Zahra Khaki - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsy)

Systematic Review Abstract
There is long-standing evidence that bullying victimisation is associated with higher rates of self-harm and suicide. However, there is little evidence clarifying why some adolescents engage in these harmful behaviours and others do not. A systematic review of the moderators and mediators of these associations was conducted to understand the factors it may be useful to focus on in interventions with victimised adolescents. A search was performed on PsycINFO, MEDLINE, Embase, CINAHL and ERIC. Two independent researchers assessed fulfilment of eligibility criteria and methodological quality. Thirty-one studies were identified which studied 27 moderators and 13 mediators. Only two studies had high methodological quality and, except for depression and social support, no variables were moderators or mediators in more than one study. It is concluded that the evidence is not robust enough to draw conclusions about these variables as mechanisms, although depression and social support deserve further study. This is an emerging field of research and further work is recommended before any definite conclusions can be drawn.
Service Improvement Project Abstract
Background: There are many mental health sequelae of domestic abuse (DA), such as depression and anxiety disorders. There has been research on help-seeking behaviours of the general population in seeking support for their mental health, but we have little understanding of the factors impacting this for DA victims. The present study aimed to identify the barriers and facilitators to accessing DA mental health support, as well as what may help to keep victims engaged in this support. Participants: Twelve individual interviews were conducted. Six of these were with victims who had accessed support and six were with members of staff from organisations supporting DA victims. Recruitment took place through a DA mental health service in Berkshire. Methods: The 12 interviews were transcribed and analysed using thematic analysis. Themes related to barriers and facilitators across the 12 interviews were developed. Findings: In total, five main themes (with 10 sub-themes) relating to barriers and four main themes (with 11 sub-themes) relating to facilitators were found. Barriers included victims’ perceptions of themselves and others, ideas and attitudes about professional support and organisation constraints. Facilitators included positive ideas about accessing support, supportive relationships and organisations placing importance on mental heatth. Major Implications: The findings of the study have implications across all professionals who work with DA victims, due to multiple professionals usually being involved when a DA victim tries to access any kind of support at any point in their journey. Recommendations are also reported which have direct relevance to mental health services working with DA victims, such as educating wider professional networks on DA and its mental health sequelae as well as highlighting the importance of wider marketing and tailoring Victim-facing materials to address their concerns and fears.
Main Research Project Abstract
Objective: There is ample research about the negative effects social media can have on those with eating disorders. However, little is known about its potential positive effects. The following study aimed to explore the impact of pro-recovery Instagram posts on self-efficacy related to recovery, with self-esteem and hope being explored as secondary aims. Method: Participants were 60 females with an average age of 22.02. 92% were white-British. Two mock-Instagram feeds were developed: one included pro-recovery posts and another included more generic posts. Participants were randomly allocated to one of these two groups. All completed measures of self-efficacy (Eating Disorder Recovery Self-Efficacy Questionnaire), self-esteem (State Self-Esteem Scale) and hope (State Hope Scale) both before and after looking at the Instagram feed for 15 minutes. Qualitative data was also collected. Results: The pro-recovery feed had a significant large positive effect on self-efficacy as compared to the control feed). A similar effect was found for self-esteem, but not for hope. Themes emerging from qualitative data suggested more positive effects of looking at the pro-recovery feed compared to the control feed. Discussion: The findings suggest that, for patients who use social media, it may be more beneficial to look at pro-recovery posts than other posts on the platform. Since this is a preliminary finding, more research needs to be conducted in this area to determine whether pro-recovery social media could aid in one’s recovery journey. Ideas for future research are also discussed.

Keywords: Self-Harm
Victimisation
Mental Health
Self-Efficacy
Adolescent
Barriers
Engagement
Domestic Abuse
Eating Disorders
Instagram
Bullying
Access
Social Media
Recovery
Suicide
Advisor: Rakovshik, S
Adams, J
Evans, K
Cooper, M