Although recent research has demonstrated that intrusive memories of negative autobiographical events are an overlapping cognitive feature of depression and PTSD, there is still a general paucity of research investigating the prevalence and maintenance of these memories in depression. Accordingly, the current thesis represented a much-needed program of empirically-driven research that delineated the cognitive processes that underpin the manifestation, experience, and persistence of intrusive memories in depression. Firstly, Study 1 used descriptive and correlational methodologies to outline the content and features of these memories, and explored whether intrusion characteristics linked to intrusive memories in PTSD are also features of intrusive memories in depression. In accord with studies in PTSD samples, sensory features accounted for unique variance in the prediction of depression severity, over and above that accounted for by intrusion frequency. This commonality raised the possibility that cognitive management strategies linked to the persistence of intrusive memories in PTSD may also play a role in depression. Accordingly, Study 2 utilized a cross-sectional and prospective design to investigate whether negative appraisals and cognitive avoidance strategies, which are key to the persistence of intrusive memories in PTSD, similarly play a role in depression. The results demonstrated that assigning negative appraisals to one???s intrusive memory, and attempts to control the memory, were positively associated with intrusion-related distress, level of depression, and cognitive avoidance mechanisms. Additionally, negative appraisals and the use of cognitive mechanisms were predictive of depression concurrently, but not prospectively. Studies 3, 4, and 5 further investigated avoidant intrusion- response strategies by assessing the role of recall vantage perspective in mediating the effects of intrusion-related distress. Study 3 found that although field memories were not experienced as more distressing than observer memories, the results supported an association between an observer vantage perspective and cognitive avoidance mechanisms. As this study employed a correlational design, Study 4 addressed the question of directionality by experimentally manipulating mode of recall to ascertain whether shifting participants into a converse perspective would have differential effects on the reported experience of their intrusive memory. Results indicated that shifting participants from a field to an observer perspective resulted in decreased experiential ratings; specifically, reduced distress and vividness and increased detachment and observation. Also, as anticipated, the converse shift in perspective (from observer to field) did not lead to a corresponding increase in experiential ratings, but resulted in reduced ratings of observation. Study 5 attempted to investigate the stability of this memory orientation phenomenon by investigating mode of recall vantage perspective prospectively. Attrition of participants across the 12-month study limited analyses to the descriptive level, but illustrated that, at least for some individuals, recall vantage perspective remained stable across assessments periods. Collectively, the findings supported the notion that recall perspective has a functional role in the regulation of intrusion-related distress and represents a cognitive avoidance mechanism. Studies 6 and 7 employed experimental methodologies to investigate whether adopting an abstract/analytical mode of processing following a negative event would result in poor emotional processing, or increased distress associated with intrusive memories. Study 6 found no differences in either intrusion frequency or associated levels of distress across the processing conditions, as hypothesized. The results of Study 6 suggested that the predicted effects of ruminative self-focus on intrusion severity may be dependent upon the self-referential nature of the material being processed. Results of Study 7 indicated that inducing an analytical ruminative mode of processing resulted in participants rating their naturally occurring, self-referential intrusive memories as more negative, more distressing, and evoking a more negative emotional response compared to inducing distraction. Taken together, Studies 6 and 7 suggest the possibility that depressed individuals may get caught up in a ruminative cycle that, due to the documented effects of analytical self-focus, may exacerbate the emotional response elicited by the intrusions and perpetuate biased attentional focus towards them. Finally, Studies 8 and 9 explored suppression as a cognitive avoidance mechanism and addressed some methodological concerns regarding the measurement of this construct. Study 8 investigated the effects of repeated suppression using a method to index the frequency, duration, and associated levels of distress of an experimentally-induced intrusive memory, and assessed whether any observed effects were differentially linked to depressive symptomatology. Results supported a secondary rebound effect in those participants who were most successful at suppressing target intrusions. Study 9 was an investigation of the English version of the TCAQ (Luciano, Algarabel, Tom??s, & Mart??nez, 2005), an index of cognitive control. Study 9 evaluated the association between this measure and performance on a thought suppression task. The results indicated that low TCAQ-20 scorers experienced intrusions of a longer duration and rated these intrusions as more distressing than high TCAQ-20 scorers, supporting the validity of the measure. These findings highlight the role of suppression as a maladaptive mental control strategy and the potential for elevated intrusion-distress to perpetuate its use. Together, the findings of this program of research confirm the importance of intrusive memories in depression, and underscore the need for an empirically-supported model to account for the occurrence and maintenance of these memories.

Although recent research has demonstrated that intrusive memories of negative autobiographical events are an overlapping cognitive feature of depression and PTSD, there is still a general paucity of research investigating the prevalence and maintenance of these memories in depression. Accordingly, the current thesis represented a much-needed program of empirically-driven research that delineated the cognitive processes that underpin the manifestation, experience, and persistence of intrusive memories in depression. Firstly, Study 1 used descriptive and correlational methodologies to outline the content and features of these memories, and explored whether intrusion characteristics linked to intrusive memories in PTSD are also features of intrusive memories in depression. In accord with studies in PTSD samples, sensory features accounted for unique variance in the prediction of depression severity, over and above that accounted for by intrusion frequency. This commonality raised the possibility that cognitive management strategies linked to the persistence of intrusive memories in PTSD may also play a role in depression. Accordingly, Study 2 utilized a cross-sectional and prospective design to investigate whether negative appraisals and cognitive avoidance strategies, which are key to the persistence of intrusive memories in PTSD, similarly play a role in depression. The results demonstrated that assigning negative appraisals to one???s intrusive memory, and attempts to control the memory, were positively associated with intrusion-related distress, level of depression, and cognitive avoidance mechanisms. Additionally, negative appraisals and the use of cognitive mechanisms were predictive of depression concurrently, but not prospectively. Studies 3, 4, and 5 further investigated avoidant intrusion- response strategies by assessing the role of recall vantage perspective in mediating the effects of intrusion-related distress. Study 3 found that although field memories were not experienced as more distressing than observer memories, the results supported an association between an observer vantage perspective and cognitive avoidance mechanisms. As this study employed a correlational design, Study 4 addressed the question of directionality by experimentally manipulating mode of recall to ascertain whether shifting participants into a converse perspective would have differential effects on the reported experience of their intrusive memory. Results indicated that shifting participants from a field to an observer perspective resulted in decreased experiential ratings; specifically, reduced distress and vividness and increased detachment and observation. Also, as anticipated, the converse shift in perspective (from observer to field) did not lead to a corresponding increase in experiential ratings, but resulted in reduced ratings of observation. Study 5 attempted to investigate the stability of this memory orientation phenomenon by investigating mode of recall vantage perspective prospectively. Attrition of participants across the 12-month study limited analyses to the descriptive level, but illustrated that, at least for some individuals, recall vantage perspective remained stable across assessments periods. Collectively, the findings supported the notion that recall perspective has a functional role in the regulation of intrusion-related distress and represents a cognitive avoidance mechanism. Studies 6 and 7 employed experimental methodologies to investigate whether adopting an abstract/analytical mode of processing following a negative event would result in poor emotional processing, or increased distress associated with intrusive memories. Study 6 found no differences in either intrusion frequency or associated levels of distress across the processing conditions, as hypothesized. The results of Study 6 suggested that the predicted effects of ruminative self-focus on intrusion severity may be dependent upon the self-referential nature of the material being processed. Results of Study 7 indicated that inducing an analytical ruminative mode of processing resulted in participants rating their naturally occurring, self-referential intrusive memories as more negative, more distressing, and evoking a more negative emotional response compared to inducing distraction. Taken together, Studies 6 and 7 suggest the possibility that depressed individuals may get caught up in a ruminative cycle that, due to the documented effects of analytical self-focus, may exacerbate the emotional response elicited by the intrusions and perpetuate biased attentional focus towards them. Finally, Studies 8 and 9 explored suppression as a cognitive avoidance mechanism and addressed some methodological concerns regarding the measurement of this construct. Study 8 investigated the effects of repeated suppression using a method to index the frequency, duration, and associated levels of distress of an experimentally-induced intrusive memory, and assessed whether any observed effects were differentially linked to depressive symptomatology. Results supported a secondary rebound effect in those participants who were most successful at suppressing target intrusions. Study 9 was an investigation of the English version of the TCAQ (Luciano, Algarabel, Tom??s, & Mart??nez, 2005), an index of cognitive control. Study 9 evaluated the association between this measure and performance on a thought suppression task. The results indicated that low TCAQ-20 scorers experienced intrusions of a longer duration and rated these intrusions as more distressing than high TCAQ-20 scorers, supporting the validity of the measure. These findings highlight the role of suppression as a maladaptive mental control strategy and the potential for elevated intrusion-distress to perpetuate its use. Together, the findings of this program of research confirm the importance of intrusive memories in depression, and underscore the need for an empirically-supported model to account for the occurrence and maintenance of these memories.

Intrusive memories, coping strategies, negative appraisals, and perceptions of control were examined in an unselected undergraduate sample. Intrusive memory frequency was positively associated with emotion-avoidant coping, but unrelated to problem-focused and emotion-approach coping. Negative appraisals and perceptions of control partially mediated the relationship between intrusive memory frequency and emotion-avoidant coping. PTSD symptoms contributed additional variance to the partial mediation models. Overall, study findings demonstrated that the intrusive memory maintenance cycle found in PTSD and depression samples can exist in an unselected sample. Individual differences within this sample may relate to varying levels of executive control and trait mindfulness. Implications for clinical practice, limitations, and directions for future research are discussed.

Sleep is a complex process: the timing of sleep is regulated by two systems (the sleep homeostat and the circadian clock) and there are many potential functions of sleep. The aim of this thesis was to investigate: the impact of light on the regulation of sleep timing (study 1) and the role of sleep in emotional processing (study 2). Study 1 used natural variations in environmental light levels at different geographical locations, to examine the influence of daily light irradiance on sleep timing and chronotype using the Munich chronotype questionnaire (MCTQ). 6443 students were included in this study from six universities from the northern and southern hemispheres. Students in southern hemisphere cities had earlier sleep timings than those in the northern cities. Daily irradiance was higher in the southern hemisphere cities. The amount of time spent outside, age and sex, but not daily irradiance, influenced sleep timings. Study 2 explored the impact of an analogue traumatic event (trauma film) in students who were either sleep deprived or not sleep deprived on intrusive memories ("flashbacks"), sleep physiology and the impact of an increased risk of a mood disorder on this relationship. In this study the sleep deprived participants (n=19) reported fewer intrusive memories to the trauma film than those not sleep deprived (n=22). A change in sleep physiology was observed in the first sleep period following the trauma film, which was more pronounced in the sleep deprived group: increased levels of arousal, REM density and activity in the occipital region. Only three participants at-risk of a mood disorder completed study 2: their data are presented as case studies. In conclusion this research has demonstrated that differences in sleep timings exist between cities in the southern and northern hemispheres and has confirmed that many factors can influence sleep timing. It has also been demonstrated that following a highly emotional event not sleeping may have a beneficial effect, which has implications for the treatment of people after trauma.

The present study investigates the effects of cognitive inhibitory mechanisms and tendency to suppress thoughts on the frequency and intensity of traumatic intrusions within the trauma film paradigm. Non clinical participants&rsquo / response inhibition and proactive inhibition levels and tendency to suppress thoughts were measured prior to exposure to a trauma film. One week after seeing the trauma film, participants reported the frequency and intensity of trauma film related intrusions with an intrusion diary and Impact of Events Scale. No significant effect of response inhibition, proactive inhibition and thought suppression tendency was found on the frequency and intensity of trauma film related intrusions. Findings of the study are discussed.

No description available.

Intrusive memories are memories for negative autobiographical events that come to mind without being deliberately recalled (Hackmann, Ehlers, Speckens, & Clark, 2004). Previous research has demonstrated that intrusive memories, and negative reactions to intrusive memories, are an important feature of depression (Starr & Moulds, 2006; Williams & Moulds, 2008b) and contribute to the maintenance of depression longitudinally (Newby & Moulds, 2011c). It has also been established that intrusive memory experience is related to individual differences in cognitive control, specifically in proactive interference resolution (Verwoerd, Wessel, & de Jong, 2009; Verwoerd, Wessel, de Jong, Nieuwenhuis, & Huntjens, 2011). The present thesis aimed to extend upon these existing findings, using the Dual Mechanism of Control theory, which distinguishes between proactive and reactive modes of control (Braver, Gray, & Burgess, 2007). Furthermore, in view of some recent ambiguity of the defining feature of an intrusive memory, as compared to a negative involuntary memory more generally (Kvavilashvili, 2014; Moulds & Krans, 2015), another goal of the thesis was to incorporate a wider focus of involuntary memories, rather than focusing only on traditionally studied intrusive memories. Participants from the student population and local community were tested. Overall, results provide some evidence for a negative involuntary memory related deficit in proactive control, on both a classic and an emotional version of the AX-Continuous Performance Task (AX-CPT). Conversely, there was no link between intrusive or involuntary memory experience and reactive control. A brief mindfulness and self-compassion based intervention, designed to reduce negative reactions to intrusive memories, was also tested. The intervention was successful in reducing intrusive-memory distress, and recommendations for the future development of the intervention are presented.

Critical Review of the LiteratureCan Borderline Personality Disorder be treated effectively in forensic settings? A systematic reviewBorderline Personality Disorder (BPD) is a common diagnosis in forensic settings. Certain features of BPD, such as impulsivity and emotional dysregulation, can create a vulnerability to impulsive acts. The condition is also associated with poor mental and physical health, making the treatment of BPD and its clinical features an important goal in forensic settings. This paper reviews evidence for the effectiveness of treating BPD and its symptoms using psychological approaches in forensic settings. A systematic search found 2913 papers, of which 13 met the inclusion criteria. The papers reported nine separate studies (six controlled) that implemented four distinct interventions, often adapted for particular forensic settings. Improvements in overall BPD symptomatology and specific BPD symptoms were reported for all types of intervention, although few differences in outcome between intervention and control groups were found. There were also reported improvements in BPD-related behaviours, but data on offending behaviour were absent. Heterogeneity in study quality and design makes it challenging to draw any firm conclusions about the effectiveness of any one form of treatment over another, nor about which treatment may best suit a particular setting. Further randomised controlled trials are needed to answer these questions. Service Improvement ProjectEvaluation of a brief educational intervention for clinical staff aimed at promoting trauma-informed approaches to careThere is growing evidence that trauma plays an important role in the aetiology of severe and enduring mental health problems. Yet staff can be reluctant to ask patients about trauma for reasons such as anxiety about harming patients and limited access to training. Where services have adopted trauma-informed approaches (TIAs) to mental health care (i.e., considering the ways in which trauma affects individuals when planning and delivering services), improved clinical outcomes have been observed. With this in mind, a new educational video was developed for mental health staff at an NHS trust. The video was intended to be (a) brief (10 minutes); (b) contemporary and engaging; and (c) accessible using computers, smartphones and tablets. Forty-one multidisciplinary staff viewed the video. Quantitative and qualitative evaluation indicated improvements in self-reported knowledge and confidence with regard to trauma, and a decrease in worries with regard to asking patients about such experiences. Participants found the video to be enjoyable, understandable and informative. Importantly, many indicated that it spurred them to further action, such as further training and asking patients about possible trauma. These findings indicate that a video of this type can offer an important ‘taster’ of trauma-related learning, constituting an important step towards embedding trauma-informed ways of working at a service. Main Research ProjectThe Role of Intrusive Imagery in Hoarding DisorderThe cardinal feature of Hoarding Disorder (HD) is persistent difficulty discarding possessions, with the resulting clutter compromising the intended use of living areas. Within the dominant cognitive-behavioural model of hoarding (Frost & Hartl, 1996), hoarding behaviours are positively and negatively reinforced in the context of certain object-related beliefs. Available treatments for HD have so far yielded modest outcomes, indicating a need for new approaches. Intrusive imagery has so far been neglected in HD research, despite the frequency of trauma in the histories of people with the condition. To address this, 27 individuals who met the DSM-5 criteria for HD and 28 community controls (CCs) were interviewed about their everyday experiences of mental imagery. Participants were also asked about the images they experienced during two recent real-life examples of actual or attempted discard of (1) an object of low subjective value; and (2) an object of high subjective value. Everyday imagery in the HD group commonly reflected themes of illness, death and reminiscence. Imagery in HD participants tended to carry negative emotional valence in comparison with CCs, and was associated with greater interference in everyday life and attempts to avoid the imagery. HD participants reported more negative experiences of intrusive imagery in comparison with CCs during recent episodes of discarding objects of low subjective value. However, HD participants experienced positive imagery when discarding, or trying to discard, high value objects. These findings indicate that although people with HD frequently report traumatic histories, this is not reflected in the everyday imagery that they experience. There is some evidence to suggest that the negative and positive memories experienced in relation to low and high value objects may aid our understanding of discarding and saving behaviour in HD. The theoretical and clinical implications of these findings are further discussed.