Bahar Pourghobad - Thesis Submitted in Partial Fulfilment of the Degree of Doctor of Clinical Psychology (DClinPsych)

Systematic Review of Literature Abstract
Cognitive models of social anxiety disorder (SAD) in adults indicate that negative self-imagery plays a key role in the development and maintenance of the disorder. Video feedback (VF) can be used to help socially anxious individuals correct their negative self-imagery, and it is hypothesised that providing individuals with accurate and objective information about how they come across to others reduces anxiety. This systematic review aimed to examine whether VF is effective in treatment of SAD symptoms. Seven databases were search for ‘Social anxiety’ and related terms (e.g. ‘social phobia’ and ‘performance anxiety’) combined with ‘video feedback’ and related terms (e.g. ‘feedback’). The 17 studies that met the eligibility criteria provided evidence that VF improved negative self-perception. Video feedback interventions that included cognitive preparation were superior to VF alone. Furthermore, adding audience feedback to VF enhanced the therapeutic effects. There was limited evidence that VF with cognitive strategies improved anxiety. However, preliminary evidence suggested that VF combined with audience feedback had stronger effects on anxiety. Further research is required among clinical population to understand whether the therapeutic effects of VF generalise to natural or ecologically valid social situations.
Service Improvement Project Abstract
Background: Carers play an important role in the recovery of individuals with psychosis. Therefore, it is recommended that they are provided with education and support as early as possible in the early intervention in psychosis (EIP) services.
Objectives: To understand the experiences and needs of carers regarding education and support within the Oxford EIP service. To make recommendations to the service about ways in which it can further meet carer education and support needs.
Method: A quantitative survey was used to collect data from carers of individuals with psychosis about their experiences and needs of education and support in the EIP service currently providing care to these families.
Results: Only 36 carers completed the survey out of 90 contacted. Most of these carers received education verbally and from care coordinators. Overall, carers found the information helpful and felt supported upon receiving it. Receiving information as early as possible in a booklet and having an opportunity to discuss the content with a member of staff were identified as the most preferred timing and format of receiving education. In addition, most of the carers received carer support in the service, but would prefer to receive this support as early as possible.
Conclusion: There are specific areas of improvement for the delivery of carer education and support in the Oxford EIP service. Further work is needed to hear from more carers.
Theoretically Driven Research Project Abstract
Background: Experiencing intrusive mental images related to health concerns is common in health anxiety, although experimental studies are needed to clarify their role.
Objective: The study aimed to investigate the effects of health catastrophising imagery compared to general threat imagery in increasing anxiety, threat perception beliefs, and behavioural responses, and whether the response is specific to health anxiety.
Method: 63 individuals, meeting criteria for health anxiety or OCD, and a comparison healthy control group were included. Semi-idiographic health catastrophising and general threat mental imagery were induced, and responses before and after were measured as ratings of anxiety, threat appraisals, and behavioural responses.
Results: Health catastrophising mental imagery resulted in significantly greater increase in anxiety in the highly health anxious group relative to general threat imagery, and this was specific to that group. Health anxiety scores were significantly correlated with the increase in anxiety in response to the health image but not to the general threat image. No significant differences were detected for threat appraisals and behavioural responses to imagery.
Discussion: The findings are consistent with the hypothesis that mental imagery with a health catastrophising focus can result in increased anxiety among highly health anxious individuals, and this effect is specific to health catastrophising mental images. Findings suggest that such imagery taps into the specific appraisals of those experiencing health anxiety.

Advisor: Cooper, M
Halldorsson, B
Johns, L
Salkovskis, P
Lack, S