Doctorate in Clinical Psychology : Main Research Portfolio

: 1) How can psychological perspectives help clinicians better understand limb disownership in Complex Regional Pain Syndrome? A scoping review; 2) Scoping the needs of older adults with ‘Complex Emotional Needs’ (CEN) in a secondary mental health service: a service evaluation; 3) How do people physically and psychologically experience limb disownership in Complex Regional Pain Syndrome? An interpretive phenomenological analysis.

Abstract

Background
People living with Complex Regional Pain Syndrome (CRPS) typically experience chronic burning or stabbing pain in a limb, alongside changes to limb appearance, sensation, temperature, movement and autonomic function. Most people describe changes to the perception of the limb which can feel altered in size, shape and weight, and feel detached or disowned. For some, symptoms may never resolve. Psychological factors are one of several variables thought to maintain the condition. Yet little is known about how these physical and psychological factors interrelate for people living with CRPS limb disownership.

Method
An interpretive phenomenological approach (IPA) was used to guide collection of semi-structured interview data and visual images of limb disownership. Quantitative measures of body perception disturbance, depression and anxiety were collected to support data interpretation. Participants were recruited from a national CRPS charity and a pool of university participants. Data were analysed by two researchers at individual and group levels, and interpretation was checked by participants.

Results
Nine individuals with CRPS limb disownership in upper and/or lower limbs participated (7female; mean age 49; mean CRPS duration 12 years) between Feb 2024 and Jan 2025. Four group themes were developed which described limbs which were physically and psychophysically disowned, and cognitively, emotionally and relationally disowned. Limb disownership was primarily a body experience in which the limb was perceived as absent and repellent. Participants related to the limb in varying ways depending on cognitive, emotional and relational responses to their disowned limb. This in turn influenced how manageable disownership was to each individual and how they engaged with treatments.

Conclusion
Limb disownership in people with CPRS was primarily a perception of limb absence and revulsion. Coping with this unnerving body experience led individuals to use cognitive, emotional and relational strategies which improved or compounded disownership perceptions. Variation between participant contexts and experiences led them to adopt differing disownership strategies to varying extents. Understanding variation between individual disownership presentations, ways of coping over the course of CRPS duration could provide helpful information to tailor interventions. Practitioner psychologists would be well-placed to support people with CRPS to attend to these cognitive, emotional and relational strategies and determine how they might influence their experience of limb disownership.

Date of Award	10 Sept 2025
Original language	English
Awarding Institution	University of Bath
Supervisor	Josh Valoroso (Supervisor) & Janet Bultitude (Supervisor)