Background: Chronic pain is a prevalent healthcare problem which influences each aspect of an individual’s life. A biopsychosocial approach is the dominant one to be taken in the understanding and treatment of chronic pain as not only physical but also psychological factors influence the pain experience. Multi-disciplinary interventions based on a biopsychosocial approach provide an effective treatment strategy for the management of chronic pain. However, the availability of these interventions is limited. Research indicates that internet-based self-management interventions can address this limitation. Aim: The aim of this study was to assess the effectiveness of an internet-based pain self-management intervention, for individuals with chronic pain that were recruited from various clinical settings. The intervention is a well-known pain self-management website known as the ‘pain toolkit’. This is the first study that we are aware of which examines the effectiveness of the ‘pain toolkit’ intervention in a ‘real-world’ clinical context. It was hypothesised that the participants’ fear of movement/(re)injury, pain-related anxiety, pain catastrophizing, pain (intensity and interference) and passive coping strategies (i.e. diverting attention, catastrophizing, praying/hoping) would decrease after engagement with the ‘pain toolkit’ website. Moreover, it was hypothesised that the participants’ self-efficacy and active coping strategies (i.e. reinterpreting pain sensations, coping self-statements, ignoring pain sensations, increasing activity level, the ability to decrease pain and to control pain) would increase after engagement with the ‘pain toolkit’ website. Finally, it was hypothesised that the participants’ readiness to engage in pain self-management would increase from the onset to the completion of the intervention. Specifically, engagement with the ‘pain toolkit’ intervention would facilitate participants’ movement into a more advanced stage of pain self-management. Methodology: Self-report questionnaires, including: Pain Stage of Change Questionnaire (PSOCQ), Tampa Scale for Kinesiophobia (TSK), Pain Anxiety Symptoms Scale (PASS), Brief Pain Inventory (Short-Form: BPI), Pain Catastrophizing Scale (PCS), Pain Self-Efficacy Questionnaire (PSEQ) and Coping Strategies Questionnaire (CSQ) were completed by the participants - both before and after the intervention. Participants engaged with the intervention for 6 weeks. Results: Forty-eight chronic pain patients (27 females and 21 males) aged 22 to 77 completed the study. Participants showed significant reductions in pain related anxiety, fear of movement/(re)injury, and pain catastrophizing and there was significant improvement in their ability to decrease pain. Conclusion: These findings indicate that internet-based, pain self-management intervention, such as the ‘pain toolkit’ is an effective intervention on a variety of measures for individuals living with chronic pain.

Background Female prisoners in Scotland have been found to have higher levels of drug dependence when compared too male prisoners. Females require gender-specific interventions designed to address their needs. Many of the services that women encounter within the prison sector are not designed to address the needs of female offenders. Aims The study aims to assess female offenders’ and service workers’ perception of needs from prison addiction services. The study intends to investigate ways in which prison addiction services can be adapted to support clients with their recovery journey. The study also aims to identify barriers that prevent female substance users from accessing treatment whilst in custody. Method The research was conducted within Scotland’s only national establishment for women HMP (Her Majesty’s Prison) &YOI (Young Offenders Institution) Cornton Vale. Five female offenders and five prison addiction workers were interviewed using semi-structured interviews. The data were transcribed and thereafter analysed using thematic analysis. 4 Results The study highlighted some of the key needs of female offenders with substance misuse issues. Six key themes were identified for female offenders: need for intensive support; importance of gender-specific provision; need for person-centred provision and choice; service provision is outdated; importance of through care, and barriers to treatment. Five key themes were identified for service workers: need for more communication and collaborative working; importance of gender-specific provision; service provision needs reviewed; improve access to psychological therapies, and barriers to delivering service. Conclusion The findings identified both female offenders’ and prison addiction workers’ views on treatment needs, interventions and potential barriers to treatment. The study highlighted the need for prison addiction services to develop interventions that take into consideration the demographics and history of female offenders.

Aim: This study examined the effects of the Scottish smoke-free legislation on smokers’ behaviours and attitudes using the transtheoretical model of change (TTM) as a framework. Design and participants: A longitudinal design was employed and data was collected from 127 Scottish smokers prior to the smoking ban introduction (T1), and at three (T2) and six (T3) months after the ban had been implemented. Findings: Results demonstrated that smokers failed to decrease their cigarette consumption when pre and post ban rates were compared. After the introduction of the ban, positive attitudes towards the smokefree legislation increased by 20%. Whilst processes of change were used less frequently in the precontemplation stage, and increased in the contemplation and preparation stage, the results did not support the changes hypothesised by stage classification. Furthermore, no differences in the pros of smoking were observed between the stages. However the cons of smoking were rated as less important by those in the precontemplation stage (F(2,122) = 20.871, p = .001, partial η² = .26). Conclusion: Whilst findings obtained in relation to attitudes towards smoking were promising, results failed to support the theoretical predictions of the TTM and advocate its use as an explanatory framework for behavioural change. In general, findings failed to corroborate the notion of distinct and quantitative stages of change.

Background: The aim of this study was to develop an understanding of how the experience of living with an Implantable Cardioverter Defibrillator (ICD) influenced patients and their partners’ educational needs and concerns. An ICD is a device that is designed to treat patients who have life-threatening arrhythmias. The quality of life (QoL) of the ICD recipient is not only influenced by the disease itself but by adjustment to an altered life situation. Providing patient education can be an effective intervention to improve patient adjustment to the device. However, there is little qualitative research on the educational needs and concerns of these patients. It is therefore argued that qualitative research focussing on the lived experiences of patients is needed to identify appropriate educational interventions to facilitate this adjustment. Methodology: The constant comparative method of constructivist grounded theory was employed for data collection and analysis. Semi-structured face-toface interviews were carried out with fourteen ICD patients and four partners. Findings: A grounded theory model was developed which described how patient’s experiences of getting back to normal following the insertion of an ICD influenced their educational needs and concerns and ultimately led to their acceptance of the ICD. The model had two key components, getting back to normal and being informed. How the patients and carers experienced getting back to normal consisted of adapting lifestyle, focusing on the positive, effect on the family and living with the uncertainty regarding experiencing an ICD shock. Their experience of the ICD influenced their educational needs in that the information needed to be tailored to their individual experiences. Discussion: This study found a strong need to feel informed, which is a major part of Mishels theory of uncertainty. The model is also compared to the crisis theory and the common-sense model of illness representations. The chapter ends with a conclusion and recommendations for future research.

Loss of limb through amputation presents a significant, life changing, circumstance for individuals. The prosthetist as the gate keeper to the health-care system and the facilitator of rehabilitation is essential to positive adjustment post-amputation. As yet, however, commonalities and differences in the understandings of each of these parties of the experience of limb loss, prosthesis use and rehabilitation remain unexamined. This comparison provides the focus for this study. Fifteen individuals post amputation and 13 prosthetists were interviewed on their perceptions of limb loss and prosthesis use. Semi structured interviews were conducted, face to face, via telephone or via email. Data were audio-recorded and transcribed as necessary and thereafter analysed using Interpretative Phenomenological Analysis (IPA) in order to gain an understanding of the subjective experiences of individuals with limb loss and of prosthetists of the post-amputation process. Analysis of the data led to identification of four key themes, namely Personal Identity, Social Identity, The Prosthesis and Communication. These themes were relevant for both groups. The meanings that they held for the two groups, however, differed in relation to key elements of the post-amputation experience. Both groups have a shared interest in the process of prosthetic limb fitting and rehabilitation and yet come from very differing perspectives. The fitting and use of a prosthetic device is not a simple, technical process but rather involves a combination of psychological, social and practical components all of which must be recognized in the rehabilitation process. The differing expectations and understandings held by both groups become especially evident in interactions between individuals with limb loss and prosthetists. Communications between members of these groups can provide a central point for addressing differences in their understandings of living with limb loss and might provide a focus for further developments in research and practice.

This research sets out investigate the determinants of social and health service utilization by the Chinese elderly in Edinburgh. Findings indicate that little use of these services was made by the first generation of Chinese elderly in Edinburgh. Factors such as family support, language difficulties, cultural differences, social isolation and structural contingencies of the service provision have all been examined. They are found to be related to one another, but language difficulties appear to be the root of many problems encountered in seeking services. Family support for older members of the Chinese community in Edinburgh has been examined. Findings suggested that four factors - lack of contact, lack of English language competence of family members, problems of family relationships and the nature of care required - all contribute to the capacity and willingness of the family to play the leading role in caring for older members at certain times. In addition, it seems evident that the majority of the elderly women who came to join their family in their late 30s or 40s are likely to have now become vulnerable and socially isolated in later life. Meanwhile this examination of the experience of Chinese immigration has not only thrown light on the scope and ethos of prevailing social policy and revealed some of the limits of its problem-solving capabilities, but also indicates its problem-exacerbating potential in this context. Two implications are highlighted. First, it is established that prevailing social policies have not adequately met the needs of the Chinese community in question. Second, a measure of statutory service is critical and ethnicity and community consultation should be taken into consideration in implementing policies in order to encourage the provision of cost-effective and appropriate services.

This thesis explores the recent phenomenon of premarital stag party tours made to Eastern European cities by groups of British men. It is based on ethnographic field research in Krakow, Poland, conducted over the course of one year. The use of qualitative methods, primarily participant-observation, allows for the exploration of the in situ meanings and social interactions which define the stag weekend. The thesis argues that the behaviour of stag tour groups offers considerable insight into masculinity and that the meanings attributed to such behaviour reveal complex construction of contemporary British masculinities. It is argued that the Eastern European stag tour is both sold and consumed on the premise that it represents a distinct physical, social and symbolic space and time within which masculine behaviour can be enacted. This is seen as a liminal space within which an exaggerated hyper-masculinity based on a carnivalesque social transgression becomes possible and desired. It is argued that the stag tour is both performative and embodied. The male body plays a central role through the consumption of alcohol, its effects upon the body and the use of bodies by stag tourists to foster an ethos of playfulness and enact a transgressive release from social restraint. Intimacy, sociability and group cohesion play a significant role in shaping the meaning of the stag weekend for tour participants. The thesis concludes that the stag tour represents a meaningful and symbolic moment for its participants, which is mediated by notions of masculinity and homosociality. While the stag tour represents a manifestation of hegemonic masculinity in a narrow sense, it also highlights the adaptability, rather than „crisis‟, of masculinity for the men involved.

Much research investigating deception and its detection has focused upon face-to-face communication, but over recent years the variety and extent of new communication media has changed the contexts in which deception might take place. Although work has attempted to characterise communication media, a much smaller body of research exists which has investigated the frequency with which people lie with different media and the detection of deceit under different communication media conditions. Through questionnaires and experimental studies, this work investigated the perceptions that both deceivers (senders) and those attempting to identify lies (receivers) have about communication media and how this relates to their observed behaviour. Results from questionnaire studies suggested that both the characteristics of deception and media influence people's perceived discomfort and believability when lying and the media choices they might make if they are planning to deceive. Some important factors appeared to be the seriousness of the deception, who senders are lying to, and the general frequency with which they use particular means to communicate. Communication media were judged to be similar and dissimilar to each other on a range of characteristics which may impact their appropriateness for deception and lie detection. There was evidence that media used at low frequency in daily life may be more likely to be chosen for deception. In laboratory studies, senders were found to lie more frequently using audio-only media compared to audio-video. There was evidence from experimental studies that detection of deceit was more successful when communication was audio only compared to audio-video. There was little consistent evidence that judgement biases varied between media conditions, but a truth bias was identified in experimental studies. No evidence was identified that interactivity between senders and receivers significantly influenced response biases or lie detection accuracy. A small corpus of messages recorded under audio-video and audio-only conditions were selected for their detectability or believability from two senders, and presented in modified formats to receivers. Stimuli had video removed or introduced, and were presented as audio-only, audio-video, text-only and video-only. The results suggested that detectability of audio-video and audio-only stimuli was dependent upon the condition stimuli were recorded under rather than presented. When messages were only seen and not heard or read, accuracy of lie detection was compromised. There was evidence that judging transcriptions could allow successful detection, but the accuracy of lie detection was typically lower than demonstrated in richer media conditions. These findings may imply that a combination of information channels and/or paraverbal information is important for accurate classification of honesty and lies. Limitations of the studies and directions for further research were discussed.

Agency attribution is the ability to distinguish between events that occur as a result of our own actions and events that occur as a result of the actions of other people. Previous accounts of agency attribution have been mainly divided into two camps, either explaining agency in terms of high-level conscious processes (Stephens and Graham, 2000) or low-level Comparator Model (CM) processes (Frith et al. 2000). Recently, however, theorists have begun to incorporate these two approaches, but as the bulk of previous experiments fail to specify which aspects of agency are investigated, little empirical evidence exists to inform us about how these different mechanisms interact. The aim of the current thesis was to tease apart these processes by examining high-level self/other judgments and low-level motor responses to actual and perturbed visual feedback of self-generated actions. Results from Chapters 3, 4 and 5 suggest that low-level (CM) agency mechanisms are situated in right hemisphere regions, disruption of which can reduce high-level self-judgments (Chapter 5). Proprioception was also found to negatively inform high-level judgments, as reducing proprioceptive signals increased self-judgments and visual-proprioceptive incongruence increased other judgments (Chapters 6 and 7). In terms of low-level agency mechanisms, however, visual-proprioceptive congruence was found to enhance low-level correction of visual perturbations (Chapter 8). Results from Chapter 8 and Chapter 9 provide evidence for a lack of high-level conscious awareness of low-level motor responses, as participants failed to notice their own low-level corrections (Chapter 8) and as a result failed to recognise their own actions (Chapter 9). Therefore, the current body of research provides evidence for a visual-proprioceptive comparison as an integral component of low-level (CM) agency mechanisms, and that these CM processes do not produce feelings of agency per se, but identify mismatches that inform and are then interpreted by conscious awareness.

This thesis explores the subjective experience of ageing with a particular focus on midlife. I argue that midlife signifies an important phase of transition in the life course which is often characterised by essential changes in personal circumstances. Although many of these changes are anticipated their impact can still come as a surprise, reawakening old psychological threats and anxieties as well as creating new ones. The death of parents, children leaving home, changes at work and an awareness of an ageing body: these changes are usually anticipated at a practical level but can create a sense of emotional instability and insecurity. The three central themes of this thesis include the way the ageing process is experienced physically and how this in turn, effects the individual psychologically, the way personal and family relationships change during this period and the impact this has and finally how people evaluate their lives and compare this evaluation to their imagined sense of what they thought their lives would be like. I highlight how the social experiences and cultural expectations which influence attitudes and pragmatic reactions to ageing are necessarily intertwined with unconscious psychic processes, conflicts and ambivalence. My method involves interviewing twenty-two men and women aged between thirty-nine and fifty-eight years old using a psycho-social approach. This method focuses on how individuals emotionally and psychically deal with age-related changes. I conclude that midlife is a time of complex emotional and psychical conflict which is triggered and challenged through a culmination of natural and anticipated losses. In order for people to negotiate midlife and move forward in a positive and productive way they must first acknowledge and then accept the natural losses and disappointments that life inevitably brings.