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Research suggests some individuals with Temporal Lobe Epilepsy (TLE) experience an increased rate of forgetting for new information; currently defined as ‘Accelerated Long-Term Forgetting’ or ALF (Butler & Zeman, 2008). This novel construct goes undetected by standard neuropsychological measures and only becomes apparent after longer testing delays. However, as yet there have been no specific measures developed for the assessment of ALF. Consequentially, it is often undetected in TLE and research (relying on various novel or adapted measures) is yielding inconsistent findings. The present study aimed to build upon the findings of a previous research project (Crowley, 2014) by adapting an existing and widely used neuropsychological measure (Wechsler Memory Scale - Fourth UK Edition [WMS-IVUK]; Wechsler, 2010) in an attempt to assess its utility at detecting ALF in TLE. 25 TLE participants and 26 unaffected controls were administered selected WMS-IVUK subtests with an additional one-week recall and recognition delay. Participants also completed a comprehensive neuropsychological battery of cognitive and non-cognitive measures. Data was analysed at the group and individual level, and the contribution of non-memory cognitive and non-cognitive variables was considered. When analysed at the group level, TLE participants displayed evidence of verbal and visual ALF on selected WMS-IVUK subtests, even when the mediating role of non-memory variables was considered. Individual analysis revealed a range of memory profiles in the TLE group. Some participants displayed primary difficulty in the encoding/retrieval of new information, assessed across standard delays. It was unclear whether these individuals also experienced accelerated forgetting. Other individuals displayed a memory profile consistent with current definitions of ALF and performed worse than controls at the extended delay despite performance being comparable at the standard delay. Evidence of ALF was observed for all three WMS-IVUK subtests, on tasks of recall and recognition. Findings suggest the utility of the WMS-IVUK at detecting ALF in TLE.

Challenging behaviour is a label often given to people with learning disabilities when their behaviour challenges the system around them (Department of Health, 1993). There are numerous ways of understanding challenging behaviour. Given the mutual dependence between community learning disability teams and community support services in supporting people with learning disabilities, it was considered interesting to make explicit some of the ideas and assumptions that might enable or disable teams to work in consistent ways. This study draws on the research of Haydon-Laurelut, Nunkoosing and Millett (2014) and Nunkoosing and Haydon-Laurelut (2011). Six support workers at day centres for adults with learning disabilities (referrers) and six clinical psychologists working at community learning disability teams (responders) took part in semi-structured interviews. The interviews asked about their understandings of challenging behaviour in the context of making and receiving referrals. Interviews were transcribed verbatim and analysed using thematic analysis. Findings suggested that the support workers and clinical psychologists had quite similar ways of understanding challenging behaviour, which was an unexpected finding. They both used dominant discourses to talk about their understandings, as well as acknowledging that challenging behaviour is a social construction. These understandings were acknowledged to occur within the system or network around the person. Although there were shared understandings, still a schism existed in terms of how the services viewed each other. It was considered that something other than ‘understanding’ may be at the root of these differences and the suggestion made that the impact of emotions and relationships not being fully attended to and a common sense of powerlessness in the network could be important. Implications of the findings on an individual, service, policy and societal level were considered as well as ideas for future research. A critical review is provided in the final part of this thesis.

Background and Aims: The barriers to accessing mental health services for UK members of the Armed Forces (MAF) and veterans experiencing post-traumatic stress disorder (PTSD), have been well documented (Iversen, Van & Hughes, 2011; Murphy, Hunt, Luzon & Greenburg, 2013). However less is known about their recovery following treatment and this study sought to explore veterans’ perspectives on what they felt had aided or impeded their recovery. Methodology: Semi-structured interviews were undertaken with nine male veterans who had recently completed treatment for PTSD at Combat Stress. The interview transcripts were analysed using Interpretive Phenomenological Analysis. Results: Four master themes emerged from this analysis and are discussed within a narrative account: “Relief of receiving a PTSD diagnosis”, “From layman’s knowledge to the technical ins and outs”, “Recovery: A changing relationship with self, the world and others” and “The road to more recovery and less suffering”. Implications and conclusion: Most participants reported the concept of recovery felt inappropriate and preferred to consider their life post-treatment as a continual journey of coping with their PTSD. Nearly all participants found their diagnosis of PTSD useful, as it gave them a long sought for answer as to why they had been struggling and offered hope for treatment. All veterans identified meeting other veterans as integral to their coping with their problems, along with psychological techniques they learned to help manage their symptoms. The proactive approach taken by many participants suggests hegemonic masculinities could be a resource for coping even if they may make initially seeking help more challenging. This research echoes other literature by arguing for the complex nature of PTSD in veterans, due to stigma surrounding mental health difficulties within the armed forces and society as well as the identity shifts they have to navigate from MAF to veteran status.