Phenomenological Examination of Depression in Female Collegiate Athletes

Collegiate athletes may be at an increased risk of depression due to the pressure and stress they face. This risk is of great concern because their health, safety, and sport performance may all be affected. In addition, collegiate athletes are more likely to turn to maladaptive coping behaviors and less likely to seek help for mental health struggles than other populations. It has been suggested that a greater understanding of personal experiences would be helpful in increasing awareness and improving treatment. Therefore, the purpose of the current study was to explore the lived experience of depression in female collegiate athletes. In-depth, unstructured interviews were conducted with 10 current and former female collegiate athletes. The interviews were recorded, transcribed, and analyzed using phenomenological research methods. Thematic analysis revealed one ground (the role of sport) and four general categories (weariness, self-doubt, out of control, and nowhere to go). Direct quotes from participants are used to illustrate these categories, and connections to relevant research are made when appropriate. Practical implications and recommendations are made for athletes, coaches, and families. Suggestions are given for future research studies. It is hoped that results from this study will contribute to increased awareness and sensitivity to the experiences of depression among female college athletes

Playing Out: Women Instrumentalists and Women's Ensembles in Contemporary Tunisia.

This dissertation focuses on the performances and lived experiences of conservatory-educated women instrumentalists in Tunis, Tunisia. Throughout the Arab-Muslim world, women musicians have been appreciated as vocalists but rarely as instrumentalists, and it has often been considered disreputable for women to play instruments in public. Tunisia, however, is unique due to government reforms passed since independence (1956) concerning women’s rights and the national music heritage. In recent decades greater numbers of women in Tunis have been “playing out” as instrumentalists for mixed-gender audiences, particularly as they have created their own women’s ensembles and received advanced degrees in music. During the past six years the number of ensembles playing at gender-segregated wedding celebrations has also increased. Drawing upon ethnographic fieldwork conducted in Tunis between 2007 and 2009, I argue that women instrumentalists have transformed the Tunisian music scene and Tunisian society. By playing out in public they have expanded the parameters of women’s performance and of gender roles in the public and private spheres. Yet they face multiple criticisms about their work. Their performances hold complex meanings concerning Tunisian national identity, and they are frequently subject to state control and mediation. These women instrumentalists demonstrate, however, that musicians have the power to play out, play with, and reconstruct concepts of national identity and gender identity in performance. In addition, their work illustrates how gender affects music performance, and how women have the potential to transform Tunisian and Arab music genres that have previously been dominated by men. Through their performances and their perspectives on playing Tunisian music, women musicians are reshaping and expanding Tunisian musical identity—especially when they create music in women-only spaces. Although such gender-segregated spaces are criticized as backwards, musicians’ performances at women-only parties offer new possibilities for expanding women’s empowerment. Above all, by forming their own spaces for women’s performance, women instrumentalists have enacted change themselves, thereby challenging stereotypes of Tunisian women as passive recipients of state reforms.Ph.D.Music: MusicologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/78752/1/aejones_1.pd

Internalised stigma in mental health:an investigation of the role of attachment style

This thesis examines the role of adult attachment style on the internalisation of stigma amongst adults affected by mental health problems in the United Kingdom. A systematic review, completed for this thesis, on the role of social and relational factors in internalised stigma found strongest evidence for a negative association between social support and internalised stigma. Just one eligible study considered the role of attachment style. In the empirical study, a transdiagnostic sample with experience of recent secondary mental health service use (n = 122) completed an online cross-sectional survey with measures of internalised and perceived public stigma, adult attachment style, self-esteem, mood and functioning. Correlation analysis tested whether internalised stigma and perceived public stigma were significantly positively correlated (hypothesis one). Hierarchical multiple regression tested whether anxious and avoidant attachment styles were positively associated with a significant amount of variance in internalised stigma when controlling for other variables (hypotheses two and three). Regression-based moderation analysis tested whether the relationship between perceived public stigma and internalised stigma was moderated by anxious and avoidant attachment styles (hypotheses four and five). Results indicated that internalised stigma, perceived public stigma and insecure attachment were common in this sample. Internalised stigma was positively associated with perceived public stigma but neither anxious or avoidant attachment were associated with a significant amount of variance in internalised stigma when controlling for other variables. Similarly, no moderating effect on the relationship between perceived public stigma and internalised stigma was found for insecure attachment. Limitations, which may have contributed towards the failure to find some predicted effects, are discussed. Implications for policy and practice are also discussed and recommendations are made for future research. It is concluded that despite these mixed results further research on the role of attachment style in internalised stigma is warranted

Internalised stigma in mental health:an investigation of the role of attachment style

Internalised stigma is associated with a range of negative outcomes, yet little is known about what determines the internalisation of stigma. In this study we examined the potential role of adult attachment style in the internalisation process in a transdiagnostic sample of adults with experience of recent mental health service use (n = 122), using an online survey. Associations between internalised stigma and perceived public stigma were tested. We also examined whether anxious and avoidant (insecure) attachment styles were positively associated with a significant amount of variance in internalised stigma when controlling for other variables, and whether the relationship between perceived public stigma and internalised stigma was moderated by anxious and avoidant attachment. We found that internalised stigma, perceived public stigma and insecure attachment were commonly reported and that internalised stigma was positively associated with perceived public stigma. However, neither anxious or avoidant attachment were associated with a significant amount of variance in internalised stigma and we found no moderating effect on the relationship between perceived public stigma and internalised stigma for insecure attachment. Despite mixed results, the strength of association between anxious attachment and internalised stigma suggests further research, which addresses some limitations of the current study, is warranted

On Care-fulness: Critical Creative Expressions of Care in a Feminist Theatre Research Project

In early 2020, as the first of many COVID lockdowns began across Australia, a collective of feminist and queer performance scholars and artists embarked on the research project Staging Australian Women’s Lives: Theatre, Feminism and Socially Engaged Art. Our aim was to document contributions of womxn theatre makers, while conducting a feminist analysis of strategies used to deal with gender inequality and oppression, on stage and off. While pivoting to the digital and the virtual, we recognised a need to support womxn theatre makers whose lives and livelihoods are thrown into further precarity by the pandemic. This paper speaks to our commitment to bringing together critical theory, arts practices and everyday life in ethical forms and encounters that make visible, recognise and express care for one another and for the work

Determining when a hospital admission of an older person can be avoided in a subacute setting: a systematic review and concept analysis

Objective To conduct a systematic review of the evidence for when a hospital admission for an older person can be avoided in subacute settings. We examined the definition of admission avoidance and the evidence for the factors that are required to avoid admission to hospital in this setting. Methods Using defined PICOD criteria, we conducted searches in three databases (Medline, Embase and Cinahl) from January 2006 to February 2018. References were screened by title and abstract followed by full paper screening by two reviewers. Additional studies were searched from the grey literature, experts in the field and forward and backward referencing. Data were narratively described, and concept analysis was used to investigate the definition of admission avoidance. Results A total of 17 studies were considered eligible for review; eight provided a definition of admission avoidance and 10 described admission avoidance criteria. We identified three factors which play a key role in admission avoidance in the subacute setting: (1) ambulatory care sensitive conditions and common medical scenarios for the older person, which included respiratory infections or pneumonia, urinary tract infections and catheter care, dehydration and associated symptoms, falls and behavioural management, and managing ongoing chronic conditions; (2) criteria/tools, referring to interventions that have used clinical expertise in conjunction with a range of general and geriatric triage tools; in condition-specific interventions, the decision whether to admit or not was based on level of risk determined by defined clinical tools; and (3) personnel and resources, referring to the need for experts to make the initial decision to avoid an admission. Supervision by nurses or physicians was still needed at subacute level, requiring resources such as short-stay beds, intravenous antibiotic treatment or fluids for rehydration and rapid access to laboratory tests. Conclusion<jats:p/> The review identified a set of criteria for ambulatory care sensitive conditions and common medical scenarios for the older person that can be treated in the subacute setting with appropriate tools and resources. This information can help commissioners and care providers to take on these important elements and deliver them in a locally designed way

How data visualisation using historical medical journals can contribute to current debates around antibiotic use and antimicrobial resistance in primary care

BackgroundThe early years of antibiotic use in primary care (c1950-1969) has received little attention. Medical journals provide a rich source for studying historic healthcare practitioners’ views and interests, with the potential to inform contemporary debate around issues of overuse and antimicrobial resistance. AimsPilot study to test the application of digital methods to interrogate historical medical journal data in relation to antibiotic use.Methods / ApproachMeta-data and scanned articles were extracted from the online British Journal of General Practice (BJGP) archive from inception (1953) to 1969. Searchable text was generated using an application called ABBYY optical character recognition, and Python used to generate data visualisations exploring (1) how BJGP changed during the period, (2) mentions of terms ‘antibiotic(s)’, ‘penicillin’, ‘resistance/resistant’ and mapping when and where they occurred.Results / EvaluationFrom 1953-1969, BJGP expanded in terms of number of annual issues (4 to 17) and annual pages (&lt;25 to &gt;1100). Heatmap visualisations were used to facilitate understanding of the frequency with which use of the term ‘antibiotic(s)’ occurred. By 1969 an article mentioning ‘antibiotic(s)’ was published monthly. Bigram searches found ‘treatment’ and ‘therapy’ to be the two most common terms that appeared with ‘antibiotic(s)’. The fourth and seventh most common terms were ‘resistant’ (first appearing in 1955) and ‘resistance’ (1962).ConclusionsThis pilot work shows that primary care publications increased considerably between 1953-1969. Articles on antibiotics featured frequently in relation to therapeutic intervention, and concerns around resistance occurred at an early stage. This approach provides new insights into how attitudes and behaviours around antibiotic use by primary care have evolved over time. It may also have the potential to inform study of the future use of antibiotics in primary care. <br/

Psychological mechanisms and the ups and downs of personal recovery in bipolar disorder

Background Personal recovery is recognized as an important outcome for individuals with bipolar disorder (BD) and is distinct from symptomatic and functional recovery. Recovery-focused psychological therapies show promise. As with therapies aiming to delay relapse and improve symptoms, research on the psychological mechanisms underlying recovery is crucial to inform effective recovery-focused therapy. However, empirical work is limited. This study investigated whether negative beliefs about mood swings and self-referent appraisals of mood-related experiences were negatively associated with personal recovery. Design Cross-sectional online survey. Method People with a verified research diagnosis of BD (n = 87), recruited via relevant voluntary sector organizations and social media, completed online measures. Pearson's correlations and multiple regression analysed associations between appraisals, beliefs, and recovery. Results Normalizing appraisals of mood changes were positively associated with personal recovery. Depression, negative self-appraisals of depression-relevant experiences, extreme positive and negative appraisals of activated states, and negative beliefs about mood swings had negative relationships with recovery. After controlling for current mood symptoms, negative illness models (relating to how controllable, long-term, concerning, and treatable mood swings are; β = −.38), being employed (β = .39), and both current (β = −.53) and recent experience of depression (β = .30) predicted recovery. Limitations Due to the cross-sectional design, causality cannot be determined. Participants were a convenience sample primarily recruited online. Power was limited by the sample size. Conclusions Interventions aiming to empower people to feel able to manage mood and catastrophize less about mood swings could facilitate personal recovery in people with BD, which might be achieved in recovery-focused therapy. Practitioner points •Personal recovery is an important outcome for people living with bipolar disorder •More positive illness models are associated with better personal recovery in bipolar disorder, over and above mood symptoms •Recovery-focused therapy should focus on developing positive illness models •Recovery-focused therapy should address personally meaningful goals such as gaining employmen

The types of psychosocial factors associated with suicidality outcomes for people living with Bipolar Disorder: a scoping review

Bipolar Disorder is associated with high rates of suicidal thoughts, behaviors, and outcomes, yet the lived experience of suicidality and Bipolar Disorder is not particularly well understood. Understanding the role of psychosocial aetiologies in suicidality outcomes for those living with Bipolar Disorder is key for developing appropriately targeted interventions focusing on factors that are amenable to change. In line with PRISMA guidance, we conducted a scoping review to identify the types of psychosocial factors studied in relation to the experience of suicidality for people living with Bipolar Disorder diagnoses. Systematic literature searches identified a sample of 166 articles from which key study data were extracted and charted. A narrative synthesis of the reviewed literature is presented ordered by the factors investigated across studies, a frequency count of the types of psychological/social aetiologies studied, and a brief overview of the key findings for each aetiology. Most of the identified literature took the form of quantitative cross-sectional studies, with only one qualitative study and 18 quantitative prospective studies. The most studied aetiologies were trauma (specifically early adverse experiences and childhood traumas) and stressful life events, impulsivity (primarily subjective self-reported trait impulsivity), social support and functioning, and personality/temperament factors. Only six studies in the final sample reported basing their research questions and/or hypotheses on an explicit theoretical model of suicide. The literature was primarily focused on using self-report measurements of key aetiologies and on factors which lead to worsened suicidality rather than focusing on potentially protective or buffering factors. Future research needs to better justify the aetiologies investigated in relation to suicidality outcomes for people living with Bipolar Disorder, including a firmer basis in theory and hypothesis testing, more prospective designs, and the use of alternative assessments of psychosocial aetiologies in addition to self-report questionnaire