Thursday, June 21, 2012

Michael Sessions completes dissertation in the School of Human and Organizational Development

Personal-Change in Adulthood -- Michael Sessions

Incongruence in the literature about personal-change in adulthood prompted the question: How do adults in their 40s and 50s who report significant personal-change in the past 5 to 7 years experience this change? Evaluation of the stories supported two of Wheaton and Gotlib’s (1997) threefold aspects of personal-change. These two aspects are a disruption in the direction of life, and a perceived permanency to that redirection. However, it did not support the third observation that a person makes sense of the change. The data found a disruptive turning point was another element of personal-change. This turning point occurred when an adult recognized that something about who-I-am did not match who-I-thought-I-am; the discovery was surprising, and it was considered to be true. Evaluation of the stories also suggested that patterns, identity, and imagined future possibilities were elements associated with personal-change. Energizing life purpose and self-esteem may also be part of the experience. Identity, imagined future possibilities, and energizing life purpose emerges as expressions of who-I-think-I-am; self-esteem emerges as an expression of feelings for who-I-am; and patterns emerge as expression of the processes of who-I-am. A proposed definition of personal-change that integrates the literature and findings is that personal-change is a subjective experience in which a person discovers and believes he or she is different than a few years ago; this difference includes a permanent change in life’s direction, and a person’s imagined future and identity are impacted by the change. A revised model of the process of personal-change was included in the discussion chapter.

Tuesday, June 19, 2012

Fotini Zachariades completes dissertation in the School of Psychology

A CBT Self-Management Approach for Insomnia Among People with Chronic Pain: A Randomized Controlled Trial -- Fotini Zachariades

Although primary insomnia has received much research attention, much less has been directed toward comorbid insomnia in the context of medical or psychiatric conditions such as chronic pain. Given the overlap between insomnia and other conditions including chronic pain, and that improvement of sleep difficulties may also have a beneficial effect on the management of chronic pain, the treatment of insomnia appears to be of much salience in terms of public health benefits. Cognitive-behaviour therapy (CBT) for insomnia has been applied to some samples with medical conditions such as cancer. Self-management approaches may be a more cost-effective and easily accessible format for the treatment of insomnia. Within the context of chronic pain, a previous study investigated a group-based CBT treatment approach. The present thesis involves a randomized controlled trial testing the efficacy of a CBT-oriented, self-management approach toward insomnia among a chronic pain population. Primary outcome measures included sleep-related variables, while mood, fatigue, and pain severity served as the secondary outcomes. Additionally, the potential mediating role of pre-sleep arousal and pain-related disability in the context of insomnia and chronic pain were investigated. Participants were adult outpatients with chronic pain recruited from a hospital rehabilitation centre and pain clinic. Findings indicated improvements amongst intervention group participants in terms of insomnia severity, time to fall asleep, and fatigue severity, relative to control group participants at post-treatment. Furthermore, findings supported the mediating role of pain-related disability and pre-sleep arousal. Theoretical, methodological, and clinical implications are discussed.

Key Words: insomnia, chronic pain, CBT, self-help