Psychological experiences in neurological conditions : multiple sclerosis and cervical dystonia

McCormack, Derval and Eccles, Fiona and O'Keeffe, Fiadhnait (2024) Psychological experiences in neurological conditions : multiple sclerosis and cervical dystonia. PhD thesis, Lancaster University.

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Abstract

This thesis focuses on psychological experiences in two distinct neurological conditions: multiple sclerosis (MS), and cervical or neck dystonia (ND). Section one outlines a systematic literature review, carried out to examine whether a relationship exists between body image and psychological outcome in MS. Four academic databases were searched systematically using key words relating to body image and MS. Manual searches of returned studies were conducted to find papers that examined psychological outcome. Although limited research has been carried out previously in this area, the findings offer preliminary evidence for a relationship between body image and psychological outcome in MS. The review suggests that positive body image is associated with better mood, lower anxiety, increased self-esteem, and greater quality of life. This has important clinical implications, suggesting that body image could be a target for future intervention. Future research should explore the association between body image and psychological outcome in more detail. Section two details an empirical study examining lived experiences of psychological distress in ND. Eleven individuals with ND were interviewed using a semi-structured schedule, and data was analysed using interpretative phenomenological analysis. The findings suggested that uncertainty, abandonment, loss, stigma, and isolation were central to people’s experiences of distress. This research contributes to wider literature regarding beliefs about psychological distress in dystonia. The results suggest that distress arises from living with ND, with some individuals also experiencing distress prior to onset of symptoms. The study provides valuable insight into gaps in clinical psychology provision, at direct and indirect levels. Future research including individuals with complex presentations of ND is recommended. Section three presents the critical appraisal, which evaluates the process of conducting this thesis. It considers important decisions, challenges encountered, and personal reflections.