Thesis (M.A.)--York University, 1997. Graduate Programme in Psychology. / Typescript. Includes bibliographical references (leaves 94-103). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL:http://wwwlib.umi.com/cr/yorku/fullcit?pMQ27356.

Thesis (Ph. D.)--West Virginia University, 2003. / Title from document title page. Document formatted into pages; contains vi, 129 p. : ill. Includes abstract. Includes bibliographical references (p. 95-108).

Thesis (Ph. D.)--University of Missouri-Columbia, 2003. / Typescript. Vita. Includes bibliographical references (leaves 174-198). Also available on the Internet.

Introduction Rheumatic disease is an autoimmune disorder with an unpredictable course of exacerbation and remission. There is no known cure for the disease at the moment. The patients’ conditions may progressively deteriorate despite intensive therapies, and runs an erratic course with the possibility of disfiguration and alteration in body image. Pain, disabilities and psychological distress are common. Rheumatic patients may respond differently to the same level of pain and physical symptoms. The understanding of the needs of rheumatic patients and how they successfully manage the disease and optimize psychological adjustment can help develop effective psychosocial interventions. Aims The aims of the study are (1) to identify the needs of rheumatic patients and perceptions of their disease, (2) to develop a conceptual framework for psychological adjustment, and (3) to identify factors associated with resilience in rheumatic patients. Methods The present study consisted of two phases. The first phase was a focus group interview, aiming to understand the patients’ feelings and to design a questionnaire. The second phase was a prospective questionnaire survey that includes a baseline study and a six-month follow-up study. Patients were recruited from support groups in Hong Kong. The baseline questionnaire was self-administrated, and the follow-up questionnaire was administrated by telephone interview. The self-regulation model was chosen as the basis for the conceptual framework for psychological adjustment. The questionnaire included demographics, illness representation, coping efforts, appraisal of coping efforts, sense of coherence, quality of care, functional disability, and health-related quality of life. The outcome measures were functional and psychological health, change in adjustment, and positive and negative resilience. Results Having a good and caring doctor, more information on the disease, and public understanding of the disease were the needs of rheumatic patients. The patients perceived that the disease was chronic, cyclical, and had poor consequences. They perceived that the disease caused great pain, stress, depression and anxiety, and affected their daily activities, appearance, and relationship with family and friends. Poor adjustment was associated with chronic and cyclical timeline, and poor perception of personal and treatment control. The analysis of resilience shows that positive perception of treatment control and disease consequence, correct understanding of disease causes, and high sense of own value and importance to the society, were protective. While those who lacked family support and blamed themselves or their families to be the cause of disease, were vulnerable. Discussion and conclusions The present study lends support to the validity of self-regulation model in psychological adjustment to disease, but coping efforts could only partially mediate the relationship of illness representation to appraisal of coping efforts, implying that the coping style might not sufficiently capture the underlying differences in individual coping styles. An effective psychosocial intervention can be developed based on the factors associated with better adjustment and resilience, and targeted at non-working older patients with rheumatoid arthritis. Last but not least, support from the community, and public understanding of the disease are important for rheumatic patients. / published_or_final_version / Psychiatry / Doctoral / Doctor of Philosophy

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The literature indicates that: (i) locus of control is a multi-factorial construct; and (ii) psychological maladjustment is associated with a generalised perception that reinforcements are not personally controlled. Little is known regarding the importance of the identified factors to psychopathology. The relationship between locus of control and adjustment is empirically well established but void of theoretical basis. The present study proposes a bridge between locus of control and Seligman's theory of learned helplessness . Forty hospitalised psychiatric patients (diagnosed schizophrenic) and forty persons chosen randomly from a voter's roll ("normals") were administered tests of locus of control; namely, the Internal-External scale (Rotter, 1966). The Internal,Powerful Others and Chance Scale (Levenson, 1972) and the Interpersonal Trust Scale (Rotter, 1967). The Psychotic Reaction Profile (Lorr, O'Connor and Stafford, 1960), a behavioural questionnaire, was completed for each patient. The results suggest that a multidimensional analysis does not add substantially to an understanding of the relationship between locus of control and psychological adjustment. It is however arguable that the study casts doubt on the utility of existing measures rather than the dimensions as such. Support was provided for the hypothesis linking locus of control to behavioural symptoms of learned helplessness. / Thesis (M.Sc.)-University of Natal, Durban, 1980.

Since the turn of the century, there has been a general awareness that children raised by parents with psychiatric disorders remain at risk for psychopathology themselves. This research investigates the mother-child responsivity and coping behavior of high risk children. Two groups of mother-infant dyads (N = 60) (mothers with and without psychiatric disorders) were coded during a videotaped, semi-structured play interaction using the CARE-Index. Results indicated that mothers with psychiatric disorders were significantly less sensitive and more unresponsive with their children than normal mothers. Mothers with psychiatric disorders who had extreme levels of psychosocial stress were significantly less sensitive and more controlling than those mothers diagnosed as living under less stressful circumstances. Children of mothers with psychiatric disorders were significantly less cooperative with their mothers in the play interaction. The results indicated that children whose mothers had chronic psychiatric disorders demonstrated significantly less effective coping behavior on all subscales of the Early Coping Inventory. Implications for the identification and treatment of children at risk for psychiatric disorder are discussed.

In spite of a broad body of theoretical discussion on generativity, empirical research has yet to confirm many central tenets of the theory. Within 2 research studies, 3 questions were addressed. A study of 98 midlife men and women pursued (1) the relationship between generative concerns and 4 indicators of adjustment, positive affect, negative affect, life satisfaction, and work satisfaction, and (2) the role of agency and communion as predictors of generative concerns, with attention to sex differences in these predictive roles. A study of 75 largely pre-midlife women and men provided a conceptual replication of the results of the first study, while also addressing a third question: (3) the role of age effects in the experience of generativity. Together, these studies provided evidence of a relationship between generative concerns and 2 adjustment variables, positive affect and work satisfaction. Evidence in favor of an additive model, in which agency and communion served as independent predictors of generative concerns, was also obtained. As well, there was modest evidence of sex differences, such that agency variables were more significant predictors of generativity for women and communion variables were more significant predictors for men. No evidence of an age effect in predicting generative concerns was found; in fact, all of the findings appear to be applicable to a pre-midlife sample as well as a midlife one. However, some interesting trends for age interactions were found. The research points to an association between generativity and adjustment. It also provides moderate support for an additive model predicting generative concerns with agency and communion. The importance of attending to possible sex differences in this predictive relationship is also illustrated.

Prior research shows a wealth of investigation into the variables contributing to psychosocial adjustment to cancer. However, the literature consistently calls for more complex investigation of the contributing factors. This investigation attempted to clarify and expand the adjustment literature in two primary areas. First, the study investigated the relationships between the variables suspected of predicting adjustment to cancer, such as socidemographic, social support, and gender-related personality variables. Second, the study determined the differential influence that the traits of agency, communion, and the unmitigated constructs had on adjustment to cancer, compared to sex. The investigator used two statistical approaches to identify the differential importance: hierarchical regression and structural equation modeling (SEM). Using SEM, the investigator tested three models to determine which variables had direct and indirect effects on adjustment.The study used a sample of 417 (238 used in final analyses) early stage (0, I, and II) male and female cancer patients diagnosed between 1998 and 2000. The patients completed mail surveys assessing their social support, gender-related personality characteristics, and adjustment to cancer. Results from bivariate correaltional analyses found that being male, having less functional social support, experiencing more problematic support encounters, and possessing unmitigated agentic traits contributed to more maladjustment. In contrast, the results revealed that possessing communion traits related to less maladjustment.Results from the regression analysis also supported that the unmitigated agentic and communal traits contributed significantly to the variance in maladjustment. When determining strength of associations, less social support from family, more informationfrom friends, and being male more strongly predicted the likelihood of maladjustment. However, findings also suggested that being on medical leave and possessing either traits of unmitigated agency or communion contributed to maladjustment to cancer.Finally, while structural models exhibited less than adequate fit, the significant paths within the models supported many of the proposed relationships. Overall, the findings supported the multifactorial nature of maladjustment, such that sex, social support, and personality traits all emerged as significant predictors. The study concluded with a discussion on improving model fit and directions for future research. / Department of Counseling Psychology and Guidance Services