An evaluation of depression, self-efficacy, satisfaction with life and perceived access to medical care across stages of HIV infection

This survey was designed to identify the incidence and scope of depression, satisfaction with life, self-efficacy and perceived access to medical care for those who are infected with the HIV virus. It also determined whether or not factors such as sexual orientation, ethnicity and socioeconomic status are intervening variables with respect to mental health issues. Subjects were recruited through a purposive sample from South Florida. A total of 871 surveys were used in the analysis. The overall response rate was nearly 90%. The incidence of depression was found to be higher than 75% across all stages of HIV infection. Furthermore, the incidence of depression increased as HIV disease progressed. Satisfaction with life and for the most part, self efficacy were found to decrease slightly as HIV disease progressed. Significant variance in depression, life satisfaction and self efficacy were found across stages of HIV infection. No significant differences between groups that were HIV infected were found for depression, life satisfaction and self efficacy. The severity of depression was found to vary significantly with self efficacy, life satisfaction and access to medical care but not with socioeconomic status. Life satisfaction was found to vary significantly with socioeconomic status, depression and self efficacy but not with access to medical care. Self-efficacy was found to vary significantly with socioeconomic status, depression and life satisfaction but not with access to medical care. Gender and ethnicity were not found to be significant precedent variables in depression for HIV infected individuals. Sexual orientation was found to be a significant precedent variable for depression, life satisfaction and self efficacy.

Empowerment, social support, and self-esteem of parents involved in an elementary school program

Parent involvement (PI) in schooling has consistently been correlated with improved academic achievement in children. However, despite the apparent benefits of parent involvement, many schools serving low-income communities report consistent difficulty in facilitating the involvement of parents in their children's schooling. The purpose of this exploratory pilot study was to examine key variables associated with a PI program at a school that served a low-income community. The program was selected because it sustained the involvement of parents for a prolonged period of time. It was also selected because the program was facilitated by social workers. Derived from the literature, four lines of inquiry were examined: (a) the relationship between PI and parent strengths and development; (b) the relationship between PI and children's academic achievement; (c) facilitators for PI; and (d) barriers to PI. These lines of inquiry yielded the study's four primary research questions. The study employed a cross-sectional research design to address them. Thirty-three parents, representing 16 school-involved (SI) parents and 17 nonschool involved (NSI) parents, served as study participants. All 33 parents resided in a high poverty community. Quantitative methods were selected to examine differences between study participants and PI. Measures of parental empowerment, social support, self-esteem, and direct and indirect measures of their children's academic achievement were utilized. Qualitative methods were developed to identify and describe SI and NSI parents' perceptions of facilitators for and barriers to PI. This study's findings suggest that PI may yield important benefits for SI parents. These benefits include parents' perceptions of their empowerment, social support, and self-esteem. This study's findings also suggest a relationship between PI and reduced rates of children's school suspensions. This study did not, however, support relationships between PI and children's standardized test scores. This study concludes that despite the apparent benefits of PI for SI parents, PI may nonetheless be a proxy for several unspecified interventions that effect parents, children, schools and communities alike. More precise specifications and robust measures of PI are needed.

An investigation of the relationships among self-care behaviors, health beliefs, and metabolic control in the non-insulin-dependent diabetic adult

Self-care and health beliefs have been found to be important concepts in the management of chronic diseases such as diabetes mellitus. Poor metabolic control has been associated with a higher incidence of complications in diabetic patients. This study sought to explore any relationships among perceptions of self-care behaviors, health beliefs and metabolic control. The sample consisted of 52 outpatients with non-insulin-dependent diabetes from a large teaching medical center. Interviews were done to obtain the patients' perceptions of their self-care behaviors, and their health beliefs concerning diabetes. Results of glycosylated hemoglobin and/or serum glucose levels were obtained from the medical records. Data were analyzed using Cochran-Mantel-Haenzel statistics, and Pearson's r. Results indicated no significant relationships among perceptions of self-care behaviors, health beliefs and metabolic control. Ethnicity, education and gender were found to be significantly associated with self-care behaviors and health beliefs.

Validation of the English version of the Scale for Psychosocial Factors in Food Allergy and the relationship with mental health, quality of life, and self-efficacy

Background. The Scale for Psychosocial Factors in Food Allergy (SPS-FA) is based on the biopsychosocial model of health and was developed and validated in Chile to measure the interaction between psychological variables and allergy symptoms in the child. We sought to validate this scale in an English speaking population and explore its relationship with parental quality of life, self-efficacy, and mental health. Methods. Parents (n = 434) from the general population in the UK, who had a child with a clinical diagnosis of food allergy, completed the SPS-FA and validated scales on food allergy specific parental quality of life (QoL), parental self-efficacy, and general mental health. Findings. The SPS-FA had good internal consistency (alphas = .61-.86). Higher scores on the SPS-FA significantly correlated with poorer parental QoL, self-efficacy, and mental health. All predictors explained 57% of the variance in SPS-FA scores with QoL as the biggest predictor (β = .52). Discussion. The SPS-FA is a valid scale for use in the UK and provides a holistic view of the impact of food allergy on the family. In conjunction with health-related QoL measures, it can be used by health care practitioners to target care for patients and evaluate psychological interventions for improvement of food allergy management.

Akrasia and the Aesthetic: Human Agency and the Site of Literature, 1760-1820

This study focuses on a series of foundational stylistic and formal innovations in eighteenth-century and Romantic literature, and argues that they can be cumulatively attributed to the distinct challenges authors faced in representing human action and the will. The study focuses in particular on cases of “acting against better judgment” or “failing to do what one knows one ought to do” – concepts originally theorized as “akrasia” and “weakness of the will” in ancient Greek and Scholastic thought. During the Enlightenment, philosophy increasingly conceives of human minds and bodies like systems and machines, and consequently fails to address such cases except as intractable or incoherent. Yet eighteenth-century and Romantic narratives and poetry consistently engage the paradoxes and ambiguities of action and volition in representations of akrasia. As a result, literature develops representational strategies that distinguish the epistemic capacities of literature as privileged over those of philosophy.

The study begins by centering on narratives of distempered selves from the 1760s. Jean-Jacques Rousseau’s Confessions and Laurence Sterne’s A Sentimental Journey narrate cases of knowingly and weakly acting against better judgment, and in so doing, reveal the limitations of the “philosophy of the passions” that famously informed sentimental literature at the time. These texts find that the interpretive difficulties of action demand a non-systematic and hermeneutic approach to interpreting a self through the genre of narrative. Rousseau’s narrative in particular informs William Godwin’s realist novels of distempered subjects. Departing from his mechanistic philosophy of mind and action, Godwin develops the technique of free indirect discourse in his third novel Fleetwood (1805) as a means of evoking the ironies and self-deceptions in how we talk about willing.

Romantic poetry employs the literary trope of weakness of will primarily through the problem of regretted inaction – a problem which I argue motivates the major poetic innovations of William Wordsworth and John Keats. While Samuel Taylor Coleridge sought to characterize his weakness of will in philosophical writing, Wordsworth turns to poetry with The Prelude (1805), revealing poetry itself to be a self-deceiving and disappointing form of procrastination. More explicitly than Wordsworth, John Keats identifies indolence as the prime symbol and basis of what he calls “negative capability.” In his letters and poems such as “On Seeing the Elgin Marbles” (1817) and “Ode on Indolence” (1819), Keats reveals how the irreducibly contradictory qualities of human agency speak to the particular privilege of “disinterested aesthetics” – a genre fitted for the modern era for its ability to disclose contradictions without seeking to resolve or explain them in terms of component parts.

Suicide and deliberate self harm in older Irish adults

Background: Hospital-treated deliberate self harm and suicide among older adults have rarely been examined at a national level. Methods: The Irish Central Statistics Office provided suicide and undetermined death data for 1980-2006. The National Registry of Deliberate Self Harm collected data relating to deliberate self harm presentations made in 2006-2008 to all 40 Irish hospital emergency departments. Results: Rates of female suicide among older adults (over 55 years) were relatively stable in Ireland during 1980-2006 whereas male rates increased in the 1980s and decreased in more recent decades. Respectively, the annual male and female suicide and undetermined death rate was 22.1 and 7.6 per 100,000 in 1997-2006. Male and female deliberate self harm was 3.0 and 11.0 times higher at 67.4 and 83.4 per 100,000, respectively. Deliberate self harm and suicide decreased in incidence with increasing age. Deliberate self harm generally involved drug overdose (male: 72%; female 85%) or self-cutting (male: 15%; female 9%). The most common methods of suicide were hanging (41%) and drowning (29%) for men and drowning (39%) and drug overdose (24%) for women. City and urban district populations had the highest rates of hospital-treated self harm. The highest suicide rates were in urban districts. Conclusions: Older Irish adults have high rates of hospital-treated deliberate self harm but below average rates of suicide. Drowning was relatively common as a method of suicide. Restricting availability of specific medications may reduce both forms of suicidal behavior.

Self-efficacy in depression: Bridging the gap between competence and real-world functioning

Background: Depression is the largest contributing factor to years lost to disability, and symptom remission does not always result in functional improvement. Comprehensive analysis of functioning requires investigation both of the competence to perform behaviours, as well as actual performance in the real world. Further, two independent domains of functioning have been proposed: adaptive (behaviours conducive to daily living skills and independent functioning) and interpersonal (behaviours conducive to the successful initiation and maintenance of social relationships). To date, very little is known about the relationship between these constructs in depression, and the factors that may play a key role in the disparity between competence and real-world performance in adaptive and interpersonal functioning. Purpose: This study used a multidimensional (adaptive and interpersonal functioning), multi-level (competence and performance) approach to explore the potential discrepancy between competence and real-world performance in depression, specifically investigating whether self-efficacy (one’s beliefs of their capability to perform particular actions) predicts depressed individuals’ underperformance in the real world relative to their ability. A comparison sample of healthy participants was included to investigate the level of depressed individuals’ impairment, across variables, relative to healthy individuals. Method: Forty-two participants with depression and twenty healthy participants without history of, or current, psychiatric illness were recruited in the Kingston, Ontario community. Competence, self-efficacy, and real-world functioning all in both adaptive and interpersonal domains, and symptoms were assessed during a single-visit assessment. Results: Relative to healthy individuals, depressed individuals showed significantly poorer adaptive and interpersonal competence, adaptive and interpersonal functioning, and significantly lower self-efficacy for adaptive and interpersonal behaviours. Self-efficacy significantly predicted functional disability both in the domain of adaptive and interpersonal functioning. Interpersonal self-efficacy accounted for significant variance in the discrepancy between interpersonal competence and functioning. Conclusions: The current study provides the first data regarding relationships among competence, functioning, and self-efficacy in depression. Self-efficacy may play an important role in the deployment of functional skills in everyday life. This has implications for therapeutic interventions aimed at enhancing depressed individuals’ engagement in functional activities. There may be additional intrinsic or extrinsic factors that influence the relationships among competence and functioning in depression.

Education and Self-Cultivation: Foundational Changes for Existential Flourishing

The strained relationship between pedagogy and self-cultivation is often overlooked in favour of more pressing and profitable concerns within educational institutions. However, the end of education is not a well-paying job. It is often thought that education will produce a certain type of learned individual. Students are entered into educational institutions from a very young age and spend most of their youth within them, subsequently forming a part of themselves, their self-identify and agency, through these institutions. A significant amount of trust is placed in the hands of educators not only to impart information about various subject matters but to teach students how to think. This, however, is a difficult task which cannot be completely accomplished; thinking is a skill which an educator can promote but only the individual can cultivate. If self-cultivation is not the end of pedagogical practice and education, there is something deeply contradictory between the theoretical and practical values and aims of educational institutions.This thesis will address the problems caused by the neglect of self-cultivation within the pedagogical practices of contemporary educational institutions. I argue that self-cultivation, existential learning and flourishing should be the focus of these institutions. Educational institutions can make alternative efforts not only to improve the learning environment for these students but to prepare them to cope with existential questions. By acknowledging and focusing on the significance of self-cultivation, educational institutions can and should make efforts not only to teach useful, marketable skills and information but to also nurture the agency and mental well-being of the student him- or herself. My hope is that this thesis will be the first step towards answering a larger concern: How can educational institutions alleviate the struggles of students, particularly the seemingly growing number who are suffering from depression, by appealing to notions of self-cultivation?

Correlation between anxiety and academic self-concept in interpreter trainees

This paper focuses on two basic issues: the anxiety-generating nature of the interpreting task and the relevance of interpreter trainees’ academic self-concept. The first has already been acknowledged, although not extensively researched, in several papers, and the second has only been mentioned briefly in interpreting literature. This study seeks to examine the relationship between the anxiety and academic self-concept constructs among interpreter trainees. An adapted version of the Foreign Language Anxiety Scale (Horwitz et al., 1986), the Academic Autoconcept Scale (Schmidt, Messoulam & Molina, 2008) and a background information questionnaire were used to collect data. Students’ t-Test analysis results indicated that female students reported experiencing significantly higher levels of anxiety than male students. No significant gender difference in self-concept levels was found. Correlation analysis results suggested, on the one hand, that younger would-be interpreters suffered from higher anxiety levels and students with higher marks tended to have lower anxiety levels; and, on the other hand, that younger students had lower self-concept levels and higher-ability students held higher self-concept levels. In addition, the results revealed that students with higher anxiety levels tended to have lower self-concept levels. Based on these findings, recommendations for interpreting pedagogy are discussed.

Self-harm, suicide and risk: helping people who self-harm. Final report of a working group.

The focus of this report is to enquire into and report on why people harm and kill themselves and to consider the role (including the limits of the role) that psychiatrists and other mental healthcare professionals play in their care and treatment. The experiences and views of people who harm themselves as well as those of their carers, health professionals and third-sector workers are central to this enquiry. As there is much policy and guidance on self-harm and suicide prevention, the report does not attempt to retrace this same ground but rather examines the evidence of practice on the ground, including the implementation of the National Institute for Health and Clinical Excellence (NICE) guidelines on self-harm (National Collaborating Centre for Mental Health, 2004). This report is the second in the Royal College of Psychiatristsââ,¬â"¢ programme of work on the broad issue of risk. The College report Rethinking Risk to Others was published in July 2008 (Royal College of Psychiatrists, 2008a) and a new Working Group was set up under the chairmanship of John, Lord Alderdice, to examine risk, self-harm and suicide. This clinical issue is an integral part of the role of the psychiatrist in ensuring the good care and treatment of patients. Our central theme is that the needs, care, well-being and individual human dilemma of the person who harms themselves should be at the heart of what we as clinicians do. Public health policy has a vital role to play and psychiatrists must be involved and not leave these crucial political and managerial decisions to those who are not professionally equipped to appreciate the complexities of self-harm and suicide. But we must never forget that we are not just dealing with social phenomena but with people who are often at, and beyond the limit of what they can emotionally endure. Their aggressive acts towards themselves can be difficult to understand and frustrating to address, but this is precisely why psychiatrists need to be involved to bring clarity to the differing causes for the self-destructive ways in which people act and to assist in managing the problems for the people concerned, including family, friends and professional carers, who sometimes find themselves at the end of their tether in the face of such puzzling and destructive behaviour.

The iceberg of suicide and self-harm in Irish adolescents: a population-based study

PURPOSE Suicide is a leading cause of death among adolescents. Self-harm is the most important risk factor for suicide, yet the majority of self-harm does not come to the attention of health services. The purpose of this study was to establish the relative incidence of adolescent suicide, hospital-treated self-harm and self-harm in the community. METHODS Annual suicide rates were calculated for 15-17 year-old in the Cork and Kerry region in Ireland based on data from the Central Statistics Office. Rates of hospital-treated self-harm were collected by the Irish National Registry of Deliberate Self-Harm. Rates of self-harm in the community were assessed using a survey of 3,881 adolescents, the Child and Adolescent Self-harm in Europe study. RESULTS The annual suicide rate was 10/100,000. Suicide was six times more common among boys than girls. The annual incidence rate of hospital-treated self-harm was approximately 344/100,000, with the female rate almost twice the male rate. The rate of self-harm in the community was 5,551/100,000, and girls were almost four times more likely to report self-harm. For every boy who died by suicide, 16 presented to hospital with self-harm and 146 reported self-harm in the community. For every female suicide, 162 girls presented to hospital with self-harm and 3,296 reported self-harm. CONCLUSIONS Gender differences in relative rates of self-harm and suicide are very large, with boys who have harmed themselves at particularly high risk of suicide. Knowledge of the relative incidence of self-harm and suicide in adolescents can inform prevention programmes and services.

Self-Harm in Secondary Schools: What are the Perceptions and Experiences of Staff ?

The purpose of this study is to explore the perceptions and experiences of secondary school staff with regard to adolescent self-harm. The research was conducted in a Local Authority where there were particular concerns about rising numbers of young people presenting with self-harm. While the majority of young people who self-harm are supported in the community and never access clinical services, surprisingly little research has considered the role of schools and their staff. The research that has been done suggests that school staff can feel underqualified and overwhelmed in their attempts to support young people who self-harm. Further, there is a growing evidence base that when young people experience negative attitudes towards self-harm it is distressing and reduces the chance of them seeking further help. To address this, qualitative exploratory research was conducted with thirteen members of staff working in secondary schools. Since the research was concerned not just with experiences, but also with perceptions of adolescent self-harm, the participants were from two groups: those with direct experience of supporting young people who have self-harmed and those without any direct experience. Data collection involved individual semi-structured interviews which were analysed using thematic analysis. The research indicated that secondary school staff are keen to help and understand young people who self-harm, but that they do not always feel skilled or confident enough to do so, often feeling that some kind of specialist is required and/or fearing that they might make a situation worse. Findings highlighted the emotional impact of this work and illustrated the importance of supporting staff, who expressed a desire for further training and other forms of professional support such as supervision.

Self-regulatory behaviours and flow dispositions in musical practice: a survey with advanced performers

Flow experience, a holistic sensation of total involvement in an activity, seems to have positive influences on musical performance activities. Although its main requirements (balance between challenges and skills, clear goals and unequivocal feedback) are inherent elements of musical practice, there is a lack of research about flow occurrences in the context of musical practice and on how specific practice behaviours affect the experience of flow and its particular dimensions. The aims of this thesis were to investigate advanced performersʼ dispositions to flow in musical practice, and to investigate whether the frequency of these experiences of holistic engagement with practice are associated with self-regulatory practice behaviours. 168 advanced classicallytrained performers (male = 50.0%; female = 50.0%), ranging in age from 18 to 74 years (m = 34.41, SD = 12.39), answered a survey that included two measures: the Dispositional Short Flow Scale, assessing performersʼ flow dispositions, and the Self-Regulated Practice Behaviours Questionnaire, developed specifically for the present research. The overall results of the survey suggested that advanced musicians have high dispositions to flow in musical practice, but not associated with the participantsʼ demographic characteristics. Three of the individual flow indicators were less experienced, suggesting that the most intense flow experiences are rare in musical practice. However, the results point to the existence of another relevant experience, named optimal practice experience. Practice engagement levels were positively associated with knowledge of oneʼs own personal resources and a capacity for practice organization, but not with inclusion/use of external resources. A capacity for setting optimal practice goals was related to self-regulation and to immersion aspects of flow. Current findings offer new clues about the assessment of flow dispositions in performers, helping to clarify how daily practice can heighten positive affective responses in musicians who are vulnerable to the requirements and difficulties of deliberate practice, as well as to other negative practice outcomes. The current research questions issues pertaining to the optimization and sustaining of flow in daily practice, suggesting future directions in the study of the affective subjective functioning of engagement with deliberate practice.

To Succeed Is to Believe: Comparison of Self-Efficacy Beliefs in Language Learning between Learner Groups of English and Swedish in Finland

In this thesis, I studied self-efficacy in the learning of English and Swedish in Finland. The theory of self-efficacy, which was created by Albert Bandura, suggests that the beliefs a person has of his or her capabilities in a certain task affect the person’s performance in the task. My aim was to study whether there are differences in self-efficacy beliefs between the learners of English and Swedish, and whether these beliefs correlate with the performance in the language in question. My hypotheses were that the learners of English have higher self-efficacy beliefs than the learners of Swedish and that self-efficacy beliefs correlate with language performance. The study was quantitative, and it consisted of a self-efficacy questionnaire and a language test which were distributed to students of English and Swedish in an upper secondary school in Rovaniemi. The study was answered by 137 students, of whom 93 were learners of English and 44 were learners of Swedish. The results indicated that the learners of English had a higher sense of efficacy than the learners of Swedish. The analysis proved that there was a significant correlation between English students’ self-efficacy and their performance in the language measured by the test and the grades. In addition, a significant correlation existed between Swedish students’ self-efficacy and their grades. However, there was no correlation between the Swedish students’ self-efficacy and their test results. The difference in the self-efficacy beliefs of the two language groups indicates that people in Finland are more confident in using English than Swedish, which also implies that English is more valued in Finnish society than Swedish. It is important to acknowledge the lower self-efficacy beliefs in Swedish because various studies have proven that self-efficacy affects academic achievement. As a suggestion for further research, the self-efficacy beliefs of different language groups could be compared in a qualitative study in order to understand the development of self-efficacy more profoundly.