Melbourne School of Psychological Sciences - Theses
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ItemPsychosocial adjustment following paediatric epilepsy surgery( 2013)Epilepsy surgery is now widely accepted as a safe and effective therapeutic option for appropriately selected individuals, including children. The importance of measuring ‘outcome’ following epilepsy surgery has long been recognised. Studies have tended to focus on quantitative methods of outcome research, whereby outcomes are enumerated by various objective measures, such as post-operative seizure frequency. More recently, there has been a shift in the literature to include broader outcome measures that reflect an interest in the experiences of epilepsy surgery patients; this has occurred in both the adult and, to a much lesser extent, the paediatric areas. In the case of children, it is often implicitly assumed that surgery will allow a child to enjoy a ‘more normal’ developmental course. Surprisingly little research, however, has been devoted to investigating the psychological and social outcomes for children who have had epilepsy surgery (and their families) and the nature of the adjustment processes involved. In particular, the perspective of children themselves (as well as their parents) has been virtually absent from investigations. The broad aim of this thesis, therefore, was to explore outcomes following paediatric epilepsy surgery, with a particular focus on psychosocial adjustment, from the perspectives of both children and parents. Two studies were conducted to achieve this aim. As a preliminary step, Study One sought to establish whether epilepsy surgery in fact alters the psychosocial prognosis for children with epilepsy. It compared and contrasted the long-term psychosocial outcome profiles of a group of surgical versus non-surgical epilepsy patients, derived from a community cohort of cases with childhood-onset temporal lobe epilepsy (N = 53). Psychosocial outcome was assessed using a semi-structured interview, which was supplemented by self-report questionnaires. Four medical outcome groups were identified: patients who underwent surgery and were either seizure-free or not seizure-free, patients who went into spontaneous remission, and patients who were ineligible for surgery and had persistent, chronic epilepsy. These four outcome groups demonstrated distinct long-term psychosocial profiles, which directly reflected the patient’s treatment experience (i.e., surgery versus no-surgery), as well as the evolution of the patient’s seizures (i.e., whether they were seizure-free and off antiepileptic medications at follow-up). Having established that surgical paediatric patients present with unique psychosocial issues, Study Two entailed a more expansive and comprehensive assessment of psychosocial outcomes in a sample of exclusively surgical cases, and their parents. Using a phenomenological approach, semi-structured interview transcripts were analysed to capture the richness of the surgical experiences of both children (n = 33) and parents (n = 44). By documenting the nature and range of individual responses, and analysing common themes within the data-set, the issue of identity change emerged and was found to play a central role in the post-surgical adjustment process. In particular, distinct patterns of adjustment and outcome were identified in the data, as represented by four different identity sub-groups: the Still Well, New Well, Old Sick, and Still Sick groups. A complex combination of pre- and post-operative clinical and psychosocial factors appeared to drive the adjustment process following paediatric epilepsy surgery. Most notable of these was illness chronicity, the burden of co-morbidities, post-operative seizure outcome, and pre- and post-operative psychosocial limitations, including a sense of disablement. Study Two also identified an overall high level of concordance between the psychosocial adjustment experiences described by children and their parents. In all, the results provide compelling evidence to suggest that the effects of paediatric epilepsy surgery on psychosocial adjustment are complex and multi-faceted, as has also been shown among adult epilepsy surgery patients. There is an intricate inter-play of factors, operating at the pre- and post-operative levels, which have important repercussions for children’s development, especially identity. This conceptualisation of outcome provides a much-needed framework within which to understand the way specific outcome variables interact in a given individual or sub-group of patients, with a view to ultimately predicting those at risk of poor outcomes. These findings are discussed in the context of previous research, and their implications for clinical practice are outlined.
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ItemMemory functioning during the menopausal transition: subjective experience and objective performance( 2013)Whilst many women complain of forgetfulness during the menopausal transition, few studies have provided a detailed examination of women’s beliefs about memory at this stage of their lives. Furthermore, prior studies have not included assessment of prospective or incidental memory, memory domains that may relate to the type of memory lapses that women describe. Therefore, this study aimed to examine women’s subjective perceptions of memory as well as their objective memory performance across the menopausal transition, including measures that have not been examined in previous studies. An additional aim was to explore relationships between subjective perceptions of memory and objective memory performance, menopausal symptoms and psychological factors during the perimenopausal stage. An improved understanding of the determinants of memory self-efficacy would allow for a more informed response to women’s concerns about memory, and potential enhancement of women’s well-being during this time of transition. One hundred and thirty women, aged 40 to 60, were recruited from outpatient menopause and gynaecological clinics at the Royal Women’s Hospital, Melbourne. Women were divided into pre- (n = 36), peri- (n = 54) and postmenopausal (n = 40) groups according to the STRAW+10 criteria based on menstrual patterns. All women completed self-report measures of physical menopause symptoms, symptoms of depression and anxiety, sleep quality and attitude towards menopause. Scales examining various aspects of memory were also administered, measuring reported frequency of common memory mistakes, sense of control over memory, use of memory strategies, memory contentment, knowledge and motivation to perform well on memory tasks. The women also completed a comprehensive neuropsychological evaluation of memory, assessing verbal learning and memory, attention and working memory, information processing speed, executive function, semantic, incidental and prospective memory. The results indicated that perimenopausal women felt less content with their memory and reported more frequent forgetfulness, despite performing at a similar level to their pre- and postmenopausal peers on a challenging and comprehensive neuropsychological assessment. This sense of dissatisfaction with memory was accompanied by a more negative attitude towards menopause, when compared to women who had experienced the transition to menopause, but the level of anxiety, depressive and sleep symptoms was similar across pre-, peri- and postmenopausal groups. Perimenopausal women who expressed a stronger sense of control over their memory function, and had lower expectations of their memory reported feeling more content with their memory. At the time of transition to menopause, perceptions of more frequent forgetting were associated with attentional capacity, and memory contentment was related to attitude towards menopause. Subjective memory in perimenopausal women was also associated with anxiety, depressive, vasomotor and sleep problems. The findings do not indicate a significant impact of the menopausal transition on memory function. Nevertheless, this does not diminish the potential adverse impact of perimenopausal women’s negative appraisals of memory on their quality of life. Modification of factors that have been shown to be related to perceived forgetfulness and memory contentment could improve memory self-efficacy at midlife and beyond.
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ItemSleep, mood, and cognitive vulnerability in adolescents: a naturalistic study over restricted and extended sleep opportunities( 2013)Introduction: It is well established that for adolescents, school days are associated with sleep restriction, and that insufficient sleep has been linked to mood disturbances. This longitudinal study assessed sleep, mood, and life stress over the school term and vacation periods with restricted and extended sleep opportunities. The relationships between objective and subjective sleep, as well as between sleep and mood were examined. A cognitive model was proposed and tested to assess whether sleep-specific (i.e., dysfunctional beliefs and attitudes about sleep) and global (i.e., dysfunctional attitudes) cognitive vulnerabilities played a role in these relationships. Methods: One-hundred and forty-six adolescents (47.3% male) aged 16.2+/-1.0 years (M+/-SD) from the general community wore an actigraph continuously for four weeks: the last week of a school term (Time-E), the following two-week vacation (Time-V), and the first week of the next term (Time-S). Social demographic information, chronotype, and cognitive vulnerabilities were assessed at Time-E. Subjective sleep, symptoms of depression, anxiety, and life stress were repeatedly measured at Time-E, Time-V, Time-S, and the middle of the subsequent school term. Regression analyses were used to explore the relationship between sleep and mood, and structural equation modelling was used to examine changes of variables over time, as well as the moderating roles of cognitive vulnerabilities. Results: Compared with school days, sleep during the vacation was characterized by later timing, longer duration, lower quality and greater variability. Daily changes in actigraphy- measured sleep over the vacation period showed linear delays in sleep timing throughout the vacation, while changes in time-in-bed were non-significant. The first vacation week was characterized by a linear decrease in total sleep time and sleep quality, and these changes stabilized during the second vacation week. Compared to vacations, school terms were associated with higher symptoms of depression, anxiety, and life stress. Poorer sleep quality, particularly poorer subjective perception of sleep quality, was significantly associated with higher symptoms of depression and anxiety. Sleep- specific cognitive vulnerability moderated the relationship between objective and subjective sleep onset latency during extended but not restricted sleep opportunity. After controlling for life stress, global cognitive vulnerability played different moderating roles in the relationship between subjective sleep and mood over school term and vacation periods. Higher global cognitive vulnerability was associated with a stronger relationship between subjective sleep and symptoms of anxiety (but not depression) during the school term, as well as with a stronger relationship between subjective sleep and symptoms of depression (but not anxiety) during the vacation period. Conclusion: Sleep, mood, and life stress changed markedly over the school term and vacation periods. Changes in sleep over the vacation suggested that the recovery from school- related sleep restriction was completed within two weeks’ extended sleep opportunity, and the average sleep duration over this period suggested that sleep requirements in adolescence may be less than conventionally described in the media and in the scientific literature. Cognitive vulnerabilities played important roles in the relationship between sleep and mood. Adolescents with higher cognitive vulnerability might be more emotionally vulnerable towards school-related sleep restriction. These findings have important implications for future studies, as well as practical implications for policies and interventions designed to improve adolescents’ wellbeing.
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ItemFrom somebodies to bodies: towards a better understanding of the causes, process, and consequences of sexual objectification( 2013)The sexual objectification of the human body proliferates throughout Western culture. Not only is the phenomenon reinforced by mainstream media, which commonly portrays individuals as sexual objects, it is also enacted through everyday experiences, such as inappropriate sexual comments, catcalls, and the objectifying gaze. According to feminist philosophers, sexual objectification occurs when an individual (most typically a woman) is transformed into a thing for another’s sexual use (Bartky, 1990). The process not only involves viewing and valuing the person as a means to an end, but also denying them their inherent worth as a human being. The psychological literature on the phenomenon, while relatively new, has in recent years shed important insight into what facilitates the process, and the negative ramifications that result from valuing individuals on the basis of their appearance (e.g., Gurung & Chrouser, 2007; Holland & Haslam, 2013; Loughnan et al., 2010; Vaes, Paladino, & Puvia, 2011). However, despite the considerable progress that has been made, at present the existing literature is somewhat limited in terms of how it assesses the phenomenon. Specifically, a lack of consensus exists regarding what objectification represents and how best to measure it. Across three studies, this thesis aimed to provide and systematically test a more comprehensive model of objectification, construing objectification as the viewing of an individual as a) an object, and b) not a subject. Study One examines how a well-established precursor to objectification – provocative clothing – impacts these two aspects, and how the aspects contribute to a host of perceptual outcomes. It also examines the mediating role of objectification in the relationship between the precursor and outcome variables. The findings demonstrate that provocative clothing differentially influences the two aspects of objectification, with each aspect contributing to different outcomes. Thus, the results suggest that objectification is multifaceted, and that considering each aspect separately contributes to our understanding of the phenomenon. Study Two extends upon the first experiment by examining whether the different aspects of objectification represent a coherent phenomenon. To do this, I systematically vary three different target precursors – clothing type (i.e., provocative vs. plain), facial prominence (i.e. high vs. low), and target age (i.e., adult vs. child) – across a range of stimuli, and examine how these factors influence the two components of objectification. The findings suggest that all three precursor variables influence the extent to which a target is depersonalized, yet have no impact on the extent to which the target is seen as object-like. The results also reveal little coherence between the different aspects of objectification, suggesting that it is important to examine each aspect separately. Study Three draws upon an intriguing result from the previous study – the finding that pre-pubescent targets are denied personhood when portrayed in swimwear. Specifically, the study examines how the denial of personhood to bikini-clad pre-pubescent girls informs reactions to scenarios in which they are harmed and helped. The results demonstrate that objectifying perceptions facilitate reduced care towards the target, and an increase in victim blaming, and that the effect of provocative clothing on the outcomes is driven by a withdrawal of moral concern for the target. Once again, the findings suggest that the aspects of objectification differentially influence the outcome variables, thus attesting to the multifaceted and complex nature of the phenomenon. Taken together, the studies reported in this thesis demonstrate that the two aspects of objectification – viewing someone as an object, and not as a subject – are distinct from one another. Not only are they differently influenced by a range of precursor variables, they also contribute to different consequences of objectification. Given this, future research would benefit from taking a multifaceted approach to the study of objectification, to gain a more complete understanding of what facilitates the process, and the resultant outcomes.
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ItemNeuropsychological characterization of typical and atypical progressive supranuclear palsy and comparison with Parkinson's disease( 2013)This thesis examined the cognitive aspects of patients with progressive supranuclear palsy defined according to the recently proposed phenotypic distinctions (PSP+). 14 patients with PSP-Richardson’s syndrome (PSP-RS), 3 with PSP-Parkinsonism (PSP-P), 4 with PSP-Pure akinesia with gait freezing (PSP-PAGF) and 19 patients with idiopathic Parkinson’s disease (PD) were examined using a comprehensive battery of neuropsychological tests encompassing a wide range of cognitive domains. The results from the current thesis provide clear evidence that the PSP clinical phenotypes can be differentiated by a characteristic pattern and progression of cognitive deficits at a group (PSP+) and at a phenotypic level (PSP-RS, PSP-P, PSP-PAGF). Specifically, the pattern of cognitive deficits most useful in distinguishing between PSP+ and PD were psychomotor slowing and prominent ‘frontal’ executive dysfunction. In addition, longitudinal analyses revealed a differential decline of executive function in patients with PSP+ in comparison to PD. At the phenotypic level, patients with the classic variant of PSP (PSP-RS) could be distinguished from those with the ‘atypical’ phenotypes (PSP-P and PSP-PAGF) by a more severe and extensive pattern of cognitive impairments and longitudinal decline in executive function. These findings were broadly consistent with the reported pathological differences in PSP-RS, PSP-P, and PSP-PAGF. Results from this research confirm the existence of three distinct clinical phenotypes of PSP, which can be differentiated on pathological, clinical and cognitive grounds. In addition, this thesis indicates that neuropsychological assessment may be able to contribute to the in vivo differentiation of the PSP clinical phenotypes in clinical practice.
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ItemEducational and cultural challenges for refugee young people in Australia( 2013)This research investigated the everyday and cultural challenges for refugee young people, using computer-assisted interviews. Patterns of everyday challenge differed among refugee, immigrant and Australian-born students, in relation to their constructions of bicultural or mono-cultural identities. Refugee young people engaged with English language, money and other challenges in various ways. In four studies, quantitative and qualitative analyses revealed how individual participants with different patterns of bicultural identity specified and engaged with challenges using personal strategies and social support.
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ItemInteraction of attention and memory: a working memory model of multiple object tracking( 2013)To accurately perceive a dynamic environment, the visual system must create mental representations of specific objects and their place in the environment, must quickly and accurately update those representations as objects move, and must be able to use those representations to direct attention to appropriate objects while ignoring those that are irrelevant. This thesis investigated these processes. Three studies were conducted, each focused on a distinct but interrelated aspect of the interaction of attention and memory processes. The first study used a training experimental design to provide evidence that representations of tracking stimuli are not constrained to a visual hemifield in the manner that deployment of attention seems to be. The second study demonstrated mutual disruption between a tracking and a visual working memory task, suggesting that tracking and visual working memory share resources of both attention and memory. The final study provided evidence to suggest that motion does not contribute to tracking when location is more informative. These results are synthesised with previous models of multiple object tracking, and with a multicomponent model of working memory, to develop a model that is able to account for each of the findings of this thesis.
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ItemThe effects of education, self-regulation, social support and cultural participation on physical activity variety in the Baby Boomer generation( 2013)If there is one principle for well-being, it is that recreational physical activities, such as walking and sports, have wide-ranging health benefits. However, most people are not active enough to realise the benefits, such as the baby boomer generation. A major public health issue is how to develop better ways to encourage the ‘boomers’ to live physically active lives. Research has identified a tendency for the boomers to participate in variety, such as a range of recreational activities (Alderson, Junisbai, & Heacock, 2007). In addition, adult education level is connected to more variety (e.g. van Eijck, 1999). If the boomers have an appetite for variety, it may be a focus for physical activity promotion. However, the potential effects of education on activity variety of this generation is unclear, and it has not been directly investigated whether forms of self-agency such as self-regulation, and seeking social support, intervene education and physical activity variety. By drawing on social-cultural psychology to integrate insights from health psychology, public health, and sociology, the current thesis investigated the potential role of formal education and self-agency in current participation in physical activity variety by the boomer generation. The aim was to establish whether education is a determinant of physical activity variety, and in particular, as a potential precursor to day-to-day agency (e.g. seeking social support to be active). A model of the effects of education on physical activity variety was developed, and investigated through a field study of boomer adults (n = 217) in the general community of Melbourne, Australia. The Model proposed that education leads to activity variety via self-regulation, seeking social support and cultural participation (e.g. visiting museums and cultural festivals). Research participants completed a detailed survey of social and life background, lifestyle patterns, and health, and a measure of cognitive ability – a potentially important capacity for self-regulation and active living. Before the main field study, the survey was developed through two pilot studies (n1 = 218, and n2 = 106), and the ability measure evaluated in the latter pilot. As anticipated, education was found to effect physical activity variety, positively and indirectly, and primarily via: (1) self-regulation and attaining social support, and (2) cultural participation. The strongest direct effect on activity variety was via social support elicitation, and the multiple indirect effects of education on variety took place via this form of adult self-agency. Cognitive ability had a negative effect on self-regulation, and a positive direct effect on social support elicitation. Women were more engaged in cultural participation than men, and less engaged in physical activity variety. The findings of this thesis suggest that physical activity promotion strategies that are focused on increasing multiple types of activity may be a promising public health approach, and may be particularly effective for boomers with higher education. Furthermore, forms of self-agency that are not normally the ‘target’ of public health, such as cultural participation, may foster more health-enhancing physical activity. The baby boomers gravitate to variety in life, and efforts to support this proclivity in the generation may confer additional benefits to their well-being.
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ItemWhat’s right and wrong depends on the relationship: the roles of relational context and relational construal in moral judgement( 2013)This thesis, in contrast to prevailing theories in moral psychology, provides evidence that moral judgements should not be treated as relational-context-invariant, and suggests a fundamental role of relational cognition in moral psychology.
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ItemDevelopmental and maintaining processes in social anxiety, and the impact upon social adjustment( 2013)Social anxiety disorder is the second most prevalent anxiety disorder in Australia and subthreshold social anxiety symptoms are experienced by a large majority of the population. Prevailing theoretical and treatment models primarily emphasise maintaining factors such as biased information-processing, but neglect developmental mechanisms which are important for both the conceptualisation and treatment of social anxiety. Using a cross-sectional methodology, the present study investigated the relationships between social anxiety and the developmental variables of adult attachment style and early maladaptive schemas. Additionally, the influence these variables have upon emotion sensitivity, which was used to measure biased information-processing, was explored. The relationship between social anxiety and social adjustment was examined to ascertain the level of functional impairment experienced as a result of social anxiety, a neglected area in the literature. The research consisted of two studies. The first study involved 348 undergraduate students, and the second study included 40 individuals diagnosed with social anxiety disorder. Participants completed the Social Phobia Scale, Social Interaction Anxiety Scale, Relationship Scales Questionnaire, Young Schema Questionnaire – Short Form, Social Adjustment Scale – Self Report, and the Morphed Faces experimental task. In addition, the clinical participants were compared with 80 participants from the first study – 40 who had high social anxiety scores, and 40 who had low scores. The results attest to the importance of preoccupied and fearful attachment styles in the onset of social anxiety, the protective influence of a secure attachment style, as well as the detrimental effect of social anxiety upon functioning. Early maladaptive schemas from the disconnection and rejection and impaired autonomy and performance domains, as well as subjugation and emotional inhibition, were important predictors of social anxiety. In addition, many of these schemas mediated the relationship between insecure attachment and social anxiety. The conceptualisation of attachment according to the dimensions of attachment anxiety and attachment avoidance was supported in the context of social anxiety. Overall, there was little difference between the high socially anxious group and clinical group on attachment and early maladaptive schemas, with both groups demonstrating elevated scores on these variables in comparison to the low socially anxious group. The clinical group, however, was faster and more accurate at identifying emotions, and had poorer social adjustment. In the first study, no significant relationships were found between emotion sensitivity and social anxiety. The findings elaborate upon prevailing cognitive-behavioural models which emphasise maintaining factors, and substantiate the importance of both maintaining and early environmental factors in social anxiety. The assertions that early maladaptive schemas may be derived from internal working models were supported, and insight has been provided into the cognitions underlying attachment organisations in socially anxious individuals. These studies suggest that understanding social anxiety symptoms as attachment-related psychopathology could be beneficial for early intervention and longer-term treatment gains.