Objectives: Gaining an informant’s perspective on cognitive decline has become an increasingly popular, and recommended practice, in the assessment of dementia. However, concern regarding the accuracy of such reports has been documented. The current study aimed to explore factors that might influence such reports, with a particular focus on informant burden. Design: Using a cross-sectional, single-group design, routinely collected data from 82 patient-informant dyads within a memory assessment service, was analysed. Univariate and multivariate analyses explored associations between informant-reported cognitive decline, demographic characteristics and clinical variables (including burden). Results: None of the demographic characteristics explored were associated with informant-reported cognitive decline. Informant reports were associated with patient cognitive functioning, as assessed by a standardised psychometric measure, and the final outcome of the assessment. Patient affective state and informant-reported burden interacted in influencing informant-reported cognitive decline. Informant-reported burden did not mediate the relationship between informant-reported cognitive decline and patient performance on a standardised psychometric measure. Conclusions: Findings suggest that informant subjective burden predicts informant-reported cognitive decline, and that patient affective state interacts with subjective burden in doing so. Clinical and empirical implications are discussed.

Several studies have reported associations between childhood gender nonconformity (CGN) and depression or other mental health problems and potential mechanisms that seek to explain this association. However methodological issues limit the power of, and therefore the confidence in, their findings. Additionally, only one previous study has investigated childhood depression as an outcome variable. The current study accesses longitudinal data to investigate whether self-esteem mediates the association between early childhood gender nonconformity and childhood depression. The dataset was obtained from the Avon Longitudinal Study of Parents and Children and consisted of 15,247 records. A mediation analysis (Hayes, 2012) showed that self-esteem mediated the association between CGN and childhood depressive symptoms in females. However the effect size was very small. In males the mediation model demonstrated an association between CGN and depressive symptoms which approached significance but this was not mediated by self-esteem. Again, the effect size was very small. Study limitations were discussed, such as high levels of missing data. Research implications include the need for further UK based, preferably longitudinal studies exploring the mechanisms which explain the association between CGN and childhood depression. This should help to develop effective, tailored clinical interventions for this client group. Additionally, community psychology and public health interventions have been discussed.

Background: Becoming a mother is a period of transition for women and during this period many of them return to work. Aims: The aim of the study was to explore psychological distress when returning to work after maternity leave. Variables such as work-family conflict, work-family balance, social support and income and their relationship to psychological distress during this period were explored. Method: 195 women completed an online questionnaire, with demographic questions as well as measures assessing psychological distress, work-family-conflict, work-family-balance and social support. Correlations, t-tests, mediation and moderation analyses were used to explore the results. Results: Psychological distress was not found to be elevated in mothers returning to work after maternity leave. However, they did have high levels of work-family-conflict and work-family-balance. Social support acted as a mediator of the relationship between work-family-conflict and work-family-balance and psychological distress.

Objective: Research into how staff working in eating disorder setting may be affected by their work is still a reasonably new area, with many previous studies relying on homogenous groups for recruitment or utilising survey based methodologies. Therefore, this study used a grounded theory approach to construct a theory of changes to body image, perceptions of food and diet experienced by clinicians, how these changes are experiences or made sense of, and what factors may contribute to these changes. Method: Thirteen members of staff were interviewed about their body image and eating habits before and since working in eating disorder settings. Participants were drawn from a range of different staff groups. Interviews were analysed using grounded theory to develop a theoretical model of why changes to body image and eating habits may occur. Results: Three core categories were defined, and a theoretical model was postulated in which pre-existing body image and ideas of food, the work environment, access to support, the impact of patients themselves and promotion of chaotic eating through the work itself all interplay to create change. Individual differences in management and the “personalised meaning” ascribed to these changes media how these changes are labelled and managed. Implications for future research and clinical practice are discussed.

Background: Research has demonstrated that there is more likely to be a disruption to the placement where foster carers have birth children. Given the limited presence of the birth children of foster carers in research and the importance of the retention of carers, it seems relevant to policy and practice to investigate the parent-child relationship. Therefore, this study aimed to explore how the birth children of foster carers experienced their relationship with their parents. Method: Interpretative phenomenological analysis was used to analyse semi-structured interviews with eight young people who were the birth children of foster carers. Results: Three superordinate themes emerged. These were: ‘relational processes that give value to my role in the family’, ‘threats to our relationship’ and ‘making sense as a way of managing the threats’. Each of these superordinate themes contained subthemes. Conclusions: The findings suggest that the processes of ‘making sense’ and ‘feeling valued’ serve to buffer the impact of potential threats to the parent-child relationship. Clinical implications include the application of a model that has been developed to elucidate the relationship between the themes. This has clinical implications for further understanding and informing the way services support both foster carers and their children.

New self-help interventions have been called for to promote psychological well-being amongst mothers in the first year post-partum, with self-compassion being identified as a promising intervention target. The present study developed and evaluated a low-intensity, online, compassion-based intervention for this population. The Kindness for Mums Online (KFMO) programme was based on Hartley-Jones (2016), and was developed in consultation with six mothers. Mothers of infants under one year (N = 206) participated in a randomised controlled trial, comparing KFMO with a waitlist control. The KFMO group showed significantly greater increases in self-compassion and in psychological well-being compared to controls, with small to medium effect sizes. Improvement in self-compassion statistically mediated the improvement in well-being observed immediately post-intervention. Treatment gains in self-compassion, but not well-being, were maintained at 6-week follow-up. The findings suggest that self-compassion can be increased in post-natal women via an accessible, low-intensity, web-based self-help programme. Study limitations include high attrition rates and poor generalisability to more diverse samples.

Objective: To understand how adolescent social media use is impacting on their identity formation and their developing self-esteem. The degree of emotional investment in the sites, and what motivations underlie discreet social media activities. It also aims to investigate adolescent responses to online feedback and their coping strategies in relation to the feedback. Method: in-depth interviews with 15 white British adolescents aged between 12 and 17 years (9, female, 6 males) consisting of four single sex friendships groups, were thematically analysed. Each group took part in a facilitated focus group, and an unaccompanied focus group. These were followed by an individual interview with the lead researcher. Results: Five key themes were identified: investment, feelings evoked by social media, motivations, observations of social media rules and cultures, and strategies to manage feelings evoked by social media use. Conclusion: while social media is providing an important new context for identity formation, it may be placing added pressures on adolescents’ developmental tasks. Digital youth fear receiving critical feedback online, due to the potential for experiences of shame to be projected widely. They are highly attuned to the quantifiable feedback they receive online and feel pressured to be effortful in their social media activity, which could impact negatively on adolescents’ ability to develop a coherent and stable self (Erikson, 1968) and psychological wellbeing, particularly for those with pre-existing mental health difficulties. A curious and non-judgemental approach to understanding how adolescents are using social media, is necessary in order to encourage supportive conversations.

Lesbian and gay people are more likely to experience long-term health problems and less likely to have relationships that typically provide informal care. Whilst some researchers have suggested that care is provided by family-of-choice relationships (i.e. a network of very close friendships), there has been no research looking at what determines the organisation of care. Grounded theory was used to explore what determines the organisation of informal care for older lesbian and gay people with health problems. Fourteen mid-later life lesbian and gay people were interviewed who had experience of providing/receiving care, or running groups for these populations. Findings suggest that this population experience losses to their network related to their sexuality as well as due to ageing and the impact of their health problem. This means that except for those living with others (partners, ex-partners or housemates), people often experience their care needs being “left to” them. In response, people seek connections or alternatives to support. Support arrangements developed for those living alone tends to be distributed across multiple people. Strategies and attitudes developed from managing being lesbian or gay influence choices and resiliencies in navigating these challenges. The results suggest that older lesbian and gay people have unique strengths and challenges in accessing care in the context of long-term conditions. Recommendations for research and practice are made, including the need for developing ways of working with distributed care networks and suggestions for supporting clients to use resiliencies developed from experiences of being lesbian and gay.

Objectives The study aimed to explore which discourses staff in crisis services draw on when discussing people in crisis. Further questions were; how those with borderline personality disorder diagnosis are positioned by these discourses and what the subsequent consequences are for people in crisis. Design This study utilised a qualitative design. Individual interviews were conducted with participants to generate personal and reflective accounts. Method Twelve staff members from home treatment, day treatment or acute ward teams were interviewed. Questions related to their experiences of people in crisis. Foucauldian Discourse Analysis was used to highlight the discourses used when talking about those in crisis. Results Four main discourses were present in language used; ‘medical legal’, ‘personal responsibility’, ‘limited resources for the problem’, and ‘human experience and emotions’. People with a diagnosis of borderline personality disorder (BPD) were positioned differently to those with other diagnosis. Staff are positioned as experts needing to diagnose and cure distress. The discourse of human experience and emotions highlighted the emotional aspect of working with people in crisis, especially those with a BPD diagnosis. Conclusion The prevailing discourses within NHS crisis services remain those of the medical model, legitimising ideas of classic mental illness and practices of medication and control. This impacts the position of people with a BPD diagnosis. Further reflective spaces are required to highlight the flexibility of these discourses, practice, and the importance of emotions raised by those in distress.

Introduction: Immigration detention leads to poor mental health outcomes. Little qualitative research has been conducted focusing on immigrants’ experiences of detention centres or the mechanisms of the particular psychosocial processes involved in harm and resilience, particularly for women in the UK. Method: A social constructionist grounded theory methodology was used. Ten adults (seven females), previously detained in UK immigration detention, were interviewed. Transcribed interview data was analysed to develop categories. Results: An initial model of the psychosocial processes of immigration detention was developed, which included the means by which individuals’ adaptation, resistance, and survival is navigated. Life as a liminal refugee and imposed criminality through institutionalisation and an unjust system was described. Detainees were not believed and felt uncared for. Detainees internalised persecution, injustice, and threat. They responded with physical and emotional. Detainees also responded with agency and defiance. They supported each other and made use of advocates. Recovery after release from detention involved processing and re-establishing oneself, despite on-going challenges. Discussion: Immigration detention has enduring effects that reflect internalisation of institutional processes. Disempowerment and resilience are discussed. Treatment may be similar to that used for complex therapy. Professionals should consider ethics and actions in relation to immigration detention.