This narrative critically reviews my contribution to the development and maturation of a sociology of complementary and alternative medicine (CAM). Through the application of qualitative methodologies, my work has documented the emergence of a ‘new’ medical pluralism, focussing on the professional development of CAM as practiced by non-medically qualified practitioners and nurses and midwives, and has provided an understanding for the groundswell of appeal of CAM to both users and practitioners. With reference to neo-Weberian, Foucauldian and feminist theories of occupational formation, the research has provided insight into CAM ‘professional projects’, detailing the attempts to secure market share, broker trust relations, and discipline work conduct. My work has also revealed the enduring capacity of (patriarchal) biomedicine to shape CAM practice and health care delivery. As a consequence, CAM is described as being situated in a position of ‘mainstream marginality’ – popular, but peripherally located in state-sanctioned health care, with an appeal to groups of users and practitioners who themselves feel marginalised. As such, my work has contributed to an appreciation of the attractions of CAM and its empowering potentials, and the dynamics of biomedical power, professionalisation and professionalism in relation to jurisdictional battles for market share. Through critical reflection on my work, however, I note there is space for further exploration into: the opportunities for affective change and collaboration that can be fostered in integrated/integrative clinics; the ways in which biomedical dominance might be mutating; the different ways in which wellbeing, efficacy and evidence might be conceptualised; the possibility of integrating post-colonial theory and anthropology with sociology to produce a globalised analysis of medical pluralisms.

Mental toughness (MT) originated within elite sport and was identified as an attribute of success. MT has emerged as being important for enhancing health-related lifestyle factors (HRLF; e.g., physical activity). Investigating the healthiness of one’s lifestyle appears a timely area to research given the current health status of the population. Therefore, the aim of this thesis was to investigate MT in relation to HRLF and weight loss. Study One investigated MT and HRLF in university students (n = 167). Self-reported MT, physical activity, exercise barriers, dietary behaviour, and psychological wellbeing were recorded. MT was significantly different between regular exercisers (M = 3.43 ± .42) and non-regular exercisers (M = 3.24 ± .54, p < .05). Components of eating identity, exercise barriers, and psychological wellbeing, were significantly correlated with MT. Study Two longitudinally investigated weight loss progress, and adherence to a weight loss support group, in slimming club members who were pursuing a weight loss goal (n = 132). MT and eating identity were assessed at baseline, three-months, and six-months, and weight was recorded at weekly meetings. Overall MT was not significantly related to weight loss (r = -.15, p > 0.05) or adherence to the service (r = .03, p > 0.05). Study Three sampled individuals who held a weight loss goal, but were not attending a weight loss support club (n = 78). Overall MT was not significantly related to weight loss (r = -.21, p > 0.05). MT was not significantly different between weight loss goal achievers (M = 3.62 ± .49) and non-goal achievers (M =3.42 ± .38, p > 0.05). Thus, irrespective of whether structured support is received, overall MT was not related to weight loss progress. II Study Four investigated the experiences of high (n = 9) and low (n = 7) mentally tough individuals pursing a weight loss goal. High and low MT individuals, identified using the MTQ48, were interviewed. Thematic analysis revealed that amongst the high mentally tough individuals, those who prioritised leading a healthy lifestyle reported weight loss success compared to those who prioritised other goals. Strategies to overcome low levels of MT (e.g., control), as well as receive additional support, appeared crucial for successful weight loss in low MT individuals. Study Five further investigated the low MT individuals’ (n = 7) perceptions, experiences, and attitudes, towards weight loss. Low MT individuals were sampled based on their MT score assessed via the MTQ48. Vignette based interviews extended the findings in Study Four. Thematic analysis revealed key findings, including the potential to change low MT individuals’ perceptions to enhance behaviour change. Overall, this thesis expanded the understanding of MT; the processes that one experiences when trying to lose weight appears to differentiate between high and low MT individuals, which offers an explanation as to why MT did not appear to play a significant role in weight loss outcomes. These findings challenged the predominant contemporary understanding of MT and demonstrated that MT was not associated with behaviour change to achieve weight loss.

Introduction: There is a growing interest in psychological and health research in the relationship between spirituality and physical and mental health variables. Forgiveness has also been considered in such research and hypothesized as a potential mediating variable. However, much of the research in this area has not examined spirituality in the dimensions ritualistic, theistic, and existentialistic, nor has it tested for the potential mediation of forgiveness. The purpose of this study was to expand upon the dimensions of spirituality, with forgiveness as a mediator, and to test how they affect state and trait anxiety. Methods: Participants in this cross-sectional study were 479 students at East Tennessee State University (Caucasian=78.29%, ♀=69.10%, Mage=22.45). Participants completed a variety of self-report measures including the RiTE measure of spirituality, state and trait anxiety measure, Heartland Forgiveness Scale, and religious background and behaviors. Results and Discussion: Existentialistic spirituality was found to be related to both state and trait anxiety with forgiveness providing both indirect only and full mediation effects. Forgiveness of self and forgiveness of situations served as the only mediators between existentialistic spirituality and state and trait anxiety. Ritualistic and theistic spirituality were not significantly related to state and trait anxiety. It appears that spirituality may operate through forgiveness of self and forgiveness of situations to affect state and trait anxiety. That is, existentialistic spirituality is associated with forgiveness, which in turn is associated with lower anxiety. As such, it may be useful to integrate the concept of these dimensions of spirituality when assessing anxiety in psychological health patients.

Research has shown that spirituality can play a role in addiction and recovery. However, little work in this area has focused on adults who have grown up with parents who have had alcohol and/or drug problems. Cross-sectional data was collected from college students from a regional university in southern Appalachia. Multiple dimensions and aspects of forgiveness and mental health were examined among undergraduates, including differences based upon participants’ likelihood of being an adult child of an alcoholic (ACOA). Individuals likely to be an ACOA had poorer levels of the forgiveness and mental health related variables. Among ACOAs forgiveness of others was associated with psychological distress and somatic symptoms in a deleterious fashion. Forgiveness of situations was associated with mental health status, psychological distress, and dysfunctional behaviors associated with being an ACOA in a salutary fashion. The process of forgiveness intervention may be an added benefit during the recovery process associated with growing up as a child in an alcoholic family.

Given past findings that have linked trauma and lack of personal control to greater suicidal risk in adults, the present study examined how trauma presence and personal control are uniquely involved in predicting suicidal risk in a sample of 469 college students. Regression analyses indicated that both trauma presence and personal control were significant predictors of suicidal risk, as was their interaction. The present findings suggest a need to consider both trauma presence and low personal control in assessing for suicidal risk in college students.

Previous research has indicated that vascular disease, trauma, and cancer lead to amputations and that 1.7 million Americans are living with an amputation. The social problem of this study is that amputees have limited places to obtain social support. Alderfer's Existence, Relatedness, and Growth Theory provided the foundation for this research. The current study examined the following questions. First, does type of social support impact amputee perceived social support satisfaction? Second, does type of social support impact life satisfaction? Survey methodology was used following attendance at either peer-to-peer or group support. A purposeful sample of 184 participants were assessed using the Satisfaction with Life Scale and the Multidimensional Scale of Perceived Social Support. ANOVA first showed that peer participants reported significantly greater perceived social support satisfaction than group. Second, ANOVA showed that participants in peer support groups reported greater life satisfaction than group. These data assist anyone concerned with helping amputees make support decisions based on the amputees' specific needs. From these findings, future research utilizing other forms of social support for amputees can be generated and expanded.

The purpose of the study was to investigate the relationship between an individual's self concept and his method of permanent birth control. The subjects consisted of two groups of males: (1) males who were seeking a vasectomy, and (2) males who were not seeking a vasectomy but who indicated that they had obtained their desired family size, or who indicated they would not consider a vasectomy. The subjects in grout, one were paired with subjects in group two according to select demographic variables such as age, race, education, and occupation. The Tennessee Self Concept Scale, TSCS, Total P Score was utilized to assess self concept. Analysis of the data utilized the Wilcoxon Matched-Pairs Signed Rank Test. The analysis indicated that the vasectomy group had a significantly higher self concept than the non-vasectomy group. The results of this study indicated a relationship between self concept and the initial decision to seek vasectomy. Males with positive self concepts appeared to be more open to the idea of vasectomy and make this decision. These findings are fairly consistent with self theory, but more investigation of personality as it relates to the decision to seek vasectomy is needed.

Previous studies have indicated that the useful or functional field of view is a dynamic visual measure. Specifically, it has been shown to constrict as a function of increasing ago, decreasing target duration, decreased conspicuity, and to expand as a function of practice. Two possible explanations for the age-related decline were examined: (1) older observers have a deficit in selective attention which prevents them from ignoring irrelevant information, thereby making a target lees conspicuous, and (2) the time required to process a given visual area increases with age. The purpose of this study was to determine which of these explanations would most likely account for the age -related constriction of the useful field of view. Four young, five middle-aged, and five older observers were each tested at five brief target durations on two versions of a peripheral localization task: one with distractors and a similar teak without distractors. Both tasks employed a concurrent focal task. All observers were then trained for five consecutive sessions on the same peripheral localization task with distractors, followed by post-training tooting on both tasks. As expected, errors in radial localization performance increased with age and also at greater eccentricities for both tasks. Only the middle-aged observers demonstrated significant improvement on both tasks as a result of practice. Young observers, however, performed so well initially that little room was left for improvement. Conversely, older observers performed poorly before and after training reflecting the age-related difficulty of the tasks. Overall, the results were consistent with the hypothesis that the time required to process a given visual area increases with age.

The present study investigated the possible relationship between the degree of risk-taking propensity and the choice of vasectomy as a preferred method of birth control. Three sample groups, vasectomy seeking men, their wives, and men using contraceptive measures other than permanent sterilization, were tested for degree of risk-taking. The instrument used to measure risk-taking propensity was The Desire For Certainty Test (Brim, 1955). In addition, selected demographic variables were analyzed for the two groups of males to assure a relatively greater degree of homogenietv among these two male sample groups. A Dunnett's Test was used to assess the difference between the means of the vasectomy seeking men and their wives and between the vasectomy men and the non-vasectomy seeking men. The results of the analysis showed that the risk-taking propensities of the vasectomy seeking men and their wives were significantly different. The females were found to be more inclined to take a risk than their husbands. The risk-taking propensities of vasectomy seeking men were not, however, significantly different from those of men choosing other means of contraception. The results of this study may have been affected by the multidimensional nature of the risk-taking construct. Until the issue of multidimensionality is adequately dealt with, research in the area of risk-taking propensity will very likely continue to yield contradictory results.

The relationships between two personality variables in alcoholics and motivation to seek treatment were examined in this study. The Psych -)logical Screening Inventory (PSI) was administered to a group of 73 alcoholics admitted to a detoxification unit. Before being discharged from the unit each alcoholic was referred to a treatment agency. Each alcoholic was then followed up at the agency to which he was referred. On the basis of this follow-up the alcoholics were divided into two groups; those seeking treatment and those not seeking treatment. No significant differences were found between the two groups on the personality variable measured on the PSI Discomfort scale. A significantly negative difference was found between the two groups on the personality variable measured by the PSI Social Nonconformity scale. The results suggest that discomfort is not a motivating factor in alcoholics' treatment seeking behavior. Results associated with social nonconformity suggest this factor is related to treatment seeking behavior. Several possible explanations for these unexpected findings are discussed. Need for further research in this area is demonstrated by this study and the available literature.