Victoria Skibsted Nielsen - A thesis submitted in partial fulfilment of the requirements of the degree of Doctor of Clinical Psychology (DClinPsych)

Critical Review of the Literature (CRL) Abstract: An exploration of betrayal within mental contamination in OCD: a mixed-methods systematic narrative review
Although there has been significant research on the possible link between betrayal and mental contamination (MC) in the context of Obsessive-Compulsive Disorder (OCD), the findings appear contradictory. The current mixed-method systematic narrative review aimed to examine and synthesise research exploring the relationship between betrayal and MC in OCD, to determine whether the current empirical literature indicates whether or not betrayal is a critically important element in the experience of MC in OCD. Experimental and exploratory research studies of both quantitative and qualitative nature were included if they examined factors associated with MC and betrayal in OCD. Ovid and Open Athens databases including PsycINFO, Pubmed, Medline and Google Scholar were searched during May 2022. Quality and risk of bias was assessed using the Mixed Methods Appraisal Tool (MMAT: Hong et al., 2018). A total of 16 studies were included in the review (three qualitative, seven experimental, three quantitative non-randomised, two quantitative descriptive and two mixed methods studies). Overall, the current evidence provides support for a connection between betrayal, MC and OCD in clinical samples with the evidence being more mixed in analogue samples. Strengths, limitations, implications and future directions are discussed.
Service Improvement Project (SIP) Abstract: The Development, Evaluation and Improvement of an Online Stabilisation Group Intervention for Post-Traumatic Stress Disorder and Complex Post- Traumatic Stress Disorder
This service improvement project evaluated a pilot online stabilisation group offered to individuals waiting for one-to-one trauma-focused therapy for post-traumatic stress disorder (PTSD) or complex post-traumatic stress disorder (CPTSD) and made recommendations to the service on how the group could be improved. Quantitative and qualitative data were employed to assess the outcomes and experiences of 10 service users (SUs) who attended a six-session stabilisation group. Descriptive statistics and framework analysis revealed that all participants found the group helpful (to varying extents), despite no significant improvement in the symptoms of PTSD for the majority of group participants. Recommendations were made to the service based on the SUs’ qualitative feedback.
Theoretically Driven Research Project (TDRP) Abstract: Is Anthropomorphism Unique to Hoarding Disorder? A comparison of hoarding, OCD and non-hoarding collectors
Hoarding disorder (HD) has a detrimental impact on the wellbeing of the individual with the disorder and those around them. Rather than being a unitary disorder, HD may represent a “final common pathway”, with multiple factors responsible for the accumulation of possessions to the point at which living space becomes unavailable. Clinically, it has been suggested that anthropomorphising (the attribution of human-like characteristics to non-human objects) may be one such factor. Objectives: The current study hypothesised that anthropomorphising would be greater for possessions than nonowned objects, and that individuals experiencing HD would anthropomorphise to a greater extent than those with Obsessive-Compulsive Disorder (OCD) in the absence of significant hoarding tendencies and to two non-clinical comparison groups (people identifying as ‘collectors’ and members of the general population without collecting or hoarding tendencies). Method: A new scale to measure anthropomorphising of owned-possessions and non-owned objects was developed and evaluated in a cross-sectional study in 499 participants. Four criterion groups were constituted: HD, OCD, ‘Collectors’ and controls. Results: Those with HD anthropomorphised to a greater extent than collectors and controls but did not differ from the OCD group. There was no difference in levels of anthropomorphism between own-possessions and unowned-objects. The results suggest that anthropomorphism may contribute to hoarding behaviours, but the high scores in the OCD group require further research clarification. Conclusion: Anthropomorphism is prominent in both hoarding difficulties and OCD.

Keywords: OCD
mental contamination
anthropomorphism
collectors
betrayal
Obsessive compulsive disorder
PTSD
hoarding disorder
Complex post traumatic stress disorder
Advisor: Salkovskis, P
Johns, L
Jenner, S
Close, H