Thesis (Ph.D.)--University of Alberta, 2009. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy, Faculty of Nursing. Title from pdf file main screen (viewed on October 10, 2009). Includes bibliographical references.

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Adolescent mothers are a vulnerable population for a multitude of reasons. For one, adolescent mothers concurrently undergo two significant developmental phases and transitions: adolescence and parenting. Adolescence is the psychosocial period of adjustment marked by dramatic neural, hormonal, cognitive, psychological, physical, and biological changes. While adolescence is a time of cognitive advancement, it is also a time of stress, identity development, peer pressure, mood disruptions, and emotion regulation difficulties. While parenthood presents with positive changes, it simultaneously introduces challenges, such as increases in caretaking responsibilities, time commitment, and distress. Additionally, as statistics have shown, many adolescent mothers face a host of risk factors (e.g., poverty, low socioeconomic status (SES), and low educational attainment), making these “adolescent mothers at risk (AMARs)” a highly vulnerable population. Adolescence is also a time when substance use initiation and experimentation occur. While some level of substance use is normative among adolescents, substance use is especially detrimental for adolescent mothers and their children. According to the literature, substance-using mothers differ from their non-substance-using counterparts in terms of how the former parent their children. For example, substance-using mothers tend to display decreased levels of warmth (Barnow, Schuckit, Lucht, John, & Freyberger, 2002; Gruber and Taylor, 2006; Mayes & Truman, 2002; Suchman et al., 2007) as well as extreme styles of parenting (e.g., minimal supervision and intolerant attitudes) (Suchman & Luthar, 2000). This dissertation used archived data to examine AMARs and explore their levels of distress tolerance, substance use, and parenting attitudes and beliefs. Specifically, this dissertation sought to address the following questions: Is there an association between distress tolerance, substance use, and parenting attitudes and beliefs? Does substance use mediate the association between distress tolerance and parenting attitudes and beliefs? Seventy-two mothers living in nine Transitional Living Programs (TLPs) across a Northeast state were interviewed. Participants were aged 16-22 years with a mean age of 19. Participants were predominantly Latino and African American, and nearly half of the participants reported having a history of living in foster care or group home with an average of five years spent in these institutions. Data were collected from the baseline interview of a pilot randomized control trial examining an intervention for increasing positive parenting among homeless AMARs. Distress tolerance was operationalized via the Distress Tolerance Scale (Simons & Gaher, 2005), and parenting attitudes and beliefs were operationalized through the Adult Adolescent Parenting Inventory-2 (Bavolek & Keene, 2010). Lifetime and recent frequency of substance use was also examined. Race/ethnicity was controlled for in all analyses because the past literature has documented racial/ethnic minority adolescent mothers experiencing more adversities and vulnerabilities compared to their White counterparts (Huang et al., 2014, 2019). Consistent with the literature, we found an association between distress tolerance and substance use, substance use and parenting attitudes and beliefs, as well as distress tolerance and parenting attitudes and beliefs. Specifically, there was an association between low distress tolerance and high levels of substance use; high levels of substance use and poor parenting attitudes and beliefs; and low distress tolerance and poor parenting attitudes and beliefs. In terms of the mediation analysis, only substance use within the past six months mediated the relationship between distress tolerance and parenting attitudes and beliefs. In other words, low distress tolerance led to higher levels of substance use within the past six months, which in turn led to poorer parenting attitudes and beliefs. One implication of the results is that recent substance use, rather than lifetime history, has a more salient effect on parenting attitudes and beliefs. Overall, the majority of the AMARs in the current study’s sample demonstrated resilience and had scores reflective of positive parenting attitudes and beliefs despite their notably low levels of distress tolerance. While the results of the study are promising, they should be interpreted with caution considering several limitations, including a small effect size from the mediation analysis and potential underreporting among AMARs. Future research should continue to explore various iterations of the research question (e.g., different combinations of distress tolerance, substance use, and parenting attitudes and beliefs as the independent, mediating, and outcome variables) and psychometric properties of the measures utilized.

Thesis (MBA)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: Psychological distress, whether caused by personality traits, biochemical imbalances, or difficult circumstances or events, can have a profound effect on a one's physical wellbeing and quality of life as an individual, manager and executive. Personality traits include type A personality, type B personality, being emotional as well as management style. Difficult circumstances or events include changes at work, the birth of a child, the death of a family member as well as a promotion received at work. Experiencing constant stress at work, in addition to having unresolved emotions such as sadness, anger, fear and anxiety can have an effect on one's physical health. This can be observed in management as sluggishness, tiredness, and depression, increasing susceptibility to infections, heart attacks, burnout, and rheumatoid arthritis. Personality, personal experiences and circumstances shape the way one responds emotionally to problems in life. A particular problem may cause one person to become ill, whereas another person might cope comfortably with it. However, because responses to problems are not set in stone, managers can learn to manage their emotional problems more effectively. Above all, managers can teach their subordinates techniques that can help them steer clear of self-neglect. People find themselves living and working in an era dominated by real-time business decision-making, and many managers are struggling to cope. Of course, there are also people who are happy, healthy, peaceful and wealthy and who seem to have it all. They have good positions and seem to have a balanced life regarding their family and work. They have achieved equilibrium. There is a perception that such people are just lucky. Perhaps they are, but more likely they simply possess appropriate coping mechanisms that others too can acquire. The objective of this dissertation is to assist not only managers, but also the individual to overcome the rat race that the new millennium has bestowed upon us. It further aims to show that everyone is capable of achieving the necessary tools to combat self-neglect and destruction of the inner self. It is suggested that by learning to change ones thinking and behavioural approach to an event it is possible to change the outcome of the event. By learning a few thinking (cognitive) and physical (meditation) techniques it is possible to overcome the mere interpretation of an event, which will allow the individual to improve their ability to cope with stress and maintain not only their own physical well being, but also the well being of the organisation. Furthermore, organisations may assist their employees by encouraging or creating a good working culture in order to improve both the coqqitive and physical environment as experienced by the individual. This "looking after the other" relationship can and will only have a positive effect. The poet, Khalil Gibran (2002), reflects: "But I say to you that when you work you fulfil a part of earth's furthest dream, assigned to you when that dream was born. And in keeping yourself with labour you are in truth loving life And to love life through labour is to be intimate with life's innermost secret." Thus to enjoy life through work, one should learn to enjoy what life hands out by changing ones perception of the event as well as the attitude towards life and work. / AFRIKAANSE OPSOMMING: Sielkundige distres wat ontstaan as gevolg van óf persoonlikheidstrekke, biochemiese wanbalanse, moeilike omstandighede of gebeurtenisse ongeag die oorsaak daarvan, kan 'n wesentlike uitwerking op 'n persoon se liggaamlike welstand en lewensgehalte as 'n individu, bestuurder en bedryfsleier hê. Persoonlikheidstrekke sluit tipe A-persoonlikheid, tipe B-persoonlikheid, emosionaliteit en bestuurstyl in. Moeilike omstandighede of gebeurtenisse sluit veranderinge in die werkplek, die geboorte van 'n kind, die sterfte van 'n familielid sowel as 'n bevordering by die werk in. Voortdurende spanning by die werk tesame met onverwerkte emosies soos hartseer, woede, vrees en angs kan 'n uitwerking op 'n mens se liggaamlike gesondheid hê. In bestuur kan dit waargeneem word as traagheid, moegheid en depressie, wat 'n mens se vatbaarheid vir infeksies, hartaanvalle, uitbranding en rumatiek verhoog. 'n Mens se persoonlikheid, ervarings en omstandighede bepaal hoe jy op die lewe se emosionele probleme reageer. Een mens mag siek word weens 'n probleem wat iemand anders heel maklik sal hanteer. Bestuurders kan egter leer hoe om hul emosionele probleme meer doeltreffend te hanteer. Bowenal kan bestuurders hul onderskiktes tegnieke leer om te verhoed dat hulle hulself verwaarloos. Die individu leef en werk in 'n era wat oorheers word deur die neem van vinnige en goeie sakebesluite en bestuurders sukkel om by te bly. Natuurlik is daar ook mense wat gelukkig, gesond, vreedsaam en welgesteld is, en lyk of hulle alles het. Hulle beklee goeie poste en ly skynbaar 'n gebalanseerde lewe tussen hul gesin en hul werk. Hulle het 'n balans bereik. Die persepsie bestaan dat sulke mense eenvoudig geluk aan hul kant het. Miskien het hulle, maar dalk het hulle net die regte meganismes om probleme doeltreffend te hanteer wat ander ook kan aanleer. Hierdie skripsie se doelwit is nie slegs om bestuurders nie, maar ook die individuele werknemer wat vasgevang is in die "rat race" wat teweeg gebring is deur die nuwe eeu, te help om die effekte daarvan teen te werk. Dit streef verder om te bewys dat elke persoon instaat is om die nodige hulpmiddele te bekom om eie-nalatigheid en uiteindelik die selfvernietiging van die innerlike mens te oorkom. Dit word verder voorgestel dat deur die aanlering om mens se denkwyses en gedragspatroon benadering tot die aangeleentheid te verander, is dit moontlik om sodoende die uitslag van die aangeleentheid te verander. Deur die aanleer van 'n paar denkwyses (kognitiewe) en fisiese (meditasie) tegnieke is dit moontlik om selfs die interpretasie van die aangeleentheid te oorkom, wat sal toelaat dat die individu sy vermoë om spanning te hanteer en die instandhouding van hulle fiesieke toestand te verbeter. Maatskappye kan ook sy werknemers bystaan deur die aanmoediging van, of die daarstelling van 'n goeie werkskultuur om sodoende beide die kognitiewe en die fisiese omgewing soos deur die individu beleef, te verbeter. Hierdie "omsien na die ander" verhouding kan, en sal net 'n positiewe uitwerking hê. Die digter, Khalil Gibran (2002), reflekteer: "But I say to you that when you work you fulfil a part of earth's furthest dream, assigned to you when that dream was born. And in keeping yourself with labour you are in truth loving life And to love life through labour is to be intimate with life's innermost secret." Dus, om die lewe deur middel van werk te geniet, moet mens leer om dit wat die lewe uitdeel, te geniet. En dit kan slegs bewerkstelling word indien 'n mens se persepsie van die aangeleentheid sowel as mens se houding teenoor die lewe en werk verander.

Thesis (Ph.D.)--University of Alberta, 2009. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy, Faculty of Nursing. Title from pdf file main screen (viewed on November 15, 2009). Includes bibliographical references.

The present study set out to investigate the biopsychosocial model of illness using variables previously identified as directly impacting illness or as mediating the relationship between other variables and illness. Oral contraceptive use, stress, and negative affect were investigated as predictors of immunological competence, measured by the level of Immunoglobulin G antibodies to Epstein-Barr Virus Viral Capsid Antigen (EBV-VCA IgG).

Since its emergence in the U.S., HIV has been a stigmatized illness. People living with HIV (PLH) are a minority and prone to psychological distress and poor mental health outcomes due to HIV-related stigma. PLH who identify with another minority group in addition to being HIV-positive (e.g., gay, African-American) experience multiple forms of oppression or layered stigma. Affirmative social support and resilience are negatively associated with HIV-stigma and are important coping resources for PLH. We used an explanatory sequential mixed methods design study involving a quantitative survey phase and a qualitative interview phase. We explored whether social support and resilience (Positive Psychological Resources) mediate or moderate the relationship between HIV Stigma and Psychological Distress among HIV-positive adults using partial least squares (PLS) path modeling and multiple regressions. Via PLS, we found Positive Psychological Resources partially mediated the relationship between HIV Stigma and Psychological Distress: the path between HIV Stigma and Psychological distress reduced (from t = 5.49, p = .000 to t = 2.39, p = .000) but remained statistically significant. Similarly, via regression, the Sobel test was significant (Sobel = .26, SE = .07, z = 3.63, p = .000). However, moderation was not found (HIV Stigma x Positive Psychological Resources β = .05, t = .66, p = .508). Overall, our quantitative survey and qualitative interview data were consistent. We anticipate that our findings will inform strengths-based therapeutic interventions to mitigate stress and stigma among PLH.

Indiana University-Purdue University Indianapolis (IUPUI) / Chronic pain, defined as pain lasting more than 3 months, is a common and costly health condition. Thirty-three percent of adults and upwards of 35% of children report experiencing pain due to various diseases, disorders, or accidents. Recent research has identified perceived injustice and anger as important constructs in an adult’s pain experience and a possible focus for intervention efforts. The present study explored the extent to which perceived injustice and anger expression operate similarly in children with chronic pain as in adults. This was a retrospective analysis of data from 122 patients seeking treatment at a pediatric pain clinic. Results supported anger expression as a mediator in the relationship between perceived injustice and pain intensity but not psychological distress, suggesting that anger expression operates similarly in children as in adults with chronic pain. Unlike previous findings in adults with chronic pain, injustice did not moderate the relationship between pain intensity and psychological distress, suggesting that injustice operates differently in children with chronic pain compared to adults. The strong association between injustice and pain outcomes (i.e. pain intensity, quality of life, functional disability) suggests that injustice is an important construct to explore in the chronic pain experience of children.

Luk, Pik Shan Yvonne. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (leaves 134-146). / Abstracts in English and Chinese ; some text in appendix also in Chinese. / Abstract (English version) --- p.ii-iii / Abstract (Chinese version) --- p.iv / Acknowledgement --- p.v / List of Table --- p.vi / Appendices --- p.vii / Chapter 1 --- Introduction --- p.1-5 / Chapter 2 --- Literature Review / Introduction --- p.6-7 / Psychological Distress --- p.7-13 / Health-related Quality of Life --- p.13-25 / Marital Relationship --- p.26-31 / Summary --- p.31-34 / Chapter 3 --- Aims & Methodology / Aims & Objectives --- p.35-37 / Operational Definition --- p.37-38 / Research Design --- p.38-39 / Setting & Sample --- p.39-40 / Instrument / Psychological Distress --- p.41-43 / Health-related Quality of Life --- p.43.44 / Marital Relationship --- p.44-46 / Demographic Data --- p.47 / Data Collection Procedure --- p.4748 / Ethical Consideration --- p.48-50 / Data Analysis --- p.50-51 / Pilot Study --- p.51-52 / Chapter 4 --- Findings / Introduction --- p.53-54 / Sociodemographic Characteristics --- p.54-56 / Psychological Distress --- p.57-58 / Health-related Quality of Life --- p.59-61 / Marital Relationship --- p.62-65 / Normality of the Outcome Variables --- p.65-66 / Relationships between the Study Outcomes and Sociodemographic Data --- p.66-68 / "Relationships between Anxiety, Depression, Health-Related Quality of Life and Marital Relationship" --- p.68-76 / Summary --- p.16-78 / Chapter 5 --- Discussion / Introduction --- p.79 / Socio-demographic and Clinical Characteristics of CAPD patients --- p.79-84 / Psychological Distress of CAPD Patients --- p.84-85 / Components of Psychological Distress: Anxiety --- p.85-86 / Components of Psychological Distress: Depression --- p.86-88 / Gender differences of the Levels of Anxiety and Depression among CAPD Patients --- p.88-89 / Cultural Difference of Anxiety and Depression among CAPD Patients --- p.89-90 / Health-related Quality of Life among CAPD Patients / Health-related Quality of Life of CAPD Patients Affected by Renal Symptoms --- p.90-91 / Health-related Quality of Life of CAPD Patients Affected by the effects of Kidney Disease --- p.91-93 / Health-related Quality of Life of CAPD Patients Affected by the burden of / Having Kidney Disease --- p.93-94 / Health-related Quality of Life of CAPD Patients Affected by the General Physical Health --- p.94-96 / Health-related Quality of Life of CAPD Patients Affected by the General Mental Health --- p.96-97 / Gender differences of the Levels of Health-related Quality of Life among CAPD Patients --- p.97-98 / Cultural Difference of Health-related Quality of Life among CAPD Patients --- p.98-99 / Sexual Issues and Marital Relationship of CAPD Patients / Sexual Issues of CA PD Patients --- p.100-102 / CAPD Patients' Perception of the Marital Relationship --- p.102-104 / Gender Differences in Perception of the Marital Relationship among CAPD Patients --- p.104 / Cultural Difference in Perception of the Marital Relationship among CAPD Patients --- p.105-106 / "Relationships between Participants' Characteristics and Psychological Distress," / HRQoL and Marital Relationship / "Relationships of Income with Anxiety, Depression and General Mental Health" --- p.107-108 / Relationship between Duration of Receiving Dialysis and Health-related Quality of Life --- p.108-109 / Relationship between Occupational Status and General Mental Health --- p.199.110 / "Relationships among Anxiety, Depression, HRQoL and Marital Relationship" / The Relationship between Anxiety and Depression --- p.110-111 / "The Relationship between Anxiety, Depression and HRQoL" --- p.112 / "The Relationship between Anxiety, Depression and Marital Relationship" --- p.112-113 / The Relationships among Domains of Health-related Quality of Life --- p.113-114 / The Relationship between Health-related Quality of Life and Marital Relationship --- p.114-115 / Predictors of Health-related Quality of Life among CAPD Patients / Anxiety and Depression as Predictors of Health-related Quality of Life --- p.116-118 / Marital Relationship as Predictors of Health-related Quality of Life --- p.118-119 / Summary --- p.119-121 / Chapter 6 --- Conclusion / Limitations / Validity of Participants' Responses --- p.122-123 / Generalization of the Study's Findings --- p.123-124 / Psychometric Property of the Chinese Version of KDQOL-36 --- p.124-125 / The Sexual Items ofKDQOL-SF --- p.125 / Appropriateness of Using HADS and Multiple Correlations --- p.126 / Implications of the Study Findings / Implications for nursing knowledge --- p.126-128 / Implications on the Nursing Practice --- p.128-130 / Recommendations for Further Research --- p.130-132 / Conclusion --- p.132-133 / Chapter 7 --- Reference --- p.134-146 / Chapter 8 --- Appendix --- p.147-179

Indiana University-Purdue University Indianapolis (IUPUI) / The presence of a chronic pain condition can have a profound impact on one’s self-concept. Some individuals may have had to make major lifestyle changes. As a result, some people may start to define themselves in terms of their pain, such that their self-schema and pain-schemas become intertwined in a process termed schema-enmeshment. It is thought that schema-enmeshment is related to psychological distress making it a prime target for intervention. Little research has been conducted on interventions to reduce schema-enmeshment. Acceptance-based interventions may be especially appropriate in reducing schema-enmeshment or the connection between self and illness symptoms as these interventions tend to emphasize learning to live with pain and other symptoms and to work toward important life goals rather than continually fighting against the condition and allowing it to control their life. This study is a randomized trial comparing Acceptance and Commitment Therapy (ACT) to education about pain management in a sample of women with Fibromyalgia Syndrome (FMS). The primary aim of this study was to assess the efficacy of ACT in reducing schema-enmeshment between self and pain, as well as enmeshment between self and other symptoms and FMS as a whole. In addition, this study also explored the role of pain acceptance, specifically activity engagement as a mediator of the relationship between treatment group membership and changes in schema-enmeshment. The data was analyzed as an intent-to-treat analysis using the “last measure carried forward” method. Results indicated that the ACT group reported statistically significant differences in self schema-enmeshment with FMS, fatigue, and cognitive symptoms, but not with pain, following the intervention, compared to the educational control group. In each of these cases, the ACT group experienced greater reductions in schema-enmeshment compared to the education group. Interestingly, no statistically significant differences were observed for schema-enmeshment with pain. Statistically significant group differences were also observed for acceptance of pain following the intervention. Finally, a mediational model in which changes in activity engagement (a form of pain acceptance) served as the mediator of the relationship between treatment group and changes in schema-enmeshment with FMS was tested. The model was tested using a bootstrapping method, and results revealed a trend toward a significant indirect effect of changes in activity engagement leading to changes in schema-enmeshment with FMS. Taken together, the results of this study indicate that ACT may be a promising intervention for targeting maladaptive beliefs about the self in relation to illness, especially schema-enmeshment of self with illness and illness symptoms. Additionally, there is evidence that ACT may target key constructs such as activity engagement, which may be related to other cognitive and behavioral changes. Future directions for research and clinical practice related to ACT as an intervention for FMS are discussed in depth.