Massey Documents by Type

Permanent URI for this communityhttps://mro.massey.ac.nz/handle/10179/294

Browse

Subject: search.filters.subject.520399 Clinical and health psychology not elsewhere classified

Search Results

Now showing 1 - 10 of 10
  • Thumbnail Image
    Item
    Media exposure to trauma, psychotherapy, and false memories : a recipe for disaster? : a thesis presented in partial fulfilment of the requirement for the degree of Doctor of Clinical Psychology at Massey University, Manawatū, New Zealand
    (Massey University, 2022) Sievwright, Olivia
    The proliferation of social media use in recent years has meant individuals are at increased risk of being exposed to images of real-life violence and trauma. This issue, along with growing concerns about the inaccessibility of formal psychological therapy, raises questions about the demand for computer-delivered therapeutic interventions. However, previous research has raised concerns about the potential for some therapeutic techniques to increase susceptibility to misinformation (e.g., Houben et al., 2018). In this thesis, I aimed to test the effects of a computerised trauma intervention on trauma memory vividness, emotional intensity, and susceptibility to misinformation. Experiment One describes novel procedures and materials for investigating misinformation effects in an online context. Participants (N = 99) completed the study online. They first watched a 10-minute video of a fictional school shooting. Between five and ten days later, they were randomly assigned to receive misinformation or no misinformation about the video before completing a recognition test. Misinformed participants were less accurate at discriminating between misinformation and true statements than control participants. This effect was most strongly supported by ROC analyses (Cohen’s d = 0.59, BF10 = 8.34). The study showed the misinformation effect can be established in an online experiment using candid violent viral-style video stimuli. The novel materials developed in Experiment One were employed in a second experiment to test the misinformation potential of Cognitive Bias Modification – Appraisal (CBM-App) training; a computerised trauma intervention. In Experiment Two, participants viewed the school shooting video and rated the vividness and emotionality of the video. They then received a post-trauma debrief via video before being randomly assigned to either complete the CBM-App training intervention or a control task. Participants again rated their memory vividness and emotionality. Five to ten days later, all participants re-rated their memory vividness and emotionality and then received misinformation about the trauma video. Lastly, participants completed a recognition test. Results showed CBM-App training successfully instilled a positive cognitive bias; however, the intervention had no effect on trauma memory vividness or emotionality. ROC analyses also demonstrated no effect of CBM-App training on susceptibility to misinformation. The present research raises questions about the efficacy of CBM-App training for reducing trauma-related distress. Moreover, findings suggest that while there is the potential for memory distortion in many therapeutic interventions, this may not be the case for CBM-App training. This research has implications for the CBM-App, misinformation, and trauma literature. It is hoped the present research provides a foundation for further research investigating therapeutic interventions and misinformation effects in an online trauma context.
  • Thumbnail Image
    Item
    Precarious feminine identities : a thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy in The Department of Psychology at Massey University, Manawatu, New Zealand
    (Massey University, 2021) Weatherley, Guenevere E. W.
    This thesis explores, from a DeleuzoGuattarian perspective, the motivations that women find for, and the actions they undertake in leaving intimate partner relationships under which they have suffered emotional and physical derogation at the hands of their abusive other. It seeks to investigate and describe their "minoritarian" actions in the context of a DeleuzoGuattarian stylistic and strategic approach towards departing intimate partner violence (IPV). In this, as well as considering particular aspects of Deleuze and Guattari's conceptual apparatus, the study pursues the differences opened up by affirmative engagement with the hopefulness of virtualities, and the "lines of flight" these offer for creative possibilities, enduring connections, and novel - if precarious - identities. The extremes to which the women in this study were pushed reveal the stresses and conflicts in the bid for autonomy and equality inherent in unhappy intimate partner relationships without the frequent rhetoric that masks the difficulties of domestic life. Compounding these women's problems is the fact that there are few obvious avenues for escape for those trapped in abusive situations, limited support for independence, or programmatic advice on the broad social mandate they must negotiate. The women's stories reveal deep fissures in the structures of conventional New Zealand families by showing that the latter cannot accommodate or validate relationships that privilege outmoded gender practices over care, commitment, and opportunity for growth. Their stories articulate social and cultural uncertainties about the unstable positions of women in unequal relationships, that privilege outmoded gender practices over care, commitment, and opportunity for growth. Their stories articulate social and cultural uncertainties about the unstable positions of women in unequal relationships, the physically and emotionally draining demands to which they are subjected, and the struggle to find acceptance in their relationships, which are too often structured not by good will, affection and effort, but by traditional roles and economic hierarchies. The narratives contribute to the conversation on persecuted women's courage and determination to endure and resist, to develop lines of flight and to expand their lives despite intolerable pressures, as well as offering a DeleuzoGuattarian conceptual pragmatic underpinning of action. It shows that assertive independent action engenders empowering becoming, and it suggests that where women initiate schizonanalytic breaks, where they embrace precarity, they can discover creative and fulfilling lives.
  • Thumbnail Image
    Item
    The "ACT-ive" pursuit of loss and gain : the impact of an acceptance and commitment therapy-based intervention on post weight-loss surgery individuals : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Auckland, New Zealand
    (Massey University, 2021) Damnjanovic, Natalija
    Obesity prevalence continues to increase at an alarming rate worldwide and poses serious health risks to those affected including increased morbidity, mortality, and psychosocial consequences. Weight-loss surgery is currently the best evidence-based treatment for obesity yet, substantial postoperative weight regain is reported within 2-5 years. Successful weight management is complicated when longstanding psychological difficulties are present, that often require psychological input to address. In response, a private weight-loss surgery clinic has developed an Acceptance and Commitment Therapy-based (ACT) Intervention entitled the Foundations of Healthy Living (FOHL) Retreat with the aim of improving weight-loss surgery outcomes by providing greater support to individuals in the post-operative period. In this thesis, an exploration of the efficacy of the FOHL Retreat is conducted. A quasi-experiment pretest posttest non-equivalent control group design is utilised to investigate the impacts of the intervention on weight-related experiential avoidance, eating behaviour, and body mass index (BMI) over time. An additional supplementary exploration into participants’ relationships with food, eating, and their bodies pre- and post-surgically is undertaken using open-text response format questions. Those who attended the Retreat were also asked to share their perspectives on how their participation in the intervention affected their psychological wellbeing. The main findings of the study showed that the ACT-based intervention demonstrated significant effects on several of the variables of interest, in particular, disordered eating and BMI. These effects were mediated by improvements in weight-related experiential avoidance, suggesting the importance of focussing on targeting experiential avoidance as a key mechanism of change in positive postoperative psychological and weight outcomes. The qualitative component of this study expanded on these findings, identifying several key themes present in the experiences of individuals both prior to, and following, weight-loss surgery. Additionally, qualitative responses provided further insight as to the psychological changes participants experienced. Taken together, these findings highlight firstly, the importance of addressing the psychological needs of weight-loss surgery individuals, and secondly, the value of ACT in augmenting surgical outcomes. The results presented here also offer suggestions for further development and future dissemination of such interventions for this population.
  • Thumbnail Image
    Item
    Te Ara Whakamana: Mana Enhancement framework in the mahi (work) of New Zealand psychologists' : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Manawatū, New Zealand
    (Massey University, 2020) Lovelock, Monika
    This study explores Te Ara Whakamana: Mana Enhancement framework, an emotional regulation and behavioural modification tool, which is centred in te ao Māori (the Māori world). This research looks at the experiences of the psychologists who use the model in various work contexts with both Māori and non-Māori clients. This was done by recounting the experiences of psychologists who participated in training for the model and are utilising the framework in practice with clients, have done so in the past, or are planning to do so in the future. Interviews allowed participants to explore how they are using the model, and what are its strengths and potential barriers. Further, this study aims at describing the key ideas that emerged while practitioners were engaging Te Ara Whakamana: Mana Enhancement. A qualitative approach was selected as the research method for this study, utilising eleven semi-structured interviews. The research findings indicate that psychologists value learning about Māori mental health models and are looking for frameworks that can enrich their cultural competence. Psychologists who are using the model found it to be helpful in their practise and those who were unable to use it expressed an interest in returning to the model or using it when their circumstance allow. Structural issues within organisations were identified as some of the possible barriers to the model.
  • Thumbnail Image
    Item
    Something's not right : exploring the lived experience of health anxiety : thesis submitted in partial completion of the requirements for the degree of Doctor of Clinical Psychology, Massey University, Albany, New Zealand
    (Massey University, 2020) Thompson, Victoria
    Changes in the diagnostic criteria for health anxiety calls for a closer investigation of the experiences of those who excessively worry about their health. This study uses a social constructionist perspective to qualitatively investigate the lived experience of people who identify as excessively worrying about their health. Experiences of nine participants were explored in semi-structured interviews. Through a thematic analysis, six key themes were identified: ‘relationships’, ‘invalidation’, ‘insight’, ‘better safe than sorry’, ‘vulnerability’ and ‘therapy.’ Overall, participants experience their health anxiety as debilitating, with challenges that included interactions with health professionals, a sense of responsibility for health and a feeling of vulnerability in relation to their bodies. However, previous research suggesting a lack of insight in health anxiety was called into question and the benefits of interacting with psychological therapies shared. Participants reflected a sense of invalidation within the medical sphere and a need for recognition, support and engagement with professionals that does not serve to further stigmatise this group.
  • Thumbnail Image
    Item
    Voices from the family violence landscape : gifts of experiences, understandings and insights from the heart of the sector : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Manawatū, New Zealand
    (Massey University, 2020) Everest, Adrienne Roslyn Joy
    Family violence continues with a ferocious tenacity to impact on the lives of many people. This study brings voices with insight and understanding, spanning decades of experience, that highlight how much work is still to be done to eliminate family violence from Aotearoa New Zealand. Yet it also testifies to exciting developments, tells stories of success, and envisions futures that not only involve surviving but also dare to reach for thriving. Interpretative Phenomenological Analysis was used to gather understandings from nine participants, who shared a common experience of facilitating stopping violence programmes as well as a diversity of other experiences regarding family violence, and five consultants with expert knowledge in areas related to family violence such as child advocacy, integrated practice and kaupapa Māori responses. A two-stage process took place where findings from stage one were shared with others in stage two for their feedback and elaboration. Qualitative interviews were conducted in both stages and analysed through an idiographic, iterative coding process focusing on meaning and interpretation to produce understandings of the research contributors’ experiences. This process resulted in six superordinate themes with associated subordinate themes. The first three superordinate themes elaborate understandings of the conditions of abuse, in environments of marginalisation; the particular experiences of children and young people living the experience, yet too often silenced despite the valuable lessons they can teach us; and the many barriers to seeking help faced by adults experiencing abuse in the eye of the storm. The fourth theme highlights the way in which people impacted by abuse are experiencing the disconnection of help, in the shadow of empire builders. This manifests in a response system that creates barriers to comprehensive support, excluding key people, agencies, or cultural contributions; silencing voices of experience, and consequently formulating disconnected, ineffective solutions. Yet contributors also recognise significant successes and how going for gold creates many effective strategies and innovations, achieved through the hard work of dedicated people. The final superordinate theme draws together learnings, articulating a process that opens up to hermeneutics of the heart in which it becomes possible to avoid hostile reactions, victim blaming and disconnection through discovering the rhythm of families and enabling responsive work at the heart of the matter.  
  • Thumbnail Image
    Item
    Women's experiences of medical miss-diagnosis : how does gender matter? : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Manawatū, Aotearoa New Zealand
    (Massey University, 2019) Thompson, Jessica
    Misdiagnosis is increasingly becoming a significant health risk. Women experience higher rates of misdiagnosed illnesses and health conditions compared to men. An androcentric, patriarchal medical system has historically under-researched female bodies and therefore has limited knowledge about recognising symptoms in women. This also extends to tests and treatments that have been developed on male bodies, making them inefficient and inappropriate for female bodies. Additionally, women have historically been positioned as ‘emotional’, ‘weak’, ‘hysterical’ and ‘hypochondrial’, meaning they are not taken seriously as legitimate patients and are considered unreliable symptom reporters. Collectively, the lack of knowledge, and negative prejudices against women, produce healthcare that ignores and silences them, and fails to diagnose and treat them appropriately. This thesis engages a qualitative feminist standpoint, using a narrative framework to explore women’s experiences of misdiagnosis and how they make sense of it. The research draws on semi-structured interviews conducted with eight women aged between 26 and 57 years old, who had experienced a misdiagnosis of an illness that is equally likely to affect women and men. A descriptive inductive analysis approach was used to look for similar experiences in the narratives to inform categories and themes. This research found that a misdiagnosis is highly distressing and often leads to disparate health outcomes. The women described doctors lacking knowledge to make a correct diagnosis, or knowledge to treat their conditions. They needed to advocate for themselves when symptoms continued or worsened. The women experienced rude and sceptic treatment, adding to the burden of being unwell. It is recommended that future research continue to privilege women’s voices in healthcare settings, and explore the misdiagnosis experience from the perspective of healthcare professionals to enable more transparent and collaborative healthcare for women.
  • Thumbnail Image
    Item
    The unmet needs of siblings of children with cancer and serious chronic health conditions in Aōtearoa/New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, Aōtearoa/New Zealand
    (Massey University, 2019) Armstrong, Kathleen
    There is evidence to suggest a subset of siblings of children with serious chronic health conditions have a range of unmet psychosocial needs which can lead to adjustment difficulties and mental health problems. A review of needs-based support services available to siblings in Aōtearoa/New Zealand found this is an under-serviced area. The current research aimed to identify the unmet needs of siblings of children with cancer and serious chronic health conditions and contribute to the development of targeted support services that protect and promote health and wellbeing in siblings. An online survey design was used to identify the unmet needs of siblings of children with cancer, cystic fibrosis, and Type 1 diabetes mellitus. The final sample included 204 respondents across the three health conditions (cancer: n=84, cystic fibrosis: n=47, diabetes: n=73). Quantitative results show the average percentage of unmet needs for the total sample was very high (57.8%). Of the three health conditions, cancer had the highest average percentage of unmet needs (66.3%), followed by cystic fibrosis (53.0%), then Type 1 diabetes mellitus (48.6%). Of the seven domains ‘Information about my sibling/whānau member’s health condition’ had the highest number of unmet needs. A significant difference was found between the total mean percentage scores between males and females (p=.001). A comparison of siblings in the ‘cancer’ health condition with an Australian study found the domains were strongly correlated but the New Zealand sample was systematically higher. The qualitative results showed siblings were affected negatively (and potentially long- term) from: a lack of information; feeling ‘invisible’ and forgotten; feeling guilty for being the ‘healthy’ sibling; suppression of needs; disruption to the family; a lack of peer and familial support; and additional care-giving roles. The impacts of these issues can lead to depression, anxiety, post-traumatic stress symptoms and affect beliefs around self-worth. Recommendations arising from these findings point to the need for effective support for siblings including: information about their sibling’s health condition; professional support offered to them; support and understanding from peers, family and teachers; time with parents to feel valued and included; guidance on how to support their affected sibling; a safe space where they feel validated and can speak freely; and ‘time out’ with other siblings.
  • Thumbnail Image
    Item
    Becoming (non)violent : accountability, subjectivity and ethical non-violence in response to intimate partner violence : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Manawatū, Aotearoa New Zealand
    (Massey University, 2019) Denne, Stephanie
    This thesis joins a movement of critical resistance and ethical activism problematising the increased institutionalisation of domestic violence interventions. A Eurocentric, capitalist, and neoliberal knowledge economy appears incapable of accounting for or accommodating the multiple, intersecting gendered social power relations and conditions of possibility that enable violence against women and children. Through a process of reflexive reading, I draw on the work of philosopher and feminist theorist Judith Butler, engaging with theories of accounting for oneself, subjectivation and ethical non-violence to analyse men and women’s narratives of (non)violence in the context of a men’s stopping violence programme. I interrogate the sociocultural regimes of intelligibility, subjectivity and morality that produce the accountability of gendered subjects of violence at sites of ethical exchange, and the consequences of such a production for those affected by, and responding to, domestic violence. Throughout the thesis, I question how systems of response and intervention reproduce power relations of domination and oppression through the production of fixed and inflexible identity categories of difference and dis-ease for targeted surveillance, regulation and discipline. Accounts of oneself are read critically as sites of embodied and embedded violence, where demands for narrative consistency and coherence enable the denial, minimisation and justification of men’s violence as a response to the risk of condemnation and subjective threat. I examine how patriarchal and colonising narratives tolerate, justify and encourage violence as a reiterative practice of hegemonic masculinity, where the embedded masculine subject self-regulates and disciplines their embodied subjectivity for authority and control within hierarchical gender binaries. I consider how feminine subjects are positioned as inferior to, or a ‘lack of’ the masculine ideal, enabling the dehumanisation, exclusion and silencing of women as objects and technologies for masculine privilege and domination. I conclude by advocating for ethical non-violence in domestic violence research and response, acknowledging our shared subordination and vulnerability to sociocultural regulatory regimes. I imagine how suspending the satisfaction of judgement and practices of patience can facilitate processes of articulation to exceed the constraints of violent subjectivities and engage in processes of ‘becoming’ within collaborative partnerships of resistance, transformation and non- violence.
  • Thumbnail Image
    Item
    Breaking bad news about cancer : the experiences of patients, patients' family/whānau members and healthcare professionals : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Wellington, New Zealand
    (Massey University, 2020) Matthews, Tamyra
    Breaking bad news is a reality of medical practice in oncology, and can be a challenging task for those receiving and delivering the news. For patients and their family members, ‘bad news’ is understandably accompanied by strong emotions and ongoing implications for their lives as they adjust to the news. For healthcare professionals (HCPs), there are numerous variables to consider and balance when having these difficult conversations, as well as managing the personal impact. The current study aims to explore the subjective experiences of patients, patients’ family/whānau members, and HCPs when bad news was delivered to patients about their cancer within the surgical departments of MidCentral District Health Board. The study is designed to allow multiple perspectives to be gathered and compared, and recommendations for practice to be made that align with the goals of those involved in the project’s inception, as well as attend to the underrepresentation of family members’ perspectives and New Zealand-based data in the literature. To achieve this, the current study utilised a qualitative approach with the epistemological and methodological basis informed by interpretative phenomenological analysis. The study also included a consumer perspective with the involvement of the Otaki advisory group to guide how the study was conducted and provide feedback on the study outcomes. Data was collected through semi-structured interviews with 10 patients, 6 family/whānau members, 5 surgeons, and 6 nurses. Interviews were analysed in two ways: by participant group (i.e., patients, family members, and HCPs) and by ‘linked case’ (i.e., direct comparisons of the perspectives of all those involved in the same patient’s case of breaking bad news). The findings are presented as a series of superordinate and subordinate themes. The group-based analysis highlighted that patients understood their bad news experiences through the lens of their health beliefs and expectations of care, the relational and support needs they, and others, had during and following the encounter, and the ongoing shifts in perspective and priorities they experienced. Family members identified the patient as the focus of care, but also acknowledged their need for support in order to cope. HCPs recognised that breaking bad news was challenging based on the variation between instances of breaking bad news and patients’ needs, organisational constraints they had to work under, and the personal toll this task could take. The linked case-based analysis demonstrated that the receivers of bad news have a range of emotional and informational needs and that HCPs and family members fulfil important roles in accurately meeting patients’ needs. Four conclusions can be drawn from the study as a whole about the process of breaking bad news. Firstly, there is variability in the situations, delivery approaches and needs of those involved in breaking bad news, requiring a flexible and tailored approach. Secondly, establishing an interpersonal connection between the deliverer and receiver of bad news is a central part of the process. Thirdly, breaking bad news is a challenge for all and receiving support in order to cope, is paramount. Lastly, there is a shared responsibility across healthcare organisations, training providers, HCP teams, and individual HCPs to make this process go as well as possible for all those involved. The current research makes an important contribution to understanding that, without doubt, breaking bad news is a complex process for those delivering and receiving the news, and improvements in this area require careful consideration, prioritising and resourcing as part of delivering effective cancer care.