Relationship Affirmation, Self-Esteem, and Important Goal Pursuit in Adolescence

The pursuit of an ideal self and related goals is a constant throughout the lifespan, and a great deal of motivation and self-regulation is required in order to move closer to this ideal. For adolescents in particular, the ability to harness enough motivation to pursue important goals can be a struggle. The current thesis examined the ways in which having close affirming relationships may enhance young people’s ability to pursue their goals, and move closer to their ideal selves. An established inter-personal model of motivation, the Michelangelo Phenomenon, was used as a backdrop for a series of four empirical studies, each building on the previous to further clarify the contributions self-esteem and relationship affirmation make to goal pursuit. The first study extended the concept of relationship affirmation for use in relationships other than romantic couples, to determine whether all forms of affirming relationships could be beneficial to goal pursuit and movement towards the ideal self. This being the case, along with relationship affirmation mediating the positive relation between self-esteem and goal pursuit motivation, the next study extended this further by applying the theory to adolescents undertaking their last years of school. A three time-point school-based study was carried out, testing the mediation hypothesis in adolescents from four Greater London schools. Three empirical chapters describe findings from this study, with Chapters 3 and 4 examining the first time points cross-sectionally, and Chapter 5 analysing the first and last time points longitudinally. The findings revealed relationship affirmation to be a strong predictor of motivation to pursue ideal-relevant goals, and of life satisfaction. The mediation model was supported for the most part, although the pattern was not found longitudinally. The findings reveal the central importance of social support, and particularly the presence of affirming relationships, to enable adolescents to pursue important goals

Not the story you want? Assessing the fit of a conceptual framework characterising mental health recovery narratives

Narratives of recovery have been central to the development of the recovery approach in mental health. However, there has been a lack of clarity around definitions. A recent conceptual framework characterised recovery narratives based on a systematic review and narrative synthesis of existing literature, but was based on a limited sample. The aims of this study were to assess the relevance of the framework to the narratives of more diverse populations, and to develop a refined typology intended to inform narrative-based research, practice and intervention development. Method: 77 narrative interviews were conducted with respondents from four under-researched mental health sub-populations across England. Deductive and inductive analysis was used to assess the relevance of the dimensions and types of the preliminary typology to the interview narratives. Results: Five or more dimensions were identifiable within 97% of narratives. The preliminary typology was refined to include new definitions and types. The typology was found not to be relevant to two narratives, whose narrators expressed a preference for non-verbal communication. These are presented as case studies to define the limits of the typology. Conclusion: The refined typology, based on the largest study to date of recovery narratives, provides a defensible theoretical base for clinical and research use with a range of clinical populations. Implications for practice include ensuring a heterogeneous selection of narratives as resources to support recovery, and developing new approaches to supporting non-verbal narrative construction

The impact of mental health recovery narratives on recipients experiencing mental health problems: Qualitative analysis and change model.

BACKGROUND: Mental health recovery narratives are stories of recovery from mental health problems. Narratives may impact in helpful and harmful ways on those who receive them. The objective of this paper is to develop a change model identifying the range of possible impacts and how they occur. METHOD: Semi-structured interviews were conducted with adults with experience of mental health problems and recovery (n = 77). Participants were asked to share a mental health recovery narrative and to describe the impact of other people's recovery narratives on their own recovery. A change model was generated through iterative thematic analysis of transcripts. RESULTS: Change is initiated when a recipient develops a connection to a narrator or to the events descripted in their narrative. Change is mediated by the recipient recognising experiences shared with the narrator, noticing the achievements or difficulties of the narrator, learning how recovery happens, or experiencing emotional release. Helpful outcomes of receiving recovery narratives are connectedness, validation, hope, empowerment, appreciation, reference shift and stigma reduction. Harmful outcomes are a sense of inadequacy, disconnection, pessimism and burden. Impact is positively moderated by the perceived authenticity of the narrative, and can be reduced if the recipient is experiencing a crisis. CONCLUSIONS: Interventions that incorporate the use of recovery narratives, such as peer support, anti-stigma campaigns and bibliotherapy, can use the change model to maximise benefit and minimise harms from narratives. Interventions should incorporate a diverse range of narratives available through different mediums to enable a range of recipients to connect with and benefit from this material. Service providers using recovery narratives should preserve authenticity so as to maximise impact, for example by avoiding excessive editing

‘Maybe I Shouldn’t Talk’: The Role of Power in the Telling of Mental Health Recovery Stories

Mental health ‘recovery narratives’ are increasingly used within teaching, learning and practice environments. The mainstreaming of their use has been critiqued by scholars and activists as a co-option of lived experience for organisational purposes. But how people report their experiences of telling their stories has not been investigated at scale. We present accounts from 71 people with lived experience of multiple inequalities of telling their stories in formal and informal settings. A reflexive thematic analysis was conducted within a critical constructivist approach. Our overarching finding was that questions of power were central to all accounts. Four themes were identified: (1) Challenging the status quo; (2) Risky consequences; (3) Producing ‘acceptable’ stories; (4) Untellable stories. We discuss how the concept of narrative power foregrounds inequalities in settings within which recovery stories are invited and co-constructed, and conclude that power imbalances complicate the seemingly benign act of telling stories of lived experience

Lipid Metabolism at the Nexus of Diet and Tumor Microenvironment

Obesity is a leading contributing factor to cancer development worldwide. Epidemiological evidence suggests that diet affects cancer risk and also substantially alters therapeutic outcome. Therefore, studying the impact of diet in the development and treatment of cancer should be a clinical priority. In this Review, we set out the evidence supporting the role of lipid metabolism in shaping the tumor microenvironment (TME) and cancer cell phenotype. We will discuss how dietary lipids can impact phenotype thereby affecting disease trajectory and treatment response. Finally, we will posit potential strategies on how this knowledge can be exploited to increase treatment efficacy and patient survival.B.P. is supported by a grant from Barts Charity and Cancer Research UK core funding (Core award C16420/A18066). A.S. is supported by grants from the German Research Foundation (DFG) and the German Cancer Aid

Living with Psychosis without Mental Health Services: A Narrative Interview Study

Objectives Little research has looked at how people who do not use mental health services experience psychosis. Thus, the present study aimed to explore the experiences and views of people with psychosis who have neither sought nor received support from mental health services for at least 5 years.Design A narrative interview study. Thematic analysis was used to analyse the data.Setting England.Participants Twenty-eight participants with self-defined psychotic experiences were asked to provide a free narrative about their experiences.Results Five themes were identified: (1) Perceiving psychosis as positive; (2) Making sense of psychotic experiences as a more active psychological process to find explanations and meaning; (3) Finding sources of strength, mainly in relationships and the environment, but outside of services; (4) Negative past experiences of mental health services, leading to disengagement and (5) Positive past experiences with individual clinicians, as an appreciation of individuals despite negative views of services as a whole.Conclusions Perceiving psychosis as something positive, a process of making sense of psychotic experiences and the ability to find external sources of strength all underpin—in addition to negative experiences with services—a choice to live with psychosis outside of services. Future research may explore to what extent these perceptions, psychological processes and abilities can be facilitated and strengthened, in order to support those people with psychosis who do not seek treatment and possibly also some of those who are in treatment