This is the first investigation of Specific Language Impairment (SLI) in Gulf-Arabic (GA) speaking children. The thesis consists of two main sections, in the first one, I discuss the definitions of SLI and the various theories put forward to account for the deficits seen in this population. I also discuss the importance of cross-linguistic investigations of SLI and why studying SLI in GA may prove useful in testing the accounts of SLI that argue for a general processing deficit vs. those that argue for a domain specific account of SLI. The remaining section of the first part is dedicated to describing the various language tests developed to identify children with SLI in GA. These tests were conducted with approximately 88 typically developing children and 26 children with SLI between the age of 4;6 and 9;4 years old. In the second part of the thesis, I report on two experiments investigating syntactic and phonological complexity in GA speaking children with SLI. The first experiment investigates the comprehension of three types of word orders: a canonical SVO, and two word orders that involve fronting of the direct object (OSV and OVS). Results showed that children with SLI differed from the TD groups on the sentences with fronted NP's, but not on the canonical word order. The second experiment involves a nonword repetition test where syllable length and consonant clusters are systematically controlled to contrast the influence of both phonological short-term memory and phonological complexity. The results are consistent with accounts that argue for a significant role of phonological complexity in NWR and question the “centrality” of phonological capacity in nonword repetition. The final chapter summarises the findings of the thesis and its contribution to theories of SLI in general, and to the study of SLI in Arabic in particular.

Background: The antiepileptic drug vigabatrin (VGB) is associated with the development of visual field loss in around 50% of exposed individuals. The mechanisms of VGB retinotoxicity are unknown, and there is continued debate as to the best methods of assessing visual function in VGB-exposed individuals, particularly in those unable to perform perimetry. Methods: 204 VGB-exposed individuals, 90 non-exposed individuals with epilepsy and 90 healthy controls participated. Individuals underwent visual field testing using Goldmann kinetic perimetry and peripapillary retinal nerve fibre layer (ppRNFL) imaging using optical coherence tomography (OCT). Results: A retrospective analysis of the evolution of vigabatrin associated visual field loss (VAVFL) in individuals continuing VGB showed progression of VAVFL in all individuals over a ten-year period. More VGB-exposed individuals were able to perform OCT compared to perimetry. Measures of ppRNFL thickness were found to be highly repeatable in this population. There was a strong correlation between ppRNFL thickness and visual field size suggesting that irreversible VAVFL may be related to loss of retinal ganglion cells (RGCs). Duration of VGB exposure, maximum daily VGB dose, male gender and the presence of a homonymous visual field defect were associated with ppRNFL thinning. The pattern of ppRNFL thinning suggested that ppRNFL loss progresses with increasing VGB exposure. Subtle ppRNFL thinning may occur in discrete areas after exposure to small amounts of VGB, whilst other ppRNFL areas appear to be resistant to large cumulative VGB exposure. The ppRNFL was significantly thinner in non-exposed individuals with epilepsy compared to healthy controls. Factors that may be associated with ppRNFL thinning included the presence of learning disability, MTLE with HS and longer duration of epilepsy. Conclusions: ppRNFL imaging using OCT provides a useful tool to assess VGB-exposed individuals, and can provide an accurate estimate of the extent of VAVFL in the absence of a reliable direct measure of the visual field. Understanding patterns of ppRNFL thinning associated with cumulative VGB-exposure may aid in the early detection of VGB toxicity. Pathophysiological mechanisms of VAVFL are unknown; however, pathology of RGC apparatus is evidently implicated.

Mammalian brains generate complex, dynamic structures of oscillatory activity, in which distributed regions transiently engage in coherent oscillation, often at specific stages in behavioural or cognitive tasks. Much is now known about the dynamics underlying local circuit synchronisation and the phenomenology of where and when such activity occurs. While oscillations have been implicated in many high level processes, for most such phenomena we cannot say with confidence precisely what they are doing at an algorithmic or implementational level. This thesis presents work towards understanding the dynamics and possible function of large scale oscillatory network activity. We first address the question of how coherent oscillatory activity emerges between local networks by measuring phase response curves of an oscillating network in vitro. The network phase response curves provide mechanistic insight into inter-region synchronisation of local network oscillators. Highly simplified firing models are shown to reproduce the experimental data with remarkable accuracy. We then focus on one hypothesised computational function of network oscillations; flexibly controlling the gain of signal flow between anatomically connected networks. We investigate coding strategies and algorithmic operations that support flexible control of signal flow by oscillations, and their implementation by network dynamics. We identify two readout algorithms which selectively recover population rate coded signal with specific oscillatory modulations while ignoring other distracting inputs. By designing a spiking network model that implements one of these mechanisms, we demonstrate oscillatory control of signal flow in convergent pathways. We then investigate constraints on the structures of oscillatory activity that can be used to accurately and selectively control signal flow. Our results suggest that for inputs to be accurately distinguished from one another their oscillatory modulations must be close to orthogonal. This has implications for interpreting in vivo oscillatory activity, and may be an organising principle for the spatio-temporal structure of brain oscillations.

Self-harm, a precursor to suicide, is argued by some to be at epidemic levels within the UK, with alarmingly high prevalence rates, particularly among adolescents. Identified by the Scottish Government (2009) as a National Health priority, there is an urgent need to gain a better understanding of this phenomenon within Scottish populations. This thesis aims to contribute to the body of knowledge in Scotland, by assessing the prevalence of self-harm, whilst making the distinction between non-suicidal and suicidal types, across a wider geographical area than previous research has sampled, surveying participants from early adolescence to adulthood. With an underpinning cognitive behavioural approach, this study investigated both thoughts of self-harm and behaviours and compared those who self-harmed with those who have never selfharmed. Age and gender variations were investigated in addition to various psychological, social and environmental influences, including suicide risk, self-critical style, problem type and difficulty, ‘looked after’ status, contagion and academic self-esteem. This research adopted a cross-sectional approach, surveying three cohorts of students enrolled within full-time education within West Central Scotland. Study 1 sampled 773 adolescent school students aged 11 to 17 years attending mainstream secondary education. Study 2 sampled 140 college students aged 16 to 53 years of age and study 3 sampled 568 university students aged 17 to 58 years of age. Participants completed a self-report questionnaire that collected data on self-harm rates and reasons, suicide / self-harm risk and self-critical style. The analysis of self-harm rates revealed 26% of school students, 60% of college students and 56% of university students had engaged in some form of self-harm. Non-suicidal self-harm was the most common type of self-harm among school students, whilst for the college and university students, engagement in both non-suicidal and suicidal self-harm types was reported most often. In general, adolescent females were found to be more likely to self-harm than males and at greater risk of suicide, however such gender distinctions were not evident among the adult samples. Whilst males were found to engage in less self-harm than females, the difference in rates of self-harm between males and females was less than previous research has reported, therefore this may indicate that the prevalence of male self-harm is underestimated. Adolescents were found to be vulnerable to the effects of contagion; with suicide risk further exacerbated among those who engaged in self-harm themselves. A strong commonality between non-suicidal and suicidal self-harm types was revealed, indicating that those who self-harm without suicidalintent may be at similar risk of suicide to those who self-harm with suicidal intent. Logistic regression analyses were used to determine the relative influence of variables in predicting selfharm. The hated form of self-criticism was found to be a key predictor of self-harm across all three student cohorts. The perceived difficulty of problems was found to be a significant predictor of suicidal self-harm within the adolescent sample and a key predictor of non-suicidal and suicidal self-harm types within the university sample. Suicide related concerns and academic self-esteem were significant predictors of all self-harm types (non-suicidal and suicidal) within the adolescent sample, whilst social influences represented by peer and family relations were significant variables in the majority of self-harm models within the university cohort. This thesis has directly contributed to the understanding of self-harm and in distinguishing between different types, thoughts and behaviours, it has drawn out some key psychosocial elements that underlie self-harm at each stage in its progression, knowledge that benefits the wider research community in this field.

Studies have indicated that many, although by no means all, people with epilepsy have difficulty in adjusting to the disorder, manifest by higher rates of psychological and social problems than amongst the general population. A variety of neurological and environmental factors have been hypothesized to contribute to these consequences. It has been suggested that the severity of seizures may be an important factor in determining psychological and social well-being, but very little research has investigated this empirically. This study was therefore undertaken to investigate the relationship between patient-rated seizure severity and adjustment to epilepsy. If greater seizure severity was associated with poorer adjustment, measurement of seizure severity might provide a suitable means of identifying those patients who could benefit from a psychoeducational intervention programme, and may also serve as a useful measure of treatment efficacy. In addition, the research considered the value of Wright's (1990) comprehensive conceptual model for the definition and assessment of adjustment, as much research in the area of adjustment to chronic illness has suffered from insufficient definition and difficulties with measurement. The results indicated that seizure severity was only weakly associated with psychological and illness-related measures of adjustment. These associations would not be sufficiently strong to allow the proposed use of seizure severity as an indicator of poor adjustment, although there may be some value in using this variable as a measure of treatment efficacy in addition to seizure frequency. The conceptual model of adjustment was found to be of value as a framework for guiding operationalisation and measurement of adjustment. Results tentatively confirmed the associations currently suggested within the model and further additions were proposed. Suggestions for future research are made.

Asperger Syndrome (AS) is considered to belong to the spectrum of autistic disorders. Although people with AS are more cognitively able than many others with autism, they share a number of traits including the social impairments identified by Wing and Gould ( 1979). Problems with processing emotional information may underlie some of these social impairments. Reported difficulties in this area include perceptual deficits which interfere with processing visual cues offered by others, difficulties in matching emotional signals across modalities (e.g. visual, auditory, and contextual), and lack of comprehension about affective information. The present study aimed to investigate the above emotional impairments, and to determine whether an intervention which developed the cognitive skills of adults with AS could compensate for some of these difficulties. Four participants, diagnosed as having AS by a psychiatrist, took part in the study. Each was assessed on emotion-processing tasks before and after finishing a six session intervention focusing on the use of cognitive and behavioural strategies to decipher affective information. Prior to the intervention, the difficulties reported by other studies on matching visual and cross-modal signals of emotional information were generally found, but results for comprehension of verbal terms and recounting emotional experiences were not clearly replicated. Following the intervention, all participants improved on or performed at ceiling level for the visual and cross-modal tasks. Predicted improvement on the comprehension tasks was not always found. It is suggested that although linguistic ability is obviously important in such tasks, exposure to social situations is required if connections are to be made between verbal labels, affective behaviours, and social contexts. Strengths and weaknesses of the overall design are discussed. It is argued that the single-case study approach was useful for revealing operational problems in an efficient manner. However, the small number of participants make it difficult to generalise the findings, and the materials used can be criticised in terms of their reliability and validity. Questions are raised about the potential to generalise improvement found in a controlled environment to more natural settings. It is concluded that although the design can be criticised on a number of counts, the results suggest it is possible to train adults with AS to systematically decipher visual and cross-modal emotional cues using their cognitive abilities. Recommendations for improving the intervention include concentrating on one aspect of emotional processing at a time. In view of the clearer findings for visual and cross-modal processing tasks it is proposed that these areas should be the starting point of an intervention. Further research could determine whether people with AS who have been taught to categorise visual cues in a systematic way can then be taught to link other forms of affective information to these physical images.

In choosing my assignment, I was torn between a focused and well structured essay title (that is, 'Critically discuss the advantages and limitations of protocol driven CBT. .. ') and the present one, which is clearly less defined and more open for interpretation. Although I am usually drawn to structure in most aspects of my life, I felt this time I would choose controversy over structure with the hope that this would drive me to fully engage in the process of writing. A further reason for selecting this essay title is that I have been a service user of mental health services in the past and therefore I felt this would be a useful and interesting opportunity for me to take a closer look at ways of conceptualising mental health within an academic context and from different perspectives. For the purpose of this essay I am going to focus on the issues this essay title raises for me, clinical psychologists and service users. The reason I have excluded psychiatrists is firstly, because it is one area I am not familiar with and secondly, because the subject area of the essay is so vast that I felt it would be important to avoid the risk of writing too broadly. The following essay very much reflects my own journey in positioning my views within such a hotly debated topic. Introduction The essay title makes reference to a picture on the front page of a magazine called the 'The Psychologist' which is published monthly by The British Psychological Society (BPS). The BPS is a professional association for academic, clinical, and other chartered psychologists. The Psychologist features articles on a number of different topics in psychology aimed at expert and non-expert audiences. Some examples of articles that are published might be current research projects, interesting debates and practical and professional issues. Edition 20(5), 2007, of The Psychologist was published as a special issue including a selection of articles written by clinical psychologists, psychiatrists and service-users on the debate of diagnosis of mental illness. The burning book on the front cover is the Diagnostic and Statistical Manual 4th edition (DSM-IV) (American Psychiatric Association, 2000) which is a text that includes psychiatric diagnostic criteria for a range of mental disorders. There are a number of questions that this image raises for me at first glance: What is DSMIV? How is it useful and what are the implications of its use? How did it catch fire? Is anything trying to blow the fire out? What is fuelling the fire? Will it disappear into a pile of dusty ashes and if so what might replace it? In order to answer some of these questions I will begin with a brief background on the Diagnostic and Statistical Manual 4th edition (DSM-IV) outlining some key points on its use and how it operates within a medical framework. I will then discuss what I view as some positive and negative implications of conceptualising mental disorders within a medical model, for example, acting as a short-hand for multidisciplinary teams, a useful tool for containing distressing experiences, self-stigma, social exclusion and diversity. In light of these, I will then draw attention to some issues this topic raises for the way clinical psychologists operate when trying to understand mental health concerns, drawing on the idea of formulation as an alternative or adjunct to diagnosis. I will then continue by exploring alternative models proposed to address mental health concerns, for example Kinderman's psychological model of mental disorder and Zalaquett and colleagues' multicultural model. Lastly, I will end with a section on service-user perspectives and the impact of diagnosis on mental health outcomes.

The physiological response to excessively strong aversive stimuli – the stress response – is relatively maladaptive and leads to various psychopathologies such as anxiety disorders only in a minority of individuals. Our lab has previously shown that severe acute restraint stress heightens anxiety-like behaviour in wild-type but not in the extracellular serine protease, neuropsin, deficient mice. Dissecting molecular changes underlying genotypic differences, our microarray and qRT-PCR approaches revealed that the stress-induced upregulation of glucocorticoid receptor (GR) co-chaperone, Fkbp5, expression in the amygdala is significantly attenuated in neuropsin-/- mice compared to the wild-type mice and attenuated expression can be restored by bilateral intraamygdala injection of recombinant neuropsin. Further, blocking neuropsin cleavage of EphB2 with anti-EphB2 antibody suppressed only neuropsin-mediated but not corticosterone-driven upregulation of Fkbp5 expression in primary amygdala cultures unraveling novel neuropsin-dependent mechanism acting in synergy with the well characterized corticosterone pathway to mediate the robust stress-effect on Fkbp5 expression. Importantly, wild-type mice lacking amygdala specific Fkbp5 exhibit stress protective phenotype in unconditioned anxiety tests. Therefore, this study characterizes and concludes an indispensable role of amygdalar Fkbp5 in stressful episodes developing into anxiety disorders.

A number of theoretical perspectives have been taken in the development of cognitive models of obsessive-compulsive disorder (OCD). Three cognitive models dominate the current literature. These models focus upon: inflated responsibility (Salkovskis, 1985); thought-action fusion (Rachman, 1993); and meta-cognitive beliefs (Wells and Matthews, 1994; Wells, 2000). The aims of this study were to develop a measure of meta-cognition for obsessive compulsive symptoms (the Thought-Fusion Instrument) based on the Wells (2000) domains of meta-cognition, and to establish its preliminary psychometric properties. The research also aimed at examining the association between cognitive factors and obsessive-compulsive symptoms, as a means of evaluating the cognitive models of OCD. In particular, the ability of inflated responsibility and meta-cognitions to predict obsessive-compulsive symptoms was tested. It was hypothesised that responsibility and specific meta-cognitive beliefs would be positively correlated with obsessive-compulsive symptoms. It was also hypothesised that the relationship between responsibility and obsessivecompulsive symptoms would be statistically dependent on meta-cognition. Furthermore, meta-cognitions would correlate with obsessive-compulsive symptoms independently of responsibility. The results demonstrated adequate reliability and validity for the Thought-Fusion Instrument (TFI). All of the hypotheses were supported. The results showed that both responsibility and meta-cognitions were positively associated with obsessive compulsive symptoms. Meta-cognitions emerged as independent predictors of such symptoms whereas responsibility did not. These findings and their clinical implications are discussed in the context of the three theoretical models described. The limitations of the present research are outlined, along with suggestions for future studies.

Huntington’s disease (HD) is a neurodegenerative genetic condition for which a predictive genetic test by mutation analysis has been available since 1993. However, whilst revealing the future presence of the disease, testing may have an adverse psychological impact given that the disease is progressive, incurable and ultimately fatal. The current literature review aimed to explore the published evidence base examining the psychological impact of predictive genetic testing for HD. Based on the synthesis of eight research studies, the process of predictive genetic testing was not found to be psychological neutral with fluctuating levels of distress irrelevant of test result. Methodological weaknesses were identified highlighting the needs of individuals not accessing testing or follow-up services, warranting further assessment. The research study sought to understand the lived experiences of partner carers of individuals diagnosed with HD throughout the disease trajectory. Qualitative interviews were conducted with six carers whose partners were currently accessing HD services. Analysis using Interpretative Phenomenological Analysis (IPA) revealed five super-ordinate themes with 18 sub-themes allowing for idiosyncrasies of respondents’ experiences to be accounted for. Themes were considered in relation to previous literature within HD and parallel fields with clinical implications highlighted. A need for further exploratory and subsequent quantitative research of phenomena was warranted and recommended. The critical appraisal provides the Researcher’s reflective account of the research process.