1 - 5 of 32
- PublicationHelp-seeking for Adolescent Mental Health Difficulties: Parents’ Perspectives(University College Dublin. School of Psychology, 2022)When an adolescent experiences a mental health difficulty they rarely seek help on their own and they frequently rely on their parents to access help and support. However, to date, the role of parents in adolescent help-seeking has been neglected. This research investigated parental help-seeking using a multi-method approach. Study one aimed to explore what factors influence parental help-seeking. Participants were 30 parents of adolescents: 23 mothers and seven fathers. The findings suggest seeking help is a complex process in which parents have to overcome a number of challenges (e.g. limited knowledge, systemic issues with the delivery of services, difficulties engaging their adolescent in services) in order to access appropriate help for their child. The results also suggest that theory needs to acknowledge the complexities of parental help seeking. Study two was informed by the results of study one. Study two tested the application of the Common-Sense Model of Illness Representations to explain how parents perceive adolescent distress and how this predicts intentions to seek help. The study employed an experimental design using video vignettes. The sample consisted of 1,176 parents of adolescents aged 10-19 years. Results showed that the model was useful for explaining parental help-seeking intentions. Parents were more likely to report intending to seek help if they believed that treatment could control the problem and if they believed the problem would have negative consequences for the adolescent. If parents believed the problem was in the control of the adolescent, they were less likely to intend to seek help. Study three was a systematic review of the literature of parental help-seeking interventions. Six electronic databases were searched from inception to May 2020 and eighteen studies met the inclusion criteria. The Behavioural Change Taxonomy was used to code behavioural change techniques, and “promising interventions” were identified using pre-established criteria. The most frequently identified Behavioural Change Taxonomies included a credible source delivering the intervention, supporting parents, and providing prompts/cues regarding services/appointments. Four interventions were identified as “promising” because of strong methodology, significant positive outcomes, and strong evidence-base. The findings from this body of research have enhanced our understanding of the parental help-seeking journey. The research also provides valuable insights regarding how parents can be better supported when seeking help for an adolescent mental health difficulty.
- PublicationAn exploration of the relationship between autism and OCD in the context of sensory processing(University College Dublin. School of Psychology, 2022)Background: Distinct sensory processing patterns have been shown to occur for both Autistic children and adolescents and individuals with Obsessive Compulsive Disorder (OCD). There are also elevated rates of OCD in autism. It has therefore been suggested that sensory processing may be an important focal point for understanding the relationship between autism and OCD. Aim: The overarching aim of this research programme is to explore the relationship between autism, OCD and sensory processing patterns, and the interplay between them. Two studies were designed with this research aim in mind. Study one: Study one is a systematic review which aimed to explore relationships between psychological features in autism and sensory processing patterns in children and adolescents. Nine studies were evaluated for methodological rigor and reporting quality, and results were systematically analysed using narrative synthesis. Sensory processing patterns were found to correlate with a range of psychological constructs. Further research which includes direct experiences of Autistic children and adults is needed to extend these findings. Study two: Study two examines the relationship between features of autism, OCD and sensory processing in children and adolescents (n = 65), measured using diagnostic interviews and parent-reported questionnaires. Correlational analyses and follow up regression analysis were performed. Findings indicate that OCD and autism have significant relationships with sensory processing patterns, but not with each other. Social and communication-related features of autism in particular appear to be related to sensory processing. OCD traits were found to be associated with hypersensitivity to sensory input, which has been suggested by both previous research and anecdotal clinical evidence. Conclusions: Findings from this research support the significance of distinct sensory processing patterns as having a significant association with both autism and OCD, which has important clinical and theoretical implications. Although OCD and autism are known to commonly occur with each other, a significant relationship between them was not established by this research programme. Future research should explore the lived experience and perspective of Autistic individuals.
- PublicationThe promotion of positive psychological functioning through cognitive and behavioural processes(University College Dublin. School of Psychology, 2022)The promotion of positive psychological functioning is a major public health need and a key objective of clinical psychology. Cognitive and behavioural processes hold promise as means to this end, and process-based CBT provides a coherent system for their integration. The research programme described in this thesis investigated the promotion of positive functioning through such processes. Accordingly, three studies are reported and each explored the promotion of positive functioning through cognitive and behavioural processes. Study 1 focused on facilitating the application of processes to conceptualise cases in process-based CBT by evaluating a conceptual model. This model proposed resilience as a pathway through which transtherapeutic mindfulness processes promote positive mental health. Findings from this study provided empirical support for the model in a sample of 129 early adolescents. This publication helped lay a conceptual foundation for the subsequent studies in this research programme. Study 2 aimed to advance the process-based CBT agenda of distilling the literature on processes that promote of positive psychological functioning. In accordance, a systematic review and meta-analysis was conducted to elucidate the efficacy of mindfulness process in promoting resilience. The findings of 57 randomised controlled trials were synthesised and revealed that mindfulness processes are efficacious in promoting resilience, but not more so than comparison interventions. This set of findings provided an empirical basis for Study 3. Study 3 sought to extend the nascent empirical research on process-based CBT interventions. A cluster randomised controlled trial was conducted to evaluate the efficacy of an intervention which integrated the processes explored in the two preceding studies. Findings did not support the efficacy of this intervention in enhancing positive psychological functioning outcomes in a sample of 604 early adolescents. Collectively, the three studies contribute to the scientific literature and present a number of implications for the practice of clinical psychology.
- PublicationSafety Planning with Adolescents at Risk of Self Harm(University College Dublin. School of Psychology, 2022)Suicide and Self Harm are major global health concerns with regards to adolescents. Safety Planning is a step-by -step brief psychological intervention that shows promise in the management of risk of self harm with this age group. However, there is limited research which examines the use of safety planning with this age-group and the involvement of parent/ guardians in the safety planning process. This thesis seeks to address this gap. In the first instance, a Scoping Review aims to explore the components and characteristics of safety planning tools and interventions, locating 74 relevant examples from across the academic and grey literature. The literature available highlights that although most safety plans described appeared to be based on specific interventions, there was a large amount of heterogeneity of components and characteristics observed, particularly with regards to safety planning within the grey literature. The results of this review informed the first-round questionnaire of a Delphi method study which sought to explore professional and parent/ guardian opinion on the components of safety planning interventions deemed most important for inclusion with adolescents as well as gathering opinion on important considerations for the delivery of the intervention. Two iterations of questionnaires were undertaken and consensus was obtained suggesting certain adaptions to the intervention were required for use with the age group, in particular the more active involvement of parents/ guardians in the process. Overall the results of this thesis add to the current literature on the topic of safety planning by providing greater insight into the use of the term, as well as insight into how safety planning might be adapted for use with this population. Future research might seek to develop these findings further, through the involvement of adolescents themselves as well as through studies examining the efficacy of the approach with this age group.
- PublicationAn investigation of the factors that contribute to the mental health and wellbeing of autistic adults(University College Dublin. School of Psychology, 2022)Autistic people experience increased rates of mental health conditions and symptoms compared to their non-autistic peers; autistic women and trans people perhaps more so. However, there is not yet a consensus as to why this is the case. Through the lens of the neurodiversity paradigm, the present thesis aimed to develop an understanding of the factors that impact autistic people’s mental health, from the perspective of autistic people themselves. First, this thesis presents a systematic review and thematic synthesis of the perspectives of autistic females on what experiences have impacted their mental health and wellbeing. Findings suggested that the biological and psychological factors associated with being autistic interact with a variety of environmental and social factors, in turn shaping wellbeing and mental health outcomes. Second, an empirical mixed-methods study is presented, which investigated mental health experiences and the factors that contributed to mental health and wellbeing in mixed-gender samples. The qualitative phase consisted of semi-structured interviews with 20 autistic adults and the quantitative phase investigated key factors identified by interviewees in a sample of 236 autistic adults using standardised questionnaires. High levels of depressive and anxiety symptoms and low levels of wellbeing were reported. Autistic cisgender women reported higher levels of anxiety, while autistic trans people reported more depressive symptoms. Feelings of exclusion and isolation, childhood bullying, autism-related stigma and challenges related to the neurotypical environment were all found to predict mental health and wellbeing. Overall, the findings of the present thesis point to the need for community adaptations or interventions to create a more accessible and accepting society, as well as improvements in service provision for autistic adults.