Online Interviewing in Psychology: Reflections on the Process

Experiences with HIV stigma, among other barriers, in oral healthcare settings in Türkiye

Oral healthcare settings can be a challenging environment for people with HIV. Combined with problematic insurance policies, insufficient health literacy, and higher treatment fees, HIV stigma contributes to barriers when accessing oral healthcare. We conducted a descriptive study via an online survey with open-ended questions to understand the experiences of people with HIV in oral healthcare settings. The survey was administered by non-governmental organizations. Thematic analysis was used to analyze the data via a critical realist approach. Seventy-five participants responded to survey between August and September 2023. Thematic analysis yielded three main themes: occurrences of stigma in healthcare, coping with HIV stigma and anxiety, and barriers beyond stigma. Participants reported a problematic understanding of HIV literature and stigma among dentists, which was manifested as excessive precaution measures, denial of care, unnecessary referrals, gossiping, discriminatory remarks and disclosure of HIV status without consent. This was reflected in people with HIV as self-stigma, fear of healthcare workers and avoidance of healthcare services. Advancements in dental education and post-qualification training are needed in infection control and ethics, while people with HIV need health education to preserve their rights and sustain good health and well-being to prevent adverse outcomes.

Caregivers' experiences in helping individuals with severe and enduring mental health challenges integrate into the community: A qualitative descriptive study in Singapore

WHAT IS KNOWN ABOUT THE SUBJECT

Individuals with severe and enduring mental health challenges continued to consume mental health services for an average of 13 years as they needed multiple acute psychiatric admissions due to the challenges they experienced in their everyday activities. As caregivers of individuals with severe and enduring mental health challenges, they often bear the brunt of caregiving through their assistance with activities of daily living (ADL), providing emotional support and ensuring medication compliance for their loved ones. When caring for their loved ones, caregivers often reported psychological stress, social isolation and emotional exhaustion due to stressors such as uncertainty of the future, the lack of support from professional services and the isolation from their own social network and support mechanism.

WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE

Insights from this study revealed that caregivers for individuals with severe and enduring mental health challenges went through a lonely and exhausting journey fraught with psychological, physical, social and financial challenges, echoing the caregiving needs and the prevalence of the caregiver burden.

WHAT ARE THE IMPLICATIONS FOR PRACTICE

Insights shared by the caregivers demonstrated the need for a centralised point of contact to navigate Singapore's fragmented mental healthcare sector. Peer-support groups should be further promoted because they offer the benefits of information exchange, mutual support and a sense of empowerment and hopefulness, which may help ease the caregiver burden. Life skills training, such as teaching how to communicate empathetically with family members, resolve conflicts using open communication, maintain a structured daily routine and solve pragmatic problems in daily life, is more critical for individuals with severe and enduring mental health challenges. This will help them learn how to manage their well-being, live independently, and stabilise their conditions. Lastly, public awareness campaigns should honour caregivers by highlighting their strength, resilience, and dedication. The state can provide financial assistance in the form of tax relief for their income per annum or caregiver allowance to alleviate the financial stress that caregivers are facing.

ABSTRACT

Introduction The progressive deinstitutionalisation of mental healthcare has increasingly shifted care responsibilities from healthcare professionals to family caregivers for individuals with severe mental illness. Caregivers must balance many obligations, which often compromise their overall health and well-being, while helping their loved ones integrate into the community. Aim To identify and understand caregivers' needs and challenges as they help individuals with severe and enduring mental health challenges integrate into the community. Methods This study used a descriptive qualitative approach to explore the experiences and challenges of caregivers for individuals with severe and enduring mental health challenges when integrating back into the community. A semi-structured guide was used during the video-conferencing interviews conducted between December 2021 and November 2022. This study was reported according to the 32-item Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Findings Fourteen caregivers were individually interviewed by the primary author. Most caregivers were female, with an average of 15 years of experience caring for their loved ones. Using Braun and Clark's six-phase thematic framework, we inductively generate the themes and subthemes from the data. The two themes were (i) challenges (whose subthemes included personal challenges in caregiving, the lack of awareness, and stigma and employment) and (ii) support (whose subthemes included the importance of socialisation for individuals with mental health conditions, existing avenues of support and potential areas for support). Discussion Our findings informed the contemporary needs of caregivers caring for individuals with severe and enduring mental health challenges integrating into the community. Like the global challenges for people with mental health issues, psychosocial support and other supplementary support are still common themes in mental health settings. The findings further specifically highlighted the importance of accessible points of contact as resources and employment-enabling and sustaining initiatives to help manage caregivers' emotional and system challenges, which addresses the gaps identified in the findings. Caregivers' peer-support groups, life skills training and public mental health awareness are also necessitated by the caregivers' voices. Implications for Practice Priority areas include having a centralised point of contact within the community for caregivers. Government or not-for-profit organisations can take the lead by initiating employment-enabling initiatives for individuals with severe and enduring mental health challenges and their caregivers.

"Self-care is being attentive to yourself": using assemblages to examine discursive-material practices of self-care among Filipino university students

PURPOSE

Researchers have observed a rise in mental health issues among university students over the course of the pandemic, in part due to the closure of schools and public spaces for wellness. Thus, the purpose of this study is to explore how students creatively reassemble their self-care practices through different objects and spaces within their homes to care for their mental health.

METHODS

Photo-elicitation interviews were conducted with ten (10) female university students from the Philippines. Photographs and interview transcripts were analysed through map-making practices and an iterative process of crafting assemblages and their cofunctionings.

RESULTS

The work-home assemblage was identified as the site of self-care, delineated by boundary-making and place-making practices and the creation of time spaces. The two major cofunctionings of the work-home assemblage were (a) caring for the self as fostering different relationalities with the self, and (b) caring for the self as copresencing with human and nonhuman others.

CONCLUSION

Findings demonstrate the importance of material and spatial relationalities in facilitating caring relational encounters with the self. Theoretical and practical implications include attuning to the existing material and spatial resources in one's environment and integrating them into one's practices of caring for the self.

Understanding How School-Based Interventions Can Tackle LGBTQ+ Youth Mental Health Inequality: A Realist Approach

Globally, research indicates that LGBTQ+ young people have elevated rates of poor mental health in comparison with their cisgender heterosexual peers. The school environment is a major risk factor and is consistently associated with negative mental health outcomes for LGBTQ+ young people. The aim of this UK study was to develop a programme theory that explained how, why, for whom, and in what context school-based interventions prevent or reduce mental health problems in LGBTQ+ young people, through participation with key stakeholders. Online realist interviews were conducted in the UK with (1) LGBTQ+ young people aged between 13-18 years attending secondary schools (N = 10); (2) intervention practitioners (N = 9); and (3) school staff (N = 3). A realist retroductive data analysis strategy was employed to identify causal pathways across different interventions that improved mental health outcomes. The programme theory we produced explains how school-based interventions that directly tackle dominant cisgender and heterosexual norms can improve LGBTQ+ pupils' mental health. We found that context factors such as a 'whole-school approach' and 'collaborative leadership' were crucial to the delivery of successful interventions. Our theory posits three causal pathways that might improve mental health: (1) interventions that promote LGBTQ+ visibility and facilitate usualising, school belonging, and recognition; (2) interventions for talking and support that develop safety and coping; and (3) interventions that address institutional school culture (staff training and inclusion polices) that foster school belonging, empowerment, recognition, and safety. Our theoretical model suggests that providing a school environment that affirms and usualises LGBTQ+ identities and promotes school safety and belonging can improve mental health outcomes for LGBTQ+ pupils.

Lived experiences of mental health conditions in Singapore: A constructivist grounded theory study

BACKGROUND

Since the 1990s, the mental healthcare field has begun shifting to conceptualisations of personal mental health recovery, emphasising the heterogeneous nature of how people develop and overcome the difficulties associated with mental ill health. Despite three decades of research on the topic, most recovery-oriented studies have been conducted in predominantly Western cultures, lacking the necessary nuances when applied in Asian settings.

AIMS

We sought to contribute to a growing body of research to fill this gap by exploring the experiences of people who experience mental ill-health in Singapore.

METHOD

We adopted a constructivist grounded theory approach and interviewed 21 people who had been diagnosed as experiencing a mental health condition.

RESULTS

The core category emerging from interview participant perspectives was a 'roller coaster ride of confusion'. This overarching category was made up of the following four sub-categories - 'not understanding what was happening', 'losing control over self', 'unpacking the root of challenges' and 'trying to make sense of the situation'.

CONCLUSIONS

Taken together, the journey of a person experiencing mental health recovery in Singapore is filled with obstacles and uncertainty due to various social and cultural influences such as family pressures, the competitiveness of society and the high-pressure nature of Singapore's educational system. Future research needs to better understand if these are generalisable experiences, and interventions to mitigate their impact need to be explored. Given the strong societal influences, change will take time. Still, this study gives a voice to the lived experiences of people who face mental health challenges in Singapore in the hope that their insights may assist future generations in developing a more mentally healthy society.

A Qualitative Study: An Examination of Police Officers' Lived Experiences During the COVID-19 Pandemic

In the spring of 2020, the COVID-19 pandemic spread across the globe prompting stay-at-home orders for all but the most essential workers in society. Policing was one of the professions that is essential for community safety, regardless of the circumstances. Officers were on the front-line of the COVID-19 public health crisis and their preparedness was crucial for officer and community health. During the onset of the pandemic little was known about how officers perceived the virus and how police agencies prepared officers to work in a highly contagious environment. This study used semistructured interviews of police officers in two states in the United States that had elevated cases of the virus. The authors explored the lived experiences of police officers to explore officers' perceptions, concerns, implications the pandemic had on patrol activity, and agency preparedness during the onset of the COVID-19 pandemic. The results revealed structural and cultural forces that resulted in officers and their agency leadership not taking the pandemic seriously, ill-preparation and ill-equipping, and disincentives in reporting exposure. Moreover, officers' fears were largely not based on their own well-being, but on the risk of spreading the disease to their family members.

Adventure-based mindsets helped maintain psychological well-being during COVID-19

OBJECTIVES

Research conducted during the COVID-19 pandemic underscores the value of physical activity and nature for psychological well-being in the general population when people's mobility and activities are restricted due to government mandates. Since restrictions may thwart the psychological benefits reported from participation in adventure recreation (e.g., rock-climbing, white-water kayaking), it is important to understand the psychological well-being of people who previously benefited from adventure opportunities. Thus, the purpose of this study was to investigate the lived experiences and psychological well-being of adventure recreation participants during COVID-19 restrictions.

DESIGN

A descriptive phenomenological approach was used.

METHOD

Participants were fifteen men, four women, and one non-binary person who engaged in a variety of adventure recreation activities that included ski-mountaineering, free-diving, rock-climbing, white-water kayaking, back-country skiing, skydiving, SCUBA diving, BASE jumping, and mountaineering. Participants had an average of 11.7 years of experience in at least one of their preferred adventure recreation activities. Participants were invited to take part in a visual and audio-recorded semi-structured interview on Zoom. Interviews lasted on average 69.3 min. Reflexive thematic analysis was undertaken inductively.

RESULTS

Overall, participants discussed a range of nuanced impacts that COVID-19 restrictions had on their psychological well-being. Participants discussed how negative affect resulted from restricted opportunities for physical and mental challenges, emotion regulation, connections to nature and people, and excitement. However, participants also benefited from several silver linings, such as reflecting on past adventures, a reduced need to compare themselves socially, and opportunities to spend quality time with others. Participants also explained how 'adventure-based mindsets' (e.g., resilience, focusing on controllable elements, humility) were protective strategies they used to limit the ill-being impacts of COVID-19 restrictions.

CONCLUSIONS

This study extends the alternative sport and exercise literature by illustrating how participation in adventure has the potential to enhance participants' resilience and their ability to maintain psychological well-being across diverse and novel contexts (e.g., the COVID-19 pandemic).

Looking at the 'field' through a Zoom lens: Methodological reflections on conducting online research during a global pandemic

For many social science scholars, the COVID-19 pandemic has forced us to re-think our approaches to research. As a result of new social distancing measures, those of us who conduct in-person qualitative and ethnographic research have faced significant challenges in accessing the populations and fields we study. Technology served as an incredibly useful tool for social interaction and research prior to the pandemic, and it has since become even more important as a way to engage with others. Although not all types of social research, or even all projects, lend themselves to online activities, digital communication platforms like Zoom, Skype, and Facebook have allowed many of us to continue our studies from a distance-in some cases, significant temporal and spatial distances away from our research sites. As such, it is important to consider how these different methodological approaches challenge our understandings of fieldwork. While the disadvantages of not physically accessing the places we study are clear, can mediated approaches offer (any) hope of the immersion we experienced with in-person fieldwork? If many of us are able to continue ethnographic research (in some form) without co-locating with our participants in our field sites, how are our studies fundamentally affected, as well as the ways we conceptualize the 'field' more largely? This paper explores these methodological and epistemological questions through reflections on conducting online research during the beginning of the COVID-19 pandemic.

"Your Body Is Not At All Where You Left It": Adolescent and Young Adult Cancer Survivors' Experiences Transitioning Back Into Physical Activity After Treatment

Physical activity (PA) can help manage cancer treatment-related side effects and improve well-being following treatment; however, resuming PA after a period of inactivity due to cancer can be challenging. The purpose of this study was to explore adolescents and young adults (AYAs) experiences transitioning back into PA after a period of inactivity due to cancer treatment. Twelve previously active AYAs (M_age = 30 ± 5.8 years) were purposefully sampled and engaged in a semi-structured interview. The following four themes were generated through a reflexive thematic analysis: PA is described as important and valuable; navigating one's appearance and fitness changes after cancer treatment within the PA context; supportive care is essential to successful PA transitions; and juxtaposed environments: fitness facilities, cities, and green spaces. Developing strategies aimed at gradually transitioning into PA should be a priority to improve AYAs' well-being through survivorship.

Digital approaches to enhancing community engagement in clinical trials

Digital approaches are increasingly common in clinical trial recruitment, retention, analysis, and dissemination. Community engagement processes have contributed to the successful implementation of clinical trials and are crucial in enhancing equity in trials. However, few studies focus on how digital approaches can be implemented to enhance community engagement in clinical trials. This narrative review examines three key areas for digital approaches to deepen community engagement in clinical trials-the use of digital technology for trial processes to decentralize trials, digital crowdsourcing to develop trial components, and digital qualitative research methods. We highlight how digital approaches enhanced community engagement through a greater diversity of participants, and deepened community engagement through the decentralization of research processes. We discuss new possibilities that digital technologies offer for community engagement, and highlight potential strengths, weaknesses, and practical considerations. We argue that strengthening community engagement using a digital approach can enhance equity and improve health outcomes.

Interpreting the perceptions of authenticity in virtual reality tourism through postmodernist approach

Based on the authenticity theory and limited extant research on virtual reality (VR) tourism experience, this study aims to extend authenticity theory by focusing on perceptions of authenticity from postmodernist approach and developing a theoretical framework for tourists participating in VR tourism experience. In-depth interviews were conducted with 28 respondents, and thematic analysis was adopted to analyze the data. Through inductive and deductive data analysis, three main themes are extracted, and six sub-themes are generated, helping to form a framework of authenticity in VR tourism. The findings contribute both to be authenticity theory and VR tourism implication.

Emotional intimacy, empathic concern, and relationship satisfaction in women with endometriosis and their partners

INTRODUCTION

This is the first study to explore relationship satisfaction through a dyadic lens in couples living with endometriosis. This is timely and important given that endometriosis is a shared experience within the couple rather than an isolated experience occurring for the individual members of a couple.

METHODS

Sixty couples completed online measures assessing emotional intimacy, empathic concern, psychological health, and relationship satisfaction.

RESULTS

Emotional intimacy was associated with one's own relationship satisfaction and partner emotional intimacy was associated with the woman's relationship satisfaction in couples living with endometriosis. Women's empathic concern was unrelated to their own and their partners' relationship satisfaction. However, partner empathic concern was associated with both their own and the woman's relationship satisfaction.

CONCLUSIONS

Healthcare providers are encouraged to engage partners of women diagnosed with endometriosis in education and treatment processes. This engagement could be used to ascertain, and improve where needed, the emotional intimacy and empathic concern experienced by the couple.

How has COVID-19 lockdown impacted smoking? A thematic analysis of written accounts from UK smokers

Objective. This study was designed to investigate UK smokers' accounts of impacts of COVID-19 on their smoking, to develop implications for supporting smoking cessation.Design. One hundred and thirty-two smokers aged 19-52 years (mean age 25 years), recruited through an advert distributed through social media and a dedicated Twitter page, completed an anonymous online questionnaire.Main Outcome Measures. Smokers produced written accounts of how COVID-19 had impacted their smoking. Responses were of unlimited length and completed online 22^nd May-22^nd June 2020 during UK COVID-19 lockdown.Results. Inductive thematic analysis generated three themes: i) increased smoking as a coping mechanism to deal with anxiety, boredom, stress, and anger in COVID-19 lockdown; ii) lockdown as enabling quitting through lifting social barriers and enabling a focus on health benefits; and iii) no change, avoiding Government/media COVID-19 information due to disbelief, lack of trust, and perceptions of bias.Conclusions. Results demonstrate a need for credible public health messaging on COVID-19 risk aimed at smokers. Implications for supporting smoking cessation are discussed, including maintaining quitting in those "social smokers" who quit during lockdown, and support on stress-management and emotion regulation in those who use smoking as a way to cope with stress, anger, and boredom.

Social network determinants of alcohol and tobacco use: A qualitative study among out of school youth in South Africa

An important determinant of alcohol and tobacco use is the adolescent's social network, which has not been explored among out of school youth (OSY). OSY are adolescents not currently enrolled in school and have not completed their schooling. This study aims to qualitatively understand how OSY's social networks support or constrain alcohol and tobacco use. Respondent-driven sampling was used to select 41 OSY (aged 13-20 years) for individual in-depth interviews in a South African urban area. The data were analysed using content analysis. Smoking and drinking friends, family close in age to OSY that drank and smoked, and lack of parental support were associated with alcohol and tobacco use among OSY. Household norms, romantic partners and non-smoking or non-drinking friends were suggested to mitigate alcohol and tobacco use. Understanding how the social network of OSY plays a role in alcohol and tobacco use is useful for gaining an insight into the profile of OSY at risk for alcohol and tobacco use. Registration of OSY youth and community-based peer led programmes that include influential OSY family and friends could be beneficial.

What do parents believe are the causes of their Type 1 diabetic child's condition?

Purpose

This paper aims to investigate parents' beliefs about the causes of their child's Type 1 diabetes to understand if this affects the way diagnosis is processed and if this impacts on sibling parenting.

Design/methodology/approach

Online, semi-structured qualitative interviews with nine parents of children with Type 1 diabetes who have at least one non-diabetic child. The results were analysed using interpretative phenomenological analysis (IPA).

Findings

Two interlinked themes were identified: “What ifs”: parents postulated underlying genetic reasons for their child's diabetes and had working theories about the triggers of diabetes that included stress, infection, vaccination or a virus. Developing a personal aetiology of their child's condition allowed some a feeling of control, while others focused on practical ways to manage diabetes. “Having something to blame”: narratives dwelt on the relationship between beliefs about causes and self-blame. Some believed that acting on an identified trigger reduced personal guilt.

Research limitations/implications

Although internet access is widespread in the UK, a limitation of this research is that it excluded those without internet access.

Practical implications

The findings of this research may provide greater depth and a more holistic perspective to the health promoter to better support parents of Type 1 diabetics.

Social implications

The analysis of illness narratives that this research provides may offer a greater understanding of the social context in which health and illness develop. This research found some examples of parental confidence about the causes and triggers of their child's diabetes being positively associated with a sense of control. This might indicate the value of a more comprehensive larger-scale study to establish whether parents who are supported to develop a personalised conception of the aetiology of their child's diabetes develop a greater sense of coherence and well-being regarding their child's condition.

Originality/value

There is very limited literature focusing on the beliefs of sufferers and their families about Type 1 diabetes causality. Of that which does exist, some research is heterogenous in its sampling of Types 1 and 2 diabetes sufferers. This study offers a rare, focused insight into the beliefs of parents about the background causes and more proximal triggers of their child's Type 1 diabetes.

Strengthening behavioral clinical trials with online qualitative research methods

Qualitative methods are integral to the systematic development of effective health behavioral interventions, as noted in recent translational models, such as the Obesity-Related Behavioral Intervention Trials model. To our knowledge, however, no scholarly literature describes how online qualitative research methods can be used to benefit the development and conduct of behavioral clinical trials. We emphasize the value of qualitative methodologies to behavioral clinical trial research more broadly and provide an introductory overview of online qualitative research methods. We highlight the specific affordances of these methods in maximizing the quality of behavioral clinical trials as well as note their potential limitations. Finally, we argue that online qualitative research methods ought to be incorporated in behavioral trial development and call for future research in this area.

Researching men who pay for sex: Using online methods for recruiting and interviewing

The use of online tools for recruitment and data collection are increasingly offering researchers access to hard to reach groups, and providing data about sensitive topics that were previously inaccessible to the research community. In this article, drawing on the experience of researching men who pay for sex with female sex workers in the United Kingdom, I explore the complexities of conducting online research, arguing that online research is indeed a valuable research tool, but that it should not be seen as the ‘easy’ option. This article outlines my rationale for using online methods and how traditional interview and recruitment practices and ethical issues were altered by this approach. A discussion of transformations in space and time follows. Finally, I reflect on how engaging with certain methods can reveal insights into the practices of those we research.

Gendered accounts of managing diabetes in same-sex relationships: A discursive analysis of partner support

The gendered dimensions of partner support in relationships where one partner has a chronic condition has been a recurring focus within the literature on gender and health. Such literature however typically focuses exclusively on heterosexual couples while same-sex relationships are rendered invisible, leading to the discourse around partner support being heteronormative. This article examines gendered dimensions within accounts of lesbian, gay and bisexual people with diabetes using a discursive psychological approach. The analysis identifies how participants drew upon a range of interpretative repertoires, including: (1) notions that women are more caring than men; (2) that men can take control in an emergency; (3) that gay men are caring; (4) that grown men can take care of themselves; and (5) that gay men are more independent than heterosexual men. It is argued that rather than simply dismissing heteronormative repertoires of gender and health, non-heterosexuals draw upon them in ways that display ideological tensions.

Talking about sunbed tanning in online discussion forums: Assertions and arguments

OBJECTIVE

There is increasing evidence of both health and appearance risks associated with sunbed use. At the same time, the sunbed industry promotes the benefits of using sunbeds, and the image of a tanned skin as attractive and healthy arguably remains embedded within contemporary western culture. These tensions are played out in everyday conversations, and this paper reports a study which explored how sunbed users manage them within online discussion forums.

DESIGN

A total of 556 posts from 13 sunbed-related threads, taken from six different UK-based online forums, were analysed thematically followed by techniques from discourse analysis.

MAIN OUTCOME MEASURES

Informed by social representations theory and discursive-rhetorical psychology, the way social representations of sunbed use are constructed, debated and disputed in online discussion forums were explored.

RESULTS

Sunbed users drew upon numerous representations to distance and protect themselves from negativity they were confronted with in the forums, utilising a range of rhetorical, discursive strategies to help them.

CONCLUSION

Theoretical contributions and potential practical implications of the findings are discussed. Findings indicate, for example, that those working on campaigns and interventions in this area need to consider the wider negativity and argumentative orientation of sunbed users' responses.

Using internet-based approaches to collect qualitative data from vulnerable groups: reflections from the field

BACKGROUND

Undertaking qualitative research with vulnerable populations is a complex and challenging process for researchers. Traditional and common modes of collecting qualitative data with these groups have been via face-to-face recorded interviews.

METHODS

This article reports on three internet-based data collection methods; email and synchronous online interviews, as well as online qualitative survey.

RESULTS

The key characteristics of using email, sychronous online interviews and an online qualitative survey including the strengths and limitations of each are presented. Reflections and insights on the use of these internet-based data collection methods are provided to encourage researchers to embrace technology and move away from using traditional face-to-face interviews when researching with vulnerable populations.

CONCLUSION

Using the internet to collect qualitative data offers additional ways to gather qualitative data over traditional data collection methods. The use of alternative interview methods may encourage participation of vulnerable participants.

The Diagnostic Validity and Reliability of an Internet-Based Clinical Assessment Program for Mental Disorders

Background

Internet-based assessment has the potential to assist with the diagnosis of mental health disorders and overcome the barriers associated with traditional services (eg, cost, stigma, distance). Further to existing online screening programs available, there is an opportunity to deliver more comprehensive and accurate diagnostic tools to supplement the assessment and treatment of mental health disorders.

Objective

The aim was to evaluate the diagnostic criterion validity and test-retest reliability of the electronic Psychological Assessment System (e-PASS), an online, self-report, multidisorder, clinical assessment and referral system.

Methods

Participants were 616 adults residing in Australia, recruited online, and representing prospective e-PASS users. Following e-PASS completion, 158 participants underwent a telephone-administered structured clinical interview and 39 participants repeated the e-PASS within 25 days of initial completion.

Results

With structured clinical interview results serving as the gold standard, diagnostic agreement with the e-PASS varied considerably from fair (eg, generalized anxiety disorder: κ=.37) to strong (eg, panic disorder: κ=.62). Although the e-PASS’ sensitivity also varied (0.43-0.86) the specificity was generally high (0.68-1.00). The e-PASS sensitivity generally improved when reducing the e-PASS threshold to a subclinical result. Test-retest reliability ranged from moderate (eg, specific phobia: κ=.54) to substantial (eg, bulimia nervosa: κ=.87).

Conclusions

The e-PASS produces reliable diagnostic results and performs generally well in excluding mental disorders, although at the expense of sensitivity. For screening purposes, the e-PASS subclinical result generally appears better than a clinical result as a diagnostic indicator. Further development and evaluation is needed to support the use of online diagnostic assessment programs for mental disorders.

Trial Registration

Australian and New Zealand Clinical Trials Registry ACTRN121611000704998; http://www.anzctr.org.au/trial_view.aspx?ID=336143 (Archived by WebCite at http://www.webcitation.org/618r3wvOG).

Stigma Resistance in Online Childfree Communities

People who are voluntarily childless, or “childfree,” face considerable stigma. Researchers have begun to explore how these individuals respond to stigma, usually focusing on interpersonal stigma management strategies. We explored participants’ responses to stigma in a way that is cognisant of broader social norms and gender power relations. Using a feminist discursive psychology framework, we analysed women’s and men’s computer-assisted communication about their childfree status. Our analysis draws attention to “identity work” in the context of stigma. We show how the strategic use of “choice” rhetoric allowed participants to avoid stigmatised identities and was used in two contradictory ways. On the one hand, participants drew on a “childfree-by-choice script,” which enabled them to hold a positive identity of themselves as autonomous, rational, and responsible decision makers. On the other hand, they mobilised a “disavowal of choice script” that allowed a person who is unable to choose childlessness (for various reasons) to hold a blameless identity regarding deviation from the norm of parenthood. We demonstrate how choice rhetoric allowed participants to resist stigma and challenge pronatalism to some extent; we discuss the political potential of these scripts for reproductive freedom. Online slides for instructors who want to use this article for teaching are available to PWQ subscribers on PWQ's website at http://pwq.sagepub.com/supplemental

Changing Bodies: Experiences of Women Who Have Undergone a Surgically Induced Menopause

We aimed to explore the lived experiences of women who had a surgical menopause as a result of undergoing a hysterectomy with Bilateral Salpingo-Oopherectomy (BSO). We adopted a qualitative interview design using Interpretative Phenomenological Analysis (IPA), and recruited 7 women aged 47 to 59. We conducted synchronous online semistructured interviews using the MSN (Microsoft Network) Messenger program. In the findings, we examine the prominent and underresearched theme of body image change. We discuss the women's journey from a deep internal bodily change, the meaning of this changing body image, through to the thoughts and behaviors involved with self-presentation concerns and coping with body image changes. A woman's perceived attractiveness and appearance investment are important factors to consider regarding adaptation to change over this transition. The findings might have implications for interventions designed to enhance mental well-being and increase health behaviors in women experiencing gynecological illness and/or menopause.