Applied Psychology - Doctoral Theses
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Item Childhood trauma and trauma-informed care in early intervention in psychosis(University College Cork, 2024) Hunt, Evan; Lambert, Sharon; Murphy, Mike; Lonergan, Edgar; O'Connor, Karen; Health Service ExecutiveThis doctoral thesis explores the integration of Trauma-Informed Care (TIC) within Mental Health Services (MHS) and examines the prevalence and impact of childhood trauma in individuals experiencing First-Episode Psychosis (FEP). Through a systematic review, the research identifies core principles and practices of TIC in MHS, leading to the development of a framework that encompasses therapeutic environment, sociocultural responsiveness, and workforce development, providing a blueprint for operationalising TIC within mental healthcare. Building on this foundation, an empirical study establishes the demographic and clinical profile of service users accessing an Early Intervention in Psychosis (EIP) service in Ireland. Findings reveal the complex and diverse needs of the population, including significant gender differences in age of onset, substance use, and functional impairments, emphasising the necessity for tailored interventions in EIP services. Further research investigates the prevalence of childhood trauma among FEP service users, revealing a high rate of trauma exposure (78%), with emotional abuse and neglect being most common. Gender differences were also found, with females reporting higher severity and cumulative trauma. These findings highlight the importance of integrating trauma-informed approaches into EIP services to address the multifaceted needs of individuals with psychosis. Finally, the thesis examines the longitudinal impact of childhood trauma on clinical outcomes in FEP. While trauma severity was linked to self-harm, it did not significantly affect other baseline clinical characteristics. Over the course of 12 months of treatment, significant improvements in symptomatology and functioning were observed, regardless of trauma history, highlighting the effectiveness of EIP services in supporting individuals with FEP. This research collectively emphasises the need for trauma-informed, individualised care to optimise outcomes for individuals with early psychosis.Item Positive psychology within the clinical context(University College Cork, 2024) Cullen, Katie; Murphy, Mike; Di Blasi, ZeldaBackground: Positive psychology is a subdomain of psychology concerned with the development and enhancement of well-being, strengths and conditions conducive to human flourishing. A plethora of research now supports the efficacy of positive psychology interventions in increasing well-being and reducing psychopathology amongst clinical populations, pointing to the utility of implementing strengths-based approaches when working with individuals with mental and physical health difficulties. However, less is understood about whether or not, and how, these approaches are used in clinical practice by clinical psychologists. Aims: The overarching aim of this thesis is to further explore the use and efficacy of positive psychology within clinical contexts. Two studies are reported addressing these aims. 1) Systematic Review: A narrative systematic review evaluating the evidence base on savouring interventions when applied to adult clinical populations is reported. Data were extracted from nine studies primary involving over 900 participants from mental and physical health clinical populations from seven countries. These specific interventions promoted some positive changes amongst participants, such as increasing levels of well-being and reducing levels of depression and anxiety. Both individuals with mental and physical health difficulties appeared to benefit. However, when comparing the results of these interventions against outcomes gained by participants in no intervention or active control groups, the efficacy of these interventions appears relatively weak. 2) Empirical Study: A mixed-methods study utilising an online cross-sectional survey and participant interviews exploring clinical psychologists’ use of positive psychology in their clinical work and attitudes towards same is reported. Findings revealed that clinical psychologists use an array of positive psychology interventions, however they are predominantly used in conjunction with other therapeutic approaches. Several barriers and facilitators to this implementation were noted, including therapist, client, and systemic factors. Results highlighted the many nuances involved in utilising positive psychology in clinical settings, given existing ambiguity surrounding knowledge and understanding of the approach, and specific therapeutic considerations needed for the approach to be implemented successfully and appropriately. Conclusions: Findings from this thesis portfolio support the far-reaching potential of positive psychology principles and interventions when applied to clinical settings. However, many factors appear to contribute to the implementation and successful use of these approaches, as reported by clinical psychologists actively working across numerous clinical settings. Clinical implications of this research are discussed. Future research should further explore systemic factors which impact on the integration of positive psychology within clinical contexts.Item Being a parent with a physical disability: an exploration of lived experiences(University College Cork, 2024) Dunne, Amanda; Ryan, Christian; Lennon, Aisling; Brennan, EmmaObjective: This thesis portfolio aims to (1) synthesise the qualitative literature exploring the parenting experiences of adults with both acquired and congenital physical disabilities, and (2) explore the parenting experiences of fathers with acquired physical disabilities. Methods: A systematic review and thematic synthesis were conducted to synthesise the qualitative literature exploring the parenting experiences of adults with physical disabilities. 11 studies were identified following searching of CINAHL, PsycINFO, PubMed, Scopus and Web of Science databases, in addition to backward snowballing. All studies were also subjected to quality appraisal. Seven fathers with acquired physical disabilities were also interviewed about their parenting experiences, with an interpretative phenomenological analysis being undertaken to analyse the data collected. Results: Each of the studies within the systematic review were deemed to be of high quality, with seven themes identified from the thematic synthesis: stigmatisation and the need to prove competence as a parent; feeling underrepresented as a parent with a physical disability; environmental limitations; experiences of accessing support; using skills and strategies to fulfil parenting role; children’s roles and reactions, and changes as they grow, and safety, wellness and health when parenting with a physical disability. Three group experiential themes were identified from the interpretative phenomenological analysis of seven fathers’ interviews: (1) the meaning of fatherhood, (2) navigating a complex emotional landscape, and (3) the dynamic nature of relationships. Conclusions: A number of clinical implications stemming from the findings of both studies are discussed, in addition to important areas for future research.Item Relations between sensory-related factors and stress in autistic and non-autistic adults(University College Cork, 2024) Harrold, Aine; Setti, Annalisa; Keating, Kim; Larkin, Fionnuala; Health Service ExecutiveBackground: There is emerging empirical evidence indicating that differences in self-reported sensory processing may be associated with differences in levels of stress in adult populations. Parenting often comes with increased sensory stimulation, such as noise or tactile stimulation. Therefore, responsivity to sensory stimuli could be a risk factor for parenting stress. Autistic parents and Highly Sensitive Persons (HSP) may be particularly at risk of elevated parenting stress, given their pronounced sensory sensitivity. Aims: The overarching aim of this thesis portfolio is to explore the relations between sensory-related factors and stress in autistic and non-autistic adults. A secondary aim was to explore relations between the constructs of HSP and autism. Systematic Review: The systematic review aimed to synthesise and summarise the available evidence examining the association between self-reported sensory processing and self-reported stress in adult populations. Twenty studies, both qualitative and quantitative, were assessed for quality and the results analysed using narrative synthesis. Overall, the evidence is strong for an association between differences in sensory processing and self-reported stress in adults, across a range of populations and measures of stress. Greater sensory sensitivity was consistently associated with higher levels of stress in cross-sectional studies. Longitudinal studies are lacking. Empirical study: This quantitative, cross-sectional study aimed to examine the role sensory-related factors play in predicting parenting stress in autistic and non-autistic parents. A total of 104 parents completed measures of autistic traits, sensory processing sensitivity, sensory processing difficulties and parenting stress. Data were analysed statistically using t-tests, correlational, and regression analysis. Autistic parents and HSP parents had higher levels of levels of parenting stress than non-autistic and non-HSP parents. Sensory-related factors predicted parenting stress in autistic and non-autistic parents. Conclusions: Findings from this research support the significance of sensory processing in contributing to stress in adults. Hypersensitivity to sensory stimuli was also found to contribute to stress in the parenting role. Individuals who have heightened sensitivity to sensory stimuli, such as autistic individuals and HPSs, were found to experience elevated parenting stress.Item The experience of sound intolerance in adults with autism(University College Cork, 2024) Clarke, Alison; Ryan, Christian; Chan, JasonChapter One: Introduction This chapter introduces autism as a heterogenic condition and discusses the different types of Decreased Sound Tolerance (DST). Further information related to influential models of autism are also provided. Chapter Two: Scoping Review This chapter presents ‘A Scoping Review of Noise-Attenuating Device Use and its Consequences in Autistic People’. The review is written in the format of a journal article for ‘Research in Autism Spectrum Disorders’. Chapter Three: Scoping Review: Extended Methodology Supplementary information pertinent to the process of completing the scoping review is presented in this chapter. This information pertains to the development of the review question, eligibility criteria, and search strategy. Further information related to the synthesis, data extraction and the rationale for selecting a scoping review as a methodological framework is included. Chapter Four: Major Research Project In this chapter, the empirical paper explores the experience of sound intolerance among autistic people, as well as the coping strategies used to address this. The paper is written in the format of a journal article for ‘Autism’. Chapter Five: Supplementary Information for Major Research Project This chapter provides further information on the methodology of the major research project. This included an in-depth description of Interpretative Phenomenological Analysis (IPA) and its use in autism research information on sampling and recruitment, further information on the data collection and analysis process, and reflexivity. Chapter Six: Discussion and Conclusion The findings of the scoping review and the major research project are summarized in this chapter, as well as the limitations, clinical implications, and original contributions. Appendices Appendices pertaining to the scoping review and major research project are presented in this section.