This thesis includes an empirical study considering sleep-wake reversal and psychosis from a Functional Contextualist perspective and a systematic review of the literature regarding moderators of rule-based insensitivity, a theoretical principle associated with psychological suffering within Relational Frame Theory. While the systematic review seeks to explore the principles underpinning functional contextual theories of psychological suffering, the empirical paper seeks to apply these principles to the exploration and description of sleep behaviours and psychosis. The thesis concludes with a discussion of implications for future research and practice.
Relational Frame Theory argues that rule-based insensitivity to changes in environmental contingencies underlies human suffering. Empirical links between theory and research serve as an important quality measure for evidence based psychological therapies. A systematic review was therefore conducted to explore the factors that moderate rule-based insensitivity. Preliminary evidence was found to suggest that rule based insensitivity may be increased when (a) where rules specify a socially mediated rather than environmentally mediated consequence and (b) where there is a longer history of deriving a rule from other stimulus relations. It is possible that more complex relations exist between rule based insensitivity and relational coherence and psychological suffering. Confidence in findings was generally low and a need for further research was identified.
consistent with past reinforced verbal behaviours
A qualitative empirical study is reported in which participant experiences of sleep are interpreted within a Functional Contextualist perspective. Participants discussed contextual factors and intended behavioural functions that were associated with sleep-wake reversal. Lack of meaningful occupation and activities was highlighted as a potentially important factor underlying the maintenance of sleep-wake reversal in the context of psychosis. Sleep-wake reversal was further discussed in terms of experiential avoidance of aversive daytime and night-time experiences.