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    Vaccination in Aotearoa : the role of anticipated regret, temporal discounting and maternal mental health : a thesis presented in partial fulfilment of the requirements for the qualification of Doctor of Clinical Psychology at Massey University, Wellington, New Zealand
    (Massey University, 2023) Kember, Sarah
    Background. Uptake of childhood vaccines in Aotearoa remains consistently lower than necessary for population immunity. Understanding drivers for vaccine hesitancy is a complex but essential exercise. New and expectant mothers are generally primary decision-makers about vaccination for their babies, yet the crucial timeframe for those decisions coincides with the highest risk period for perinatal anxiety and depression. Study aims. This study was designed to test the hypothesis that anxiety and depression in pregnancy and postnatally have an effect on vaccination rates, given research support for a link between psychological distress and decision-making challenges. Decision theory guided the study, specifically temporal discounting, and anticipated regret. Participants’ own perspectives about key influences on their decisions were also explored. Methods. The study was a cross-sectional survey of new and expectant New Zealand mothers, recruited via social media – N = 387 (quantitative); N = 411 (content analysis). Survey items included existing measures (EPDS, GAD-7, MCQ) alongside purpose-built items and open-ended questions. Possible confounds, ethnicity and socio-economic status, were identified from a literature search and statistically controlled. Results. Anticipated action regret (action and inaction) was strongly and significantly correlated with vaccination intention. However, the hypothesised relationships between temporal discounting and either perinatal depression or anxiety were not observed. Further, neither anticipated regret nor temporal discounting had the expected effects on vaccination intentions. The observed depression/intention relationship was negligible, and anxiety was moderately, statistically significantly, and (contrary to prediction) positively correlated with intention. The sixth hypothesis (partial mediation of the distress-intention relationship by temporal discounting and anticipated regret) was also unsupported. Content analysis of open-ended questions suggested six main categories of influence on vaccination intentions - beliefs (safety/risk, effectiveness); knowledge/experience; health protection; formal sources (health officials/professionals); social (whānau/family, others); and pragmatic. Latent themes - fear and confidence, underpinned each category. Most participants reported no change, unless a strengthening of their position, due to the COVID-19 pandemic. Conclusions. Overall, there was evidence of a strong relationship between anticipated regret and vaccination intentions. However, perinatal depression did not have an observable effect on intentions, and – contrary to predictions - perinatal anxiety increased, rather than decreased, intention to vaccinate. Although the hypotheses were not supported here, the findings nevertheless suggest that intention is impacted by predicted regret about the consequences of that decision. Furthermore, a role for anxiety or regret in vaccination decision-making was supported by analysis of participants’ self-reported key influences on their decision-making. In this sample, limited variance in levels of elevated levels of either depression or anxiety (most experiencing no to low symptoms) or vaccination intentions (most being pro-vaccination), potentially affected the results obtained. Further investigation of the role of emotion and perinatal distress relationship is justified.
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    Investigating decision-regret and distress among psychologists impacted by client suicide : a thesis submitted in partial fulfilment of the requirement for the degree of Doctor of Clinical Psychology at Massey University, Auckland, New Zealand
    (Massey University, 2022) Marshall-Edwards, Shoni
    Background: Mental health professionals are tasked with making critical decisions about their client’s care. It is thus unsurprising that client suicide has been described as a distressing experience among professionals. Significant emotional, cognitive, and professional impacts have been reported which include psychological distress, shock, self-blame, guilt, and absenteeism. Due to the variability of impacts reported across the literature, a novel theoretical approach to understanding the impact of client suicide on psychologists was implemented using two decision-regret theories. Methods: A quantitative cross-sectional survey design was used to measure the impact of client suicide on psychologists. By using structural equation modelling, the following factors were investigated: regret, distress, self-blame, supervisory support, and beliefs about suicide preventability. Additionally, two regret theories were tested which included the following variables as predictors on regret: decision-regret, decision justification, decision-process quality, and intention-behaviour consistency. Control models were tested to control for carefully selected confounding variables, and a supplementary qualitative analysis was included investigating the factors related to coping following client suicide. A sample of 248 psychologists from New Zealand, Australia, Canada, United Kingdom, and the United States of America was included in this study. Results: The results identified statistically significant relationships between the following predictor variables on regret: decision-justification, decision-process quality, and beliefs about suicide preventability. Additionally, a significant moderate positive relationship was evidenced between regret (as the predictor) and distress. The qualitative analysis indicated that high-quality supervisory support and understanding the predictive limitations in assessing suicide risk were important factors in coping with client suicide. Additionally, factors identified that were related to poor coping included judgement, counter-factual thinking and blame, and confidentiality limitations preventing seeking support from loved ones. Conclusions: The present study demonstrates support for two factors which appear to influence regret levels: decision-justification and decision-process quality. Additionally, this study also evidenced regret as a significant moderate predictor of distress, highlighting the role that regret may play in influencing a range of affective states among psychologists following client suicide. The findings of the present study highlight the need for the development of robust support structures that acknowledge the impact of client suicide.
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    Regrets? I've had a few, but then again-- : towards a psychology of regret : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology at Massey University
    (Massey University, 2003) Bloore, David John
    The aim of the present study was to investigate the experience of regret and how regret affects people's lives. A convenience sample of 101 adult volunteers (mean age 32.5) completed a questionnaire, which measured the content of regret, the emotional profiles of action and inaction regret, the temporal pattern of regret and the relationship between regret and life satisfaction. Results showed that personal responsibility was an important aspect of most regret experiences. Contrary to the hypothesis and previous research, there was no difference in the number of action and inaction regrets reported by the participants. Previous research claims regrets of inaction are more frequent and more significant than regrets of action. As predicted, action regrets were experienced more recently than inaction regrets, thus providing indirect evidence for the 'temporal pattern' theory of regret. However, other results indicated that action and inaction regrets have different emotional profiles and that characteristic differences may cause this 'temporal pattern'. It is recommended that a longitudinal study be conducted in this area of regret research. The main content areas of the participants' regrets were for intimate relationships, family, education and health/self-care, as found in previous research. Some content differences were found for action/inaction and gender; there were no age differences however. Consistent with the hypotheses, the number of regrets, the intensity of regrets, the frequency of regret thought and the impact of regret were all negatively correlated with life-satisfaction. Participants whose regrets had a positive impact were also more satisfied with their lives. Thus, the present research suggests that regret can have a constructive function. Based on these findings, a number of suggestions are outlined to help minimise the negative effects of regret. These include, accepting one's past mistakes, using past regrets as learning experiences and minimising the amount of time spent thinking about regret.
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    Consolidating mistakes of the heart and mind : toward a dual process theory of regret : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Palmerston North, New Zealand
    (Massey University, 2009) Towers, Andrew James
    There are many idiosyncrasies in the emotion of regret that we do not fully comprehend and our traditional reliance on economic theories of human decision-making, which view regret as stemming from illogical and explicit decision-making processes, may be the cause. This thesis explores the development and testing of the Dual Process Theory of Regret (DPTR) which claims that individuals use both implicit ‘orientation’ and explicit ‘justification’ systems of thought to guide their daily decision-making and the differential use of these systems should be reflected in the intensity of regret felt for a poor outcome. To assess its utility in predicting variation in regret intensity the DPTR was tested in conjunction with two popular theories of regret; one focussing on the distinction between actions and inaction, and the other focussing on decision justification. Three thousand adults were randomly selected from the New Zealand electoral roll and invited to participate in a postal survey of short and long-term life regrets. Of this initial sample 653 participants returned questionnaires with usable data, a response rate of approximately 23% which, while a relatively low response rate, was expected given the sensitive topic and provided more than enough respondents for the present analysis. Results showed that the DPTR had greater utility in predicting trends in short and long-term regret intensity than either of the current regret theories. Results also illustrated that changes in justification strength had little effect on regret intensity and that explicit justifications only influenced regret in the long-term. In contrast results supported the conceptualisation of the implicit orientation and showed that it was a key source of influence on regret intensity in both the short and long-term. This research concludes that the DPTR’s focus on both implicit and explicit cognitive systems provides greater insight into the nature of regret than the reliance on explicit cognitive analysis alone. Implicit feelings of right and wrong are a better indicator of eventual regret than our ability to justify our decision. These results help resolve past anomalies in regret research, clarify conflicting trends in regret highlighted in the current media, and have application for understanding criminal recidivism.