Thesis (Ph. D.)--Victoria University of Technology, 2005. / Includes bibliographical references.

<p> Although breast cancer is typically considered a disease that affects women at an older age, younger women are also impacted by breast cancer. Additionally, current literature suggests that women who are diagnosed at a younger age face greater challenges adjusting to breast cancer survivorship. Young survivors are often in the midst of starting their career, beginning a family, and planning for their future. Thus, a cancer diagnosis drastically interrupts these plans. This study examined the relationship between different variables that are commonly studied in young breast cancer survivorship. Women were eligible if they were diagnosed between the ages of 19-45 years, were post-treatment at the time of the study, and first-time survivors of breast cancer. Participants were recruited from social media websites, online support and advocacy group, and cancer centers across the United States. Participants completed an online survey. This study examines the structure of the hypothesized latent variables included in a proposed structural model of psychosocial adjustment to breast cancer survivorship. Two of the four hypothesized latent factors were supported by the data, and a revised structural model of psychosocial adjustment to young breast cancer survivorship is provided. Follow-up research should examine the structural model and determine the most important factors in predicting young breast cancer survivors' quality of life and life satisfaction. </p>

This research assessed the clinical utility of an augmented Short Form 36 (SF-36) instrument, namely, the Treatment Outcomes in Pain Survey (TOPS) in an Australian chronic pain population. A pretest-posttest quasi-experimental design was adopted. Intervention comprised patients attending the Comprehensive Outpatient Pain Education and Rehabilitation (COPER) program, which is an intensive, inter-disciplinary, three-week, cognitive behaviour therapy based outpatient chronic pain treatment. Statistical analysis comprised pre-treatment and post-treatment means and standard deviations, effect sizes, paired samples t-tests, and Cronbach's alpha. Australian norms for 86 (42 males and 44 females) patients were presented for initial values and treatment-related improvements. Internal consistency reliability coefficients (Cronbach's alpha) demonstrated that the TOPS was a reliable measure of group outcomes. Two dimensions, Life control and Total Pain Experience, were sensitive enough to follow individual patients. All SF-36 domains and ten of the fourteen TOPS domains improved significantly following treatment. Despite the limitations to this research, the results are consistent with previous findings (Fishbain, 2000; Morley, Eccleston, & Williams, 1999) that cognitive behavioural, multidisciplinary pain treatment is associated with improvement in a number of biopsychosocial aspects of chronic pain as measured by the TOPS. These include Pain Symptom, Lower Body Functional Limitations, Perceived Family/Social Disability, Objective Family/Social Disability, Total Pain Experience, Life Control, Solicitous Responses, Upper Body Functional Limitations, Fear Avoidance, Patient Satisfaction with Outcomes, as well as general health and wellbeing aspects measured by the SF-36 component of the TOPS. Limitations of the study and potential future research are discussed. / Thesis (MPsy(Clinical))--University of South Australia, 2005.

Thesis (Ph.D.)--Pacific Graduate School of Psychology, 1998. / Source: Dissertation Abstracts International, Volume: 59-07, Section: B, page: 3704. Adviser: Teresa Elliott.

Thesis (Ph.D.)--Pacific Graduate School of Psychology, 1999. / Source: Dissertation Abstracts International, Volume: 60-05, Section: B, page: 2338. Chair: Catherine Classen.

Thesis (Ph.D.)--Fairleigh Dickinson University, 2005. / Source: Dissertation Abstracts International, Volume: 65-04, Section: B, page: 2084. Chairperson: Judith Kaufman. Available also in print.

The aims of the present study were threefold: firstly, to further the understanding of the psychological response to heart disease; secondly, to consider the differences in the ways in which doctors and patients perceive heart disease; and thirdly, to consider how the doctor, patient, and condition interact within the illness process over a period of time. The nature of coronary heart disease (CHD) was considered, and the influence of psychological variables in CHD was discussed. Psychological factors in illness were examined, with particular emphasis on health beliefs, illness behaviour, compliance, and the doctor-patient relationship. Conclusions were drawn that to understand the illness process in heart disease, doctor, patient, and condition must be considered together, in an interactional framework. Two pilot studies were performed. The first study found that heart patients' health beliefs differed from a normal population. The second pilot study, with raised cholesterol patients, suggested the existence of five major components of the illness process: illness perception, illness effect, health orientation, doctor-patient relationship, and compliance. The main study considered groups of heart and cholesterol patients (experimental groups) and a group of general outpatients (control group), over a four-to-six month period. Patients were interviewed and given a questionnaire concerning their feelings regarding their condition. Doctors and judges also completed similar questionnaires. Results indicate that cholesterol patients rate superior coping to the other groups, and both experimental groups were higher than controls with regard to patient understanding, responsibility for health, and communication with doctor. Findings suggests alterations should be made in current conceptualization of illness behaviour. and that patient and doctor assessment of condition severity were found to be unrelated to illness behaviour. Doctor and patient perception of patient behaviour were found to be discrepant. Modifications in the treatment of heart and cholesterol patients are suggested.

<p> Body image disturbances are associated with a variety of health compromising behaviors; however, less is known about their impact on health maintenance behaviors. The present study investigated the relationship between body image disturbances and the frequency of a specific body-focused health maintenance behavior: breast self-examination (BSE). It was hypothesized that two manifestations of body image disturbance, body shame and body avoidance, would be negatively associated with frequency of BSE in the past year and intended frequency of BSE in the coming year. Furthermore, it was hypothesized that health anxiety and risk perception for breast cancer would moderate the relationship between body image disturbance and frequency of BSE in the past year. As a secondary research question, the impact of body image disturbance on the self-reported level of negative affect experienced during BSE was investigated. </p><p> Participants were 120 women between the ages of 21 and 40 (M age = 24.14, SD = 4.78; M BMI = 24.73, SD = 5.75) recruited from a large public university. Following informed consent, participants completed a battery of self-report questionnaires assessing demographic variables, body image disturbances, BSE behaviors and intentions, health anxiety, and risk perception. Participants were also encouraged to complete follow-up questionnaires for three months assessing frequency of BSE and associated negative affect. </p><p> Results showed that when the entire sample was considered, neither body shame nor body avoidance were significantly associated with past year BSE or BSE intentions and neither health anxiety nor risk perception emerged as moderators. However, when only women ages 22 to 40 years old were considered in post hoc analyses, body shame significantly predicted past year BSE and both body shame and body avoidance significantly predicted BSE intentions. Additionally, risk perception emerged as a predictor of past year BSE. An additional post hoc analysis revealed that age moderated the relationship between risk perception and past year BSE when the entire sample was considered. Follow-up data revealed that neither body avoidance nor body shame significantly predicted affect during BSE after controlling for physical discomfort. These findings have important implications for health promotion among women of all ages.</p>

This research began as an examination of the problem solving strategies of individuals who believe they can control reinforcements they recelve (internals) and those who believe that outside forces control reinforcements (externals) under different conditions of skill and chance. This developed into a study of the cognitive functioning of internals and externals in concept formation tasks. Internal and external persons were identified using the internal-external locus of control scale developed by J.B. Rotter and his colleagues. Three studies were conducted uSlng different tasks and groups of Subjects. The subjects of the first study were required to find a principle relating one of two response words to a list of five stimulus words. There were fifty trials using different sets of words. Three groups of subjects were used, each made up of internals and externals. The group under the skill condition was instructed that their performance depended primarily on their own skill; the group under the chance 1 condition (quasi chance) was instructed that their performance on the task would probably be no better than chance due to the extreme difficulty of the task; and the group under chance 2 (pure chance) were told that their performance on the task was totally controlled by chance as the arrangement of the words was purely arbitrary. It was expected that internals would perform better than externals under the skill condition while externals would perform better than internals under chance 2. Subjects' perception of, and reactions to, the task were measured by a post-task questionnaire. The results did not uphold the predictions. Externals, relative to internals, utilised, produced and changed significantly more solution hypotheses while working on the task. The two groups did not differ in the number of correct answers and both of them were unsuccessful in deciphering the principle. In terms of subjects' reactions to the task, it was found that the internals reacted differently to the skill and chance 2 conditions, while externals were stable across these conditions. Moreover, subjects construed the chance 1 condition as resembling a skill condition. The different ways ln which internals and externals handled their solution hypotheses was further investigated in the second study. Two groups, one of internals and one of externals, were asked to scan a list of characteristics describing an object, and then to scan another list containing objects, one of which was best described by the characteristics. The two lists were presented separately to the subjects in order to discover whether subjects needed to switchback between the two lists while attempting to identify the correct object. The subjects' reaction times in studying the characteristics (preparation time) and in naming the appropriate objects (solution time) were recorded. The subjects' perception of and reactions to the task were measured by a post-task questionnaire. The results strongly supported the predictions: the internals preparation and solution times were significantly faster than those of the externals who also used more switchbacks than internals. Moreover, both groups performed equally well on the task (in terms of naming the appropriate objects). Analysis of the subjects' perception of the task indicated that internals perceived the task to be more skill controlled than externals. The third study was conducted to clarify some methodological problems associated with the first study and to further investigate the problem solving behaviour of internals and externals. Subjects were presented with a series of sets one per trial for twenty four trials, each of which consisted of two letters and two numbers. Certain sets were constructed using a common principle and subjects were required to identify the principle. Subjects perception of, and reactions to the experiment were measured by a post task questionnaire. The results showed that more externals were successful at finding the principle than internals. Externals used less trials per solution hypothesis and guessed on more trials than internals. Both groups had similar numbers of correct answers. More internals than externals, however, employed complex solution hypotheses. It was also found that the internals confidence in finding the principle before commencing the task was higher than that of the externals. Taken in conjunction the three studies indicate that finding the solution per se to the tasks did not differentiate internals from externals as readily as their different approaches to the tasks. The internals were more cautious and systematic in handling their solution hypotheses and processed information more efficiently and thoroughly. The externals, on the other hand, adopted a &quot;butterfly&quot; approach to testing their solution hypotheses, readily switching between them and returning to previously rejected hypotheses. They were less able than internals to process simultaneously two aspects of the task. It was concluded that the different problem solving behaviours of internals and externals resemble distinctive cognitive styles. Whether these cognitive styles are effective in terms of identifying the solution to a problem seems to depend largely on three main factors: the skill element of the task, the type of task, and the level of task difficulty.

Thesis (MPsy(Clinical))--University of South Australia, 2001.