The relationship between stress and the symptomatology of fibromyalgia

Fibromyalgia is an unexplained but often debilitating syndrome, characterised primarily by widespread pain. This thesis provides direct evidence that physical and emotional stress exacerbates pain, fatigue and other symptoms of Fibromyalgia and supports the assertion that symptoms may be related to disordered stress-response mechanisma in the human brain. The professional portfolio presents four clinical case studies that demonstrate the utility of Acceptance and Commitment Therapy (ACT) in the psychotherapeutic treatment of people with chronic illness.

The interaction of diet, obesity and mood to stress response

Acute stress did not alter sucrose and salt preference. A dietary pattern low in sodium and high in potassium and magnesium improved overall mood. Modest weight loss did not alter the daily secretion of cortisol, but did reduce the blood pressure response to stress which may improve cardiovascular risk.

Perceptions of stress among people with an intellectual disability

A new stress scale was devised based on issues raised by people with an intellectual disability and entitled the Lifestress Inventory. The Inventory was used in a number of studies in order to assess the impact of daily hassles and life events on their perceived stress levels and quality of life. Data suggests that they experience general worries, negative interpersonal relations with others, and frustration with their restricted coping skills as their principal areas of stress.

Stress, health, work and family in the Australian hospitality industry

Hospitality was found to be a potentially high stress occupation. Potential work and family stressors, symptoms, affective factors, coping strategies and resources were identified. A stress-psychological health model was developed. Possible implications for stress research, measurement, prevention and management in the hospitality industry were proposed.

Subjective wellbeing

The thesis proposes that depression can be understood as a consequence of the failure to maintain subjective wellbeing. This represents a paradigm shift from the view of depression as being caused by negative affect. It suggests a new diagnostic approach that uses measures of wellbeing as indicators of depression.

Psychosocial epidemiology of colorectal cancer

The research explored the role played by personality and stress in the development and progress of colorectal cancer. Personality type was related to health outcomes following diagnosis, and to participation in bowel cancer screening. The personality types also differed in terms of their capacity to deal with stress.

Depression and anxiety in patients with cancer and their families

This thesis identified aspects of family relationships and the patients' illness that were associated with depression and anxiety in patients and their relatives after a cancer diagnosis and during treatment. It also tested the ability of a measure of family relationships to identify psychological distress in these families.

Factors influencing the impact of secondary exposure to trauma

The research found significant relationships between secondary exposure to client trauma and symptoms associated with secondary traumatic stress and vicarious trauma in a sample of community mental health clinicians. The research supports developmental conceptualisations of the relationships between these constructs and burnout, and identifies potential individual vulnerability and protective factors. The portfolio explores the impact of childhood maltreatment from an attachment theory perspective. Four clinical cases are presented illustrating the clinical relevance of the impact of childhood maltreatment and attachment disturbance, and the complexities associated with current attachment classification systems and differential diagnosis.

Evaluation of a stress management course in adult education centres in rural Australia

Objective: To investigate whether attending a six-week stress management course in a rural adult education centre is effective in reducing participants' levels of stress, anxiety and depression.

Design: Repeated measures design using self-report measures of stress, anxiety and depression at commencement and completion of a six-week stress management course, and six months post-completion follow up.

Setting and participants: One hundred and thirty-two adults (age range 18–73 years) living in a rural community who self-enrolled in the stress management course at adult education centres.

Intervention: The course consisted of six weekly group sessions. Each two-hour session conducted by mental health professionals, included teaching cognitive behavioural strategies targeted at reducing individual symptoms of stress.

Main outcome measures: Comparative analysis of pre- and post-test and six-month follow up on measures of stress (Stress Symptom Checklist), anxiety and depression (Hospital Anxiety and Depression Scale).

Results: Results indicated a significant reduction in stress symptoms (F(7,90) = 34.92, P < 0.001), anxiety and depression (F(3,95) = 87.92, P < 0.001) from course commencement to course completion. These improvements were sustained six months after course completion for stress symptoms (F(11,65) = 22.40, P < 0.001), anxiety and depression (F(5,73) = 41.78, P < 0.001).

Conclusion: Findings demonstrate the stress management course is an effective community intervention in a rural community. Challenges for future implementation of the program are discussed.

The potential utility of Daoist theory and practice in psychology

This thesis attempted to demonstrate the potential for adaptation from the Chinese philosophical tradition of Daoism into modern psychology. The candidate was able to succesfully demonstrate a link between Daoist thinking style and reduced stress levels, especially in Chinese individuals.