Dr Laura Simonds

The research-practice (or science-practice) gap is a commonly observed and written about phenomenon in a range of applied disciplines. The current paper focuses on the research-practice gap in practitioner clinical psychology doctoral training and the struggle with identity transition that clinical researchers undergo throughout the course of their professional doctorate. In the UK, clinical psychology trainees are recruited and trained in a national context that emphasises the importance of the scientist-practitioner identity position. Clinical psychology trainees are expected to become leaders in research development within the National Health Service (NHS) and to be sophisticated consumers and producers of evidence-based research. In the course of their training, however, clinical psychology trainees are inevitably met with varied views about what constitutes evidence, the value of research to practice, and how these two domains of knowledge can and might work together. They also enter training with their own views about what constitutes legitimate ways of producing knowledge in clinical psychology and the ways in which they can and should evidence their own practice. Clinical training programmes, therefore, need to develop learning experiences through which trainees might be facilitated to reflect on and develop their identity position as a scientist-practitioner.

Parental accommodation of pediatric OCD is common and is associated with negative affect in parents. Qualitative accounts of caring for a child with OCD are limited and no studies have assessed differences between mothers and fathers in accommodation, coping and distress. The current study used a mixed methods approach to understand parental accommodation, negative affect and coping. Forty-one mothers and 29 fathers of 43 children with OCD were asked to write narratives about their understanding and management of OCD and to complete measures of accommodation, coping, and distress. Symptom accommodation was high with almost half of the parents watching the child complete rituals or waiting for the child on a daily basis. Analysis of parental narratives indicated a distressing struggle between engaging in and resisting accommodation in order to manage their own and their child’s anger and distress. T-tests and correlation analysis indicated that accommodation did not differ significantly between mothers and fathers but was more strongly associated with negative affect in mothers. Analyses indicated that mothers reported using all types of coping strategy more often than fathers, particularly escape-avoidance, taking responsibility and using social support. Escape-avoidance coping was positively correlated with accommodation and negative affect in both mothers and fathers. Interventions that target parental constructions of OCD and their behavioural and emotional responses to it may assist in reducing the occurrence of accommodation, avoidant coping and parental distress.

Despite the obvious phenomenological similarities between magical thinking and obsessive-compulsiveness, the relationship between them has been the subject of few empirical investigations in samples of children. The present study aimed to examine the relationship between a general epistemic stance towards magical causation and tendencies towards obsessive-compulsiveness in a non-clinical sample of schoolchildren. One-hundred and two children, aged between 5 and 10 years (48 boys, 54 girls), completed questionnaire measures designed to assess magical thinking, obsessive-compulsiveness and other forms of anxiety. School teachers completed a measure of strengths and difficulties for each child. General belief in magical causation was correlated with all types of anxiety, not just obsessive-compulsiveness, with significant correlations shown for boys in the sample, but not girls. General belief in magical causation contributed little to the prediction of obsessive-compulsiveness beyond general anxiety. In this study, a general epistemic stance towards magical causation did not differentiate obsessive-compulsiveness from other anxiety dimensions. The findings are considered in the context of developmental theories of magical and scientific causal reasoning.

Background and objectives Mental contamination is the psychological sense of internal dirtiness that arises in the absence of physical contact with a perceived contaminant. Mental contamination can be evoked through imagining perpetrating a moral transgression. This study experimentally evoked mental contamination by asking men to imagine perpetrating a non-consensual kiss. It explored whether reducing sense of personal responsibility for the kiss moderated the mental contamination effect. Methods Male students (N = 60) imagined giving either a consensual or non-consensual kiss. Personal responsibility for the kiss was manipulated in one of two non-consensual kiss conditions by way of the inclusion of social influence information. Feelings of mental contamination were assessed by self-report and through a behavioural index. Results Mental contamination was successfully induced in the two non-consensual kiss conditions. There was evidence to support the hypothesis that reducing personal responsibility might moderate specific components of mental contamination (shame, dirtiness and urge to cleanse). The effect of responsibility modification was evident in the self-report measures, but not in the behavioural index. Limitations The sample comprised male university students which limits generalizability of the findings. The behavioural assessment of mental contamination was limited to a proxy measure. Conclusions Imagined moral violations are associated with increases in indices of mental contamination. Further research should investigate whether feelings of shame, dirtiness and urge to cleanse are particularly responsive to responsibility modifications.

The psychometric properties of a new scale, the Obsessive Compulsive Inventory (OCI; Foa, Kozak, Salkovskis, Coles, & Amir, 1998), were examined in a nonclinical student sample. The study was a partial replication of the original validation study by Foa et al. Test-retest reliability, internal consistency, and convergent validity were examined using a sample of 126 undergraduate psychology students. Statistical analyses (Pearson's r and Cronbach's alpha) indicated adequate test-retest reliability for the full scales and subscales (coefficients ranging from 0.69 to 0.88) and high internal consistency (all coefficients exceeding 0.7). Convergent validity with the Maudsley Obsessional Compulsive Inventory (MOCI; Hodgson & Rachman, 1977) was adequate for the full scales and for the Washing and Checking subscales (coefficients ranging from 0.61 to 0.75). The OCI is a useful supplement to existing self-report measures of obsessive-compulsive symptomatology.

The increased emphasis on the practical application of research has led to expansion in the number and diversity of professional doctorates (PD) within the USA, UK and Canada. However, the research-practice gap is a commonly observed and written about phenomenon and PD programmes have been questioned for not being able to support the development of a scientist-practitioner identity. This exploratory study focuses on the research-practice gap in practitioner clinical psychology doctoral training and the struggle with identity transition that clinical researchers undergo throughout the course of their professional doctorate. A questionnaire using closed and open-ended questions was developed to explore both scientist-practitioner identity in fourteen final year doctoral clinical trainees and, their perception as to how the connection between these two aspects of identity had either been facilitated or undermined during the course of training. Results showed that by the end of their training, all but one trainee identified themselves as a scientist-practitioner whereas, prior to entering training, none did. Supervisor guidance and reflection were identified as key aspects of training that supported this identity transition. Tensions within the professional practice context and some programme assessment practices challenged the scientist-practitioner model. Trainees recounted specific changes in their professional practice that reflect this new dual identity.

300 participants, including volunteers from an obsessional support group, filled in questionnaires relating to disgust sensitivity, health anxiety, anxiety, fear of death, fear of contamination and obsessionality as part of an investigation into the involvement of disgust sensitivity in types of obsessions. Overall, the data supported the hypothesis that a relationship does exist between disgust sensitivity and the targeted variables. A significant predictive relationship was found between disgust sensitivity and total scores on the Obsessive Compulsive Inventory (OCI; Foa, Kozak, Salkovskis, Coles and Amir, 1998) for both frequency and distress of symptomatology. Disgust sensitivity scores were significantly related to health anxiety scores and general anxiety scores and to all the obsessional subscales with the exception of hoarding. Additionally, multiple regression analyses revealed that disgust sensitivity may be more specifically related to washing compulsions: frequency of washing behaviour was best predicted by disgust sensitivity scores. Washing distress scores were best predicted by health anxiety scores, though disgust sensitivity entered in the second model. It is suggested that further research on the relationship between disgust sensitivity and obsessionality could be helpful in refining the theoretical understanding of obsessions

There has been a surge of interest regarding the application of resilience theory in childcare practice and how resilience can be promoted among vulnerable children, in particular, looked after children. However, little is known about how people working with looked after children understand the concept of resilience. This study aimed to explore how social workers, teachers and foster carers, working with looked after children, understand resilience and whether there is consensus as to what constitutes resilience. The study also sought to explore whether there are differences in how resilience is constructed across these groups. In total, 106 participants took part in a Delphi survey (34 teachers, 36 foster carers, 36 social workers). There was moderate consensus that resilience related to survival, coping and a sense of self-worth. Resilience was not considered a panacea but a concept that also had limitations. Participants understood resilience in ways that were both similar and different to existing conceptualisations within the literature. However, there were many aspects of resilience for which there was no consensus or significant difference of opinion between the participant groups. The need for further training and research is discussed, in order to support attempts to promote resilience among looked after children.

This chapter provides a basic introduction to ethnographic methodology and explores its implementation in settings relevant to psychologists, arguing that its use potentially can give researchers insight into human experiences that are otherwise diffi cult to access. After describing some of the basic tools of this methodology (such as participant observation, map-making, census, informal interview, and object- or photo-elicitation), the authors make a case for considering and using a number of the key features underlying this approach to research, including sustained contact, attention to place, pansensory investigation, and emergent theory generation. We then discuss how psychologists can engage with a concentrated version of ethnographic methodology—focused ethnography—and provide two brief examples to illuminate its practical use.

Evidence is mixed regarding the potential utility of therapist self-disclosure. The current study modelled relationships between perceived helpfulness of therapist self-disclosures, therapeutic alliance, patient non-disclosure, and shame in participants (n=120; 95% women) with a history of eating problems. Serial multiple mediator analyses provided support for a putative model connecting the perceived helpfulness of therapist self-disclosures with current eating disorder symptom severity through therapeutic alliance, patient self-disclosure and shame. The analyses presented provide support for the contention that therapist self-disclosure, if perceived as helpful, might strengthen the therapeutic alliance. A strong therapeutic alliance, in turn, has the potential to promote patient disclosure and reduce shame and eating problems.

The presence of a dermatological condition may deter contact with the affected person because it falsely signals the threat of infection. The current study investigated interpersonal aversion towards individuals with the appearance of acne and psoriasis. Participants (N=196) either viewed a female face with the appearance of acne, psoriasis, or no visible dermatological condition. Participants rated the attractiveness of the person, and indicated their willingness for social and indirect contact with them. The person depicted with acne was rated significantly less attractive than the person with psoriasis or no dermatological condition. Participants reported significantly less willingness for indirect contact with the person depicted with acne or psoriasis compared to the person with no visible dermatological condition. In contrast, participants expressed more willingness for social contact with a person with acne than with the person with psoriasis or no dermatological condition. Group differences were significant when controlling for attractiveness ratings. Unwarranted fear of infection might underpin avoidance and discriminatory behaviour towards those with skin conditions. Further research is required to understand factors that influence avoidance of contact.

Like other self-conscious emotions, shame takes on particular significance during late childhood and adolescence because of a developing capacity for self-reflection, self-other comparisons, and sensitivity to the views of others. Shame is a potentially important variable in adolescent well-being given its established associations with depression, reduced feelings of self-worth, and problematic anger. Three studies are reported that describe the development and validation of the Adolescent Shame-Proneness Scale (ASPS), a novel semi-idiographic measure of shame-proneness. The ASPS is a 19-item measure assessing 3 components of shame-proneness-negative self-evaluation, externalization, and emotional discomfort. Taken together, the studies support the reliability and validity of the ASPS as a semi-idiographic measure of shame-proneness in adolescents aged 11 to 18 years. ASPS scores correlate as expected with scores on existing measure of shame-proneness and with measures of anger, negative affect, and self-esteem. More important, the data suggest that ASPS scores are related to, but distinct from, guilt. Confirmatory factor analysis supported the validity of the ASPS factor structure (RMSEA = .08, SRMR = .05, CFI = .97, NNFI = .97). The ASPS represents a unique contribution to existing options for measuring shame-proneness in research and clinical contexts. Further work is required to assess the ASPS' temporal stability and its viability and psychometric properties in more culturally diverse samples. (PsycINFO Database Record

Background Recovery has become a central concept in mental health service delivery, and several recovery-focused measures exist for adults. The concept's applicability to young people's mental health experience has been neglected, and no measures yet exist. Aim The aim of this work is to develop measures of recovery for use in specialist child and adolescent mental health services. Method On the basis of 21 semi-structured interviews, three recovery measures were devised, one for completion by the young person and two for completion by the parent/carer. Two parent/carer measures were devised in order to assess both their perspective on their child's recovery and their own recovery process. The questionnaires were administered to a UK sample of 47 young people (10–18 years old) with anxiety and depression and their parents, along with a measure used to routinely assess treatment progress and outcome and a measure of self-esteem. Results All three measures had high internal consistency (alpha ≥ 0.89). Young people's recovery scores were correlated negatively with scores on a measure used to routinely assess treatment progress and outcome (r = −0.75) and positively with self-esteem (r = 0.84). Parent and young persons' reports of the young person's recovery were positively correlated (r = 0.61). Parent report of the young person's recovery and of their own recovery process were positively correlated (r = 0.75). Conclusion The three measures have the potential to be used in mental health services to assess recovery processes in young people with mental health difficulties and correspondence with symptomatic improvement. The measures provide a novel way of capturing the parental/caregiver perspective on recovery and caregivers' own wellbeing. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Message •No tools exist to evaluate recovery-relevant processes in young people treated in specialist mental health services. •This study reports on the development and psychometric evaluation of three self-report recovery-relevant assessments for young people and their caregivers. •Findings indicate a high degree of correspondence between young person and caregiver reports of recovery in the former. •The recovery assessments correlate inversely with a standardized symptom-focused measure and positively with self-esteem.

Scrupulosity is a manifestation of obsessive-compulsive disorder concerned with religious themes. It is unclear how religious leaders understand scrupulosity, the support they offer, or how they view collaboration with mental health practitioners. This study was designed to address these issues. Eleven Catholic priests took part in a semistructured interview based on a vignette describing a person with scrupulosity. Data were analysed using a grounded theory approach. Priests understood scrupulosity as a psychological problem that they felt unqualified to deal with but for which they could offer spiritual guidance. Scrupulous individuals were perceived as difficult to develop a supportive relationship with and were sometimes a challenge to priests’ emotional wellbeing. Collaborative working between priests and mental health services was suggested as a way to address these issues, although priests recognised some difficulties in implementing this. Further research, with other religious groups and with people with scrupulosity, would be beneficial in order to expand the current conceptual framework.

A small evidence base suggests that parents with learning disabilities are likely to have their children permanently removed from their care. There is no known research involving magistrates in England, despite their role in care proceedings. This study aimed to explore the experience of magistrates making decisions in care proceedings involving parents with learning disabilities. Four family court magistrates took part in a semi-structured interview. The findings suggest that the magistrates in this sample perceive a distinction between themselves and others in terms of their ability to accommodate complexity in conceptualising learning disabilities. The ability to appreciate such complexity was considered important by magistrates in them adopting a more proactive role when presented with expert opinion. Four main influences were spoken of when determining the best interests of the child: timescale and age of the child, expert opinion, parenting abilities and support. Participants indicated how their experiences with people with learning disabilities outside of the court system have impacted on their role within care proceedings and have shaped their awareness of the limits of their own knowledge. Magistrates indicated a general need for more training about learning disabilities. Limitations and implications for practice are discussed.

Objectives Approximately 15–20% of women experience their hot flushes and night sweats as problematic. There is some evidence that cognitive appraisals may help explain individual variation, and that cognitive behaviour therapy can alleviate related distress. This paper describes the development of the Hot Flush Beliefs Scale (HFBS), a questionnaire to assess women's appraisals, and reports on the reliability, validity and factor structure of the scale. Methods An initial pool of 63 items was generated from several sources: empirical literature, clinicians’ views, and in-depth interviews, with the aim of reflecting common thoughts and beliefs about flushes and sweats. A total of 103 women, aged 41–64 years completed the initial measure. Principal components analysis and principal axis factoring were applied to the data, with both orthogonal and oblique rotation to determine the most coherent and interpretable solution. Results Exploratory factor analysis culminated in a 27-item measure comprising three dimensions: beliefs about self in social context; beliefs about coping with hot flushes; beliefs about coping with night sweats/sleep. The HFBS was internally consistent, with subscale alphas ranging from 0.78 to 0.93, and test–retest reliability 0.74–0.78. Validity was supported through correlations with other measures of mood and menopause beliefs. Conclusions Preliminary analysis of the HFBS reveals it to be a psychometrically sound instrument. The HFBS has the benefit of being grounded in women's experiences and shows initial promise as a tool to aid further clinical and theoretical understanding of the impact of hot flushes and night sweats.

Social recovery has become a prominent aspect of mental health service design and delivery in the past decade. Much of the literature on social recovery is derived from first-person accounts or primary research with adult service users experiencing severe mental illness. There is a lack of both theoretical and empirical work that could inform consideration of how the concept of social recovery might apply to adolescents experiencing common (non-psychotic) mental health problems such as anxiety and depression. The current study was conducted to understand the process of experiencing anxiety and depression in young people. Semi-structured interviews were conducted with nine adolescents with anxiety and depression (seven girls and two boys aged 14-16 years) and 12 mothers who were recruited from a specialist Child and Adolescent Mental Health Service in the South of England. Thematic analysis indicated that young people do experience a process of 'recovery'; the processes participants described have some congruence with the earlier stages of adult recovery models involving biographical disruption and the development of new meanings, in this case of anxiety or depression, and changes in sense of identity. The accounts diverge with regard to later stages of adult models involving the development of hope and responsibility. The findings suggest that services should attend to social isolation and emphasise support for positive aspirations for future selves whilst also attending to young people's and parents' expectations about change. Methodological challenges face enquiry about 'recovery' given its connotations with cure in everyday language. Copyright © 2013 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: Theoretical and empirical work on social recovery in young people and families is lacking. Using interviews, this study sought to understand the relevance of social recovery for adolescents with anxiety and depression and their mothers. Findings suggest some congruence with the earlier stages of adult recovery models involving meaning and identity. Findings diverge with regard to later stages of adult recovery models involving hope and responsibility. Social recovery in mental health services for young people needs significant empirical attention and critical debate.

Co-rumination refers to the process of engaging in repeated discussion of personal problems in dyadic relationships. The current systematic review and meta-analysis provided an evaluation of the relationship between co-rumination and internalizing problems in children, adolescents and young adults, along with an investigation of potential moderator variables. Studies were eligible for inclusion if they quantitatively assessed the relationship between co-rumination and depression, anxiety and/or internalizing problems using validated measures. An electronic search was conducted in PsycINFO, PsycARTICLES, Medline, Scopus and the Cochrane Library database of systematic reviews for studies published since 2002. In addition, unpublished studies were located by contacting authors in the field and by online searches of dissertation databases. Thirty-eight studies were deemed eligible for inclusion comprising a total of 12 829 community-based participants. A random-effects model was employed in the analysis, and effect sizes were obtained exclusively from cross-sectional data. Small to moderate effect sizes were found across four outcomes representing internalizing problems (mean corrected correlation range 0.14 to 0.26), with no significant variability across these variables. Female participants were found to score significantly higher on measures of co-rumination compared with males (d = −0.55). Moderator analyses revealed mixed findings. No significant effects were found for age, gender or publication status. A significant effect was found for co-rumination questionnaire version used (p = 0.05), and a marginal effect found for co-rumination partner (same-sex best friend versus other confidants; p = 0.08). These findings indicate that co-rumination may have a modest but significant association with internalizing problems. The implications of these findings and directions for further research are discussed.

Research investigating the impact and experience of first episode psychosis amongst siblings is limited. This study reports the findings of a narrative analysis of the accounts of four siblings, two male and two female, aged between 17 and 24 years, of young people with a first episode of psychosis. The aim of the analysis was to explore the impact of this experience on siblings’ sense of self and their identity development and the roles they adopt within their families. The analysis focused on the core narrative, tone and genre of each account as well as providing a cross-case analysis. This cross-case analysis indicated an overarching genre of “rite of passage” within which a gender difference was interpreted. The emphasis in the accounts of the two young women was on finding personal meaning whereas, for the two young men, the emphasis was on taking up responsibilities. As found in other studies of serious mental health problems, siblings provide much direct and indirect care for their families. The implications for services providing support to siblings and families in early intervention services are discussed.