abstract: In rehabilitation settings, activity limitation can be a significant barrier to recovery. This study sought to examine the effects of state and trait level benefit finding, positive affect, and catastrophizing on activity limitation among individuals with a physician-confirmed diagnosis of either Osteoarthritis (OA), Fibromyalgia (FM), or a dual diagnosis of OA/FM. Participants (106 OA, 53 FM, and 101 OA/FM) who had no diagnosed autoimmune disorder, a pain rating above 20 on a 0-100 scale, and no involvement in litigation regarding their condition were recruited in the Phoenix metropolitan area for inclusion in the current study. After initial questionnaires were completed, participants were trained to complete daily diaries on a laptop computer and instructed to do so a half an hour before bed each night for 30 days. In each diary, participants rated their average daily pain, benefit finding, positive affect, catastrophizing, and activity limitation. A single item, "I thought about some of the good things that have come from living with my pain" was used to examine the broader construct of benefit finding. It was hypothesized that state and trait level benefit finding would have a direct relation with activity limitation and a partially mediated relationship, through positive affect. Multilevel modeling with SAS PROC MIXED revealed that benefit finding was not directly related to activity limitation. Increases in benefit finding were associated, however, with decreases in activity limitation through a significant mediated relationship with positive affect. Individuals who benefit find had a higher level of positive affect which was associated with decreased activity limitation. A suppression effect involving pain and benefit finding at the trait level was also found. Pain appeared to increase the predictive validity of the relation of benefit finding to activity limitation. These findings have important implications for rehabilitation psychologists and should embolden clinicians to encourage patients to increase positive affect by employing active approach-oriented coping strategies like benefit finding to reduce activity limitation. / Dissertation/Thesis / Ph.D. Psychology 2012

Il presente programma di ricerca si è proposto di valutare l’utilizzo di un intervento di scrittura su una popolazione di soggetti adolescenti iscritti al primo anno di scuola superiore. Ciò nei termini di risultati (effetti a breve e lungo termine), mediatori e moderatori. Tali questioni sono state esplorate nell’ambito di due diversi progetti. Il primo progetto si è esplicato in uno studio sperimentale sull’efficacia di un intervento di Expressive Writing [EW] standard rispetto ad un compito di scrittura focalizzato sugli aspetti positivi di un evento (Benefit Finding [BF]) e ad un gruppo di controllo che scriveva su temi superficiali (Trivial [TR]). Le analisi quantitative sono state effettuate all’interno di due studi finalizzati a testare gli effetti della modificazione delle consegne di scrittura e gli effetti di mediazione del linguaggio sui risultati dell’intervento (Studio 1), nonché gli effetti di moderazione di ottimismo, supporto familiare e relazioni interpersonali (Studio 2). Questi studi hanno fornito supporto alla letteratura di ricerca che ha messo in luce gli effetti positivi della scrittura tra gli adolescenti, rivelando risultati migliori per il gruppo BF. Il secondo progetto ha implicato uno studio naturalistico condotto in una scuola superiore del Nord Italia due settimane dopo la morte di uno studente, avvenuta durante le lezioni. In particolare è stato esaminato il processo della scrittura, considerando i cambiamenti linguistici in funzione di variabili legate al trattamento (le tre sessioni di scrittura) e ai partecipanti (l’ottimismo e le traiettorie individuali di adattamento). / The current research program aimed to evaluate the use of a writing intervention on an adolescent population transitioning from middle school to high school in terms of outcomes (short and long term effects), mediating mechanisms, and moderators. These issues have been investigated within two different projects. The first project implied a longitudinal, randomized, controlled trial on the efficacy of a standard Expressive Writing [EW] intervention relative to a writing assignment focused on positive aspects of an event (Benefit Finding [BF]) and a control group writing on neutral topics (Trivial [TR]). Quantitative analyses were performed within two studies aimed to test the effects of altering writing assignments and the mediating effects of language on writing outcomes (Study 1), and the moderating effects of optimism, family support, and interpersonal relationships (Study 2). These studies provided support to research literature showing positive effects of writing among adolescents, revealing greater outcomes for the BF group. The second project implied a small, naturalistic study conducted in a high school of Northern Italy two weeks after a student died during classes (Study 3). The process of writing was examined, considering linguistic changes in writing as a function of treatment variables (the three writing sessions) and participant variables (optimism and individuals’ adjustment trajectories).

Submitted by Morgana Andrade (morgana.andrade@ufes.br) on 2017-09-22T21:30:38Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) OTIMISMO, COPING E GANHO PERCEBIDO EM CUIDADORES DE CRIANÇAS COM CÂNCER (1).pdf: 1457980 bytes, checksum: 235bda3f561aa8f252320cc12ea2df50 (MD5) / Approved for entry into archive by Morgana Andrade (morgana.andrade@ufes.br) on 2017-10-03T16:05:32Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) OTIMISMO, COPING E GANHO PERCEBIDO EM CUIDADORES DE CRIANÇAS COM CÂNCER (1).pdf: 1457980 bytes, checksum: 235bda3f561aa8f252320cc12ea2df50 (MD5) / Made available in DSpace on 2017-10-03T16:05:32Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) OTIMISMO, COPING E GANHO PERCEBIDO EM CUIDADORES DE CRIANÇAS COM CÂNCER (1).pdf: 1457980 bytes, checksum: 235bda3f561aa8f252320cc12ea2df50 (MD5) / FAPES / O câncer infantil é considerado um estressor potencial não apenas para a criança, mas também para seus familiares. Para lidar com a doença do filho, pais e/ou cuidadores precisam empregar estratégias de coping que protejam o ajustamento familiar. Nesse contexto, atributos pessoais positivos, como o otimismo, podem contribuir para um coping mais adaptativo, de modo que seja possível perceber ganho na adversidade. Com o objetivo de analisar as relações entre otimismo, coping e ganho percebido em cuidadores de crianças com câncer, participaram 60 cuidadores principais que estavam acompanhando seus filhos em tratamento, em um hospital de referência da Grande Vitória, ES. Após o consentimento para participação na pesquisa, os participantes responderam os instrumentos sobre: otimismo (Teste de Orientação da Vida - TOV-R); coping (Escala de Coping); e ganho percebido (Inventário de Desenvolvimento Pós-Traumático). Variáveis sociodemográficas e clínicas, medidas por meio do Questionário sociodemográfico e do Protocolo de registro das características clínicas da criança, também foram obtidas. Os dados referentes aos instrumentos padronizados obedeceram aos critérios normativos estabelecidos e foram submetidos à análise estatística descritiva e à análise estatística inferencial para verificar a relação entre variáveis. Em relação ao otimismo, verificou-se que a maior parte dos cuidadores referiu uma percepção otimista da vida. A análise do coping mostrou que categorias de coping de alta ordem adaptativas obtiveram a maior média quando comparadas com categorias mal adaptativas, com destaque para resolução de problemas. Verificou-se que na adversidade de ter um filho com câncer, os cuidadores referiram ganho percebido, especialmente, no domínio do desenvolvimento espiritual. Foram encontradas relações entre: otimismo e coping (cuidadores mais otimistas 11 referiram menos submissão e menos estratégias das categorias de coping de alta ordem mal adaptativas); otimismo e ganho percebido (cuidadores com uma orientação otimista de vida perceberam mais recursos e competências pessoais); coping e ganho percebido (cuidadores que referiram mais busca de suporte e menos autoconfiança, desamparo e estratégias não adaptativas, perceberam maior fortalecimento das relações interpessoais; e cuidadores que se perceberam mais competentes, referiram menos autoconfiança, mas maior desenvolvimento espiritual). Variáveis clínicas da criança e estado civil dos cuidadores também se relacionaram com otimismo, coping e ganho percebido: cuidadores casados perceberam maior ganho, especialmente, no fortalecimento das relações interpessoais; cuidadores de crianças com tumores sólidos referiram mais resolução de problemas e negociação; cuidadores de crianças com diagnóstico de linfoma referiram mais delegação e oposição; cuidadores de crianças fora de quimioterapia referiram mais competência, delegação, e maior ganho percebido; e cuidadores cujos filhos tinham mais tempo de tratamento, se mostraram mais otimistas e referiram menos tristeza, mais competência para lidar com o estressor, mais vontade de estar longe do mesmo e maior ganho percebido. Intervenções com cuidadores de crianças com câncer devem ser pensadas de forma a favorecer um coping adaptativo, valorizando características individuais que possam auxiliar este processo, de modo a permitir uma ressignificação da experiência de ter um filho com câncer e o crescimento em meio à adversidade. / Child cancer is considered a potential stressor not only for children, but also for their family members. To cope with the disease of the child, parents and / or caregivers need to use coping strategies that will protect family adjustment. In this context, positive personal attributes, like optimism, can contribute to a more adaptive coping, so that it is possible to notice some benefits in adversity. In order to analyze the relationship between optimism, coping and benefit finding in caregivers of children with cancer, 60 main caregivers who were accompanying their children in treatment, at a referral hospital in Grande Vitória, ES attended. After the permission to participate in the study, participants answered the instruments on: optimism (Life Orientation Test - LOT-R); coping (Coping Scale); and benefit finding (Posttraumatic Growth Inventory). Socio-demographic and clinical variables, as determined by the Socio-demographic Questionnaire and Registration Protocol of the clinical characteristics of the child, were also obtained. The data relating to standardized instruments met the established normative criteria and were submitted to the analysis of the descriptive and inferential statistics to verify the relationship between variables. Regarding optimism, it was found that most caregivers reported an optimistic view of life. The coping analysis showed that coping categories of higher adaptive order obtained the highest average when compared to maladaptive categories, with emphasis on problem solving. It was found that the adversity of having a child with cancer, caregivers reported perceived benefits, especially in the field of spiritual development. There were relationships between: optimism and coping (more optimistic caregivers reported less submission and less strategies of coping categories of high maladaptive order); optimism and benefit finding (caregivers with an 13 optimistic life orientation realized more resources and personal skills); coping and benefit finding (caregivers who reported more search for support and less self-reliance, helplessness and maladaptive strategies, noticed greater strengthening of interpersonal relationships); and caregivers who found themselves more competent, reported less self-reliance, but higher spiritual development. The child’s clinical variables and marital status of caregivers also related with optimism, coping and benefit finding: married caregivers noticed greater gain, especially in the strengthening of interpersonal relationships; caregivers of children with solid tumors reported more problem solving and negotiation; caregivers of children diagnosed with lymphoma reported more delegation and opposition; caregivers of children out of chemotherapy reported more competence, delegation, and greater benefit finding; and caregivers whose children had a longer time treatment, were more optimistic and reported less anxiety, more power to deal with the stressor, more willing to be away from it and greater benefit finding. Interventions with caregivers of children with cancer should be thought to favor an adaptive coping, valuing individual characteristics that can assist this process, in order to allow for a reinterpretation of the experience of having a child with cancer and growth through adversity.

Transverse myelitis (TM) is a rare auto-immune inflammatory disease in which the patient’s immune system attacks their spinal cord resulting in an unpredictable degree of neurologic disability, ranging from complete recovery to quadriplegia. TM patients often experience insufficient assistance towards understanding causes of the illness and have little to depend on in trying to deal with it. This study explores psychological strengths and coping strategies used by TM patients in coping with the illness. A theoretical framework of positive psychology with a strong focus on seven constructs, namely positive coping, searching for meaning, benefit finding, hope, sense of humour, resilience, as well as religion and spirituality is presented. The main data collection strategy for this study was the gathering of stories as a form of conversation. These were subjected to thematic analysis by interpretative phenomenological analysis (IPA) focused on identifiable themes and patterns of living and behaviour. The emerging patterns and identified fortigenic qualities were then considered, analysed and argued in relation to corresponding coping strategies. A model for the psychological coping and well-being of TM patients, based on emphasising the positive and constructive and considering existing models and strategies for the well-being of patients, was developed. The strategic and therapeutic model is presented in easily understandable language for the benefit of any care-giver (e.g. family member, friend or nurse) or the patient him/herself. / Thesis (PhD)--University of Pretoria, 2013. / lk2013 / Psychology / unrestricted