Psychology & Sociology
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Item Lay and professional constructions of childhood ADHD (Attention Deficit Hyperactivity Disorder): a discourse analysis.(Queen Margaret University, 2008) Gray, Carol A.Childhood ADHD is a contested yet rising public health phenomenon, due to greateruse of inclusive American diagnostic classification. In the UK ADHD is considered to be 'incompletely medicalised' with rising incidences predicted. A critical approach was adopted in this thesis, based on a number of social constructionist assumptions in order to examine the emergence and increased use of the construct and to contribute to broader critical debate in the field. Parents and teachers are key adults in childhood ADHD as they may identify and care for diagnosed children yet they have been relatively neglected in the literature. How such adults account for children's difficulties was the focus of an empirical analysis. A 'critical discursive psychology' approach was adopted using Edley's (2001) framework in order to examine culturally available talk by parents and teachers about ADHD, from semistructured interviews in Scotland. Analysis highlighted how parents deployed contradictory interpretive repertoires in talk using a Biological repertoire as a genetic explanation and an Environmental repertoire in relation to various parenting issues. Such talk was organised to attend to the ideological dilemma of parental moral adequacy and accountability and which sought to accomplish the 'good parent'. Further analysis considered how parents accounted for competing versions of the difficulties and their positioning in relation to controversial medication talk. Teacher accounts of children's difficulties deployed an ADHD repertoire as a medical condition and a Not ADHD repertoire as due to temporal difficulties. Through the 'cases I know' device, teachers managed their own experiential knowledge and thereby negotiated agency and control for childhood behaviours. Analysis considered accounts of (mis)diagnosis and (mis)treatment as alternative explanations for ADHD. This innovative focus on how health policy for children's difficulties as ADHD were socially produced by lay parent and teachers accounts, highlighted the limitations for agency in ADHD diagnoses and implicated further critical debate about this topic. Parental talk which drew on current biopsychosocial models for ADHD was largely reductionistic and fragmentary. The reliance on discursive efforts about the 'good parent' identity meant that this was a temporal accomplishment in talk rather than achieved by a diagnosis. Analysis of teacher accounts originating from a Scottish context highlighted how they differed from a North American context and provided greater understanding of how teachers succeeded in offering robust alternative explanations to ADHD. The implications for health and education policy of ADHD efforts aimed at the 'education' of teachers may be limited in the face of the teacher talk. Finally, within methodological debate in discourse analysis, this work contributes to further arguments for an eclectic discourse analysis as applied to the field of ADHD.Item An interactive classroom timetable for children with high functioning autism : development and qualitative evaluation of a computer-based timetable(Queen Margaret University, 2007) Murray, SusanTeachers report that advanced knowledge of the day's activities can considerably lessen anxiety for children with autism, especially if this information is highly visual in its presentation. Teaching children with autism often follows a highly structured approach including use of visual planning aids, such as symbolic timetables (Gillberg & Coleman, 2000; Mesibov, Browder, & Kirkland, 2002). Children with autism have been noted to be skilled at using computers and it has been suggested that the computer presents an ideal resource for both educational and recreational use (Attwood, 1998; Higgins & Boone, 1996; D. Moore, 1998; Murray, 1997). However, in spite of widespread use of visual timetables in schools by children with autism, there is little evidence of research being conducted in the area of computerised timetabling for this population. The overall aim of this particular study was to develop an interactive, computer-based timetable and to explore and assess the practical value for children with autism. The research was of an ethnographic nature and involved a case study approach. The development of the interactive timetable followed a user-centred design. Participating children attended a language and communication class attached to a mainstream primary school in Scotland. Seven males aged between six and nine years of age were involved, with four of the children able to participate in the final evaluations of the interactive timetable. Other participants included special needs teachers, nursery nurses, speech and language therapists, and parents of participating children. Examination of a symbolic timetable identified several important issues relevant to the design of an interactive timetable, whilst consideration of parental and educationalist views, gathered through interview, highlighted both benefits and concerns. By extending use to the home environment, the interactive timetable was considered to facilitate communication between child and parent. Concerns regarding access, size and position, user ability, and availability of resources were identified. Although findings were inconclusive, it was possible to communicate timetable information in a computer-based form and furthermore, the children appeared to enjoy using the timetable. Whilst the setting for this study was a single language and communication class attached to a mainstream primary school, this research has implications for a wider debate. The study found generally that the prospect of using information and communication technology to display an interactive timetable which was accessible both at school and at home, offered numerous possibilities for children with autism and their families.Item Models of health enhancing and illness provoking factors in mental health.(Queen Margaret University, 2005) Hipwell, MicheleThe aim of this study is to increase understanding about the causes of dysphoria, depression and anxiety by identifying the psychological factors that predict the development or protect the individual from developing mental health problems. A quantitative study, it is conducted over a period of a year and utilises a 3 wave observational longitudinal cohort design to investigate the relationship between the psychological variables and processes leading to mental health or ill health in a community group of female undergraduate students (N=183). Data is collected at 6 montly intervals for a period of a year from 183 female students. The participants are first year undergraduate students at a college of higher education. Characteristics from the students are collected using a battery of paper and pencil self report questionnaires in a group administration for the first wave of data and two postal questionnaires for follow up. Conceptual models are developed and tested statistically using structural equation modelling to explore the relationship between the elements identified for each model retrospectively and prospectively over a period of 12 months. Longitudinal and cross-sectional analyses are conducted for anxiety and depression separately. The elements of the models include positive and negative life events and protective and vulnerability factors for depression and dysphoria. Results from the cross-sectional and logitudinal analysis demonstrate that psychological factors have a significant effect on the development of depression and anxiety, with illness provoking factors explaining between 33-55% of the variance of depression in longitudinal analyses and 59-42% of the variance in cross-sectional analyses. They explain 45-57% of the variance in anxiety in longitudinal analyses and 28-50% in cross-sectional analyses. Health enhancing factors explain 18-19% of the variance in deprssion in longitudinal analyses and 47-49% of the variance in cross-sectional analyses. They explain 15-20% of the variance in anxiety in longitudinal analyses and 12-=20% of the variance in cross-sectional analyses. Health enhancing and illness provoking characteristics for depression and anxiety are identified in this study. They include enduring personality characteristics, cognitive styles and coping strategies and act as predictors for mental health outcomes or mediate or moderate the relationship between predictors and mental health outcomes.Item Understanding Anorexia Nervosa: an online phenomenological approach(Queen Margaret University, 2009) Williams, SarahAnorexia has often been theorised as a way of obtaining a sense of control and a sense of identity. Previous research has identified the positive functions anorexia plays for those who experience it. Healthcare professionals perceive anorexia as something to be treated whilst those experiencing it are often ambivalent and see it as something to maintain. Those who feel misunderstood in their offline environment can turn to the physically anonymous environment of the internet to discuss their experiences and opinions. The aims of the research were (1) to determine the understandings of anorexia, recovery and treatment through participants' lived experiences, and (2) to identify how participants' understandings affected pathways to and through treatment. An online phenomenological approach was used to explore the experiences of those recruited through online resources for anorexia. Data was collected using online focus groups and e-mail interviews and was analysed using Interpretative Phenomenological Analysis. Results indicated a strong theme of maintenance of anorexia due to its egosyntonic and functional role. Anorexia was initially perceived as a solution to problems or crises but over time it became problematic. Nonetheless, strong psychosocial mechanisms such as feelings of ambivalence, an 'anorexic voice' and a sense of feeling addicted to anorexia affected its maintenance. Recovery required the acceptance of anorexia as a problem. Recovery was interpreted as a sense of living rather than existing and required four main factors: self-acceptance, acceptance of and from others, the development of alternative, healthy behaviours and the ability to manage residual anorexic cognitions. Implications for treatment are discussed. Online communication is considered a safe environment due to its physical anonymity, allowing people to feel more comfortable disclosing views and experiences that may be stigmatised or uncomfortable to discuss in an offline situation. Future research should utilise the internet in conducting studies with people with body image issues.Item Self help and the early management of acute, non-specific low back pain(Queen Margaret University, 2008) Robertson, Ann R R.This research investigated whether there might be benefit from encouraging early self management in an episode of non-specific low back – a common and costly condition in the U.K. It aimed to address a lack of research evidence on interventions to improve current, Step 1 of primary care management for back pain. A self help, audio programme, to give information and reassurance about non-specific back pain and skills training in some components of cognitive behavioural pain management, could be used independently at home. Self help could widen access to early, cognitive behavioural based treatment, might offer an inexpensive and practicable means of intervention delivery in busy GP practices and would accord with government policy of encouraging increased self management by NHS patients. Pilot evaluation: The face validity of two, self help, audio CD programmes for use at home, “Using Relaxation Skills” and “Using Thinking Skills”, was assessed by six primary care patients with nonspecific, acute low back pain. Participants in the pilot evaluation expressed some satisfaction with both self help programmes and found them helpful. The audio CD with a focus on progressive muscular relaxation, “Using Relaxation Skills”, was more popular. Pragmatic randomised controlled trial of self help CD effectiveness: The primary objective was to demonstrate whether using a three week, self help programme at home showed benefits with respect to back pain specific functioning as measured by the Roland and Morris Disability Questionnaire (RDQ). Forty four members of the public with a current episode of back pain lasting between two and nine weeks were randomised to a CD intervention arm or a control arm. Back pain specific functioning, self reported pain intensity and general health and well being in physical and mental domains were assessed at baseline and at one and six months' follow up. Data analysis conducted using a mixed between-within subjects analysis of variance demonstrated significant improvement across all measures over time for all participants. Compared to controls, those using a self help, audio CD showed significantly improved scores on the RDQ at six months [F =6.673, p=.013], although the magnitude of the mean group difference was small (partial eta squared=.137). It is concluded that a three week, home based self help programme delivered by audio CD can improve functional outcomes in the short to medium term in early, non-specific low back pain. Interpretative Phenomenological Analysis (IPA) of self help for back pain: The study aimed to explore possible reasons for the slow uptake by the public of a free, self help CD for early back pain. Nine people with non-specific low back pain were interviewed by email to explore their experiences of using self help for managing pain. An IPA analysis revealed four, major themes: taking control, social comparisons, ongoing learning and “with hindsight”. The findings suggest that turning to self help for back pain may be a developmental process over time, related to the variable course of back pain symptoms. Interviewees wished with hindsight they had been directed towards self management in the initial stages of back pain. At the time of first consulting a GP, they had hoped for a medical “cure”. The findings indicated that slow recruitment into a self help intervention for early low back pain may reflect a lack of perceived need for any intervention in the initial phase of the condition, with implications for the likely uptake of an early, self help intervention.