Ranjeet Kaur Bassi - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych)

Keywords: impulsivity
Eating disorders
comorbidity
substance use disorders

CRL
A systematic narrative review of the shared mechanisms in substance abuse and eating disorders
Objective: Eating disorders (ED) and substance use disorders (SUD) have high rates of comorbidity and the highest mortality rates of any mental health disorders. Several reasons for the comorbidity have been suggested. The aims of this review were to synthesise the research evidence for comorbid ED and SUD and evaluate the quality of the studies.
Methods: Six databases were searched, using terms related to ED, SUD, and psychological mechanisms. The search yielded 3,725 papers. 20 papers met inclusion criteria. Data on the measures used and mechanisms explored was extracted, and the quality of each paper was rated by two independent raters. Findings were synthesised in a narrative review.
Results: Of the 20 papers, five papers measured DSM-5 Axis II personality pathology and showed mixed results, with evidence for clusters A, B and C in both disorders. Twelve papers measured various personality temperaments or dispositions. Impulsivity and novelty seeking were two aspects of personality traits repeatedly linked to comorbid ED and SUD. Five papers explored emotional regulation and showed individuals with comorbidity are more likely to struggle with emotional regulation skills.
Conclusion: Papers focusing on personality pathology and traits failed to propose specific mechanisms for how ED-SUD comorbidity occurs. Personality traits are not considered modifiable and therefore do not readily lead to treatment targets. Emotional regulation-based factors used schema-based models and proposed several treatment options. Future research should focus on schema (and related cognitive) based models.
SIP
A qualitative exploration of working with Panjabi speakers in Buckinghamshire Memory Clinic
Introduction: Government reports have highlighted the rising rates of dementia in Black, Asian and Ethnic Minority individuals. However, many ethnic minority groups face barriers in accessing memory services, and often feel services are not set up for them. South Buckinghamshire Memory Clinic aimed to explore the needs and views of non-English speaking Panjabi individuals, to consider how they might best work with this group.
Methods: Semi-structured interviews were carried out with eight Panjabi speaking members of the local community, aged between 55 and 76 years old. The authors also conducted focus groups and interviews with staff from the memory clinic to explore their experiences of working with Panjabi speaking service users.
Results: Thematic analysis of the data revealed four key themes for community members: wanting to be around “people like us”; negative views of memory difficulties; believing services “don’t have things for people like us”; and valuing professional help. Data from staff members revealed six key themes: A desire to be person-centred; staff don’t always feel confident; family members want to be helpful; having a choice in interpreters; difficult to keep tests reliable and valid; and using flexible approaches to gathering information.
Discussion: This study made several recommendations for South Buckinghamshire Memory clinic including use of second languages in the staff team to support assessments, using resources specifically made for Panjabi individuals, and being mindful that families may not want an interpreter, but service users may still benefit from being offered one.
TDRP
Stigma and its Impact on Seeking Professional Psychological Help – Are there Cultural Differences?
Introduction: Individuals from a South Asian background are thought to utilise mental health services less often than other individuals. Literature has suggested several barriers to accessing mental health support, one being stigma. Corrigan et al.’s Why Try? model is used to understand perceptions of stigma from others (public stigma) and stigma towards the self (self-stigma). This paper aims to explore whether a population of South Asian individuals has more negative views towards seeking professional psychological help, when compared to White British individuals, and whether stigma or acculturation play a role in this.
Methods: An online questionnaire was used to gather data on people’s attitudes towards seeking professional psychological help, views on self-stigma, perceptions of public stigma and levels of acculturation.
Results: There were no differences in attitudes towards seeking professional help between the two groups. Public stigma was not associated with attitudes to seeking help, however greater self-stigma was associated with poorer attitudes to seeking help, regardless of culture. Acculturation impacted the relationship between public stigma and attitudes to seeking help only.
Conclusion: This paper adds a novel contribution in its recruitment of individuals who have experienced mental health difficulties. The paper highlights the importance of looking at other barriers outside of public or self-stigma to understand why South Asian individuals may be underrepresented in mental health services.