Saudi Cultural Missions Theses & Dissertations
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Item Restricted The Impacts of the NAPLAN Test System on the Mental Health and Well-being of Educators and Teaching Strategies in Australia(Saudi Digital Library, 2025) Alghamdi, Sahar Abdullah; Lucas, Carey; Terry, CummingThe National Assessment Program - Literacy and Numeracy is Australia’s standard procedure to measure the performance of students in literacy and numeracy. Although this procedure was intended to identify weak areas and address them by allocating more resources and implementing appropriate strategies, it has been criticised in research due to its potential to dictate teaching strategies, curriculum development, and its overall impact on the mental health and well-being of students. This study aimed to investigate its implications on the mental health and well-being of teachers as well as the teaching strategies. Furthermore, it also aimed to study how teachers integrate student-centred, holistic and individually-tailored teaching strategies. A scoping review was implemented in this study to identify and extract the findings of the existing articles on this topic. Online research databases such as EBSCO Educational Research Database, ProQuest and Web of Science were searched using Keywords and Boolean Operators. A total of 11 articles were included in this scoping review. The extracted data indicate that NAPLAN impacts the well-being of teachers through excessive mental pressure and work responsibilities. It also influences teaching strategies, curriculum development and the learning quality of students. Although teachers try to implement student-centred and holistic teaching strategies. Based on this scoping review, a literature gap is identified regarding how teachers ensure holistic learning for students, which can be addressed through further primary studies.7 0Item Restricted Managing Generation Z Employees’ Well-Being in a Hybrid Working Environment in the Hospitality Industry(Saudi Digital Library, 2025) Alajmi, Rakan; Jennifer, JohnstonThis study investigates the strategies used by hospitality organisations to manage the well-being of Generation Z employees in a hybrid working environment. With the increasing presence of digital natives in the workforce and the growing adoption of hybrid work models, traditional human resource practices are facing significant challenges in addressing employee well-being. The study adopts a secondary qualitative research approach, analysing twelve organisational reports from four major hospitality companies in the UK using qualitative content analysis. The findings indicate that psychological well-being is a primary concern for Gen Z employees and is addressed through strategies such as recognition, career and professional development, work-life balance, supportive relationships, and mental health initiatives. Physical well-being is mainly supported through technology integration and health-related programmes. The study provides valuable insights into Gen Z employees’ workplace expectations and highlights the importance of adapting human resource management practices to enhance employee well-being in hybrid work settings. Future research is recommended to incorporate primary data to validate the findings.18 0Item Restricted Exploring Resilience, Well-being, and stress in University students: A cross-national Mixed methods analysis between the UK and Saudi Arabia(Saudi Digital Library, 2025) Abulfaraj, Ghalib; Zavos, Helena; Dommett, Eleanor; Upsher, RebeccaGlobally, university students are increasingly stressed, due to high academic workloads, financial, familial, and social responsibilities, which negatively impact their well-being. University support services are unable to cope with the increased demands. To better understand how to address this situation, it is important to examine the relationship between stress and well-being in university students of diverse cultural backgrounds with the view to identifying ways to mitigate their stress. It is also crucial to investigate psycho-social moderators of this relationship and better understand some existing interventions. For example, there are current gaps in the mental health literature regarding the effectiveness of resilience interventions on the well-being and stress levels of on-campus undergraduate and postgraduate university students. Additionally, limited research has explored students’ subjective perceptions of well-being and stress, and moderators of the stress-well-being relationship outside of western countries. This thesis employed three interrelated mixed methods studies to address these research gaps. Chapter 2 is a systematic review that investigated 47 quantitative research studies examining the effects of resilience interventions on the resilience, stress, depression, and anxiety of students. The eligible studies were from 19 countries and included several research designs, although no research was conducted in Saudi Arabia (SA), demonstrating the under-representation of this country in the mental health literature. Results indicate that there is limited evidence of positive effects on depression, but stress and anxiety could be reduced following interventions. Data on well-being data was inconclusive. This study included the first systematic review on the effect of resilience-based interventions on well-being and mental health, featuring several study designs and focusing on higher education students. Chapter 3 is a qualitative study utilising semi-structured interviews. These interviews were conducted with 13 SA and 13 UK students to examine their perceptions of stress, mental health, and well-being. SA and UK-based students had similar responses regarding definitions of stress, mental health, and resilience. However, there were some differences, as SA-based students reported using religious coping as a stress coping method. In addition, within the Saudi sample, some participants noted that being the eldest child in the family was a stressor related to increased responsibilities. This study was the first to compare the perceptions of resilience, mental health, and stress among Saudi and UK university students across all study levels and disciplines. Building on Chapter 3, Chapter 4 is a quantitative survey-based study between SA and UK university students. It aimed to examine whether social support, belonging, family relationships and religious coping moderate the relationship between stress and well-being. Recruited participants included: 163 UK home students, 93 Saudi students in the UK, and 55 students studying in Saudi Arabia. Increased stress among university students was significantly associated with lower well-being levels in all participants. However, there was not much evidence for moderation. However, all moderators positively affected well-being. This study was the first to examine social support, belonging, family relationships, and religious coping as moderators between undergraduate and postgraduate SA and UK students representing various disciplines of study. By addressing the gaps in the literature and highlighting the relationship between stress, resilience, and well-being in diverse cultures, these findings have implications for the development of future well-being interventions. Although this thesis makes essential contributions to the cross-cultural mental health and well-being literature, it is not without limitations. These include issues with the representation of SA national students, assumptions of homogeneity in UK student samples, and an unbalanced gender distribution, which future research should address.8 0Item Restricted CULTIVATING QUALITY OF LIFE: ASSESSING DIET, PHYSICAL ACTIVITY, AND MENTAL HEALTH AMONG ARAB-AMERICAN BREAST CANCER SURVIVORS - UNCOVERING BARRIERS AND FACILITATORS FOR HOLISTIC WELL-BEING(Claremont Graduate University, 2025) Alhomaidhi, Nouf Ali; Clague DeHart, JessicaThis dissertation examines the quality of life among Arab-American breast cancer survivors, with a particular emphasis on dietary practices, physical activity, and mental health. Despite increasing survivorship rates in this population, there remains a significant gap in the literature addressing their unique post-treatment experiences and needs. Employing a convergent parallel mixed-methods design, this study integrates quantitative survey data and qualitative narrative interviews to assess adherence to health behavior guidelines and to identify culturally specific barriers and facilitators to well-being. Quantitative findings indicated suboptimal adherence to recommended dietary and physical activity guidelines and highlighted prevalent psychological distress among participants. Thematic analysis of qualitative data revealed that enablers of healthy behaviors included fear of cancer recurrence, strong social support, and pre-existing cultural dietary patterns. Conversely, major barriers encompassed financial constraints, limited access to culturally appropriate resources, treatment-related physical limitations, and sociocultural stigma surrounding mental health. This research provides a nuanced understanding of the complex interplay between cultural, structural, and individual factors influencing survivorship among Arab-American women. The findings underscore the urgent need for culturally tailored, community-engaged public health interventions to improve survivorship outcomes and promote holistic well-being in this underserved population.15 0Item Restricted Three Essays in Mental Health Economics: Education and Labor Market Outcomes(Saudi Digital Library, 2025-06) Alarabim, Hosam; Koreshkova, TatyanaThis dissertation explores how mental and physical health influence key economic outcomes over the life course, focusing on education, occupational outcomes, and workplace productivity. Using longitudinal data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), the study employs advanced modeling techniques, including Generalized Structural Equation Modeling (GSEM) and mixed-effects regression, to construct latent health measures and quantify their economic consequences. The first chapter examines the impact of adolescent mental health on academic achievement, particularly high school completion and college enrollment. It addresses the limitations of using narrow diagnostic proxies for mental health by applying a factor-analytic approach to create latent constructs. The findings reveal that better mental health significantly improves educational attainment, with a stronger effect on college entry than on high school completion. The second chapter investigates how health status shapes occupational sorting across two major classifications: white-collar and full-time employment. It finds that individuals with poor mental health are disproportionately concentrated in low skill, physically demanding, blue-collar jobs, while those with better health are more likely to enter cognitively intensive, white-collar occupations. Physical health also influences job type, reinforcing disparities in labor market access and long-term mobility. The third chapter evaluates the effect of mental health on workplace productivity. By constructing a composite latent productivity score, based on job satisfaction, hours worked, and income, the study estimates the long-term effects of lagged health status. A one standard deviation increase in mental health is associated with a 0.0251 rise in latent productivity and a 0.0201 increase in wage measure of productivity, confirming the strong and persistent influence of psychological well-being. Together, these chapters show that mental health is a critical determinant of economic opportunity, shaping individual outcomes from adolescence through adulthood.16 0Item Restricted An Adapted Framework for the Interaction of Parenting Style in Shaping/Facilitating Attachment to God and Parents in Islamic, Middle Eastern Culture(Widener University, 2025-06-23) Alotaibi, Ohud; Boyer, BretThis study sought to further research regarding the relationship between parenting and interpersonal attachment styles, attachment to God, and life satisfaction, by extending the Western centric theoretical framework and data to cultural contexts and values of Islamic faith in the Middle East, specifically, Saudi Arabia. Data was collected from 474 participants. Multiple regression results indicate a strong positive relationship between authoritative parenting and life satisfaction, and a negative correlation with insecure interpersonal attachment. Conversely, individuals exposed to authoritarian parenting are at a higher risk of developing insecure attachment styles, which can manifest as difficulty forming secure interpersonal relationships, which further relate to attachment relationships to God (Allah), and life satisfaction.169 0Item Restricted Does Integrating Cognitive Behavioural Therapy into Cardiac Rehabilitation Improve Depression and Quality of Life in Adults with Cardiovascular Disease? A Systematic Review.(Cardiff University, 2025) Alqahtani, Ola; Gale, NicholaDoes Integrating Cognitive Behavioural Therapy into Cardiac Rehabilitation Improve Depression and Quality of Life in Adults with Cardiovascular Disease? A Systematic Review. Background & Rationale Cardiovascular disease (CVD) is the world’s leading cause of death and disability, placing significant clinical and economic burdens on healthcare systems. While cardiac rehabilitation (CR) encompassing exercise, education, and routine psychosocial support has been shown to improve clinical outcomes, up to thirty percent of cardiac patients experience clinically meaningful depressive symptoms which reduce CR adherence and long-term success. Cognitive behavioural therapy (CBT) offers a structured approach to modifying maladaptive thoughts and behaviours, potentially addressing psychological barriers more effectively than generic psychosocial support. However, many reviews have evaluated heterogeneous ‘psychological interventions’ rather than isolating CBT’s specific impact. This systematic review set out to determine whether CBT, when integrated into CR, alleviates depression and enhances health-related quality of life (HRQoL) more effectively than CR alone. Methods A systematic literature search was conducted across five major databases (Medline, EMBASE, CINAHL, Cochrane CENTRAL, and PsycINFO) from inception to the most recent feasible date, adhering to PRISMA guidelines for study selection and reporting. Six randomised controlled trials, totalling 708 participants, satisfied the inclusion criteria by focusing on adults (≥18 years) undergoing CR for various cardiac conditions (such as myocardial infarction, heart failure, or post-cardiac surgery). Studies which integrated structured CBT sessions into standard CR were compared to CR alone or other forms of standard care. The primary outcome was the reduction in depressive symptoms, measured by validated scales (e.g., the Hamilton Rating Scale for Depression or the Hospital Anxiety and Depression Scale (HADS)). Secondary outcomes involved changes in HRQoL, assessed by either generic or cardiac-specific instruments (such as the Minnesota Living with Heart Failure Questionnaire). Quality appraisal followed the Joanna Briggs Institute guidelines and due to heterogeneity in intervention formats, population characteristics, and outcome measures, a narrative synthesis approach was applied rather than a meta-analysis. Key Findings and Discussion Although the six trials varied in terms of sample size, intervention intensity, and follow-up duration, they shared an overarching conclusion that integrating CBT within CR can lead to notable reductions in depressive symptoms and meaningful improvements in HRQoL. The degree of benefit was generally greater in patients presenting with moderate-to-severe baseline depression. Face-to-face CBT delivery typically achieved better adherence (often exceeding 75%) and larger effect sizes, whereas fully digital CBT programmes suffered from low engagement (approximately 15% module completion). These findings suggest that the personal interaction and therapeutic alliance inherent in face-to-face sessions remain critical for maximising CBT’s clinical impact in cardiac populations, particularly those facing multiple stressors related to their disease. CBT combined with exercise, in several trials, appeared to deliver synergistic benefits for depression and HRQoL, possibly through complementary behavioural (cognitive restructuring and skill-building) and physiological (improved cardiovascular function) mechanisms. The interplay between exercise encouragement and cognitive-behavioural strategies against fear-avoidance thinking also emerged as an important determinant of enhanced functional capacity and sustained improvements in mood. Limitations Several limitations may constrain the generalisability of these results. First, the overall sample predominantly comprised of male participants (approximately two-thirds were male), leaving questions regarding whether women, who often exhibit different depressive symptom profiles and a greater prevalence of depression post-myocardial infarction, would experience similar outcomes. Second, varied measures of depression and HRQoL, along with wide differences in the intervention ‘dose’ (ranging from five-session brief interventions to twelve-week combined programmes), precluded direct quantitative comparisons across studies. Some trials were also underpowered and only a few extended follow-up beyond six to twelve months. Digital CBT approaches did not yield strong results in this review but that may reflect poor adherence rather than intrinsic ineffectiveness, highlighting a need for more engaging and personalised technological platforms. Finally, these RCTs spanned multiple healthcare settings in Europe and the United States where infrastructural and cultural factors might influence both the feasibility of CBT delivery and participant engagement. Conclusions and Recommendations This review provides evidence that structured CBT, when delivered in tandem with cardiac rehabilitation, can significantly alleviate depressive symptoms and promote better quality of life. The most robust outcomes were observed in trials that targeted moderate-to-severe depression, employed face-to-face group or individual CBT sessions, and ensured consistent patient follow-up. These findings strengthen the case for systematically screening CR entrants for depressive symptoms and offering a dedicated CBT component to those above a certain severity threshold. Practical feasibility can be enhanced by training nurses, physiotherapists, or other allied professionals in CBT skills, as illustrated in studies where task shifting maintained strong outcomes. Policy-making bodies, such as national cardiac societies and health agencies, may wish to recommend CBT as a priority psychological intervention in CR programmes, particularly for patients with moderate or severe depression. Future research should further refine the optimal ‘dose’ of CBT, compare blended or stepped-care digital and in-person models, and evaluate the cost-effectiveness to guide broader adoption. By focusing on cognitive restructuring and behaviour change within the supportive framework of CR, healthcare systems can potentially improve both the mental health and functional recovery of individuals with CVD.7 0Item Restricted Mental Health on Social Media: AI-Driven Detection and Response(Arizona State University, 2025) Alghamdi, Zeyad; Liu, HuanMental health issues are increasingly prevalent, with stress playing a critical role in the development of severe mental and physical health conditions. Early detection and effective intervention are essential for mitigating these challenges. In an increasingly digital world, social media serves as a valuable repository of large-scale data on how individuals vent and express stress. This data source captures two critical dimensions or perspectives: the individual and the social. The individual dimension is revealed through direct expressions of stress in users’ posts, where emotional states and linguistic patterns provide important indicators. In a synergistic manner, the social dimension is discerned from the reactions of others, offering contextual cues that reflect the broader environment’s influence on the user’s mental state. My dissertation builds on this dual perspective by integrating social science and psychological theories to inform a methodologies,that strengthens AI’s capacity to recognize stress-related cues and also to engage with mental health discourse in a refined and contextaware manner. To achieve this, I propose three innovative detection strategies that capture the individual and social dimensions. The first strategy focuses on analyzing the finegrained linguistic and emotional features to identify stress within individual posts, directly addressing the individual perspective. The second strategy extends this analysis by examining the broader contextual nuances embedded in these posts, thereby deepening the understanding of individual stress expressions. The third strategy shifts attention to the social perspective by incorporating emotional cues from community responses as auxiliary signals to enhance the stress classification. Finally, drawing on the insights from these works, I established a data-supported refinement process that improves AI’s ability to produce more supportive responses that are both contextually aware and socially attuned. This research exemplifies how interdisciplinary innovation can redefine AI’s role in addressing complex challenges in mental health.29 0Item Restricted The Efficacy of Cognitive Behavioural Therapy for Schizophrenia(QUEEN’S UNIVERSITY, BELFAST, 2025-01-21) Dabsh, Munirah; Ownes, MarkThis dissertation evaluates the efficacy of cognitive behavioural therapy (CBT) in treating schizophrenia, focusing on symptom reduction, social functioning improvement, and cultural adaptations. A systematic review of ten studies was conducted using rigorous inclusion criteria, resulting in a synthesis of evidence spanning diverse settings and methodologies. Findings highlighted CBT's significant impact on positive symptoms, moderate effect on negative symptoms, and the necessity for culturally sensitive approaches. However, barriers such as methodological limitations, cultural barriers, and limited therapist training were evident. Future research is essential to refine interventions and expand access to evidence-based care46 0Item Restricted Unveiling Maternal Mental Health: Exploring the Perceptions and Practices of Mental Health Care for Pregnant and Postnatal Women in Kingdom of Saudi Arabia: A Mixed Methods Study(University of East Anglia, 2024) Alshammari, Athar; Crozier, Kenda; Wadnerkar, MeghanaBackground: Mental health during pregnancy and the postpartum period is critical yet often overlooked. In Saudi Arabia, cultural and societal norms significantly influence perceptions and practices related to mental health and these are compounded in the context of maternal mental health. Objective: This thesis aimed to explore the knowledge, perceptions, and challenges faced by women and healthcare providers (HCPs) regarding mental health during pregnancy and postpartum in Hail, Saudi Arabia. Methods: An embedded mixed-method design was used. Semi-structured interviews with ten pregnant and postpartum women and ten HCPs. An online cross-sectional survey was conducted with 349 HCPs to evaluate their knowledge of depression symptoms, risk factors, and treatment options. Results: Qualitative interviews revealed four major themes: Awareness and Education on Maternal Mental Health, Stigma and Shame, Barriers to Accessibility, and Enhancing Maternal Mental Health Care. Women's misconceptions and fears of stigma led to reluctance to seek help. HCPs highlighted gaps in training and guidelines, with barriers including limited time and inadequate mental health education. Quantitative results showed insufficient knowledge among HCPs, with an average score of 8.62 out of 20 (44.86% correct). Knowledge was higher in treatment (53%) compared to assessment (45.88%) and education (35.71%) domains. Discussion: The integrated findings reveal gaps in knowledge and perceptions of maternal mental health among both women and HCP. This study offers novel insights by combining perspectives from both groups, uncovering underexplored cultural barriers and care gaps. It highlights how cultural stigma, HCP training, and systemic issues impact Saudi women’s perinatal and postnatal experiences. Conclusion: This thesis provides new insights into maternal mental health issues in Saudi Arabia, highlighting the need for targeted education, reduce stigma, and improved support systems. Future research should explore socio-cultural interventions to address these gaps and enhance care delivery32 0