Depression has consistently been associated with cognitive deficits, particularly on tasks involving executive function. Depression is also characterised by a self-focused, ruminative thinking style. It has been hypothesised that this ruminative thinking style may deplete limited executive resources, giving rise to inefficient cognitive regulation of emotion and behaviour. Previous research with adults has supported this hypothesis and indicated that, relative to non-depressed controls, those who are low in mood and are induced to ruminate demonstrate impairments in executive function. Whilst some research with adolescents has also supported this finding, this has mainly been correlational in nature. Adolescent-onset depressive disorders represent particularly insidious conditions because of their strong association with chronic and recurrent emotional problems in adulthood; thus, a detailed understanding of the cognitive processes underlying these disorders is essential. The current study provides the first experimental investigation of the effects of engaging in a ruminative and a concrete processing style on executive function in dysphoric adolescents. The study was conducted with a school-based sample of 46 young people, who scored high or low on a measure of depressive symptoms. Participants completed two experimental conditions, rumination and concrete thinking, in counterbalanced order, as well as a measure of executive function (random number generation) at baseline, and again following each of the experimental conditions. For the first time, results demonstrated that one facet of executive function (working memory updating) differed significantly at baseline, with dysphoric adolescents demonstrating significantly worse performance than non-dysphoric adolescents, and that this difference was maintained regardless of the thinking style inductions. Contrary to the study’s hypotheses, inhibition ability of either group was not significantly affected by either of the processing style inductions. Potential explanations for these results are discussed, as well as methodological limitations, clinical implications, and potential directions for future research.

Background Sri Lanka has experienced large-scale forced internal displacement of people due to conflict. The impact of prolonged displacement and resettlement on mental health ans resilience are poorly understood. Objectives: Key objectives were to describe the prevalence, incidence and maintenance of common mental disorder (CMD) and post-traumatic stress disorder (PTSD) in an adult sample internally displaced because of conflict since 1991 and currently considering returning to areas of origin. Levels of personal resilience, and social network/social support were also investigated in relation to CMD. Methods: A cross-disciplinary survey sample of 450 IDPs living in displacement was recruited and followed one year later, supplemented at follow-up by an additionally recruited sample of 228 IDPs who had return-migrated. CMD was measured by the Patient Health Questionnaire and PTSD by the Composite International Diagnostic Interview K-section. Resilience was measured with the Resilience Scale-14 item version. Social support and social networks were measured using the Multi-Dimensional Social Support and Lubben Social Network scales. Results: The baseline prevalence of any CMD was 18.8%, PTSD prevalence was 2.4%. The CMD prevalence had reduced to 8.6% at folloow-up in those remaining in displacement, and was 10.3% in return migrants. PTSD prevalence were 0.3% and 1.6% respectively; unemployment, widowed or divorced status, female gender and food insecurity were independently associated with CMD. The mean resilience scores were 80.2 at baseline and 84.9 at follow-up. At both time points, lower resilience was interdependently associated with food insecurity, lower social support availability and social isolation, and there were significant associations with CMD in unadjusted analyses, but only independent at baseline. Conclusions: Policy implications on providing post-conflict mental health care to IDPs in Sri Lanka stem from findings, providing important insights into interventions that can reduce the risk of mental disorders and promote resilience.

Background: It is well established that adverse experiences during childhood increase the chances of developing emotional psychopathology in adulthood, particularly during vulnerable times, such as pregnancy. Furthermore, research has also demonstrated an association between maternal depression in pregnancy and poorer offspring developmental outcomes. The primary aim of this thesis is to investigate the pathways by which maternal history of abuse during childhood interacts with depression during pregnancy, and how both conditions affect offspring development at six days, eight weeks and one year after birth. The second aim of this study is to explore the alterations in maternal hypothalamic-pituitary-adrenal (HPA) axis functioning during pregnancy among women who are depressed and/or have experienced childhood abuse, and whether these are related to offspring behavioural and physiological regulation as well as to offspring HPA axis response to stress. Methods: The sample comprises 125 pregnant women recruited in the area of South London. Women were assessed in pregnancy for maternal depression and history of abuse in childhood in a one-to-one clinical interviews (25 weeks gestation), and for maternal HPA axis (25 and 32 weeks gestation) through the collection of salivary samples. Infants were administered the Neonatal Behavioural Assessment Scale (NBAS) at six days, with an assessment of the HPA axis functioning before and after the NBAS. Infant HPA axis response was reassessed at eight weeks and one year before and after routine immunization. Results: Women who have been abused in their childhood were 7 times more likely to develop depression in pregnancy than non-abused women. Furthermore, women who were depressed in pregnancy and especially those with both childhood abuse and antenatal depression, showed an increase in the evening cortisol levels at 32 weeks gestation compared with the other women. Neonates of depressed women had poorer behavioural regulation at 6 days, with an increase in their HPA axis stress response following the NBAS compared with neonates of non-depressed mothers, irrespective of maternal history of childhood abuse. At one year, infants of mothers with childhood abuse and depression exhibited greater stress following the immunization compared with infants of non-depressed mothers, but this difference was not seen at 8 weeks. Conclusions: The effects of exposure to childhood abuse and depression in pregnancy can be seen in the mothers’ high level of stress hormone circulating in the evening in the 3rd trimester of pregnancy. Moreover, the effects are also seen in the next generation during the first year of life, as observed in the persistent biological and behavioural changes in the offspring. These findings have implications for clinical practice: doctors and midwives in antenatal clinics should be aware of the importance of asking about women’s own childhood histories and their mental health during pregnancy in order to offer support during their transition to motherhood.

Stress Management Training (SMT) may be an effective treatment for patients diagnosed with anxiety and depression. An SMT package has been given to active regular military personnel diagnosed with anxiety and depression under the care of the Department of Community Mental Health (DCMH), RAF Brize Norton. The SMT was not standardised and provided psycho-education and generic anxiety management. This thesis describes attendees (n=90) of the unstandardised SMT. The unstandardised SMT was then standardised and its effectiveness was investigated by means of a Randomised Controlled Trial (RCT). The RCT compared participants (n=53) who received standardised SMT to those on the waiting list (control group) (n=45). Outcome measures used in the RCT were the General Health Questionnaire (GHQ-28), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI) and Clinical Global Impression (CGI). The results of the unstandardised SMT study showed that most attendees (91%) were diagnosed with adjustment disorders prior to the study. Most attendees (57%) met the threshold, as determined by the BDI-II, for a possible depressive disorder by the time they received the unstandardised SMT. This finding was replicated in the RCT where most participants (94%) were diagnosed with adjustment disorders prior to the study but most participants (81%) exceeded the threshold, as determined by the BDI-II, for a possible depressive disorder by the time they received the standardised SMT. The results of the RCT showed that standardised SMT had a short term beneficial effect at six weeks in participants with high scores on the BDI-II but not in participants with high scores on the BAI. This effect was no longer present at 12 weeks. This thesis does not support the continued use of SMT as a tertiary stress management intervention within the military or the wider adoption of standardised SMT to treat regular, active military personnel with diagnoses of anxiety or depressive disorders. This thesis recommends that the military may wish to test the effectiveness of providing different stress management interventions as a secondary stress management intervention instead.

Borderline personality disorder has repeatedly been associated with a history of maltreatment in childhood; however, research on maltreatment and its link to borderline features in children is limited. The aim of this review is to synthesise the existing data on the association between maltreatment and borderline features in childhood. In total, ten studies were included in this systematic review. Results of the studies indicated that children with borderline features were more likely to have a history of maltreatment, and children who had been maltreated were more likely to present with borderline features. Other risk factors such as cognitive and executive functioning deficits, parental dysfunction and genetic vulnerability were also identified across studies. This review adds to the literature by highlighting maltreatment as a risk factor for borderline features in childhood. Longitudinal research is required to establish the link between childhood borderline features and adult borderline features. Implications for early identification, prevention and intervention services are discussed.

The preferential deployment of attention to noxious versus benign information in the internal and external environment - “attentional bias” - is thought to confer vulnerability to pain. The current thesis tested this putative mechanism by modifying the bias using the visual-probe task (attentional bias modification; ABM) and examining effects of this experimental manipulation on attentional bias and critical pain outcomes. Drawing on recent evidence that the impact of pain on attentional bias varies across its temporal components, this thesis additionally tested the component stages of attentional bias implicated in pain experience by manipulating the duration for which visual-probe stimuli were presented. Study 1 confirmed that both rapid and slower attentional orienting was biased in individuals with persistent musculoskeletal pain. Results from Studies 2 and 3 indicated that acute experimentally-induced pain modified the faster bias and that participants whose fast bias was modified had reduced vulnerability to cold pressor pain, in comparison with control participants. This suggested that mechanisms of initial orienting were more active in the acute pain experience. Studies 4 and 5 revealed that concurrently retraining fast and slower bias was optimal for persistent musculoskeletal pain. Results of a systematic review and meta-analysis indicated a small overall statistical effect of ABM on pain severity. Critically, however, whereas ABM had been effective at reducing acute pain severity, this was not the case for persistent pain. Overall, these findings suggest that the faster bias influenced vulnerability to acute pain, indicating a potential therapeutic target for future research. However, retraining the earlier stage of attention alone did not influence persistent pain outcomes, where there appeared to be greater involvement of the slower bias. It was concluded that not only could attentional bias influence critical pain outcomes, but that the optimal timings may vary across temporal pain classifications.

Migration is a global phenomenon and the varied social and individual nature of relocation, has led to cross-disciplinary perspectives of a process, both physical and emotional which forms a significant part of a person’s life. Historically, migration has been largely studied from a male perspective and has not specifically reflected the experiences of women. There has been a move towards recognising the need to study the experiences of female migrants. Cypriot migrants’ experiences, like those of women, have also been relatively neglected, with studies on migrant groups focusing upon more visible, larger groups for example, migrants from the West Indies, Africa and South Asia. Cypriots, along with Italians, Spanish and Portuguese have been overlooked ‘invisible migrants’. This ethnographic study focuses upon the Greek Cypriot community living in Great Yarmouth, Norfolk, a unique; small; rather isolated community. Most of its’ members originate in the same village in Cyprus and were initially involved in the service industry. The ethnography involved narrative interviews; a focus group; a virtual ethnography; participant observations; and the collection of documentation and photographic evidence. Drawing upon the theoretical concept of social capital, this thesis contributes to the understanding of the formation, transformation and erosion of this migrant community. It tells the story of how the community first began, how different organisation and institutions came to be and how these are eroding through the fluid processes of ‘bonding’ and ‘bridging’ capital. Findings from the research highlight women’s stories of migration and how they account for the process of migration; how they experience, maintain and challenge community boundaries which relate to feelings of inclusion and exclusion. The traditional role and expectations of women emerged from this research through the women’s stories of control, and this serves to fill a gap in knowledge around the experiences of female migrants living within this unique community.

A basic theme of this thesis is that different approaches to psychology are legitimated by different philosophies of science or wider philosophical perspectives. Several influential contemporary arguments about whether and how a scientific psychology ought to be pursued are first introduced. Next the attempt to reconstruct the recent history of the discipline in line with T.S. Kahn's theory of science is critically discussed as is that theory itself. This leads to a case study of the influence of Logical Positivism on Behaviourism, illustrating the historical importance of philosophy of science for psychology. The case study also provides the background for the examination of Karl Popper's philosophy of science and its associated methodology. Historical objections to Popper's epistemology are then discussed in some detail, with special attention paid to Lore Lakatos's Methodology of Scientific Research Programmes. Popper's views are defended against these objections but substantially modified in response to normative criticisms by Nicholas Maxwell. The different approaches to psychology, already discussed, are then evaluated in the light of this modified Popperian philosophy of science. The mentalist programme, as articulated by Noam Chomsky, is given a qualified endorsement but the claim that it vindicates rationalist epistemology is rejected. Finally, in a more speculative vein, Popper's metaphysical theory of Worlds 1, 2 and 3 is examined in the light of various criticisms and an interactionist alternative to mentalism is given favourable consideration.

No description available.

No description available.