Emma Corcoran - A thesis submitted in partial fulfilment of the requirements of the Degree of Doctor of Clinical Psychology (DClinPsych)

Systematic Review of the Literature
Experiencing burden is particularly common for carers of people with dementia, and is associated with a range of negative outcomes for carers and people with dementia themselves. Caregiver stress theory outlines the importance of understanding the factors associated with caregiver burden so that these factors can be addressed in interventions. It is possible that caregiver burden may differ in frontotemporal dementia and Alzheimer’s disease due to the differences in the two conditions. The current systematic review of the literature aims to determine whether caregiver burden is higher in frontotemporal dementia compared to Alzheimer’s Disease, and to compare factors predicting caregiver burden across the two conditions. Six databases were searched, which resulted in eighteen papers being included in the final review. The majority of papers found that caregiver burden was higher in frontotemporal dementia compared to Alzheimer’s Disease. Of the papers showing that carers of frontotemporal dementia had higher burden, these carers were older and more likely to have a spousal relationship. Due to the heterogeneity of predictors of caregiver burden measured, no clear conclusions could be drawn about the factors predicting caregiver burden in frontotemporal dementia and Alzheimer’s disease. Strengths and limitations of the papers are discussed, and recommendations for future research are outlined.
Service Improvement Project
Over 42,000 people are living with young-onset dementia (YOD) in the United Kingdom, however there has been relatively little research on how to support this client group. This service improvement project explored the extent to which Northamptonshire Healthcare NHS Foundation Trust’s Young Person’s with Dementia team was meeting the needs of people with YOD, and to determine what further support could be offered. Five staff members of the Young Persons with Dementia Team took part in a focus group, and nine people with YOD took part in semi-structured interviews, all accompanied by their carers. The thematic analysis demonstrated that most people with YOD are satisfied with support from the team, however there was scope for further input in a number of areas, such as specialised input for rare dementias, more social support and more tailored support for carers. Limitations and areas for future research are discussed.
Theory Driven Research Project
Background and Aims
Opiate misuse is a serious problem within the UK, with the relapse rate reported as over 90%. It is important that clinicians have an understanding of psychosocial factors associated with substance use so that these can be incorporated into interventions. Previous research has demonstrated the importance of social network in recovery and interventions, but loneliness is often not taken into account within social network research with opiate users. The study aimed to understand whether loneliness could predict opiate use at baseline and six months, when controlling for social network size, depression, anxiety, engagement and baseline substance misuse.
Design
The study used both a cross-sectional and longitudinal questionnaire design.
Setting
Recruitment took place in a Tier 3 NHS Substance Misuse Service.
Participants
Participants were 178 service users who were receiving opiate substitution treatment from the service. 122 participants completed the follow-up questionnaires after six months.
Measurements
Participants filled out the following questionnaires: University of California Los Angeles Loneliness Scale; an adapted Treatment Outcomes Profile; Social Network Index; Patient Health Questionnaire; Generalised Anxiety Disorder Scale. Participants also indicated the three most important contacts in their social network from a pre-determined list. The amount of times participants visited the service over a six month period was also measured.
Findings
The results demonstrated that only baseline substance use predicted substance use after six months, and that loneliness did not predict substance use at either timepoint.
Conclusions
The findings suggest that simply focusing on loneliness or social network size may not be beneficial for opiate users, and service users may benefit from an approach tailored to their individual circumstances. It may also be possible that reducing substance use may also impact levels of loneliness, which may not have been captured by only measuring baseline levels of loneliness.

Advisor: Evans, K
Vohora, R
Hogg, L
Birkett-Swan, L
O'Ryan, D