regarding the effects of the knowledge intervention on people’s climate change beliefs and policy support, there were some evidence that the analogy and cognitive elaboration tasks interacted with ideology to influence climate change beliefs. However, there was no clear pattern of effects. The third strand of investigation was clarifying the relationships among climate change knowledge, ideology, and beliefs about climate change. Two types of knowledge were tested; specific and perceived climate change knowledge. Among students (Studies 1, 3, and 4), specific knowledge interacted with hierarchy to produce an attenuating effect on belief that climate change is occurring. While climate change scepticism increased with hierarchy among those with little specific climate change knowledge, there was no relationship between hierarchy and occurrence belief among students who were knowledgeable about the issue. Specific knowledge also had an attenuating effect on egalitarians’ belief such that belief in the existence of climate change decreased with increases in knowledge. Among the Australian public, people who possessed greater specific climate change knowledge were more willing to accept that climate change is occurring. Furthermore, specific knowledge attenuated the negative relationship between individualistic ideology and belief in the existence of climate change. Specific knowledge did not influence other climate change beliefs: belief that it is being caused by human activities and that it has negative consequences. Nonetheless, these findings suggest that climate change knowledge has the potential to positively influence public discourse on the issue. Furthermore, the results of the effectiveness of analogy for understanding CO2 accumulation suggest that it can produce improvements but that using graphs to convey information is detrimental to such gains. The results have particular relevance for climate science communicators, educators, and policy-makers.
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ItemEarly communication and social functioning outcomes of two-year-old children born moderate-to-late preterm( 2014)Children born in the moderate to late preterm (MLPT) period (32 to 36+6 weeks gestational age) represent an epidemiologically significant group of preterm children and there have been increasing concerns about their neurodevelopmental outcomes in recent years. Although numerous studies have documented the presence of communication and social functioning impairments in preterm children born at <32 weeks gestational age, comparatively very little is known about these outcomes in MLPT children. Therefore the primary aim of this study was to comprehensively examine the communication and social functioning outcomes in a group of MLPT children in comparison with a group of full term (FT) control children at two years corrected age. The relationships between specific environmental factors including social risk, primary caregiver mental health, and primary caregiver sensitivity with early communication and social functioning outcomes in MLPT and FT children were also assessed. The sample included 130 MLPT children and 34 FT children. Language and communication skills were evaluated directly using the Bayley Scales of Infant and Child Development-3rd Edition (Bayley-III) and by parental report using the social communication, speech, and symbolic composites on the Infant Toddler Checklist of the Communication and Symbolic Behaviour Scales-Developmental Profile (CSBS-DP ITC). Measures of social functioning were collected using the Social Emotional Questionnaire (SEQ) and Adaptive Behaviour Scale (ABS) of the Bayley-III as well as the Infant Toddler Social and Emotional Assessment (ITSEA), completed by the primary caregivers. Social risk was obtained via parental questionnaire at term- corrected age and at two years corrected age. Symptoms of parental anxiety and depression were assessed using the Hospital Anxiety and Depression Scales (HADS), a parental questionnaire. Additionally, at the time of the two-year follow-up assessment, children and their primary caregiver participated in an observational parent-child interaction task, using the Emotional Availability Scales 4th Edition (EAS), to assess parental sensitivity. Results indicated that compared with children born FT, there was a non-significant trend towards poorer outcomes for MLPT children on the expressive and receptive language scales of the Bayley-III, but there was little evidence of group differences on parent report measures of communication. There was also little evidence to suggest that the MLPT group exhibited social functioning difficulties at two years of age. When exploring factors influencing outcomes, higher social risk, increased symptoms of primary caregiver depression, and decreased primary caregiver sensitivity were significantly predictive of poorer communication skills for both MLPT and FT children at two years of age (corrected). Similarly, increased primary caregiver depression and decreased primary caregiver sensitivity were significantly predictive of poorer social functioning outcomes in both groups of children at two years of age (corrected). Overall, these findings show that while the MLPT children performed within the ‘average’ range across measures of communication and social functioning, there was some evidence to show that receptive and expressive language skills were mildly reduced in this population when compared to FT children. Furthermore, potentially modifiable environmental risk factors influencing communication and social functioning were identified, which helps provide a framework for future intervention strategies aimed at improving these outcomes for all children, regardless of perinatal risk.
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ItemParental psychological distress following very preterm birth: impact on infant social-emotional development and parent-child interaction( 2014)It is known that there are high rates of psychological distress in parents of very preterm infants, but previous researchers examining parental mental health after preterm birth have usually assessed mental health at one point in time. As such, little is known about the evolution of parental distress, particularly during the inpatient period in the Neonatal Intensive Care Unit (NICU). Parental distress can negatively impact parent-child relationships, which can then affect longer term child social-emotional development. Furthermore, children born very preterm have higher rates of early social-emotional difficulties, and are more likely to experience suboptimal parent-child interaction. These problems are likely to be compounded by parental mental health difficulties. Understanding these issues in the first year of life is vital to guide appropriate intervention, both for the wellbeing of mothers and fathers during this difficult period, and for the optimal development of their very preterm infants. This study aimed to describe the trajectory of psychological distress (depression, anxiety and post-traumatic stress symptoms) in mothers and fathers of very preterm infants at several key time points from birth to 12 months corrected age. It also investigated how this distress influenced parent-child interaction and the infant’s social-emotional development at 12 months corrected age. Finally, it examined whether parent-child interaction explained the relationship between maternal psychological distress during the first 12 months and infant social-emotional development at 12 months corrected age. Participants included 96 mothers and 86 fathers of 127 infants (99 families including 26 sets of twins and one set of triplets) born prior to 30 weeks gestational age and admitted to the Royal Women’s Hospital NICU in Melbourne, Australia. A subset of families of 55 infants were followed up at 12 months corrected age. Mothers and fathers completed measures assessing depression (The Centre for Epidemiological Studies Depression Scale) and anxiety (The Hospital Anxiety and Depression Scale) fortnightly from birth until the infant reached term equivalent age, and at three, six and 12 months corrected age. In addition, parents completed the Post-traumatic Stress Disorder Checklist Specific Version at term equivalent age and 12 months corrected age to assess post-traumatic stress symptoms. At 12 months corrected age the mothers and infants participated in the Emotional Availability Scales, an observational task assessing parent-child interaction, and mothers completed the Infant-Toddler Social and Emotional Assessment to assess infant social-emotional development. Overall, results showed that symptoms of depression, anxiety and post-traumatic stress were initially high for both mothers and fathers, and reduced in severity over time between the birth of their infant and 12 months corrected age. However, rates of clinically significant symptoms of depression remained above levels that would be expected in the general population at 12 months corrected age. Psychological distress in parents at various time points was predictive of certain infant social-emotional development and parent-child interaction outcomes. When these associations were examined more closely, it was found that the relationships between maternal mental health predictors and infant social-emotional development could not be explained by the influence of parent-child interaction. The findings of this study represent a substantial advance in the understanding of parental mental health following very preterm birth, especially in fathers. Additionally, the results may help identify the optimal timing of assessment and intervention to improve mothers’ and fathers’ wellbeing, and thus their infants’ development.
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ItemTuning in to teens: examining the efficacy of an emotion-focused parenting intervention in reducing pre-adolescents’ internalising difficulties( 2014)The transition from childhood to adolescence coincides with an increase in anxiety, a peak in somatic complaints, and a post-pubertal rise in depression by mid-adolescence, particularly for girls. For those affected, internalising difficulties result in considerable stress and impairment for the young person even if symptoms do not reach criteria for clinical diagnosis. Up to 50% of all adult psychological disorders have their onset during adolescence, highlighting the importance of identifying methods of prevention that are evidence-based. Emotional competence has been found to be an important protective factor for healthy social, emotional, and behavioural functioning. Both adolescents and adults with internalising difficulties show deficits in aspects of emotional competence. Research in child development suggests that parents’ emotional competence and emotion socialisation practices are related to children’s emotional functioning, including child internalising difficulties. This research has not yet been translated into intervention or prevention programs targeting parents of adolescents. The current study examined the efficacy of the Tuning in to Teens parenting program in improving emotion socialisation practices in parents of pre-adolescents and in measuring the impact on youth internalising difficulties. Grounded in emotion socialisation theory, this program teaches parents skills in responding to emotions in ways that enhance emotional competence in the young person, while also improving parent-youth communication and connectedness. A group-randomised control design was used where participants were recruited from schools and randomised into intervention and control conditions. Data were collected from 225 parents and 224 youth during the young person’s final year of elementary school (6th grade) and again, 10 months later in their first year of secondary school (7th grade). The thesis includes three studies. Study 1 reports the results of multilevel analyses, which showed participation in Tuning in to Teens resulted in significant improvements in parental emotion socialisation and reductions in youth internalising difficulties for the intervention condition. Study 2 examined moderators and mediators of program outcome. Results showed greater program effects for intervention subgroups with high pre-intervention difficulties. Parental education, income, parental internalising difficulties, parental difficulties in emotion awareness and regulation, and attendance rate did not moderate program effects. Mediation analyses supported emotion socialisation theory and showed parents who participated in the Tuning in to Teens parenting program reported improvements in emotion socialisation, which in turn was related to reductions in youth internalising difficulties. Study 3 investigated the relationship between parent emotion socialisation and youth somatic complaints. The study extended the literature on somatic complaints by being the first to consider parents’ emotional competence and emotion socialisation practices as predictors of youth somatic complaints alongside parents’ own somatic complaints. Results indicated that changes in parents’ awareness and regulation of emotion and emotion socialisation practices resulted in reduced youth somatic complaints. These findings have important implications for current aetiological models of somatic complaints and provide support for using an emotion-focused approach to enhance current treatment models of youth somatic complaints. A significant contribution of this thesis is that it presents the first randomised control trial evaluation of a parenting program that utilises research linking parents’ emotion socialisation with young people’s mental health, applying it in practice with a sample of parents of pre-adolescents. The research findings provide support for emotion socialisation theory and for using an emotion focused parenting program to prevent internalising difficulties in early adolescence.
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ItemIntercultural contact, ethnocentrism and the mediating role of epistemology( 2000)This thesis describes a model which proposes that level of epistemology mediates the relationship between intercultural contact and ethnocentrism. This model was tested by examining the effects of participation in a secondary school cultural exchange program, on the grounds that the cultural immersion characteristic of such programs constitutes cognitive conflict under circumstances which should stimulate epistemological development. The intercultural knowledge, epistemological level and ethnocentrism of 128 adolescents aged 14-18 were tested before and after participation in an exchange program. These results were compared with those from a demographically similar group of 72 adolescents, who had applied for information on exchange programs but did not go during the year of testing. The results of the study supported the proposed model.
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ItemA study of Australian and international experiences to inform the development of curriculum for psychologists working in primary care in Indonesia( 2014)While mental health is acknowledged as an integral part of human health, the capacity of low and middle income countries to provide adequate treatment and care for people with mental health disorders is limited. The key strategy for expanding such capacity is provision of mental health services through existing primary care services. An obstacle in achieving this goal is the limited number, and the limited mental health knowledge and skills, of doctors and nurses working in primary care. A strategy to overcome this obstacle in both high income and low and middle income countries is to have more psychologists working in primary care settings. However, the process of integrating psychologists into primary care services presents many challenges. Among these challenges is the issue of whether psychologists’ training adequately prepares them for working as part of primary care clinical teams. The integration of psychology into primary health care in Indonesia commenced in 2004 in Sleman District (Yogyakarta Province) in collaboration with the Faculty of Psychology, Universitas Gadjah Mada. Based on the experience so far, it is evident that the psychologists’ current education is not adequate preparation for working effectively in a primary health care setting. This study aimed to produce recommendations for a revised curriculum for psychologists working in primary health care in Indonesia, which, in the absence of other research evidence, were based on consensus among international, Australian and Indonesian experts with expertise in primary mental health care. Data were collected over a series of four inter-related studies. The first study utilised the Delphi study to ascertain the views of International experts on the ideal curriculum for psychologists working in primary health care. The second study involved semi-structured interviews with Australian experts in primary mental health care. The third study entailed interviews with Indonesian's experts in mental health care. The fourth study was a Delphi study to determine the views of Indonesian experts on recommendations for curriculum for training psychologists for primary care. These were derived from the first three studies which were analysed and then condensed into a series of 11 recommendations. Overall, International experts, Australian experts and Indonesian experts from various stages of study agreed that psychologists working in primary care require additional training in a range of clinical, advocacy, educational and leadership skills. Eleven recommendations were generated for psychologists’ training in relations to dealing with patients, interacting with other primary health care providers and high level skills in organisation, community education and policy reform.
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ItemDevelopment of the caregiver: intergenerational influences on parental bonding and behaviour( 2014)This thesis aimed to identify preconception predictors of the parent-to-infant bond. Drawing on data from two intergenerational cohort studies, the quality of mothers' and fathers' parent and peer relationships during adolescence were prospectively examined as predictors of their subsequent felt connection to their own children. The first sample were 287 mothers who had participated since age 14 years in a 10-wave longitudinal study and who completed self-reported data on maternal bonding and parenting of their infant. The second sample were 114 Generation 2 parents (81 mothers) who had participated along with their Generation 1 parents in a 30-year, 15-wave longitudinal study, and were now involved in a Generation 3 study. As hypothesised, in a series of hierarchical regressions, using data from the first sample, maternal overprotection during adolescence was positively associated with difficulties with maternal bonding; paternal care was negatively associated with bonding difficulties; and, maternal care was found to moderate the effect of postnatal depression on bonding difficulties. Using data from the second sample, path analyses were used to test a series of models predicting parental bonding and warm parenting. Peer communication and parent trust during adolescence were found to be significant predictors of both indicators of caregiving. The combined studies showed that parents' relationships with their own mothers, fathers and peers, from early to late adolescence, differentially predicted the quality of the parental bond and warm parenting with offspring aged 12-36 months. The findings are discussed within the context of the caregiving behavioural system as described within attachment theory. In particular, it is suggested that parental bonding is influenced by the qualities of multiple relationships during adolescence and prior to conception of the next generation infant. These findings suggest that family and peer relationship interventions during adolescence may have preventative implications for next generation parent-infant relationship difficulties. They may therefore contribute to a solution to break intergenerational cycles of psychosocial problems.