Children with Williams syndrome (WS) are often reported to show a hyper-social phenotype which can pose implications for their interactions with strangers and peers. The present thesis aimed to obtain an in depth examination of two key areas of social difficulty in children with WS: social approach behaviour (SAB) and peer relationships. A multi-informant approach was used in order to examine the nature and stability of these atypicalities across environmental settings and from different perspectives. Within the present thesis, five studies are reported. Within chapters 3, 4 and 5, SAB was examined in children with WS (aged 7-16 years) by administering an experimental rating task (Adolph’s Approachability Task), a parent questionnaire and semi-structured interview. The children with WS indicated significantly higher levels of SAB in Adolph’s Approachability Task than typically developing (TD) children matched on verbal ability and TD children matched on non-verbal ability. These high levels of SAB were reported by parents to have substantial implications for the children’s vulnerability and family life. However, there was within-syndrome variance in the manifestation of this SAB. Impairment in social functioning, specifically deficits within social cognition and social awareness, were significantly associated with levels of SAB in the children with WS. Within chapters 6 and 7, questionnaires and interviews were used to solicit the perceptions of children with WS, their parents and teachers regarding the child’s peer relationships. Parents and teachers reported that many of the children with WS had difficulties forming and sustaining friendships and demonstrated atypical patterns of behaviour during social interactions. However, these peer relationship difficulties were not reported by the children themselves. Peer relationship difficulties were found to be significantly associated with the children’s deficits within social communication, social cognition and social awareness. The findings from the current thesis provide insight into substantial social difficulties among many children with WS. Importantly, and in line with the heterogeneous nature of the disorder, there was within-syndrome variance in the children’s social functioning. The present findings have important implications for both research and practice. These implications will be discussed, with suggestions for future research.

Objective: To explore how cognitive and metacognitive function influences workplace success in dyslexic adults. Background: Prior research suggests that dyslexic adults experience difficulties with executive functioning and developing metacognitive skill, in addition to continuing problems with literacy. This thesis proposes that these difficulties may affect their performance at work. This research therefore aims to investigate these aspects of cognitive and metacognitive function to discover how they relate to workplace success. These findings will provide evidence to inform interventions for dyslexic adults in the workplace. Method: Three studies were conducted. The first study (n=180 dyslexics) established the workplace success criteria: job satisfaction, self-efficacy, academic qualifications and financial success; and explored the relationship with cognitive function in terms of planning and executive attention (the Cognitive failures questionnaire, Broadbent et al.,1982)). The second study (n=116 dyslexics) assessed the participants’ metacognitive skills, confidence and problem solving and investigated the relationships with workplace success criteria. The third study (n=60 dyslexics) assessed executive functioning skills of updating, inhibition and shifting (Miyake et al., 2000) and explored the relationships with workplace success criteria. The data from all three studies were compared with a non-dyslexic control group (n= 30). Variations between the dyslexic and control groups on metacognitive and executive skill were anticipated, and the relationships between these differences and workplace success were investigated. Results: Study 1 found that cognitive failures were related to aspects of workplace success in dyslexics, and that dyslexics experienced more cognitive failures than the control group. But there were no differences between dyslexic and controls in planning or overall workplace success. Study 2 found that metacognitive skill was related to aspects of workplace success in both dyslexics and controls. Dyslexics had less metacognitive self-understanding than controls, but other aspects of metacognition were similar. Study 3 found no clear relationship between executive function and workplace success, but dyslexics performed less well than controls in aspects of working memory. Conclusion: Dyslexic participants attained comparable levels of workplace success despite deficits in working memory processes and self-understanding, and weaker literacy skills. However similar workplace success could not be attributed to compensatory use of metacognitive skills by dyslexics because dyslexics did not have greater metacognitive skill. Possible explanations and recommendations for further research are discussed.

Although males constitute a substantial proportion of carers until recently there has been little focus on the impact of caring on their mental well-being. This study aimed to examine the extent to which a variety of contextual, caring related and protective factors predicted the mental well-being of middle-aged male carers informed by Pearlin’s Stress Process Model. The study used secondary data from the Understanding Society study. Cross-sectional analysis of how factors relating to the role of caring, interferences of caring on employment and social participation and leisure predict mental well-being measured by the GHQ-12 was undertaken. Longitudinal analysis following those that became carers and potential changes in social participation, satisfaction with leisure and mental well-being was also undertaken. Data from 8,063 middle-aged men (1,612 carers and 6,451 non-carers) was used for the cross-sectional element and data from 4,665 (614 carers and 4,051 non-carers) was used for the longitudinal element. An estimated 20% of middle-aged men were carers. Carers had significantly poorer mental well-being (p = 0.014), measured by their scores on the GHQ-12, compared to non-carers but the difference was very small (η2 = 0.001). At the cross-sectional level, three predictors were identified to most strongly impact mental well-being: subjective financial status; satisfaction with leisure time; and employment status (partial eta squared = 0.053; 0.046; 0.051 respectively). Longitudinal analysis suggested that carers’ mental well-being was poorest prior to undertaking caring. However, there was no evidence that mental well-being became worse for those that became carers relative to those who remained non-carers. Middle-aged male carers who were under financial stress, unable to pursue leisure activities and unemployed or long term sick were found to be particularly vulnerable to poorer mental well-being. Providing support to this group of middle-aged men both in practical and therapeutic terms would help meet their mental well-being needs.

Background: Chlamydia is the most common Sexually Transmitted Infection (STI) in England (Public Health England, 2016) and the impact of the infection has serious health and financial implications (World Health Organisation (WHO), 2003). The stigmatisation of STIs is linked to self-conscious emotions (Earl, Nisson & Abarracin, 2015) which could have a negative impact for treatment as physician communication which promotes shame has been found to influence adherence to treatment for health problems (Harris & Darby, 2009). Aim: The aim of this study was to further understand the effect of practitioner-patient communication, particularly the effect of guilt-promoting, shame-promoting or neutral communication on likelihood of following medical advice for chlamydia. Method: 140 females aged 18-25 took part in an online experiment. Participants were randomly allocated to one of three practitioner communication conditions: 1) designed to induce shame (internal focus on self) 2) designed to induce guilt (external focus on behaviour) 3) designed to be neutral. Participants then answered questions about their likelihood of adhering to medical advice (take medication, use condoms in future, make and attend follow-up appointments (NHS choices, 2015)). Participants also completed measures of shame and guilt proneness. Results: Counter to expectation, both the shame and guilt promoting communication had a significantly positive effect on some aspects of likely adherence to medical advice. There was no evidence that shame and guilt proneness correlated with likeliness to adhere to medical advice for those who received corresponding shame or guilt provoking communication. However, there was a relationship between guilt proneness and intention to perform safe sex in the future and take prescribed antibiotics. Conclusion: Findings might not be as predicted because likelihood of adherence to medical advice may not be suggestive of actual adherence to medical advice. Furthermore, as STIs are so greatly stigmatised by society, it may be that all participants were influenced by the effect of self-conscious emotions. The study also suggests that guilt-proneness may predict intention to follow medical advice of taking antibiotics and practicing safe sex in the future. The study could also be interpreted as suggesting that those who are guilt-prone or receive shame provoking communication are more likely to engage in behaviours that would ensure they would not have to attend a sexual health screening appointment in the future, which is counter to current medical advice of yearly screening for under 25 year olds.

Background: Research has found that carers have limited leisure engagement compared with non-carers and they have reduced mental wellbeing. Middle aged women who are intensive carers (>20 hours a week) are at particular risk and were therefore the focus for this study. Objectives: The cross-sectional part of this study aimed to explore whether there was an association between leisure time satisfaction, variety, sporting engagement and frequency of leisure with carer wellbeing. The longitudinal part of this study aimed to explore whether becoming an intensive carer was associated with reduced leisure engagement and reduced wellbeing. Further, whether leisure engagement predicts wellbeing. Method: This study used data from a national UK study (UKLHS) that stratified sampling across the country. Data was collected annually and waves two and five were used for this study as they included a module about leisure and culture. Wellbeing was assessed through the GHQ-12. Secondary analysis of this data included general linear modelling and chi square. Results: Generally, cross sectional hypotheses were supported although frequency of leisure engagement was less relevant for wellbeing than variety and satisfaction (the latter of which explained 12% of the variance). Individuals who did sport had better wellbeing than those who did not. Individuals who became carers did not reduce their leisure engagement more than non-carers. Change in satisfaction and variety predicted change in wellbeing but change in frequency did not. Unexpectedly, individuals who were not carers at wave two, but were at wave five had poorer wellbeing at both time points compared to the non-carers. Conclusions: Leisure is a key contributor to emotional wellbeing, in particular, carer’s satisfaction with the amount of leisure time they have and whether they engage in physical activities. This has important implications for services that work with carers at a local level, and at a policy level.

Background and Objectives: In recent years there has been a growing interest in understanding caregiver experiences within a positive psychology framework, however several issues have impacted on the development of literature in this area. These include a lack of theory from which to understand positive aspects of caregiving, and a difficulty in operationalising positive aspects of caregiving. Furthermore, despite acknowledgement that subgroups of caregivers experience positive aspects of caregiving in different ways, there has been very little research into the experiences of male caregivers. The aim of this study was therefore to investigate how male caregivers describe their experiences of caregiving using qualitative methods to help corroborate or develop existing literature around positive aspects of caregiving. Research Design and Methods: 6 male caregivers from the south-east of England were interviewed about their caregiving experiences using qualitative research methods. Data was transcribed and analysed by the researcher using interpretative phenomenological analysis. Results: The analysis revealed 3 themes around the caregiver experience: experiencing losses and frustrations from caring for a loved one, finding ways to hold on to a sense of self, and experiencing caregiving as bringing one closer to one’s values. The concepts of value and identity were identified within each of these themes. Discussion and Implications: Results are discussed in the context of Breakwell’s identity process theory. In particular, it is noted that caregiver experiences relate to how much caregiving allows one to be true to one’s identity. Homogeneity of the sample is discussed as a limitation. Further research is suggested to explore how values and identity relate to caregiver well-being.

Aim: Given the move towards community-based care and potential changes in attitudes towards men and caring, it was the aim of this study to explore the experiences of fathers caring for and coping with having a son or daughter with psychosis and begin to identify ‘how’ they cope or ‘what helps’ them to cope in this challenging role. Methods: A qualitative exploratory design was employed using semi-structured interviews. Interviews were transcribed and analysed using Interpretative Phenomenological Analysis (IPA). Participants were six white British fathers who self-identified as providing care to their son/daughter who had experienced a first-episode of psychosis, and were under the care of an early intervention team. All fathers were of working age, with a mean age of 56 years and the identified child was living with them at the time of interview. Results: Results suggest that gender identity and masculinity play some role in these fathers’ understanding of their caring role. Strategies that helped them to cope were identified and themes around men and talking emerged as prominent in interviews. Conclusions: With the literature lacking in focused research around coping in relation to parents caring for children with psychosis, and even less focused on fathers, the current research adds valuable research into this important population. Themes suggest that providing opportunities for fathers to talk about their emotions and encouragement to make use of strategies they find effective will enable these fathers to continue providing care to their son or daughter. Implications for clinical practice are discussed.

The thesis sets out to examine the way in which Gestalt therapy methods have been developed and to analyse the theoretical arguments which underpin them. An empirical study was undertaken in which Gestalt training methods were applied over a period of six months to a group of psychiatric day hospital patients who were simultaneously recipients of orthodox psychoanalytically oriented treatment. Their progress was compared with that of a matched group who were receiving the same psychoanalytically oriented treatment, except that painting sessions replaced the Gestalt therapy sessions. Outcome for both groups was measured pre and post treatment using the Personal Orientation Inventory (Shostrom), a form of repertory grid test (Kelly) and the Target Complaint Scale (Battle). Results generally indicated that the patient. had benefitted from the Gestalt therapy. These benefits were variable and different between the experimental and the control group. A further study was undertaken, designed to explore the effect of Gestalt training (in a therapeutic form) in a different culture and with non-psychiatric subjects. A group of Belgian mental health professionals received Gestalt training over a period of one year and change was measured using the Middlesex Hospital Questionnaire (Crown and Crisp), the Personal Orientation Inventory, a form of repertory grid test and the Semantic Differential (Osgood). Similar benefits to those noted for the patient population were evident. The usefulness of Gestalt theory is argued to rest primarily in its ability to induce time competence (the capacity to experience actual here and now stimuli) and its value in resolving antagonistic forces within the person (toward achieving personality integration).

There exist contradictory perceptions of child molesters. Whereas the criminal justice system treats them as similar to other criminals the academic literature views them as victims of a pathological disorder emphasizing the need for treatment. A deeper exploration of the academic literature reinforces this distinction. Instead of researching and categorising the similarities or differences between child molesters and other criminal offenders the literature has implicitly accepted that no commonalities exist by postulating only variations within child sexual offenders. It is argued in this thesis that this constricted approach has missed existing communal characteristics between the groups. The thesis is proposed that child molesters should be viewed as exploitative and abusive individuals for whom sexual deviancy with a young vulnerable victim forms part of a diversity of symptoms demonstrating the way they relate to other individuals within society. This is in contrast to the academic literature which views him as an individual with only one distinguishing trait, an exclusive sexual motivation towards children. In order to explore this further all detected sexual offenses committed on children aged between 5-12 years for a three year period (1987-89) which were reported to the Lancashire Constabulary were compiled. Victim, offence, and offender details were then content analyzed for all 416 offenses, and evaluated using a number of statistical tests. The initial analysis did not support previous conceptual classifications that offenders could be distinguished by a sexual preference for children. Instead the offenses exhibited similarities to other criminal offenses which allowed their discrimination on a variety of criteria. These comprised: age and gender of victim; age and gender of offender, relationship of offender to the victim; type of offence and how it was committed; and the previous convictions and the antecedents of the offender. It was further hypothesized that offenders could further be discriminated as to their degree of invasiveness towards the victim. Ninety-seven of the offenses were then content analyzed over 59 variables relating specifically to offence behaviour. A multi-dimensional scaling procedure known as Smallest Space Analysis (Lingoes, 1973) revealed a faceted structure to child molestation behaviour, distinguishing offenders between levels of aggression and intimacy. The facet structure provided a model to test and confirm the social interactive model proposed by Canter, 1989. Using Chi-square analysis it was established that those who related to the child in the most abusive fashion were revealed to have distinct characteristics; the most exploitative offenders showed criminal recidivism and an inability to sustain relationships. In contrast the intimate, socially motivated offender, who demonstrated the most apparent empathy towards the victim had less criminal history, and a superior ability to form non-deviant relationships. It was hypothesized that a linear continuum relating to levels of abuse existed between these two extremes of offender behaviour. The ability to differentiate child sex offenses on a number of clearly defined offence behaviour criteria and to then ascribe offender characteristics was subjected to a field validation test. The subsequent profile was found accurate on all 22 variables in relation to an offender who indecently assaulted a number of pre-pubertal boys. Aggressively orientated behaviour was then described in terms of an "anti-social personality" whereby indiscriminate sexual deviancy appeared as just another symptom of impulsive criminal behaviour. In contrast "intimate orientated behaviour" was described in terms of relationship inadequacy. The continuum of behaviour between the two extremes was explained in terms of coercive and abusive behaviour explained within the parameters of a multi-disciplinary criminological model. In conclusion the theoretical benefits are discussed of a psychological framework which allows offenses to be understood in terms of observable criteria. Similarly the practical benefits for criminal investigation are also addressed.

The research reported in this dissertation supports a conceptualisation of impulsivity as a fundamental trait which is not subsumed by other traits in large scale models of personality, whether of three five or more factors. It argues for this by showing that a measure of impulsivity demonstrates incremental validity over and above the validity of two measures of the Big Five personality traits in the prediction of a variety of behaviours which previous research has linked to individual differences in impulsivity. The research also demonstrates that while impulsivity is a coherent trait it nevertheless subsumes at least two and perhaps three correlated lower order traits; in the first instance this is demonstrated through an analysis of the factor structure of the BIS-11 which replicates the factor structure proposed by Patton et al (1996). Research reviewed in the first three chapters suggests a conceptual overlap between the multi-facetted trait of impulsivity and the dual factor model of inattentive and impulsive behaviours which constitutes the syndrome of ADHD. Two studies explore this overlap by first establishing that ADHD behaviours may be considered as two highly correlated traits and then exploring the correlations and conceptual overlap between these ADHD traits and the impulsivity facets measured by the BIS-11. The results suggest that while the correspondence between the variables across the two questionnaires and domains is not simple it does justify further exploration. The final study explores the relationships between self report measures of inattention and impulsivity and laboratory tasks selected to tap into behavioural and cognitive inhibition. The significant correlation between the cognitive inhibition tasks and the variance shared by the inattention and impulsivity scales supports the hypothesised role of cognitive variables in affecting individual differences in a unitary construct of impulsivity/inattention.