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Background: There has been little research into the psychosocial needs of older people living with bipolar disorder (BD). There is evidence to suggest that psychological treatments developed for working aged adults are effective. These treatments may not be acceptable or effective for an older population due to differences in presentation in later life. Aims: The overarching aim of the thesis was to develop a recovery focused therapy (RfT) for older people with BD. The main aims were to: improve our understanding of how BD presents in older adults, identify whether any potential adaptations were needed to an existing therapy (RfT) to meet the needs of an older adult population and to evaluate the feasibility and acceptability of RfT for older adults (RfT-OA) with BD. Methods: Study one was a systematic review of psychosocial functioning and quality of life in older people with BD. Study two was a qualitative study, using focus group methodology, to increase our understanding of BD in later life and inform the development of RfT-OA. Study three was a mixed methods study to evaluate the feasibility and acceptability of RfT-OA. Results: The results from study one indicate that older adults demonstrate a wide range of functioning. Study two found that older adults with BD reported changes in their symptomatology, physical health and cognition. They proposed a number of specific adaptions for delivering RfT-OA including techniques to enhance memory and learning and recommendations for the therapist including: nurturing pre-existing strengths and work focused on building assertiveness and confidence. The findings from study three largely support the feasibility and acceptability of RfT-OA. Clinical assessment measures provided evidence of a signal for effectiveness on a range of outcomes including: mood symptoms, time-to-relapse and functioning. Conclusions: The findings suggest that RfT-OA is feasible, acceptable and has the potential to improve a range of outcomes for older adults with BD.

Substance abuse is very common in Bipolar Disorder (BD) and can lead an individual having an increased range of difficulties. Studies have indicated that cannabis is used very frequently, but most research into substance use and BD has focused on either alcohol use or substance use disorders generally. The relationship between BD and cannabis use specifically has received far less attention. This thesis specifically explored the co-occurring relationship between BD and cannabis use. In the first section the author examines and critically evaluates studies that have reported on the relationship between BD and cannabis use. The initial phase included a literature search of the area and the identification of relevant papers. A total of 13 research studies were identified and included in the final review. The studies varied considerably in terms of their research questions, design and methodological quality. The findings from the studies were synthesised in relation to a number of existing hypotheses for why BD and substance use in general co-occur. On the whole, the 13 studies contributed sufficient evidence both for and against the existing hypotheses. The findings suggest that there are a number of factors that contribute towards the high co-occurrence of BD and cannabis use (e.g. the use of cannabis to self-medicate symptoms).The second section was designed to investigate a number of the factors derived from the literature which might explain the high co-occurrence of BD and cannabis use. The Experience Sampling Methodology (ESM) was utilised to provide a close investigation of a number of factors over the course of daily life. Twenty-three participants with BD type I and type II completed diary entries for 6 days using ESM. The procedure allowed a close investigation into the associations between cannabis, mood, BD symptoms and Behavioural Activation System (BAS) sensitivity. Self-reported BAS was also measured to indicate the extent to which this predicted changes in mood, BD symptoms and cannabis use. The findings indicate that cannabis use is associated with a number of psychological effects, although no evidence for the self- medication of mood and BD symptoms was revealed in the daily life of the participants. An association between BAS sensitivity and positive affect and manic symptoms was revealed and this is consistent with the findings in current literature. The final section provides a critical reflection of the research process. This includes a rationale for the development of the literature review and the main research paper. This is followed by a description of the study context and then a reflection on the methodological and ethical issues which were faced. Finally it discusses theoretical, clinical and future implications for research in this area.

This thesis uses a study of the collocation of words for treasure to address the question of the relationship between the conventionality and originality of Old English verse. Collocation will be defined as the tendency for words to appear together. Such a definition allows for the examination of patterns of repetition beyond the half-line while also including the half-line formula thereby including stylistic features which have been considered, negatively, as constraints and restrictions on the freedom of the Old English poet, as well as other stylistic features which have been considered positively, as evidence of the rhetorical skill of the Old English poet. Rather than restrict the number of poems which I study, I have chosen to restrict the number of words to five words (mađm, hord, gestreon, sinc and frætwe) for treasure. This restriction allows for a wide spectrum of Old English verse to be examined since the words appear widely throughout the corpus. I hope thus to avoid the tendency common in scholarship to study not the whole of Old English poetry but to focus on Beowulf and verse at one time thought to be at least partly heroic. With few exceptions, the study of the style of Old English verse has largely ignored meaning. The restriction of this study to five words will allow for comments on stylistic features to be drawn with reference not only to the needs of verse form but with careful attention to the subtlety of the semantic fields of the words involved. In Chapter One, I review past scholarship on the lexis and style of Old English Verse with particular emphasis on the question of conventionality and originality. Chapter Two examines the place of treasure in Old English verse. Chapter Three focuses on the semantic analysis of the five words for treasure. I devote attention to the referents of each word and also include an account of such semantic aspects as nuance, connotation and themes associated with each word. Chapter Four consists of a study of the lexical collocations associated with each of these five words for treasure. Chapter Five considers the implications of the collocations of words for treasure for the conventionality and originality of the style and lexis of Old English verse. The conclusion attempts to comment on the style and quality of individual Old English poems. Lexical collocation is an aspect of lexis and style which has been largely ignored and which offers a new vantage point from which to consider Old English poetics further.