Aika Hui - Thesis submitted in partial fulfilment of the requirements of the degree of Doctor of Clinical Psychology (DClinPsych)
Keywords: transgender mental health
violence and aggression
childhood sexual abuse
social anxiety
mixed-methods
clinical psychology

Systematic Review of the Literature (SRL): The Impact of Childhood Sexual Abuse on Interpersonal Violence in Men: A Systematic Review
Aim: The current systematic review aimed to critically examine the growing body of literature proposing that there is an ‘intergenerational cycle’ of violence, whereby victims of abuse during childhood are posited to have a higher propensity of becoming perpetrators during adulthood. This review examined whether there is quality evidence to support a relationship between childhood sexual abuse (CSA) victimisation and interpersonal violence perpetration (sexual/physical) in adult men. Method: 20 studies published between 1992 and 2022, with a total of 88,585 participants, were included in this review. The quality of studies was systematically assessed to provide a weighted conclusion to the primary research question. Results: Overall, there was limited evidence to confidently support or reject the link between CSA and physical and/or sexual violence in adulthood for men. The current review found that whilst there were studies that found an association on a univariate and multivariate level between CSA and interpersonal violence in adult men, significant methodological issues limit the validity of conclusions made. A sizeable proportion of high-quality studies at both univariate and multivariate levels of analysis suggest mixed results or did not find a significant relationship. Discussion: Implications of the results on the theory of, and research on, ‘intergenerational cycles’ of violence, as well as the limitations of the current study, were discussed.
Service Improvement Project (SIP): Improving outreach output to aspiring psychologists from disadvantaged socio-economic backgrounds in the Oxford Institute in Clinical Psychology Training and Research (OXICPTR)
Abstract
There is increasing recognition and action in recent years to widen participation in the clinical psychology workforce. However, much of the recent efforts have focused predominantly on diversity characteristics of ethnicity and race and much less so on other equally important diversity characteristics like socioeconomic status or class. The aim of this project was to examine ways in which the Oxford Institute in Clinical Psychology Training and Research (OXICPTR) could improve its outreach output. This project was a mixed-methods study that contained three stages. In the first stage, admissions data related to socioeconomic status from the OXICPTR was compared with admissions data nationally across all Doctorate of Clinical Psychology (DClinPsy) courses. Secondly, the experiences of 275 trainee and aspiring clinical psychologists self-identifying as from a socioeconomically disadvantaged background were surveyed and thematically analysed. Findings were summarised in terms of (i) the practical and perceptual barriers they have faced in their clinical psychology journey and (ii) their perceptions of Oxford as a training course. Lastly, 32 sixth-form students from disadvantaged schools were surveyed to explore their needs to be supported towards a career in clinical psychology. Based on these findings, recommendations for the Oxford Institute in Clinical Psychology Training and Research in terms of future outreach efforts were provided.
Theoretically Driven Research Project (TDRP): Examining the relationship between gender identity, psychological processes and social anxiety in a transgender clinical sample
Aim: There is currently limited understanding of the nature and prevalence of social anxiety disorder in transgender populations. The aim of the study was to examine the prevalence of social anxiety in a transgender sample and examine whether there were any gender identity differences in various psychological processes hypothesised to correlate with social anxiety.
Method: The current study was split into two phases. In the first phase, 251 cisgender participants were compared with 161 transgender participants on the Social Phobia Inventory (SPIN). In the second phase, 120 transgender participants from the first phase completed further measures related to cognitive-behavioural and transgender minority stress-related processes hypothesised to underlie social anxiety.
Results: Compared to cisgender males, cisgender females and transgender females, transgender males were found to have elevated social anxiety scores on the SPIN. There were no differences in cognitive behavioural measures and transgender minority stress-related measures between transgender males and females. Significant associations between cognitive and behavioural processes and social anxiety levels were found. The additional contribution of minority stress measures on predicting the level of social anxiety was smaller but significant.
Discussion: Implications of these findings on the applicability of established cognitive-behavioural models on transgender experiences of social anxiety, as well as limitations of the current study, were discussed.