Medicine & Health
Medicine & Health
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(2022) Shvetcov, ArturThesisRodents learn to fear a stimulus (e.g., a light) that signals the imminent arrival of an innate source of danger (typically an aversive foot shock). They also learn to fear a stimulus (e.g., a noise) that signals a learned source of danger (e.g., the already conditioned fear-eliciting light). Following Pavlov (1927), the former type of fear is termed first-order conditioned fear, because the stimulus is paired with an aversive unconditioned stimulus (US). The latter is termed second-order conditioned fear, because the stimulus is paired, not with a US, but with an already conditioned stimulus. There are both commonalities and differences in the neural substrates underlying these two forms of fear. Both require neuronal activity in the basolateral amygdala complex (BLA), including activation of NMDA receptors, for their encoding, and both require CaMK signalling, gene expression and DNA methylation for their consolidation. However, de novo protein synthesis is required for consolidation of first-order fear but not for consolidation of second-order fear.
(2022) Watfern, ChloeThesisThere are studios all over the world where neurodiverse artists work together in a supportive way. This thesis is an inquiry into how art works in two of these organisations—Studio A in Sydney, Australia, and Project Art Works in Hastings, UK. It draws from traditions of narrative inquiry and ethnography to understand the lived experiences of the people at the heart of these studios, and the role that art has played in their storied lives. As such, the thesis contributes to knowledge in three ways: 1) It documents the important practices of makers and organisations whose work has not yet received significant critical or academic attention. It explores the dimensions of these practices that hold potential for reshaping normative understandings of both art and disability; 2) It conceptualises the role of art as a point of connection between neurodiverse people, and as a way of coming to express and understand lived experience. It maps the resonances across different fields that help articulate empathic encounters with and through art; 3) It demonstrates, through its written form, an ecological mode of creative inquiry that resists reductionism—an inquiry that is, like the practices it studies, embodied and relational. It interrogates the value, and ethical implications, of this mode of research. To contribute to knowledge in this way, the thesis assembles many forms of pre-existing knowledge, including the lived experience of its subjects, and the academic literature preceding it. It is grounded in an ecological understanding of cognition, informed by theories that help situate thought in the world, as a dynamic system of relationships between self, others, and the environment. It draws links between disability aesthetics, care ethics, and an ecological approach to empathy, through detailed insights into the social and aesthetic dynamics operating in the work of the two studios. These insights were built up over three years of fieldwork, including over one hundred interviews, and hundreds of hours spent looking, listening, and making alongside artists in the studio. This thesis is an invitation to enter the world of the studios, and of some of the people who work there. It offers a way of paying attention to art, and to other people, that is attuned to the senses, and that allows us to be comfortable with not knowing—or, knowing differently. It argues that this is a practice of ethical importance, in a world where both disability and art are still poorly understood.
(2022) Joubert, AmyThesisTargeting and reducing the processes underlying the development and maintenance of depression and anxiety disorders, such as repetitive negative thinking (RNT), is a promising approach suggested to improve the efficacy and durability of psychological treatment. Delivering treatment online overcomes many of the barriers to accessing mental health treatment and improves treatment coverage. This thesis therefore involved the development and evaluation of a novel internet-delivered treatment targeting RNT. Study 1 involved an online qualitative survey to gain insight into how individuals define, experience, and understand rumination and worry. The findings from Study 1 were used to inform the development of the online intervention evaluated in subsequent chapters. Study 2 outlines the pilot evaluation of the online intervention. The results of Study 2 demonstrated the preliminary efficacy and acceptability of the intervention in adults, with significant reductions in participants self-reported levels of RNT, rumination, and worry, as well as symptoms of depression and generalised anxiety. Treatment effects were maintained at 1-month follow-up. Study 3 aimed to extend these preliminary findings using a randomised controlled trial design and compared the intervention when it was delivered with and without clinician guidance to a treatment-as-usual (TAU) control group. Participants in both the clinician guided and self-help groups had significantly lower levels of RNT, rumination, and worry, as well as symptoms of depression and anxiety compared to TAU at both post-treatment and 3-month follow-up. Treatment effects were significantly larger in the clinician guided group compared to self-help. This thesis provided the first evidence that targeting rumination and worry, both types of RNT, using an online intervention is efficacious, feasible, and acceptable in adults. This thesis also provided the first direct comparison of treatment outcomes and adherence between guided and self-help intervention formats and, in doing so, is the first to demonstrate the superiority of the clinician guided format. These findings add to the growing body of literature suggesting that internet-delivered interventions can successfully simultaneously target rumination and worry and that doing so is associated with significant improvements in depression and anxiety symptoms.
(2022) Macdonald, DianeThesisThe agency of women with disability is undermined by long-held ideas of what women with disability can or should be. These narrow, reductive views of their identity are limiting and harmful, and lead to exclusionary practices. My research used a feminist framework to challenge these views. My research addressed the social inclusion of women with physical disability in two stages. First, it investigated identity and inclusion through photographic self-portraits by women with physical disability. Second, my research examined the role of arts-based research in shifting negative community attitudes about disability. In the first stage, six women with physical disability photographed aspects of themselves using the photovoice method to focus on their strengths and issues affecting them. Photos, stories, interviews and discussions were analysed thematically. Findings from the first stage indicate that these six women engage in the ‘work of disability’. They articulated identity through their depictions of gender and disability. They challenged expectations through portraits of strength, sexuality and connection. They illustrated the gendered realities of daily life with disability that explain disability to non-disabled others. This research emphasised the personal capacity of the women to critically challenge how women with disability are portrayed. In the second stage, I explored the extent to which a public exhibition of disability self-portraits could be an effective platform to provoke social change. Audiences responded to open-ended questions about their thoughts and feelings after viewing the exhibition. I employed interpretive thematic analysis through a generic social processes framework to analyse responses. My findings indicate that audiences acknowledged underlying conscious or unconscious biases that contribute to their negative attitudes about disability. Audiences connected with the exhibition in ways that not only explored the women’s stories, but also led to better understandings of their own value sets. Audiences reassessed their assumptions about disability as a direct result of viewing the exhibition. My research findings demonstrate the valuable role of arts-based research. The agency expressed through self-portraits and stories helped shift negative attitudes and perceptions of disability to counter prejudice and promote equality. My research reveals a new pathway for the public to see women as they see themselves through art.