Zarotti, Nicolo and Simpson, Jane and Fletcher, Ian (2017) Emotional processing and communication in people with Huntington's disease : a mixed methods inquiry. PhD thesis, Lancaster University.
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Abstract
Huntington's disease (HD) is a progressive neurodegenerative disorder caused by the inheritance of the mutation of a protein called Huntingtin. Its typical symptoms include motor impairments, cognitive deterioration, and significant psychological difficulties. All these impairments can have a significant effect on the communication of affected individuals, including nonverbal components such as emotional processing. However, the current literature on HD appears to be particularly characterised by a medical approach to the topic, with little evidence from studies adopting a psychological perspective. Thus, the overarching aim of the current thesis was to investigate the impact of Huntington's disease on the emotional processing and communication of affected individuals from a health psychology perspective and with the adoption of a mixed-methods approach. After an initial scoping review of the literature, a qualitative study was conducted in the first phase of the research project, with the aim of exploring the perspectives on communication of people with symptomatic HD. In the second phase, two quantitative investigations were carried out, specifically addressing how HD affects emotional processing - in particular emotion regulation and recognition - in symptomatic and presymptomatic individuals. The results showed that, although emotional processing and communication are affected by HD, the achievement of feelings of control, better emotion regulation, effective medication regimes, and close interpersonal relationships can play a pivotal role in alleviating the burden of the disease. In addition, emotion regulation and emotional body language (EBL) recognition abilities were both impaired in symptomatic individuals, while evidence with presymptomatic people suggested a relative preservation of these skills. In both cases, no significant relationship was found between these abilities. However, the relationship between depressive symptoms and specific elements of emotion regulation such as emotional awareness should be further explored in presymptomatic participants, as it may play a potential precursory role in the development of emotion recognition impairments in fully symptomatic individuals. The implications of the findings for theory and practice are discussed, and possible directions for future research are provided.