The postnatal period has long been associated with emotional and mood disturbance. While postnatal depression and psychosis have been well documented, anxiety disorders such as obsessive-compulsive disorder (OCD) are less so. The postnatal period is a high-risk time for the development/exacerbation of OCD (PNOCD) and is characterised by aggressive intrusions about the baby. Aggressive intrusions have also been found in the non-clinical postnatal population and in mothers with postnatal depression (PND). Dysfunctional responsibility beliefs have been implicated in the development of OCD. This research seeks compare PNOCD, PND and non-clinical mothers in terms of intrusive thoughts and responsibility beliefs in order to improve differential diagnosis and obsessive-compulsive symptoms (OC). It is hypothesised that mothers with PNOCD have inflated responsibility compared to the other two groups. In this study, three groups of mothers with PNOCD, PND and a non-clinical group were compared across measures of baby-related intrusions, behavioural responses, responsibility attitudes, beliefs, and obsessive-compulsive symptoms. Results showed that all mothers had intrusions of accidental or deliberate harm in relation to their baby. Mothers with PNOCD were the most distressed by their intrusions. All mothers showed an increase in responsibility beliefs in the postnatal period compared to previous research. Mothers in both clinical groups scored significantly higher than the non-clinical group. Significant differences between mothers with PNOCD and PND were not found . Despite high levels of responsibility beliefs, this did not predict OC symptoms. Intrusions of harm are common in the postnatal period; however, responsibility attitudes and interpretations do not clearly differentiate mothers with PNOCD from mothers with postnatal depression. Findings suggest that a complex relationship exists between mood and QC symptoms. Perhaps a broader conception of postnatal illness, taking into account anxiety, depression and QC symptoms would be a more helpful approach to diagnosis and treatment.

Although compulsive hoarding is often considered a symptom of obsessive compulsive disorder (QCD), the nosology of hoarding has not been fully determined. Hoarding is a heterogeneous syndrome with different experiences and beliefs underlying hoarding behaviour. Recent theorising (Seaman, Qldfield, Gordon, Forrester & Salkovskis, 2010) suggest three belief dimensions underpin hoarding. One may be psychologically indistinguishable from QCD, due to its association with harm avoidance, while two other dimensions are different; hoarding as a result of fear of material deprivation, and attachment disturbances associated with heightened sentimentality in relation to possessions. The role of these hypothesised belief dimensions in hoarding was evaluated in this study, and the association between compulsive hoarding and QCD in relation to several clinically relevant variables, was examined. Employing a measure developed for this study(the Beliefs about Hoarding Questionnaire), it was hypothesised that the distinction between harm avoidance hoarding and hoarding motivated by material deprivation and emotional attachment would be reflected in a group of individuals with hoarding and QCD, and a group with hoarding but without QCD, respectively. Participants were 21 individuals with primary hoarding with QCD and 24 people with compulsive hoarding without QCD. For comparison purposes, the following participants were also recruited: 22 patients with QCD without hoarding, and 21 non-clinical controls. As hypothesised, individuals with hoarding and co-existing QCD reported greater harm avoidance beliefs in relation to possessions compared with a group of hoarders without QCD. Contrary to expectation, however, the hoarding group without QCD did not report significantly greater beliefs associated with material deprivation and attachment 3 disturbance relative to the hoarding with QeD group. Furthermore, the clinical presentation of participants across groups lends further support to the notion that hoarding should be considered a distinct clinical syndrome. The theoretical and clinical implications of these findings, the limitations of the methodology, and suggestions for future research are discussed. 4

Background and Aim: Obsessive compulsive disorder (OCD) is a disabling psychiatric condition. It is characterised by anomalous subjective experience that is seen by sufferers as incongruent with their existing self-narrative and treated as unwanted and irrational; sufferers report being unable to discount its validity and attempt to neutralise it with often elaborate rituals. Current medically based treatments of OCD such as cognitive behavioural therapy report partial successes. In this study the . validity of a sole reliance on a medical ontology is questioned and social constructionist approach to understanding OCD is advanced. The ways that people self-positioned as suffering from OCD construct accounts of agency and responsibility are examined within two online support forums. Method: Two internet fora were used as sources and the data were analysed using a multi-level discourse analysis. Results: A number of discursive practices around agency and responsibility were discerned. Internet posters abnormalized subjective experience which allowed them to problematize its emergence. Agency for the production of problematic aspects of subjectivity was attributed to OCD as an external entity or to aspects of subjectivity that are constructed as external to the speaker's agentic self. These practices worked towards disowning this subjective experience and renouncing responsibility for its negotiation. Internet posters contested consequences for action arising from the problematic experience by orienting to dilemmatic binaries around which experiences could be legitimately termed as the product of OCD and therefore 'not real'. The use of a medical discourse permitted and solidified these practices which were reproduced by support seekers and respondents. A longer extract is presented which demonstrates how a support seeker both appeared to request and consistently discount reassurance about the 'reality' of his experience. Conclusion: These strategies reduce responsibility, but also miniize agency and opportunities for resolution of dilemmas. The discursive constructions consistently lead to circular conversations and linguistic dead ends. It appears that these strategies, largely influenced by a medical discourse, offer some stability; but appear inadequate to resolve sufferers' distress. The implications for psychotherapy are examined.

Objective: To investigate whether there is a causal relationship between moral self-ambivalence and obsessive-compulsive behaviours, as this relationship has previously received only correlational support. Design: The study utilised a between-groups experimental design. There were three conditions, consisting of one experimental and two control groups. Participants: A non-clinical sample was used. For the final analysis, 198 participants were recruited. Participants were recruited through the university and contacts of the principal researcher. Participants were randomly allocated to one condition and completed the study online. Procedures: Participants in the experimental condition completed two manipulation tasks designed to prime moral self-ambivalence; participants in the control conditions completed the same tasks designed to prime general uncertainty or to be neutral. All participants completed a task requiring them to present answers to moral dilemmas. The time taken to complete the moral dilemmas, and number of characters used to do so, was recorded. Statistical Analyses: Factorial, three-way ANOVAs were used to examine differences between the experimental groups. Findings: Priming moral self-ambivalence in participants high in moral self- ambivalence who were also morally 'self-sensitive' led to an increase in the time taken to respond to the moral dilemmas and the number of characters used to do so. The statistical significance of this finding varied depending on which covariates were controlled for and which groups were compared. The finding that number of characters used was higher in the experimental group was consistently significant. Conclusions: Moral self-ambivalence appears to play a causal role in obsessive-compulsive behaviour. Intrusive thoughts in individuals who are morally self-ambivalent and morally self- sensitive may prime their anxiety about themselves, leading to compulsive behaviour designed to address this anxiety. The theoretical and clinical implications of this are discussed, together with limitations of the present study and how these might be addressed in future research.

The sense of agency (SoA) refers to the subjective experience of controlling one's own actions and resultant effects. Recent research has indicated possible underlying SoA abnormalities in people with Obsessive Compulsive Disorder (OGD), although these findings are inconsistent. This study attempted to clarify the nature of SoA alterations for people with subclinical checking tendencies compared with non-checking individuals. This was achieved by measuring both explicit and implicit aspects of the SoA in two separate tasks. In a 'Judgement of Agency' task, participants first engaged in a learning phase in which associations between actions (button press) and effect (tone type) were established. In the subsequent testing phase, the degree by which the tone following the action matched participants' learned expectations was varied. Participants provided SoA ratings for each trial. The checking group (n = 20) recorded significantly higher agency judgements than the non-checking group (n = 22), indicating a greater explicit sense of agency. The second task required participants to make time estimates for their actions and resultant effects, which provided a measurement for the subjective temporal compression of the interval between an action and effect. This phenomenon is known as 'Intentional Binding', and is recognised as an implicit measure of SoA This intentional binding effect was greater for the checking group (n = 22) compared with the non-checking group (n = 23). Together, these findings indicate that subclinical checkers experience greater explicit and implicit SoA compared with non-checking individuals. The findings are discussed in relation to previously described cognitive features of OCD such as intolerance of uncertainty, inflated sense of responsibility, and feelings of incompleteness. Potential implications for clinical practice are explored.

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Through examining evidence for an extant model of compulsive hoarding and considering the experience of professionals working with hoarders, this thesis improves current understanding of hoarding and the approach professionals take to its treatment. Section 1. The literature review considers empirical evidence for emotional attachment to objects, proposed as one of four key constructs in determining hoarding (Frost & Hartl's, 1996). Differences in emotional attachment to objects in hoarders compared to control populations, the impact of intervention on emotional attachment and evidence regarding the nature of emotional attachment in hoarding are considered. The paucity of research and methodological limitations inherent in this field are highlighted. Theoretical and clinical implications of the review findings are outlined. Section 2. The empirical report considers the experience of professionals working with hoarders using a Q-methodological approach. Interviews with professionals (N=5) experienced in hoarding were analysed using thematic analysis to develop a 49-item Q-set. Subsequently, professionals with experience of working with hoarders (N=36) participated in the Q-sorting task. Q-analysis and factor interpretation evidenced three distinct clusters of professionals: (1) therapeutic and client focused, (2) shocked and frustrated and (3) accepting but task focused. Directions for future research and clinical implications are highlighted.

Background: Accommodation of symptoms related to obsessive compulsive disorder (OCD) is common and has been associated with greater OCD symptom severity. in addition to poorer treatment outcome. Levels of accommodation also seem to be associated with family/carer mental health. However, not all families/carers accommodate the OCD symptoms to the same degree and it remains unclear as to why this variability in levels of accommodation exists. Aims: This study examines a theoretical model that suggests accommodating behaviours mediate the relationship between distress tolerance (more specifically, intolerance of uncertainty (IU) and tolerance of negative emotions; TNE) in a significant other living with someone with OCD and OCD symptom severity. Method: Thirty two adults experiencing symptoms of OCD and someone who lived with them completed a survey comprising of screening questions, demographic information and self-report questionnaires (total N=64). Results: The mediation analysis found that the 95% confidence intervals crossed zero, showing that levels of relational accommodation did not significantly mediate the relationship between IU or TNE in the significant other and OCD symptom severity. Furthermore, IV and TNE did not significantly predict levels of accommodation to the OCD symptoms. Levels of accommodation predicted OCD symptom severity (p<.05), but this did not remain significant when controlling for mental health in the significant other living with someone with OCD.

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No description available.