Social and cultural diversity are globally increasing at an unprecedented pace. The implications of this increase for individuals and societies can vary: Benefits such as cognitive flexibility and creativity may ensue when groups manage to cooperate and integrate, but stress and conflict may follow when groups are segregated and marginalised. This thesis focuses on a form of diversity that challenges traditional stereotypes (e.g., a female entering a male-dominated profession) and is thus termed counter-stereotypical diversity. The aim is to empirically and theoretically explore how people psychologically adapt to counter-stereotypical diversity. One primary prediction was derived from the literature, which is that exposure to exemplars of counter-stereotypical diversity (termed counter-stereotypes, CSTs) can boost cognitive flexibility, and this was tested across 12 experiments (reported in Chapters 4, 5, and 6). Various secondary predictions were also tested, for example the role of need for cognition in moderating the effects of exposure to CSTs on cognitive reflection (Chapter 5), and the longitudinal effects of exposure to CSTs on cognitive flexibility and intergroup bias (Chapter 6). CSTs were conceptualised as a special case of expectancy violations, and Chapter 7 theorised that they can be followed by three types of responses: (1) indifference, (2) threat (and defensiveness), and/or (3) challenge (and open-mindedness). Overall, this thesis improves our understanding of how people psychologically adapt to counter-stereotypical diversity.

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Self-disclosing mental health diagnoses may not only result in earlier help and support but also minimise the effects of mental health stigma, such as low self- esteem and isolation. However interventions designed to enable this have inconsistent outcomes. Forecasted interactions can predict disclosure-related distress and may offer an appropriate target for these interventions. Meta- stereotypes, or the way one believes others’ stereotype them, may be particularly amenable to intervention. The current study aimed to identify whether mental health meta-stereotypes exist and how they impact disclosure comfort and self-esteem. Interviews and quantitative analysis were used to develop a meta-stereotype measurement tool. Seventy-two individuals with mental health diagnoses participated in an experiment asking them to imagine disclosing to someone with either positive or negative attitudes towards mental health. Results show imagining disclosing to someone with negative attitudes increases meta-stereotype elicitation and rejection-expectation, whilst decreasing comfort with disclosure. Furthermore, meta-stereotype elicitation was associated with disclosure comfort more so than rejection-expectation. Meta-stereotype elicitation did not impact self-esteem, however mediational analysis indicates an indirect relationship via rejection- expectation. However, in both conditions, disclosure was considered an uncomfortable experience, therefore alternative influences should be considered. Results are discussed in terms of the evidence base and future research is considered.

Critical Review of the Literature The consequences of childhood maltreatment are pervasive and implicated in the development of a range of mental health difficulties, including eating disorders. However, the mechanisms which mediate the link between childhood maltreatment and eating disorders are unknown. This has important implications for effective intervention, as eating disorders are notoriously difficult to treat. There are numerous factors which predict poor therapy outcome that overlap with mediators between childhood maltreatment and disordered eating behaviours in non-clinical samples. This may suggest people with a history of maltreatment could be at greater risk of developing an eating disorder which does not respond to currently available interventions. This review aimed to identify the mediating variables between childhood maltreatment and eating disorders. Studies which tested mediators of the relationship between childhood maltreatment and eating disorders were systematically reviewed and a narrative synthesis of the findings reported. The findings suggested mediators of the relationship between childhood maltreatment and eating disorders could be mapped onto cognitive-emotional-behavioural and affective models of eating disorders. Limitations of the reviewed studies and clinical implications are discussed. Service Improvement Project Formulation, in the context of clinical psychology, involves integrating a breadth of knowledge to create a tentative hypothesis to describe the difficulties service users may experience. Team formulations, created by a multi-disciplinary team to construct a shared understanding of a service user’s experiences, can facilitate a more consistent and collaborative approach within a team and lead to a more holistic, psychosocial understanding of a person’s difficulties. This project was carried out in two recovery teams in a locality within an NHS trust in which staff had been trained to use the 5 Ps model of formulation (Weerasekera, 1995). The project aimed to establish whether staff were using 5 Ps formulations in their work, whether these were experienced as useful, what supports staff to use a 5 Ps formulation, and what staff feel the barriers to using a 5 Ps formulation are. A questionnaire and two focus groups were used and analysed using descriptive statistics and thematic analysis. The results suggested staff used the model to inform their clinical thinking, in consultation with therapist colleagues, and in group reflective practise. Overall, the 5 Ps model was well received. The model appeared to support staff both with their clinical work and to be more reflective and holistic in their approach. However, staff did raise some drawbacks with the model and difficulties with integrating it consistently into their clinical practise. Service recommendations include areas for continued practise, areas for development and change, and areas for further service evaluation and potential research opportunities. Main Research Paper The ‘Common Sense Model’ (CSM; Leventhal, Meyer, & Nerenz, 1980) aims to explain how psychological factors influence long-term health condition (LTC) management. Research has shown the CSM applies to children and young people (CYP) as well as adults. However, the model does not incorporate systemic factors, which are especially relevant for CYP, for whom families hold more illness management responsibilities. Caregiver perceptions of an illness have been linked with outcomes for the person with the health condition. Other factors which have been shown to affect illness perceptions include the LTC itself. This pilot study examines differences in illness perceptions between two groups of parents: those whose children had type 1 diabetes, and parents of children with juvenile idiopathic arthritis. This study also examined mood, anxiety and time since the child’s diagnosis as predictors of parental illness perceptions. It was found that having a child with type 1 diabetes was predictive of anticipating longer illness duration and perceiving greater control over the condition. Additionally, having greater levels of anxiety was predictive of more perceived control, which may be associated with condition monitoring behaviours in type 1 diabetes. Finally, scores indicating lower mood predicted perceiving the consequences of the condition as more severe and lower levels of perceived control over the condition. Future research directions and clinical implications are discussed.

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When individuals are diagnosed with Autism Spectrum Conditions (ASC), the whole family is affected. Recently, qualitative research has investigated the experiences of siblings of autistic people. A literature review was undertaken to identify and evaluate the research investigating siblings' experiences. Six databases were searched, resulting in seventeen studies meeting criteria for the review. Data was analysed using Thematic Synthesis. Results described the roles and responsibilities participants undertook which were different to those normally expected by siblings. Themes also explored the impact of their siblings' behaviours, experiences of acceptance and empathy and interpersonal relationships. Participants expressed love for their siblings. But, several factors, including their siblings' diagnosis of ASC affected participants' mental health. Results found participants wellbeing was improved if they had control over how they supported their siblings, understood more about ASC, had alone time with parents and had the opportunities to meet with other siblings of autistic people. A research project was conducted. ASC diagnoses often occur later for females than for males. So, many females' needs are not understood until later life. Research investigating the lived experiences of autistic females is limited. The study aimed to investigate the experiences of females diagnosed with ASC at forty years old or over. Data was gathered and analysed using Interpretative Phenomenological Analysis. Eleven females were interviewed. Results revealed that ASC was misunderstood by professionals and many participants used strategies to try to 'fit in' with peers. The consequences of this included poor mental health. Participants described experiences of grief and adaptation to diagnosis. This was affected both positively and negatively by other people and many participants experienced positive changes to their identities and psychological wellbeing after diagnosis. Services require training to understand ASC in females to prevent it being under recognised.

This thesis examines the effectiveness of imagined intergroup contact at promoting intergroup helping behaviour. Theoretically, it is argued that by adopting a third-person perspective in the imagined contact task prosocial action can be facilitated across intergroup boundaries. The results of eight studies provide evidence that imagining prosocial contact from the third-person perspective increased prosocial attitudes and actions. Additionally, results revealed that the imagined helping did not need to be specific to a particular group, or even an intergroup encounter: Any imagined helping scenario subsequently enhanced specific and generalised attitudes towards helping others, and increased the likelihood of observing prosocial behaviour. Importantly these effects were observed in laboratory and field studies, in the UK and Malaysia, and with majority and minority groups. Overall, this thesis contributes to a greater understanding the impact of mental simulation on enhancing prosocial attitudes and behaviours, and helps explain how and why imagined contact can encourage intergroup helping in a range of experimental and real-life contexts.