Background: Recent studies have highlighted the importance of peritraumatic reactions and cognitive appraisals on the development of PTSD among adults. Cognitive theories predict firstly, intense stress and dissociation during trauma disrupt mental processing, leading to fragmented memory and increased risk of PTSD and secondly, negative cognitive appraisals of the trauma and/or sequelae maintain PTSD. Emerging evidence suggests that subjective stress and cognitive appraisals are also key factors in the development of PTSD in children but little is known about the effects of peritraumatic dissociation within this age group. This prospective study investigated the influence of these factors, as well as pre-trauma risk factors, among 7-14 year olds attending A&E following a frightening event. Method: Children were assessed for symptoms of depression, anxiety, and PTSD within 4 weeks of the event and again at 2-3 months. Children provided a trauma narrative and described their peritraumatic response and cognitive appraisals. Parents provided information on pre-trauma risk factors. Results: At follow-up, a significant minority reported clinical levels of depression and a third reported symptoms sufficient to warrant a diagnosis of PTSD. More negative appraisals, greater subjective stress and dissociation during the trauma were associated with more trauma symptoms at both time points. However, these variables did not predict chronic trauma symptoms after controlling for pre-trauma risk factors. Conclusions: This exploratory study underscores the importance of assessing pre-trauma risk factors in identifying those children most at risk after traumatic events and brings into question claims that peritraumatic dissociation is a causal factor in the development of PTSD.

The literature detailing the effects of growing up with a parent with depression is extensive, and there is a burgeoning body of literature delineating processes of resilience in at-risk children. Both of these fields are summarised here, before a more in-depth examination of studies which have brought these two areas together. Only a limited number of studies have explored resilience in offspring of depressed parents. These studies have focused on coping, on factors that aid resilience and on preventive interventions designed to promote resilience. Relevant factors have emerged from this review but less is understood about the processes that underlie resilience. Further research is needed to increase our understanding of both why and how some offspring of depressed parents show positive adaptation despite being at risk.

An emerging literature consistently shows that individuals with Pervasive Developmental Disorder (PDD) experience higher rates of mood and anxiety difficulties than typically developing populations. The current review considers the evidence for the increased relative prevalence rates and addresses the queried validity of such diagnoses in PDD populations. The complex issue of assessment in this population, particularly with regards to self-report, is discussed. The evidence that psychiatric co-morbidity forms part of the broad autism phenotype is also reviewed. Possible etiological factors are then explored, including the hypothesised role of self- concept and friendships. The implications of these findings for the understanding of and assessment of PDD are presented.

This thesis explores the characteristics, role and manipulation of negative overgeneralisations in depression. The empirical studies conducted as part of this thesis set out to fulfil three main objectives: firstly, to investigate whether overgenerality to positive and negative cue words is a function of the autobiographical memory test (AMT) itself, rather than an accurate representation of memory recall in depression. The second objective was to explore the mechanism proposed in Brewin's dual representation theory (DRT 1989). A sad mood induction procedure followed by a scrambled sentences paradigm were used to investigate whether reducing access to generalised negative situationally accessible memories, by encouraging participants to consider their mood within a broader context, could reduce the effects of negative primes on despondent mood. Thirdly, building on the previous objective of using contextual information to reduce despondency, a training paradigm was developed to assess whether currently-dysphoric participants' despondent mood could be reduced by inducing a contextual interpretation bias. In line with prediction, data suggest that overgeneral thinking in response to positive cue words may be an artefact of the AMT, or of a particular style of thinking induced by experimental tasks rather than a stable characteristic of depression. In relation to the second and third objectives, findings were mixed and limited support for Brewin's DRT found. Successful reduction of despondency using tasks that encourage participants to consider contextual information about negative events was confounded by several limitations. Limitations of the methods employed are discussed and the implications of the findings in relation to current research are considered. The incorporation of contextual training tasks, after further development, in to therapy for depression is suggested.

The regulation of emotion is central to human functioning and may play a particular role in the processing of traumatic material. This review provides an outline of the empirical literature surrounding emotion regulation. It then considers this research in relation to the continuum of experiential avoidance, which ranges from the evasion of unwanted internal experience to its non- judgemental acceptance. The main models of Posttraumatic Stress Disorder (PTSD) are then introduced and the insight they provide into emotion regulation in the condition is considered. Finally the relationship between experiential avoidance and PTSD is explored and suggestions for future research are made.

Non-suicidal self-injury (NSSI) is a destructive act to oneself that may be related to low self-esteem. However, little is known about the nature of this relationship in adulthood. Therefore, this review synthesized the available literature. Articles were independently identified and risk of bias assessed by two reviewers searching PsycINFO, CINAHL, Medline and Web of Science databases. Inclusion criteria were: (1) a mean sample age of eighteen years or over (2) full manuscripts available in English (3) assessment(s) of NSSI (4) assessment(s) of self-esteem. Nineteen studies were identified and indicated a significant relationship between low self-esteem and NSSI. Results suggested that although low self-esteem and NSSI are related, there are a number of factors which also influence this relationship. It will be important for clinicians to consider the impact of self-esteem in those seeking support for NSSI. Further research should undertake longitudinal research to better understand the self-esteem and NSSI relationship.

The following thesis examines the role of shame in eating disorder (ED) symptomatology. In doing so, the roles of guilt and social comparison, two mechanisms postulated to accompany shame in the aetiology of ED presentations, are also considered. This thesis consists of two parts: a systematic review and an empirical study.

Understanding of inferences and non-literal language, such as idioms, is critical for successful communication and academic learning. Assessment of inferential and idiom comprehension is essential for children who are showing difficulties in these areas so that appropriate intervention and support can be provided. There is very little information on the typical development of these specific areas of verbal comprehension in the literature and there are very few current assessments of inferential and idiom comprehension for British school-aged children. While many assessments that do exist have face validity, very few are standardised. Some children with comprehension difficulties do well on existing picture-based assessments of verbal comprehension but they demonstrate significant difficulties with more abstract language comprehension. There is a gap in the current battery of assessments available to paediatric speech and language therapists for assessing inferential and idiom comprehension in detail. The primary aims of this thesis were to develop a robust standardised British assessment of inferential and idiom comprehension for 5:00 to 9:11 year-old children, to provide supporting validity and reliability data for the newly devised assessment, to provide normative and statistically significant data for inferential and idiom comprehension in typically developing children aged 5:00 to 9:11, to provide qualitative information on the typical development of these areas of verbal comprehension and to carry out exploratory studies using the new assessment with children with communication impairments. Secondary aims of the study were to examine if there was any relationship between gender and test performance and between socio-economic status and test performance. A new assessment, the Hewitt Inferential Comprehension and Idioms Test (HICIT) was created following a review of the literature and of the existing assessments in these areas of verbal comprehension. A pilot study was carried out with sixty-two 4:06 to 10:06 year-old children in two primary schools in the North West of England. The fourteen section, 210 item pilot test was reduced to the twelve section, 140 item final version of the HICIT. This was then trialled with a further 200 children, aged 5:00 to 9:11, making an overall standardisation sample of 250 children. Normative data were provided from the application of descriptive and inferential statistics to the results. A two-way ANOVA examined the effects of age group and gender on test scores and a one-way ANOVA and post-hoc independent T tests looked at the relationship between socio-economic status and test performance. The construct validity of the test was examined with exploratory and confirmatory factor analyses. These demonstrated a single factor loading and good model fit measurements. The reliability of the test, as assessed by Cronbach’s Alpha was moderate, similar to an existing published British standardised verbal language assessment. Rasch analysis indicated that the internal consistency of the test was good. The inter-rater reliability of 98.6% was excellent. The descriptive and inferential statistics demonstrated that there was a developmental progression between the age groups for inferential and idiom comprehension but that there was no effect for gender. The idioms sub-section was the only section not to reach ceiling scores by 9:11. The results for the relationship between socio-economic status and test scores were inconclusive. Quantitative analysis of the HICIT data demonstrated that the test is a robust assessment of inferential and idiom comprehension. Some sub-tests of the test are more robust with different age groups so different versions of the test could be used with different age groups. Qualitative analysis of the test responses, exploratory case studies using the HICIT to assess four children with communication impairments and feedback from practising speech and language therapists produced useful information on the possible applications of the test and suggested that it could be very useful to assist in differential diagnosis of different types of communication impairments.

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