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The purpose of the current research was to extend knowledge of attribution processes in sport. Specifically, the attribution processes of coach-athlete dyads were investigated over several weeks of competition, focusing on the application of theoretical frameworks (i.e., Heider, 1958; Kelley, 1967; Rees, Ingeldew, & Hardy, 2005a; Weiner, 1985) to attribution processes. Attribution change and the influence of coach feedback and post-game review procedures on attribution processes were also investigated. Three elite junior Australian Football (AF) players (18-19 years) and their head coach (45 years) were interviewed on multiple occasions through an attribution lens. Each athlete was interviewed on three occasions (pre-game, post-game, post-feedback) and the athletes’ coach was also interviewed two days post performances for the same three games. Player-participants’ stories are presented as case studies, with attention given to how their stories related to the literature. Participants’ stories reflected several aspects of theoretical frameworks (i.e., Heider, 1958; Kelley, 1967; Weiner, 1985). There was evidence of actor and observer divergence with the coach-participant providing more dispositional causal ascription than player-participants. Player-participants demonstrated attribution change after their post-game feedback possibly revealing the influence of review processes for mediating attributions. For example, after coach feedback, athletes used the coach’s attributions to explain their performance outcome. In addition, their attributions tended towards using more dispositional causes in their post-coach feedback interviews than were used in their post-game interviews. The findings may demonstrate the strong influence that coaches have on athletes’ perceptions of their performance outcomes. The research findings extend knowledge of attribution processes in sport and could inform researchers and sport psychologists in determining interventions of choice to assist athletes and coaches.

Relatively little is known about the impact psychotropic drugs, particularly sedatives, have on human behaviour in a residential fire emergency. Two separate but related avenues of investigation were conducted to explore human behaviour in fire when under the influence of psychotropic drugs. In Study One the efficacy of current and alternative smoke alarm signals was tested after the consumption of hypnotics. A supplementary objective was to examine the relationship between sleep quality and arousal thresholds. Study Two retrospectively analysed an Australian database of fire fatalities using advanced algorithmic modelling techniques to determine: (a) if users of psychotropics and hypnotics were overrepresented in the Australian fire fatality statistics; and (b) the relationship between psychotropic drug consumption and a number of behavioural, environmental, and demographic risk factors. The research provided new, important evidence revealing an uncomfortably high level of risk to users of psychotropic drugs, particularly hypnotics, in a residential fire context. This was the first time psychoactive drug usage had been considered in such detail in the international literature.

Firelighting behaviour amongst children and adolescents poses a significant concern for the well-being of the young person and their wider communities. Often difficult to detect, young firelighters account for a fifth of the fires lit in Australia. The focus of this study was to explore the characteristics and profiles of young firelighters in an Australian sample and to determine the rate of recidivism and identify variables that may predict firelighting recidivism risk.

A number of studies have found that both dysfunctional beliefs and attitudes about sleep and sleep hygiene behaviours contribute to sleeping problems, particularly for those with insomnia. However, limited research has investigated beliefs and attitudes about sleep and sleep hygiene from a developmental perspective, within the community. This study was divided into two Phases. In Phase One, the aim was to develop a questionnaire assessing ‘community’ beliefs and attitudes about sleep, named the Views on Sleep Scale (VOSS). Another aim was to re-test the psychometric properties of a published scale assessing people’s beliefs about sleep hygiene (Sleep Beliefs Scale, SBS, by Adan, Fabbri, Natale & Prat, 2006). Phase One of the study comprised of 209 adults from the general community, ranging in age from 18 to 86 (M = 41, SD = 15). The results found that both the VOSS and SBS had good internal reliability when examining the total score and individual items of the scales. In Phase Two, the aim was to test two age groups (18-25 years and 60+ years) about their beliefs and attitudes about sleep using the VOSS, SBS and the Sleep Plot (developed by Lack, 2007). Participants in Phase Two were younger adults (n=113; aged 18 to 25, M = 21.41 years) and older adults (n= 110; aged 60+ years, M = 72.13 years). Consistent with the hypothesis, the older adults held more dysfunctional beliefs and attitudes about sleep than the younger adults. In comparison, younger adults and males were found to hold more incorrect beliefs/less sleep hygiene knowledge than the older adults (respectively). An explanation was put forth, suggesting that older adults tend to be more concerned about their sleep and the consequences of poor sleep on daytime functioning. Therefore, it is suggested that the older adults are more concerned about practicing the correct sleep hygiene behaviours in comparison to younger adults. In addition, results found that both age groups realistically portrayed the sleep of a healthy 65 year old to have less deep sleep than a healthy 18 year old. Yet, both age group’s perceived sleep to be unrealistically deep and uninterrupted throughout the night. This study suggests that dysfunctional beliefs and attitudes about sleep are more widespread across the community than just in those defined as poor sleepers. This study highlights important areas for education in the general community, such as sleep expectations, sleep beliefs, sleep hygiene behaviours, and the usual sleep-wake cycles across the night. It is proposed that changing widespread faulty perspectives may be helpful in the prevention and/or treatment of insomnia.

This thesis examines work stress in the Community Services Sector (CSS) in Victoria. Psychological injuries are extremely high in the CSS (WorkSafe Victoria), and yet there has been no research specifically addressing this issue in the sector. Further, there has been little research that examines workers’ perspectives of work stress. The thesis thus focuses on the ‘missing voices’ of workers by outlining what workers have to say about work stress, its causes and its effects. In order to place this research into both its historical and socio-political contexts, the genealogical roots of work in the CSS are examined and the impact of neo-liberalism on the sector critically assessed.

A suicide attempt is a very significant and usually disturbing event for the person who makes the attempt, for his or her family, and for clinicians who respond. Moreover, epidemiological studies have established that a suicide attempt is associated with an increased risk of subsequent attempt or suicide, suggesting that understanding more about experiences following a suicide attempt may have implications for prevention. Yet, despite calls for more qualitative research in the field, there have been few studies investigating these experiences. This thesis reports on a qualitative research study in which adults who had made a suicide attempt were interviewed about their experiences following the attempt. Lethality of suicide attempts varied but was within the moderate to severe range of medical seriousness. Ten participants (eight women and two men, aged 28 to 52) were asked about the nature of the suicide attempt, their personal experiences in the period that followed, their interactions with family and friends, and their experiences of clinical services. Findings support theorising a suicide attempt as trauma, with core experiences of loss of control, helplessness, disconnection from others, shame, guilt and humiliation. Movement from helplessness and disempowerment toward a sense of agency and control, and from disconnection and aloneness to repaired relationships were crucial aspects of the recovery process,. Analysis of interactions with family and friends noted the significance of sustained relationships and support, while also identifying a pattern of reciprocal recoil from the horror of the suicidal crisis and mutual silences aimed at protection of self and other, followed by efforts to repair ruptures in relationships. Experience of significant losses characterised the period following the suicide attempt. Respect and being taken seriously vs humiliation, blame or indifference was the overarching theme in relation to experiences with clinical services. Collaborative decision-making in the clinical setting was experienced as central to overcoming helplessness and regaining a sense of agency. Psychotherapy was valued for containing distress and/or working through underlying issues. Recommendations for practice are presented, while acknowledging the limitations of the study.

Childhood sexual assault (CSA) is a prevalent societal issue that can have long-term negative effects on the survivor. Adult survivors of CSA frequently seek therapy from mental health professionals. However, mental health professionals are not necessarily aware of, or trained, in working with CSA. This lack of knowledge can result in considerable negative consequences for the survivor. This study aimed to explore the experiences and needs of CSA survivors who engage in therapy, and identify helpful and unhelpful mental health professional practice. This was achieved qualitatively, with data gathered by a semi-structured interviewing style and evaluated via thematic analysis, guided by a social constructionist epistemology. Three survivors of CSA, who had previously engaged in therapy with a mental health professional, as well as 13 mental health professionals, participated in the current study. This study found that despite mental health professionals’ lack of education and training about CSA, they did not need to be particularly knowledgeable to be considered effective. Specifically, the ability to listen was crucial, as this indicated the professional was comfortable with the disclosure. However, an inability to listen was commonly cited and demonstrated to the survivor in a variety of ways. The issue of referral upon disclosure of CSA was identified as problematic, as well as considered a professional ethical dilemma. Whilst mental health professionals are bound by a professional responsibility of working within their realm of expertise, it could also be perceived as negative in terms of the messages it sent to the survivor. An ideal solution was suggested to circumvent this problem. The implications of mental health professional practice on CSA survivor wellbeing is discussed.

There is a paucity of research on the mental health of asylum-seekers, particularly in comparison with refugee and migrant populations. Yet asylum-seekers occupy a vulnerable place in our community. After applying for a protection visa upon arrival in the host country, asylum-seekers frequently endure uncertainty for a protracted period as they traverse the Refugee Determination Process (RDP). The RDP in Australia and other Western countries can take years. Furthermore, asylum-seekers face psychosocial difficulties including numerous barriers to employment and access to health services, which can precipitate or perpetuate mental health problems. Despite this, little research has been undertaken with asylum-seekers negotiating the RDP, particularly studies employing a prospective design.

Despite the theoretical link between jealousy and self-esteem, research has yielded inconsistent results with regard to this relationship (review: White & Mullen, 1989). Although defenses such as projection, denial and repression have been linked with jealousy (Freud, 1922), there has been no research to date exploring this relationship. This quantitative study used self-report questionnaires, and aimed to contribute to previous research on jealousy and self-esteem, and defenses and selfesteem, and to explore the relationship between jealousy and defenses. Participants consisted of a convenience sample of 188 individuals aged from 20 to 81 years (M = 38.3, SD = 15.47), and included 73 men and 112 women. Measures included a brief demographic questionnaire, an 8-item dispositional jealousy measure (Melamed, 1991), the Rosenberg Self-Esteem Scale (Rosenberg, 1965), and the Defense Style Questionnaire (DSQ-40; Andrews, Singh & Bond, 1993). The hypothesis that jealousy and self-esteem would be negatively correlated was supported for the overall sample (r = -.31, p = .005), however when split by gender there was a correlation for women (r = -.37, p = .0005), but not for men. The findings supported the hypothesis that jealousy would be positively correlated with immature defenses (r = .34, p = .0005) and negatively correlated with mature defenses (r = -.32, p = .0005). Jealousy was also positively correlated with the individual defenses of undoing, projection, passive aggression, acting out, devaluation, autistic fantasy, displacement, splitting, and somatization. Jealousy was negatively correlated with the individual defenses of sublimation, humor and suppression. The relationship between jealousy and defenses was often considerably stronger for men than for women. It was concluded that a relationship between jealousy and self-esteem did indeed exist, however this was only the case for women. For men, jealousy was found to be particularly associated with use of defenses.

Depression is among the most common mental disorders in young Australians. Through evolving theory two depression subtypes, sociotropic (anaclitic) and autonomy (introjective), have emerged. Attachment and intimacy have also been implicated as important to mental health in young adults, and vulnerability to depression has been linked to intimacy, sociotropy, autonomy and attachment. Therefore the aim of the current study was to examine depression in relation to attachment, intimacy, autonomy and sociotropy in young adulthood, in a clinical and community sample. In this context the study also aimed to explore ‘experience of intimacy’ in young adults (given Erikson’s psychosocial model implicating its importance), and its relation to attachment and depression. Further, based on theory of Holmes about the way autonomy and intimacy relate, the study aimed to examine this relationship. There has been limited research exploring all these variables together in the context of depression.

Most women use family planning services during their reproductive lifetime, but many lack ready access to such services, particularly in a rural area. The aim of this study was to document and thus develop an understanding of the facilitators and barriers to accessing three types of family planning services (emergency contraception, termination of pregnancy, and options counselling) within a particular rural area of Victoria, Australia, and how these might affect women’s psychosocial health and their ability to make timely decisions about continuation of a pregnancy.

Infants differ in their ability to achieve organised sleep-wake behaviour. Difficulties in this developmental process are associated with problems falling asleep at bedtime and repeated night awakenings where parental assistance is needed to return to sleep. Studies have shown that a number of maternal psychosocial factors have been linked to differences in infant sleep outcome. The primary aim of this study was to examine the relative contribution of maternal psychosocial factors including depression and anxiety symptoms, perceived past maternal parenting, maternal cognitions about infant sleep, maternal sleep history and the maternal settling strategy of active physical comforting to infant sleep outcome. A further aim was to explore the extent to which these variables affect infant sleep outcome through their link to maternal cognitions about infant sleep.

This thesis investigates the predictors of Malaysian employee wellbeing, specifically, whether the psychosocial work environment (job demands, job control, social support), organisational justice (procedural, interactional, distributive) and work family conflict (work to family and family to work conflict) can reliably predict employee wellbeing (job satisfaction, job affective wellbeing, life satisfaction, positive affect, negative affect and psychological wellbeing). Drawing upon the Job Demand-Control (JDC) and Job Demand-Control-Support (JDCS) models, it also examines the moderating effects of job control and social support on the relationship between job demands, organisational justice and work family conflict, and wellbeing.

A number of studies have found maladaptive eating behaviours and attitudes in individuals with narcolepsy, however, few studies have comprehensively investigated possible reasons (other than hypocretin deficiency) for these findings. The aim was to investigate the eating behaviours and attitudes of individuals with narcolepsy. The sample consisted of 73 individuals with narcolepsy and 74 controls. Measures used were the Bulimia Test, Depression Anxiety Stress Scale and Epworth Sleepiness Scale, a one day Food and Drink Intake Diary, a newly developed Meal and Snack Timing Questionnaire and an adapted Meal Choice Questionnaire and Snack and Drink Choice Questionnaire. Results showed that individuals with narcolepsy consumed significantly more snacks and drinks than controls. Controls were more concerned about the impact of snack and drink choice on their weight. Individuals with narcolepsy were more likely to binge eat than controls. Individuals with narcolepsy rated the importance of timing food intake with convenience of sleepiness more highly than controls. Individuals with narcolepsy had significantly higher levels of depression, anxiety and stress than controls. Individuals with narcolepsy with moderate to severe levels of anxiety and stress scored significantly higher on the binge factor than those with normal to mild levels of anxiety and stress. A hypothesis is developed suggesting that two opposing frameworks may be operating in narcolepsy, one of a purposeful eating behaviour and another of uncontrolled eating behaviour. The pattern of timing meals and snacks according to the convenience of sleepiness implies that individuals with narcolepsy are engaging in a purposeful behaviour to control their symptom of daytime sleepiness. Binge eating may be an uncontrolled compensatory factor as a consequence of this purposeful timing of food and sleepiness. Further, this study suggests that this extent to which binge eating is engaged by individuals with narcolepsy may be driven by anxiety and stress.

Accurate assessment of memory functioning is integral in the framework of comprehensive neuropsychological examination. Knowledge of the integrity of memory functioning contributes to decisions regarding diagnoses, competency, rehabilitation and surgery. The Wechsler Memory Scale-Revised is a frequent memory assessment tool in everyday neuropsychological practice. The present study reports the modification and validation of an alternate scoring system for the Visual Reproduction subtest of the Wechsler Memory Scale-Revised and generation of Australian normative data. This test is frequently used in clinical practice and therefore an improved scoring method and collation of locally appropriate normative data forms a significant contribution to knowledge and extension of the evidence base for the practice of clinical neuropsychology. An alternate scoring system for the Visual Reproduction subtest of the Wechsler Memory Scale-Revised was previously developed and preliminarily validated in a clinical population by Dowling and Clark (2000). The current research project modified the Alternate Scoring System to improve reliability. Subsequent to its modification, normative data was required to enhance clinical utility in an Australian population. The scoring system was applied to subject responses from a large-scale normative study conducted between 1996 and 1998. The Macquarie University Neuropsychological Normative Study involved 399 Australian adults aged between 18 and 34 years of age and included administration of the Wechsler Memory Scale-Revised. As hypothesised, the alternate scoring system generated a similar grading of memory to the original scoring system. Major outcomes of the present study include a substantial literature review to support the development of the alternate scoring system, modification of the alternate scoring system in collaboration with original authors, further validation of the alternate scoring system through comparison with the original scoring system, and production of Australian normative data. Implications of the modified alternate scoring system, together with the normative data produced through the present study, have broadened the clinical applications of the WMS-R Visual Reproduction subtest and provided another tool to guide result interpretation in the assessment of visual memory functioning in an Australian population.

The purpose of the present study was to validate the Physical Activity and Leisure Motivation Scale (PALMS). This included examining the internal consistency and criterion validity of the PALMS, as well as testing the proposed model of PALMS subscales in a confirmatory factor analysis. This study also looked at the various reasons people nominate for engaging in physical activities. A community sample of 202 volunteer participants, 120 males and 82 females, aged 18 to 71 years, was recruited from various organizations, clubs, and leisure centres. The participants represented different forms of physical activity namely, Australian Football League (AFL), gym-based exercise, tae kwon do, tennis, and yoga. Results indicate that the PALMS has a robust factor structure (CMIN/DF = 2.22; NFI = 0.95; CFI = 0.97; RMSEA = 0.078). The PALMS also demonstrated good internal consistency with a Cronbach’s alpha (α) of 0.79. The α values for the PALMS subscales ranged from .80 to .99. In terms of criterion validity, Spearman’s rho (rs) indicated a strong positive correlation between the REMM and the PALMS (rs = .9). The correlations between each PALMS sub-scale and the corresponding sub-scale on the validated REMM were also high and varied from .76 to .95.

Cultural competence is a relatively recent term describing appropriate ways of working with increasingly diverse cultures in society. By interviewing diabetes practitioners, this study sought to investigate the interaction between scientific knowledge and the practice of diabetes healthcare with patients from non-Western cultural groups.

Previous research has highlighted general practitioners (GPs) maladaptive coping efforts, but little is known about GPs who appear to adapt positively to their inherently demanding work. This study aimed to address this knowledge gap by identifying factors that optimise GPs adaptation to working in general practice. A qualitative methodology underpinned by a constructionist epistemological stance was used. Twenty-six semistructured individual interviews with suburban and rural GPs in the State of Victoria aged between 24 and 77 years were conducted. GPs identified work demands consistent with previous research: time pressure, long hours of work, heavy workload, and pace of work; work interfering with non-work/family, threat of malpractice litigation, and bureaucratic interference. However, the degree of concern and coping responses was varied; some GPs appraised the work demands as a threat while others considered them an opportunity. GPs adopted a range of adaptive behaviours to manage and resolve work demands that were influenced by six key elements. These were: (1) the degree of work centrality to GPs, (2) the inclination of GPs towards integration or segmentation of work and non-work/family domains, (3) situational factors in the general practice and non-work/family domains, (4) ability to psychologically detach from GP role (5) choice of respite activity, and (6) adequate recovery from work demands. An heuristic schema that brings together these six elements and their implications for GP adaptation was presented. Understanding and self-knowledge about work orientation, and preference for integrating and segmenting life domains, point to the need for tailored respite strategies that facilitate psychological detachment, recovery of resources, and successful adaptation to working in general practice and life as a GP. This knowledge may also assist medical students to prepare for meeting the challenges of their future medical careers.

Perhaps due to the perception of midwifery being an inherently pleasurable pursuit, there has been limited research of the stress and burnout midwives may experience. However, with evident difficulties in recruiting and retaining midwives, this is an area that requires research. Therefore the stress and burnout experienced by midwives who work in birthing suite was explored in terms of their coping style and levels of social support and assessed in terms of the levels of stress, burnout and compassion fatigue experienced.

The majority of research over the past several decades in the area of body image, evaluations of physical appearances, and implications of eating disorders, has largely focused on women. In the late 80s, some researchers challenged the conceptualisation of body image dissatisfaction as a uni-gender problem and pioneered a series of studies, which found that men have succumbed to societal pressures of the idealised body and experience greater prevalence of body concerns and resultant negative implications than previously reported. While the focus of body image studies have included male participants since then, many of them were flawed by using measures that were originally intended to measure body concerns among women. The current study aimed to examine the relationships between men's self-reported physical attributes of men including; weight, body image, penis size and satisfaction, general psychological health, and Internet dating behaviours using measures that have been specifically developed to measure male concerns.

Nightmares have been described as the most common form of disturbed dreaming. The definition most widely accepted considers two criteria as definitive elements of nightmares, acute anxiety or fear, and awakening from sleep with full alertness. Contemporary studies suggest that nightmares are relatively common and can either be benign or malignant to the point of being compared to psychosis. Thus when nightmares become frequent and/or recurrent, they tend to become problematic and warrant treatment. The current study aimed to investigate the frequency of nightmares in a large community based sample and trial a brief story line alteration technique. More specifically, the current research was designed to conduct two related studies in order to elucidate nightmare frequency and intensity in an Australian sample and examine the efficacy of self-help nightmare treatments. The main hypotheses in the first study predicted that more than 10% of the sample would report weekly nightmares and significant gender differences in reporting nightmares would be observed. Participants in the first study were 440 university students (115 men and 325 women) aged between 18 and 34 (M = 20.41 years). Participants completed the retrospective metric/s Nightmare Frequency Questionnaire (NFQ) and Pittsburgh Sleep Quality Index (PSQI) and Addendum. The results showed that yearly, monthly and weekly nightmares were common, in particular weekly nightmares. However no significant differences between genders were found. Participants in the second study were 20 students who reported weekly nightmares aged between 18-31 (M = 21.6 years) and completed a battery of retrospective metrics including the Nightmare Effects Survey (NES), Posttraumatic Diagnostic Scale (PDS) and the Profile of Mood States (POMS-37 items). The main hypotheses in the second study predicted that the Storyline Alteration Technique (SLAT) would ameliorate nightmare frequency and waking distress overtime and achieve significantly better therapeutic outcomes in contrast to the Systematic Desensitization (SysD) technique. Results showed that the SLAT was efficacious in significantly ameliorating nightmare frequency overtime and in contrast to the SysD technique. It was concluded that weekly nightmares were more prevalent than previous retrospective findings had indicated and self-help nightmare treatments were efficacious in ameliorating nightmare frequency, associated waking distress and poor sleep.

This thesis examines a case for the inclusion of narrative therapy by mainstream alcohol and other drug (AOD) services in counselling Australian indigenous people. Narrative therapy and narrative practices emerged from work developed in partnership with indigenous practitioners in the 1980s in Australia, and although little research has been done on these methods, they are generally regarded as being culturally acceptable to indigenous people. Currently, the interventions most commonly used in mainstream AOD counselling are generally short term and focus on changing behaviour. The argument of this thesis is not that mainstream AOD interventions are without value, but rather that some reductionist methods of counselling may not constitute the most culturally appropriate approach for working with indigenous clients, many of whom continue to be affected by trauma related to colonisation and its practices and experiences of ongoing racism and social disadvantage. This thesis also concerns itself with issues of language and power and proposes that these are of great significance in counselling indigenous AOD clients.

Intimacy is a central component of romantic relationships with the development of a capacity for intimacy regarded as being one of the milestones of adulthood. Fear of intimacy has been defined as “the inhibited capacity of an individual, because of anxiety to exchange thoughts and feelings of personal significance with another individual who is highly valued” (Descutner & Thelen, 1991, p. 219). Although a number of studies have focused on fear of intimacy, there has been limited research on th The primary aim of this study was to investigate the influence of past parenting (perceived maternal care and overprotection), and separation-individuation on young adults’ fear of intimacy regarding heterosexual partner relationships. A further aim was to examine whether there were differences in separation-individuation according to living situation and partnership status.e factors that might influence fear of intimacy. Past experience in the parent-child relationship has been found to influence both the capacity to form romantic relationships and separation-individuation. Establishing a romantic relationship and leaving the parental home have both been identified as important markers of adulthood, however current Australian statistics indicate that, compared to previous decades, in the period of emerging adulthood (18-25 years) fewer individuals are involved in a romantic relationship and a higher percentage of young people are living at home with their parents. The relationship between these social trends and past parenting, separationindividuation and fear of intimacy has not been explored.

The present study sought to understand the social and clinical characteristics of a group of pathological gamblers in Macau known as Paichai (扒仔). This study recruited participants from the casinos in Macau. Fifteen participants, all active gamblers and ranging in age from 24 to 53 years, were recruited and were repeatedly observed and interviewed. After initial screening, there were four non-Paichais, which were taken as a comparative sample. Further, the participants were assessed by the Problem Gambling Severity Index (PGSI) of the Canada Problem Gambling Index (CPGI) (Ferris & Wynne, 2001). There were a number of significant findings in this investigation. Firstly, the Paichais could be classified as antisocial-impulsive gamblers according to Blaszczynski and Nower’s (2002) pathways model of problem and pathological gambling. The development of pathological gambling among the participants was found to follow a linear model with a strong stage-based trajectory. In the first stage, the participants often recalled an early involvement of gambling during childhood. The majority of them reported coming from a family environment which encouraged gambling. They had a history of conduct disorder prior to the acquisition of their gambling habits. With increased involvement in gambling, these gamblers entered stage two where the participants often reported more frequent involvement of casino gambling. With the increase of time in the casino, the Paichais entered stage three of their development process. In this stage, the gamblers demonstrated significant detachment from the outside world as they spent most of their waking hours in the casinos. The current study attempted to understand the development of pathological gambling amongst these individuals from the particular social and cultural perspectives of Macau.

Contemporary western psychiatry is disengaging too readily with the notion that severe mental disorder characterised by psychotic experiences such as hallucinations and delusions can be a primary reaction to overwhelming stress or distress (Ungvari & Mullen, 2000). Reactive psychosis, a term coined over a century ago to differentiate these disorders from other psychotic processes more closely resembling schizophrenia, was investigated in 217 first episode psychosis patients being treated at the Early Psychosis Prevention and Intervention Centre, in Melbourne, Australia. Reactive psychosis criteria were first operationalised using the Reactive Psychosis Rating Form (RPRF). These patients’ course and outcome were then compared with their non-reactive psychosis counterparts over a 15-month follow up period. Twenty nine percent of first-episode psychosis patients met criteria for reactive psychosis. The reactive psychosis group had a more rapid initial recovery from their psychosis and social and occupational impairments, compared with their non-reactive psychosis counterparts. Clinical practice at the centre dictated that these patients had discontinued their anti-psychotic medication faster than the non-reactive psychosis group, suggesting the need to reconsider early psychosis treatment guidelines.

Academic performance is an important aspect of functioning for all children, particularly during late childhood with the pending transition to high school and subsequent increase in academic demands. Research suggests that it is important for children in late childhood to achieve academically not only to aid their learning as schooling progresses, but also to reduce the likelihood of a range of short and long-term negative outcomes. Factors which affect academic performance have been explored in previous research, however there has been limited research attention given to how children’s relationships in late childhood may influence academic outcomes. While it is recognised that parents and teachers play important roles in children’s lives, and that teachers play a leading role in relation to children’s acquisition of academic skills and knowledge, the level of influence these key relationships have on academic performance scores in late childhood is largely unknown. The current study investigated the effect of Child-Parent and Child-Teacher Attachment relationships on academic performance.

Understanding and treating individuals who have a combination of borderline personality disorders, self-injurious behaviours and sometimes suicidality, presents one of the most confusing and problematic challenges to mental health professionals. While the use of mental health legislation for this group is considered unusual, guardianship legislation in Australia is sometimes additionally utilised. To date, there has been no examination of the effectiveness of guardianship for people with borderline personality disorder in the Victorian context. This study aims to examine the role of guardianship for this population by assessing the contributing factors that led to the appointment of a guardian including the mental health responses prior to a guardianship application being made, subsequent service responses provided and finally to enhance current knowledge by determining whether guardianship is an effective intervention. This research has two phases. Phase one assessed guardianship as an intervention by the examination of case materials held by the Office of the Public Advocate. In phase two some participants from phase one were interviewed to elicit their experience of such an intervention. Findings indicated that the combination of high level self-injurious behaviours and refusal of treatment led to the appointment of a guardian. Service and system responses were quite diverse for this cohort, particularly regarding the ongoing provision of case management. Empathic responses were often not forthcoming from health professionals. Combined results indicated that advocacy rather than guardianship was more beneficial. Recommendations to improve the legal and healthcare framework are suggested.

Previous research investigating affect and behaviour following mild Traumatic Brain Injury (mTBI) in children has produced variable results. It has been suggested that following a mTBI children may experience transitory "post-concussion" symptoms but subsequently will make a full recovery. In contrast, other studies have reported changes in children's behaviour and affect lasting even years post injury. The current study aimed to further document the impact of mTBI on behaviour and affect in children. This prospective study reports on a sample of 26 children aged between 6 and 12 years. The children were assessed at baseline, one week, three months and a subgroup at 12 months post injury. No changes were found over time on the standardised measures of behaviour and affect with the Behavioural Assessment System for Children, Second Edition (BASC2). However, on the BASC2 the children with pre-existing problems displayed higher incidence of scores in the 'At Risk' or 'Clinically Significant' range on the Externalising Problems composite scale in comparison to the children with no preexisting problems. A qualitative question was also administered to parents. Approximately half of the whole sample reported some change in their child's mood or behaviour at one week post-injury and approximately one quarter continued to report changes at three months post injury. It was also investigated whether the children who had problems or changes reported at three months post-injury differed from the other children on any pre-morbid factors, however, no significant results were found. The overall conclusions drawn from the study were that the group of children referred to the study had a higher proportion of children with pre-existing problems than that expected in the general population. Further, these children differed pre-morbidly from those without pre-existing problems on standardised behavioural measures. While no changes were found over time on standardised measures of behaviour and affect, subjective parental report suggested that in fact there may have been more subtle changes in some children's behaviour up to 3 months post-injury. These findings are worthy of further systematic investigation.

According to the literature, borderline personality disorder (BPD) is often viewed negatively by mental health clinicians. The primary aim of this research was to assess the attitudes of clinicians working in mental health continuing care teams (CCTs) in Melbourne . A purpose-designed questionnaire, Attitudes to Borderline Personality Disorder Scale (BPD-APS), was used to gather demographic information from a sample of 91 participants and to assess clinicians' attitudes. Participants were from four main disciplines: 22 nurses (24%), 16 psychologists (18%), 17 social workers (19%), 12 consultant psychiatrists (13%), 11 psychiatric registrars (12%). Clinicians' discipline, years of practice, consultation and training with a specialised service (Spectrum) and level of burnout, measured by the Maslach Burnout Inventory (MBl-HSS), were all factors expected to influence clinicians' attitude towards BPD patients. Fifty-eight per cent of the participants had positive attitudes to BPD patients but a substantial proportion ( 42%) had negative attitudes. Years of experience in mental health impacted on clinicians' levels of interest in working with BPD patients but were not associated with their attitudes towards such patients. Significant statistical differences were found between the four main disciplines: psychiatrists/registrars and psychiatric nurses had more negative attitudes to patients with BPD. Social workers and clinical psychologists were more positive. Analyses indicated that clinicians (58%) experienced moderate to high levels of emotional exhaustion. Thirty eight per cent of the clinicians reported moderate to high levels of depersonalisation, while 61 per cent rated low to moderate levels of personal accomplishment on the MBl-HSS. The attitudes of the clinicians were correlated with depersonalisation but not with emotional exhaustion. Consistent with recent literature, clinicians with access to consultation and training had more positive attitudes. The findings of this study clearly indicate the need for clinicians working in mental health services to receive specific training, supervision and support for working with BPD patients.

Obesity has been described by the World Health Organisation as a global epidemic, and is perceived as a major health concern due to the associated medical, psychosocial, and economic problems. One approach of understanding obesity is directed towards exploring the psychological and social determinants underlying non-hungry eating (NHE) (eating without physical sensations associated with hunger) and overeating (eating past the physiological sensations of fullness). The immediate psychosocial cues that trigger NHE and overeating, along with the psychosocial antecedents that influence NHE and overeating have been found to be important contributors to obesity.

This study investigated the experiences and post-natal depression rates in women experiencing problems in establishing and maintaining a successful breastfeeding process with their babies. There were two phases in the project. Phase 1 gathered categorical data about this client group, their partner and baby, the breastfeeding problems experienced and screened the women for post-natal depression. Phase 2 involved semi-structured, in-depth interviews with ten of the women involved in Phase 1. The interviews explored women’s physical and emotional experiences of the breastfeeding problem(s); how this/these impacted on their relationship with their baby and partner; sought to elicit and evaluate the professional assistance they have received to remedy the problem(s); examined the amount and quality of family and social support received by the women; and invited participants to provide suggestions as to how other women in the same situation could be assisted. The results obtained found that this sample group had a higher level of PND than found by most previous researchers; that breastfeeding problems had a considerable physical and emotional impact on the women; they supported previous findings that professional, family and social supports are very important to new mothers; and that professional assistance and support to these women could be improved. It is recommended that further investigation is warranted – with a larger and more representative sample - to explore whether breastfeeding problems contribute to the aetiology and exacerbation of post-natal depression.

The purpose of this study was to explore the effect of war-related psychological trauma on refugees from the former Yugoslavia who came to Australia in the last 20 years, and to examine how their process of recovery from trauma was assisted by the power of healing relationships, family strength and resilience. The aim was to explore the entire family unit in the context of whole-family interaction.

This study set out to explore Malaysian professionals’ experiences of working with sexually abused children. Although the international literature on professionals’ experiences of sexually abused children is considerable, Malaysian research is sparse. The current study sought to redress this imbalance by conducting a qualitative study, informed by a grounded theory approach to investigate how working with sexually abused children affects the lives of professionals both professionally and personally; the strategies, including coping strategies, professionals used to overcome the difficulties associated with their work and whether any characteristics of the Malaysian sociocultural context contributed to the difficulties they encountered. In depth semi structured interviews were conducted with 21 participants representing a range of professions, all of whom had experience of working with child sexual abuse victims.

A number of studies have examined the behavioural and academic difficulties that follow paediatric Acquired Brain Injury (ABI) and made recommendations that students with an ABI be provided with an aide program. However, there is a lack of studies that have been carried out to examine the outcomes of the implementation of aide programs in the paediatric ABI population. The current study investigated the impact of aide programs on eight students (aged nine to fifteen years) with an ABI. In addition, the current study also investigated factors that were found to promote positive outcomes of aide programs. Measures used included: direct observation; interviews with the students, parents, teachers and aides; and neuropsychological tests including the BRIEF, CAFT, TEA-Ch, and WISC-IV Digit Span subtest. The data were analysed descriptively using both qualitative and quantitative techniques. Results demonstrated that the provision of an aide program resulted in a decrease in negative behaviours in the classroom and an increase in students‟ access to the curriculum. In addition to three frequently discussed factors (including individual assessments of students' cognitive profile, the provision of education and support to teaching staff on the impact of ABI), additional factors important to the outcome of aide programs were raised. These factors included aides having an adequate knowledge of the curriculum, aides being able to provide support through a positive helping style, and awareness of the students' need to fit-in. A model to promote positive outcomes of aide programs for students with an ABI was then proposed based on these six factors. This model suggested that these six factors fall into one of two stages required for the provision of aide programs with positive outcomes. The factors in stage one are those that require consideration during preparation for the implementation of an aide program. The factors in stage two require consideration during service delivery of an aide program (i.e. in the classroom). Consideration of both stages was found to lead to positive outcomes of aide programs, with an absence of either stage found to lead to negative outcomes of aide programs for students with an ABI.

This thesis explores the relationship between creative arts practice and trauma, loss and grief, including the shadowy world of sexual abuse. It is an examination of what art and the artist can contribute to wellbeing in the aftermath of such experiences through collaborative processes. It has involved creating art with a community of women who have inhabited spaces of trauma and loss and who carry the stigmata of these experiences. It examines what it means for artists to delve into the shadows of what hurts, disturbs and stultifies so as to offer something back that reveals, transforms and restores. Through a process of reflection and critical analysis, this research contributes to a more nuanced understanding of how art-making and a relationship with art and artists can influence the wellbeing of those dealing with trauma, loss and grief.The thesis also considers the creative spaces of artists: both the studio and the artist’s internal world.

Since 1984, regular contact, or openness, between birthmothers and the adoptive family has been practised in the state of Victoria, Australia. Open arrangements, that is, face-to-face contact and information exchange, are written into the Adoption Order and legally ratified by the Victorian County Court. The aim of the study was to investigate the birthmother experience of relinquishment and subsequent contact within this circumstance. The study used a mixed method approach: in-depth semi structured interviews and standardised measures of grief symptoms, adverse childhood experiences, depression/anxiety and satisfaction.

Obstructive Sleep Apnoea (OSA) and Chronic Obstructive Pulmonary Disease (COPD) are both medical conditions clearly associated with cognitive impairment. Impaired performance on tasks measuring reaction time, concentration, learning, memory, and driving ability have been observed. These deficits result in a higher risk of accidental injury for people who are diagnosed with such disorders. In patients with OSA, impaired performance on these measures may reflect the sleep fragmentation associated with multiple arousals during sleep, and/or the degree of hypoxemia and oxygen desaturation. In contrast, the level of impairment seen in COPD is related to the degree of hypoxemia both during sleep and during waking hours. The major aim of this study was to compare driving performance and neuropsychological function in OSA and COPD patients with healthy control participants, and to also compare OSA patients to COPD patients. The second aim was to determine the contribution of sleep fragmentation and hypoxaemia to poor performance and neuropsychological decline.

ABSTRACT A growing body of literature is emerging on the topic of athletic retirement. In particular, there are numerous reports about the adjustment difficulties many athletes experience at the end of their sporting careers. Despite the recent profusion of retirement research, there is still much more work to be done in terms of understanding athletes’ retirement transition experiences, and more specifically, determining what paths lead to successful adjustments. One path that has been suggested to influence the quality of athletes’ retirement experiences is staying involved in sport by becoming coaches. Unfortunately, little is known about the athlete-to-coach transition because few researchers have investigated this area. This research used a qualitative approach to explore the transition experiences of three retired tennis players who became coaches. Participants’ stories were collected using in-depth interviews and presented as case studies, with attention given to how their stories related to the literature. The case studies illustrate that the athlete-to-coach transition is a multifaceted idiosyncratic process and is best understood on a case-by-case basis. The Athlete Apperception Technique (Gibbs, Marchant, & Andersen, 2005) was also administered to the third participant to determine if this new tool could complement, illuminate, or add to the information gathered in the in-depth interview. By sharing the stories of retired athletes who became coaches, this research provides information that might potentially be helpful in athlete development, career transition, and coach education programs, and may assist other athletes navigating through their retirement journeys.

Attractiveness, and associated thinness, continues to be the determinant of social acceptance and desirability for most women in Westernised societies. The way in which females are objectified through social attitudes and gender ideals, highlights the importance of attractiveness in through which women gain social status, acceptance and power. Failure to achieve this ideal has been linked to increased body surveillance, body dissatisfaction, and disordered eating behaviour(s). While many women express body dissatisfaction and negative self-talk, fewer women actually engage in disordered eating practices. This study aimed to explore women‟s views about their bodies and to identify predictors of body objectification, body dissatisfaction, and disordered eating behaviour in a non-clinical population. It was hypothesised that women, who have strongly based their identity according to societal values and gender role expectations, would be more likely to experience higher levels of body dissatisfaction and be at greater risk of manifesting disordered eating behaviour(s). Two-hundred-and-nine women, aged between 18-65 years were recruited via convenience sampling and completed the following battery of questionnaires: Socio-cultural Attitude Towards Appearance Questionnaire (SATAQ), Body Image Ideals Questionnaire (BIQ), Objectified Body Consciousness Scale (OBC), Silencing the Self Scale (STSS), Sense of Belonging Instrument-Psychological (SOBI-P), Eating Attitudes Test (EAT-26), and Conformity to Feminine Norms Inventory (CFNI). Predictors of body objectification, body dissatisfaction, and disordered eating were determined using multiple linear regression and analyses of variance were used to make comparisons between groups based on developmental age, disturbed eating, disordered eating, and body mass index. Consistent with previous research findings, the current study found that body dissatisfaction, objectified body consciousness, and disturbed eating behaviour were prevalent within women aged 18-65 years.

Research studies have investigated the presentation and prevalence of anxiety problems in children and found that anxiety is very common among young children. However, there is a substantial gap in research regarding correlates of anxiety problems in this population. Given established research associations between childhood somatisation and anxiety, the current study focused on somatisation as well as anxiety per se in its investigation. The primary aim of this research was to examine changes over time in anxiety and somatisation in group of children with and without a diagnosis of asthma, using baseline data from an earlier study (Siddons, 2004). The current study also examined parental, psychosocial, and illness related factors associated with anxiety in children.

The aim of this research was to carry out a systematic prospective study of the cognitive functioning of young persons residing in a secure care facility. These adolescents have been identified as being at an immediate risk for harm and are placed in a secure facility to establish safety. Typically, these young persons have been in protective care for some years, and represent a cohort of maltreated children at the severe end of the spectrum. More recently, it has been recognized that as a group, these children are exposed to risk factors for neuropsychological deficit. The present study adopted a neuropsychological perspective to document the pattern and extent of their cognitive impairments. The results of the study indicated that Secure Welfare participants performed significantly worse than controls in all cognitive domains, including working memory, executive functioning, learning and memory, visuo-perceptual function and processing speed. Overall cognitive functioning, as represented by the WISC IV FSIQ was almost one standard deviation below the population mean. The data suggests that most adolescents with histories of maltreatment experience a number of cognitive difficulties, and, these difficulties are not specific to those identified as intellectually disabled. The implications of such deficits are potentially profound, influencing academic performance, adaptive behaviour and social functioning. As these deficits are not consistent with a specific neuropsychological disorder, these adolescents remain misunderstood and unsupported in their activities across various aspects of functioning.

In recent years there have been growing concerns about the impact of disordered eating in female populations and the harmful consequences of disordered eating in females with type 1 diabetes. However, the emphasis of diabetes research in this area has been focused on eating issues and associated risk factors in adolescent populations or combined age ranges from young adolescents to older adults, while the young adulthood phase, an important transitional period has been mostly neglected. There are relatively few studies that have looked at eating disturbances and associated risk factors in Australian community samples. Overseas research has indicated that there is a higher incidence of eating disturbances in females with type 1 diabetes compared to females without type 1 diabetes but there have been no previous Australian studies that have specifically examined these issues in young women aged 18 to 25 years with type 1 diabetes. The primary aim of the current study was to investigate whether having type 1 diabetes made any additional contribution to disordered eating after taking into account the contribution of known risk factors including body dissatisfaction, depressive symptoms, perceived maternal influence, attachment to peers, and perfectionism. The second aim was to investigate the influence of disordered eating and other risk factors including body dissatisfaction, depressive symptoms, and diabetes onset age on diabetes management and metabolic control levels. Two models were developed to test these aims.

While the literature demonstrates that the relationship between religion and well-being is generally positive, detailed information about the context where the religion is based is rarely given. Drawing on multi-dimensional perspectives of spirituality, the present study regards spirituality as an integral dimension of a person’s religious beliefs, practices and experiences within a given context. The manifestation of spirituality can be viewed from personal, interpersonal and social dimensions. The primary objective of the study is to examine whether, how and why the spirituality and religious community of Protestant tradition can affect the well-being of people in the context of Hong Kong. In the first phase of the study, 324 Chinese from four Protestant communities, representing four major kinds of Protestant spirituality, and one non-religious comparison group in Hong Kong were recruited. MANOVA results showed that religious community exerted a significant impact on people’s spirituality and sense of community, which enhance their well-being - manifested in life satisfaction, social trust and civic participation. The different religious contexts exhibited different dimensions of spirituality and well-being, suggesting that the impact is not only direct but also dependent on and intertwined with the religious setting. Path analyses demonstrated the complex relationship between spirituality and well-being variables. While some of the spirituality-related variables may directly predict civic participation, the relationship between such variables and life satisfaction and social trust are mainly mediated through mental health and sense of community. The second phase of the study incorporated a field study (participant observation, interview and documentary analysis). Activity setting analysis was used as the interpretive framework, to unpack the elements of the various religious settings and to identify the present and absent conditions that help explain the variety and diversity of well-being outcomes manifested in the survey section. The data showed that immediate religious settings affect people’s emotions, cognitions and behavioural patterns, through relational, ideational and even material aspects of the social environment, which finally lead to various kinds of well-being. Results also demonstrate that not only may the different religious settings enhance different kinds of well-being, but that they also provide different pathways to enhance a certain kind of well-being. These findings suggest that religious impacts on people’s well-being are diverse and intricate. The present study thus confirms the important role of religion in people’s well-being, but further signifies the intricate relationship between the various dimensions of religion and well-being. Moreover, when studying the effects of religion, both the subjective and the community context of a person’s spirituality cannot be overlooked when drawing any conclusion on the costs and benefits of religion.

Telephone counselling plays an important role within the mental service context. This study explores, describes and analyses the dynamics of crisis telephone counselling provided by Lifeline Melbourne. The study is important as there is limited empirical research on the processes and outcomes of telephone counselling. The study identifies the implications of the Lifeline service model for provision of counselling services that are appropriate to the Lifeline context and address client needs.

Insulin dependent diabetes mellitus, or Type 1 Diabetes, is a potentially lifethreatening chronic illness which places affected individuals at increased risk of heart disease, stroke, kidney failure, blindness, and amputation. The incidence of Type 1 Diabetes has increased in countries world wide including Australia. During adolescence and young adulthood diabetes management and control have been found to deteriorate placing the young person at risk of diabetes related complications. This deterioration in diabetes management and control among adolescents and young adults has been suggested to be related to the many developmental changes taking place in this period. In particular, the process of separation-individuation referred to in different developmental theories could be relevant to how a young person manage a chronic illness such as Type 1 Diabetes. However, very little empirical research has been conducted in regard to separation-individuation and most research to date has been done in the US with college students. The generalizability of the results from these studies to other populations of adolescents and young adults is unknown. The primary aim of the present study was to examine factors thought important to the separation-individuation process in a sample of young Australian women and to investigate how having a chronic illness such as Type 1 Diabetes might influence this developmental process. A further aim was to explore factors expected to be important to diabetes management during young adulthood.

Accurate interpretation of pre- and post-surgical cognitive assessments is essential for patients undergoing surgery for temporal lobe epilepsy (TLE). However, potentially confounding issues such as practice effects and low test-retest reliability may influence a person’s test score when they are given the same neuropsychological test on a second occasion, such as following surgery. Determining how much change in test scores is due to methodological issues and how much is due to genuine post-operative cognitive improvement or decline can better inform both clinical and client decisions regarding surgical intervention for TLE. Such data has been reported in North American TLE populations but the generalisability of this data to other centres is unknown. Using data obtained from unoperated patients with TLE, the current study utilised standardised regression-based change (SRB) and reliable change index (RCI) methodologies to determine change on retest across cognitive domains. Both the local and North American RCIs and SRB change norms were then applied to an Australian post-operative sample to evaluate cognitive outcomes, as well as to investigate the generalisability of change data derived from different demographic backgrounds.

This thesis examines the counseiUng needs of ethnic migrant groups, in particular the counselling needs of Maltese-Australian females and their female descendants. Research indicates that some Maltese migrants in Australia have experienced acculturation difficulties. Maltese- Australian women record a high prevalence of depression. Reports indicate that children of Maltese- Australian migrants experience lower self- esteem and more parent-child conflict than their Anglo- Australian peers. Research indicates that some members of the Maltese- Australian community, in particular Maltese -Australian females experience more mental illness than other groups and that this may be attached to experiences of unresolved acculturation stress. Children of Maltese- Australian females are at risk of being affected by trans-generational acculturation stress Theraputic interventions for Maltese-Australian females need to target specific cultural needs, identity confusion and experiences of unresolved acculturation stress. An integrated trans- theoretical model of counselling was recommended and included a culturally focused Narrative, Existential and Family therapeutic model for Maltese- Australian females and their female descendants.

The current thesis investigated the professional attitude of Psychologists towards the depression of Psychologists by conducting two phases of interviews with 14 Psychologists, designed and analysed according to the protocol of grounded theory. The aims of the current investigation were to gain an increased understanding of the experience and opinions of this cohort, and to develop theory based upon this information. Additional aims were to provide data that may inform further discussion, and thereby, to partly redress the gaps within the available literature about the depression of Psychologists. In the first phase of the current thesis, Psychologists who had themselves experienced depression were asked what they, as Psychologists, considered to be the important issues about their experience of depression. In the second phase, Psychologists who themselves had not experienced depression, were asked what they, as Psychologists, considered to be the important issues about the depression of those who were also Psychologists. Analysis of the data from both sets of interviews found four primary areas. These were firstly, the struggle or difficulties experienced by the depressed Psychologist, secondly, the attempts of the depressed Psychologist and his or her colleagues to make sense, or bring meaning to the experience, thirdly sensitivity, or the product of the experience of depression upon the personal and professional spheres of practice of an individual, and finally engagement, or responses towards the depression of Psychologists. It was hypothesised that an understanding of the experience of depression is a difficult struggle of which the depressed Psychologist seeks to make sense to effect personal and professional progress, and secondly, that the depression of Psychologist colleagues demands a collegial response. As a result of these findings, recommendations were made in the areas of collegial and organization support for depressed Psychologists, as well as the need for increased measures of workplace advocacy. Specifically, it was recommended that efforts are made within the profession as a whole, as well as within professional organizations, workplaces, and training programs that are specific to Psychologists, that a supportive and preventative approach towards the depression of Psychologists be followed, which, rather than regulatory, is adaptive and flexible in philosophy, approach, and solutions, and does not enforce a particular viewpoint. It was also recommended that these resources be overseen, reviewed, and publicised, and that services should be highly respectful of privacy and confidentiality, as the decision as to whether or not to disclose having had depression is a personal one that is congruent with the philosophical constructs of each individual.

Volume one looks at the language of spirituality to deepen our understanding of the suicidal crisis. Spirituality remains the primary motivation for my work. However, two other significant influences have emerged in my research. The first is the intellectual tradition from the school of philosophy known as phenomenology. The second is only at an embryonic stage as a academic discourse. This is the social change, human rights movement that is becoming known as Mad Culture. The accompanying volume to this exegesis, Thinking About Suicide, gives expression to the lived experience of suicidality as I have lived it and in my own words. Throughout Thinking About Suicide there is a theme of story-telling, a theme that continues here. Two distinct voices are used to tell the stories of Thinking About Suicide - a narrative voice that tells of my personal journey into and out of suicidality, and a commentary voice that reflects on that history. The aim of Thinking About Suicide is to encourage and contribute to a broad community conversation about suicide, so both these voices are in plain language to speak to that audience. In this exegesis, a third voice is heard, an academic voice telling academic 'stories'. These stories are told here through a selection of the academic papers that were written during the research and which represent the three central issues of my thesis and this exegesis: firstly, a phenomenology of the subjective, lived experience of suicidality; secondly, an anthropological or cultural critique of suicidology; and thirdly, a role for spirituality in understanding the suicidal crisis of the self.

The study of the lay meanings of health has shown that good health can have a variety of meanings and that thèse meanings can influence health behaviour. Health and illness are subjective expériences which are determined by the interrelations of individual, social and cultural factors. The influence of thèse factors on the expérience of CHD have implications for secondary prévention programs such as cardiac rehabilitation and the capacity of thèse programs to address the increasing importance of psychosocial factors in CHD. The Common Sensé Model (CSM) of health and illness, proposed by Howard Leventhal and colleagues, provides a dynamic model for the understanding of health and illness behaviours which can contribute to a better understanding of thèse social and cultural factors. Perceptions of health and illness are especially important when considering the health behaviours of culturallydiverse groups, such as Italian-speaking cardiac patients. This thesis explores the lay meanings of health and the illness perceptions of Italian-speaking cardiac patients who have participated in a language-specific cardiac rehabilitation program. Semistructured interviews with Italian cardiac patients and health professionals were conducted. Findings established a priori .and a posteriori thèmes and the thèmes served to demonstrate how the response to cardiac illness was influenced by the Personal expériences and broader psychosocial contexts of the participants. Implications for traditional cardiac rehabilitation programs include the potential benefïts of addressing the psychosocial needs of culturally-diverse cardiac patients, which can accommodate the subjective meanings that they make of their illness expérience and of their broader health and social needs.