Introduction: Deliberate self-harm is being increasingly recognised as a behaviour with significant clinical importance. Yet, there remains uncertainty regarding which forms of psychological therapy are most effective for its treatment. Schema Therapy is an integrative psychotherapy blending elements of cognitive behaviour therapy, object relations and gestalt therapy into a unified approach for the treatment of individuals with complex and chronic psychological conditions. The current thesis aimed to provide a better understanding of the Schema Therapy model and its association with deliberate self-harm. Systematic Review: Despite the increasing evidence base for the efficacy of Schema Therapy, less is known about the evidence for its theoretical underpinnings. To address this gap in the literature a systematic review was undertaken to explore the following question: How empirically supported is the theoretical underpinning of Schema Therapy? In a systematic search of the literature conducted until 01 June 2012, studies based on cross-sectional, longitudinal, intervention, meditational and experimental designs were considered. These studies underwent detailed quality analysis culminating in 19 articles being included in the current review. Overall these studies indicate that many of the key theoretical assumptions in Schema Therapy are supported by the literature. Empirical Study: Schema Therapy has recently been expanded to include the ‘schema mode’ concept, with a number of researchers highlighting an association between particular schema modes and a number of chronic psychological conditions. Although the schema mode model allows a method for understanding moment-to-moment emotional states it has not previously been explored in relation to deliberate self-harm. The current project aimed to explore the relationship between these variables and their association with early experiences of parental bonding and current levels of perceived stress. 70 psychiatric outpatients with a history of deliberate self-harm completed a number of measures including the Deliberate Self-Harm Inventory, Schema Mode Inventory, Parental Bonding Instrument and Perceived Stress Scale. Results revealed significant associations between deliberate self-harm, maladaptive schema modes, perceived stress and patterns of parental care. Maladaptive schema modes significantly mediated the relationship between parental care and deliberate self-harm. The Punitive Parent and Angry Child modes were significant mediators in this relationship. Conclusion: Results from the systematic review support the notion that Schema Therapy has a good theoretical underpinning. The empirical study also supports Schema Therapy by highlighting the meditational role of maladaptive schema modes in the relationship between low parental care in childhood and deliberate self-harm in adulthood. These findings provide further support for the Schema Therapy model and suggest that individuals with deliberate self-harm may benefit from this treatment.

Aim: Schema therapy is becoming an increasingly popular psychological model for working with individuals who have a variety of mental health and personality difficulties. The aim of this review is to look at the current evidence base for schema therapy and highlight directions for further research. Method: A systematic search of the literature was conducted up until January 2011. All studies that had clinically tested the efficacy of schema therapy as described by Jeffrey Young (Young, 1994; Young et al., 2003) were considered. These studies underwent detailed quality assessments based on Scottish Intercollegiate Guidelines Network (SIGN-50) culminating in twelve studies being included in the review. Results: The culminative message (both from the popularity of this model and the medium to large effect sizes) is of a theory which has already demonstrated clinically effective outcomes in a small number of studies and which would benefit from ongoing research and development with complex client groups. Recommendations: It is imperative that psychological practice be guided by high quality research that demonstrates efficacious, evidence based interventions. It is therefore recommended that researchers and clinicians working with schema therapy seek to build on these positive outcomes and further demonstrate the clinical effectiveness of this model through ongoing research.

Young's schema theory offers a theoretical approach that relates negative childhood experiences, temperament, and early maladaptive schema, to the experience of negative affect and/or depression in adulthood. However, despite the widespread use of schema therapy in clinical practice, little research has explored the pathways theorized by Young. This study explored the pathways posited by Young and colleagues looking at the direct and indirect relationships among negative childhood experience, temperament, early maladaptive schema, and the experience of negative affect in adulthood. Self-report data were collected from 365 undergraduate students. Results demonstrated consistent and robust direct relationships between temperament and negative affect, as well as indirect relationships between temperament and/or NCE, schema, and the outcome of negative affect. Results, though mixed, reveal strengths of the schema therapy model and provide suggestions for future research.

Submitted by Geandra Rodrigues (geandrar@gmail.com) on 2018-07-04T15:13:40Z No. of bitstreams: 1 melissagevezierfioravante.pdf: 1354852 bytes, checksum: 808f66014cdf608e6275e8c268614016 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-07-06T14:20:42Z (GMT) No. of bitstreams: 1 melissagevezierfioravante.pdf: 1354852 bytes, checksum: 808f66014cdf608e6275e8c268614016 (MD5) / Made available in DSpace on 2018-07-06T14:20:42Z (GMT). No. of bitstreams: 1 melissagevezierfioravante.pdf: 1354852 bytes, checksum: 808f66014cdf608e6275e8c268614016 (MD5) Previous issue date: 2014-05-16 / Este estudo tem por objetivo dissertar sobre as confluências e divergências teóricas entre a Terapia Cognitiva de Aaron Beck e a Terapia do Esquema de Jeffrey Young. Nos últimos 30 anos, surgiu um esforço de alargamento das terapias cognitivas para atender pacientes com patologias graves e com transtornos de personalidade, pois esses casos acabavam por não responder, de maneira satisfatória, ao tratamento de terapia cognitiva tradicional. Dentro desta perspectiva, as diferentes abordagens são definidas em 1ª geração e 2ª geração de terapias cognitivas. A distinção entre ambas as gerações ocorre na adaptação de três pontos importantes: conceitual, estrutural e de processo. Atualmente, observa-se o crescimento de Terapias Cognitivas com proposta integrativa, às quais, além de apresentarem características pertencentes as três abordagens, somam-se preocupações pertinentes às diferenças culturais e espiritualidade. A Terapia dos Esquemas surgiu em 1990 para tratar pacientes com transtornos de personalidade ou transtornos mais severos e arraigados. Através deste estudo, buscou-se analisar as semelhanças e divergências entre os conceitos e hipóteses usados em ambas as teorias: o conceito de “esquema”, o papel da emoção, perspectiva de tratamento para pacientes com transtorno de personalidade e pacientes caracteriológicos ou com transtornos crônicos, o modelo modal e a relação terapêutica e escalas utilizadas. Analisando o conceito de esquema na Terapia do Esquema, observa-se que a definição é significativamente vaga. Quanto à origem dos esquemas disfuncionais, a Terapia Cognitiva aponta para uma falha no processamento de informação diante das situações vivenciadas na realidade. Já a Teoria do Esquema, os esquemas pessoais refletem com bastante precisão o seu ambiente remoto. Quanto ao aspecto relacionado à relação terapêutica, Young apropria-se da ideia de “experiência emocional corretiva” de Alexander e French para dar formas ao seu constructo denominado reparação parental limitada, cujo objetivo é diminuir conflitos remotos através da relação terapêutica, causados por necessidades emocionais não supridas. Diferentemente, a Terapia Cognitiva de Beck aponta para o papel importante da relação terapêutica, defendendo o papel do terapeuta como conselheiro ou modelo, nos casos de pacientes com Transtorno de Personalidade, não objetivando a resolução de conflitos emocionais remotos. / This study aims to work on the confluences and divergences between the theoretical Aaron Beck’ Cognitive Therapy and Jeffrey Young’ Schema Therapy. Over the past 30 years, there has been a broadening effort from cognitive therapies to assist patients with serious illnesses and personality disorders, because these cases ended up in not respond satisfactorily to the treatment of traditional cognitive therapy. Within this perspective, the different approaches are defined in "1st generation" and "2nd generation" cognitive therapies. The distinction between the two generations of adaptation occurs in three major issues: conceptual, structural and process. Currently, there is growth of integrative Cognitive Therapies, which, besides having the three characteristics of all three approaches, add to the concerns about cultural differences and spirituality. Schema Therapy emerged in 1990 to treat patients with personality disorders or those with more severe or entrenched disorders. Through this study, we sought to examine the similarities and differences between the hypothesis and concepts used in both theories: the concept of "scheme", the role of emotion, the prospective treatment for patients with personality disorder or with chronic disorders, the modal model, the therapeutic relationship and the scales. Analyzing the concept of schema in Schema Therapy, it is observed that the definition is significantly vague. Regarding the origin of dysfunctional schemas, Cognitive Therapy points to a failure in the information processing at the situations experienced in reality. Regarding the Theory of Schema, personal schemes reflect quite accurately your remote environment. About the therapeutic relationship, Young appropriates the idea of "corrective emotional experience" from Alexander and French to shape his construct called “limited parental repair”, whose goal is to reduce remote conflicts through the therapeutic relationship, caused by unmet emotional needs. Differently, the Beck Cognitive Therapy points to the important role of the therapeutic relationship, defending the role of counselor or therapist as model in cases of patients with personality disorder, not aiming at the resolution of remote emotional conflicts.

Made available in DSpace on 2014-12-17T15:38:46Z (GMT). No. of bitstreams: 1 FelipeV.pdf: 1709782 bytes, checksum: 2b820100fec1deb399dfed881d7a3183 (MD5) Previous issue date: 2009-07-21 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Parenting styles concern overall interaction characteristics between parents and children. To assess them, it is important to build and adapt valid and reliable instruments. The main objectives of this dissertation were to translate, adapt and evaluate the psychometric properties of the Young Parenting Inventory (YPI) for the Brazilian context, as seek associations between the YPI and Familiogram Test (FG). In current study, YPI was adapted to Portuguese by backtranslation method. Content analyses were made by five judges. 920 high school and college students (543 females), whose ages were between 14 and 69 years (M = 21.3, SD = 6.1), filled out the research instruments. Data were collected in Natal, Petrolina and Brasilia cities and Porto Alegre metropolitan region. The results confirmed the existence of five factors. Final version of the YPI was composed by 49 items. Exploratory factorial analysis (principal components) were conducted using oblimin rotation. Five factors extracted explained 45.12% of the maternal scale variance and 47.59% of paternal scale. Each factor explained, at least, 3% of the variance and showed Eigenvalue over than 1.5. All items have factorial loadings values above 0.3. The confirmatory factorial analysis has showed fit statistics reasonably adequate: for maternal scale, &#61539; ? [1114] = 4636.38, p < 0.001, &#61539; ? / df = 4.16, with GFI = 0.83, AGFI = 0.81 and RMSEA = 0.06; for paternal scale, &#61539; ? [1114] = 5133.69 p < 0.001, &#61539; ? / df = 4.61, with GFI = 0.81, AGFI = 0.79 and RMSEA = 0,06. Thus, final instrument was composed by the following factors: (I) Disconnection and Rejection (&#61537; = 0.89 and 0.90), (II) Affectivity and Emotional Stability (&#61537; = 0.85 and 0.88); (III) Overvigilance and Other Directedness (&#61537; = 0.83 and 0.85), (IV) Overprotection and Impaired Autonomy (&#61537; = 0.78 and 0.79) and (V) Impaired Limits (&#61537; = 0.66 and 0.71). Finally, relations between the YPI and FG were assessed. Pearson's correlations between the YPI and FG showed moderated associations, particularly between the factors Affectivity (YPI) and Affection (FG) (r = 0.69 and 0.7 for maternal and paternal scale, respectively); and the factors Disconnection and Rejection (YPI) and Conflict (FG) (r = 0.59 and 0.58). The regression models indicated that over than 40% of variance of factors of FG can be predicted by factors of YPI. Beta coefficients for Affection-Affectivity relation were 0.67 (maternal scale) and 0.53 (paternal scale); for Disconnection-Conflict relation were 0.31 (maternal scale) and 0.44 (paternal scale). We conclude the YPI has adequate psychometric parameters and can be used in future research in this area. However, adjustments in the structure of the YPI were made. Moreover, it is suggested further studies to consider other samples and variables, increasing the knowing of parenting styles and the Young&#8223;s theory in the Brazilian context / Os estilos parentais referem-se ?s caracter?sticas globais de intera??es entre pais e filhos. Para sua avalia??o, ? importante que instrumentos v?lidos e fidedignos sejam constru?dos e adaptados. Dentro desta perspectiva, a presente disserta??o teve como objetivo traduzir, adaptar e estudar as propriedades psicom?tricas do Invent?rio de Estilos Parentais de Young (YPI) para o contexto brasileiro. Buscou-se avaliar tamb?m as associa??es entre o YPI e o Teste Familiograma (FG). Nessa pesquisa, o YPI foi adaptado ao portugu?s atrav?s do m?todo de tradu??o reversa (Backtranslation). As an?lises de conte?do foram realizadas por cinco ju?zes. Para realiza??o das an?lises emp?ricas do YPI, contou-se com a participa??o de 920 estudantes do Ensino M?dio e Superior, com idades entre 14 e 69 anos (M = 21,3; DP = 6,1), sendo 543 do sexo feminino (59%). Eles responderam ao YPI, FG e question?rio s?cio-demogr?fico. Os dados foram coletados nas cidades de Natal, Petrolina, Bras?lia e na regi?o metropolitana de Porto Alegre. Os resultados obtidos confirmaram a exist?ncia de cinco fatores. A vers?o final do YPI foi composta de 49 itens. An?lises fatoriais explorat?rias (Componentes Principais) foram conduzidas, utilizando a rota??o oblimin. Os cinco fatores extra?dos explicaram 45,12% da vari?ncia da escala materna e 47,59% da escala paterna. Cada fator explicou, no m?nimo, 3% da vari?ncia e apresentou Eigenvalue superior a 1,5. Todos os itens apresentaram cargas fatoriais acima de 0,3. As an?lises fatoriais confirmat?rias apresentaram ?ndices de ajuste razoavelmente adequados: para a escala materna, &#61539;? [1114] = 4636,38 p < 0,001, &#61539;?/gl = 4,16, com GFI=0,83, AGFI=0,81 e RMSEA=0,06; para a escala paterna, &#61539;? [1114] =5133,69 p < 0,001, &#61539;?/gl = 4,61, com GFI=0,81, AGFI=0,79 e RMSEA=0,06. Assim, a vers?o final do instrumento foi composta pelos seguintes fatores: (I) Desconex?o e Rejei??o (&#61537;=0,89 e 0,90); (II) Afetividade e Estabilidade Emocional (&#61537;=0,85 e 0,88); (III) Hipervigil?ncia e Orienta??o para o Outro (&#61537;=0,83 e 0,85); (IV) Superprote??o e Autonomia Prejudicada (&#61537;=0,78 e 0,79); e (V) Limites Prejudicados (&#61537;=0,66 e 0,71). Finalmente, as rela??es entre o YPI e o FG foram avaliadas. As correla??es de Pearson entre o YPI e o FG indicaram associa??es moderadas, principalmente, entre os Fatores Afetividade, do YPI e Afeto, do FG (r=0,69 e 0,7, para as escala materna e paterna, respectivamente); bem como entre os Fatores Desconex?o e Rejei??o, do YPI e Conflito, do FG (r=0,59 e 0,58). Os modelos explicativos, das an?lises de regress?o, indicaram que mais de 40% da vari?ncia dos fatores do FG podem ser preditos por fatores do YPI. Os coeficientes Beta para a rela??o Afetividade-Afeto foram de 0,67 (escala materna) e 0,53 (escala paterna); para a rela??o Desconex?o-Conflito foram de 0,31 (escala materna) e 0,44 (escala paterna). Conclui-se que o YPI apresenta par?metros psicom?tricos adequados, podendo ser utilizado em pesquisas futuras nesta ?rea. N?o obstante, ajustes na estrutura do YPI foram realizados. Ademais, sugere-se a realiza??o de novos estudos que considerem tamb?m outras amostras e vari?veis, ampliando a compreens?o dos estilos parentais e da teoria de Young no contexto brasileiro

Personality disorders have traditionally been considered refractory to psychological interventions. Two of the most common, and potentially harmful personality disorders are antisocial personality disorder / psychopathy, and narcissism. Although a great deal of conceptual overlap exists between psychopathy and narcissism, the empirical study of these constructs has proceeded largely independently of one another. Further complicating the discrimination of these constructs is the identification of the bi-factorial nature of psychopathy - conceptualised as primary and secondary psychopathy - as well as the identification of two distinct forms of narcissism, overt and covert. The recent resurgence of interest in the sub-clinical manifestations of these two constructs has led to the development of a number of easily administered instruments to measure each of the psychopathy and narcissism constructs, as dimensional traits, within normal populations. This has provided empirically validated and reliable instruments to further explicate these two overlapping constructs. The first of the two studies reported sought to discriminate between psychopathy and narcissism through the recharacterisation of these constructs in terms of the early maladaptive schemas outlined in Young’s early maladaptive schema theory (Young, 1999). Two hundred and ninety one participants completed questionnaires measuring primary and secondary psychopathy, overt and covert narcissism, and early maladaptive schemas. Findings are consistent with the hypothesis that psychopathy and narcissism are discriminable in cognitive-interpersonal terms, as operationalised by early maladaptive schemas. Findings also call into question the earlier observed hierarchical structure of the Young Schema Questionnaire. The current analysis identified a two-factor structure to the schema questionnaire, rather than the previously stated 5-factors. Having demonstrated the usefulness of understanding psychopathy and narcissism in cognitive-interpersonal terms, the second study sought to further clarify the association between psychopathy and narcissism through the reconceptualisation of these constructs in cognitive terms, through the identification of the cognitive distortions operative in each disorder. One hundred and thirty two participants completed a cognitive distortions questionnaire developed by the author, along with the same measures of primary and secondary psychopathy, and overt and covert narcissism, as those administered in study 1. Findings were interpreted as providing support for the notion of psychopathy representing a sub-category of narcissism. Findings also provide further supportive evidence for the validity of the primary / secondary psychopathy, and overt / covert narcissism distinctions. The further clarification of the factor structure of the Young Schema Questionnaire, and the replication of the reliability and construct validity of the measure of cognitive distortions developed for this research are highlighted as areas for future research.

The objective of this research was to present to the cognitive-behavioral therapists a cinematherapeutic technique, based on the Disney animated films, which can be used for children and adolescents for psychoeducate about the entitlement / grandiosity scheme and insufficient self-control/self-discipline scheme, which make up the impaired limits domains, according to the theory Jeffrey Young. Seven experts professional in the clinical area of cognitive-behavioral approach aged between 26 to 47 years (&#119909;= 33; DP = 8,01) and average acting time of &#119909; = 9 anos (DP = 7,1). All participants had evidence of specialization in Cognitive-Behavioral Therapy (CBT), 29% had master\'s degree and 29% had postdoctoral. The instrument used was a test of judges composed of the transcription of verbal and nonverbal content of 19 scenes relative to the movies Cars , Beauty and the Beast , Wreck-It Ralph and Brave . Judges should read and judge which category was being portrayed in the scene at issue: entitlement / grandiosity scheme or insufficient self-control/self-discipline scheme. Data collected by test judges that these were nominal variables were transformed into binomial variables and then analyzed using the Wilcoxon test. The results indicated which scenes had a prevalence of impaired limits schema domain. Regarding the movie \"Cars\" was found predominance of entitlement / grandiosity scheme in three scenes; in \"Beauty and the Beast\" three scenes were representative of entitlement / grandiosity scheme and two about insufficient self-control/self-discipline scheme; in Wreck-It Ralph four scenes were considered examples of such schemes, three relating to insufficient self-control/self-discipline scheme and one concerning the entitlement / grandiosity scheme; finally, on Brave prevalence of insufficient self-control/self-discipline scheme was found in two scenes. In total was found a predominance of the impaired limits schemes characteristics in 14 scenes, which are represented by speech and nonverbal language of the characters. These scenes can be used to psychoeducate children and adolescents about these schemes. The use of tools able to engage the child and arouse their interest is very important in cognitive play therapy and is known to that the cinematherapy has a high potential for motivating patients. Psychoeducation is an essential practice in CBT because can affect adherence to treatment and enables the achievement of the other aim of therapy. Therefore, applying the cinematherapy in psychoeducation for children and adolescents contributes to increasing the effectiveness of the therapeutic process. This work contributes to expanding the arsenal of cognitive-behavioral techniques, as it suggests scenes that can be used as psychoeducational tools in the cognitive play therapy, based on a systematic categorization. / O objetivo desta pesquisa foi apresentar aos terapeutas cognitivo-comportamentais uma técnica cinematerápica, baseada nos filmes animados da Disney, que possa ser utilizada para psicoeducar crianças e adolescentes sobre os esquemas de arrogo/grandiosidade e autocontrole/autodisciplina insuficientes, que compõem o Domínio III Limites prejudicados, de acordo com a teoria de Jeffrey Young. Participaram deste estudo sete profissionais experts na área clínica de abordagem cognitivo-comportamental, com idade entre 26 e 47 anos (&#119909;= 33; DP = 8,01) e tempo médio de atuação de &#119909; = 9 anos (DP = 7,1). Todos os participantes possuíam título de especialista em Terapia Cognitivo-Comportamental (TCC), além de 29% possuírem mestrado e 29% pós-doutorado. O instrumento utilizado foi uma prova de juízes composta pela transcrição do conteúdo verbal e não verbal de 19 cenas relativas aos filmes Carros , A Bela e a Fera , Detona Ralph e Valente . Os juízes deveriam ler e julgar qual categoria estava sendo retratada na cena em questão: arrogo/grandiosidade ou autocontrole/autodisciplina insuficientes. Os dados coletados através da prova de juízes, que se tratavam de variáveis nominais, foram transformados em variáveis binomiais e então submetidos ao teste Wilcoxon. Os resultados indicaram quais cenas possuíam prevalência de um dos esquemas do domínio limites prejudicados. Com relação ao filme Carros , foi encontrado predomínio do esquema de arrogo/grandiosidade em três cenas; em A Bela e a Fera três cenas foram consideradas representativas do esquema de arrogo/grandiosidade e duas de autocontrole/autodisciplina insuficientes; em Detona Ralph quatro cenas foram consideradas exemplos desses esquemas, sendo três referentes ao autocontrole/autodisciplina insuficientes e uma ao arrogo/grandiosidade; finalmente, em Valente foi encontrada prevalência do esquema de autocontrole/autodisciplina insuficientes em duas cenas. No total, foi encontrado predomínio de características dos esquemas referentes aos limites prejudicados em 14 cenas, os quais são representados através de falas e linguagem não verbal dos personagens. Essas cenas podem ser utilizadas para psicoeducar crianças e adolescentes a respeito desses esquemas. A utilização de ferramentas capazes de envolver a criança e despertar o seu interesse é de grande relevância na ludoterapia cognitiva e sabe-se que a cinematerapia possui um alto potencial de motivação dos pacientes. A psicoeducação é uma prática essencial na TCC, pois interfere na adesão do paciente ao tratamento e possibilita o alcance dos demais objetivos da terapia. Portanto, aplicar a cinematerapia na psicoeducação de crianças e adolescentes colabora para o aumento da eficácia do processo terapêutico. Este trabalho contribui para a ampliação do arsenal de técnicas cognitivo-comportamentais, uma vez que sugere cenas que podem ser utilizadas como ferramentas psicoeducativas na ludoterapia cognitiva, baseando-se em uma categorização sistematizada. / Mestre em Psicologia Aplicada

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.

Schema therapy is a leading contemporary approach to treating mental illness. The therapy integrally uses self-report measures of negative schemas (“long lasting patterns of emotions, cognitions and memories”), and the negative parenting patterns that are linked to the development of these schemas. However, the negative parenting measures are insufficient, and there are no corresponding measures of positive schemas or positive parenting patterns. Study 1 focused on the development of a measure for positive schemas, the Young Positive Schema Questionnaire (YPSQ). Study 2 focused on the development of a measure for positive parenting patterns, the Positive Parenting Schema Inventory (PPSI). Finally, Study 3 empirically showed that the subscales of the Young Parenting Inventory (YPI) were not robust, and it provided a revised alternative (YPI-R2). For all three studies combined, community samples (n = 204 to 628) were collected from five countries in Asia (India, Indonesia, Malaysia, Singapore, and the Philippines) as well as the United States. The factor structure of the three instruments (the YPSQ, PPSI and YPI-R2) was stable in both Eastern and Western samples (in multigroup confirmatory factor analysis). All three scales showed prediction of mental health over and above what was possible with previous measures (incremental validity). The scales were not simply proxies for previously measured constructs (divergent validity). These scales also demonstrated significant associations with other established measures of parenting (construct validity). They also showed associations with negative schemas, well-being and ill-being (convergent validity). This thesis provides the tools needed to include a focus on positive as well as negative schemas and parenting patterns in both research and clinical practice. It also shows the benefits of so doing.