This is a study of the usefulness of psychoanalytic psychotherapy in the treatment of a group of severely disturbed children, for each of whom there was good evidence of sexual abuse. This abuse had begun early in life; and had been perpetrated within a family by one or more male figures; in the presence of a mother who was unable to intervene. The purpose of the study was to examine whether, and how, such treatment could be of help to the child. It was felt necessary to approach the work via a small group of detailed case studies; partly because the children are uncommon, and a large statistical study would be difficult to organise (cf Trowell 2001). Further, the existence of a sort of diagnostic category to describe the children was really only elucidated by the process of making the detailed case studies in the therapy room and through supervision. Thus it was possible to make an examination of the mental and emotional processes which had brought about the children's condition and of approaches that were likely to help; and to review when and in what circumstances the child was helped. This approach was therefore more open-ended than a statistical study could be. Its similarities, for example, continuous review and triangulation, with the method defined by Glaser and Strauss (1967), in the field of Sociology, as Grounded Theory, are described below; as is the method of doing this via sessions with the child as part of his/her treatment, and the recording of an archive of notes (data collection); subsequent triangulation against the literature that was found to help; data analysis through first and second supervisions; and further review and analysis leading to conclusions and recommendations for practice. For this purpose, therefore, the case study technique was found to be more appropriate. Findings were that a group of children exists among those who have been sexually abused, who are not truly psychotic but who have precarious contact with reality. The precariousness of reality for them derives from the lack of emotional comprehension on the part of a mother figure, who, for reasons described below, has a heavy emotional investment in the child's abuse by a partner of hers - that is to say, the whole family group is involved in a dire failure of the oedipal triangle. This group of children, probably synonymous with the Tavistock Society's category of Multiple Traumatic Loss, defy understanding by experienced workers who rely on the child's having some trust in the strength and power of adults. They were better understood by the researcher when the concept of the Dangerous Inner Object became available (Dubinsky and Dubinsky 1998) - their distrust is so overwhelming, because their experiences are so adverse, that they have no hope of help, but have to learn about it, against all their beliefs. In the field of Attachment, such children are described as Disorganised, and as hating and fearing the simultaneously needed attachment figure. This description seems both apt and accurate from a descriptive and diagnostic point of view. It also enables links to be made with work published in the field of neuroscience by workers such as Schore (2001) and Siegel (1999) - see below; but the writer has found the Dangerous Object idea more helpful to the treatment process, in which the aim is for the child to acquire and to internalise over however long a time is needed, a different and more integrated kind of object development. Because of the difficulty of doing this work without considerable background in theory, and because of the intensity and time input needed, the researcher's conclusion was that lasting improvement, measured by the sense of relief in the child as well as improved functioning (but not measured in terms of ease of management by the adults) would only be achieved where psychotherapy was used. Naturally the child would also need a stable, understanding Holding Environment as well as educational facilities which could work with him/her; though it was found that the child's ability to make use of education and other sources of help improved with the therapeutic treatment.

Mesial temporal lobe epilepsy (MTLE) is the most common drug resistant form of epilepsy, and is associated with progressive memory impairment. Currently there is no pharmacological means to restore memory function in these patients, making it a significant unmet therapeutic need. This research thesis shows severe impairment in spatial memory acquisition and long term retention on a virtual Morris Water Maze (MWM) task in patients who had trans-slyvian selective amagdalohippocampectomies as treatment for MTLE. This pattern of impairment was also found in patients with MTLE and with MRI positive hippocampal sclerosis. Memory impairment in MTLE has been associated with depleted levels of stem cell derived new neurons, a process called neurogenesis which occurs almost exclusively in the dentate gyrus of the hippocampus; a brain area frequently associated with memory. Rats with kainate induced epilepsy also show learning and memory deficits on a MOlTis Water Maze We have shown that neurogenesis is depleted in chronic animal models of epilepsy, supporting the theory that there is a temporary increase in neurogenesis post insult but then a chronic depletion in the levels of neurogenesis. We are also one of a very small number of studies able to show abnonnal neurite sprouting in new neurons born in the chronically epileptic hippocampus. Uniquely we have been able to restore spatial learning ability and reverse the reduction in neurogenesis seen in chronically epileptic animals by administration of chronic dose of fluoxetine, although this did not alleviate the accelerated forgetting impairment. This opens a possible therapeutic avenue for h·eating spatial memory impairment in patients with MTLE.

This thesis explores the relationship between epilepsy, the brain, and the mind from the nineteenth century to contemporary neuroscience. I begin by exploring the relationship between the experimental animal and the epileptic patient in the nineteenth century through a focus on the work of the animal experimentalist David Ferrier and the epileptician John Hughlings Jackson. I continue to explore this relationship through an analysis of the work of animal experimentalist Charles Sherrington and its influence upon the twentieth century epileptic ian and brain experimentalist Wilder Penfield, who conducted experiments upon the brains of his epileptic patients using electrical stimulation. I then explore the use of epileptic patients in the split brain research conducted by Roger Woolcot Sperry, for which he won the Nobel Prize in 1983. I develop the thesis by exploring the relationship between the epileptic and the hysteric in the nineteenth century in both Sigmund Freud's work and Jackson's work; and I relate this to the contemporary manifestation and diagnosis of 'psychogenic seizures' in epilepsy medicine. Finally, I explore the relationship between the brain and the mind and epilepsy as they are constituted within the imaging technologies. I conclude by arguing that both contemporary neuroscience and sociological engagement with neuroscience is one in which the brain is occluded by the mind rather than is currently supposed that the mind is replaced by the brain.

The current study aimed to explore the nature of self-understanding in adolescents diagnosed with an autism spectrum condition. A photoelicitation interview (PEI) design was used whereby participants took photographs and talked about them in an interview. An additional aim was to assess the utility of the PEI approach in carrying out research with this population. Five participants aged thirteen to fifteen took part in the study. Interview data was interpreted using Interpretative phenomenological analysis (IPA). Three superordinate themes emerged from the analysis: self in action, self in relation to others and self extended in time. Findings include how participants' self-understanding was derived from relationships with their parents and by reflecting on their past. The use of photographs was found to be helpful in engaging participants with the research process and in producing rich interview data. Introduction According to the medical model, Autism Spectrum Conditions I (AS Cs) are characterised by impairments in social interaction and social communication as well as restricted, repetitive patterns of behaviour (American Psychiatric Association, 2013). A range of difficulties with social cognition are thought 1 The term 'autism-spectrum condition' will be used rather than 'autism-spectrum disorder' as it is less stigmatising, and reflects that in addition to having difficulties, individuals with autism also have areas of strength (Baron-Cohen et al., 2009)

Huntington’s disease (HD) is a fatal late onset neurodegenerative disorder that is caused by an expansion of a polyglutamine encoding tract in the huntingtin gene. This expansion in mutant huntingtin (mHtt) causes the protein to misfold, aggregate and leads to widespread cellular dysfunction principally through a toxic gain of function mechanism. The expression of mHtt in baker’s yeast recapitulates many of the cellular phenotypes observed in mammalian models. Here I have exploited a yeast HD model to perform genetic screens for mammalian cDNAs whose overexpression suppresses mHtt toxicity. We identified 102 protective genes, which are significantly enriched for components of the translational machinery. Further investigations revealed that translational efficiency but not fidelity is decreased in yeast expressing mHtt. Interestingly, overexpression of a subset of these genetic modifiers further decreases the efficiency of translation in yeast. I have validated a subset of the translation related suppressors in a neuronal model of HD and observed that their overexpression significantly reduces mHtt-dependent caspase activation. In yeast mHtt aggregation and toxicity are dependent on the presence of the Rnq1 prion. Previous genetic screens in our laboratory have identified a number of other putative yeast prions as modifiers of mHtt toxicity. I have further investigated their ability to alter mHtt aggregation and to substitute for the Rnq1 prion. I have observed that overexpression of the aggregation prone Ybr016w and the Sup35 prion partially restores aggregation of mHtt in a dose-dependent manner in a rnq1Δ strain. My studies have revealed new information about the role of genetic modifiers in mHtt toxicity and aggregation, and may help inform novel therapeutic strategies for HD.

The purpose of the study was to examine the reported prevalence of mood and anxiety disorders along the adult lifespan in a number of European countries and to consider whether the low prevalence of these disorders often reported by standardised diagnostic instruments in later life was likely to be realistic. Methods Data from the European Union World Mental Health (EU-WMH) project, a cross-national study of 37,289 adults from ten European countries assessed using the Composite International Diagnostic Interview (CIDI) were analysed. A multiple group methodology was used to model all relationships with age, with the countries forming the groups. Analyses included logistic regression, multinomial regression, Poisson regression, latent class analysis and confirmatory factor analysis. This was a much wider examination of the suitability of multiple group methods for cross-national research than has traditionally been the case within psychiatric epidemiology. Sociodemographic variables were included as appropriate. Results In most countries adults over 80 years of age were unlikely to be diagnosed with any l2-month DSM-IV mood or anxiety disorder. The 12-month prevalence of individual disorders, disorder groupings, and latent classes of disorders typically declined with age among older adults in Western Europe and increased with age in Eastern Europe but this was not always the case. The burden associated with double depression increased with age in a number of countries. Older adults in Western Europe were those least likely to endorse any of the lifetime mood and anxiety screening questions. They were also those least likely to receive at least a lifetime diagnosis of major depressive episode or endorse the minimum episode duration requirements assessed at the start of the depression module. There were no significant relationships between the latent construct for major depressive episode, the symptom groups and age in any country. Conclusions Multiple group methods form an attractive strategy for the cross-national study of both observed and latent variables. The prevalence of mood and anxiety disorders in later life as reported by the CIDI does not correspond with other sources. It is debateable whether some of the reporting patterns observed among older adults, such as responses to lifetime screening questions 01' the minimum duration requirements, are likely to be realistic. We recommend that validity studies of the CIDI and sensitivity analyses of the screener specifically take place among older adults in a number of countries, not least within Eastern Europe.

This thesis examined the effect ofdysphoria on emotional experience and memory processes using standardised emotion-eliciting stiinuli and Autobiographical Memories (AMs). In the first two experiments, facial Electromyographic (EMG) responses were recorded whilst participants viewed emotional stimuli. Facial EMG responses were found to be influenced by the category of stimulus type used, as well as the ratings of emotional content. In addition, facial EMG responses were found to be different for participants who were actively appraising the stimuli, compared to participants who were viewing them passively. In the next study, the effect of dysphoria on facial EMG responses and self-reported emotional experience was investigated. Although there were few differences between dysphoric and non-dysphoric individuals in their facial EMG responses or subjective emotional experience when confronted with emotional stimuli, differences were found in participants' AMs. Although memory for experimentally-presented emotional stimuli did not differ between the two groups, dysphoric individuals displayed mood-congruent memory biases when recalling AMs, verbally describing negative AMs using a higher proportion of negative emotion words, and recalling a low proportion of specific AMs compared with non-dysphoric individuals. To extend the AM finding, a personally relevant emotion-eliciting task was developed and tested on normal participants. This methodology was refined in a final study which investigated the effect of dysphoria on emotional experience and mood-congruent memory recall of AMs. During the recall ofAMs, dysphoric individuals displayed a number of heightened negative emotional responses and to a lesser degree, blunted positive emotional responses, compared with non-dysphoric individuals. However, the two groups did not differ in the amount of specific AMs that they recalled. Taken together, the results from these studies emphasize the degree to which emotional responses in both dysphoric and non-dysphoric participants differ depending on the type of stimuli used, and the exact task being performed.

The aim of this study was to explore the differentiated experiences of parents who have a child with a diagnosis of ASD and investigate how parental engagement varies with a range of different circumstances, care time-lines and family backgrounds. This study reports data from seven parents who have a child with a diagnosis of ASD. Information was gathered through semi-structured interviews and the use of an events timeline. All data was analysed using Interpretative Phenomenological Analysis. The analysis confirmed that parents have very different experiences across the care-pathway. Some parents experienced a number of critical periods whereby they found it particularly difficult to cope with their child's behaviour. Relationships with professionals were extremely important in building parental confidence across the whole care-pathway. Parents cited that they would like more professionals to develop further care-giving skills in partnership building in order to understand, appreciate and include the parent voice. The study provides recommendations for all professionals and services working with parents who have a child with ASD, in particular the need for professional training in care-giving skills, the importance of providing early intervention in complex cases and the need for additional support at crisis points and during the secondary years.

Purpose: This study investigated whether gesture, naming and communication therapy enhanced the communication skills of 14 people with severe aphasia. It compared the gains made in gesture and naming therapy and evaluated whether there were any cross-modality gains. It also investigated whether improvements generalised to untreated items and explored factors that might influence individual participants' success in therapy. It probed whether participants were able to use gestures and words learnt in communicative scenarios with a partner and the benefits of involving the partner in therapy. Method: All participants received 15 hours of therapy that aimed to teach 20 pantomime gestures and 20 spoken or written words (Therapy A). Seven participants then progressed to a second is-hour phase of therapy that aimed to develop the communicative use of gesture alongside other strategies (Therapy B). Their partners attended all sessions and were actively involved. The other seven participants received_ no further therapy. A repeated measures design was used. Outcome measures evaluated the intelligibility of pantomime gestures and the accuracy of spoken or written words. Two novel tasks investigated the communicative use of gesture and naming. These evaluated participants' ability to convey messages and narratives to their partner. All assessments included items that had been treated for gesture and for naming as well as untreated items. Results: The outcome measures showed that participants' ability to name and gesture items was stable at baseline and then improved significantly following Therapy A. Improvements on these assessments were confined to treated items with no evidence of cross-modality generalisation. Overall, gains were greater for naming than gesturing items, although there was considerable individual variation with three participants making greater gains in gesture than naming. Performance on the communicative assessments was also stable at baseline and improved following Therapy A. On these tasks gains were evident in messages and video narratives that involved untreated as well as treated items. Participants who received Therapy B made further improvements on the message assessment, but not the video narrative assessment. Conclusions: People with severe aphasia improved in their ability to produce both pantomime gestures and words following therapy, but they generally made greater gains in naming items. However, there was considerable individual variation in response to therapy in the two modalities, suggesting that gesture therapy may be a more fruitful approach for some but not all people with severe aphasia. Gains were confined to treated items, suggesting that gesture therapy should focus on items that are likely to be used in everyday communication. The results suggest that gesture and naming therapy can lead to improvements in people with aphasia's ability to convey information to their partner. Therapy involving communication partners led to some further gains in conveying messages, but the benefits of this approach were less marked.

This thesis set out to determine the characteristics of relaxing music for anxiety control. Instructed to imagine themselves in an anxiety-producing situation, eighty-four undergraduate sport students were asked to (1) rate thirty music compositions for levels of relaxation; (2) identify factors that either enhanced or detracted from relaxation; (3) state the emotions induced by each composition and (4) provide an importance rating for thirteen music components. Additional information was obtained using a focus group of music. experts. It was found that particular music characteristics were conducive to relaxation (e.g. slow tempo, secure melody). The most frequent emotional labels ascribed to relaxing music for anxiety control were 'peaceful', 'serenity' and 'sadness' . Tempo, melody, beat and harmony were the components considered to be most conducive to relaxation. Gender and level of music knowledge had minimal impact upon the outcomes. The effects of relaxing music for anxiety control on competitive state anxiety were also examined. Seventy-two undergraduate sport students were required to compete in a sports competition. Participants were assigned to one of three conditions (relaxing music for anxiety control, non-relaxing music and no-music). During a precompetition intervention period, anxiety measures (CSAI-2R, subjective relaxation and HR) were taken (baseline, pre-intervention, post-intervention). All three interventions led to significant reductions in somatic anxiety, cognitive anxiety and HR. Both music conditions provoked significant increases in subjective relaxation. ES, mean-difference and 90% data did offer some support for relaxing music for the applications of anxiety control. This thesis also examined some of the mechanisms responsible for music's anxiety reducing effects.