Depression is a common and disabling condition which is often treated with antidepressant medication within the primary care setting. There is growing interest in the possibility that non-pharmacological treatments such as physical activity could lead to a reduction in depressive symptoms. A pragmatic, multi-centre, two-arm, parallel, individually-randomised controlled trial investigated the effectiveness of a facilitated physical activity intervention as an adjunctive treatment to usual care for adults presenting to general practitioners with depression. The intervention comprised three face-to-face sessions and ten telephone calls with a Physical Activity Facilitator over an 8-month period. The primary outcome was depressive symptoms assessed using the Beck Depression Inventory at 4-month follow-up. Secondary . outcomes included quality of life, prescription and use of antidepressants and physical activity at 4-, 8- and 12-months post-randomisation as well as longer term depressive symptoms measured at the 8- and 12-month end-points. 361 patients with a depression diagnosis were recruited from 65 general practices in Bristol and Exeter. Adherence to the intervention was good, with 71 % of those offered the additional treatment receiving an 'adequate dose'. The primary comparative analysis indicated an adjusted between-groups difference in means of -0.54 points (95% CI -3.06 to 1.99; p=0.68) on the Beck Depression Inventory at 4-month follow-up. There was no evidence that the intervention influenced the prescription or use of antidepressants or made any impact on quality of life at any stage. However, there was a significant increase in the amount of physical activity reported by the intervention group (OR = 2.27, 95% CI 1.32 to 3.89; p=0.0003) over the course of the 12-month trial compared to the usual care group. It was clear that adding a facilitated physical activity intervention to usual care did not benefit depression outcomes and that, consequently, it should not be recommended as a treatment option within UK primary care.

This thesis is an examination of the idea that dyslexia is a heterogeneous condition and can be characterised by distinct subtypes. The thesis contains four studies conducted on a sample of 41 dyslexic children and around 300 normally reading children. The first three are concerned with the theory that the dual route model of reading applies to developing as well as adult reading. Study One used a regression outlier approach to compare children's nonword reading and irregular word reading and found that roughly equal incidence of surface and phonologica l dyslexia can be found in children. Study Two found, via path analysis of component reading tasks in normal readers, that a particular well-used reading test is inappropriate for use in some studies of surface dyslexia, and Study Three showed, via analysis of predicted word reading ability compared to age, that the dual route model is capable of predicting children's reading performance. Study Four was an investigation of the hypothesis that some dyslexic children have naming speed deficits rather than phonological deficits and the further hypothesis that surface dyslexia and naming speed dyslexia are two manifestations of the same condition. Use of the regression-outlier approach to compare naming speed, nonword reading and irregular word reading found limited support for these hypotheses. The thesis shows that the dual route theory is applicable to developing reading and that dyslexia is characterised by heterogeneity. Future research should bear in mind the diverse nature of dyslexics and attempt to explain this diversity.

Disordered eating, binge eating and other related eating problems are increasing around the world, and a greater understanding about the psychological variables that influence eating is required to improve the understanding and treatment of these non-clinical conditions. This study investigated internal, external, and experiences of shame, and self-compassion in a non-clinical sample (n =327) of adults who presented with disordered eating and who binged, while controlling for anxiety and depression. Results demonstrated a statistically significant difference in levels of shame, self-compassion, anxiety and depression between adults who binge ate and adults who did not. Spearman's rho calculations demonstrated positive correlations for binge eating with internal shame, external shame, experiences of shame, anxiety, depression, and self-compassion. Three logistic regressions demonstrated internal shame, experiences of shame, and depression significantly predicted binge eating. Spearman's rho calculations demonstrated positive correlations for disordered eating with the predictor variables of internal shame, external shame, experiences of shame, anxiety, depression, and self-compassion. Three multiple regressions demonstrated a significant association between disordered eating and all three measures of shame, depression, and anxiety. The findings of this study are considered in the context of the recognition of a need for longitudinal research to further explore the causal influences in the development and treatment of disordered eating and binge eating in non-clinical adults.

Background: Eating disorders are serious mental health conditions and premature treatment termination from eating disorder services is high. Therefore the development of suitable psychological therapies is essential. Autism Spectrum Disorder (ASD) traits have been noted as higher in eating disordered populations compared to control groups. As a result, it is important to discover whether high traits of ASD affect an individual's ability to adhere to treatment. Objective: The aim of this study was to investigate whether traits of ASD are related to the premature termination of treatment in eating disorder populations. Method: 71 participants were recruited from two eating disorder services. Participants completed a battery of questionnaires investigating ASD traits, disordered eating and clinical co-variates. Participants also completed four neuropsychological tasks that investigated cognitive traits associated with ASD. A sub-group of participants completed the Diagnostic Interview for Social and Communication Disorders (DISCO) to investigate whether high traits of ASD in eating disorders would relate to categorical ASD. Results: The overall rate of premature termination of treatment was 37.5%. High ASD traits were found to be predictive of treatment completion (p=.036 at logistic regression analysis). Also, a significant positive correlation was discovered between obsessive compulsive traits and ASD traits (p=.001). However, it was also discovered that obsessive-compulsive disorder features significantly decreased with weight gain, whilst ASD features remained constant. Overall 28.1% of participants met criteria for high ASD features (Autism Spectrum Quotient (AQ) score >=26). Ten percent of participants met screening criteria for possible categorical ASD (AQ score >=32) and 2.86% met criteria for categorical ASD using DISCO analysis/previous diagnosis. Conclusion: Those who reported higher ASD levels were more likely to adhere to treatment. However, treatment completion does not necessarily mean recovery. Longitudinal research is needed to follow up on participants of this study to examine recovery and ASD traits.

Scrupulosity is a disorder characterised by the presence of religious or moral obsessions and compulsions, which poses significant treatment challenges largely due to reluctance of individuals to seek help. An area missing from the literature on scrupulosity is how families and significant others conceptualise the disorder and how they may accommodate it. The current study uses Interpretative Phenomenological Analysis (IPA) to explore the experience of family members and close friends of people with scrupulosity. Three case studies are presented with an overview of pertinent themes across cases. Findings include the importance of demarcating the boundary between religious devotion and obsession in understanding and managing scrupulosity for significant others. A shared faith between the scrupulous individual and their significant other impacts how this boundary is both understood and managed, as well as the perceived authority of the significant other in challenging scrupulous beliefs and actions.

Research into Obsessive Compulsive Disorder (OCD) has shown that when highly valued se1f-domains, such as morality, are threatened, repetitive behaviours may be performed to resolve uncertainty about the se1f (Doron, Sar-El & Mikulincer, 2012). However, few attempts have been made to understand the emotional link between self.domain threat and certainty striving. Given that shame and guilt arise when discrepancies occur between one's standards and one's actual performance, it can be hypothesised these emotions emerge following se1f-domain threat. A between-participants experimental design was employed to test the hypothesis that shame and guilt mediate the relationship between se1f-domain threat and certainty striving. Fifty-two participants (20 male, 32 female, M=26.17 years, SD=7.07) were randomly allocated to one of three conditions in which either their sense of morality or competency was threatened or no threat to se1f was evident. State shame, guilt and pride were measured via a se1f-report questionnaire followed by tasks operationalising certainty striving and dehberation. Results indicate that both experimental groups reported significantly higher ratings of guilt and lower ratings of pride compared to the no threat group, as expected. However, groups did not differ significantly in shame ratings. In terms of certainty striving and dehberation, there was little evidence of a difference between experimental groups except for dehberation in the task with the greatest level of ambiguity when a near significant difference emerged for the competency group only. The results of the current study suggest that increased guilt and decreased pride might be consequences of se1f-domain threat. Given the null findings regarding certainty striving behaviour, further replication is required with different operationalisations of this variable.

Objective: Current research suggests there are many individuals with Autism Spectrum Conditions (ASC) who desire friendships with their peers. However they are unable to engage in such relationships because they often lack the social skills required. Peer rejection and a paucity of childhood friendships in those with ASC has been linked to negative longer term outcomes such as depression and anxiety. Over the last decade there has been· an emerging body of qualitative research which has elicited a small number of instances where individuals with ASC have formed long lasting and stable friendships with their peers. At present the current qualitative literature appears incomplete and often hampered by methodological constraints inherent with the social difficulties which characterise those with ASC. The objective of this study was to increase our understanding of how young people with ASC experience and understand their friendships and how these relationships have developed throughout their lives. Design: This study adopted a semi-structured interview design comprising two thirty minute interviews. Interview data was transcribed and analyzed using the qualitative methodology of Interpretive Phenomenological Analysis. Participants: Ten boys aged between ten and fifteen years took part in the study. All participants had a formal diagnosis of an ASC and attended the same specialist educational provision.

This Portfolio is a collection of work spanning three years of training on the Practitioner Doctorate course in Psychotherapeutic and Counselling Psychology at the University of Surrey. The Portfolio comprises three dossiers pertaining to academic work, therapeutic practice and research respectively and aims to demonstrate the range of competencies and skills that I have developed across these three areas. Three essays are presented as part of the Academic Dossier. These have been selected to evidence my psychological understanding of child psychodynamic therapy, models of human distress and cognitive-behavioural therapy. The Therapeutic Practice Dossier outlines the three clinical placements that I have undertaken and the skills that I developed at each alongside my personal reflections. Additionally, it contains my Final Clinical Paper, which details my personal and professional development over the training and my understanding of Counselling Psychology. Finally, the Research Dossier contains three pieces of research; a critical literature review and two pieces of empirical research. Each piece is concerned with the sibling relationship in the context of eating disorders and represents a different type of methodological enquiry; a critical literature review using thematic synthesis, a thematic analysis of interview data and finally a quantitative analysis of questionnaire data. Family members of those with mental illnesses often report experiencing stigma as a result of this association. Studies of family stigma identify stereotypes of blame, shame and contamination. No studies have investigated family stigma towards adolescent siblings of those with Anorexia Nervosa. 232 adolescents (mean age=16.83yrs) completed measures of knowledge of eating disorders, familiarity with eating disorders, compassion, stigma towards those with Anorexia Nervosa and family stigma towards siblings. The data indicates that adolescents do not stigmatise those with Anorexia Nervosa or their siblings. Stigma is more strongly endorsed by males, 'non-white' participants, those less knowledgeable about eating disorders and without interpersonal contact with eating disorders. Compassion was negatively correlated with stigma. These individual differences are likely interconnected and have, implications for the design and implementation of anti-stigma programmes.

This portfolio is divided into three sections; the Academic Dossier, the Therapeutic Practice Dossier and the Research Dossier. Contained herein are papers I have written during my three years of doctoral training, capturing aspects of my personal and professional development during the course. The Academic Dossier comprises of three selected essays. The first paper presents a critique of a chosen text, unpacking the author's account of Roger's condition 'congruence' in therapy. The second essay draws on psychoanalytic theory and practice. This piece of work outlines how one might work psychoanalytically with an individual presenting with Anorexia Nervosa, using hypothetical case examples. The third essay explores the Systemic Cognitive Behavioural Therapeutic framework, as applied to working with children and adolescents, drawing on personal clinical experience. The Therapeutic Practice Dossier places focus upon my personal clinical experience spanning the three years of training. Outlined here is an account of my three clinical placements, and my Final Clinical Paper. This paper provides a personal reflection on my experience as a developing Counselling Psychologist, bringing together how theory, research and clinical practice have shaped this learning process. Finally, the Research Dossier contains a literature review and two qualitative research reports investigating the father-daughter relationship and anorexia nervosa. Primarily, the literature review explores various theoretical modalities and existing literature, to provide a coherent . rationale for the importance of research study on this topic. Following this, the first research report is an Interpretative Phenomenological Analysis that explores the nature of the father . daughter relationship and Anorexia Nervosa, from the recovered daughter's perspective. Finally, the second research project places focus on the investigation of the father-daughter relationship and Anorexia Nervosa from the father's perspective, using a Grounded Theory methodology.

Inferential confusion is a reasoning process observed in obsessive compulsive disorder (OeD) which is defined by a distrust of reality-based information in favour of imagined possibilities. Studies have shown inflated self-reported inferential confusion in mixed-anxiety populations. The current study hypothesised that individuals high in social anxiety (RSA) would be more influenced by possibilitybased information than those low in social anxiety (LSA). 1.2 DESIGN A quasi-experimental design was utilised. Participants completed the Inference Processes Task (IPT) that required them to make probability-based judgements (inferences) based upon possibility- and reality-based information for situations that typically trigger worries regarding social anxiety, OeD, and non-disorder based scenarios. Participants also completed self-report measures of social anxiety, inferential confusion, OeD symptoms, and general distress. 1.3 PARTICIPANTS On the basis of a self-report measure of social anxiety, participants were classified as either high (n = 102) or low (n = 68) in social anxiety. Participants were recruited using online advertisements on internet forums and social media websites.