Multiple sclerosis and economic well being: role of health, age, and duration of illness

This study used quantitative and qualitative techniques to examine the role of health, age, and duration of illness among people with multiple sclerosis (MS) in their economic well-being. Participants were 113 adults (31 males and 82 females) with MS who lived in urban and rural regions of Australia. The results demonstrated that health and age had a significant impact on both the economic well-being and psychological adjustment of people who contract this disorder. Different health variables predicted different aspects of economic well-being. Fatigue was the major health variable that predicted costs of MS and economic pressure, with age also predicting economic pressure, whereas income levels were predicted by cognitive confusion and mobility problems. Duration of illness, gender, and urban/rural location were not significant predictors of the economic variables. These results demonstrate the importance of obtaining multiple measures of economic well-being, as well as a broad range of health-related measures, in determining the impact of MS on the economic well-being of people with this disorder.

Body image dissatisfaction among males across the lifespan- a review of past literature

Objective: Most past research has focused on body dissatisfaction among females. This paper provides a review and evaluation of studies that have examined body dissatisfaction among males. Body dissatisfaction in males has been associated with poor psychological adjustment, eating disorders, steroid use, exercise dependence, as well as other health behaviors. It is therefore important to understand the level of body dissatisfaction, as well as the factors that are related to this construct. Method: The review is divided into three sections: body dissatisfaction among children, adolescents and adults. Within each section, levels of body dissatisfaction are examined, as well as the research that relates to sociocultural influences on body dissatisfaction. Difficulties in drawing valid conclusions from the data due to methodological problems are highlighted. Results: From the current data, it would appear that there are strong similarities in the levels of body dissatisfaction of male and female children, with most children demonstrating high levels of body satisfaction. During adolescence, boys are about equally divided between wanting to lose weight and increasing weight, but there are few studies that have examined a desire for increased muscle size. In adulthood, men evidence a stronger desire to lose weight as they get older. Conclusion: Overall, past studies have primarily focused on questions that are relevant to females, and there is a need to conduct studies that evaluate areas of body dissatisfaction that have greater relevance for males. This will then allow a better understanding of the relationship between body dissatisfaction and psychological and behavioral problems experienced by males at all stages of the lifespan.

Adolescent and parental perceptions of interparental conflict

Research indicates adolescent adjustment problems are associated with high levels of interparental conflict. This study examined parents’ and adolescents’ perceptions of interparental conflict and the relationship of these perceptions to adolescent adjustment through a survey of adolescent secondary students and their parents. Sixty-two adolescents and 62 parents participated in the study. Adolescents completed three self-report measures of psychological adjustment, a demographic questionnaire and the Consensus and Cohesion subscales of the Dyadic Adjustment Scale (DAS). Parents completed the same subscales of the DAS and a demographic questionnaire. There were no significant differences between the levels of interparental conflict perceived by adolescents and parents. However, adolescent perceptions of interparental conflict were a better predictor of adolescent psychological adjustment when compared to parental perceptions of conflict. The results of this study emphasise the importance of adolescent perceptions of interparental conflict, and provide support for both parental and adolescent reports of family functioning to be taken into account in future clinical studies.

Adolescent body image and psychosocial functioning

Researchers have highlighted the significance of a poor body image in the development of dysfunctional eating but have systematically investigated few other outcomes. The authors examined the relationships between different aspects of body image and psychosocial functioning. Participants were 245 boys and 173 girls from Grades 8 and 9 (M age = 13.92 years, SD = 0.69 years). Respondents completed measures of physical attractiveness, body satisfaction, body image importance, body image behaviors, appearance comparison, social physique anxiety, self-esteem, depression, anxiety, and same-sex and opposite-sex relations. Whereas girls tended to report a more negative body image than did boys, the relevance of body image to self-esteem was similar for boys and girls. Concern about others' evaluation of their bodies was especially important in understanding low female self-esteem, whereas for boys, ratings of general attractiveness most strongly predicted self-esteem. The authors found a negative body image to be unrelated to symptoms of negative affect but to be strongly associated with poor opposite-sex peer relationships, especially among boys. A negative body image also affected same-sex relations among girls.

Relationship between body image and social and sexual functioning: gender and development trends

The purpose of this study was to examine the relationship between body image and social and sexual functioning. The respondents were 426 men and women from metropolitan and rural Victoria, who ranged in age from 18 to 86 years (mean age = 42.26). Respondents completed measures of attractiveness, body satisfaction, body image importance, body image behaviours, appearance comparison, social physique anxiety, self-esteem, depression, anxiety, and social and sexual functioning. Regression analyses were used to detelmine the prediction of social and sexual functioning by body image variables for men and women of different age groups, beyond the effects of psychological adjustment. The results demonstrated that while there were moderate correlations between body image and sociallsexual functioning variables, many of these relationships were best explained by the shared variance of self-esteem. There were some exceptions, particularly among middle-aged men, which are discussed.

The impact of chronic illness on relationships in early adulthood: a comparison study between healthy and arthritic young adults

While engaging in romantic relationships is regarded as a normative task during young adulthood, non-normative life events such as the emergence of chronic illness can mitigate against the successful negotiation of such tasks. Chronic illness brings with it a series of additional challenges and stressors to the realm of personal relationships that are thought to interrupt the development of normative interpersonal and intra-individual processes. However, few studies have examined how young adults faced with a chronic illness such as arthritis navigate romantic relationships and the consequences of illness and relationships on psychological adjustment. The aim of the study was to compare the relationship experiences of healthy young adults with those faced with arthritis. One hundred and nine young adults (M 23.01 years, SD 2.43) took part in the study. Of these participants 41 had been diagnosed with arthritis. A univariate MANOVA revealed arthritic young adults reported significantly more insecure attachment, lower levels of readiness for intimacy, and poorer relationship satisfaction compared to healthy young adults. Further correlational and regression analyses on the arthritic sample revealed psychological adjustment was related to arthritis severity, attachment and components of coping. Findings will be discussed in relation to attachment theory and coping processes.

Explanations for mixed-orientation marriage : a comparative study of previously married and never-married gay men

Despite a large body of literature on the development of sexual orientation, little is known about why some men who marry women have (or develop) a homosexual orientation. In the current study, a selfselected sample of 43 never-married gay men and 26 gay men who were married to a woman completed a self-report questionnaire. As well as obtaining descriptive information from the 26 men about their marriages and reason for marrying, hypotheses were tested, based on five possible explanations for gay men’s marriages: (a) internalised homophobia; (b) religious intolerance (c) confusion created because of childhood/adolescent sexual experiences; (d) poor psychological adjustment; and (e) differences in strength of sexual preference. The two most frequent reasons for marriage were that it “seemed natural”, and a desire to have children and “family life”. The attitudes to gay men and lesbians held currently by the married group were significantly more positive than their reports of their attitudes around the time their marriage commenced, and the level of childhood sexual experiences with adults or older adolescents was significantly associated with the extent of their unsafe sexual practices with men (prior, during and/or after marriage). Marrieds described their families’ religious beliefs as more fundamentalist than never-marrieds. Family adaptability and family cohesion and the degree to which respondents reported having experienced child maltreatment did not distinguished between marrieds and never-marrieds, however these variables did predict the level of self-depreciation. No differences were found between marrieds and never-marrieds’ ratings of their sexual orientation and identity, homophobia, or self-depreciation. The results highlight how little is understood of the reasons why gay men marry, and the need to develop an adequate theoretical model.

Chronic illness and its impact : considerations for psychologists

A significant proportion of the population is affected by chronic illnesses, which have a marked impact on psychological adjustment at both the individual and family level. The nature of these illnesses and their impacts is complex, and has implications for psychological practice. This paper reviews these issues, and argues that more emphasis should be given to medical conditions in training programmes for psychologists.

Volunteering and well-being : do self-esteem, optimism, and perceived control mediate the relationship?

Volunteers play a vital role in modern societies by boosting the labor force within both the public and private sectors. While the factors that may lead people to volunteer have been investigated in a number of studies, the means by which volunteering contributes to the well-being of such volunteers is poorly understood. It has been suggested through studies that focus on the absence of depression in volunteers that self-esteem and sense of control may be major determinants of the increased well-being reported by volunteers. This is consistent with the homeostatic model of subjective well-being, which proposes that self-esteem, optimism, and perceived control act as buffers that mediate the relationship between environmental experience and subjective well-being (SWB). Using personal well-being as a more positive measure of well-being than absence of depression, this study further explored the possible mediating role of self-esteem, optimism, and perceived control in the relationship between volunteer status and well-being. Participants (N = 1,219) completed a 97-item survey as part of the Australian Unity Wellbeing project. Variables measured included personal well-being, self-esteem, optimism, and a number of personality and psychological adjustment factors. Analyses revealed that perceived control and optimism, but not self-esteem, mediated the relationship between volunteer status and personal well-being.

Fracturing the façade : exploring the impact of childhood sexual abuse

Examination of previous empirical literature illustrates how researchers have concentrated on documenting the impact of childhood sexual abuse (CSA) on the later psychological functioning of survivors, through comparisons with those who have not had such a history. Only more recently has there been a focus on assessing the relationship between aspects of the abuse and specific psychological difficulties. This thesis investigated the relationships between CSA characteristics and women’s later psychological adjustment. The role of attributions, coping methods, parenting competency and marital satisfaction were also investigated. Qualitative data on perception of benefit and general reflections of participants were used to explore participants’ self-esteem, locus of control, decisions relating to parenting, disclosure experiences, and attributions in relation to their abuse, including the search for meaning. Recruitment through newspapers and counselling services led to 118 women volunteering to complete a questionnaire evaluating the characteristics of their CSA and their current psychological adjustment. Of this group, 33 subsequently volunteered to participate in a telephone interview that explored in greater depth issues related to the long-term impact of their CSA. Both quantitative and qualitative analyses were conducted on the data. The women reported a high prevalence of dysfunction in their families of origin. Abuse had generally commenced by middle childhood, and lasted for a number of years and often involved a number of perpetrators. Perpetrators were most likely to be intrafamilial, with stepfathers being over-represented. Sexual activities generally involved physical contact, with participation often induced by the use of coercion. Participants demonstrated significant difficulties in psychological adjustment, but attributions regarding the abuse improved over time. Some concerns were expressed regarding parenting competency, and avoidant coping methods were favoured. In general, participants were satisfied with their current marital relationship. Significant associations were found between coping methods, attributional style, beliefs and various psychological adjustment measures. Participants, in general, demonstrated low self-esteem and displayed an external locus of control. As a consequence of their experience of CSA, many participants reported they had decided not to have children. For those who did have children, CSA was almost universally seen as having had an impact on their parenting. Disclosure of CSA was usually delayed for a number of years, with poor outcomes generally resulting from disclosure when it occurred. Women with current partners rated them as very caring and not controlling. Participants were generally still searching for meaning in their abuse, despite many having accepted it. Survivors outlined an extensive range of long-term effects of CSA, and nominated a number of strategies that would assist in reducing these effects. The results of the study indicated that there are a number of characteristics associated with CSA which signal a higher risk of difficulties in psychological adjustment. Concerns of survivors regarding parenting were confirmed according to those who undertook this role. Unfortunately, concerns expressed by survivors that disclosure of their CSA would have had negative consequences was usually the case when they did finally disclose. However, the accessing of social and family support appeared to have an important role in changing the attributions of survivors regarding their CSA. Furthermore, change of attributions in relation to abuse may provide the key to resilience in survivors against the negative impact of CSA on later psychological adjustment.

Prevention of body concerns and risk behaviours in adolescent boys

Overall, this thesis was designed to explore the nature of adolescent boys' body image, the effects of body image on body change strategies and psychological adjustment, and the factors that influence body image. The first study examined body image in 362 adolescent boys. Body image was considered in terms of attitudes to different body parts and attributes, including, lower, middle and upper body, as well as weight, shape and muscles. The relationships between Body Mass Index (BMI), body image, sociocultural messages, psychological adjustment and body change strategies, including strategies to decrease weight and increase muscles using food and exercise, drive for thinness, bulimic attitudes and behaviour, excessive exercise, food supplements to lose weight, increase muscles and steroids, were also investigated. Multiple regression analyses were used to examine the role of body image, sociocultural messages and psychological adjustment to predict satisfaction with different body attributes and body change strategies. The findings from study one led to the development of a program aimed at preventing the development of unhealthy attitudes and behaviours among adolescent boys. Study two involved the implementation and evaluation of this prevention program. One hundred and twenty one boys participated in the program. The program was based on social-cognitive theory, and included a focus on accepting differences and the development of self-esteem. The boys who participated in the program indicated some change in existing attitudes and showed less development of risk behaviours relative to the control group. The implications of the findings from this thesis in relation to future research, as well as the prevention of adolescent boys' body image problems are discussed.

PTSD symptomatology in children and adolescents : treatment development and evaluation

This thesis developed, implemented and evaluated a cognitive-behavioural group treatment programme for children and adolescents experiencing symptoms of PTSD (Post-traumatic stress disorder). Results of the study indicate that symptoms of sleep disturbance and flashbacks, reduced markedly in the participants, providing a useful tool in reducing synptoms experiences by individuals exposed to trauma. The Professional portfolio presents four case studies that demonstrate the clinical application of the affect of chronic illness on the psychological adjustment of the sufferer and their families.

The neuroanatomical correlates of subjective wellbeing following head injury

The thesis found results supporting the involvement of the Right Frontal area of the brain in the subjective wellbeing (SWB) of individuals. Additional results suggested SWB is dependent upon Core Affect, itself dependent upon the Right Parietal area of the brain. These results provide evidence that SWB and Core Affect are based upon a neurological substrate. The portfolio investigated the association between chronic medical conditions and anxiety disorders, and how the occurence of anxiety issues can affect overall psychological adjustment to illness.

Adults with arthritic conditions and care-seeking in an attachment framework

This thesis investigated the role of care-seeking amongst adults with arthritis, using an attachment framework to help explain the inconsistent results of previous studies in regard to psychological adjustment to a chronic illness. The results highlight the importance of attachment processes in partially influencing care-seeking and coping strategies that shape psychological adjustment. The portfolio addresses the frequent co-occurence of depression with chronic medical disorders. This impacts the ability for chronic, medically ill adults to engage in self-management strategies. Four case studies are presented.

Women's psychosocial well-being following a major life transition

Some women are devastated by divorce, while others learn from the experience. In-depth interviews with sole-parenting women yielded themes that were then assessed using structured questionnaires. Statistical models showed that psychological adjustment and physical well-being related more strongly to psychological factors, such as sense of coherence, than to situational variables.