Psychological and Social Perspectives on Malingering and Symptom Exaggeration: Conceptualization and Interventions Using Acceptance and Commitment Therapy

Malingering and the production of false symptoms seen in such disorders as Factitious Disorder are an ongoing mystery to medical and mental health professionals. Historically, these presentations have been difficult to identify and treat. As might be expected, individuals with such symptomology rarely agree to participate in research, possibly because of a reluctance to admit to the feigning or exaggerating behaviors and a fear of reprisals. Many different etiologies have been proposed, including the assumption of roles in order to manage impressions, taking control of symptoms in order to gain attention or other rewards or avoid aversive events, and even the production of symptoms that is largely out of awareness such as is seen in conversion or somatoform presentations. By examining historical and present-day beliefs about etiology and treatment interventions, professionals can explore what new types of effective treatment might look like. The behaviorist philosophy that underlies Acceptance and Commitment Therapy proposes a perspective emphasizing effective working in context. This philosophy also suggests individuals sometimes engage in behavior in order to escape from or avoid aversive experiences. Utilizing case examples and fresh behavioral perspectives provides insight and ideas for conceptualization of these behaviors of interest. Using the above conceptualizations, an ACT based treatment of those who produce false symptoms is introduced.

A Discursive Perspective on China's Global Politics of Climate Change, 1992-2013

This dissertation investigates China’s recent shift in its climate change policy with a refined discourse approach. Methodologically, by adopting a neo-Gramscian notion of hegemony, a generative definition of discourse and an ontological pluralist position, the study constructs a theoretical framework named “discursive hegemony” that identifies the “social forces” for enabling social change and focuses on the role of discursive mechanisms via which the forces operate and produce effects. The key empirical finding of this study was that it was a co-evolution of conditions that shaped the outcome as China’s climate policy shift. In examining the case, a before-after within-case comparison was designed to analyze the variations in the material, institutional, and ideational conditions, with methods including interviews, conventional narrative/text analysis and descriptive statistics. Specifically, changes in energy use, the structure of decision-making body, and the narratives about sustainable development reflected how the above three types of social force processed in China in the first few years of the 21st century, causing the economic development agenda to absorb the climate issue, and turning the policy frame for the latter from mainly a diplomatic matter to a potential opportunity for better-quality growth. With the discursive operation of the “Science-based development”, China’s energy policy has been a good example of the Chinese understanding of sustainability characterized by economic primacy, ecological viability and social green-engineering. This way of discursive evolution, however, is a double-edged sword that has pushed forward some fast, top-down mitigation measures on the one hand, but has also created and will likely continue creating social and ecological havoc on the other hand. The study makes two major contributions. First and on the empirical level, because China is an international actor that was not expected to cooperate on the climate issue according to major IR theories, this study would add one critical case to the studies on global (environmental) governance and the ideational approach in the IR discipline. Second and on the theory-building level, the model of discursive hegemony can be a causally deeper mode of explanation because it traces the process of co-evolution of social forces.