Applying discursive approaches to health psychology

Objective: The aim of this paper is to outline the contribution of two strands of discursive research, glossed as ‘macro’ and ‘micro’, to the field of health psychology. A further goal is to highlight some contemporary debates in methodology associated with the use of interview data versus more naturalistic data in qualitative health research. Method: Discursive psychology is a way of analysing talk as a social practice which considers how descriptions are put together and what actions they achieve. Results: A selection of recent examples of discursive research from one applied area of health psychology, studies of diet and obesity, are drawn upon in order to illustrate the specifics of both strands. Whilst both approaches focus on accountability, ‘macro’ discourse work is most useful for identifying the cultural context of talk and can demonstrate how individuals are positioned within such discourses, and examine how such discourses are negotiated and resisted. ‘Micro’ discursive research pays closer attention to the sequential organisation of constructions and focuses on naturalistic settings which allow for the inclusion of an analysis of the health professional. Conclusion: Diets are typically depicted as an individual responsibility in mainstream health psychology but discursive research highlights how discourses are collectively produced and bound up with social practices

Body dissatisfaction, appearance investment and wellbeing: how older obese men orient to 'aesthetic health' [forthcoming]

Most research on male body image to date has focused on young men using quantitative methods. The study reported here is based on qualitative interviews with a sample of older men (n = 30) on a weight management programme, and we asked them about body-related feelings. The interviews were all transcribed and analysed using thematic analysis. Our results indicate that although body weight was typically minimised, body image was a key concern, with many examples of body consciousness and body dissatisfaction evident. On the other hand, post-programme weight loss was associated with a transformative shift in body image, with the men emphasising enhanced body confidence, self-esteem and psychological wellbeing. We conclude by highlighting the need to recognise and address appearance issues and/as health concerns for middle-aged and older men

Stumbling into sexual crime: the passive perpetrator in accounts by male internet sex offenders.

Public reactions to internet child offending remain ambivalent in that, while there is vocal condemnation of contact child sex offending, there is less indignation about internet child abuse. This is potentially due to a lack of recognition of this type of offence as sexual offending per se. This ambiguity is reflected by internet sex offenders themselves in their verbalizations of their offending. This article presents a qualitative analysis of the accounts offered by seven individuals convicted of internet-based sexual offences involving the downloading and viewing of images of children. In particular, this article presents an analysis of the explanations of offenders for the commencement of internet activity and the progression to more illicit online materials. The data were collected through semi-structured interviews and analyzed using discursive methods, paying close attention to language use and function. The analysis documented the practices that internet child abusers employed in order to manage their identities, distance themselves from the label of sex offender, and/or reduce their personal agency and accountability. Implications of this analysis are discussed with reference to the current minimization of the downloading of sexually explicit images of children as a sexual crime per se by the public and offenders alike and the risk assessment and treatment of individuals convicted of these offences

Body dissatisfaction, appearance investment, and wellbeing: How older obese Men orient to "aesthetic health"

© 2015 American Psychological Association. Most research on male body image to date has focused on young men using quantitative methods. The study reported here is based on qualitative interviews with a sample of older obese men (n = 30) on a weight management program, and we asked them about body-related feelings. The interviews were all transcribed and analyzed using thematic analysis. Our results indicate that although body weight was typically minimized, body image was a key concern, with many examples of body consciousness and body dissatisfaction evident. On the other hand, postprogram weight loss was associated with a transformative shift in body image, with the men emphasizing enhanced body confidence, self-esteem and psychological wellbeing. We conclude by highlighting the need to recognize and address appearance issues and health concerns for middle-aged and older men

Food assessment: a discursive analysis of diet talk in interviews with older men who are obese

Objective: Obesity rates are increasing faster in men than in women, with particular concerns raised regarding older men. However, men are less likely than women to engage in weight-loss activities such as dieting, typically constructed as a feminine practice. Previous research has argued that men’s food consumption is notably different and unhealthier than women’s. The novel contribution of this article is an analysis of food assessments in order to explore how older men (mostly) undergoing weight management programmes make sense of changes in their nutritional intake. Design: Semi-structured interviews were conducted with 30 men who were obese, 27 of whom were engaged in weight loss programmes. Discursive psychology was employed to analyse the data. Results: In contrast to other research, participants constructed nutritional advice as enlightening. Participants worked up ‘ownership’ and pleasure assessments to certain food choices which they contrasted with new, less calorific, eating practices. Moreover, new diets were constructed as acceptable. Conclusion: Our study contributes new insights about how nutritional advice impacts upon preconceived (mis)understandings of healthy eating practices. During the interviews, men positioned themselves as educators – health promoters might usefully develop nutritional advice in collaboration with men who have successfully changed their diets for optimum effect

"Our people has got to come to terms with that": changing perceptions of the digital rectal examination as a barrier to prostate cancer diagnosis in African-Caribbean men

Objective: African‐Caribbean men in the United Kingdom in comparison with other ethnicities have the highest incidence rate of prostate cancer. Psychosocial aspects related to screening and presentation impact on men's behavior, with previous studies indicating a range of barriers. This study explores one such barrier, the digital rectal examination (DRE), due to its prominence within UK African‐Caribbean men's accounts. Methods: African‐Caribbean men with prostate cancer (n = 10) and without cancer (n = 10) were interviewed about their perceptions of DRE. A synthetic discursive approach was employed to analyze the data. Results: Findings illustrate that an interpretative repertoire of homophobia in relation to the DRE is constructed as having an impact upon African‐Caribbean men's uptake of prostate cancer screening. However, the discursive focus on footing and accountability highlight deviations from this repertoire that are built up as pragmatic and orient to changing perceptions within the community. Conclusions: Health promotion interventions need to address the fear of homophobia and are best designed in collaboration with the community

PROCEE: a PROstate Cancer Evaluation and Education serious game for African Caribbean men

Purpose – Prostate cancer is the most common cancer diagnosed in men in the UK. Black men are in a higher prostate cancer risk group possibly due to inherent genetic factors. The purpose of this paper is to introduce PROstate Cancer Evaluation and Education (PROCEE), an innovative serious game aimed at providing prostate cancer information and risk evaluation to black African-Caribbean men. Design/methodology/approach – PROCEE has been carefully co-designed with prostate cancer experts, prostate cancer patients and members of the black African-Caribbean community in order to ensure that it meets the real needs and expectations of the target audience. Findings – During the co-design process, the users defined an easy to use and entertaining game which can effectively raise awareness, inform users about prostate cancer and their risk, and encourage symptomatic men to seek medical attention in a timely manner. Originality/value – During focus group evaluations, users embraced the game and emphasised that it can potentially have a positive impact on changing user behaviour among high risk men who are experiencing symptoms and who are reluctant to visit their doctor

A qualitative analysis of offenders' modus operandi in sexually exploitative interactions with children online

Transcripts of chat logs of naturally-occurring, sexually exploitative interactions between offenders and victims that took place via Internet communication platforms were analyzed. The aim of the study was to examine the modus operandi of offenders in such interactions, with particular focus on the specific strategies they use to engage victims, including discursive tactics. We also aimed to ascertain offenders’ underlying motivation and function of engagement in online interactions with children. Five cases, comprising 29 transcripts, were analyzed using qualitative thematic analysis with a discursive focus. In addition to this, police reports were reviewed for descriptive and case-specific information. Offenders were men aged between 27 and 52 years (M = 33.6, SD = 5.6), and the number of children they communicated with ranged from one to twelve (M = 4.6, SD = 4.5). Victims were aged between 11 and 15 (M = 13.00, SD = 1.2), and were both female and male. Three offenders committed online sexual offenses, and two offenders committed contact sexual offenses in addition to online sexual offenses. The analysis of transcripts revealed that interactions between offenders and victims were of a highly sexual nature, and that offenders employed a range of manipulative strategies to engage victims and achieve their compliance. It appeared that offenders engaged in such interactions for the purpose of sexual arousal and gratification, as well as fantasy fulfillment

Gender differences in the Force Concept Inventory for different educational levels in the United Kingdom

The Force Concept Inventory (FCI) is widely used to investigate the effect of education level on conceptual understanding of Newtonian mechanics but has only recently been scrutinized for gender effects and retention. This study examines both the gender gap in first year physics undergraduates compared to the gap for nonphysicists and the FCI retention after three months. All participants were either studying or working at the University of Sheffield in the UK and had completed a similar compulsory level of secondary education. As expected the results show that a greater level of education in physics is associated with a larger average FCI score. However, further analysis shows that there exists a gender gap at all levels of education. The size of the effect of gender is quantified using Cohen’s d and ranges from 0.84 to 1.17 which indicates a large effect due to gender for all levels of education. Despite the FCI having been used as a tool to measure learning gains immediately following instruction in Newtonian mechanics there has been little work to investigate whether this increase in FCI score remains after some time has elapsed. Here the increase in FCI scores is found to remain increased after a three month absence of mechanics-related teaching, and that this retention of FCI scores is independent of gender. Despite this, the gender gap still remains large and statistically significant after the three month delay