Melbourne School of Psychological Sciences - Theses
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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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ItemOlder parent-child relationships and their associations with older people’s psychological wellbeing: a comparison of Australian-born people and Chinese immigrants( 2014)Parent-child relationships are one of the most fundamental types of family relationships. Against the background of population ageing in Australia and many other Western countries, the present study explored the nature of these relationships in later life and their associations with older people’s psychological wellbeing. Alongside population ageing, Australian populations are becoming culturally diverse. To enhance our understanding of cultural diversity in these issues, the study focused the differences between older Australian-born people and older Chinese immigrants. Older Chinese immigrants were included in the present study because there are some unique features in the nature of parent-child relationships in this group, such as the concept of filial piety. A convenience sample of 122 participants were recruited in the present study, comprising 60 Australian-born people and 62 Chinese immigrants. These participants were interviewed using a standardized interview schedule. Three groups of measures were used, assessing socio-demographic factors, the nature of parent-child relationships, and psychological wellbeing. The solidarity–conflict model and the concept of ambivalence were used to operationalize the nature of parent-child relationships, and four indicators (i.e., depression, anxiety, loneliness, and quality of life) were used to present a broad picture of older people’s psychological wellbeing. Most participants reported relatively high levels of solidarity in their relationships with adult children. Specifically, the majority lived close to, had frequent contact with, and were involved in some kind of exchange relationships with their children. Most participants felt close to their children, believed that their children’s opinions and values were relatively similar to their own, and had some kind of filial expectations. However, conflict and ambivalence were common, albeit, of low intensity, in participants’ relationships with adult children. The study further found that these relationship dimensions were significantly associated with the four wellbeing indicators and that most of these associations persisted when socio-demographic variables were considered. There were both similarities and differences in the nature of older parent-child relationships between Australian-born people and Chinese immigrants. For example, participants from both groups preferred to live independently and to receive help from professional aged care services than from their children. However, older Chinese immigrants were more likely to live with children and reported higher levels of ideal filial expectations. There were also stronger associations between depressive symptoms and the nature of older parent-child relationships among Chinese participants. These findings highlight the complexity of parent-child relationships in contemporary multicultural Australian society and suggest that using a comprehensive model, such as the solidarity-conflict model, helps to present a more complete picture of these relationships. They also provide evidence for the importance of these relationships to older people’s psychological wellbeing. Finally, these findings have important implications for policy development and service planning and provision for older people, in particular, those for older Chinese immigrants.