The family experience of frontotemporal dementia : a qualitative study

Overview This thesis is submitted in partial fulfilment for the requirements of the degree of Doctor of Clinical Psychology at the School of Psychology, University of Birmingham. It comprises of a research and a clinical volume. Volume I Volume I is the research component of the thesis. It consists...

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Bibliographic Details
Main Author: Bradley, Paul
Published: University of Birmingham 2009
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Online Access:https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.512424
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Summary:Overview This thesis is submitted in partial fulfilment for the requirements of the degree of Doctor of Clinical Psychology at the School of Psychology, University of Birmingham. It comprises of a research and a clinical volume. Volume I Volume I is the research component of the thesis. It consists of two papers, the first of which is a review of the literature that uses ‘Theory of Mind’ (ToM) tasks with people with frontal-variant frontotemporal dementia (fvFTD). All the research identified is systematically appraised in terms of the methodology and the quality of the published reports. The evidence indicates that ToM is impaired in people with fvFTD; however more robust findings were evident from research which comprehensively measured neuropsychological functioning and used established and well known ToM tests. More recent research has diversified into exploring other aspects of social cognition, such as emotional processing and empathy, and their relationships with ToM. The nominated journal for this review paper is ‘Neuropsychologia’. The second paper is a qualitative research project that explores the experiences of family members of people living with fvFTD. The research questions were: How does the development of fvFTD in a working age person affect the family experience of living with that person, and how might mental health services respond to the needs of those family members? Individual in-depth interviews were carried out with six relatives (including partners, a sibling, and an adult child), and Interpretative Phenomenological Analysis (IPA) was used to analyse the data resulting in the emergence of four main themes. The findings demonstrate how family caregivers of people with fvFTD have to contend with specific behavioural challenges and personality changes associated with the condition. The study also indicates that knowledge about fvFTD is lacking in both carers and professionals alike, causing uncertainty and long periods waiting for a diagnosis, which adds to the burden of care for these people. Services need to be developed to cater for specific individual needs and awareness needs to be raised in all health care services. The nominated journal for this research paper is ‘Dementia: The International Journal of Social Research and Practice’. Volume II Volume II is the clinical component of the thesis, which consists of five clinical practice reports (CPRs) that describe and evaluate clinical work carried out during clinical placements throughout the training course. The first CPR ‘Psychological Models’ formulates the case of an 18-year-old woman with anxiety symptoms from a systemic and a cognitive perspective. The second CPR ‘Small Scale Service-Related Research Project’ is a qualitative evaluation of a drop-in service for young people leaving care. The third CPR ‘Single Case Experimental Design’ evaluates the intervention designed to support a woman with a moderate learning disability and behaviour that challenged services. The fourth CPR ‘Case Study’ details the neuropsychological assessment of an 81-year-old man with memory problems. The fifth CPR was presented orally and it describes the use of Cognitive Analytic Therapy with a woman presenting with anxiety following treatment for breast cancer. The abstract is included here only.