Dissertations / Theses on the topic 'Mindfulness Based Cognilive Therapy (MBCT)'

Background. Mindfulness-based Cognitive Therapy (MBCT) is a relapse-prevention treatment for people in remission from major depression (rMDD). The neuropsychological mechanisms of MBCT are largely unknown. The key theoretical mechanisms of MBCT include self-compassion and rumination, with other mindfulness-based studies suggesting mechanisms across domains of attention, emotional processing, and cognitive flexibility. The aims of this thesis were to investigate the neuropsychological and neuroimaging mechanisms of MBCT in rMDD and to investigate relationships with relapse six months beyond MBCT. Paper One. 40 MBCT, 33 Treatment As Usual (TAU), and 42 healthy volunteers (HVs) took part. Experimental tasks for self-compassion and rumination were completed at baseline and post-session, alongside self-report questionnaires. Results showed increases for self-compassion following MBCT, with non-specific reductions for rumination. Paper Two. 40 MBCT, 33 TAU, and 42 HV participants took part. Tasks of attention, emotional processing, and cognitive flexibility were completed at baseline and post-session. Results showed increases in positive emotions post-MBCT, with non-specific changes for face emotion recognition and affective attentional bias tasks both post-MBCT and TAU. There were no changes over time for sustained attention or cognitive flexibility. Paper Three. 16 rMDD participants completed baseline and post-MBCT fMRI tasks of sustained attention and self-blame. Results showed reduced activation over time in the bilateral dACC in self-blame contrasts but no activation changes for sustained attention. Paper Four. 69 rMDD participants (38 MBCT & 31 TAU) completed task-based and self-report assessments up to six months follow-up. Non-relapsing MBCT participants showed increased self-compassion post-session which was maintained in follow-up. MBCT non-relapsing and TAU participants showed reduced rumination post-session and in follow-up. Conclusions. MBCT encourages a move towards more self-compassionate, positive processing but does not alter more automatic, bottom-up levels of processing. MBCT initiates a process for change beyond the course, particularly for self-compassion. Findings have theoretical and clinical implications and extend our understanding of the mechanisms of MBCT in rMDD participants.

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Mindfulness practices have been used in the treatment of clinical problems, for some time, with the use of the pioneer program of Kabat-Zinn, Mindfulness-based Stress Reductions (MBSR), program that served as a prototype for the development of other mindfulness-based, among them the of Segal, Williams and Teasdale, MindfulnessBased Cognitive Therapy (MBCT), which integrates mindfulness practices with strategies of Cognitive Therapy. From these integrations mindfulness practices have been inserted in the process of Cognitive Behavioral Therapy (CBT) increasingly, even the two clinical models showing-philosophical and theoretical principles of methods different interventions. Therefore, this study aimed to discuss how the theoretical fundaments of MBSR and CBT are integrated in MBCT, as well as possible reasons and implications of the inclusion of mindfulness strategies in CBT. For this we used articles available on the internet, books and chapters of books on the subject, in English, Portuguese and Spanish, without restriction to year of publication. The theoretical comparison was accomplished through four conceptions that supports the theoretical models: cognition, behavior, and environment of pathology. In addition, he likened himself, through the analysis of two sections, the interventions carried out in TCC and MBCT. Overall, they identified some similarities and compatibilities between the theoretical assumptions of CBT and MBCT, MBSR programs and being a significant difference how understand the cognitions, because while in TCC she is seen as deterministic and causal, MBSR programs and MBCT is just another mental event. It appeared also, controversies clear when one considers the classical cognitive model of Aaron Beck.
As práticas de mindfulness vêm sendo utilizadas no tratamento complementar de problemas clínicos, há algum tempo, com o uso do programa pioneiro de Kabat-Zinn, o Mindfulness-Basead Stress Reductions (MBSR), programa que serviu de protótipo para o desenvolvimento de outros baseados em mindfulness, dentre eles o de Segal, Williams e Teasdale, o Mindfulness-Based Cognitive Therapy (MBCT), que integra práticas de mindfulness com estratégias da Terapia Cognitiva. A partir dessas integrações as práticas de mindfulness vêm sendo inseridas no processo da Terapia CognitivoComportamental (TCC) de modo crescente, mesmo os dois modelos clínicos apresentando princípios teóricos-filosóficos e métodos de intervenções diferentes.Diante disso, este estudo objetivou discutir como os fundamentos teóricos do MBSR e da TCC são integrados no MBCT, bem como possíveis razões e implicações da inclusão de estratégias mindfulness na TCC. Para isso foram utilizados artigos disponibilizados na internet, livros e capítulos de livros sobre a temática, no idioma inglês, português e espanhol, sem restrição de ano de publicação. A comparação teórica foi realizada por meio de quatro concepções: cognição, comportamento, ambiente e visão de patologia. Além disso, comparou-se, por meio da análise de dois trechos de sessão, as intervenções realizadas na TCC e no MBCT. De modo geral, foram identificadas algumas semelhanças e compatibilidades entre os pressupostos teóricos da TCC e dos programas MBSR e MBCT, sendo a diferença significativa o modo como entendem as cognições, pois enquanto na TCC ela é vista como causal e determinista, nos programas MBSR e MBCT é apenas mais um evento mental. Verificou-se também, controvérsias claras quando se considera o modelo cognitivo clássico de Aaron Beck.

Depressioner återkommer ofta och varje ny depressionsepisod ökar risken för en ny beroende på en allt större känslighet för inre och yttre triggers. Mindfulnessbased Cognitive Therapy (MBCT) har utarbetats av Z. Segal, M. Williams och J. Teasdale som en gruppbaserad behandlingmodell för att förebygga återinsjuknande kombinerar mindfulnesstekniker och kognitiv terapi (KBT) för depression. I en studie publicerad 2000 visade sig MBCT signifikant halvera återinsjuknandet jämfört med sedvanlig behandling. Resultatet har upprepats och ett flertal studier har undersökt effekter av MBCT. Syftet med denna systematiska litteraturstudie är att undersöka vilka effekter som de olika studierna tagit fasta på och vilka effekter som setts inom de olika aspekterna i Christine Padeskys femfaktorsmodell, tanke-känsla-fysiologi-beteende och i relation till sammanhang mot bakgrund av den ständiga interaktion som råder mellan dessa1. Resultatet visar positiva resultat inom alla aspekter men att de kognitiva och känslomässiga aspekterna är de mest välstuderade medan fysiologiska effekter som trots den stora betydelse kroppen har i MBCT-träningen är mindre studerat. Det framgår att fortsatt och mer forskning behövs om verksamma mekanismer, kausalsamband  och processer. 1  Femfaktormodell refererar till ”five aspects of life ” modellen enligt Christine Padesky. Se sid.15.

This study investigated the discharge practice of a Community Mental Health Team (CMHT) by examining records (electronic and file) of clients discharged between April 2005 and March 2006. Out of a total of 211 discharged clients a random sample of 20 clients was selected to examine the extent to which records and reasons for discharge adhere to current CMHT policies and guidelines. In addition, a sample of clients who had been engaged by the CMHT for 6 months or less was compared to a sample of clients who have been engaged for 1 year or longer to establish whether these differed in sociodemographic characteristics, diagnoses and extent of service provision. The majority of clients discharged during the specified period consisted of clients engaged for 6 months or less. The sampling process revealed that a proportion of these included clients seen for one-off assessments or duty calls, indicating that there is room for improvement to clarify referral criteria (e.g. to GPs) and the role of the CMHT. Similarly, the examination of recording practice also revealed room for improvement in the closing of care packages electronically and inclusion of required information in discharge letters. Almost 50% of clients in the sample were discharged following a decline of any further intervention the reasons for which it will be important to investigate in the form of an audit or survey of service user’s views. Clients engaged for 6 months or less and 1 year or longer seemed to differ mostly in terms of employment rates, diagnosis and previous inpatient admission and mental health act sections. The findings are discussed in relation to the limitations of this study, implications for the service and further research.

Existing research has supported mindfulness-based cognitive therapy (MBCT) as an efficacious intervention for depressive relapse prevention, finding it comparable – if not even more effective at times – to antidepressant medication maintenance and other psychoeducational active control conditions. In light of bicultural populations being under-addressed in previous MBCT research, this study will attempt to examine whether bicultural-specific psychological mechanisms, specifically bicultural self-efficacy, will moderate mindfulness for depressive relapse. It will also examine mindfulness as a determining factor in preventing depressive relapse compared to cognitive behavioral therapy (CBT), a treatment of comparable design without mindfulness implementation. Seven hundred and forty-seven Asian American participants previously diagnosed with clinical depression will be randomly assigned to undergo MBCT or CBT treatment. Results will indicate that participants undergoing mindfulness training through MBCT will have significantly lowered rates of depressive relapse, compared to participants undergoing CBT training as a control intervention. Bicultural self-efficacy will also act as a moderator for mindfulness, further promoting the effectiveness of mindfulness in MBCT.

Mindftilness based cognitive therapy (MBCT) is a group psycho-educational treatment designed to reduce the risk of recurrent depression by integrating mindfulness based meditation practices with cognitive therapy techniques. Existing studies have focused on the effectiveness or acceptability of MBCT as an intervention, yet have failed to discretely examine the experience of meditative homework assignments. Given the prominence of this aspect of the MBCT programme, the aim of the present study was to explore subjective accounts of the meaning of carrying out meditative homework assignments in the context of a MBCT programme within the National Health Service. The research questions focused on the impact of meditative homework on thought processes as well as an exploration of barriers and facilitating factors from a participant's perspective. Individual in-depth interviews were conducted with six adult participants, all of whom had completed an eight-week MBCT programme. The Interpretive Phenomenological Analysis methodology was adopted to analyse interview transcripts. Data analysis began with a detailed examination of one case until a thorough analysis was completed after which subsequent cases were analysed. Finally a cross case analysis was carried out where individual themes were interrogated for similarities and differences (Smith, et al., 2009). Two master themes emerged from the analysis: 'The relationship of meditative homework to metacognitive experience' and 'motivating and discouraging factors for engagement in meditative practice'. Participants' accounts of completing the meditative homework component of the MBCT programme revealed a transformation in metacognitive processes as a result of undertaking meditative homework. Participants' experiences of metacognitive processes are examined in the context of existing psychological theories of metacognition, including the ICS (Teasdale, 1999a, 1999b) and the S-REF (Wells, 2000). A model for the perceived facilitating factors and difficulties experienced in carrying out meditative homework is constructed based on the Integrated Theoretical Foundations Model for CBT homework assignment (Kazantzis et al., 2005). This model explores participants' motivation in three stages of the homework process: during assignment of the homework task; in completing the planned task; and in carrying out a review of the task. The theoretical and clinical implications of the present study are discussed in relation to psychological literature, homework assignment and the practise of MBCT.

Background: Mindfulness-based cognitive therapy (MBCT) is a promising new alternative to anti-depressant medication (Kuyken et al., 2015) and whilst some qualitative studies have explored participants' experiences of MBCT, none yet have explored experiences of participants who are considering coming off their antidepressant medication alongside MBCT or how patients experience change in relationships with self, others and illness. Aim: To examine MBCT participants' experience of change across 24 months, particularly in relation to change in views of their self and their illness over time. Method: Thematic analysis of in-depth retrospective interviews with 42 participants, two years after attending an 8 week MBCT group with an invitation to taper their antidepressant medication (ADM). Each participant took part in one retrospective interview which was semi-structured and focused on experiences of MBCT and ADM over the previous two years since attending an MBCT group and how these have impacted on a change in self and experience of illness. Findings and conclusion: Four over-arching themes were found: taking control, relationships (with self, other and illness), rebuilding the self and shifts in perspective. The findings in the current study are very similar to those found in transformation in the physical chronic illness literature (e.g. Paterson et al., 1999). Perhaps MBCT could be the challenge which lead patients suffering from chronic depression towards change and creates a context in which patients can consider self and identity.

MBCT has been successful in preventing depressive relapse. However, its efficacy has not been studied in non-mental health settings for stress, affect, and level of mindfulness. In this study, participants were selected on a volunteer basis after enrolling in an 8-week Mindfulness-Based Cognitive Therapy (MBCT) group at a health and wellness center. Prior to beginning the group, participants completed the Perceived Stress Scale (PSS), Positive/Negative Affect Schedule (PANAS) and the Mindful Attention Awareness Scale (MAAS). Participants completed the PSS, PANAS, and MAAS after week four, and at the completion of the eight-week course. Twenty-two participants were included in the study. Results were computed with a one-way repeated measures ANOVA. Post hoc pairwise comparisons or paired-samples t-tests, where appropriate, were computed to examine the specificity of changes over time. Descriptive data was gathered including demographic data and homework compliance. The following two follow-up questions were included for further descriptive data: 1) On a scale of 1-10 (1 = not at all important, 10 =extremely important), how important has this program been for you? 2) Please say why you gave it that rating. Results revealed decreases in perceived stress, increased positive affect, decreased negative affect, and increased overall level of mindfulness by week eight. Qualitative data supported the empirical data. This data suggests MBCT may serve as a cost effective method for managing stress and providing useful skills in the daily lives of individuals in non-clinical and/or community populations.

Background: Inflammatory Bowel Disease (IBD) is a group of chronic gastrointestinal diseases with a relapsing nature. The two main types are Crohn’s disease (CD) and ulcerative colitis (UC). Both CD and UC patients experience very similar and distressing symptoms: acute abdominal pain, vomiting, malnutrition, fever, fatigue, diarrhoea and rectal bleeding. These symptoms are disabling and have a severe impact on physical and psychosocial wellbeing. Around 30% of patients suffer from moderate to severe psychological distress and have difficulties coping with the illness even in remission. However, it appears that mental health is overlooked by clinicians who often focus on physical gastrointestinal symptoms only. Mindfulness-Based Cognitive Therapy (MBCT) is evidence based, group psychological intervention that has been successful in reducing depression and anxiety scores in patients with depression while improving overall quality of life. However, MBCT has never been tested in the IBD population before. PhD question: Can MBCT be used as an adjunct therapy to IBD symptom management, for improving IBD patients' general well-being and quality of life? Aims and objectives: The overall aim of the thesis was to develop and collate the evidence for a definitive randomised controlled trial (RCT) testing the effectiveness of MBCT for patients with inflammatory bowel disease (IBD). The thesis brings together six publications. The six publications were integrated into four objectives that collectively contributed in answering the overall PhD question. Results: The findings from the first three publications highlighted the disease-related concerns and psychological needs for patients with IBD. The findings from the last three publications highlighted how feasible it is to use MBCT in IBD and emphasised the IBD patients’ perspectives about MBCT. Conclusion: The thesis concluded that a definitive RCT of MBCT for IBD patients is both feasible and acceptable.

The Buddhist philosophy from which mindfulness-based approaches originate proposes a system of understanding whereby inherent suffering stems from attachment to a rigid and unchanging concept of self. Though this notion of selfhood is afforded centrality within such traditions, as well as having been a predominant concern in the history of theoretical psychology, our modern research interests and clinical applications have seemingly preferred to focus on operationalisable constructs, such is their relative amenity to empirical study, whilst at the same time, an interest in the clinical application of mindfulness is abound. As such - and with MBCT as currently the most evidenced of mindfulness-centred clinical protocols - we consider the extent to which the benefits apparent may pertain directly to, and be more clearly understood in terms of, this broader theme of change in conceptualisation of and relationship with self, commensurate in particular with the key Buddhist tenets of Dukkha, Anicca and Anatta (inherent suffering, transience of forms, and non-self). Our motivation is to explore the context within which well-researched content-based mechanisms of change in MBCT (e.g. cognitive reactivity and self-compassion) may operate. Explorative interviews investigating processes of change experienced were conducted with 21 subjects; comprising current MBCT patients, previous MBCT patients, and Clinical Psychologists in Training, with a Grounded Theory methodology employed in data collection, abstraction, and integration of theory. Findings indicate a dynamic three-phase process of change; capturing the accounts of individuals firstly in gaining insights into "how I am constructed and controlled", secondly in "getting to know my experience", and finally in "knowing myself differently". The constituent categories of these central concepts (which make up our explanatory scheme) are described and illustrated in detail. Our findings and interpretations are suggestive that MBCT does indeed promote change in conceptualisation of, and relationship with selfhood, potentially through processes seemingly well aligned with the Three Marks of Existence outlined in Buddhist philosophies. Implications, both theoretical; regards the prominence of context versus content in psychological literature, and clinical; with respect to the issue of working therapeutically - and more explicitly - with selfhood, or personhood, are considered. Links are made with existing research into known change mechanisms in MBCT, as well with prominent clinical models, in particular CBT, ACT and PBCT. Finally, wider structural inferences and potential future research are suggested.

Au regard des conséquences du stress sur la santé des travailleurs sont apparues des méthodes visant à modifier la perception des situations stressantes telle la MBSR et ses pratiques méditatives de pleine conscience. Ce constat laisse entrevoir la pertinence potentielle de la MBCT combinant des éléments de la MBSR et de la thérapie cognitive dans la prise en charge du stress professionnel.Objectif : Expliciter les concepts de mindfulness et d’awareness par une démarche sémantique et réaliser un état de l’art de la MBCT. Vérifier son applicabilité au stress professionnel via deux études-pilotes auprès de populations non cliniques. Méthode : Conception d’un programme manualisé adapté au stress professionnel puis application à une étude comparative MBCT/Contrôle randomisée et à une étude de cas. Administration Pré-Post d’échelles relatives au stress (PSS, Indice de Stress au Travail de Légeron), à ses symptômes associés (MBI, GHQ-28, BDI-13), aux stratégies de coping (Brief COPE) et aux compétences de pleine conscience (PHLMS) et recueil de témoignages.Résultats : Améliorations Pré-Post significatives sur la quasi-totalité des mesures à l’exception de l’accomplissement personnel du MBI et du stress perçu (PSS). Significativité statistique de l’épuisement émotionnel au MBI et du stress perçu contextualisé au travail dans la comparaison intergroupe. Amélioration des compétences psychosociales en situation de stress au travail.Conclusion : Potentiel d’applicabilité de la MBCT à la prise en charge du stress professionnel. Malgré des limites, ces études montrent un intérêt indéniable tant pour la recherche que les entreprises en quête de rapports coût/bénéfice optimaux
Methods aimed at altering the perception of stressful situations such as the MBSR have come into being following the stress after-effects involved for workers. This problematic situation let us anticipate the possible relevance to the occupational stress management of the MBCT program combining both the MBSR mindfulness meditative practices and cognitive therapy elements.Objective : To shed light on the concepts of mindfulness and awareness through semantic research and to achieve a MBCT scientific litterature review. To check its applicability to the context of occupational stress by means of two pilot experimentations in non-clinical populations. Method : Design of an occupational stress-adapted manualized program and implementation as a randomized MBCT/Control comparative study and as a case study. Filling of scales relative to stress (PSS, Indice de Stress au Travail de Légeron), stress-associated symptoms (MBI, GHQ-28, BDI-13), coping strategies (Brief COPE) and mindfulness skills (PHLMS) Pre- and Post-program and gathering of accounts.Results : Significative Pre-Post improvements at almost all of the measures except for the personal accomplishment subscale of the MBI and for perceived stress (PSS). Statistical significance on the MBI emotional exhaustion subscale and on the work-contextualized perceived stress measures in the inter-group comparison. Improvement of psychosocial skills in work stress situations. Conclusion : Applicability potential of the MBCT to occupational stress management. Despite a number of limitations, these studies express an indisputable interest both for the research and for companies on the look-out for optimal cost-benefit ratios

Mindfulness-based Cognitive Therapy (MBCT) is a promising approach aimed at the prevention of relapse in people suffering from recurrent depression. However little is known about what factors support gains in the longer-term. This study examines participants’ experiences of the perceived benefits and barriers to MBCT reunion attendance. Thirteen people, who had participated in MBCT classes for recurrent depression within a primary care setting, were interviewed about their experiences of the reunion meetings or their reasons for not attending. Seven of these had completed their program within the previous 12 to 18 months at the time of interview, and six had completed their program between 20 months and 4 years prior to the time of the interview. Interpretative phenomenological analysis (IPA) was used to analyze participants’ accounts. Four themes highlighted the participants’ experiences: In terms of benefits, reunion attendees experienced the reunions as a booster reminding them of their mindfulness practices and as a sanctuary where these practices were further nurtured within an accepting and compassionate environment. Barriers to reunion attendance were difficulties around the group experience and wanting to put the experience behind them. This related to the memory of depression as well as to the program and group experience for some individuals. Theoretical, clinical and research implications are discussed.

Ancient scholars, theologians and philosophers have debated for centuries about the nature of the mind. Yet depression is the leading cause of disability across the world. The ubiquitous growth of mindfulness has in recent decades, been applied to assist parents with affect regulation. Mindful parenting is defined as a set of parenting skills that enhance present-centred, discerning awareness in parent–child relationships. The potential benefits of mindful parenting could span across generations to promote affect regulation for both children and parents. However further clarity is needed on how mindful parenting facilitates affect regulation. To date the literature examining the effectiveness of Mindful Parenting (MP) programs has been plagued by poor methodological design, diversity of interventions, questions surrounding program fidelity and a lack of clarity about change processes. Aims: The overall purpose of this dissertation was to critically analyse how mindful parenting is associated with affect regulation to evolve emotions. The focus of this dissertation is on mindful parenting of children aged 0 to 18 years. More specifically it aims to: - 1. Systematically review the international and national literature on the effectiveness of MP programs in promoting the wellbeing of children and parents (Study 1). 2. Investigate the effectiveness of an Australian MP program called Caring for Body and Mind in Pregnancy (CBMP) in reducing perinatal depression, anxiety and stress amongst a sample of at-risk pregnant women (Study 2). 3. Critically analyse how change processes utilised by MP programs are associated with affect regulation (Study 3). 4. Clarify which factors in the change processes of self-compassion and mindfulness scales have the strongest correlation with the reduction of perinatal depression (Study 4). xvi Method: Four diverse epistemologies were utilised to investigate the overarching research aim. Study 1 utilised the systematic review methodology to review the best available evidence on the effectiveness of MP Programs. Study 2 employed a repeated measures design to investigate the effectiveness of CBMP from a seven-year hospital dataset. Study 3 critically analysed the change processes that promote affect regulation by using Interpretative phenomenological analysis (IPA) to examine semi-structured interviews with four facilitators of MP programs. Finally, Study 4 utilised Structural Equation Modelling (SEM) to analyse the change processes associated with the reduction of perinatal depression. Results: The systematic review yielded inconclusive evidence to support the effectiveness of MP programs due to the poor methodological quality of studies. Study 2 found CBMP significantly improved perinatal depression, anxiety, stress, mindfulness and self-compassion. The findings from Study 3 resulted in the anchor, a novel theoretical framework to investigate change processes. The anchor incorporates closely interconnected change mechanisms namely reflective functioning, attachment, cognitive, affective, somatic and social change mechanisms. The results from Study 4 indicated that self-kindness, observing and acting with awareness were associated with significant reductions in perinatal depression. Conclusion: Although the systematic review was unable to conclusively establish the effectiveness of Mindful Parenting programs, the other three studies provided suggestive evidence of its effectiveness. Contributions to new knowledge include conducting one of the first systematic reviews on mindful parenting, clarifying change processes associated with the reduction of perinatal depression and developing, a novel model of change, the anchor. The phenomenology of affect regulation still appears to puzzle humanity. Keywords: mindful parenting, mindfulness, affect regulation, attention regulation, emotions, perinatal depression, perinatal anxiety and stress.
Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School, 2019

The evidence base for Mindfulness-Based Cognitive Therapy (MBCT) is growing, but there is a lack of experimental validation among populations with acquired brain injuries (ABI). The purpose of this study was to investigate the acceptability and effectiveness of MBCT in fostering psychological recovery among adults with ABI. More specifically, this study was conducted to:(a) extend Finucane and Mercer’s (2006) study by applying MBCT to another population (i.e., adults with ABI); (b) corroborate the Bedard et al. (2008) finding of MBCT’s effectiveness in reducing depression in adults with TBI; (c) establish if empirical findings of the effectiveness of MBCT on depression and anxiety in the general population and in primary care patients with active symptoms of depression and anxiety extended to adults with ABI; and (d) explore the effect of MBCT treatment on measures of locus of control, satisfaction with life, self-awareness, and coping in adults with ABI. A mixed methods design was used and participants were recruited from two community-based brain injury programs. The final sample comprised 12 adults with mild, moderate, and severe injuries. Interview and self-report measures were administered pre- and post-treatment. Qualitative data were collected through semi-structured focus groups following MBCT treatment. Depression, denial, and self-awareness among participants showed statistically significant improvements and participants’ demonstrated statistically significant increases in positive reframing and active coping. Focus group data confirmed MBCT as an acceptable and effective approach for adults with ABI, and also speak to implications for the use of MBCT in ABI populations specifically. The need for a larger replication study with a control group is discussed.
Graduate

Chin, Yu.
Thesis Ph.D. Chinese University of Hong Kong 2015.
Includes bibliographical references (leaves 162-183).
Abstracts also in Chinese; appendixes in Chinese, appendix B6 in English.
Title from PDF title page (viewed on 15, November, 2016).