This thesis describes the process of exploring the therapeutic engagement (TE) experiences of men detained in forensic environments. Therapeutic non-engagement for this hard to reach group can have devastating consequences for themselves, for staff, and to the public. A review of the literature highlighted how individual environments are likely to create specific factors which staff may consider when attempting to engage with men who are detained. There had however been limited investigations into TE from service users’ (SUs) perspectives. To better understand the factors involved in TE for men engaged in medium secure care, an SU informed study was completed to explore the lived experiences of men in a regional UK hospital. Using Interpretative Phenomenological Analysis (IPA), the resultant themes included how SUs experienced occupying different worlds to staff, as well as themes relating to what the individual brings to therapy, what the therapy entails, and having or not having control. The researcher used the resultant themes to comment on the processes of conducting the research by considering their navigation between different worlds of SU research and ethics, and how implementing the findings achieved personal goals.

The concept of recovery in mental health has changed over time and reflects our increased understanding of the factors that are important to service users and mental health professionals in defining recovery. This thesis investigates service user and trainee psychologists’ perspectives of recovery in a community-based project. The first part of this thesis reviews the literature on the development of our understanding of recovery in mental health. The search strategy that was developed yielded 9 studies that met the inclusion criteria and a further 3 studies were added following a hand-search of relevant literature. Four themes were identified that charted the development of our understanding of recovery: i) Recovery over the past decade; ii) Changing Perceptions of Recovery; iii) The rise of service user involvement; and iv) New ways of providing services. The review identified that there was a move from a medical model towards a recovery based model. The second part of this thesis is a Q-methodological study that investigates service user and trainee psychologists’ perceptions of recovery in a community based project. The sample of 23 participants comprised 12 service users and 11 trainee clinical psychologists. Participants sorted 50 statements related to the process of recovery from mental health problems. A Centroid Factor Analysis revealed a 3 Factor Solution. Factor 1 was solely endorsed by trainee clinical psychologists and proposed that understanding and social support is the key to recovery. Factor 2 was solely endorsed by service-users and proposed that attending Growthpoint and medication was the key to recovery. Factor 3 was endorsed by both service-users and trainee psychologists and proposed that attending Growthpoint and personal growth was the key to recovery. A visual representation of the conceptual space is presented through the use of multidimensional scaling. An in depth interpretation of the factors is presented and the implications of the research are discussed. The third part of this thesis is a reflective paper whereby the author uses a narrative approach to compare her experience of recovery from diabetes to the experience of recovery from mental health problems. The author uses Q-Sort methodology to compare factor viewpoints that emerged from the Q-Sort analysis and combines this with the model of Reflective Practice developed by Atkins & Murphy (1994).

This research thesis evaluates existing literature which considers whether offenders who commit violent crime experience psychological trauma as a direct result of their behaviour (‘offence related trauma’). It further explores the experiences of professionals working with such offenders who experience ‘offence related trauma’. Chapter one is a literature review examining ten empirical studies which investigated whether offenders who commit violent crime were traumatised by their actions. The findings revealed that a significant number of offenders experienced ‘offence related trauma’. However, due to methodological limitations these findings need to be considered. The results do pose significant clinical implications for the assessment and treatment of ‘offence related trauma’. Chapter two is an empirical study conducted in a low and medium secure unit which explored the experience of professionals, including those undertaking professional training, working with violent offenders traumatised by their actions. Six professionals participated in the study and the data were analysed using Interpretative Phenomenological Analysis (IPA). Three super-ordinate themes emerged from the data; ‘psychological resilience of professionals’, ‘barriers to engagement’ and ‘managing offence related trauma’. These findings are integral to the application of clinical supervision, staff training and the recovery of offenders. The findings are discussed in detail as well as the clinical implications, limitations and areas for future research. Chapter three offers a reflective account of a novice researcher conducting empirical research and explores the parallel process between participant and researcher. Methodological limitations and ethical dilemmas are also discussed together with the professional and personal impact of this research.

Exercise can improve mood and some facets of cognitive performance acutely and may suppress appetite transiently. Breakfast consumption is associated with mood and memory enhancement and superior control of appetite and body weight. Beneficial pre-exercise nutritional practices for those who exercise for mood, cognitive and appetite benefits, rather than to improve physical performance, have not been well established. Therefore, the current PhD programme aimed to uncover the potential effects of breakfast consumption prior to exercising on cognitive function, mood and appetite later in the day, with a particular focus on recreationally active females, an under-represented population in this area of research. The results from two intervention studies presented in this thesis determined that consuming, compared to omitting, breakfast prior to exercise reduced appetite until the next meal was consumed and abridged mental fatigue in the post-exercise recovery period in active males (Chapter 2) and females (Chapter 5). Active females may choose to undertake morning exercise in a fasted state to avoid discomfort during exercise and due to lack of time (Chapter 3), but postexercise, overall mood positively correlated, and mental fatigue inversely correlated with breakfast size prior to exercise in active females when assessed in a field setting (Chapter 4); however, consuming a lower energy dense breakfast still elicited the aforementioned positive effects, and was preferential to consuming a larger breakfast to avoid cognitive detriments in the afternoon when measured in a laboratory setting (Chapter 5). To conclude, the results from this thesis suggest that consuming breakfast prior to morning exercise is beneficial for post-exercise mood and appetite in both habitually active men and women, but consuming a large breakfast may impair cognitive function after exercise. Consuming a light breakfast pre-exercise may be a particularly beneficial practice for habitual female exercisers who chose to omit breakfast prior to exercise due to lack of time or to avoid discomfort during exercise.

The Neurocognitive Model of insomnia proposes that, through conditioned arousal, individuals with insomnia may experience heightened cortical arousal leading to increased sensory processing of external stimuli and sleep state misperception. This thesis provides a novel contribution to the literature by utilising auditory stimuli to examine the propositions of the Neurocognitive Model as a method of both eliciting and measuring the effects of cortical arousal. Firstly, the effect of noise on sleep was observed within the habituated home environment, evidencing that NREM sleep may be more susceptible to increased arousal through noise comparative to REM. Furthermore, traits typically associated with insomnia showed relationships with sleep disturbance due to noise, indicative that noise may increase cortical arousal. Secondly, the administration of novel noise in a non-habituated laboratory environment was utilised to raise cortical arousal levels in good sleepers to directly test the propositions of the Neurocognitive Model. Results demonstrated that noise altered both subjective and objective sleep along with creating a misperception of sleep onset, albeit not associated with explicit memory of noise stimuli. Finally, utilising individuals assumed to be experiencing heightened cortical arousal (insomnia) and good sleepers, words were administered during sleep onset periods to directly assess the processing and misperception components of the Neurocognitive model. Results demonstrated that both explicit and implicit recognition for words presented during sleep was greater for individuals with insomnia, yet this did not associate with a misperception of sleep. Therefore, this thesis proposes that the Neurocognitive Model could be a model of the effects of raised cortical arousal on sleep of which the two outcome pathways are the processing of auditory stimuli and sleep state misperception. Future research may wish to continue to examine the role of cortical arousal in the context of the Neurocognitive Model as a potential mechanism of sleep state misperception in those with insomnia and vulnerable good sleepers.

This programme of work investigated the psychophysiological pathways that link chronic stress with increased vulnerability for ill health. Data from study one indicated that atypical patterns of cortisol secretion, widely implicated in the aetiologies of severe pathologic conditions, partially mediated the effect of higher perceived levels of stress on greater incidences of the kinds of common health problems that typically affect young otherwise healthy individuals. As a logical next step in the programme, studies two and three looked more closely at the psychophysiological consequences of informal caregiving, one prototypical model for chronic stress. Data indicated that caring for child with autism/ADHD exacts a considerable psychophysiological toll on the carer. Indeed, relative to controls, caregivers reported increased psychological morbidity, greater incidences of ill health and reduced social support. Dysregulated immunity, manifested by higher concentrations of the inflammatory marker, C-reactive protein (CRP) was also apparent in the caregivers. In fact, caregivers’ mean concentrations of CRP satisfied clinical criterion for moderate risk of cardiovascular pathologies, compared with low risk in the controls. However, psychological morbidity and incidences of ill health were reduced in caregivers who reported greater social support. Socially supported caregivers also displayed a steeper cortisol awakening response (CAR), which is indicative of more adaptive endocrine functioning. Therefore, interventions that enhance social connectivity might be effective for alleviating caregiver related stress. However, logistical challenges such as a lack of alternate and reliable supervision make it difficult for caregivers to access support related interventions, most of which are time consuming and based outside the home. Expressive writing on the other hand is a simple and time effective intervention that can run in participants’ homes, and as such, might be especially well suited for informal caregivers. Data from study four indicated that writing about the benefits of caring for a child with autism/ADHD can be applied as a home based intervention, and is associated with clinically meaningful improvements in caregivers’ psychological well being.

There is an abundance of research on the aetiology and maintenance of child sexual offending and many factors have been proposed as being influential, including distorted cognitions. These are the focus of this study, in particular, the underlying implicit theories thought to generate them. Ward and Keenan (1999) hypothesised that child sexual offenders hold five distinct implicit theories which account for the majority of their cognitive distortions, and which they use to make predictions about the meaning of children’s behaviour and underlying desires and intentions. These include Children as Sexual Beings, Nature of Harm, Uncontrollability, Dangerous World and Entitlement. However, it is unclear at the present time whether child sexual offenders with a mental disorder have similar or different cognitions which may have influenced their offending. This aim of the current study was to explore this. Semi structured interviews eliciting cognitions were carried out with 12 adult male high secure child sexual offenders. Content analysis indicated that the majority of the cognitive distortions exhibited by this sample of men could be categorized within Ward and Keenan’s (1999) five implicit theories. Evidence of a possible new implicit theory representing deviant sexual interest in children, Children as Sexually Attractive, was also found. Additionally, child sexual offenders whose offending appeared to be associated with intimacy deficits were not felt to be adequately captured under the Dangerous World implicit theory, and the theme of ‘Lonely World’ was felt to be more suitable to represent this group of men. Diagnosis did not impact upon the presence of implicit theories although content differences were found. Participants with a diagnosis of personality disorder (n = 5; 100%) more commonly articulated cognitions associated with the Children as Sexual Beings implicit theory and reported deviant sexual interest in children. In comparison, participants with a diagnosis of mental illness reported beliefs associated with the Uncontrollability implicit theory (n = 5; 100%), and only two men made reference to symptoms of their mental illness. 2 These preliminary findings appear to support previous studies identifying cognitions and personality as risk factors to sexual offending in men, irrespective of diagnosis. It can be concluded from this that psychosis alone is not a sufficient motivator for sexual offending and cognition appears to play an influential role. This is particularly relevant to those with a mental illness as the majority of research into their sexual offending up to now has mostly focused on the role of psychosis. In terms of assessment and treatment, these findings primarily suggest that implicit theories should be addressed in therapy rather than focusing solely on their surface level cognitive distortions, regardless of diagnosis. Further research is necessary in order to advance understanding of implicit theories in child sexual offenders with a mental disorder before any treatment and assessment tools can be adequately developed. Additionally, future research will build on the limited theories and typologies, particularly for those with a mental illness, which in turn should help to advance the assessment, formulation and treatment of these offenders.

A current theoretical model (Cacioppo & Hawkley, 2009) proposes that lonely people are hypervigilant (i.e. on high alert) to social threats in the social environment. This leads to attention, memory, and confirmatory biases, which undermine the opportunity to develop positive social relationships. This thesis outlines a series of six studies that systematically examine the hypervigilance to social threat hypothesis in loneliness using adult samples. The studies described in this thesis make an original contribution to the loneliness literature and uses different experimental paradigms to examine whether lonely adults are hypervigilant to social threats that are visually presented. Studies 1 and 5 bridge the gap in the current knowledge to examine the visual attention processing of lonely adults to social threat depicted as social rejection stimuli using eye-tracker methodology. Study 2 investigates whether loneliness is associated to eye-gaze and emotion processing utilising a cognitive paradigm. Studies 3 and 4 extend the literature on visual attention processing of lonely adults to investigate the processing of emotional information depicted as facial expressions using eye-tracker methodology. Specifically, study 3 uses a paradigm of four different emotional expressions (i.e. anger, afraid, happy and neutral), and study 4 utilises a face in a crowd paradigm for which different ratios of happy to angry faces were presented. Study 6 extends the work on hypervigilance to social threats depicted as social rejection stimuli to examine how these stimuli are processed by lonely adults in the brain using EEG methodology. Findings from study 1 and 5 suggest that lonely adults show visual attentional biases to social threat stimuli linked to social rejection. Specifically, study 1 findings indicate that lonely adults show a hypervigilance-avoidance pattern of processing towards social rejection stimuli, whilst study 5 findings indicate that lonely adults show disengagement difficulties when processing social rejection stimuli. Study 2 indicates that loneliness is not associated to eye-gaze and emotion processing. Study 3 and 4 provide support that lonely adults are more attentive to angry facial expressions presented as static images. Findings from study 6 indicate that lonely adults detect and process social threats quickly compared to non-social threats in the brain. As outlined in Cacioppo and Hawkley’s theoretical model, the findings of this thesis support the idea that loneliness is related to initial cognitive processes. Specifically, lonely adults are hypervigilant to social threats depicted as angry facial expressions and social rejection stimuli. Thus, the thesis examines an important process within the model. The findings of the thesis can be used to inform ideas for future academic and intervention work in the loneliness field.

Given sport’s increasing political, economic, and social importance, there is an obvious need to develop sporting talent in an efficacious and efficient manner. However, despite their widespread adoption, many talent development systems suffer from poor predicative validity, with a lack of supporting empirical evidence. This thesis sought to identify the key issues associated with effective talent development through both the examination of extant literature and empirical study. First, a series of semi-structured, qualitative interviews were conducted with sporting academy directors, coaches, and clinical psychologists to identify the issues impacting upon development. Wide support was found for the appropriate deployment of Psychological Characteristics of Developing Excellence (PCDEs) throughout, along with several other adaptive constructs. A range of factors deemed maladaptive to talent development were also identified, including issues around mental health. Furthermore, some characteristics were seen to be either adaptive or maladaptive, dependent upon context (termed ‘dual-effect’). Based on these results, and furthering the existing work of MacNamara and Collins (2011), a new psychometric assessment tool was developed to help facilitate effective talent development. Following a process of item generation, cognitive interviews, pilot studies, and exploratory factor analysis, the 7 factor, 88 item Psychological Characteristics of Developing Excellence Questionnaire version 2 (PCDEQ2) was developed. The PCDEQ2 accounted for 40% of response variance, and was subsequently able to accurately predict 72.9% of group membership (i.e., differentiate between those likely to progress to elite sport and those less likely). Accordingly, the PCDEQ2 is able to offer coaches and practitioners an empirically derived, valid and practical way to formatively assess the key psychological constructs that underpin effective talent development, thus informing effective intervention.

Research on former-intimate harassment has focused on associated perpetrator behaviour, particularly physical aggression ( e.g., Coleman, 1997), and on the impact of harassment on victims ( e.g., Sheridan, 2001 ). The current research aimed to contribute to a wider understanding of former-intimate harassment by simultaneously investigating behavioural, dispositional and personality variables, and their roles in harassment perpetration and victimisation, using questionnaire based studies. Study 1 (N = 160 undergraduates; 73 males) assessed whether three levels of harassment (non-, minor or severe) were associated with physical aggression, control, and personality traits. Personality characteristics of, and relationship behaviours engaged in by victims of former-intimate harassment were also investigated. The harassment groups significantly differed on: perpetration of control, physical aggression, and harassment victimisation, and on neuroticism. Discriminant Function Analysis (OF A) correctly identified 66% of cases (n = 83). There were no sex differences in harassment victimisation rates. The majority of victims also reported perpetrating harassment, indicating harassment mutuality. Harassment victimisation was associated with physical aggression and control victimisation, as were victims' use of these behaviours during the intimate relationship, and victims' psychoticism scores. Study 2 aimed to classify the three harasser groups based on undergraduates' responses to measures of jealousy, dependency, attachment, perpetration and victimisation of relationship aggression, and harassment victimisation (N = 177; 50 males). Groups significantly differed on: preoccupied attachment, jealousy, emotional reliance, verbal aggression and harassment victimisation, and physical aggression perpetration. DFA correctly classified 61 % of cases (n = 107). The findings demonstrated the prevalence and mutuality of harassment, and develop understanding of behavioural and dispositional variables that theoretically distinguish harassers. Study 3 investigated a sample of offenders incarcerated for crimes other than harassment, to contribute to understanding of the disparity between the large number of victims' reports of harassment and the relatively few cases proceeding to court. Male prisoners (N = 95) completed the measures from Study 2, and a measure of personality disorder (PD) tendencies. Harassment was common, and groups differed significantly on: harassment victimisation, relationship aggression perpetration and victimisation, fearful attachment, antisocial, schizotypal, and borderline PDs. DF A correctly classified 63% of cases (n = 48). Study 4 utilised crime survey data to examine stalking vi timisation in a large scale population. Victims of stranger stalkers were more likely to be men, and were significantly older than victims of intimate stalkers, who were more likely to be women. Men and women were equally likely to be stalking victims, although men experienced significantly more stalking acts than women did. Generally, there were no sex differences in disclosure of victimisation to a number of sources. Many victims reported that police and government agencies were not responsive enough regarding 'domestic violence'. Five broad conclusions can be drawn from the research findings, relating to: {l) the prevalence of harassment; (2) mutuality of harassment; (3) behavioural associations with harassment; ( 4) traits and dispositions of harassers and victims; and (5) disclosure of, and responses to, victimisation. Implications, limitations, and future research considerations are discussed.