Background: Shame and disgust are often associated with posttraumatic stress disorder (PTSD) following interpersonal traumas such as sexual assault. It has been suggested that individuals with high levels of shame might do less well in standard cognitive behavioural (CBT) interventions. Aims: To see whether applying compassion-focused therapy and developing a compassionate mind can enhance trauma-focused CBT in an adolescent with high levels of shame and disgust the way it has been shown to within the adult population. Method: This single case study describes how trauma-focused CBT was enhanced by compassionate mind training. It details work using this approach with an adolescent female experiencing shame and disgust-based flashbacks. Treatment was provided for 20 sessions over 8 months. Symptoms of PTSD, depression and self-criticism, as well as the ability to self-soothe/reassure, were measured at assessment/start of treatment, mid- and end of treatment. Results: Clinically significant reductions in PTSD, depressive, shame and self-attacking symptoms were found between assessment and completion of treatment. Clinically significant increases in self-reassurance were also reported. Following treatment, symptoms of PTSD and depression were sub-clinical. Conclusion: This case study suggests that developing a compassionate mind alongside trauma-focused CBT may be beneficial to adolescents experiencing shame and disgust with consideration for the young person's level of development and personal circumstances.

Background: Numerous studies have shown that paranoia is common in the nonclinical population; however, little research has examined whether nonclinical paranoid beliefs change over time, or considered potential reasons for change. Aims: The aim of the present study was therefore to examine naturalistic change in nonclinical paranoid experiences. Method: 60 participants described an idiosyncratic experience of paranoia, including when it occurred, and rated their experience along four key belief dimensions: preoccupation, impact, distress and conviction. Participants provided two ratings for each dimension, retrospective recall at the time of the occurrence of the paranoid event, and again at the time of the interview. Participants were also asked to provide qualitative descriptions of reasons for change in belief dimensions. Results: Participants described paranoid experiences that had occurred over a large timeframe (1 day-25 years). Reductions across all four belief dimensions were found, and seven key themes emerged following qualitative analysis of the participants’ reason for change in response to the paranoid event. Conclusions: The findings highlight a number of factors associated with reported naturalistic changes in belief dimensions of conviction, distress, preoccupation and impact, which might be useful in enhancing interventions for clinical and nonclinical paranoia, and in helping to build models to account for why people showing clear paranoid ideation do, or do not, go on to develop clinical paranoia.