This thesis investigates the roles of identity and personality in the home making process. Well-known approaches to identity typically define context in social or temporalterms, largely neglecting the physical environment. Personalisation of the dwelling has been argued to function in self-definition and self-presentation, yet only a small body of research corroborates such theories. Personalisation of the dwelling therefore presents an ideal context within which to explore identity processes in the physical environment. The thesis argues that the connection of identity to a dwelling has strong psychological implications for dwellers. Such implications are investigated, particularly in relation to meanings of home. The first study explores psychological and social drivers on the personalisation process through interviews with people who have converted farm buildings to home use. In the second study, attitudes towards home making behaviours are investigated in relation to social and personal identity orientations. The study explores whether such identity-based personality traits influence the way in which the dwelling is used as a means of self-definition. In the third and final study in-depth interviews are carried out with people living in typical Aberdeenshire dwellings. These interviews explore the ways in which identity and personality are connected to the dwelling and how these contribute to the process of home. Quantitative findings suggest that only a small relationship exists between identity orientations and personalisation. However qualitative findings in particular from the third study show a strong link between various aspects of identity and the dwelling. The ways in which identity is connected to the dwelling vary as a function of personality differences. Importantly these connections contribute to the process of home. This research constitutes contributions to a number of research areas, in particular home research and research exploring the role of personalisation and possessions. The research brings together identity, personality and home - areas which have not previously been explored together in great detail. The thesis presents a valuable framework within which to study the interactions of place, personality and identity processes and therefore makes an important contribution to a number of academic fields, in particular environmental psychology and built environment research.

Literature Review: A systematic review of the literature on the use of Dialectical Behaviour Therapy (DBT) in both inpatient and outpatient settings was conducted. The results demonstrated that significant treatment gains were made by individuals with BPD when treated with DBT. The review supported the use of DBT in both treatment settings. Research Report: This explored patients’ experiences of DBT in a long term secure inpatient unit. Nine participants diagnosed with BPD were interviewed. The interviews were transcribed and analysed using Interpretative Phenomenological Analysis. A total of eight superordinate themes were identified and summarised separately. The first section related to the DBT programme and two superordinate themes emerged. These were the Components of DBT and the Effects of DBT. The second section examined the journey participants described when undergoing DBT in an inpatient unit. Six superordinate themes emerged, these were: A Hopeless Beginning; the DBT Programme; Promoters of Inpatient DBT; Obstacles of inpatient DBT; A Brighter Future and Preparing for Discharge. The present study highlighted that inpatient uses of DBT are as acceptable as outpatient uses. The journey participants described highlighted the unique promoters and obstacles of inpatient DBT therapy. The clinical implications of this research supported the use of DBT in inpatient settings and provide a rationale for the development of more DBT services. Areas for future research were also discussed. Critical Appraisal: This paper provides an account of the researcher’s reflections and experience of the research process. Issues related to the decision making processes involved in the research and reflections on personal reflexivity are discussed.

Background and Aims: Looked After Children (LAC) have complex mental health needs, as a result of the trauma and inadequate care which they have typically experienced during their early years, and the instability that continues to permeate their lives in many cases. Outcomes of psychological interventions with this group may be particularly difficult to assess, yet little consideration has been given to this issue in the research literature to date. The current study aims to explore the perspectives of clinicians working in specialist Child and Adolescent Mental Health Services (CAMHS) for LAC, on the nature, process and outcomes of the psychological interventions they undertake with clients, and the implications of their observations for measuring outcomes. Method: Fourteen individual interviews with clinicians were undertaken, each exploring clinicians’ experiences and observations of a particular case with which they had undertaken an intervention. Preliminary themes from these interviews, regarding the nature, process and outcomes of clinicians’ interventions, were fed back to clinicians during two focus groups; clinicians were asked to reflect on the implications of these themes for measuring outcomes of psychological interventions with LAC. Results and Conclusions: Thematic analysis of interview and focus group data was conducted. The data was organised into five super ordinate themes, relating to the impact of the external context of the child’s life, the nature of presenting problems, the nature of interventions undertaken by clinicians, changes and outcomes observed by the clinician and implications for measuring outcomes. Relationship factors, particularly those in the relationship between the carer and child, were identified as the focus of CAMHS interventions and the changes that clinicians most commonly observed. Measuring these changes in the carer-child relationship, which existing outcome measures do not capture, is crucial. The need to contextualise treatment outcomes within the child’s overall life was also highlighted.

The literature review synthesises the literature examining the impact of having a sibling with autism on siblings unaffected by autism. Four electronic databases and two journals were scrutinised in a systematic literature search for studies focusing on the effects of having a sibling with autism. Studies published between 1979 and 2007 were elicited for inclusion. The literature suggests that having a sibling with autism is not necessarily a harmful experience. The review indicates that the impact a child with autism has on their typically developing sibling can have positive and negative aspects, which are likely to change over time and are mediated by various factors. The experience of the sibling relationship when one child has autism has yet to be fully explored from the perspective of the siblings without autism themselves. Early quantitative research examining the impact of having a sibling with autism indicated various negative effects. Qualitative studies have begun to explore the factors determining the positive and negative effects of having such a sibling, from child sibling perspectives. In this study child sibling's perceptions and experiences of the quality of the sibling relationship with their brother or sister with autism were explored using semi-structured interviews and a grounded theory methodology. Fifteen siblings without autism aged between six and thirteen with a sibling with autism aged between four and fourteen were interviewed. A theoretical account and process model of children's perceptions and experiences of their relationship with their sibling with autism were generated. The analysis indicated that for children who have a brother or sister with autism, a deep need for a relationship with their sibling is apparent. The analysis is discussed in terms of supplementing previous research findings and going some way to explaining the processes behind positive adaptation and negative adaptation to having a sibling with autism. Clinical implications are discussed and suggestions for further research are made. The critical appraisal offers an examination of the research process and the research journey as an enlightening learning experience.

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Aims: The thesis had the broad aim of facilitating the development of theory that is grounded in the post-stroke context that begins to explain the phenomena of stroke-related anxiety. Specifically, it aimed to explore stroke survivors‟ views about factors they associated with their post-stroke anxiety. Literature Review: A review of literature into the prevalence rates for post-stroke anxiety disorders and the factors significantly correlated with post-stroke anxiety, found that research in this area was in its infancy. Limitations in studies undermined the reliability and validity of some findings. No prevalence rate could be given with any confidence for post-traumatic stress disorder (PTSD). However, evidence suggested a prevalence rate for general anxiety disorder (GAD) of between 20-28%. There was little evidence relating to other anxiety disorders. A relatively small number of studies identified a few factors significantly correlated with post-stroke GAD or PTSD. The evidence was strongest for GAD being comorbid with: depression, pre-morbid psychiatric history, reduced quality of life, and reduced social support. Methodology: The research adopted a qualitative approach, using semi-structured interviews to gather data from stroke survivors. The interview transcripts were analysed using Grounded Theory. Main findings: Participants associated factors with their anxiety that could be grouped into three main categories: dependence, vulnerability and inability to meet expectations. Participants expectations appeared linked to pre-stroke beliefs and experiences of the self and were used to compare with and judge their post-stroke experiences and identity over a prolonged period post-stroke. The relationship of anxiety with these phenomena could be explained with cognitive behavioural psychological theory. Adjustment to stroke related changes may have been delayed by unclear prognosis, vague expectations and slow rehabilitation that seem to be part of the pathway of post-stroke rehabilitation.

Chronic pain has been associated with significant distress and disability (Dahl, Wilson & Nilsson, 2004; McCracken, Eccleston & Vowles, 2005). Consequently, it has been the focus of much investigation in the search for evidence based clinical interventions. Recent empirical inquiry has identified the role of psychological and social factors in the prediction of these adverse effects (Green et al., 2003; Keefe et al., 2000; Severeijns, van der Hout, Vlaeyen & Picavet, 2002). This thesis explores two of these social and psychological spheres. Firstly, a literature review was conducted that systematically assessed ethno-cultural variation in physical and psychological functioning and related processes in people experiencing chronic pain. Studies were included where participants were differentiated into at least two ethnically or geographically defined cultural groups. Some evidence was provided for ethno-cultural variation in North America. Overall, however, research studies were limited by weak designs, sparse cultural groups and a failure to address process issues. Secondly, this thesis explored the concept of mindfulness which originates from Eastern traditions of Buddhist Vipassana philosophy and practice and involves moment-to-moment, non-judgmental and non-responsive attention and observation of thoughts, feelings and bodily sensations (Baer, 2003; Kabat-Zinn, 1982). A quantitative study examined the role of catastrophising and kinesiophobia for the operation of mindfulness benefits in people with chronic low back pain. Questionnaire assessments of mindfulness, pain intensity, disability, affect, pain catastrophising and kinesiophobia were collected from 116 adults embarking on a pain management programme. Longitudinal questionnaire data was also collected from 87 of these participants. Findings provided some support that mindfulness acts as a protective agent against catastrophising, kinesiophobia, disability and distress. As a result of these investigations, suggestions were identified for future research and effective chronic pain interventions. The critical appraisal encapsulates reflection on the processes and stages involved in the thesis and highlights avenues for chronic pain research linking ethno-cultural factors and mindfulness.

This thesis uses structural equation modelling to gain an insight into the psychological mechanism governing individual differences in interrogative suggestibility. It investigates why vulnerable interviewees tend towards a negative mindset before and during interview, which in turn appears to generate the factors that Gudjonsson and Clarke (1986) consider central in eliciting suggestible behaviour during questioning. The research considers the relationship between neuroticism (vulnerability especially) and compliance within the Five-Factor personality model, attachment anxiety and avoidance, the experience of intense negative life events and interrogative suggestibility. The key findings are that: (1) answer shifts on the Gudjonsson Suggestibility Scale (GSS) may sometimes come about through compliance and not suggestibility. Vulnerable interviewees may not always believe the negative feedback given by the interviewer and therefore not feel uncertain about their memory. Uncertainty may not necessarily be a pre-requisite for shifting on the GSS; and (2) Attachment anxiety and avoidance (as well as trait compliance with respect to answer-shifts) is related to an endogenous susceptibility to distress. These factors may be the basis of the negative mindset within vulnerable interviewees, evoking expectations of success, sometimes causing uncertainty, and inducing vulnerable behaviour. Such behaviour may manifest as false statements and confessions during interview.