Psychology

There is a widely held view that learning to play a musical instrument is a valuable experience for all children in terms of their personal growth and development. Although there is no statutory obligation for instrumental music provision in Scottish primary schools, there are well-established Instrumental Music Services in Local Education Authorities that have been developed to provide this facility for pupils. This article presents the findings of a study that was aimed at investigating the extent to which the opportunity to undertake instrumental instruction in Scottish primary schools is equitable. The study employed a mixed-methods approach. Data were gathered from 21 Scottish primary schools, a total pupil population of 5122 pupils of whom 323 pupils were receiving instrumental instruction. The analysis involved an investigation of the academic profile of this group, the representation of children with additional support needs (ASN) and the nature of their ASN. A qualitative analysis of policy and guideline documents and interviews with Heads of Instrumental Services, headteachers and instrumental instructors served to explain and illuminate the quantitative data. The findings showed that particular groups of children with ASN were significantly under-represented and offer explanations of the processes by which this occurs.

Previous studies have reported associations between conspiracist ideation and domain-level facets of schizotypy, but less is known about associations with lower-order facets. In the present study, 447 adults completed measures of conspiracist ideation and the Schizotypal Personality Questionnaire (SPQ), consisting of nine subscales grouped into four domains. Results of a multiple regression showed that two domains of the SPQ significantly predicted conspiracist ideation, but multicollinearity was a limiting factor. In a second regression, we found that the subscales of Odd Beliefs or Magical Thinking and Ideas of Reference significantly predicted conspiracist ideation, without any multicollinearity constraints. We interpret these results as implicating two specific lower-order facets of schizotypy in belief in conspiracy theories. We further contrast the present results with previous studies indicating associations between conspiracist ideation and paranormal beliefs.

Much debate in schizotypal research has centred on the factor structure of the Schizotypal Personality Questionnaire (SPQ), with research variously showing higher-order dimensionality consisting of two to seven dimensions. In addition, cross-cultural support for the stability of those factors remains limited. Here, we examined the factor structure of the SPQ among British and Trinidadian adults. Participants from a White British subsample (n=351) resident in the UK and from an African Caribbean subsample (n=284) resident in Trinidad completed the SPQ. The higher-order factor structure of the SPQ was analysed through confirmatory factor analysis, followed by multiple-group analysis for the model of best fit. Between-group differences for sex and ethnicity were investigated using multivariate analysis of variance in relation to the higher-order domains. The model of best-fit was the four-factor structure, which demonstrated measurement invariance across groups. Additionally, these data had an adequate fit for two alternative models: (a) 3-factor and (b) modified 4-factor model. The British subsample had significantly higher scores across all domains than the Trinidadian group, and men scored significantly higher on the disorganised domain than women. The four-factor structure received confirmatory support and, importantly, support for use with populations varying in ethnicity and culture.

Previous research has suggested that the factor structure of Body Appreciation Scale (BAS), a widely-used measure of positive body image, may not be cross-culturally equivalent. Here, we used confirmatory factor analysis to evaluate the conceptual equivalence of a Chinese (Cantonese) translation of the BAS among women (n = 1,319) and men (n = 1,084) in Hong Kong. Results showed that neither the one-dimensional nor proposed two-dimensional factor structures had adequate fit. Instead, a modified two-dimensional structure, which retained 9 of the 13 BAS items in two factors, had the best fit. However, only one these factors, reflective of General Body Appreciation, had adequate internal consistency. This factor also had good patterns of construct validity, as indicated through significant correlations with participant body mass index, self-esteem, and (among women) actual-ideal weight discrepancy. The present results suggest that there may be cultural differences in the concept and experience of body appreciation

Dr Tina Cartwright is a senior lecturer at the University of Westminster. She is interested in patients' perceptions of illness and their experiences of health care, particularly in relation to complementary medicine. Rebecca Torr is a postgraduate at the University of Bath and is interested in people's perception of science and attitudes towards complementary medicine. Word count: 8 254 (including references)

Surprisingly few studies have explored the use of complementary medicine amongst older persons and existent research is typically restricted to those who can afford private treatment. The aim of the current qualitative study was therefore to explore the experiences of older people using subsidised complementary health care.

Background Alopecia can have substantial psychological consequences, but there has been no research looking at patients' beliefs about their condition nor how they relate to quality of life (QoL). Objectives To investigate the relationships between illness perceptions, coping and QoL in patients with alopecia. Methods The study employed a cross-sectional design. In total, 214 individuals with alopecia were recruited from four internet support groups. There were 171 women and 43 men (mean age 35 years). Participants completed an online questionnaire comprising the Revised Illness Perception Questionnaire, the Dermatology Life Quality Index and the brief COPE.

Teachers of statistics are often faced with the task of teaching their subject to heterogeneous groups of students. At the University of Westminster we are faced with groups of students who are all studying psychology but have very different academic and social backgrounds. To teach statistics and research methods successfully to such heterogeneous groups we have developed teaching and learning strategies to enhance student experience of the course. These strategies encompass curriculum design and student support and include interventions using blended learning, study groups, reflective learning journals and the management of statistics anxiety.

Objectives: Evidence suggests that immersive learning increases empathy and understanding of the patient experience of illness. This study evaluated a digital training intervention 'In Their Shoes' which immerses participants in the experience of living with inflammatory bowel disease (IBD), highlighting the biopsychosocial impact. The simulation program uses a mobile application to deliver time-based tasks and challenges over 36 h, supplemented with telephone role-play and 'kit' items to open and use. This study investigated changes in IBD understanding and connection to patients, empathy and perception of job value in a group of pharmaceutical employees. Additionally, it explored experiences and impact of taking part in the intervention. Methods: A mixed methods pre-post design was utilized, with an opportunity sample of employees taking part in the training. 104 participants from sites in 12 countries completed measures at baseline and 97 post-intervention. Measures included the Toronto Empathy Questionnaire, Prosocial Job Characteristics Scale, and structured questions around IBD understanding and connection to patients. Two focus groups (N = 14) were conducted regarding participants experiences of the intervention to complement an open-response question in the questionnaire (N = 75). Qualitative data was analyzed using thematic analysis. Results: Following the intervention, there were statistically significant increases in IBD understanding and connection to patients (p < 0.00025), evaluation of organizational innovation (p < 0.00025), empathy (d = 0.45) and prosocial job perceptions (d = 0.28). Qualitative analysis revealed more fully the transformative personal journey undertaken by participants which provided 'eye opening' insight into the psychosocial impact of living and working with IBD. This insight encouraged patient perspective-taking and a strong desire to promote patient advocacy and reduce stigma around chronic illness. Finally, greater organizational pride and connectivity was evident for some participants. Conclusions: An immersive training program, focussing on the lived experience of illness, led to significant increases in disease understanding and empathy. These findings

Traditional masculinities can mean men are unable or unwilling to deal constructively with distress. However, researchers increasingly acknowledge that men and masculinities (including hegemonic styles) are diverse. Moreover, men can positively manage their wellbeing, although little research explores how they do so. Uniquely, our study sought to find men who report finding ways to care for themselves to examine narratives about how such self-care originated. We aimed to do this by exploring issues underpinning men's journeys towards meditation, focusing on implications for well-being. In-depth interviews were conducted in 2009 with 30 meditators, selected using principles of maximum variation sampling, and analysed with a modified 'constant comparison' approach. Men's journeys toward meditation were fraught with difficulties. Men described crossing a threshold from boyhood into 'manhood' where they encountered traditional forms of masculinity (e.g. stoicism), and most described subsequent strategies to disconnect from emotions. While men eventually found ways to engage more constructively with their emotions and well-being, this paper explores the struggle and distress of their journeys. Masculinity and distress Gender differences are frequently noted in rates of common mental disorders, e.g. anxiety and depression, with rates in England of 19.7% for women, against 12.5% for men (McManus et al., 2009). However, there is concern that men may express their distress in other ways, with men three times more likely to commit suicide than women (ONS, 2011). While distress is often ill-defined, it refers to mental suffering, representing 'an unpleasant emotional state' (Gadalla, 2009: 2200), and is often used to denote negative subjective experiences that fall short of clinical diagnoses for mental disorders (Green et al., 2010). Some commentators argue that rather than 'internalising' distress as sadness, for example, men are more likely to 'externalise' it in ways including aggression, risk-taking, and alcohol use (Pollack, 1998). For instance, in an Australian study of people who identified as being 'down in the dumps,' men were more likely to try and avoid feelings of distress, e.g. through numbing or escape behaviours, until these culminated in a 'build-up,' including aggression and suicide attempts (Brownhill et al., 2005). Men are also considered in most research as less likely to seek help for distress and disorders, being less willing than women

Engagement with meditation as a positive health trajectory: Divergent narratives of progress in male meditators 2 Objective: Studying personal narratives can generate understanding of how people experience physical and mental illness. However, few studies have explored narratives of engagement in health positive behaviours, with none focusing on men specifically. Thus, we sought to examine men's experiences of their efforts to engage in and maintain healthy behaviours, focusing on meditation as an example of such behaviour. Design: We recruited 30 male meditators, using principles of maximum variation sampling, and conducted two in-depth interviews with each, separated by a year. Main outcome measures: We sought to elicit men's narratives of their experiences of trying to maintain a meditation practice. Results: We identified an overall theme of a 'positive health trajectory,' in particular, making 'progress' through meditation. Under this were six main accounts. Only two articulated a 'positive' message about progress: climbing a hierarchy of practitioners, and progress catalysed in other areas of life. The other four reflected the difficulties around progress: progress being undermined by illness; disappointment with progress; progress 'forgotten' (superseded by other concerns); and progress re-conceptualised due to other priorities. Conclusion: Men's narratives reveal the way they experience and construct their engagement with meditationas an example of health behaviour-in terms of progress.

Traditional masculine norms around emotions (e.g., inexpressiveness) can mean men have difficulties managing their emotions, contributing to potential mental health problems. However, it is recognized that men and masculinities are diverse, and that some men can positively self-manage their mental health, although this has received little attention in the literature. Uniquely, we sought to find men who had discovered ways to engage constructively with their emotions, in this case through meditation. Thirty male meditators, recruited using a maximum variation sampling strategy, participated in a longitudinal mixedmethod study in the UK. Participants undertook two cognitive neuroscience sessionsapproximately one year apart-comprising cognitive assessments of attention, in combination with EEG measurement during task performance and meditation. In-depth narrative interviews exploring men's experiences of meditation were also conducted at both timepoints, analyzed using a modified constant comparison approach. Taken together, the quantitative and qualitative results suggested men developed attention skills through meditation, although there were variations according to previous meditation experience (e.g., a sharper longitudinal increase in theta amplitude under meditation for novice practitioners). Moreover, development of attention appeared to enhance men's emotional intelligence, which in turn could be conducive to wellbeing. The paper has implications for psychologists working with men, pointing to the potential for teaching men about better regulating their emotions for improved wellbeing.

Although empirical interest in meditation has flourished in recent years, few studies have addressed possible downsides of meditation practice, particularly in community populations. In-depth interviews were conducted with 30 male meditators in London, UK, recruited using principles of maximum variation sampling, and analysed using a modified constant comparison approach. Having originally set out simply to inquire about the impact of various meditation practices (including but not limited to mindfulness) on men's wellbeing, we uncovered psychological challenges associated with its practice. While meditation was generally reported to be conducive to wellbeing, substantial difficulties accounted for approximately one quarter of the interview data. Our paper focuses specifically on these issues in order to alert health professionals to potential challenges associated with meditation. Four main problems were uncovered, of increasing severity: meditation was a difficult skill to learn and practise; participants encountered troubling thoughts and feelings which were hard to manage; meditation reportedly exacerbated mental health issues, such as depression and anxiety; and in a few cases, meditation was associated with psychotic episodes. Our paper raises important issues around safeguarding those who practise meditation, both within therapeutic settings and in the community.

Against a backdrop of increasing secularization, the number of Buddhists in Britain continues to rise (Office for National Statistics, 2012). However, few studies have explored the reasons people are drawn towards Buddhism, with none focusing on men specifically. Uniquely, we conducted in-depth narrative interviews with 30 male meditators in London, UK, to explore the appeal Buddhism held for them. Buddhism was portrayed as a nexus of ideas and practices which improved men's lives. Analyzed through the prism of a multidimensional biopsychosocial model of wellbeing, Buddhism appeared to have the potential to promote wellbeing in biological terms (e.g., health behaviors), psychological terms (e.g., generating subjective wellbeing), and social terms (e.g., offering a supportive social network). From a gendered perspective, Buddhism offered men the opportunity to rework their masculine identity in ways that enhanced their wellbeing. This was a complex development, in which traditional masculine norms were upheld (e.g., Buddhism was constructed as a 'rational' framework of ideas/practices), yet also challenged (e.g., norms around alcohol abstinence). Our study offers new insights into the hazards and the attractionsparticularly for menof engaging with Buddhism.

been shown to be 6100 s 2 and it is proposed the practise walk may not be needed. Completing the standard ESWT protocol presents a considerable burden to patients and clinicians alike; being able to drop the practise walk would be of benefit. This study investigated the need for a pESWT when measuring change after 8 weeks. Method A retrospective analysis of the data collected from ESWTs performed as part of another study was carried out. A 2-walk and a 1-walk protocol were defined. Both protocols required 2 ISWTs; the 2-walk protocol used 2 ESWTs, the longest taken as the outcome, the 1-walk protocol used the first walk as the outcome. Completion rates, floor and ceiling effects, same-day limits of agreement, and limits of agreement for change over 8 weeks were calculated for the protocols. Results 41 COPD patients (26 male) were recruited; mean (SD) age 68(11) years, FEV1% predicted 47(15.80)%. Results of comparison of protocols are given in Abstract P42 Table 1. At 80%, the limits of agreement for the protocols was less than the 92% change expected from pulmonary rehabilitation 3 and less than that described 2 as 'somewhat better ' (113%) but greater than the MCID of 68%. 2 The 1-walk protocol had superior completion but higher ceiling rates. Conclusion The data presented here suggests that, in clinical practice when measuring change related to an exercise intervention, only one ESWT is required. For research purposes, particularly for non-exercise interventions, the standard protocol should be retained as it is more likely to identify marginal difference and demonstrates less of a ceiling effect.

Mindfulness meditation is thought to help practitioners become more tolerant of dysphoric emotions by enabling them to cultivate decentring skills. Such skills may be especially useful for male meditators, as men are thought to have particular difficulties regulating their emotions, partly due to masculinity norms related to emotional toughness. However, few studies of mindfulness have focussed specifically on men to explore the intersection between wellbeing and masculinity. Uniquely, we sought to examine the development of decentring capabilities in a non-clinical sample of male meditators using a longitudinal mixed-methods design. Thirty meditators were recruited in London, UK. Participants completed an emotional Stroop task-at two points, a year apart-to assess changes in emotional reactivity linked to meditation. Participants also undertook qualitative interviews at both time points, analysed using a modified constant comparison approach. Together, the two datasets converged to suggest that men did develop decentring skills through meditation, leading to greater equanimity in the presence of negative qualia. In addition to offering insights into the mechanisms underpinning the impact of mindfulness on wellbeing, the study provides a gendered dimension to the analysis of wellbeing strategies like meditation, a dimension which has hitherto been conspicuously absent from recent literature in fields such as positive psychology.

Connell's (1995) concept of hegemonic masculinity is often reduced to a singular construct, consisting of 'toxic' traits viewed as detrimental to wellbeing. However, the concept allows for variation in hegemony, including the possibility of forms more conducive to wellbeing. Through indepth interviews with 30 male meditators in the UK, we explore the social dimensions of meditation practice to examine its potential implications for wellbeing. Most participants became involved with 'communities of practice' centered on meditation that promoted new local hegemonies; these included ideals experienced as conducive to wellbeing, like abstinence. However, social processes associated with hegemony, like hierarchy and marginalization, were not overturned. Moreover, participants faced challenges enacting new practices in relation to the broader system of hegemonic masculinityoutside these communitiesreporting censure. Our findings are cautionary for professionals seeking to encourage wellbeing behaviors: there is potential for adaptation in men, yet complex social processes influence this change. MEDITATION-BASED 'POSITIVE' HEGEMONIC MASCULINITY 3 BACKGROUND In academic literature, and society at large, there is a prominent discourse constructing men as 'damaged and damage doing' (Mac an Ghaill & Haywood, 2012, p.483). For example, in terms of health 1 , men have higher mortality and morbidity rates on most indices (Courtenay, 2000). Accounting for these trends, it is argued that 'masculinity' itself is problematic and represents a 'risk factor' for health (Gough, 2006), as men are encouraged to demonstrate their manhood in ways seen as detrimental to health. Brannon (1976) identified prominent masculine stereotypes in Western culture, including risk-taking and demonstrating strength/toughness. Attempts by men to emulate these stereotypesasserting their claim to masculinity by performing 'manhood acts,' like risk-taking (Schrock & Schwalbe, 2009)can impact negatively upon health. For example, Phillips (2006, p.43) suggests risk-taking accounts for much of the 'male mortality excess' (among 15-29 year-olds in Canada, male deaths outweigh female deaths by 2.6 to 1). The identification of risk-taking with masculinity generates research titles like 'Masculinity causes speeding in young men,' which assert that 'masculinity is hazardous to health' (Mast et al., 2008, p.840). However, this view of masculinity as 'hazardous to health' is challenged by theorizing recognizing variability among men and masculinities. Connell's (1995) theory of masculinities introduced two important ideas. First, Connell used the plural 'masculinities' to emphasize the diversity of masculine practices-not simply suggesting a 'typology' of men, but highlighting diversity within individual men as they strategically negotiate the varying demands of everyday situations (Connell & Messerschmidt, 2005). Eschewing static trait-like conceptions of gender, masculinities enacted by men are seen as 'configurations of practice that are accomplished in social action,' varying according to the dynamics of particular settings (p.836). Second, Connell adapted the notion of hegemony to emphasize hierarchy: within a given milieu, a particular masculine form-'hegemonic masculinity'is normative, with power over subordinate and marginalized masculinities through the ability to levy social penalties on men who deviate from expectations. Hegemony itself follows diverse forms, varying with locale. Connell and Messerschmidt depict a complex terrain of three 'levels' of hegemony: local ('immediate communities'); regional ('culture or the nation state');

ObjectivesDespite the popularity of yoga and evidence of its positive effects on physical and mental health, little is known about yoga practice in the UK. This study investigated the characteristics of people who practise yoga, reasons for initiating and maintaining practice, and perceived impact of yoga on health and well-being.Design, setting and participantsA cross-sectional online anonymous survey distributed through UK-based yoga organisations, studios and events, through email invites and flyers. 2434 yoga practitioners completed the survey, including 903 yoga teachers: 87% were women, 91% white and 71% degree educated; mean age was 48.7 years.Main outcome measuresPerceived impact of yoga on health conditions, health outcomes and injuries. Relationships between yoga practice and measures of health, lifestyle, stress and well-being.ResultsIn comparison with national population norms, participants reported significantly higher well-being but also higher anxiety; lower perceived...