| Summary: | <p><strong>Systematic Review of the Literature</strong></p>
<p><strong>Clinical psychology and voice disorders: A meta-analytic review of studies assessing psychological characteristics across individuals with and without voice disorders</strong></p>
<p>Clinical voice disorders are heterogenous conditions capturing problems with vocal production and control. Psychological conceptualisations of voice disorders posit that mood, anxiety, and personality characteristics contribute to the development and maintenance of voice symptoms. This review brings together research comparing these psychological characteristics across groups with and without voice disorders, with the aim of profiling group differences. A systematic search of PubMed, CINAHL, Ovid (PsycInfo, MEDLINE, Embase) and Web of Science databases was conducted, with studies required to assess psychological characteristics between samples with and without voice disorders. Relative study quality and risk of bias was formally evaluated, synthesising results via meta-analysis and narrative synthesis. Forty-three studies (N=5158) were reviewed. Marked psychological differences were observed between clinical and case groups, including significantly higher self-reported features of depression (d=0.51), state anxiety (d=0.56), trait anxiety (d=0.49), and health anxiety (d=0.57) in voice disorder groups. However, less consistent patterns of difference were observed between voice disorder types, including minimal quantitative differences between functional and organic diagnoses. Findings underline the psychological features associated with voice disorders, indicating that affected individuals present with considerable psychological needs which may benefit from clinical psychology input.</p></br>
<p><strong>Service Improvement Project</strong></p>
<p><strong>Forensic mental health staff understanding and experience of personality disorder: A service improvement project</strong></p>
<p>There is increasing evidence for the prevalence of personality-related difficulties within the forensic mental health service user population. Services therefore need to feel able to provide meaningful and supportive care to those presenting with personality difficulties and personality disorder diagnoses. Current guidelines suggest that categorical approaches to personality, which are increasingly outdated in inferring fundamental differences between those with and without personality diagnoses, continue to dominate forensic mental health service practice, with concerns about implications for service user care and wellbeing. This service improvement project follows the Plan-Do-Study-Act (PDSA) cycle to provide recommendations for service improvement, using a questionnaire and a focus group to explore staff understanding and experience of caring for people with personality disorder diagnoses within the service. Findings identified that respondents feel that those with a personality disorder diagnosis might experience adverse service outcomes, potentially linked to lack of staff understanding or limited training. Recommendations for service improvement focused on theoretical familiarity, access to training, trauma-informed initiatives, psychological workforce representation, outcome data review, protocol updates, and reflective practice opportunities. Recommendations were shared with the service to inform future PDSA cycles and plans for service improvement.</p></br>
<p><strong>Theory Driven Research Project</strong></p>
<p><strong>Psychosocial distress and interpersonal interaction experience in facial palsy: Associations with facial emotional mimicry</strong></p>
<p>The impact of facial palsy on mood and interpersonal functioning is increasingly recognised. This research investigated differences in psychosocial distress and interpersonal interaction experience between matched groups with (n=91) and without (n=86) facial palsy, exploring associations with spontaneous facial emotional mimicry as indexed using a mimicry task. Self-report measures were used to assess psychosocial distress and interpersonal interaction experience, with facial emotional mimicry assessed via video observation task in a participant subsample (n=61). Group differences in psychosocial distress and interpersonal interaction experience were observed, with facial palsy participants reporting more pronounced self-reported symptoms of depression, anxiety, and appearance-related dissatisfaction alongside less interpersonal pleasure and excitement. No group differences in facial emotional mimicry were observed, however, with limited associations between mimicry and psychosocial distress and interpersonal interaction experience. Findings are discussed in the context of the social regulator framework and its relevance to people with facial palsy.</p>
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