dc.contributor.advisor | Gillanders, David | |
dc.contributor.author | Graham, Christopher Darryl | |
dc.date.accessioned | 2017-03-09T09:57:47Z | |
dc.date.available | 2017-03-09T09:57:47Z | |
dc.date.issued | 2016-07-01 | |
dc.identifier.uri | http://hdl.handle.net/1842/20950 | |
dc.description.abstract | Muscle disorders are chronic, progressive conditions, the majority of which are
without disease modifying treatments. Quality of life (QoL) is reduced in these
conditions, and alternative methods, such as psychological intervention, may offer ways
to improve QoL. Previous work has suggested that aberrant illness perceptions may be
influential targets for psychological interventions; however, emerging evidence suggests
that psychological flexibility might offer another treatment target.
This thesis first presents a longitudinal investigation of the role of these two
variables, alongside disability level, in explaining life satisfaction and mood measured
four months later. Participants were recruited from charities and online communities,
with data collected via online questionnaires. Here, illness perceptions and
psychological flexibility, but not disability level, were cross-sectionally associated with
all dependent variables. In prospective analyses psychological flexibility accounted for
greater variance in life satisfaction and anxiety; while illness perceptions explained
more variance in depression. However, after controlling for variance in time one
dependent variables, psychological flexibility alone was predictive of life satisfaction
and anxiety at time two. Therefore, psychological flexibility represents a possible
influential target for psychological intervention in muscle disorders.
Acceptance and Commitment Therapy (ACT) is a psychological intervention
specifically designed to improve psychological flexibility. Subsequently, the results of
the empirical study imply that ACT is worthy of trial with muscle disorders. However,
there has been no comprehensive review of the use of ACT in chronic disease or long-term
conditions. Therefore, Chapter 2 presents a systematic review of ACT as applied to
chronic disease/long-term conditions. The aims were to collate all ACT interventions
with chronic disease/long-term conditions; evaluate their quality and comment on
efficacy.
Ovid MEDLINE, EMBASE and Psych Info were searched, with a further search
of citing articles undertaken using Google Scholar. Studies with mental health or
chronic pain populations were excluded. Study quality was then rated, with a proportion
re-rated by a second researcher. Seventeen studies were included, of which: eight were
randomised controlled trials (RCTs), three used pre-post designs, and seven were case
studies. A broad range of applications were observed (e.g. improving quality of life and
symptom control, reducing distress) across many diseases/conditions (e.g. HIV, cancer,
epilepsy). However, study quality was generally low, and many interventions were of
low intensity. The small number of RCTs per application and lower study quality
emphasise that ACT is not yet a well-established intervention for chronic disease/long-term
conditions. However, there was promising evidence for certain applications: the
parenting of children with long-term conditions, seizure-control in epilepsy,
psychological flexibility and possibly self-management/lifestyle.
The studies comprising this thesis suggest that, whilst psychological flexibility
appears influential in muscle disorders, high-quality research into ACT interventions for
chronic disease/long-term conditions is generally lacking. Therefore one cannot
confidently generalise from existing studies that ACT will improve outcomes in muscle
disorders. Thus an evaluation of ACT in the context of muscle disorders is now
required. This should adhere to the methodological suggestions provided in the
systematic review. | en |
dc.contributor.sponsor | other | en |
dc.language.iso | en | en |
dc.publisher | The University of Edinburgh | en |
dc.relation.hasversion | Graham CD, Rose MR, Grunfeld EA, Kyle SD, Weinman J: A systematic review of quality of life in adults with muscle disease. Journal Of Neurology. 2011, 258:1581-1592. | en |
dc.relation.hasversion | Burns TM, Graham CD, Rose MR, Simmons Z: Quality of life and measures of quality of life in patients with neuromuscular disorders. Muscle & Nerve. 2012, 46:9-25. | en |
dc.relation.hasversion | Graham CD, Simmons Z, Stuart SR, Rose MR: Issues & Opinions – The potential of psychological interventions to improve quality of life and mood in muscle disorders. Muscle & Nerve. 2014:n/a-n/a. | en |
dc.relation.hasversion | Harrison SL, Robertson N, Graham CD, et al.: Can we identify patients with different illness schema following an acute exacerbation of COPD: A cluster analysis. Respiratory medicine. 2014, 108:319-328. | en |
dc.relation.hasversion | Graham CD, Weinman J, Sadjadi R, et al.: A multicentre postal survey investigating the contribution of illness perceptions, coping and optimism to quality of life and mood in adults with muscle disease. Clinical Rehabilitation. 2014, 28:508-519. | en |
dc.relation.hasversion | Graham CD, Gillanders D, Stuart S, Gouick J: An Acceptance and Commitment Therapy (ACT)–Based Intervention for an Adult Experiencing Post-Stroke Anxiety and Medically Unexplained Symptoms. Clinical Case Studies. 2014. | en |
dc.relation.hasversion | Graham CD, Rose MR, Hankins M, Chalder T, Weinman J: Separating emotions from consequences in muscle disease: Comparing beneficial and unhelpful illness schemata to inform intervention development. Journal of Psychosomatic Research. 2013, 74:320-326. | en |
dc.rights | Attribution-NonCommercial-ShareAlike 4.0 International | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-sa/4.0/ | * |
dc.subject | Acceptance and Commitment Therapy | en |
dc.subject | ACT | en |
dc.subject | psychological flexibility | en |
dc.title | Potential of acceptance and commitment therapy (ACT) to improve outcomes in muscle disorders: a longitudinal investigation of psychological flexibility and systematic review of ACT for long-term conditions | en |
dc.type | Thesis or Dissertation | en |
dc.type.qualificationlevel | Doctoral | en |
dc.type.qualificationname | DClinPsychol Doctor of Clinical Psychology | en |