published_or_final_version / Education / Doctoral / Doctor of Philosophy

In support of Snyder’s cognitive theory, hope has been found to be a positive factor in psychological adjustment among adult cancer patients and non-cancer paediatric patients with various illnesses. Nonetheless, Snyder’s cognitive theory of hope has not been specifically examined among childhood cancer patients and survivors. Unlike adult cancer patients, childhood cancer patients and survivors are characterized by early onset age in their cancer diagnosis which may mean that they face different psychological and physiological challenges. The identification of positive factors that attenuate negative psychological adjustment outcomes may be crucial in the development of effective therapeutic interventions. Despite that previous studies support the correlation between hope and positive adjustment outcomes, the exact cognitive mechanism that underpins the cognitive theory of hope remains underexplored. Although Snyder postulated that hope is goal-directed thinking which comprises willpower and waypower, he failed to establish any association between hope and rumination. The role of rumination in predicting the onset of mood symptoms and maintaining psychopathology has been well-researched, but it is conceptually meaningful to investigate the potential association between hope and rumination and their respective roles in affecting psychological adjustments in cancer experiences. The current thesis improves on the understanding of relationships between hope, rumination and cancer adjustment, and expands on studies of cancer adjustment by tapping into both positive and negative psychological outcomes, and examines how these two juxtaposed outcomes are associated with hope as mediated by positive and negative ruminations respectively. Eighty-nine childhood cancer survivors from the Children’s Cancer Foundation in Hong Kong took part in questionnaires that measured their levels of hope, rumination, mood symptoms and self-perceived positive changes or post-traumatic growth (PTG). The findings suggest that hope is negatively correlated with depression and anxiety, which are specifically mediated by negative cancer-related rumination. Hope is also positively correlated with PTG, which is specifically mediated by positive cancer-related rumination. These results provide empirical evidence to support the postulation by Snyder that low hope individuals adjust poorly because they are more likely to have negative rumination. High hope individuals adjust better as they are more likely to engage in positive rumination which is associated with PTG. The overall findings provide a possible explanation for the cognitive mechanism that underlies hope. A supplementary pilot study conducted measuring 20 childhood cancer patients’ hope level and mood symptoms over a period of nine months post-acute treatment also suggests patients have fewer prospective depressive symptoms have higher hope level in early measurement. The findings of the current thesis have important clinical implications. The understanding of hope and its association with rumination and cancer adjustment may inform the specific development of hope-based therapeutic interventions for childhood cancer patients and survivors, such as the hope-based storybook developed in this study with the aim to increase the hope levels of childhood cancer patients. / published_or_final_version / Clinical Psychology / Doctoral / Doctor of Psychology

This research study investigated the effectiveness of child-centered group play therapy with children experiencing adjustment difficulties. Specifically, this study determined the effectiveness of child-centered group play therapy in: (a) improving self-concept, (b) reducing externalizing, internalizing, and overall behavior problems, (c) enhancing emotional and behavioral adjustment to the school environment, and (d) increasing self-control of kindergarten children experiencing adjustment difficulties. Also investigated were child-centered group play therapy effects on reducing parenting stress of the parents of kindergarten children experiencing adjustment difficulties. The experimental group consisted of 15 kindergarten children who received one 40-minute child-centered group play therapy session per week, for twelve weeks. Group facilitators were play therapists who were doctoral students at the University of North Texas. The control group consisted of the 14 kindergarten students that had been assigned to the control group in Baggerly's (1999) study. Before the group play therapy sessions began and after termination of the sessions: the researchers administered the Joseph Pre-School and Primary Self-Concept Screening Test; parents completed the Child Behavior Checklist-Parent Report, Self-Control Rating Scale, Filial Problem Checklist, and Parenting Stress Index; and teachers completed the Child Behavior Checklist-Teacher Report, Early Childhood Behavior Scale, and Self-Control Rating Scale. Although the general results of this study did not show statistically significant change due to child-centered group play therapy sessions, positive trends in the children's behavior, self-control, and self-concept were observed by the researcher, play therapists, and teachers. These trends and observations support the continued application of child-centered group play therapy with children experiencing adjustment difficulties. Several factors may have contributed to the lack of statistical significance demonstrated within this study. These factors include a) a small sample size; b) the sample was drawn from only one school; c) a minimum of interactions between therapists and teachers, and therapists and parents; d) two unforeseen and unfortunate events; and e) pre-existing strength and resilience of the children comprising the control group.

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Thesis (Ph. D.)--University of Oregon, 2001. / Typescript. Includes vita and abstract. Includes bibliographical references (leaves 125-131). Also available for download via the World Wide Web; free to University of Oregon users.

Thesis (Ph. D.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 267-307). Also available in print.

Adaptive coping behaviors of children with a mild to moderate intellectual disability educated in regular and special classrooms were examined using a comparative design incorporating both quantitative and qualitative analyses. Children's coping behaviors were examined using the Coping Inventory (Zeitlin, 1985) and their behavior was assessed using the Child Behavior Checklist (Achenbach, 1991). Children with an intellectual disability integrated in regular classrooms were found not to exhibit more adaptive coping behaviors than their counterparts in special classrooms. Descriptive analyses delineated several factors within both environments that influence children's coping efforts such as dependency on adults, external control, the quality of instruction, the social organization of the classroom, and the lack of direct instruction in developing children's adaptive coping efforts. Recommendations from the current study focus on the need for children with an intellectual disability to be provided with direct instruction of adaptive coping behaviors and facilitated opportunities to learn through trial and error in order to become more autonomous copers.

The purpose of the present study was to continue the development of the Children's Life Situation Scale, in an attempt to create a scale which answered some of the methodological and statistical problems with existing scales and to establish psychometric evidence for its use. The participants were 210 fifth, sixth and seventh graders. Respondents were primarily from the middle class with approximately equal numbers of males (n=105) and females (n=106).The following research questions were addressed: 1. How well do individual items relate to a central concept and what is the internal consistency of the scale?2. What is the internal factor structure of the scale? 3. What is the criterion related validity of the scale in relation to the Behavior Assessment System for Children (BASC; Reynolds & Kamphaus, 1992)? 4. Do positive events affect outcome measures in a different way than do negatively stressful events?Results of reliability analysis suggested that the scale was highly internally consistent, and that all items equally related to the central concept of stress. However, Principal Axis Factoring revealed two factors which were conceptualized as "Life Events," and "Daily Hassles." When the total stress score as well as individual factor scores were correlated with the BASC, they were found to correlate significantly with all subscales, with the strongest correlations involving scales of an internalizing nature such as depression. The "Daily Hassles" factor was found to correlate most strongly with students' reports of psychological distress. Not only do the results support the use of the present scale as a reliable and valid measure of stress in children, results support the conceptualization of stress as involving two components, both "Life Events" and "Daily Hassles." / Department of Educational Psychology

Studies on the effects of marital conflict and child adjustment have documented a consistent relationship between higher amounts of marital conflict and increased child adjustment problems. Recently, researchers have focused on viewing children's perceptions of marital conflict as an important variable that may influence the strength of the association between marital conflict and child adjustment. Recent research has indicated that children's perceptions of interparental conflict may influence overall child adjustment. The present study examined the relationship between marital conflict and child adjustment and the role of children's perceptions of marital conflict in a clinical sample.Forty-four 8- to 12-year-old children and one of their parents participated in this study. Adult participants completed four questionnaires: (1) The O'Leary- Porter Scale; (2) The Conflict Tactics Scale; (3) The Child Behavior Checklist; and (4) a demographic questionnaire. The child participants completed one scale, The Children's Perception of Interparental Conflict Scale. The following research questions were investigated: (1) Is parental assessment of marital conflict related to child adjustment in a clinical sample? (2) Are children's appraisals of marital conflict related to child adjustment in a clinical sample? (3) Are boys' appraisals of interparental conflict related to the parents' appraisals of interparental conflict in a clinical sample? (4) Are girls' appraisals of interparental conflict related to the parents' appraisals of interparental conflict in a clinical sample? And (5) Are children's perceptions of marital conflict better predictors of child adjustment than parents' perceptions of marital conflict in a clinical sample?A significant relationship was found between parents' perceptions of marital conflict and child adjustment. However, children's perceptions of marital conflict did not significantly predict their overall adjustment. In accordance with these findings, it was also found that parents' perceptions of marital conflict were better predictors of child adjustment than children's perceptions of marital conflict in a clinical sample. It was also found that boys' appraisals of marital conflict were significantly related to parents' appraisals of marital conflict. Whereas, girls' perceptions of marital conflict were not significantly related to parents' perceptions of marital conflict. Implications and limitations of these findings and recommendations for future research were discussed. / Department of Counseling Psychology and Guidance Services