Changes In Self-concept Research Articles

The Gap Between Theory and Practice of Psychiatry in Developing countries of Asia

This study examines the extent to which three mental health measures (hopelessness, depression, and poor self-concept) are improved through a family-based economic intervention implemented among adolescents living with HIV in Uganda.We used repeated measures from Suubi + Adherence, a large-scale 6-year (2012–2018) longitudinal randomized controlled trial. Bivariate analyses were conducted to test for observable group differences between the intervention and control conditions. Multilevel piecewise repeated measure mixed models were then conducted to assess hypothesized time × intervention interaction in changes in hopelessness, depression, and self-concept using participant-specific follow-up intervals.At 24-month postintervention initiation, adolescents in the intervention condition reported a statistically significant lower hopelessness score than adolescents in the control condition (4.79 vs. 5.56; p = .018; N = 358). At 36-month follow-up, the intervention condition reported a statistically significant lower score on depression in the depression subgroup (N = 344) than the control condition (4.94 vs. 5.81; p = .029).The results indicate that family-based economic interventions such as Suubi + Adherence can effectively improve the mental health of adolescents living with HIV who evidenced mental health challenges at baseline. Given the promising positive effects of these interventions, at least in the short term, future studies should investigate strategies to promote the sustainability of these mental health benefits.

Psychological effects of risk glorification in the media: Towards an integrative view

Media contents that glorify risk-taking (e.g., video games that simulate illegal street racing, TV depictions of dangerous extreme sports or stunts) are becoming increasingly popular. Theory and research suggest that risk glorification is associated with risk-taking among the audience. Until recently the evidence was limited in three ways: First, most studies, being correlational, did not permit clear causal inferences. Second, we did not know the strength of the effect of different types of media and different types of risk-taking outcomes. Third, early research did little to isolate the underlying psychological processes that mediate the pernicious effects of risk glorifying media formats. In order to address these open questions we review the results of an experimental programme of research and the findings of a comprehensive meta-analysis. The main findings are that (a) the risky media contents do indeed have causal force; (b) according to our meta-analysis active participation in risk glorifying media interfaces has a larger effect than passive consumption; (c) psychological processes include the priming of risk-related constructs, effects of risk-positive situational heuristic cues, perceived social norms, personal risk habituation, and changes in the recipient's self-concept. To integrate these findings we propose a theoretical framework derived from broad-range socio-cognitive models. We conclude with a discussion of possible directions for future research.

Mental health care for Canadians with developmental disabilities.

Abstract My research focuses on the promotion of mental health and the treatment of mental health problems in people with developmental disabilities. People with developmental disabilities are at high risk for developing mental health problems or serious challenging behaviours at some point in their lives. Research is needed to address these mental health concerns by studying programs that can promote mental health in people with developmental disabilities, die experiences of parents of people with developmental disabilities, and the training needs of graduate students in psychology to provide mental health care to clients with developmental disabilities. More generally, Canadian psychology has an important role to play in mental health promotion for individuals with developmental disabilities. Keywords: developmental disability, intellectual disability, autism spectrum disorders, mental health Approximately 1-3% of the population has a developmental disability (DD), which includes individuals with intellectual disabilities and/or autism spectrum disorders (American Psychiatric Association, 2000; Ouellette-Kuntz & Paquette, 2001). Individuals with DD are at high risk for developing mental healdi problems and have poorer prognosis dian typically developing individuals. In Great Britain for instance, 36% of children with DD also meet criteria for a co-occurring mental healtii problem, a prevalence rate five times greater than in peers without DD (Emerson & Hatton, 2007), and similar rates are found in adults with DD (Cooper, Smiley, Morrison, Williamson, & Allan, 2007). Mental healdi disorders are important predictors of poor overall health in individuals with DD (Linehan, Noonan Walsh, van Schrojenstein Lantman-de VaIk, & Kerr, 2004). As a result of the sizable population base and level of need, it is important to conduct research that investigates protective factors that bolster mental health, and there is a need for new and more effective treatment options mat rectify problems when they arise. My program of research comprises three streams that study: (a) interventions that can improve mental health in people with DD, (b) families who care for people with DD, and (c) mental health services and training that can increase access to mental health care for people with DD. Research on Interventions One efficient way of targeting mental healdi risk is to identify programs that serve a protective role by promoting mental health before problems arise. More specifically, I have been involved in studying Special Olympics, a sport organisation for children and adults with DD, which has long been noted by parents and professionals as a program that can enhance the self-esteem, confidence, independence, and socialization of participants (Klein, Gilman, & Zigler, 1993). My research was among the first in Canada to quantitatively examine psychological benefits of involvement, studying athlete participation in Special Olympics over a 3-year period, and finding positive changes in athletes' self-concept, and adaptive and maladaptive behaviours (Weiss & Bebko, 2009). This research identified specific program characteristics (e.g., the number of competitions and years in the program) that related to addete psychological well-being (Weiss, Diamond, Demark, & Lovald, 2003). Empirically identifying variables of import has led to a renewed focus on ensuring that sport programming results in positive psychological benefits for athletes with DD, and has informed program developers about the aspects of the program that should be emphasised (e.g., focusing on creating more opportunities for local level competitions). Research on Families If we are interested in prevention and intervention for people with DD, it is integral that research be directed toward understanding and supporting parents, who are significant agents in maintaining the mental health of their children across the life span. …

Short‐Term Psychological Outcomes in Severely Obese Adolescents After Bariatric Surgery

Bariatric surgery is suggested as a treatment option for severely obese adolescents. Because adolescence is characterized by intense psychosocial adjustment and development, it is important to study the effect of this procedure on adolescents' psychological health. This study examined baseline status and short-term changes in anxiety, depression, anger, disruptive behavior, and self-concept in 37 adolescents (mean age 16.6 ± 1.3). Participants completed the Beck Youth Inventories (BYI) at inclusion and (on average) 4 months after undergoing Roux-en-Y gastric bypass (RYGB). Internalizing (anxiety and depression) and externalizing (anger and disruptive behavior) symptoms were higher at baseline than gender-specific norms. One fifth had a very low self-concept. Four months after surgery, the adolescents showed significantly fewer symptoms of anxiety and depression and significantly improved self-concept from baseline. Anger and disruptive behavior showed no significant changes. An analysis of clinically meaningful changes was conducted, and besides the overall positive outcome, 16% (n = 6) of the adolescents had deteriorated on two or more inventories in BYI shortly after surgery. This impaired group did not show any specific features at inclusion. The results indicate the importance of psychological monitoring immediately after bariatric surgery and the need for additional psychosocial support to be available for vulnerable sub-groups of adolescents. Further studies with larger samples are necessary to identify characteristics predictive of short-term adverse psychological outcomes in adolescents after bariatric surgery.

Psychological Sequelae of Ovarian Cancer Screening and Genetic Testing for Ovarian Cancer Susceptibility

Ovarian cancer is the most lethal of gynaecological malignancies. Although early detection efforts have been relatively unsuccessful in reducing mortality at the population level, ovarian cancer screening continues to be offered to some women. Testing for mutations in the BRCA1/2 genes can determine whether women have a heightened risk of developing ovarian cancer and those found to be at high risk are closely followed and offered cancer risk-reducing strategies. Yet, ovarian cancer screening and genetic testing have potential psychological sequelae. The purpose of this article is to present an overview of these psychological sequelae. Overall, women who receive normal ovarian cancer screening results benefit emotionally and the emotional distress associated with abnormal results subsides once a cancer diagnosis is excluded. There are psychological benefits of genetic testing as well as potential challenges that include interpreting results, feelings of anxiety, distress and depression, changes in self-concept, experiencing guilt and worry regarding family members, communicating with family and making decisions about ovarian cancer screening and riskreducing oophorectomy. Psychological support that addresses the unique psychological sequelae associated with hereditary ovarian cancer risk and targets the subgroup of women who are more likely to experience difficulties would likely be beneficial. Keywords: Ovarian cancer, screening, genetic testing, psychological, women's health, gynaecological malignancies, BRCA1/2 testing, oophorectomy, women's psychological health, biomarker screening

The storm and stress (or calm) of early adolescent self-concepts: within- and between-subjects variability.

This study uses intraindividual variability and change methods to test theoretical accounts of self-concept and its change across time and context and to test the developmental implications of this variability. The 5-year longitudinal study of 541 youths in a rural Pennsylvania community from 3rd through 7th grade included twice-yearly assessments of self-concept (academic and social), corresponding external evaluations of competence (e.g., teacher-rated academic skills, peer-nominated "likeability"), and multiple measures of youths' overall adjustment. Multiphase growth models replicate previous research, suggesting significant decline in academic self-concept during middle school but modest growth in social self-concept from 3rd through 7th grade. Next, a new contribution is made to the literature by quantifying the amount of within-subject variability (i.e., "lability") around these linear self-concept trajectories as a between-subjects characteristic. Self-concept lability was found to associate with a general profile of poorer competence and adjustment and to predict poorer academic and social competence at the end of 7th grade above and beyond level of self-concept. Finally, there was substantial evidence that wave-to-wave changes in youths' self-concepts correspond to teacher and peer evaluations of youths' competence, that attention to peer feedback may be particularly strong during middle school, and that these relations may be moderated by between-subjects indicators of youths' general adjustment. Overall, findings highlight the utility of methods sensitive to within-subject variation for clarifying the dynamics of youths' self-system development.

Self-stigma and its relationship with insight, demoralization, and clinical outcome among people with schizophrenia spectrum disorders

BackgroundParadoxically, insight is associated with positive outcomes, such as better treatment adherence and recovery, and negative outcomes, such as depression, hopelessness, low self-esteem, and quality of life. Self-stigma as a moderating variable can be decisive whether more insight leads to better or worse outcome. On the other hand, self-stigma can act as a mediator between insight and outcomes. We therefore examined self-stigma both as a moderator and a mediator. MethodsInsight, self-stigma, demoralization, symptoms, and functioning were assessed among 145 outpatients with schizophrenia spectrum disorders using questionnaires and structured interviews. Structural equation modeling was used to analyze the cross-sectional data. ResultsResults confirmed self-stigma as a moderator: The association of insight and demoralization was stronger as self-stigma increased. Self-stigma also partially mediated the positive relationship between insight and demoralization. Moreover, demoralization fully mediated the adverse associations of self-stigma with psychotic symptoms and global functioning. DiscussionGiven the decisive role of self-stigma regarding the detrimental consequences of insight, interventions should address self-stigma, particularly if psychoeducational or other interventions have increased insight. Therapeutic implications for changes of dysfunctional beliefs related to illness and self and change of self-concept in the context of recovery at the level of narrative identity are discussed.

Big Fish in a Big Pond: a study of academic self concept in first year medical students

BackgroundBig-fish-little-pond effect (BFLPE) research has demonstrated that students in high-ability environments have lower academic self-concepts than equally able students in low-ability settings. Research has shown low academic self-concepts to be associated with negative educational outcomes. Social comparison processes have been implicated as fundamental to the BFLPE.MethodsTwenty first-year students in an Australian medical school completed a survey that included academic self-concept and social comparison measures, before and after their first written assessments. Focus groups were also conducted with a separate group of students to explore students' perceptions of competence, the medical school environment, and social comparison processes.ResultsThe quantitative study did not reveal any changes in academic self-concept or self-evaluation. The qualitative study suggested that the attributions that students used when discussing performance were those that have been demonstrated to negatively affect self-concept. Students reported that the environment was slightly competitive and they used social comparison to evaluate their performance.ConclusionsAlthough the BFLPE was not evident in the quantitative study, results from the qualitative study suggest that the BFLPE might be operating In that students were using attributions that are associated with lower self-concepts, the environment was slightly competitive, and social comparisons were used for evaluation.

I know you're me, but who am I? Perspective taking and seeing the other in the self

Research examining the consequences of perspective-taking on cognition suggests that through perceiver–target overlap, perspective-taking can lead to greater valuing of targets, greater helping of targets, and a reduction in stereotyping of targets and the groups to which they belong. Research has also begun to focus more closely on the ways perceivers come to think and act like targets. This research, however evocative, is not conclusive. The current studies set out to provide firmer support. Reported here, two studies found that perspective-taking influences perceiver–target overlap, which mediates changes in self-concept (ratings of the self on researcher-related attributes and beliefs after taking the perspective of a researcher in Study 1 and attitudes toward African Americans after taking the perspective of a racist in Study 2). In the same studies, overlap simultaneously mediated valuing of the targets (target ratings on positive attributes in Study 1 and liking for the target in Study 2).

Identity, grief and self-awareness after traumatic brain injury

The objective of this study was to investigate perceived identity change in adults with traumatic brain injury (TBI) and explore associations between identity change, grief, depression, self-esteem and self-awareness. The participants were 29 adults with TBI who were being followed up by a community brain injury rehabilitation service. Participants were longer post-injury than those more commonly studied. Time since injury ranged from 2.25 to 40 years (mean = 11.17 years, SD = 11.4 years). Participants completed a battery of questionnaires. Significant others and clinicians completed a parallel version of one of these measures. Questionnaires included the Head Injury Semantic Differential Scale (HISDS-III), Brain Injury Grief Inventory (BIGI), Hospital Anxiety and Depression Scale – Depression, Rosenberg Self-Esteem Scale (RSES) and the Awareness Questionnaire (Self/Significant other/Clinician versions). The main findings were that participants reported significant changes in self-concept with current self being viewed negatively in comparison to pre-injury self. Perceived identity change was positively associated with depression and grief and negatively associated with self-esteem and awareness. Awareness was negatively associated with self-esteem and positively associated with depression. These findings were consistent with previous research, revealing changes in identity following TBI. Further research is needed to increase our understanding of the psychological factors involved in emotional adjustment after TBI and to inform brain injury rehabilitation interventions, including psychotherapy approaches.

Effects of The Coach Approach Intervention on Adherence to Exercise in Obese Women

The link between physical activity and weight loss has precipitated interest in interventions to foster adherence to exercise. It has been suggested that treatment effects, when significant, should be analyzed to determine theory-based mediators. This research assessed possible mediation of changes in Physical Self-Concept, Exercise Self-Efficacy, Total Mood Disturbance, and Body Areas Satisfaction scores on the relationship between exercise session attendance and participation by obese women in a 6-month treatment based on tenets of social cognitive theory (n = 73) or a control condition (n = 64). Participation in the treatment was associated with significantly greater exercise session attendance and significantly greater improvements in Physical Self-Concept, Exercise Barriers Self-Efficacy, and Body Areas Satisfaction. Overall, changes in the assessed psychological factors demonstrated significant mediation of the association between group membership and exercise session attendance, R2 = .23, with only change in Physical Self-Concept scores providing a significant unique contribution. Extensions of this research across different sample types, and with longer durations, were suggested to refine theory and, ultimately, improve exercise adherence treatments.

Defining and Measuring Self-Concept Change

The self-concept and the manners by which it changes are two of the most important, and challenging, areas of psychological study. In this review, we define the self-concept as a multifaceted psychological construct, composed of a variety of characteristics. People with low self-esteem, incremental theorists, self-monitors, and people with a high uncertainty orientation and relational self-construal are mentioned as some of the types of people who are likely to undergo change. Various approaches to measuring the self-concept and investigating it across cultures are also discussed. Recommendations for future research include utilizing an intraclass correlation coefficient measure of change, and accounting for context-specific self-definitions in several cultures.

Changes in Stress and Nurse Self-Concept Among Baccalaureate Nursing Students

This pilot study's purpose was to investigate the relationship between stress and nurse self-concept. Specifically, it examined whether enrollment in a wellness course affected stress levels and self-concept acquisition among sophomore baccalaureate nursing students (N = 52). The findings showed that early in the curriculum these students had a fairly well developed sense of professional self-concept but made gains in facets of leadership and communication over the course of the semester. Students demonstrated high levels of stress that remained unchanged over the semester, regardless of self-concept acquisition. This study concluded that enrollment in a wellness course was insufficient to prepare nursing students to manage stress as they transition to professional roles, and it was possible that undergraduate education perpetuated the internalization of stress as part of a nurse's professional identity. Future studies are needed to determine effective ways to teach stress management and best design nursing curricula to reduce stressors.

Foreword

We surveyed first-year students at the ANU College of Law on various measures of wellbeing, thinking styles and motivations for attending law school. We followed up our surveys with a student–faculty dialogue retreat. The results of our work confirm that, even in a law school where formal mentoring programs are in place and where resources for student counselling are readily available, law students suffer symptoms of psychological distress at levels higher than their age peers in the general public. During the first year of law school, many students experience psychological struggles, changes in their thinking styles, and changes in self-concept and sense of wellbeing. By the end of the first year many students in our sample showed increased rational thinking and lower experiential thinking. Lower levels of experiential thinking were associated with increased symptoms of psychological distress, while students with a higher propensity toward experiential thinking showed little change in depressive symptoms from the beginning to the end of the year of law study. In extended deliberations on law student wellbeing, faculty and student retreat participants highlighted their sense that law school changed them in important ways, making them more rational, analytical, competitive and adversarial. Law school also promoted feelings of insecurity, inefficacy and isolation. To address these changes, participants made a variety of proposals for curricular reform, which are discussed here. Specific changes in law school curricula – including proposals for greater transparency, clarity and guidance about course work, for more positive and formative feedback, and for more social and intellectual engagement – are identified as having potential to improve law student wellbeing.

The Effects of Concealing Academic Achievement Information on Adolescents’ Self-Concept

Using an experimental design, the effect of concealing academic achievement information on adolescents’ self-concept was examined in the current study. Specifically, adolescents with low academic achievement and adolescents with average to high academic achievement (N = 129) were randomly assigned to different interview contexts wherein academic-achievement information could be concealed or not. Results showed that participants with low academic achievement in the concealing-achievement-information condition had higher levels of state self-esteem and more self-representation suppression. Their negative self-representation was also activated when they were under high cognitive load. Participants with high academic achievement in the condition in which positive achievement information was concealed had lower state self-esteem and activated the positive self-representation under high cognitive load. Overall, the results showed that concealing academic-achievement information can cause short-term change of self-concept for adolescents.

Mutual influences between the implicit and explicit self-concepts: The role of memory activation and motivated reasoning

Whereas previous research has predominantly focused on dissociations between the explicit and implicit self-concepts, the current research investigates how these aspects of self-representation come into correspondence through the activation of information about the self in memory. Experiment 1 provides evidence for a “bottom-up” process of self-construal in which information activated in the implicit self-concept produces congruent changes in the explicit self-concept. Experiment 2 provides evidence for a “top-down” process of self-construal in which the motivated assertion of a propositional belief in the explicit self-concept leads, via a process of confirmatory hypothesis testing, to the activation of substantiating information in the implicit self-concept. These two processes of self-concept change are integrated within a framework that specifies how the explicit and implicit self-concepts are related within an overall, dynamic self-system. Possibilities for expanding the framework to account for self-concept dissociations are discussed.

Peer Influences on Academic Motivation: Exploring Multiple Methods of Assessing Youths’ Most “Influential” Peer Relationships

The present study examines the relative role of three distinct types of peer relationships (reciprocated friendships, frequent interactions, and shared group membership) in within-year changes in academic self-concept and engagement before and after the transition to middle school (fifth and seventh grade). In a series of linear regression analyses, main effects of each peer type’s academic self-concept and engagement on changes in youths’ academic characteristics were used to test socialization processes. Interactions of youths’ academic skills with those of each peer type were used to test social comparison processes influencing changes in academic self-concept. Results suggest unique roles of each peer relationship differentially influencing changes in youths’ academic adjustment as well as stronger influence effects during seventh than fifth grade. Implications are discussed in terms of distinct influence processes associated with each peer relationship type as well as potential developmental differences in the role that certain peer relationships play.

Relations of changes in self-regulatory efficacy and physical self-concept with improvements in body satisfaction in obese women initiating exercise with cognitive-behavioral support

Effects of exercise on body image are not well understood. Obese women seeking weight loss were randomly assigned to groups of exercise supported by a cognitive-behavioral protocol ( n = 68) or typical introductory methods ( n = 66), and assessed on body satisfaction (Body Areas Satisfaction Scale; BASS), self-regulatory efficacy (Exercise Self-Efficacy Scale; ESE), physical self-concept (Physical Self-Concept; PSC), weight, and body composition, over 6 months. Improvements on all measures were greatest in the cognitive-behavioral support condition. Improvement in BASS scores was better predicted by changes in the two psychological measures (PSC, ESE; R adj 2 = .30 and .32 , respectively) than changes in the two physiological measures (weight and body composition; R adj 2 = .07 and .00 , respectively). When all four predictors were entered into a multiple regression equation, only changes in ESE and PSE demonstrated significant unique contributions to the overall explained variance in BASS change. Theory and treatment implications were discussed.

Barriers to symptom management in oncology.

9083 Background: Optimal symptom management is a critical aspect of supportive care in cancer. Patient-reported outcomes such as QOL can be negatively impacted by uncontrolled symptoms such as pain and fatigue. Research suggests that barriers (patient, professional, systems-related) to symptom management hinder the quality of supportive cancer care. Methods: This NCI-supported prospective study assessed barriers to pain and fatigue management in a cohort (n=280) of cancer patients. The sample included breast (39%), lung (26%), colon (20%), and prostate (15%) cancer patients with moderate to severe (4-10) rating of pain and/or fatigue. Instruments included the COH-QOL questionnaire, Piper Fatigue Scale (PFS), Barriers to Pain and Fatigue questionnaires, and Patient Knowledge tools for Pain and Fatigue. Results: Mean age was 60, and 36% represented ethnic minorities. Half of the subjects had stage IV disease, and 80% were receiving cancer treatment. QOL concerns were identified for the psychological well-being (impact of cancer on appearance, changes in self-concept, distress from initial diagnosis and treatments, fear of recurrence), social well-being (family distress, interference with daily activities), and spiritual well-being (uncertainty) domains. Subjects reported high levels of distress from fatigue that interfered with daily functions. Patients believed in the importance of communicating pain and fatigue issues with clinicians, but barriers persisted for beliefs regarding pain medication addiction and the lack of effective fatigue treatments. Overall, patient knowledge of pain and fatigue was high, but lack of knowledge persisted for addiction, withdrawal, side effects of pain medications, and avoiding exercise for fatigue. Significant system-related changes occurred through dissemination of patient education materials, advocacy posters, professional education, clinical feedback, and increased referrals to supportive care services. Conclusions: Barriers to optimal symptom management persist for cancer patients who are actively receiving treatments. Structured patient and professional education coupled with system-wide dissemination of awareness can reduce barriers to symptom management and maintain QOL for cancer patients. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Genentech, Lilly

The Effect of Services and Stigma on Quality of Life for Persons With Serious Mental Illnesses

This study examined the effects of mental health services and stigma on self-concept and quality of life among individuals with serious and persistent mental illnesses. A broad array of inpatient and outpatient services, as well as perceptions of stigma, was assessed among 188 individuals who had been diagnosed as having serious mental illnesses. Quality of life and self-concept (that is, self-esteem and mastery) were also assessed at baseline and follow-up (approximately six months). Receiving mental health services had an effect on changes in quality of life over time. Specifically, receiving counseling services had a positive influence on quality of life, whereas receiving inpatient services decreased quality of life. Stigma was not significantly associated with changes in quality of life over the study period. Self-esteem and mastery influenced the association between stigma and quality of life but did not influence the relationship between services and quality of life. Finally, although services had little effect on changes in self-concept, perceived stigma significantly reduced both self-esteem and mastery. The extent to which services influenced quality of life was dependent on the type of service examined. Moreover, although the effects of services were more pronounced with respect to quality of life than self-concept, the opposite was true with respect to the effects of stigma. Efforts should be made to increase access to specific types of services, such as counseling, as well as to reduce negative perceptions of stigma that erode self-image among individuals with serious mental illnesses.