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Past intersectional research has suggested that men living in socially deprived areas are 51% more likely to experience major depressive disorder. Furthermore, men have increased rates of mental distress and psychopathology in comparison to individuals from higher socioeconomic status's (Remes, Lafortune and Wainright et al. 2019; Johnson, Cohen and Dohwrenwend, 1999), and for middle aged men, there is an increased risk of suicide (Simms, Scowcroft and Mette et al. 2019). Whilst links between areas of social deprivation and mental health are widely acknowledged within the literature, the mechanisms that underpin these statistics are less understood (Wickham, Shryane and Lyons et al. 2014). To address this identified gap in the literature, this study explored individual mental health experiences and perceived barriers to engaging with services for working class men in the South Wales Valleys. Six men, ages from 25 - 35 took part in semi-structured interviews, five of which occurred face to face, and one via Microsoft teams. All the participants identified as 'white', 'heterosexual' and as being 'lower' or 'poor' class when asked to identify their socio-economic positioning. The qualitative study adopted a critical realist and phenomenological approach as the epistemological position, and interpretative phenomenology analysis was employed to explore mental health experiences and perceived barriers to support seeking. Identifying the difficulties in recruiting from a participant population that do not engage well with support services, an intimate partial insider perspective was adopted in which the researcher utilised already established relationships as the basis for investigative research (Ryan, Hoffman and Aaron, 2011). Twelve themes were developed from the data, eight of which were constructed as subthemes, and four were developed into superordinate themes: Theme 1 "It's hard to live around here, I see the Valleys as fight or flight", Theme 2 Questioning the masculinity script "We're not fucking cavemen anymore", Theme 3 "Self-medicating in the Valleys" and Theme 4 Us and them. Each superordinate theme contained two sub themes. The results offer a developed insight into how social, political, and ideological powers and oppressions operate, and how they impact the mental health experiences of six working class men in the South Wales Valleys. Findings indicate normalisation of mental health distress, economic hardship, and poor mental health literacy within the Valleys. Although economic issues such as poor opportunities were identified to impact wellbeing, predominantly individualistic views of mental health difficulties were identified. This was particularly problematic for the participants as it induced feelings of personal responsibility and shame. From an intersectional lens hegemonic masculine ideologies in the socio-political context of the participants experience were identified to create intense intra and interpersonal difficulties for the participants. Professional support for mental health difficulties was conceptualised as an unattractive option for participants until reaching a point of crisis. Distrust and relational difficulties with mental health professionals were identified as emerging from processes of 'othering' that has its roots in unarticulated social power inequalities within the participants relationships with professionals. This research encourages professionals to consider how individual therapy can be at best be limited and at worst harmful if it doesn't consider the wider challenges to an individual's experience (Bostock, 2017), and encourages psychologists to view individual distress in its social context. It also highlights the need to raise class-consciousness within therapeutic training programs and within individual practice to encourage therapists to take a critical stance on the prevailing individualistic discourses of mental health. By acknowledging the client's socio-political context, and the social power dynamics in professional relationships therapist can avoid replicating oppressive experiences.

Identity fusion – a visceral sense of oneness with the group linked to extreme pro-group action in adults – is thought to result from at least two distinct pathways, namely shared experience and shared biology. The main objective of this thesis was to focus on the shared experience pathway – in which self-defining memories about intensely emotional events are perceived as shared with other group members – in populations largely unexplored in previous fusion literature, namely children, adolescents, and women. Autobiographical reasoning about shared personal experiences – the cornerstone of narrative identity – in conjunction with other post-event processes, were examined across three studies. Study 1 explored the role of autobiographical memory processes in the emergence of identity fusion over the course of development. Findings showed that while identity fusion could be reliably measured from early adolescence, autobiographical reasoning was positively linked to identity fusion beginning in mid-adolescence. Studies 2 and 3 investigated the relationship between a woman’s first experience of childbirth and her identity fusion with other mothers. While Study 2 examined both antenatal and postpartum first-time mothers, Study 3 examined only postpartum first-time mothers. Findings demonstrated that identity fusion was stronger for women who had experienced childbirth for the first time in their lives than for women who were still pregnant with their firstborn. The pathway to identity fusion among first-time mothers manifested in different ways, such that the nature of first-time mothers’ childbirth experiences created powerful social bonds with other mothers who had also endured similar experiences. Thought processes and autobiographical reasoning mediated the pathway to identity fusion in complex ways. Identity fusion showed the potential to affect women’s psychological health outcomes after childbirth. Altogether, autobiographical memories of shared life-altering experiences are the means by which autobiographical reasoning and other post-event processes give rise to identity fusion.

This thesis investigates the relationship between labour market statuses and well-being in the UK working age population, and the moderating role of the Great Recession. Research on the relationship between labour market statuses and well-being outcomes identifies negative associations with unemployment and economic inactivity. These findings are typically presented as independent of macroeconomic conditions, but to what extent does this assumption hold? The central proposition of this thesis, is that economic crises moderate the way in which labour market statuses affect well-being, thereby changing the value of statuses, not just their prevalence. The main research question addressed is ‘for the UK working age population, to what extent did labour market and employment statuses contribute to the greater or lesser effects of the economic crisis (2007/8–2011) on well-being, compared to the pre-recession ‘boom’ period (2003/4–2006/7)?’I make use of a national panel data series from the British Household Panel Survey and Understanding Society. Firstly, after critiquing the reliance on subjective well-being (SWB) measures, confirmatory factor analysis is used to develop a measure of positive psychological health, representing a single dimension of well-being. This is then compared to a measure of SWB in a series of latent growth models to investigate individual trajectories over the study period. Secondly, multilevel models are used to estimate the relationship between five labour market and employment statuses and positive psychological health, comparing the pre-recession and recession periods. Finally, a dynamic structural equation modelling approach is used to investigate selection and causation in the relationship between labour market status and positive psychological health. Aggregate positive psychological health was associated with a recession period decline, in contrast to SWB which remained stable. Labour market statuses were found to moderate the impact of recession. People who were economically inactive were associated with the largest declines in positive psychological health during the recession period, compared to the pre-recession period, followed by those in standard employment. In contrast, the relationship between non-standard employment and unemployment and positive psychological health remained constant over time. Finally, despite evidence of selection into labour market statuses, the findings show a strong causal impact of statuses on positive psychological health. The findings provide a different take on those hardest hit by recession, showing that some of the most vulnerable to low psychological health were most exposed to the impact of recession by virtue of their labour market status. The protective value of standard employment was also diminished relatively. Evidence in favour of a causal interpretation suggests policy makers should use employment and welfare policy to prevent an accumulation of welfare issues.

This study aims to examine to what extent Dutch GPs are at risk for burnout, and to identify personal, professional and practice related characteristics that are associated with high burn out scores. In the extant literature, physicians are identified as professionals who are high risk for burnout. In the past decade, working conditions for general practitioners (GPs) in the Netherlands have changed for the worse. There are no recent data on GP burnout in the Netherlands. Although much is known in the literature about factors that are associated with burnout and the role job demands and resources play in getting burned out, the extent to which these findings apply in the context of Dutch GPs is unknown. This study is designed as a quantitative, survey based, empirical study. An invitation to complete an online survey was sent to 4,000 GPs in the Netherlands, of whom close to 1,300 participated in this study (33% response rate). The data were analysed using IBM SPSS 22.0. The data analysis consisted of a descriptive analysis of the data with an emphasis on the outcome of burnout measurements, as well as an inferential analysis of the data with an emphasis on the association between respondents' characteristics and burnout measurements. The results from this study indicate, that one in seven practicing Dutch GPs could be classified as burned out with fulltime working GPs reporting an average working week of 62 hours. According to the findings, the amount of hours worked per week is the most important determinant of emotional exhaustion. Variation in emotional exhaustion, depersonalisation and professional efficacy can to a large extent be explained by variation in demands (administrative burden, work-home conflict, psychological job demands) and resources (decision latitude, co-worker support and home support). Increased job demands are predominantly associated with emotional exhaustion, while a scarcity of resources predominantly leads to increased depersonalisation and reduced professional efficacy. The findings demonstrate, that a bigger job size, more hours worked and a more responsible position held, are associated with higher experienced demands, which is in turn associated with unfavourable burnout scores, particularly increased emotional exhaustion. Working in a group setting, being professionally active outside of one's own practice and being in a relationship were found to be associated with increased resources, which is in turn associated with favourable burnout scores, particularly decreased depersonalisation and increased professional efficacy. Based on the findings of this study, three recommendations for government bodies, healthcare providers and other healthcare stakeholders were formulated: 1) Reduce the length of the working week, predominantly by reducing the number of allocated patients per GP. This recommendation implies an increase in the GP workforce; 2) Undertake a comprehensive analysis of the quantity, type and purpose of administrative duties currently performed by GPs and trim unnecessary paperwork and bureaucracy within the GP practice and 3) Increase co-worker support, either within the GP practice or by using the existing collegiate support infrastructure.

Care work is emotionally and physically demanding and is coupled with organisational challenges. As such, care work has been associated with emotional exhaustion which not only negatively impacts staff but also the care that they provide. Greater understanding of the psychological health of dementia care staff and their perceptions of their work will provide insights into how this group may be better supported. The first paper provides a review of the literature relating to psychological outcomes in dementia care staff. The literature identified was viewed in terms of an existing model of psychological health, the BASIC Ph, with the aim of evaluating the evidence and enhancing understanding of psychological health in this group. The utility of this model was also evaluated. The model highlighted areas for potential intervention as well as those for future research. Clinical implications for Clinical Psychologists were also discussed. The second paper aimed to increase understanding of the experiences of dementia care assistants who perceived themselves to be competent in their role. Eight care assistants who had high levels of self-efficacy were interviewed. Interpretative Phenomenological Analysis (IPA) revealed four superordinate themes. Accounts of experiencing dilemmas provided important contextual information and constituted the first superordinate theme. The second theme 'togetherness and connection' described participants' experience of the need for support, closeness and the value of engaging with older people with dementia. The third theme encompassed the attunement between care assistants and the older people for whom they cared and described empathy, personal perspective-taking and circularity of emotion as guides to care. The final theme 'caring as part of life' described the link between caring and identity as well as a genuine interest in people, an accepting attitude and motivation to care. These themes provide fruitful areas for further research and have implications for care staff training.

The core constructs of Acceptance and Commitment Therapy (ACT, Hayes, Strosahl and Wilson, 2012) (including psychological flexibility) and Self-Determination Theory (SDT, Ryan and Deci, 2000) (including type of goal pursuits, basic psychological needs satisfaction and resilience) are contextual process-orientated components and there is research to support their affiliation with psychological health. These criteria are significant to counselling psychology’s objective to cultivate current knowledge on fostering psychological health according to its humanistic ethos as well as being relevant to psychology more broadly (Gelso and Fassinger, 1992; Gelso and Woodhouse, 2003; BPS, 2009). To date, minimal research has specifically investigated the relationships between the constructs of ACT and SDT and the current research aimed to address this by asking a community sample of 191 participants (m= 69, f= 122) to complete an online survey. It was hypothesised that psychological flexibility (AAQII-10 item version), basic psychological needs satisfaction (Basic Psychological Needs Scale), goal pursuits (AI), and resilience (CDRISC) would be positively associated with each other and outcomes of psychological health; fewer symptoms (GHQ-12), vitality (SVS) and life satisfaction (SWLS). Then, simple mediation analysis was used to test the hypothesis that basic psychological needs satisfaction, type of goal pursuits and resilience mediate the relationship between psychological flexibility and outcomes of psychological health. Overall, the research findings support the hypotheses, however, multi-collinearity between some of the constructs indicate that psychological flexibility and the SDT components are conceptually similar. The implications these findings have for further research are suggested and the limitations of the current research are highlighted.

The student experience is a unique journey of challenge and opportunity, for which their success, subjective well-being (SWB) and psychological health are key elements. In three related investigations, this mixed-methods research programme examined the effects of Time-Perspective (TP: An individual’s psychological relationship with time) and Character-Strengths (CS: 24-positive traits associated with good character) on these outcomes. Investigation 1 involved developing a Likert-type scale to measure students’ success in areas they felt were important to the construct. Qualitative content analysis identified that HE students and staff collectively defined success as a multifaceted construct, consisting of numerous academic, non-academic and social aspects. These informed the development of a reliable and valid questionnaire for measuring success perceptions in seven of these areas. This was used in the following investigation to assess a range of outcome variables pertaining to student success. Investigation 2 was a longitudinal study assessing the effects of TP and CS on the success, good/poor psychological health and SWB of Year-1 HE students. In line with previous research, excessive or insufficient use of certain TP orientations was associated with, and could predict multiple positive and negative outcomes. For example, Future and Past-Positive orientations were predictive of academic success, perceived student success and SWB. Student psychological problems were associated with a bias towards Past-Negative and Present-Fatalist orientations. Additionally, a new formula for calculating a continuous Balanced Time Perspective (BTP) variable was devised and tested. High levels of BTP were associated with many positive aspects of the HE experience. Strengths were mainly associated with SWB and perceptions of success. However, Hope and Self-Regulation were inversely related with depression, anxiety, stress and negative-affect. Investigation 3 was a follow-up interview study with six student participants, who presented interesting profiles in Investigation 2. They talked about their experiences of psychological ill-health/well-being and student success in relation to TP and CS. Five super-ordinate themes were identified, including ‘Living with negative past experiences’, ‘A balancing act’ and ‘Using my strengths’. Psychological difficulties represent an escalating problem in HE, and student success and SWB are important outcomes. Both TP and CS offer additional understandings of these areas, adding value in academic, practical and theoretical contexts. This research has indicated that interventions focused on TP modification (i.e. developing a BTP) and strength development, may potentially offer preventative mental-illness strategies for susceptible students and enhance their success and SWB.

Are there vestiges or elements of African traditional cultural beliefs and practices that affect the psychological and spiritual well-being of African Christian students in Tangaza University College (TUC)? If there are, how best can pastoral carers work with the affected students to help them deal with the issues and regain congruence? These questions, arising out of our practice in the Student Life Ministry in TUC, are the puzzles I set out this study to try to resolve. Our experience was that some of the students were presenting issues in counselling and spiritual direction emanating from unresolved conflict between their African backgrounds and the Christian faith. Observation was that the issues did not surface easily and when they did the carers were not sure how best to help the clients. I thus felt a need to find out what cultural issues affect the students, how the issues manifest in their lives and how best the pastoral care team could work with those affected to help the issues surface and be resolved. This is an original research designed as an inductive case study and to collect data, a multi-dimensional approach including focus discussion groups with students and members of the SLM, depth interviews with SLM members, selection of some vignettes of counselling and spiritual direction and practitioner observation - were used. The main finding is that there indeed are elements of African beliefs and practices that impinge on the psychological and spiritual wellbeing of some of the African Christian students in TUC. However, not all the students experience such dissonance as some have developed a synthesis between their two world views. Those who have not are embarrassed about and reticent in disclosing the issues thus the need for the pastoral carers to help them to integrate their traditional culture with their Christian faith. Clinical experience has shown that by combining two counselling models – the Rogerian Person-centred and Albert Ellis’s Rational Emotive Behaviour Therapy, underpinned in a dialogical, theological paradigm, counsellors and spiritual guides can help the affected students not only to talk about the issues but also to work through them to re-gain equilibrium and enjoy greater fullness of life.

The research literature contains a significant amount of information on the psychological health of managers, however, relatively little has been written about the psychological health of workers. There has been a long held assumption that there is little difference in the psychological health of workers and managers. This study challenges that assumption and investigates differences in psychological health that appertain to job role and job characteristics determined by job role. This study tested two related hypotheses, firstly, that 'managers have significantly better psychological health than workers'; secondly, that 'that better psychological health was largely due to the increased self esteem that comes from having a more socially desirable role'. Initial analyses of the data indicated that hypothesis 1 was upheld, but when split by sex hypothesis 1 was only upheld for females and not males; similarly hypothesis 2 was only upheld for females. This result was attributed to the influence of two variables, the 'attribution of blame' and 'need for external validation', and the different moderator and mediator roles they play for males and females. The study contradicts the assertion that the psychological health of workers and managers is similar, if not the same, and uses the differences found to explain why research in this field has often produced conflicting results. Areas of potential future research are indicated.

This study explores how highly educated refugees in the U.K. perceive the relation between their post-migration experiences and their psychosocial well-being. A literature review of the migration and psychological health area and the widely-used stress and coping approach revealed that the “vulnerable” and “passive” images have all too often been assigned to refugees when discussing their psychological health, and that the latter have often been approached as beings detached from their social context. The aim of the research was to explore the participants’ own perceptions (or “lay narratives”) of their experiences and their well-being. These were used to converse with the stress and coping concepts and with the images related to psychological activism, an alternative stress and coping perspective that views people as active agents who try to take control of their life, instead of mere passive recipients of stress. The study is based on constructivism, and accordingly the emphasis is put on the subjective world of experience and the researcher critically reflects on how the social context shapes the participants’ perceptions. The empirical work consists of two studies. In the first one, semi-structured interviews were carried out with fifteen young and highly educated refugees in the U.K. The findings highlight how the participants used the stress and coping concepts and the images related to psychological activism, so the value of such concepts is reconfirmed. But a deeper critical look reveals that the semi-structured interviewing may have strongly directed how the participants discussed their perceptions and that it was unclear how these perceptions are formed in social interaction. Consequently I conducted additional empirical work to carry the emerging issues further. In the second study, autobiographical narrative interviews were carried out with another group of fifteen highly educated refugees in the U.K. The findings reveal that they made sense of their experiences and their well-being through three distinctive stories. The stories of hope and survival presented by two subgroups of participants suggest a more balanced view of refugees, one that is not necessarily “vulnerable” and “passive”. These participants made sense of their experiences and well-being through the elements of “hope, persistence and activism”. But the story of disappointment presented by a third subgroup revealed that some participants did not perceive their experiences and their well-being through a positive lens. It also highlighted the need to further explore how they formed their perceptions in social interaction. Indeed, it was shown how the social context, particularly negative attitudes they received at the community level, was largely responsible for their narrative of disappointment. The theoretical contribution of this research lies in exploring how the participants, through their own narratives, made sense of the concepts of stress and coping. The methodological contribution refers to the bridging of ideas and previous work from other disciplines and to the innovative application of narrative interviewing to this population. A major practical contribution is that this research offered a channel for refugees to talk about their experiences and their well-being in their own words. Furthermore, possible explanations emerge on why some refugee groups can indeed seem “vulnerable” and “passive” and this has important implications for those who design and implement interventions aimed at enhancing the well-being of refugees.

Perceived ethnic/racial discrimination (PERD) is a psychosocial stressor that may undermine the health of people of color, but these associations have been understudied among Latino young adults. Ethnic/racial identity (ERI) has been proposed to be a moderator of PERD-health associations, but theoretically-based moderation effects have been inconsistently tested and results within the broader literature have been mixed. The current study examined whether ERI developmental dimensions (i.e., commitment and exploration) may individually moderate associations between PERD and the health of Latino youth, and whether ERI commitment may have stronger buffering effects among those who are higher on ERI exploration. Latino young adults (N = 702; ages 18-25; 70% female) were recruited using both a campus-based (N = 511) and a national online recruitment system (N = 191). Participants completed online surveys measuring PERD, ERI developmental dimensions, psychological distress, general physical health perceptions, and sociodemographic variables. Data were analyzed using moderated moderation models in the PROCESS macro version 4.2. As expected, heightened PERD was associated with poorer health (i.e., heightened psychological distress and poorer general physical health perceptions). However, neither ERI exploration nor ERI commitment moderated these PERD-health associations, and the hypothesized moderated moderation effect was not significant. The findings of the current study support a growing body of work which suggests that PERD can undermine both the psychological and physical health of Latino young adults in the USA, but raise questions about whether and how ERI development may moderate PERD-health associations among Latino youth. Implications for future research are discussed.

This research aimed to investigate the prevalence and distribution of mental health conditions across the paramedic workforce, to compare levels with the general population and to assess the association of stressors with scores on measures of mental health. A survey was constructed to assess general psychological health, depression, anxiety, stress, suicidality, posttraumatic stress disorder, sleep health and the frequency and severity of stressor variables. Impact scores for stressor variables were generated by multiplying frequency and severity scores. Participant and workplace sociodemographic variables were measured. The survey was distributed within Ambulance Victoria in September 2010. Only data from 879 participants that transported emergency patients was analysed. The ANOVA procedure and chi-square tests were employed to compare means and prevalences of psychological health scores within the paramedic sample according to sociodemographic variables. Independent-sample t-tests and chi-square tests for independence were used to examine means and prevalence rates by comparing this paramedic sample with general population statistics and other paramedic populations. Logistic and multiple regression analyses were conducted to investigate associations between stressor impact scores and mental health conditions. Key findings were the higher levels of suicidal thinking and planning, PTSD, substandard sleep health and poor general psychological health compared to the general population. The level of PTSD was comparable to other paramedic populations while suicidality was higher: there were mixed findings on the other measures. Regression analyses found that stressors related to the organisation, the broader work context and shift work were significantly associated with measures of mental health while, with the exception of anxiety, emergency work was not. There were no meaningful differences in levels of mental health conditions within groups across the paramedic workforce except that PTSD caseness was higher outside the major cities and, higher levels of suicidality were reported in three ambulance service regions. The higher levels of suicidality in this paramedic sample is a new finding although further research is needed to determine its nature and sources. Many stressors associated with mental health are not emergency work related but are instead associated with the organization and aspects of the broader working environment, suggesting that some stressors may be amenable to being managed. The lack of meaningful differences within this paramedic sample indicates that targeting mental health interventions is not practical, and should instead be directed across the entire workforce.

People are not impassive bystanders to their emotional experiences. Instead, people tend to judge their emotions as good or bad. In this research, I examined individual differences in emotion judgments and their implications for emotional responses and psychological health. In Study 1 (N = 1,136), I developed a questionnaire to assess four types of habitual emotion judgments. The four types of emotion judgments differed according to the valence of the emotion being judged (positive or negative) and the valence of the judgment (positive or negative). In Study 2 (81 participants and 2,999 observations), I examined the relationship between habitual emotion judgments and emotion judgments in daily life. Emotion judgments were common in daily life and were predicted by habitual emotion judgments. In Study 3 (same participants as in Study 1), I examined cross-sectional associations between habitual emotion judgments and psychological health. Positive judgments of positive emotions were associated with greater psychological health and negative judgments of negative emotions were associated with poorer psychological health, above and beyond other types of emotion judgments and key confounds. In Study 4 (111 participants and 835 observations), I examined prospective links between habitual emotion judgments and psychological health over one month and the mediating role of net emotions (emotions that linger after an emotional event has passed). Negative judgments of negative emotions were associated with worse psychological health one month later, and this relationship was partially mediated by daily net emotions. In sum, individuals differ in the types of emotion judgments that they tend to make and these individual differences appear to powerfully shape daily emotional responses and in turn, psychological health.

Posting on the internet, including weblogs or social media, is one of the ways individuals seek for an outlet to express themselves or mental health concerns. For many mental health issues such as psychosis, the timing of detection and treatment is critical; short and long-term outcomes are better when individuals begin treatment close to the onset of psychosis. While the internet offers a positive medium for short term therapy, it is not a face to face therapy session, wherein a trained professional is better able to deduce the root of the problem. Many clinicians are adopting electronic communication to strengthen their therapeutic alliance with their patients. The drawback of psychiatry is that it lacks objectified tests for mental illnesses that would otherwise be present in medicine. Current neuroscience has yet not found genetic markers that can characterize individual mental illnesses. A thought disorder (ThD) which is a widely found symptom in people suffering from schizophrenia, is diagnosed from the level of coherence when the flow of ideas is muddled without word associations. A system that can explore the use of speech analysis for aiding in psychiatric diagnosis is highly desirable and would help early detection and effective treatment results.This thesis introduces a framework – Prediction Onset Prediction System (POPS) - to predict the onset of psychosis based on written language habits. A scrape of a multitude of individual comments is analyzed using a trained psychosis prediction module that is able to predict if an individual is psychotic (based on the semantics) using natural language processing, machine learning techniques and a customized corpus with terms consist with psychotic language tendencies created using speech analysis techniques. The effectiveness of the corpus and its implication in psychosis detection is explored.

Evidence to date suggests that a higher level of positive emotion is generally associated with improved psychological health (e.g., Tugade, Fredrickson, & Barrett, 2004). However, the specific features characterizing the ways in which upregulation of positive emotion is associated with good psychological functioning are less understood. I investigated how three factors may link regulation of positive emotions to greater psychological health: 1) the presence of both a large repertoire and persistent use of regulation strategies; 2) a “match” between the features of a situation and the strategy used; and 3) the use of specific categories of regulatory strategies, such as expression (capitalization), and less use of suppression. One-hundred and thirty-four undergraduates (mean age = 19.22; 73% female; 78% Caucasian) indicated the strategies they would use to maintain or improve their mood in response to eleven hypothetical positive situations. After their initial response, participants were prompted four more times to report how they would respond if their initial strategy was not working. Participants then completed a battery of self-report measures assessing psychological health variables, including measures of positive emotion and psychopathology. Coders rated the quality (effectiveness) of each strategy and assigned them to categories. Coders also rated each situation for its degree of ambiguity (how ambivalent the situation was), and whether it represented a more hedonic (i.e., short-term pleasure) or eudaimonic (i.e., long-term meaning) form of well-being. Data were analyzed with a series of correlations and regression models using the three factors above as predictors and the psychological health (PH) measures as criterion variables. Repertoire was associated with several indices of positive emotion, but was unrelated to measures of psychopathology. In contrast, persistence was unrelated to PH, except for an inverse association with intensity of positive emotion across situations. The use of suppression was related to greater borderline personality disorder features and lower ratings of happiness, whereas the use of planning, past focus, or expression was related to higher reports of positive emotion. Finally, individuals using expression more frequently in situations of a more eudaimonic nature reported a higher intensity of positive emotion across situations (ß = .21, p = .02); likewise, individuals using cognitive awareness (savoring) more frequently in situations of a more hedonic nature also demonstrated a trend toward more intense positive emotion (ß = .16, p = .07). Collectively, these findings preliminarily suggest the importance of “regulatory diversity” (Quoidbach, Berry, Hansenne, & Mikolajczak, 2010), i.e., varying one’s use of strategies, and hint at the role of situation-strategy matches in upregulating positive emotion. However, several limitations of this study warrant cautious interpretation of the results, such as the correlational nature of the data, the large number of tests conducted, and the disproportionality among the frequencies of strategy categories. Suggestions for future research are discussed, such as the use of real-world data and experimental work to clarify the connection between repertoire and positive affect.

Hooking up, or casual sexual interactions between uncommitted partners, are prevalent among young adults. Despite its prevalence, the influence of hooking up on young adults’ psychological health is not well understood. The present study utilized a short-term prospective design to examine the longitudinal associations between hooking up (any involvement in hook ups, frequency of hook ups, and number of hook up partners) and psychological health (depressive symptoms, anxiety, self-esteem, and alcohol use) over a 10-week period, among a sample of 287 college students. We tested for associations in both directions and for moderating effects of gender, sexual intimacy, and hook up motives. Results indicated effects in both directions, such that those involved in hook ups showed more increases in depressive symptoms and alcohol use compared to those who had not hooked up, and, greater levels of initial depressive symptoms, anxiety, and alcohol use, and lower self-esteem predicted increased likelihood of hooking up in the following 10 weeks. Results revealed no moderating effects, indicating that these associations may be fairly consistent among individuals. Despite that hooking up is normative during emerging adulthood and a common way to explore one’s sexuality, findings indicate that it is more common among those experiencing poor psychological health, and, also leads to increases in emotional distress and hazardous alcohol use.

Previous research has indicated that psychological health, academic self-efficacy, and academic stress are significant factors in the personal and academic lives of many college students. Each of these issues has been found to influence academic performance, adjustment to college, and many other aspects of students' lives. The impact that academic self-efficacy and academic stress have on psychological health has not been examined in detail however.In this study, the researcher examined gender, academic self-efficacy, and academic stress as predictors of psychological health in college students. An online survey comprised of instruments assessing these variables was distributed to a sample of college students at one Midwestern university in the USA. The final sample size consisted of 146 participants. A hierarchical regression analysis was conducted to analyze the results, where gender was the first variable entered into the regression analysis, academic self-efficacy second, and academic stress was entered last as it was predicted to account for the most variation in psychological health scores.The results of the analysis indicated that gender was not a significant predictor of psychological health in this sample. Academic self-efficacy and academic stress were both significant predictors of psychological health. Academic self-efficacy accounted for 12.6% of the variation in psychological health scores and academic stress accounted for an additional 11.7% of the variation in psychological health scores. Academic stress did not account for more variation than academic self-efficacy as was hypothesized. Academic stress was found to have a negative correlation with psychological health as expected, but academic self-efficacy also had a negative correlation with psychological health unexpectedly. These results are discussed and possible implications for counselors and others who work with college students are outlined. The limitations of the study and possible directions for future research on these topics are also detailed.

There is robust empirical evidence for a link between lower economic status and adverse health outcomes, but little is known about whether a sudden, unplanned loss of assets – a negative wealth shock – has long-term health consequences. Previous research has shown associations between negative wealth shocks and short-term health declines, primarily from losses of housing and investment wealth, with macroeconomic recession presumed to have triggered these shocks. Even during better economic times, however, negative wealth shocks arise frequently from more individualized circumstances, such as high medical expenses, but causal mechanisms linking subsequent health outcomes to these endogenous shocks can be difficult to establish due to the potential for reverse causality and residual confounding. Using data from the Health and Retirement Study, a nationally representative study of US adults aged 50 and older, this dissertation examined markers of short-term changes in stress and health care consumption after negative wealth shock in late middle age, a time of particular vulnerability. Then, differences by whether an individual experienced negative wealth shock in late middle age were assessed for three long-term aging-related trajectories – cognitive decline, physical function limitation accumulation, and all-cause mortality. Design and analytic methods addressed bidirectional and time-dependent causation in the relationship between negative wealth shock and health outcomes. Over 15 percent of late middle-aged adults with existing assets experienced negative wealth shock. The main findings indicated that experiencing a negative wealth shock during late middle age was associated with a higher risk of elevated depressive symptoms, a marker of increased stress, as well as long-term risk of mortality and cognitive decline. However, there was no significant association between negative wealth shock and risk of cost-related medication non-adherence – a marker of reduced health-related consumption, nor accelerated physical function limitation accumulation. With a substantial proportion of the late middle-aged population experiencing negative wealth shock, targeted interventions to prevent of the occurrence of these shocks and the health consequences thereafter may have a large impact on the health of older Americans.

Previous studies show that health outcomes of immigrants in the United States are favorable compared with U.S.-born whites. Middle Eastern (ME) immigrants are a growing U.S. minority population, yet research on their health is minimal. Using data from the 2002–2012 National Health Interview Surveys, this dissertation addresses key gaps in the immigrant health literature of the ME population through three empirical chapters examining the association between ac¬culturation and various physical/psychological health outcomes of ME immigrants in the U.S. I first examine the association between acculturation and three health outcomes (self-rated health, activity limitations, and chronic health conditions) among ME immigrants, comparing their health to those of U.S.-born whites. Results show that whereas the least acculturated ME immigrants have significantly lower odds of reporting fair or poor health, the most acculturated ME immigrants have higher odds of reporting fair or poor health compared to U.S.-born whites. Additionally, ME immigrants are significantly less likely to report any activity limitations or chronic health conditions compared to U.S.-born whites. I next investigate whether the relationship between acculturation and the three health outcomes varies by gender. Results indicate that, ME immigrants are generally healthier than U.S.-born whites; ME immigrant men are healthier than ME immigrant women. The study finds evidence of an association between acculturation and self-rated health. However, the acculturation pattern does not hold for activity limitations or for chronic health conditions. Male and female ME immigrants of all accultura¬tion levels are less likely to report any activity limitations or chronic health conditions compared to their U.S.-born counterparts.I then examine the linkage of duration status and serious psychological distress (SPD) of ME immigrants comparing their SPD to those of U.S.-born whites and investigating whether this relationship varies by gender. I find evidence that duration status and SPD pattern pertains to ME immigrants, particularly women, who report higher odds of SPD compared to their male counterparts. Results show no statistically significant differences between ME immigrant men and U.S.-born white men with regard to SPD. On the contrary, whereas ME immigrant women with shorter duration are less likely to report SPD than U.S.-born whites, ME immigrant women with longer duration are significantly more likely to report SPD compared to U.S.-born whites.

Affective intra-individual variability (IIV) and affective psychological flexibility (PF) are both types of within-person variability. Affective IIV is defined as the range of emotions experienced by an individual assessed at multiple time points. PF is defined as the ability to vary one’s responses in a contextually dependent manner in order to appropriately meet situational demands. Currently, there are no comparisons between affective IIV and PF demonstrating how these constructs might be uniquely different from each other. The current study proposed to examine affective IIV and PF in order to establish discriminant and convergent validity, and stability data for each construct. The National Study of Daily Experiences (NSDE) waves 1 and 2, an 8-day daily diary portion of the Midlife Development in the United States (MIDUS I) and MIDUS II surveys was used for this study (n =793 adults completed both waves of the NSDE). Affective IIV was related to higher mean NA and neuroticism, and lower perceived control. Affective PF was related to lower mean NA, neuroticism, and higher mean PA and perceived control. Higher affective IIV was associated with more psychological distress when assessed concurrently at both waves and predicted more psychological distress and physical ill-health 10 years later. Higher affective PF was related to less psychological distress and physical ill-health when assessed concurrently at wave 1 and less psychological distress and physical ill-health 10 years later. When situational context is included in the calculation of emotional variability, changes in emotional response may represent emotional complexity and increased control rather than emotional lability and are related to better psychological and physical outcomes.

Previous studies on occupational health and safety (OHS) management in construction have largely focused on injuries and physical health, but marginally on an important, complex issue that is the psychological health of foreign workers, leaving a significant knowledge gap in construction OHS research globally. Hence, this research aimed at investigating factors affecting the psychological health of foreign workers in the construction industry and developing a framework of interventions to address them. Socio-ecological theory was used as lens to analyse the problem and to derive solutions from multiple perspectives. The psychological health of workers is a more serious concern in developing nations, particularly in the GCC countries where foreign workers form the major workforce, warranting extensive research. The Saudi Arabian construction industry was therefore chosen as the context for this study. A mixed-methods strategy, involving both qualitative and quantitative data collection and analyses, was adopted whereby interviews with 39 participants and a questionnaire survey with 108 respondents from the construction industry of Riyadh were conducted. Fifteen factors critically affecting the psychological health of foreign construction workers in this region were discovered. Subsequently, a framework of interventions from three perspectives such as organisation, community and state, is suggested to counteract them. This research contributes significantly to knowledge and practice. First, the study adds a new dimension to OHS research in construction, which concerns socio-psychological aspects, rather than the traditional physical, technical and managerial dimensions. Second, it has demonstrated how the socio-ecological theory might be applied to investigate complex problems in construction and derive solutions from multiple perspectives. Finally, OHS management in the GCC construction is poorly researched and the issue of psychological health has almost never been explored though it is an urgent need. This study fills this gap and functions as the seminal work on this topic in the region. For practice, the study offers a holistic framework for policy makers and government authorities to enable them to improve the OHS condition, especially the psychological health, in the Saudi Arabian construction sector. Similarly, valuable insights are offered for construction organisation as to how their OHS management systems might be improved. Keywords: Occupational health and safety, psychological health, foreign workers, socioecological theory, Saudi Arabia.

This research aimed to clarify the relationship between ethnic identity and psychological health by addressing two theoretical issues. First, the construct of ethnic identity was conceptualized by distilling the underlying developmental process theorized in past work to generate a secure, stable, and positively defined self-concept, and to thus lead to improved psychological health. This developmental process, or ethnic identity achievement, occurs as people develop a commitment to their ethnic group derived from exploring its meanings and social significance. With this conceptualization in hand, two theoretical processes connecting ethnic identity achievement to improved psychological health were tested: identity change and the development of positive relations with other ethnic groups. Ethnic identity achievement was theorized to foster improved psychological health by facilitating a definitional change in one's ethnic identity to one that is more likely to positively evaluated and verified, thus contributing to a stable and positively defined self-concept. In addition, the process of ethnic identity achievement was theorized to improve psychological health by fostering a more sophisticated understanding of how relations with other ethnic groups are informed by social context, and thus leading to a greater appreciation of other ethnic groups and a diminished likelihood to perceive interactions with other groups as threatening. Using survey data drawn from an ethnically diverse sample of college students (N = 427), these processes were tested with structural equation modeling. The results showed that the theoretical model, specified by both processes, adequately fit the data and that the hypothesized path coefficients were generally supported. The final chapter discusses the theoretical contributions to the ethnic identity literature, identity theory and social identity theory, while closing with directions for future research.

In the last decades there has been a growing interest towards the concept of “Quality of Life” (QoL), not only in the bio-medical field, but also in other areas, such as sociology, psychology, economics, philosophy, architecture, journalism, politics, environment, sports, recreation, advertisements. Nevertheless QoL does turn out to be an ambiguous and elusive concept – a precise, clear and shared definition appears to be a long way off. In this article an analysis of how QoL is interpreted and defined in various scientific articles published in the last two decades, is offered. In addition, an illustration of how widespread the use of this concept is in different fields of knowledge, the difficulties in reaching a shared understanding of QoL, the problems involved in stating clearly the construct, and a presentation of some of its conceptualizations, are provided. The importance of subjectivity in the definition of what QoL is, emerges as a key aspect. This personal and subjective dimension could be the starting point for a more thorough and holistic understanding of this concept, in which standardized sets of valid, reliable and evidence-based measures of, e.g., psychological and spiritual dimensions, are encompassed in the person’s quality of life evaluation.

The definition of a psychologically healthy person varies depending on changes in personality or counseling theories. Several common features—such as independence and autonomy—appear to describe the psychologically healthy person in the Western mental health field (Pack-Brown & Williams, 2003), reflecting personality and counseling theories based on European American individualism. European American values of psychological health, however, may not be entirely applicable to other cultures or countries, because one’s cultural orientation and values influence one’s understanding of well-being and what is ideal (Suh, 2000). The purpose of this study is to explore college students’ and counselor trainees’ perceptions of a psychologically healthy person and perceptions of certain cultural values while examining for potential differences between the United States and South Korea. United States participants included 200 undergraduate students and 103 graduate students in counseling psychology programs in the Midwestern United States. Korean participants included 241 undergraduate students and 119 graduate students in counseling psychology programs in Korea. The study used four different versions of the survey: a counselor trainee version and a college student version in both English and Korean. Each survey consisted of two different parts. The first part was comprised of the Asian American Values Scale–Multidimensional (AAVS-M; Kim, Li, & Ng, 2005) and the independent Self-Construal Scale (Singelis, 1994). The second part was an open-ended questionnaire which asked for participants’ perceptions of psychological health. A two-way MANOVA was performed with SPSS to examine differences in perceptions of Asian cultural values with the five subscales (i.e., Collectivism, Conformity to Norms, Emotional Self-Control, Family Recognition through Achievement, and Humility) of AAVS-M by nationality (United States vs. South Korea) and profession status (college student vs. counselor trainee). A two-way ANOVA was performed to examine differences in perceptions of individualistic values by nationality and profession status. The qualitative data was analyzed using qualitative content analysis (Morgan, 1993) with principles of inductive analysis (Patton, 2002) and Consensual Qualitative Research (Hill, Thompson, & Williams, 1997) to find themes in participants’ answers for open-ended questions using Nvivo software. The MANOVA revealed significant differences in perception of Asian cultural values by both nationality and profession status. The interaction effect of the two independent variables was also statistically significant, indicating that the nature of the difference between counselor trainees and college students varies in the United States and Korea. The ANOVA revealed significant differences in the perception of individualistic values by both nationality and profession status. The interaction effect was also significant, indicating that American counselor trainees perceived individualistic values in a more negative light than American college students, while Korean counselor trainees perceived individualistic values in a more positive light than Korean college students. As a characteristic of a psychologically healthy person, 8 domains (personal and self, interpersonal relations, social norms, affect, cognitive-behavioral, purpose in life, coping, absence of mental illness) and 29 themes emerged as a result of qualitative analysis. Thematic differences between the United States and Korea as well as college students and counselor trainees were identified. The results help us understand cultural value differences as well as impacts of counselor training in the United States and Korea. The findings suggested that counselor trainees in both the United States and Korea should be aware of their potential tendency to devalue Asian cultural values in their clinical work. The greater value differences between Korean college students and Korean counselor trainees particularly raised needs to develop culturally relevant counseling models and training in Korea. Suggested implications for training and practice of counseling in cross-cultural situations will be elaborated upon in detail.

The current study investigates the relationships among self-reported feelings of chronic social isolation, risk, and protective factors. The study sample included 2,516 adolescents and young adults. Participants responded to survey questions regarding relationships, risk behaviors, psychological health, and protective factors. The findings revealed that reported social isolation at Time 1 was associated with an increased risk for social isolation at Time 2. Demographic characteristics were associated with an increased risk of chronic social isolation. Individuals with chronic isolation demonstrated psychological issues such as higher levels of depressive symptoms and lower levels of self-esteem. Dropout and increased screen time were a risk factor for chronically isolated females. Protective factors did not significantly influence the associations between social isolation and risk.

The purpose of this study was to explore the relationship between socioeconomic status, resilience, racial identity and the psychological health of African American men. The independent variables in this study were socioeconomic status, resilience, and racial identity. The dependent variable in this study was psychological health. A sample of 105 African American men was surveyed using the Hollingshead Four Factor Index of Social Status (Hollingshead, 1975); the Resilience Scale (Wagnild & Young, 1993); the Black Racial Identity Attitudes Scale (Parham & Helms, 1981); and the Mental Health Index (Veit & Ware, 1983). Additional demographic data included asking participants to indicate: if they were born in the U.S.; whether they regularly attended church; if they lived with or near a close knit group of family and/or friends; whether they grew up in the Columbus area; and if they had a male role model while growing up.A hierarchical regression analysis was used to analyze the data. The results of the regression analysis found that socioeconomic status accounts for 4.6% of the variance in psychological health. Resilience did not significantly account for any of the variance in psychological health, however, when racial identity was added to the regression, the model became significant. Supplemental analyses found that Pre-Encounter and Encounter racial identity ego statuses were significant predictors of psychological distress, and that the Internalization ego status and resilience were significantly correlated to psychological wellness. Additional analyses found that psychological distress was significantly correlated to men who live with or near a close knit group of family and/or friends. A factor analysis was also conducted on each of the measurement instruments used in this study. A parallel analysis and scree plot supported just one factor in a principal component analysis for the RS-25 scale. Due to a smaller sample size a parallel analysis was not conducted for the RIAS-B, however, a scree plot supported seven components for the scale. For the MHI, a parallel analysis and a scree plot supported two components in a principal components analysis. Overall, some findings are consistent and supportive of the current literature regarding socioeconomic status, resilience, racial identity, and psychological health as they pertain to African American men. Other findings challenge the current research thus concluding that more in depth studies with variables used in this study and samples of African American men are a necessity. Discussion of the measurement instruments, data analysis procedures, implications for counseling and further research are presented.

Research suggests that living in a disordered neighborhood can negatively affect physical health and psychological well-being. There is also evidence that social and personal assets can moderate these effects. A sample of 77 participants was given a questionnaire that assessed their perceptions of disorder in their neighborhood, their individual assets, and their physical health and psychological well-being. Neighborhood disorder predicted physical health, fear, and mistrust. Formal social ties and church attendance buffered the effects of neighborhood disorder on health, fear, and mistrust.

This study examined the relationship between body dissatisfaction and psychological health. Several scholars have suggested that body image is an increasingly relevant issue for men. However, limitations in current measurement make it unclear how meaningful such findings are. Furthermore, few extant studies in the general body image literature have examined the role of positive psychological coping variables. Therefore, this study sought to examine the relationship between body dissatisfaction and psychological health. It was hypothesized that body dissatisfaction would be positively correlated with symptoms of psychological distress, and negatively correlated with indices of positive psychological adjustment. Furthermore, it was hypothesized that the indices of positive psychological adjustment (satisfaction with life, proactive coping, hardiness, and optimism) would moderate, or buffer, the relationship between body dissatisfaction and the indicators of psychological distress (depression, symptom reports, self esteem). It was also hypothesized that the Male Body Attitudes Scale, a new measure of body dissatisfaction in men, would demonstrate adequate reliability and validity. In this study, 368 male participants recruited from an introductory psychology class took ten measures, including the General Health Questionairre-28 and the Psychological Hardiness Scale. Participants also completed a demographics questionnaire. Correlational analysis was used to examine the hypothesis regarding the relationship between body dissatisfaction and the psychological health indices, and hierarchical moderated regression analysis was used to examine the buffering hypothesis. Furthermore, MANOVA was used to assess the demographic variables, and ANOVA was utilized to test for order effects. Maximum likelihood analysis was utilized to impute missing data values. The first main hypothesis of this study, that body image dissatisfaction would be positively related to indices of psychological distress, and negatively related to indicators of positive psychological adjustment, was supported. The second main hypothesis of this study, that the relationship between body image dissatisfaction and indices of psychological distress would be moderated by the indicators of positive psychological adjustment, was not supported overall. The reliability of the MBAS overall scale and its three subscales, as well as the convergent and concurrent validity of these scales, was supported. These results support the practical significance of body image for men.

Mother's subjective neighborhood evaluations are linked to mother's psychological health and parenting strategies (Gonzalez, Cauce, Friedman, & Mason, 1996; Jarrett, 1997; White, Kasl, Zahner, & Will, 1987). In this study, differences in maternal evaluations of the same neighborhood were evident in semi-structured qualitative interviews. Few studies have investigated what specific factors contribute to mothers' overall neighborhood assessments. This study investigates how different contextual factors---social interaction, fear of crime, neighborhood appearance, and community violence---are associated with maternal evaluations of their neighborhoods. I then examine the impact of mothers' subjective neighborhood evaluations on maternal mental health and parenting behavior. The sample consisted of 104 mothers representing an impoverished multiethnic group, with 52% reporting an annual personal income under $10,000. Mothers and children resided in an economically disadvantaged, high-risk neighborhood in Detroit, Michigan. Using mothers' qualitative interview responses, their overall neighborhood evaluations were categorized into four groups: (1) consistently negative, (2) consistently positive, (3) inconsistent (e.g. describing the neighborhood as a positive place to raise children and then describing many serious neighborhood dangers), and (4) both positive and negative. Multivariate Analysis of Variance revealed that mothers' ratings of neighborhood incivility (e.g. offensive neighborhood appearances) had the greatest affect on subjective neighborhood perceptions, followed by mothers' fear of crime, and their own experiences of personal victimization. Hierarchical regression analyses were used to investigate the relation of specific neighborhood characteristics on mothers' psychological well-being and parenting. Neighborhood factors are related to the psychological health of mothers which, in turn, predicted children's psychological functioning. In sum, this dissertation highlights the important interplay of various contextual factors on mothers' overall neighborhood assessment, mental health, and parenting.

The purpose of this study was to observe the effects of a 10-week walking program on the physiological (cardiovascular health, body composition, and flexibility), psychological (loneliness), and nutritional (eating patterns) parameters of an independent-living older adult population, and to use this study to determine the logistics for a proposed grant through the Center for Rural Health and Research at Georgia Southern University. The subjects (n=10) were randomly assigned into one of two groups, WALK (n=5) and CON (n=5). One subject in the WALK group withdrew, and one subject requested to be moved to the CON group, resulting in the WALK group (n=3) and the CON group (n=6). Both the WALK and the CON groups were administered a battery of test assessments (consisting of: The Modified Bruce Submaximal Graded Exercise Test (utilizing the time on the treadmill), heart rate, blood pressure, body composition, flexibility, the Revised UCLA Loneliness Scale (RLS), a Food Frequency Checklist, and a 24-Hour Nutritional Recall), before and after the exercise prescription (10-week walking program). The WALK group (n=3) participated in a 10-week walking program prescribed by and under the supervision of an exercise physiologist. The CON group (n=6) did not participate in any exercise during this 10- week period. Results of pretest/posttest data were compiled with means and ranges reported. The pretest/posttest scores of the physiological and psychological data were analyzed using the Mann-Whitney U Test. The Food Frequency Checklist information was analyzed by a registered dietician, and the 24-Hour Nutritional Recall data was analyzed by the computerized software program, Nu-Deal (Manore, Vaughan, and Lehman, 1989). Results of the physiological, psychological and nutritional data showed no statistically significant results for either the WALK or CON groups from pretest to posttest.