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    Has cutting become cool? : Normalising, social influence and socially-motivated deliberate self-harm in adolescent girls : a research project presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Albany, New Zealan
    (Massey University, 2013) James, Shelley Anika
    The literature focusing on deliberate self-harm (DSH) has grown exponentially over the last decade. The most commonly understood reasons for DSH are based on distress relief and attenuation of emotional numbness. However, few studies have explored the social aspects of DSH. With the advent of some youth subcultures where DSH appears to be routine, the possibility arises that DSH may have become a normalised, social behaviour which is influenced by peers and which may not always be rooted in underlying psychopathology, such as borderline personality disorder (BPD), or it may derive from a somewhat different pattern of underlying psychopathology than that which is usually found among those who engage in DSH. This study aimed to explore the differences between self-harming and non-self-harming adolescent girls, and between girls who self-harm for social reasons and those who endorse other reasons for DSH, in terms of social influence, underlying psychopathology and normalising of DSH. Participants were 387 adolescent girls (303 non-self-harmers and 84 self-harmers) from schools in the greater Auckland area. Results showed that socially-motivated selfharmers were more susceptible to peer pressure and endorsed higher levels of normalisation of DSH than their counterparts, although overall levels of normalisation were low. However, those who endorsed social reasons for harm did not do so exclusively and were just as likely to endorse emotional reasons. Social harmers did not differ from other harmers in terms of psychological problems but indicated that the impact of their problems was less. When compared to non-self-harmers, the selfharming girls scored higher in peer influence and lower in parent influence, and also scored higher on measures of psychopathology. Clinical implications and suggestions for further research are discussed.
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    Towards an integrated biopsychosocial risk model of distress disorder aetiology for children of middle childhood : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology, Massey University
    (Massey University, 2004) Stuart, Nancy Eleanor
    Recent theoretical developments both within and outside the clinical literature have stressed the complex interactions between biological and environmental risk in relation to psychopathology development. They have also highlighted the importance of cognitive dimensions, especially those related to control perceptions, in the developmental path towards anxiety and mood disorders in children. Few studies have investigated these cognitive dimensions in relation to risk and protective factors. In light of these considerations, the present study evaluated structural models investigating the relationship of perceived control and competence to child temperamental risk, parent personal risk, family environmental risk and anxious and depressed feelings. It was hypothesised that temperamental, and psychological risk in relationship to family environment would be mediated by the cognitive dimensions of perceived control and competence. It was further hypothesised that family environment, would mediate the relationship between child temperamental risk and anxious and depressed feelings. A school sample of 293 New Zealand children aged between 8 and 11 and their parents was assessed using a cross-sectional design. Overall results indicated that in the face of temperamental and family adversity, feeling in control of emotions and social interactions and feeling socially competent afforded children protection from anxious or depressed feelings. In addition, a sensitive, accepting family environment was seen to protect a temperamentally vulnerable child from distressed feelings. In contrast, distress was more likely to occur when a temperamentally vulnerable child lived in a family characterised by parental psychological control and conflict than one characterised by less cohesion and parental rejection. Results also indicated that, in terms of cognitive features, perceptions of social competence were particularly important in protecting a child from having anxious or depressed feelings. These findings are discussed in relationship to Barlow's and other recent integrated aetiological theories of distress disorder. Findings are also considered in relation to implications for identification, intervention and prevention strategies for distressed children in both clinical and school populations. Further results, limitations and proposals for future research are also discussed.
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    Identifying fundamental criteria for eating disorder recovery: a systematic review and qualitative meta-analysis.
    (2017) de Vos JA; LaMarre A; Radstaak M; Bijkerk CA; Bohlmeijer ET; Westerhof GJ
    BACKGROUND: Outcome studies for eating disorders regularly measure pathology change or remission as the only outcome. Researchers, patients and recovered individuals highlight the importance of using additional criteria for measuring eating disorder recovery. There is no clear consensus on which additional criteria are most fundamental. Studies focusing on the perspectives of recovered patients show criteria which are closely related to dimensions of positive functioning as conceptualized in the complete mental health model. The aim of this study was to identify fundamental criteria for eating disorder recovery according to recovered individuals. METHODS: A systematic review and a qualitative meta-analytic approach were used. Eighteen studies with recovered individuals and meeting various quality criteria were included. The result sections of the included papers were searched for themes that were stated as criteria for recovery or 'being recovered'. All themes were analyzed using a meta-summary technique. Themes were labeled into criteria for recovery and the frequency of the found criteria was examined. RESULTS: In addition to the remission of eating disorder pathology, dimensions of psychological well-being and self-adaptability/resilience were found to be fundamental criteria for eating disorder recovery. The most frequently mentioned criteria were: self-acceptance, positive relationships, personal growth, decrease in eating disorder behavior/cognitions, self-adaptability/resilience and autonomy. CONCLUSIONS: People who have recovered rate psychological well-being as a central criterion for ED recovery in addition to the remission of eating disorder symptoms. Supplementary criteria, besides symptom remission, are needed to measure recovery. We recommend including measurements of psychological well-being and self-adaptability/resilience in future research, such as outcome studies and in routine outcome measurement.