How well does Anorexia Nervosa fit with personal values? An exploratory study.

BACKGROUND: Despite an increasing clinical interest in the use of personal values as a motivational tool in psychological therapies for Anorexia Nervosa (AN), research is limited. This study explored personal values among individuals with AN, with a particular focus on the 'fit' between participants' values and their AN. METHODS: A qualitative research design was employed in this study. In-depth, semi-structured interviews were carried out among eight female outpatients and inpatients with a diagnosis of AN or Eating Disorder Not Otherwise Specified - AN type (EDNOS-AN type). Data was analysed using Interpretative Phenomenological Analysis (IPA; Smith, Jarman & Osborne, 1999). RESULTS: Three super-ordinate themes emerged from analysis: 'Balancing Values' (difficulty finding balance in relating to and acting on values), 'Congruence and Clashes between AN and Values' (experiences of AN representing a mixed-fit with values) and 'From Ambivalence to Motivation' (ambivalence toward both AN and recovery - in the context of its mixed-fit with values - and experiences of values as a motivational tool in recovery). CONCLUSIONS: Study findings support a role for psychological therapies in working with personal values as a means of promoting recovery in AN, through supporting individuals to explore AN's workability in the context of their values. Further research investigating the optimal stage of treatment to work with values as a motivational tool is warranted

Effectiveness of Acceptance and Commitment Therapy as a Treatment for Posttraumatic Stress Disorder and Moral Injury

Posttraumatic stress disorder (PTSD) is a common condition among military personal and veterans. Despite strong empirical support for first line treatments for PTSD, many veterans do not complete or respond to treatment. Research suggests that experiential avoidance is a contributing factor to both treatment dropout and minimal treatment gains. Acceptance and commitment therapy (ACT) is an empirically supported cognitive behavioral intervention that aims to decrease experiential avoidance while increasing psychological flexibility. Research has shown ACT to be a promising intervention for the treatment of PTSD; however, its effectiveness in veterans with PTSD is limited. In conjunction with Utah State University (USU) and the Salt Lake City Veterans Affairs Medical Center, Ellen Bluett, a USU doctoral psychology student and staff psychologist at the VA conducted a study to examine a next-step treatment for veterans with PTSD. The main purpose of this study was to examine the effectiveness of an 8- week closed group design ACT intervention for veterans with PTSD and subclinical PTSD who had previously completed a first line intervention for PTSD. Thirty-three veterans enrolled in the intervention, which focused on vitality (e.g., increasing valued living and decreasing experiential avoidance) rather than symptom reduction. Symptom and process of change measures including PTSD symptoms, valued living, and quality of life were measured at pretreatment, posttreatment, and again at 1-month follow-up. Findings from this study showed that 64.7% of veterans showed a favorable response to treatment as measured by a 5-point change in PTSD symptoms. Additionally, outcomes of interest including PTSD symptoms, valued living, depression, wellbeing, and moral injury by transgressions improved from pretreatment to posttreatment. Of note, a majority of treatment gains were not maintained at follow-up. Overall, results provide preliminary support for ACT as a second-line intervention for veteran PTSD

Psychology and the research enterprise: Moving beyond the enduring hegemony of positivism

Almost since its inception, psychology has embraced the positivist orientation of the natural sciences. The research enterprise in psychology has reinforced this through its insistence that psychological science is objective, generalisable, and value free (or neutral). Consequently, experimental designs are privileged over other forms of enquiry and alternate epistemologies, methodologies, and methods remain marginalised within the discipline. We argue that alternate methodologies, and the philosophies that underpin the research endeavour, should be included in mainstream psychology programmes so that the existing imbalance is rectified. Achieving this balance will mean that psychology will be better positioned to address applied research problems and students will graduate with the skills and knowledge that they will need in the multidisciplinary workforce they will enter. We discuss recommendations for how psychology in Australia can move towards embracing methodological and epistemological pluralism. Breen, L. & Darlaston-Jones, D. (2008). Psychology and the research enterprise: Moving beyond the enduring hegemony of positivism. Australian Journal of Psychology, 60 (S1), 107-208. doi:10.1080/0004953080238555

A new direction for public understanding of science: toward a participant-centered model of science engagement.

Engaging the public with science is not an easy task. When presented, scientific findings, public health recommendations, and other scientific information filter through the personal values, beliefs, and biases of members of the public. Science communicators must contend with these differences in order to be effective in cultivating a public understanding of science. Given the importance of scientific understanding for living well in a complex world, increasing science understanding through science engagement is imperative. The field of public engagement with science is dichotomized by a public information deficit approach and a contextualist approach. The deficit approach prizes the factual content of science, its epistemic authority, and its communication to the public while the contextualist approach recognizes the sociocultural embeddedness of science in society, how science is received by publics, and how local knowledges intersect with science. I contend both approaches are incomplete, and I put forth a synthesis. My approach, the participant-centered model of science engagement, incorporates the factual content of science and its epistemic authority, but in a way that is sensitive to context. I argue for a deliberative democratic approach to public engagement with science and articulate a model inspired by learner-centered approaches to teaching in the formal education literature. I outline and assess six participant-centered strategies along with recommendations for particular practices associated with each

The Science of Meditation: From Mysticism to Mainstream Western Psychology

Psychological applications of meditative practice have become the ‘third-wave’ tools in the psychology clinician’s therapeutic tool kit. Meditation techniques for numerous psychological disorders, as well as the psychological impacts of chronic medical conditions, are being used by a growing number of mainstream clinicians in Western healthcare contexts, which were previously the domain of alternative practitioners, and formerly the sometimes secretive and mysterious domain of the orthodox and esoteric spiritual traditions. Many questions arise regarding how this conversion has taken place and why. This thesis explores some of the issues surrounding the adoption, reduction, and application of meditation practices from the Eastern and Western origins and transmission to mainstream Western healthcare contexts. By tracing the history of the rise in popularity of meditation in the mainstream Western health sciences, particularly within the mental health sector over the past century or so, it is intended to contribute to an answer to, in part, the question of ‘why’ and, in part, the question of ‘how’. A further question of whether sufficient cognizance has been taken of the subjective experiences and understandings of long-term meditation practitioners and what they can contribute to Western psychological understanding of meditation—its application potentials and pitfalls—is explored. Why is this important? At present, being intelligent, and highly trained, as most clinicians have come to believe they are, it has become somewhat taken for granted that reading journal articles or books on meditation, and attending a workshop or two, perhaps even a week-long residential training retreat, qualifies one to begin using meditation processes with clients. However, is clinician training and competency in the use of meditation currently sufficient to ensure its safe and appropriate use, particularly for psychologically impaired clients, given the phenomena reported by long-term meditators and the judicious preparatory processes required by teachers in the wisdom traditions of origin? Using qualitative methodology and a social constructionist viewing lens, I elucidate whether Western psychology’s reductive approach may create barriers to the growth of a knowledge-field of the potential of meditation for personal and collective development and wellbeing—which has existed since antiquity, but which current psychological interest indicates is by no means antiquated. Twenty three semi-guided indepth interviews were conducted with 18 long-term meditators from diverse backgrounds and nationalities, to explore their subjective experiences—the phenomena they encountered and the meanings they ascribed to their meditation practices. What became apparent through the course of this research was the divergence that exists between the positivist Western scientific literature on meditation and the experiences and understandings of this sample of meditators. The implications that arise from a paradigm clash between the fundamental premises of a positivist approach to a Western science of meditation for the healthcare sector and those of the wisdom traditions of origin are discussed. Finally, potential paths of resolution to enable contributions to the development of a knowledge-field of meditation for Western healthcare contexts from the understandings and technologies of both ways of knowing are mooted

Electroencephalographic Asymmetry, Emotion Regulation, and Their Relationships with Depression Risk

Background: Research investigating patterns of electroencephalographic (EEG) brain asymmetry aids our understanding of neural systems involved in the processing of emotion, motivation, and psychopathology. Withdrawal-motivated negative emotions characteristic of depression are associated with relative right prefrontal cortex (PFC) activity, whereas approach- motivated positive emotions are associated with relative left PFC activity. Styles of emotion regulation (ER), or modulation of the intensity and duration of emotional responses, are also associated with presence (e.g., suppression, or maladaptive ER) versus absence (e.g., cognitive reappraisal, or adaptive ER) of depression vulnerability. Most PFC asymmetry studies of emotion, depression, and/or ER rely upon EEG recorded during uncontrolled resting states that appear to be less reliable than EEG recorded during cognitive or emotional challenge tasks. To this end, the present study examines whether current depression symptoms and ER styles moderate PFC asymmetry when individuals attempt to recover from an emotional challenge and whether future depression symptoms will be predicted by PFC asymmetry and/or ER styles. Methods: EEG asymmetry was recorded before, during and after 38 young adults experienced a state emotion manipulation induced via film clip (happy: n=16; sad: n=22). Self-reported depression symptoms and ER were collected in the same session as EEG asymmetry as well as a follow-up session one year later. Hypotheses: It was predicted that participants in the sad film clip condition would demonstrate greater relative right film-clip PFC asymmetry than participants in the happy film clip condition, consistent with prior state emotion manipulations. With regard to within-subjects changes over time, it was predicted that trait sadness (depression) and use of ER strategies would be associated with PFC asymmetry during and after the film clip mood induction. For the longitudinal component, it was hypothesized that relative right PFC asymmetry and use of ER strategies would be associated with future depressive symptoms, one year after EEG recording. Results: Although happy and sad groups did not differ in PFC asymmetry pre-, during- or post- clip, moderation analyses revealed that individuals with lower depression symptoms or greater use of adaptive ER strategies paired with greater leftward PFC asymmetry during the film clip resulted in greatest relative left PFC asymmetry post-clip. However, PFC asymmetry and ER styles were not associated with the onset of depressive symptoms at follow-up. Conclusions: Approach-related brain activity paired with adaptive ER and lower depressive symptoms promote approach-related recovery from brief emotional states and could index a marker for resilience to stress

The effectiveness of an ACT based intervention in the management of disordered eating

Disordered eating is a term that refers to patterns of thoughts and behaviour that are maladaptive, and often centred around food, weight, and eating. For individuals who engage in disordered eating, the risk of progression to a clinically significant disorder is high, and once the diagnostic threshold is crossed, time becomes an increasingly important factor. This research endeavours to evaluate the efficacy of an intervention which is widely accessible and low cost, which may be used to address increasingly high rates of diagnosis and demand for services. The efficacy of Acceptance and Commitment Therapy (ACT) in treating a broad range of disorders has been well-established in empirical literature. The present study utilised a non-concurrent multiple baseline design to evaluate the efficacy of a self-help ACT workbook intervention in managing non-clinical disordered eating. Follow up data was collected six weeks after completion of the intervention. Participants were also asked to complete pre and post-intervention measures of acceptance, valued living, disordered eating pathology, and a general screen of psychopathology. The book, ‘Get Out of Your Mind and Into Your Life’, by Steven Hayes, was used for the purposes of this study in a community sample. The content of the book is based on ACT and contains information and exercises based around the six core principles of ACT. Seventeen participants who were concerned about their eating were recruited for this research via poster advertisements placed around a university campus and the wider city. 11.8% (n=2) of the participants were male and 88.2% (n=15) were female. Following a two-week baseline, participants worked through select chapters in the book over the course of six weeks. All participants were contacted via telephone to collect weekly measures of suffering, struggle, workability, and valued action, which are key components of ACT. Participants were also asked to rate the extent to which the week’s reading had aided them in managing disordered eating behaviour. After completing the intervention, acceptance and quality of life ratings showed improvements at a trend level, and disordered eating pathology significantly decreased. All of these improvements were maintained at follow up. There were no significant changes in general measures of pathology, (i.e. depression and anxiety), although non-significant trends were observed, which indicated improvement. Although the small n nature of this research means that findings should be interpreted with caution, the results of this research support the hypothesis that self-help interventions can be useful for mitigating subclinical disordered eating pathology, and suggest that further research is warranted into the development of ACT-based interventions for subclinical disordered eating which are widely available and accessible to all

Act now: you have control over workplace bullying

This thesis research aims to identify and test the efficacy of a self-administered intervention that victims of workplace bullying can use to help themselves if they have fallen into a state of psychological inflexibility. Some such individuals will resort to using an active or passive approach to confront a bully. While these approaches can be useful to temporarily alleviate the negative experiences arising from workplace bullying, they do not help to address the negative thoughts and emotions, such as self-blame and shame, that can manifest themselves because of bullying. Individuals dwelling in their negative experiences are essentially allowing themselves to get stuck in their thinking, which can eventually lead to depression and stress. There is currently no self-administered intervention that deals with this. Acceptance and Commitment Therapy (ACT) was chosen to be examined as a possible solution for this problem in this thesis research. ACT has been found to be useful in helping individuals who suffer from depression, stress and anxiety disorders, all of which are symptoms suffered by victims of workplace bullying. In the ACT model, there are six inter-related processes (acceptance, defusion, being present, self-as-context, committed action and values) and the culmination of all these processes helps individuals to become psychologically flexible. Three studies were conducted in this thesis research and the participants were from Asia, specifically from Hong Kong, Singapore and Malaysia. Study 1 involved a total of 50 participants using a questionnaire, sent using Qualtrics, an online software. It was conducted to identify whether those who have been exposed to workplace bullying are indeed low in psychological flexibility. This was found to be the case in this research. In Study 2, ten participants from those who had participated in the questionnaire were identified to have been bullied and to have scored low in their psychological flexibility score. The ten participants were randomly allocated into either an intervention group or a control group. Those who were in the intervention group received three sessions of skills training, and, apart from two participants, the remaining participants were found to have shown some change in their psychological flexibility. Using a qualitative approach in Study 3, thematic analysis was conducted and revealed that the participants did show a change in their mindset and were able to apply what they had learned to attain psychological flexibility. This thesis research reveals preliminary evidence of the efficacy of ACT for individuals who have been exposed to workplace bullying. This thesis should pave the way for further research in the area of workplace bullying, to explore and focus on intervention that bullied targets can use to help themselves to navigate through the residual psychological thoughts and emotions they carry as a result of their bullying experiences

Mindful Resilience: Investigating Mindfulness and Resilience in Relation to a Broad Range of Adversity

This dissertation research sought to establish a complex understanding of the relationships between adversity severity, resiliency, mindfulness (and its mediating mechanism components: reperceiving, values clarification, exposure, cognitive-emotional-behvioural flexibility, and self-regulation). Through one cross-sectional (N = 914) and one repeated-measures study (Time 1 N = 1891; Time 2 N = 990) these relationships are investigated using online questionnaire batteries and assessed via multiple regression analysis. Initial findings demonstrated an effective, reliable, and valid assessment of adversity severity was developed and that this variable contributes to the experience of adversity and the resiliency process. Additional findings indicated the majority of the proposed relationships were found to reach levels indicating statistical significance. Evidence provided preliminary support for an integrated model of mindful-resilience that seems to describe phenomena that generalized beyond work-related adversity to a broad range of experienced adversity. Given the results obtained through the completion of this study it is argued that the parameters limiting the King and Rothstein model of resiliency be removed and that a new inclusive framework be adopted for applications requiring a comprehensive and more detailed understanding of mindful-resilient phenomena promoting health and wellness in the face of adversity. The impact of these findings with regards to individual and organizational wellness, post-traumatic growth theory, resiliency theory, and future research are discussed