This thesis explored possible underlying processes of bulimic behaviours by conducting a naturalistic examination into binge antecedents and consequences. Main hypotheses were derived from contemporary theories of binge-eating behaviour, which postulate that dietary restraint, negative affect, and dissociative phenomena (i.e., lapses in self-awareness) may precipitate and maintain bulimic symptoms. A secondary aspect of this study was to determine whether or not personality variations influence individuals' sensitivity to processes that may precipitate binge eating or that may shape binge consequences. A sample of 39 women with bulimia-spectrum eating disorders provided "on line" self-reports on eating episodes, urge to binge, behavioural and cognitive dietary restraint, negative and positive affect, and dissociation, with samplings obtained in response to random prompts, and before and after every eating episode. Across participants, recording with the daily diaries spanned 7- to 29-day intervals and resulted in a total of 3,204 recordings. Multilevel modelling analyses indicated that increases in behavioural dietary restraint preceded stronger urges to binge. Affect was also poor prior to actual binge episodes and seemed to worsen after bingeing. In addition, dissociation was likely to be present prior to and after bingeing. These results suggest that processes linked to dietary restraint, affect, and dissociation potentiate, trigger, and/or maintain bulimic behaviours. In contrast, the results did not consistently support the role of personality traits as moderators of binge antecedents or consequences. The present findings suggest that binge eating is a multiply determined behaviour that is linked to diverse cognitive, behavioural, and affective processes. Recommendations for future research and clinical implications are discussed.

Thesis (Ph. D.)--University of Hawaii at Manoa, 1990. / Includes bibliographical references (leaves 145-158) / Microfiche. / viii, 158 leaves, bound 29 cm

The increased intensity and complexity of cancer treatment has an impact on the lives of the adolescents undergoing such treatments. Living with cancer is a distinct experience for them which include physical, psychological, spiritual and social dimensions. The cancer experience comprises more than the measurement of symptom occurrence, frequency, duration and severity, or the ratings of quality oflife. The meanings of the lived experience from the adolescent's perspective and self-report can give a more accurate, holistic picture of the nature and scope of the experience. Practitioners need to know and understand the meaning of the experience from the adolescent's perspective in order to design appropriate interventions to prevent or relieve distress in these patients. The purpose of this study was to describe the meanings of the lived experience ofhaving cancer for adolescents undergoing treatment. Phenomenology was the qualitative research methodology used. As outlined by Patricia Munhall, this methodology seeks to understand the meaning of lived experiences. Seven adolescents, 14 to 18 years of age, in treatment for cancer were interviewed. Six males and one female participated in this study. Six were receiving treatment for acute lymphocytic leukemia and one for a solid tumor. All participants were of Pacific Island origin; two live in Hawaii and five were temporary residents. The audio taped interviews were transcribed and analyzed to understand the meaning of the cancer experience. The essence of the experience for the individual adolescent was described and a composite interpretation of the meaning derived. Recommendations to healthcare providers for improving communication with adolescents in treatment for cancer are provided, including discussing death and dying early in the illness trajectory. The interdisciplinary concept of care is stressed, as well as the importance of a thorough physical examination. The importance of social support and techniques to potentially strengthen and increase this support are outlined. Solutions to the problems of school reintegration are introduced.

This research was a pilot study at improving the medical, psychiatric and addiction care provided to women detainees at the jail. Few studies have been completed with women atjail intake, yet the population is suspected of having a multitude of medical, psychiatric and addiction in jail treatment and community reentry needs. Utilizing a descriptive, cross-sectional survey design, the following aims were completed for this pilot study: documented the creation of a nursing research infrastructure within a large jail; compared the results of the traditional 16- item paper and pencil Intake Service Center Screen with the 8-item paperless Brief Jail Mental Health Screen obtained via Audio Computer Assisted Self Interviewing (ACASI) technology; compared Addiction Severity Index scores and addiction treatment motivation and readiness scores obtained via ACASI technology with normative data; assessed the frequency of HIV risk behaviors and the medical, psychiatric and addiction treatment needs obtained via ACASI technology; while assessing the frequency and the average length of time for screening by providers at the jail via medical chart review. The results showed that the ACASI technology proved to be more effective than paper and pencil methods. This technology not only assessed detainee treatment needs, but simultaneously created reentry/discharge plans. The study demonstrated that HIV risk behaviors and the prevalence of past suicide attempts were high among the participants. The Addiction Severity Index scores and the Circumstance Motivation and Readiness scores demonstrated that methamphetamine addiction, and mental health severity is high among this population however motivation and readiness for treatment arc low. Therefore, recommendations for the most suitable jail psychiatric Advanced Practice Registered Nurse candidates could be given as a result of the study. This study was the first phase at improving the medical, psychiatric and addiction care provided to detainees at the jail. In future phases of this study more valid and reliable assessment tools and treatment planning aimed at reduced recidivism rates will be established. Future phases will build on the lessons learned here about working with security staff, collaborating with experienced researchers in the community, and seeking advice from the Department of Justice recognized experts.

Remorse continues to play an important role in the legal system and in offender rehabilitation; yet, it remains an understudied concept. Research related to remorse at the phenomenological level is sparse and studies that focus on youthful offenders are nearly non-existent. The purpose of this study was to describe the essence of the lived experience of male, adolescent offenders, who have experienced the phenomenon of remorse in the context of their crimes. Colaizzi‟s descriptive, phenomenological approach to inquiry and analysis guided this qualitative study. Narratives from in-depth, semi-structured interviews with 13 male, African American and European American, ages 16-18 year-old offenders placed in privately owned Residential Treatment Programs served as data. Eight clusters of themes and 18 themes emerged from the data and provided rich descriptions of the remorse experience among this population. Findings supported the positive and negative aspects of remorse noted in the literature. Implications for future nursing research, nursing practice, and policy were provided.

No description available.

This feminist postmodern praxis oriented research investigates the journey and discourses of women living with breast cancer. This study explores the ways in which discourses and health care practices are implicated in relations of power, and how these discourses and practices inter-relate and inform each other. Alternative possibilities for creating new discourses and practices for women living with breast cancer are also examined in the study. Seventeen women in various stages of being diagnosed and treated for breast cancer participated in two years of individual interviews, group discussions, and informal conversations with the researcher. Participants also read and responded to the emerging construction of the dissertation and contributed pieces of original writing that they had created over the course of their journey with breast cancer. This research uncovers and illuminates the ways in which participants interpret biomedical discourse and position themselves in biomedical and other discourses. It also fosters an understanding about the ways in which women's discourses, sense of agency, power, and identity are impacted as they traverse their journey with breast cancer. In fore-grounding women's discourses, the differences between a woman's personal illness story and her journey with breast cancer and the biomedical emphases on the disease diagnosis and treatment trajectory are highlighted. An examination of women's discourses also illuminates the various ways that women may be positioned by biomedical discourse, position themselves and others, and as well, resist and reposition themselves in relationships. These understandings direct our attention to the strengths and capacities of women and the manner in which they exercise personal and collective agency. This research is unique in it's emphases on illuminating women's discourses about living with breast cancer and on the professional, social, historical and institutional discourses that shape experiences for women. Highlighting a woman's journey with breast cancer, her own discourses, exercise of agency and development of transformative knowledge provides health care professionals with an insider's view. Knowledge of health care practices and relationships in the care of women with breast cancer are useful in envisioning ways of practicing to support and strengthen women's construction of a cogent illness journey and ability to participate in their care in meaningful ways. / Graduate

From Preface: The present study attempts to explore, both theoretically and empirically, some implications that a personal consideration of death may have for the way we live our lives. Existential-Phenomenology has concerned itself with the description of the dimensions of human existence. It is in this enquiry that Death, and through it, human finitude, emerges as an important dimension of existence. It is not the fact of death itself, but the MEANING it has for our lives which may be of important consequence. It is to this area that this research addresses itself. The methodology employed arises out of a concern to contribute to the establishment of Psychology as a Human Science. To this end, a chapter focusing on the philosophical bases of methodology is included. It is hoped that this study may, however little, contribute both to the field of Thanatology as well as to the more theoretical issue of what Psychology is, and where it is going. / KMBT_363 / Adobe Acrobat 9.53 Paper Capture Plug-in

This research can be seen as being a step towards an answer to the question "what is bisexuality?". Such an aim, however, appears to be a contradiction in terms. Surely we must be assuming an answer by asking the question. How can one ask a question such as “what is bisexuality?", if we have no conception of what the word bisexuality means? Owing to the lack of information in the literature with which to answer the question of this study, it was decided that an in-depth study of one individual would be a most suitable starting point to begin an illumination of the themes which lie in the depths of this complex phenomenon . An in-depth study would hopefully do this without lapsing into the stereo - typed ways of thinking and terminology that could eventuate from a more populous and necessarily more superficial approach (Kotze 1974). Arising out of the prevailing conception of human sexuality as comprising two modes of sexual existence - heterosexuality and homosexuality only, the idea of bisexuality is hardly to be found in the ordinary man's or, for that matter, the psychologist 's, conceptual frameworks. The only extensive work that has been undertaken to date which uncovers, to a certain extent, the nature of human sexuality, is that of Kingsley (1948 and 1953). Although it must be kept in mind that this research is dated, it certainly does indicate that perhaps it would not be unrealistic to begin to reconceptualise our views on man's sexual mode of existence . This thesis presents the case of a man, who, according to our present view, does not exist.

This project attempts to articulate an understanding of the worlds of selected subjects suffering from schizophrenia, through their dreams. It proceeds from the implicit question of whether or not schizophrenic dreams reflect the schizophrenic worlds as literature defines, and tries to address some of the dream features which reflect the schizophrenic world. Five psychiatric inpatients suffering from schizophrenia were selected. The data gathered included the subjects' dreams and subsequent interviews for the purpose of clarification of the dreams. A phenomenological-hermeneutic methodology was deemed to be appropriate as it gave access to the richness of the dream experiences as well as the following dialogue between the data and literature. The results indicate that the subjects' dream worlds bear evidence to a fragmented state of ego which is to be expected to be found in schizophrenia. On the other hand some of these subjects' dreams also point to evolving health that is present in their world, at least on an intrapsychic level.