KEYNOTE SPEAKERS - 'Understanding and treating the psychopathology of abnormal cognitive experiences'

Friday 13th April

Perinatal mental health

Louise Howard, King’s College London

I will discuss the epidemiology of perinatal mental health problems, clinical manifestations, comorbid problems and impact on parenting. I will particularly focus on how having a mental health problem in the perinatal period impacts on treatment considerations and will present new data on experiences of women in primary care psychology services (IAPT)

There is more to compulsions than meets the eye

Christine Purdon, University of Waterloo, Canada

It generally accepted that compulsions are enacted to reduce emotional distress and that the resolution of emotional distress constitutes negative reinforcement for their performance. In leading treatment models of obsessive-compulsive disorder amelioration of the distress evoked by the obsessional concern is emphasized, the rationale being that if the obsession produces no distress the compulsion will become obsolete. However, 20+ years of research on the factors evoking distress over obsessions and introduction of cognitive strategies for managing negative appraisal of obsessions has resulted in absolutely no change in treatment efficacy; our ability to successfully treat OCD stubbornly remains at 50% (when treatment refusal and drop-out rates are taken into account), as it was over 20 years ago. This begs the question as to whether there are lacunae in our understanding of the presentation of OCD. Recent research clearly suggests that once a compulsion is enacted a number of self-perpetuating mechanisms can be activated which lead to reduced confidence that the compulsion can be terminated. Meanwhile, there has been scant phenomenological analyses of compulsions. Recent research from in-lab and diary studies suggests that there is considerably more to compulsions than meets the eye. For example, the expressed goal of a compulsion is seldom to reduce anxiety; although distress reduction may be a distal goal, data suggests that the compulsion is designed to meet specific proximal goals worth identifying and addressing. Compulsions are also associated with conversational thought, the tone of which might be worth attending to. This talk will present recent data on the phenomenology of compulsions and discuss potentially useful treatment strategies.

Body Image Problems in all its guises

David Veale, South London and Maudsley NHS Foundation Trust and King’s College London

Body image problems appear in many different forms from “objective” disfigurement to perceived defects. However the degree of disfigurement does not predict the degree of distress or interference in life. I will describe the model of the self as an aesthetic object and the behavioural processes that may maintain distress and interference in life. I will also highlight some unusual body image problems from phantom limb to body integrity identity disorder and whether tattoos are a sign of psychopathology. Finally, we will focus on therapeutic processes that may help improve body image