Kate Gleeson

De)constructing Body Image

The reification of body image leads to unarticulated ideological and conceptual assumptions that obscure the most dynamic and productive features of the construct. These assumptions are that body image: (1) ‘exists’; (2) is a socially mediated product of perception; (3) is ‘internal’ and ‘of the individual’; (4) can be treated and measured as if real; and (5) individuals’ respond to body image measures as if neutrally providing information about pre-existing images held in their heads. We argue that it is more useful to consider body imaging as a process, an activity rather than a product.

Mixed Methods in Health Psychology Theoretical and Practical Considerations of the Third Paradigm

This article has two purposes: to examine why mixed methods is a legitimate approach particularly well suited to health psychology; and to describe the challenges inherent in conducting mixed methods research. First, arguments justifying the status of mixed methods as a third paradigm alongside solely quantitative and qualitative frameworks are discussed. Second, a qualitatively driven model of mixed methods is illustrated using examples from a research programme exploring the psychosocial impact of a rare, genetic skin disorder. The flexibility of a mixed methods approach enables the researcher to be responsive to a range of issues, but it is important the approach is used thoughtfully and appropriately.

The Psychosocial Impact of Epidermolysis Bullosa

Epidermolysis bullosa (EB) is a disease in which the skin blisters in response to minimal friction, causing painful wounds. Despite the potentially severe nature of epidermolysis bullosa, research on the psychosocial issues is scarce. The aims of the study were to explore the psychosocial impact of epidermolysis bullosa on affected adults and to identify associated support needs. We collected data using semistructured interviews and employed inductive thematic analysis to organize and analyze them. Three main themes—beliefs about containing the impact of EB, understandings of the disease, and the disabling impact of EB—describe the ways in which living with EB influences the daily lives of participants at intraindividual, interindividual, and sociocultural levels. The associated support needs ranged in type and intensity, from a preference for brief, skills-based interventions and the facilitation of peer support through to longer-term specialist psychological support. The results highlight how the particular combination of the rarity of the disease, its lifelong and hereditary nature, and its disfiguring impact on the skin differentiate epidermolysis bullosa from other chronic conditions.

'Just do it': An analysis of accounts of control over health amongst lower socioeconomic status groups

Recent interest in health inequalities research has focused upon psychosocial factors such as a sense of control. Previous work has sought to measure or describe personal beliefs about control over health without addressing the contradictory and rhetorical dimensions of such accounts. These issues are explored through an analysis of interviews with 30 lower socioeconomic status (SES) participants drawn from two qualitative studies of health inequalities. Key findings concern the rhetorical construction and interweaving of two contrasting positions regarding control over health: fatalism and positive thought. Fatalistic talk provided a means by which participants acknowledged their limited control over health, although not in an exclusively negative manner. Talk about thinking positively enabled participants to present themselves as having agency in the face of adversity. The creative interweaving of these two positions in accounts of control over health enabled participants to navigate the moral imperative of responsibility for health in the context of adverse and capricious circumstance. By foregrounding the social character of accounts of control the significance of moral and ethical dimensions for health inequalities research and practice are highlighted.

Place-identity and geographical inequalities in health: A qualitative study

Psychological research on health inequalities has yet to consider the geographical dimension to these injustices. The study reported here is aimed to describe accounts of health, well-being and place-identity associated with two inner-city locales within a southern English city, distinct in terms of the health of their populations, to advance psychosocial explanations of geographical inequalities in health. Thirty participants, sampled using a combination of purposive and theoretical strategies, completed semi-structured interviews which were subsequently analysed using discourse analysis. The three key themes of pollution, space and community elucidate the material, psychological and social domains of place-identity in accounts of health, well-being and inequality. By centring upon the locatedness of human subjectivity, analysis of place-identity may be a useful tool in explicating how multiple dimensions of stratification interact within local contexts to reproduce geographical inequalities in health and social (dis)identification with place, without losing sight of the objective structural and material context of space.

An exploration into the relationships people with dementia have with physical objects: an ethnographic study.

In recent years there has been increasing interest in how different aspects of object relations theory might apply to dementia. While attachment theory in dementia has been well studied, there have been no systematic investigations of the way in which transitional objects are used by people with dementia. This study explores the relationship people with dementia have with physical objects using a focussed ethnographic method. Twenty-one residents and the staff of a care home for people with dementia were observed over a two-month period. Observations were recorded and analysed in light of Winnicott’s criteria for transitional objects and incorporated the work of other key theorists. The ethnography found evidence that people with dementia have varied relationships with objects and can employ objects in a transitional way. The paper then explores the implications of this research for understanding the function of transitional objects for people with dementia. The findings suggest that that Winnicott’s theory of transitional objects can provide a framework for understanding some of the processes of dementia.

Editorial: Imag(in)ing Visual Methodologies

From the use of models to show cognitive processes, to recordings of parent /child interaction, the visual has always had a place in psychology. Indeed, visual representation is an integral part of ‘doing’ scientific theory (see Garfinkel et al ., 1981; Lynch and Edgerton, 1988), and the verbal and the visual are integrally intertwined in representing scientific theory, method and data, and in enabling the expression of everyday experiences. Notwithstanding this interweaving of the verbal and the visual, psychology has tended to privilege the verbal / even when examining text that contains both visual and verbal communication (cf. Rose, 2000). Despite a long history of using visual techniques as stimuli for eliciting data and as tools for representing theory or empirical findings, psychologists have rarely self-consciously explored visual methodologies as a source of knowledge construction in their own right. This special issue draws together researchers who use visual methods to examine different ways of meaning-making, and who explore some of the key issues that underpin the use of visual methods. Visual methods are an exciting means of doing psychology, but using them makes salient concerns of process, translation, ethics and representation.

Dressing the Body: The Role of Clothing in Sustaining Body Pride and Managing Body Distress

This qualitative research extends current theorizing on behavioural strategies for managing body distress by exploring how women manage body image through clothing practices. Eighty two women reported their subjective understanding of how body evaluation and clothing practices are interconnected in response to open-ended questionnaires. Thematic analysis of responses revealed that clothing practices are a mundane and agentic part of the adjustive and self-regulatory processes for managing distressing body image (cf. Cash, 2002b). Clothing is used strategically to manage bodily appearance and anxiety by hiding ‘problem areas’, accentuating ‘assets,’ and flattering the figure. Body image is actively negotiated and managed through everyday behaviours which fluctuate on ‘fat’ days and ‘thin’ days. These data illustrate the processes which underpin the active negotiation of body image and capture the fluidity of body evaluations and strategies for managing the appearance of the body. These findings raise a number of challenges for theorizing and research including the need to adopt methods which capture the dynamic interplay of body image processes, and the need to address body appreciation as well as distress.

Exploring the perceptual characteristics of voice-hallucinations in deaf people

Introduction. Previous research has not taken account of the possibility that deaf people will show greater heterogeneity in how they experience voice-hallucinations due to individual differences in experience with language and residual hearing. This study aims to explore how deaf participants perceive voice-hallucinations and whether the perceptual characteristics reported reflect individual experience with language and sensory input. Method. A statement-sorting task generated data about perceptual characteristics of voice-hallucinations for exploratory factor analysis. The sample included 27 deaf participants with experience of voice-hallucinations, and a range of hearing loss and language backgrounds. Results. Perceptual characteristics of voice-hallucinations map closely onto individual auditory experience. People born profoundly deaf loaded onto nonauditory factors. Deaf people with experience of hearing speech, through residual hearing, hearing aids, or predeafness experience, reported auditory features or uncertainty about mode of perception. Conclusions. This is the first study to systematically explore voice-hallucinations in deaf people and to advance a model of subvocal articulation to account for such counterintuitive phenomena.

The long-term psychosocial impact of corrective surgery for adults with strabismus

Huisingh and McGwin1 have suggested that the one-way analysis of variance (ANOVA) Jackson et al 2 reported using was an incorrect statistical method to have employed on the repeated measures data collected from adult participants undergoing corrective surgery for strabismus at three time points; 6 weeks preoperatively (T1), 3 months (T2) and 18 months postoperatively. However, Jackson et al 2 also reported the use of …