Effects of Parenting Experiences & Early Maladaptive Schemas on Adjustment to Atopic Dermatitis

312 Pages·2014·1.85 MB·English

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Effects of Parenting Experiences &
Early Maladaptive Schemas on Adjustment to Atopic Dermatitis

Elli Kalaki

Submitted for the degree of
Doctorate in Counselling Psychology
September 2014

Department of Psychology
London Metropolitan University
London, UK
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Copyright
The copies of the thesis submitted for examination shall remain the property of
London Metropolitan University but the copyright in the thesis shall be vested in
the student
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TABLE OF CONTENTS
Page No
Abstract…………………………………………………………………………….24
CHAPTER 1: INTRODUCTION………………………………………………….26
1.1. Introduction………………………………………………………………..27
1.2. Understanding Atopic Dermatitis……………………………………........28
1.2.a. Distribution………………………..…………………………………….......28
1.2.b. Prevalence…………………………………………………………………...29
1.2.c. Management…………………………………………………………...........30
1.2.d. Etiology……………………………………………………………..............31
1.3. Psychological Distress & Atopic Dermatitis: A Bidirectional Link……….....31
CHAPTER 2: PSYCHOSOCIAL ADJUSTMENTTO ATOPIC
DERMATITIS…………………………………………..………....34
2.1. Psychological Adjustment to Atopic Dermatitis……………………………...35
2.2. Early Onset of Atopic Dermatitis:….…………………………………………37
2.2.a. The Developmental Experience of the Affected Child...………………….38
2.2.b. The Experience of Parents of Affected Children & The Parent-Child
Relationship……………………………………………………………...40
2.3. Conclusions………….………………………………………………………..44
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CHAPTER 3: VARIABILITY IN ADJUSTMENT TO ATOPIC
DERMATITIS…………………………………………….………..46
3.1. Factors That Determine Variations in Adjustment to Atopic
Dermatitis………………………………………………………………….47
3.2. Coping………………………………………………………………………...50
3.3. Factors That Determine Coping………………………………………………51
3.3.a. Appraisal Theory……………………………………………………………51
3.3.b. Self-Regulatory Model of Illness……………………………………….......52
CHAPTER 4: PERSONALITY DEVELOPMENT & HEALTH..…......................56
4.1. Personality……………………………………………………………….........56
4.2. Schema-Therapy Model of Personality Development &
Psychopathology……….……………………………………………………...57
4.2.a. Model‟s Theory………………….………………………………….57
4.2.b. Model‟s Assessment & Critique……..……………………………...63
CHAPTER 5: RATIONALE……………………………………………………....67
5.1. Thesis: A New Explanatory Model of Adjustment to Atopic
Dermatitis……...…………………………………………………………..68
5.1.a. Overview……………………………………………………………………68
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5.1.b. Case Conceptualization……………………………...……………………...69
5.2.Conclusions…………….………….…………………………………….........73
5.3. Clinical Significance for Counselling Psychology……………………………74
5.4. Purpose…………..…………………………………………………................78
5.5. Αims………..…………………………………………………………………79
5.6. Hypotheses……………………………………………………………………79
CHAPTER 6: STUDY & RESULTS……..……………………………………….81
6.1. Method……..…………………………………………………………………82
6.1.a. Research Methodology …………………………………………………….82
6.1.b. Participants….…………………………………………………………........84
6.1.c. Design……………………………………………………………………….87
6.1.d. Instruments…………………………………………………………….........87
6.1.e. Procedure……………..…………………………………………………….90
6.1.f. Ethical Considerations………………………………………………………93
6.1.g. Data Analysis………………..………………………………………………94
6.2. Results...……………..………………………………………………………..95
6.2.a. Internal Consistency of Scales………………….……………………….......96
6.2.b. Demographic Characteristics…………………………………………..........96
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6.2.c. Differences in Young Schema Questionnaire-Short Form 3 Scores Among
Groups………………………………………………………………………107
6.2.d. Differences in the Young Parenting Inventory –Revised Scales Among
Groups ……………………………………………………………………..114
6.2.e. Differences in Adjustment to Chronic Skin Disease Questionnaire Across
Groups….……………….…………………………………………………1
6.3.Relationship Between Variables………………………..…………………….116
6.3.a Relationship Between Early Maladaptive Schemas & Adjustment………..116
6.3.a.i Bivariate Correlations……………………………………….....................116
6.3.a.ii. Regression Analysis………………………………………………..........116
6.3.b. Relationship Between Young Parenting Inventory –Revised &Early
Maladaptive Schemas………………………………………………….....121
6.3.b.i. Bivariate Correlations…………………………………………………….121
6.3.b.ii. Regression Analysis……………………………………………………..121
CHAPTER 7: DISCUSSION…………..………………………………………...134
7.1. Overview………….…………………………………………………………135
7.2. Interpretation of Findings………………..………………………………......135
7.2.a. Early Maladaptive Schemas Between Groups………………………..……135
7.2.b. Early Parenting Experiences Between Groups………………….…………138
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7.2.c. Relationship Between Parenting Experiences & Early Maladaptive
Schemas……………….……………………………………………………142
7.2.d. Differences in Adjustment to Atopic Dermatitis Between Groups………..149
7.2.e.Relationship Between Early Maladaptive Schemas &
Adjustment………........................................................................................150
7.2.e.i. Early Maladaptive Schemas & Social Anxiety/Avoidance ……………..150
7.2.e.ii. Early Maladaptive Schemas & Itching/Scratching………………………153
7.2.e.iii. Early Maladaptive Schemas & Helplessness…………………………...156
7.2.e.iv. Early Maladaptive Schemas& Anxious/Depressive Mood…………......159
7.2.e.v. Early Maladaptive Schemas & Quality of Life………………………….159
7.3. Implications for Counselling Psychology …………………………………..163
7.4.Limitations of the Present Study……………………………………………..165
7.4.a. Limitations…………………………………………………………………165
7.4.b. Conceptual Limitations of the Present Study……………………………...172
7.4.c. Researcher‟s Personal & Methodological Reflexivity….………………….173
7.5. Future Research……………………………………………………………...180
7.6. Summary & Conclusions…………………………………………………….181
REFERENCES…………………………………………………………………...183
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FIGURE CAPTIONS…………………………………………………………….208
APPENDICES……………………………………………………………………213
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TABLE OF APPENDICES

Page No
Appendix A. Early Maladaptive Schemas and Associated Schema Domains…...214
Appendix B. Young Schema Questionnaire-Short Form 3…….…………….......217
Appendix C. Young Parenting Inventory-Revised……………………………….222
Appendix D. Adjustment to Chronic Skin Disease Questionnaire……………….231
Appendix E. Demographic Questionnaire…………………..……………............234
Appendix F. Present Study‟s Advertisements on Eczema Web Sites and Facebook
Groups……………………..……………………………………….238
Appendix G. Advertisement that was circulated at London Metropolitan
University……………………………………………………….241
Appendix H. Information Sheet…………………………….……………………242
Appendix I. Consent Form………………….……………………………………244
Appendix J. Ethical Approval of the Research Ethics Committee, Psychology
Department, London Metropolitan University...............................................245
Appendix K. Debriefing………………………………………………………….246
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TABLE OF FIGURE CAPTIONS
Page No
Figure A: Mean percentage of age and years in education as a function of group
condition…………………………………………………………......209
Figure B: Mean percentages of gender, marital status and ethnic background as a
function of group condition………………….………………………..209
Figure C: Mean scores of adjustment subscales as a function of age of
onset………………………………………………………………..210
Figure D: Mean scores of Young Parenting Inventory-Revised subscales for
mothers as a function of group condition……….……………………210
Figure E: Mean scores of Young Parenting Inventory-Revised subscales for
fathers as a function of group condition……………………………….211
Figure F: Mean scores of Young Schema Questionnaire –Short Form 3 subscales
as a function of group condition……………………………................212