@KingsDClinPsy #KingsDClinpsy Tickets available from Eventbrite Doctorate in Clinical Psychology Research Showcase The Individual and Beyond: Psychology in a Changing World IoPPN, King’s College London DClinPsy Showcase 2019 - 2022 Friday 23 rd September 2022 13.00 - 17.00 Panel 1: Young People 1:10pm – 1:15pm: Matthew Kelly – Network analysis of childhood adversity, anxiety, and callous unemotional traits 1:15pm – 1:20pm: Tara Radwan – Increasing pleasure through positive future thinking in young people with low mood 1:20pm – 1:25pm: Elizabeth Bangura – Assessing the plasticity of threat interpretations in maintaining youth loneliness: Developing a cognitive bias modification training task 1:25pm – 1:30pm: Monica Gupta – Exploring the relationship between social media use and body dysmorphic symptoms in young people 1:30pm – 1:45pm: PANEL 1 Q&A MATTHEW KELLY Supervisors: Professor Ted Barker & Dr Troy Tranah A Network Analysis of Childhood Adversity, Anxiety and Callous Unemotional Traits What we were interested in: Callous unemotional (CU) traits are known to associate with severe and persistent childhood conduct disorder behaviours (CBD). CU traits appear heterogenous, with one subtype with low levels of anxiety and one with high levels of anxiety. Evidence suggest s these subtypes can be explained by exposure to adverse childhood experiences. Most research has utilised scale scores to explore these distinct subtypes. However, the aim of this study was to investigate the symptom level mechanisms that can explain how and why CU, CDB and anxiety associate on the experience of adversity What we did: Data was taken from a birth cohort study examining 6,662 participants. Repeated early year adversity exposure measures were utilised to develop adversity trajectories using l atent class growth analysis. 86.4% of sample were included in the low adversity trajectory while 13.6% were included in the high adversity trajectory. Mother reported child CU traits, CDB and anxiety symptoms, at age 13, were examined using unregularized p artial correlation network models. The models examined patterns of symptom association through network structure, central symptoms of importance and bridge symptoms reinforcing links between disorders. Three networks were modelled: full sample, low adversi ty , and high adversity. Overall structure of networks and symptom centrality remained similar across networks. CU traits placed as their own construct in the networks, consistently acting as bridge symptoms between CDB and anxiety. Three bridge symptoms ap peared to differ between networks. Why it is important: The results provide further evidence that early adversity exposure plays a role in defining two distinct CU trait constructs with regards to comorbid anxiety, identifying key symptom mechanisms of int erest. The findings also suggest that callousness may be its own construct rather than a specifier of extreme CDB. Leading to potential clinical implications in assessment of CU subtypes, development of targeted therapeutic treatments and areas of further research. T ARA RADWAN Supervisors: Dr Victoria Pile, Dr Jennifer Lau & Dr Patrick Smith Increasing pleasure through positive future thinking in young people with low mood What we were interested in: One important feature of depression is how much we look forward to events in our future, or anticipatory pleasure. This might be linked to episodic future thinking (EFT), which is a person’s ability to imagine situations or events that may happen in their future. Research has found that people with depression show less detailed EFT and lower anticipatory pleasure. We were interested in whether enhancing EFT through a single - session intervention would increase anticipatory pleasure in young people with low mood. We were also interested in exploring whether working memory was linked with EFT and anticipatory pleasure. What we did: We invited participants with symptoms of depression to take part in a brief lab session, which took place remotely. Half of the pa rticipants received an intervention which enhanced EFT of a targeted future goal, while the other half received a neutral control task. Participants also completed measures of EFT specificity, working memory, mood, and anticipatory pleasure during the lab session, and finally completed follow - up questionnaires a week after their session. Why it’ s important: Depression affects almost 5% of young people and impacts many aspects of their life, including their education, relationships, and social life. However, current interventions are not always effective. This suggests that these therapies may not be targeting the thinking styles which might trigger and maintain depression. Understanding these thinking styles can help us improve interventions, which might hel p reduce the risk of future depression. ELIZABETH BANGURA Supervisors: Dr Jennifer Lau & Dr Patrick Smith Assessing the plasticity of threat interpretations in maintaining youth loneliness: Developing a cognitive bias modification training task What we were interested in : We wanted to explore whether a single session of CBM training using age - appropriate, ecologically valid ambiguous social situations (compared to control training) can modify threat interpretations of social situations in lonely young people and reduce experiences of loneliness. What we did : Young people aged 18 - 24 were recruited into an experimental study with pre - and post - assessment time points. Participants were randomly allocated into two groups: single session CBM and contro l training. In the CBM training group participants listened to 50 scenarios co - developed with young people; 80% were resolved positively. In control training, participants listened to 50 ambiguous scenarios; all the scenarios remained unresolved. Participa nts completed self - reported measures on loneliness and threat interpretations before and after the intervention. Mixed design ANOVA compared between - group differences of pre - to - post changes in threat interpretations and loneliness. Why it is important : Lon eliness is commonly reported in young people, where it can lead to adverse somatic and mental health outcomes. As threat interpretations of real - life social scenarios contribute to loneliness in young people, we wanted to find out if young people may exper ience less loneliness if more positive interpretations are fostered. In previous research, cognitive bias modification (CBM) training has aimed to modify threat interpretations associated with negative social behaviour and social anxiety. However, there ha s been limited research explored on youth loneliness. We hope that this study holds the possibility of both improving existing treatments for youth loneliness and developing new ones. MONICA GUPTA Supervisors: Dr Georgina Krebs & Dr Amita Jassi Exploring the relationship between social media use and body dysmorphic symptoms in young people What we were interested in: Body dysmorphic disorder (BDD) is characterised by a persistent preoccupation with perceived appearance flaw(s) which are unobservable to others, leading to significant distress and impact on daily functioning. Social media use (SMU) is rife amongst young people and offers constant exposure to unrealistic appearance ideals. It has been associated with mental health difficulties like depression and poor body image. The relationship between SMU and BDD is yet to be explored. What we did: 208 16 - 18 - year - olds completed our online survey measuring BDD symptoms, frequency of SMU, type of SMU (active or passive), motivati ons for SMU (appearance - based, popularity, connection or values and interests), and anxiety and depression symptoms. We found that higher frequency of SMU was significantly associated with higher BDD symptoms but only with image - based and mixed - media socia l media platforms (like Instagram and Tik Tok). Appearance - based motivation for SMU was the only motivation uniquely associated with BDD symptoms. Only Active, not Passive, SMU was significantly associated with increased BDD symptoms when controlling for t he young people’s age, gender, ethnicity and anxiety and depression symptoms. Why it is important: We now know that image - related SMU is associated with higher BDD symptoms. We do not know whether image - related SMU causes higher BDD symptoms or if higher B DD symptoms cause increased image - related SMU. Clinicians and parents can use these findings to purposefully enquire about young people’s SMU and whether it is interacting negatively with their appearance anxiety. Preventative measures can be utilised to a ttenuate this interaction. Panel 2: Trauma & Psychosis 1:45pm – 1:50pm: Natalie Lim – Exploring depersonalisation disorder: Subjective experiences of onset and how that impacts on attitudes, experiences and beliefs surrounding DPD and treatment 1:50pm – 1:55pm: Dr Andrew Watson – Exploring cognition, symptoms, and functioning interactions in early psychosis, before and after cognitive remediation – A network approach 1:55pm – 2:00pm: Julieta Esteves – Investigating obsessive - compulsive intrusions in psychosis: An observational study and an imagery - rescripting case series 2:0 0 pm – 2: 10 pm: PANEL 2 Q&A NATALIE LIM Supervisors: Dr Blake Stobie, Dr Vanessa Lawrence & Dr Tom Parsloe Exploring depersonalisation disorder: Subjective experiences of onset and how that impacts on attitudes, experiences and beliefs surrounding DPD and treatment What we were interested in: To address a qualitative research gap in the literature, we wanted to explore the subjective experiences o f people with DPD, and their journey with the disorder. We were particularly interested in how they made sense of their experiences, and how that may influence the beliefs and attitudes they may have on treatment and the disorder itself. What we did: 18 participants with a diagnosis of DPD was recruited from a national specialist clinic targeting DPD. We conducted semi - structured interviews that typically lasted 1 - 1.5h, and covered topics such as their subjective experience of depersonalisation symptoms, their own understanding of what depersonalisation is and how they came to experience it, their childhood experiences and any experimentation with substances, and their journey to, experiences of and beliefs about treatment. The interviews were then transcr ibed, coded and analysed using constructivist grounded theory methodology. What we found: DPD participants’ subjective identification with emotional harm in their abusive or high - pressured childhood environments shapes their understanding and attributions of their disorder into 4 broad groups: childhood difficulties (CD), stressful life change/event (St), substance use (SU) and no known cause or factor (NC). Across the groups, however, a common pattern of emotional repression became apparent following anal ysis, and an anxious, sensitive personality prone to existential reflections was also felt to predispose vulnerability to DPD, as reported by most participants. Many participants reported shared experiences of DP and common difficulties in articulating the se experiences, hindering them from accessing appropriate support from services. Self - reliance and self - advocacy emerged as a strong theme in their journey to support. When entering treatment, many appeared to bring an expectation that they will be ‘cured’ and were disappointed upon realising that that was unlikely, although they appreciated that therapy and change may take time and effort. CD group particularly valued a sense of ‘readiness’ for therapy, and most felt therapy helped better their understandi ng of the self, the disorder, and its contributing factors. DR ANDREW WATSON Supervisors: Dr Matteo Cella & Professor Dame Til Wykes Exploring cognition, symptoms, and functioning interactions in early psychosis, before and after cognitive remediation – A network approach What we were interested in: Variable illness presentations and trajectories have been a key limiting factor for developing interventions with durable effects and manageable side effects to improve outcomes for people with early psychosis. This is in part due to the complex interplay between symptoms, which remains poorly understood. We were interested in better understanding these relationships, with a view to informing the development and refinement of interventions for psychosis. What we did: To address this complexity, we used a n ovel data - driven approach known as network analysis (NA). NA considers mental health problems as emerging from dynamic causal interactions among symptoms, rather than a singular underlying common cause or mechanism. NA produces spatially - ordered networks which identify unique interplay between symptoms. Data were taken from a large randomised controlled trial of cognitive remediation (CR), with networks examined both pre - and post - CR. Why is it important: We found cognition, negative, and positive symptoms , were separable constructs, with symptoms showing independent relationships with cognitive domains. Negative symptoms (such as lack of motivation and pleasure) represented a key intervention target, with reductions in these symptoms leading to improvement in social and occupational outcomes. Negative symptoms significantly reduced following CR and were also linked to improved verbal and visual learning, with the nature of this relationship requiring further investigation. Independent relationships between visual and verbal learning, and functioning, suggest that these domains may also be key intervention targets to both directly and indirectly enhance social and occupational functioning in people with early psychosis. J ULIETA ESTEVES Supervisors: Dr Amy Hardy & Dr Nadine Keen Investigating obsessive - compulsive intrusions in psychosis: An observational study and an imagery - rescripting case series What were we interested in: This project was completed in two parts. Firstly, we wanted to explore the occurrence of OCD and obsessive - compulsive intrusions, in people who experience psychosis. OCD and Psychosis are associated with distressing and aversive intrusions, although there is limited research into the co - occurrence of both. We explore d whether other factors may be involved in this relationship, including trauma and post - traumatic stress reactions and metacognitions. Secondly, we also wanted to explore whether a brief imagery - rescripting (ImRs) intervention would be feasible, safe, acce ptable, and effective to target obsessive - compulsive intrusions in people with psychosis. ImRs is a therapeutic technique used in various psychological disorders which targets intrusive imagery. There is emerging evidence to suggest ImRs can be used effectively i n people with psychosis and comorbidities, as well as in OCD, although it has not yet been used to target OCD intrusions in psychosis. What we did: We recruited people from a community psychosis team and completed a series of structured measures, to assess their symptoms of psychosis, OCD, trauma and associated psychological processes . Those who reported experiencing an obsessive - compulsive intrusion in the two weeks prior to completing the measures, that was distressing, were invited to take part in the Im Rs case - series. Five participants took part in the case - series and received four sessions of ImRs and a follow - up assessment. Why it’s important: Psychosis and OCD are both mental health conditions associated with high levels of distress, lower well - being and functional impairment. Although both psychosis and OCD are similarly characterized by intrusions and the appraisals of these, and have similar factors implicated in their maintenance, there is limited research on the prevalence of OCD in psychosis. Ini tial findings from previous research suggest a higher prevalence of OCD and obsessive - compulsive symptoms in psychosis, though further research in this area is required, including further understanding of factors which may influence this relationship. Obse ssive - compulsive intrusions can be conceptualised as a form of imagery, and ImRs interventions have shown promise in psychosis and OCD. However, to date, ImRs interventions for obsessive - compulsive intrusions in psychosis are yet to be examined. Research i nto novel targeted interventions is essential, as it allows the evidence - base behind treatment practices to grow, creates new opportunities to target specific presentations and informs future research directions. PANEL 3: Diversity & Health 2:20pm – 2:25pm: Amelia Ralph - Lewis – Exploring the phenomenology of inner language in deaf people and how this informs the adaptation of psychological therapies for use with deaf clients 2:25pm – 2:30pm: Elenya Harston – The experience s of people with IBD and comorbid anxiety or depression and their views on an online intervention for people with long term conditions (COMPASS): A qualitative framework analysis 2:30pm – 2:35pm: Bryony Crane – A new, semi - structured clinical interview to assess social cognition difficulties following brain injury 2:00pm – 2:20pm: PANEL 3 Q&A AMELIA RALPH - LEWIS Superv isors: Dr Joanna Atkinson & Dr Patrick Smith Exploring the phenomenology of inner language in deaf people - how this informs the adaptation of psychological therapies for use with deaf clients What we were interested in: Many people say that they think to themselves using inner speech or an inner voice, but some do not. Inner voices can take many different forms. Some p eople say they can hear themselves think, some see imagery, etc. Inner speech/language has long been researched, but not much is known about how this is experienced by deaf people. This is interesting because deaf people are diverse in their experience of communication, language learning, sound, and use of audiological aids. This study explored the inner language experiences of a diverse deaf sample. What we did: 20 deaf participants were asked to sort 228 statements about different features of inner language alongside an interview. The participants had to decide if the statements were relevant to their experiences or not. They were also asked to elaborate and expl ain their answers throughout the task. Why it is important: The findings have been considered in the context of informing the adaptation of psychological therapies for use with deaf clients. This is vital because deaf people are twice as likely to have me ntal health problems, such as anxiety and depression than the general population and experience greater difficulty accessing mental health care. It was important to be clearer about the nature of their inner experiences because these cannot be assumed to b e the same as the general population who speak and hear. This study showed how interventions must be tailored to the inner language experiences of deaf people. ELENYA HARSTON Supervis ors: Professor Rona Moss - Morris & Dr Joanna Hudson The experiences of people with IBD and comorbid anxiety or depression and their views on an online intervention for people with long term conditions (COMPASS): A qualitative framework analysis What we were interested in: Inflammatory Bowel Disease (IBD) has high levels of comorbid mental health conditions, with anxiety and depression being more common in this group than the general population. No studies have qualitatively explored the experience of IBD and comorbid anxiety and depress ion whilst also evaluating the experience of an online, digital, transdiagnostic therapy for long term conditions (LTCs) called COMPASS. What we did: 22 adults with IBD and comorbid anxiety or depression related to their IBD who participated in the COMPAS S intervention were interviewed using semi - structured interview schedules. The data was analysed using framework analysis. Why is it important: This study is the first to qualitatively explore both the experience of living with comorbid IBD and anxiety or depression, in addition to evaluating a LTC transdiagnostic digital intervention. The cyclical, interconnected nature of IBD and anxiety and depression was highlighted, with participants noting bidirectional influence between their physical and mental heal th. ‘Embarrassment, shame and stigma’ was found to be an overarching theme, which influenced the core themes of ‘isolation’, ‘identity changes’ and the ‘perceived lack of control’. The COMPASS intervention reduced scores on the PHQ - ADS from baseline (M=21. 78, SD=9.20) to the end of the intervention (M=11.36, SD=6.05 at 12 weeks). The COMPASS experience highlighted themes of ‘connection and support’, ‘practical benefits of COMPASS’ and ‘the empowering process’. Future research could tailor COMPASS to address embarrassment, shame, and stigma, and focus on IBD - specific anxieties relating to incontinence and toilet access, hypervigilance around physical symptoms and fear of recurrence. BRYONY CRANE Supervisors: Professor Francesca Happé & Dr Camille Julien Interview to assess social cognition in acquired brain injury What we were interested in: Social cognition can broadly be defined at the skill set needed for social interactions, through an understanding of how others are thinking and feeling. Difficulties with social cognition are pervasive and persistent in brain injury populations and can ha ve a negative impact on long - term outcome, but uptake of existing tools and assessment in clinic settings is variable. What we did: 1. PPI interviews with a small panel of brain injury survivors, their loved ones, and professionals working in this area. This information was used to create an online survey, asking professionals about tool development. 2. Using data from the online survey, cl inical experience of the researchers involved in the project, and input from a psychometrics expert, we developed a new interview schedule to assess social cognition in brain injury 3. The interview schedule is currently being piloted on healthy controls and a clinical population. Why it is important: Our new measure is designed specifically for this population with input from other professionals and uses an interview/observational format. This format may allow us to detect some of the more subtle social cog nition difficulties which may not be captured by other tools. If results from our pilot are supportive of this, it could allow clinicians and service - users to develop a deeper understanding of social cognition difficulties and inform subsequent input from neuropsychological services. PANEL 4: Parenting & Perinatal Mental Health 3:10pm – 3:15pm: Dr Emily Seager – The mental wellbeing of fathers and partners of women accessing perinatal mental health services 3:20pm – 3:25pm: Megan Jansen – What predicts better infant outcomes for those with mothers with serious mental illness? 3:25pm – 3:30pm: Dr Ellen Grimås – Predicting treatment outcomes in the Helping Children Achieve randomized controlled trial: Exploring possible moderators and mediato rs of treatment effects on child conduct and literacy 3:30pm – 3:35pm: Marina Hunt – Examining the Clark and Wells (1995) social anxiety model in the postnatal context 3:35pm – 3:45 pm: PANEL 4 Q&A DR EMILY SEAGER Supervisors: Dr Vaheshta Sethna, Dr Jane Iles & Dr Robin Schacht The mental wellbeing of fathers and partners of women accessing perinatal mental health services What we were interested in: Fathers’ and partners’ mental health are not routinely screened during the perinatal period, despite an increased risk at this time. The NHS long - term plan has set ambitions for implementing screening and signposting of fathers and partners of women acces sing perinatal mental health services. What we did: Part one looked at the feasibility of screening fathers and partners of women accessing a Mother and Baby Unit (MBU) and community perinatal mental health teams within an inner - city NHS Trust for mental w ellbeing and couple satisfaction. Part two involved two focus groups with nine clinicians working across these perinatal mental health teams, to investigate their views on engaging fathers and partners. Why this is important: The first part of the study i ndicated that whilst the numbers of fathers and partners approached was low, mental health screening was more feasible in the MBU as opposed to community perinatal mental health teams. The focus groups highlighted clinician’s views and perceptions of engag ing fathers and partners in services as well as identifying potential barriers. Results from both parts of the study have important implications for partner involvement in perinatal mental health services. MEGAN JANSEN Supervisors: Dr Fiona Challacombe, Dr Susan Pawlby & Dr Laura Satchwell What predicts better infant outcomes for those with mothers with serious mental illness? What we were interested in : Serious mental illness (SMI) during the perinatal period can have a significant impact on a mother’s general health, child development and their ability to form a healthy bond with their infant. Despite adversities such as SMI or having a history of childhood trauma, a significant number of moth ers are able to form a healthy mother - infant relationship. However, little is known about what maternal and infant characteristics predict better perceived and observed mother - infant relationships as well as infant developmental outcomes for those with mot hers with SMI and/or a history of childhood trauma. This study provided a unique opportunity to explore this. What we did: This was a secondary analysis of the ESMI (Effectiveness and Cost - Effectiveness of perinatal mental health services) dataset. Mothers with SMI were recruited from psychiatric mother and baby units (MBU), general acute inpatient wards and crisis resolution teams (CRT) at the point of, or within one month of, discharge. Why it is important: Specialist perinatal mental health services have seen a huge expansion in recent years with further expansions planned under the NHS long term plan. It is imperative to continue to improve these services so that they are of benefit to both the mother and the infant. This study aimed to provide further i nsight into the positive pathways for recovery and/or resilience, which in turn may translate into appropriate perinatal interventions.