Exploring the experience of stigma in functional neurological disorder and mindfulness for functional seizures

Foley, Ciarán and Eccles, Fiona and Kirkby, Antonia (2021) Exploring the experience of stigma in functional neurological disorder and mindfulness for functional seizures. PhD thesis, Lancaster University.

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Abstract

Overview: This thesis explored the concept of stigma as experienced by people with functional neurological disorder (FND) and assessed a mindfulness-based intervention for people experiencing functional seizures (FS). Systematic Literature Review: The systematic literature review used a qualitative meta-synthesis approach to explore the experience of stigma amongst people experiencing FND. The review identified four themes: delegitimization; excluded, isolated and abandoned – the social cost of stigma; the cost of attempts to manage stigma and; threats to identity and the meaning of mental health. Stigma appears to be a central experience for those with an FND diagnosis. Empirical Paper: The empirical paper comprised of a single case experimental design (SCED) which assessed the effect of a mindfulness training intervention delivered through a smartphone app for people experiencing FS. Four participants completed the study and a fifth completed it partially. Results found that two participants showed reliable and clinically significant changes on the outcome measure of quality of life and distress as well as process measures of experiential avoidance and mindfulness. However, clinically significant outcomes were not observed for the remainder. The implications of these results are discussed. Critical Appraisal: This paper shared reflections on the process of this research and provided additional background to some of the key decisions taken over the course of the study while offering a critical analysis of the project.