Embodied theories propose that understanding meaning in language requires the mental simulation of entities being referred to. These mental simulations would make use of the same modality-specific systems involved in perceiving and acting upon such entities in the world, grounding language in the real world. However, embodied theories are currently underspecified in terms of how much information from an event is contained in mental simulations, and what features of experience are included. The thesis addresses comprehension of language that describes speed of events. Investigating speed allows embodied theories to be extended to a more complex feature of events. Further, speed is a fine-grained feature and thus testing an embodied theory of speed will reveal whether or not mental simulations include the fine details of real-world experience. Within the thesis four main methods of investigation were used, assessing simulation of speed with different types of speed language under different conditions: behavioural testing combining speed in language with speed in perception and action, eye-tracking investigating whether eye-movements to a visual scene are affected by speed in sentences, a psychophysics paradigm assessing whether speed in language affects visual perception processes, and finally, as a crucial test of embodiment, whether or not Parkinson’s patients, who have difficulty moving speedily, also have problems with comprehension of speed language. The main findings of the thesis are that: (1) speed, a fine-grained and abstract dimension, is simulated during comprehension, (2) simulations are dynamic and context-dependent, and (3) simulations of speed are specific to biological motion and can encode specific effectors used in an action. These results help to specify current embodied theories in terms of what the nature of simulations are and what factors they are sensitive to, in addition to broadly providing support for the sharing of cognitive/neural processes between language, action and perception.

Research suggests that parents of children with learning disabilities are particularly vulnerable to stress and that parental distress impacts negatively on family functioning, parenting roles and relationships, behaviours, socialisation and the psychological well-being of both parent and child; as a consequence many parents reach ‘breaking point’ and will choose to place their child in out-of-home care. However, the research literature outlining this process is limited. The purpose of this research was twofold: to explore the process leading to ‘breaking point’ in parents and caregivers of children with learning disabilities and how this impacted on the decision making process leading to out-of-home care, and secondly, to formulate a grounded theory of this process and its consequences. The study used a social constructionist grounded theory methodology. Fourteen participants were interviewed and three participants completed a qualitative survey. The sample included two birth fathers, twelve birth mothers, one adoptive mother, one sibling and one guardian. The level of their child’s learning disability varied from mild to severe. In all cases, the child had additional diagnoses, such as autism, fragile-X syndrome and Down’s syndrome. A grounded theory was constructed from the data outlining the basic psychosocial process which led to ‘breaking point’ and the decision to place the child in out-of-home care. Parents developing awareness of their child’s disability combined with social prejudice, contributed to the development of a negative parental identity. To defend against this, parents created a compensatory good parent identity and in doing so convinced themselves that they could cope with the 24/7 child. This increased stress, caused relationship breakdowns, financial difficulties and mental health problems. Parents faced additional stressors when screaming to be heard by professionals as they sought guidance, diagnosis and support. Eventually breaking point was experienced as they became overwhelmed. This initiated the decision making about out-of-home care. Once the move occurred, a process of adjusting and managing the loss of role was entered, linking to evaluation and constant monitoring of care. In this sense parental responsibility was never relinquished and parental roles were redefined. The findings outline a lack of support, information and guidance for parents and families based on their experiences of prejudice and dismissal of concerns by society, professionals and on occasion family and friends. Suggestions for future research and research limitations are explored. The implications for practice and more generally for counselling psychology are also considered.

Binge drinking has been identified as common place among student populations and due to its association with a number of negative consequences is generally considered to be problematic. This thesis adopts a mixed methods approach to the study of the binge drinking behaviour of undergraduate students at an English university, employing focus groups (N=6 groups), cross-sectional and prospective questionnaires (N= 117 and N= 300 respectively) to explore the antecedents of students’ alcohol use and binge drinking. The findings of the qualitative work demonstrate that students consider binge drinking to be drinking to get drunk and identify student drinking behaviour as highly social. A number of key alcohol related expectancies that may be perpetuating high alcohol use in this population also emerge from the data. These are interpreted as indicating that the application of social cognitive models to the study of these behaviours is appropriate. The quantitative studies support the application of the TPB to the prediction of student binge drinking behaviour showing that it accounts for between 51 and 63.3% of the variance in students’ intentions to binge drink and 34.7% of the variance in students’ self-reported binge drinking behaviour. However a number of expansions the TPB are shown to be effective with expanded models accounting for 69.6% of the variance in intentions to binge drink and 51.5% of the variance in self-reported binge drinking behaviour. Implications for further research, including replications of the suggested expanded model are discussed and potential applications to future intervention and prevention works are presented.

BACKGROUND: There is a dominant discourse within the literature that collaboration is the ideal way of working when formulating in CBT and particularly with clients experiencing psychosis. Despite formulation and collaboration being considered key principles for this widely evidence-based approach, the literature deconstructing these concepts or explicating the way these add value to CBT for psychosis is insufficient. The literature does not acknowledge complexities, challenges or inconsistencies regarding this dominant discourse. This may be due to methodological challenges of investigating such variable and abstract constructs. However discourse analysis is a productive way of investigating inconsistent and complex constructs. Foucauldian Discourse Analysis was utilised within this study to investigate how clinical psychologists talk about and construct collaboration within this context, discourses drawn upon, tensions apparent, and ways of managing these. DESIGN: Semi-structured interviews were conducted with 12 clinical psychologists working across 3 NHS trusts in England. All participants self-reported working with clients experiencing psychosis and developing cognitive-behavioural formulations with these clients. A local collaborator within each trust provided names and contact details of clinical psychologists working with this client group, all of whom were sent participant invitation letters. Interviews were transcribed verbatim using a light version of Jeffersonian transcription, according to the level of analysis. ANALYSIS: Foucauldian Discourse Analysis was used to analyse the data and the guidelines of Willig (2008) were heavily drawn upon. This involved investigating how collaboration was constructed in accounts and inconsistencies or variations in this; discourses drawn upon; close examination of the discursive context and the action orientation of talk within the interview; subject positions adopted; and the relationship between discourse, practice and subjectivity. RESULTS: Collaboration in the context of formulation in CBT for psychosis was constructed in diverse and inconsistent ways by participants. Collaboration was often initially presented as a straightforward process whilst accounts quickly moved on to construct this as complex and ambiguous. Clinical psychologists adopted multiple and seemingly conflicting positions within their talk such as ‘collaborator’ but also ‘expert’ and ‘protector’. Tensions were apparent between conflicting discourses drawn upon such as ‘collaboration as the ideal’ but also ‘openness and transparency as dangerous’ and the ‘importance of a shared understanding’ alongside ‘accepting multiple perspectives’. CONCLUSION: Current understandings of collaboration presented in the literature are inadequate and a more nuanced understanding of the complexities, tensions and variations of collaboration in CBT for psychosis, as presented by participants is called for. The research highlights that collaboration may be more usefully constructed as being made up of a range of approaches rather than as a singular way of working. It may be useful to consider an approach similar to the ‘matching hypothesis’ seen in health and social psychology literature when determining type of collaboration and therapeutic alliance suitable for the individual.

Cultural stereotypes highly influence people's cognition and behaviour and while a great deal is known about when they are used and why, relatively little is known about how they form and evolve over time. Recently, utilising linear diffusion chains, researchers in linguistics have demonstrated that novel languages can unintentionally form and evolve via cumulative cultural evolution. We examined whether novel stereotypes might also spontaneously form and evolve in a similar manner. As information about novel social targets and their attributes was passed down a chain the information became simplified and categorically structured. Over time novel stereotypes emerged that not only made information increasingly learnable but allowed people to make inferences about previously unseen social targets (Chapter 2). In Chapter 3 we examined whether convergent stereotypes emerged when each chain was initialised with the same information. In response to findings from Chapters 2 and 3 we examined whether the category colour was more perceptually salient in categorisation than shape or movement (Chapter 4). Cognitive load was reduced in Chapter 5 to examine how this impacted stereotype formation. We subsequently examined whether stereotypes formed in a similar manner for non-social information (Chapter 6) and the impact of social identity on stereotype formation (Chapter 7). Chapter 8 looked at how the presence of existing social category information (i.e., sex) influenced the formation of stereotypes and concluded with a cross-experimental analysis in Chapter 9. We suggest that stereotype formation is a consequence of the shared cognitive limitations and biases of individuals in the chains that are exposed via cultural transmission. We believe that stereotype formation is both the unintentional and seemingly inevitable consequence of how people store, recall and share information.

Children adopted from care are likely to have been exposed to similar adverse, early experiences as those suffered by looked after children, and therefore have an increased risk of developing complex emotional and behavioural difficulties. Consequently, parenting an adopted child may present significant challenges. Despite government commitments to improve support for vulnerable children and their caregivers, post-adoption support is often lacking and therapeutic interventions for adoptive families are currently offered in the absence of a robust evidence base. The current literature review aimed to explore the efficacy of therapeutic interventions for adopted children and their caregivers. Synthesis of eleven studies found limited support for a positive impact of interventions on children’s behavioural functioning and caregivers’ confidence and perceived competency. However there was a paucity of evidence for the benefits of interventions for children’s emotional and relational functioning, a key reason why adoptive families seek support. Methodological weaknesses indicated multiple evidence requirements would provide a more effective approach to evaluating the efficacy of interventions. The research study sought to understand the lived experiences of adoptive caregivers’ formal and informal help-seeking for their children’s emotional and behavioural difficulties. Qualitative interviews were conducted with six adoptive mothers whose children were currently accessing a child and adolescent mental health service (CAMHS). Interpretive Phenomenological Analysis (IPA) generated four super-ordinate and 12 sub-themes, which enabled convergence and divergence within respondents’ experiences to be accounted for. With a view to informing post-adoption intervention, themes were discussed in relation to existing theory including; parental help-seeking, stigma and attachment. Further qualitative research of particular populations of adoptive caregivers and issues highlighted by the current study was recommended. The critical appraisal presents a reflective account of the research process to maximise transparency and facilitate readers’ evaluation of the research process.

Peer support workers are people with lived experience of mental health distress who provide mental health interventions or services to people with mental health problems who are at an earlier stage in their recovery journey (Davidson et al., 2006). Disclosing personal strategies with a recipient is seen as one beneficial aspect of the peer support model. However minimal research has been conducted to explore how the individual experiences this relationship. This remains an important question due to the increase in recovery-orientated services operating peer support models in UK mental health settings. Literature Review: The act of self-disclosure (SD) within the peer model may be seen as a critical ingredient to the models success. Qualitative studies examining client’s perception of therapist SD were reviewed using the meta-ethnographic process. Seven studies were found to meet inclusion criteria. Themes identified were that SD could simultaneously strengthen and also impede the alliance formed between therapist and client. Findings overlap with the salient components of effective therapeutic alliance, but also that SD can trigger early unhelpful attachment experiences leading to alliance ruptures. Research Report: Little is known about the circumstances in which the peer support model works (Repper & Carter, 2011). Semi-structured interviews were conducted with seven individuals who had been in receipt of peer support self-management intervention as part of a Randomised Controlled Trial. Interviews were analysed using interpretative phenomenological analysis. Findings indicated that internal and external stigmatising attitudes and concealment of mental health identity contributed to ambivalent identification with the peer. Contrary to this, individuals also used the relationship to challenge stigmatising attitudes. Results are also considered in light of criticisms of the recovery model. Critical Appraisal: Critique of the research methodology and limitations are discussed. The trainee reflects on a psychology of humanistic values, counter to the experimental/positivist psychological tradition.

Palliative care is a term which refers to the services provided to those with incurable, life-limiting illnesses. In addition, the specialism of clinical genetics is increasingly able to identify individuals who are genetically predisposed to illness, particularly Breast Cancer (BRCA) 1 and 2 mutations which increase the chance of developing breast or ovarian cancer. A range of preventative and screening interventions are available. These issues have the potential for psychological consequences for patients at the end of life, their families and for the clinicians raising these issues with them. The review of the literature examined the qualitative evidence-base regarding the impact of caring for the dying on hospice nurses. A qualitative metasynthesis of 11 articles was carried out and identified two main themes and eight subthemes. These reflected what nurses’ considered to be core elements of their work with patients and a primary driver to facilitate a ‘good death’. Further to this, factors which either facilitated or impeded achieving this aim were identified to act to either replenish or drain nurses’ resources. Recommendations for how to best meet these identified needs were made with potential benefit for both nurses and patients. The research consisted of interviews with 13 palliative care staff to explore issues pertaining to the discussion of genetic risk in a palliative care setting. Thematic Analysis (TA) was used to develop four main themes and seven subthemes identifying the main considerations for participants regarding the inclusion of conversations about potential genetic risk of BRCA 1 and 2 mutations within their general practice. These formed the basis of recommendations which may be useful to services as they adapt to novel clinical interventions within their care for dying patients. The critical appraisal provides a reflective account of the experience of undertaking research and limitations of the research are discussed.

Literature Review: Qualitative evidence of the experience of doctors in training encountering clinical errors was synthesised following a systematic literature search. A meta-ethnographic approach to metasynthesis was used to develop two third order themes which were novel to the existent literature; i) in error trainees revealed as being betwixt and between and; ii) professional assimilation at a cost. These findings captured the psychological and emotional experience of error as being situated within a wider context of medical culture and learning for participants as they acclimatized and internalized socially available response to error. Implications for practice and future research are considered. Research Report: The experience of 6 participants who believed they had experienced diagnostic error (missed, delayed or incorrect) prior to a correct diagnosis of cancer. An Interpretative Phenomenological Analysis (IPA) approach was undertaken. Three superordinate themes were identified; i) diagnostic error as invalidating; ii) shifting appraisals of diagnostic error during the cancer journey; and, iii) seeking reconstruction of the self. Themes were considered in relation to their contribution to current understanding of diagnostic error and cancer survivorship research. Clinical implications and critique were identified in addition for future directions for research. Critical Appraisal: The researcher’s account of the research process, reflections, personal learning and critique are offered.

A survey of the current literature published in the field of childhood autism suggested that despite a rapidly expanding body of research, we have little definitive understanding of the aetiology of the condition or a highly efficacious treatment model. However, there is a growing consensus that the autistic child suffers from a primary organic impairment, resulting in particular deficiencies in cognition and language, and consequently he displays pronounced learn-ing difficulties. The literature survey also indicated that there is a lack of empirical data on the manner in which parents interact with their autistic child, including the contingencies they deliver upon his characteristic responses, and the influence of the child upon the adult's behaviour. Analysis of mother-child interactions were conducted therefore, using diads with normal and autistic children and their mothers. Differences were found between the behaviour of mothers of normal children and mothers of autistic children on a number of verbal and non-verbal measures relating to their mode of interaction with these children. Such data may have potential utility for the design of generalizable behavioural treatment programmes for autistic children, with parents as the primary charge agents. The second study involved an analysis of psycho-physiological data collected from a group of non-verbal autistic children who typically display infrequent, abnormal or unpredictable overt responses to important environmental events including traditional reinforcers, novelty and social stimulation. Autonomic data appeared suitable for determining the effects of such environmental stimuli, which also may have implications for treatment design and for an understanding of the aetiology of childhood autism. The third area of investigation consisted of three studies designed to investigate further the apparent deficits and abnormalities in cognitive functioning that have been reported recently in experimental research literature. These studies involved binary sequence learning, concept attainment and probability-learning tasks, and contrasted the performance of autistic children with normal and subnormal control subjects. It was concluded from these data that there is evidence of abnormalities in functioning on cognitive tasks and that they may be particularly related to the nature of strategies adopted in such tasks and the failure to utilise task-relevant information feedback in an appropriate manner.