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Sommers-Spijkerman M, Zwarts-Engelbert A, Kruitwagen-Van Reenen E, Van Eijk RPA, Visser-Meily JMA, Heijmans E, Austin J, Drossaert C, Bohlmeijer E, Beelen A. Acceptability and potential benefit of a self-compassion intervention for people living with amyotrophic lateral sclerosis: a mixed methods pilot study. Amyotroph Lateral Scler Frontotemporal Degener 2024:1-11. [PMID: 39258586 DOI: 10.1080/21678421.2024.2400516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 08/27/2024] [Accepted: 08/30/2024] [Indexed: 09/12/2024]
Abstract
Objective: This proof-of-concept study aimed to explore the acceptability and potential benefit of a self-guided online self-compassion intervention to aid resilient coping and reduce emotional distress among patients and caregivers living with ALS. Methods: A single-arm pilot study was conducted in 20 adults living with ALS either as a patient or as a caregiver. Acceptability was examined using questionnaires (n = 20) and semi-structured interviews (n = 9). Potential benefit was assessed as changes in self-compassion, self-criticism and emotional distress, determined using psychological questionnaires at 3 and 6 weeks. Questionnaires were analyzed using linear mixed-effects models and interview data using inductive thematic analysis. Results: Out of 20 participants who started the intervention, 16 completed the study (80%). The majority of study completers (12/16) were satisfied with the intervention, but the data suggest room for improvement in terms of personalization. Qualitative data revealed multiple psychological benefits of using the intervention, including self-kindness, emotional self-awareness and savoring. Although not statistically significant, quantitative data showed positive trends with increased self-compassion (mean difference: 2.07; 95% CI: -.5.76 - 1.63) and reduced self-criticism (mean difference: -2.62; 95% CI: -.1.97 - 7.23) and emotional distress (mean difference: -2.49; 95% CI: -.51 - 5.50) at week 6 compared to baseline. Conclusions: The findings suggest that a self-compassion intervention is acceptable to people living with ALS, but its beneficial effects and the mechanisms involved have yet to be established in larger and more diverse samples, using controlled designs.
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Affiliation(s)
- Marion Sommers-Spijkerman
- Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Aimée Zwarts-Engelbert
- Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Esther Kruitwagen-Van Reenen
- Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Ruben P A Van Eijk
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Biostatistics & Research Support, Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands, and
| | - Johanna M A Visser-Meily
- Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Emmy Heijmans
- Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Judith Austin
- Department of Psychology, Health & Technology, University of Twente, Enschede, the Netherlands
| | - Constance Drossaert
- Department of Psychology, Health & Technology, University of Twente, Enschede, the Netherlands
| | - Ernst Bohlmeijer
- Department of Psychology, Health & Technology, University of Twente, Enschede, the Netherlands
| | - Anita Beelen
- Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
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Keetharuth AD, Gould RL, McDermott CJ, Thompson BJ, Rawlinson C, Bradburn M, Bursnall M, Kumar P, Turton EJ, Tappenden P, White D, Howard RJ, Serfaty MA, McCracken LM, Graham CD, Al‐Chalabi A, Goldstein LH, Lawrence V, Cooper C, Young T. Cost-effectiveness of acceptance and commitment therapy for people living with motor neuron disease, and their health-related quality of life. Eur J Neurol 2024; 31:e16317. [PMID: 38660985 PMCID: PMC11235598 DOI: 10.1111/ene.16317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/27/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Given the degenerative nature of the condition, people living with motor neuron disease (MND) experience high levels of psychological distress. The purpose of this research was to investigate the cost-effectiveness of acceptance and commitment therapy (ACT), adapted for the specific needs of this population, for improving quality of life. METHODS A trial-based cost-utility analysis over a 9-month period was conducted comparing ACT plus usual care (n = 97) versus usual care alone (n = 94) from the perspective of the National Health Service. In the primary analysis, quality-adjusted life years (QALYs) were computed using health utilities generated from the EQ-5D-5L questionnaire. Sensitivity analyses and subgroup analyses were also carried out. RESULTS Difference in costs was statistically significant between the two arms, driven mainly by the intervention costs. Effects measured by EQ-5D-5L were not statistically significantly different between the two arms. The incremental cost-effectiveness was above the £20,000 to £30,000 per QALY gained threshold used in the UK. However, the difference in effects was statistically significant when measured by the McGill Quality of Life-Revised (MQOL-R) questionnaire. The intervention was cost-effective in a subgroup experiencing medium deterioration in motor neuron symptoms. CONCLUSIONS Despite the intervention being cost-ineffective in the primary analysis, the significant difference in the effects measured by MQOL-R, the low costs of the intervention, the results in the subgroup analysis, and the fact that ACT was shown to improve the quality of life for people living with MND, suggest that ACT could be incorporated into MND clinical services.
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Affiliation(s)
- Anju D. Keetharuth
- School of Medicine and Population Health, Sheffield Centre for Health and Related ResearchUniversity of SheffieldSheffieldUK
| | | | | | - Benjamin J. Thompson
- Clinical Trials Research Unit, Sheffield Centre for Health and Related ResearchUniversity of SheffieldSheffieldUK
| | | | - Mike Bradburn
- Clinical Trials Research Unit, Sheffield Centre for Health and Related ResearchUniversity of SheffieldSheffieldUK
| | - Matt Bursnall
- Clinical Trials Research Unit, Sheffield Centre for Health and Related ResearchUniversity of SheffieldSheffieldUK
| | - Pavithra Kumar
- Clinical Trials Research Unit, Sheffield Centre for Health and Related ResearchUniversity of SheffieldSheffieldUK
| | - Emily J. Turton
- Clinical Trials Research Unit, Sheffield Centre for Health and Related ResearchUniversity of SheffieldSheffieldUK
| | - Paul Tappenden
- School of Medicine and Population Health, Sheffield Centre for Health and Related ResearchUniversity of SheffieldSheffieldUK
| | - David White
- School of Medicine and Population Health, Sheffield Centre for Health and Related ResearchUniversity of SheffieldSheffieldUK
| | | | - Marc A. Serfaty
- Division of PsychiatryUniversity College LondonLondonUK
- Priory Hospital North LondonLondonUK
| | | | | | - Ammar Al‐Chalabi
- Maurice Wohl Clinical Neuroscience InstituteKing's College LondonLondonUK
| | - Laura H. Goldstein
- Department of Psychology, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Vanessa Lawrence
- Health Service & Population Research Department, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Cindy Cooper
- Clinical Trials Research Unit, Sheffield Centre for Health and Related ResearchUniversity of SheffieldSheffieldUK
| | - Tracey Young
- School of Medicine and Population Health, Sheffield Centre for Health and Related ResearchUniversity of SheffieldSheffieldUK
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3
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Gould RL, McDermott CJ, Thompson BJ, Rawlinson CV, Bursnall M, Bradburn M, Kumar P, Turton EJ, White DA, Serfaty MA, Graham CD, McCracken LM, Goldstein LH, Al-Chalabi A, Orrell RW, Williams T, Noad R, Baker I, Faull C, Lambert T, Chhetri SK, Ealing J, Hanratty A, Radunovic A, Gunawardana N, Meadows G, Gorrie GH, Young T, Lawrence V, Cooper C, Shaw PJ, Howard RJ. Acceptance and Commitment Therapy plus usual care for improving quality of life in people with motor neuron disease (COMMEND): a multicentre, parallel, randomised controlled trial in the UK. Lancet 2024; 403:2381-2394. [PMID: 38735299 DOI: 10.1016/s0140-6736(24)00533-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND Motor neuron disease is a progressive, fatal neurodegenerative disease for which there is no cure. Acceptance and Commitment Therapy (ACT) is a psychological therapy incorporating acceptance, mindfulness, and behaviour change techniques. We aimed to evaluate the effectiveness of ACT plus usual care, compared with usual care alone, for improving quality of life in people with motor neuron disease. METHODS We conducted a parallel, multicentre, two-arm randomised controlled trial in 16 UK motor neuron disease care centres or clinics. Eligible participants were aged 18 years or older with a diagnosis of definite or laboratory-supported probable, clinically probable, or possible familial or sporadic amyotrophic lateral sclerosis; progressive muscular atrophy; or primary lateral sclerosis; which met the World Federation of Neurology's El Escorial diagnostic criteria. Participants were randomly assigned (1:1) to receive up to eight sessions of ACT adapted for people with motor neuron disease plus usual care or usual care alone by a web-based system, stratified by site. Participants were followed up at 6 months and 9 months post-randomisation. Outcome assessors and trial statisticians were masked to treatment allocation. The primary outcome was quality of life using the McGill Quality of Life Questionnaire-Revised (MQOL-R) at 6 months post-randomisation. Primary analyses were multi-level modelling and modified intention to treat among participants with available data. This trial was pre-registered with the ISRCTN Registry (ISRCTN12655391). FINDINGS Between Sept 18, 2019, and Aug 31, 2022, 435 people with motor neuron disease were approached for the study, of whom 206 (47%) were assessed for eligibility, and 191 were recruited. 97 (51%) participants were randomly assigned to ACT plus usual care and 94 (49%) were assigned to usual care alone. 80 (42%) of 191 participants were female and 111 (58%) were male, and the mean age was 63·1 years (SD 11·0). 155 (81%) participants had primary outcome data at 6 months post-randomisation. After controlling for baseline scores, age, sex, and therapist clustering, ACT plus usual care was superior to usual care alone for quality of life at 6 months (adjusted mean difference on the MQOL-R of 0·66 [95% CI 0·22-1·10]; d=0·46 [0·16-0·77]; p=0·0031). Moderate effect sizes were clinically meaningful. 75 adverse events were reported, 38 of which were serious, but no adverse events were deemed to be associated with the intervention. INTERPRETATION ACT plus usual care is clinically effective for maintaining or improving quality of life in people with motor neuron disease. As further evidence emerges confirming these findings, health-care providers should consider how access to ACT, adapted for the specific needs of people with motor neuron disease, could be provided within motor neuron disease clinical services. FUNDING National Institute for Health and Care Research Health Technology Assessment and Motor Neurone Disease Association.
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Affiliation(s)
- Rebecca L Gould
- Division of Psychiatry, University College London, London, UK.
| | - Christopher J McDermott
- Sheffield Institute for Translational Neuroscience, and the NIHR Sheffield Biomedical Research Centre, University of Sheffield, Sheffield, UK
| | | | | | - Matt Bursnall
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Mike Bradburn
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Pavithra Kumar
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Emily J Turton
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - David A White
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Marc A Serfaty
- Division of Psychiatry, University College London, London, UK; Priory Hospital North London, London, UK
| | - Christopher D Graham
- Department of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | | | - Laura H Goldstein
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ammar Al-Chalabi
- Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK
| | - Richard W Orrell
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Tim Williams
- The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Rupert Noad
- Department of Neuropsychology, Derriford Hospital, Plymouth, UK
| | - Idris Baker
- Swansea Bay University Health Board, Swansea, UK
| | | | - Thomas Lambert
- Department of Neurosciences, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - Suresh K Chhetri
- Regional Neurosciences Centre, Lancashire Teaching Hospitals NHS Foundation Trust, Lancashire, UK
| | - John Ealing
- Northern Care Alliance NHS Trust, Salford, UK
| | | | | | - Nushan Gunawardana
- Department of Neurology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Gail Meadows
- Department of Psychological Medicine, Northern Lincolnshire and Goole NHS Foundation Trust, Grimsby, UK
| | - George H Gorrie
- Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK
| | - Tracey Young
- Division of Population Health, Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK
| | - Vanessa Lawrence
- Health Services & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Cindy Cooper
- Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Pamela J Shaw
- Sheffield Institute for Translational Neuroscience, and the NIHR Sheffield Biomedical Research Centre, University of Sheffield, Sheffield, UK
| | - Robert J Howard
- Division of Psychiatry, University College London, London, UK
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Gerritzen EV, Lee AR, McDermott O, Coulson N, Orrell M. Online peer support for people with Amyotrophic Lateral Sclerosis (ALS): a narrative synthesis systematic review. Front Digit Health 2024; 6:1138530. [PMID: 38357638 PMCID: PMC10864493 DOI: 10.3389/fdgth.2024.1138530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
Background Amyotrophic Lateral Sclerosis (ALS) significantly impacts the lives of people with the diagnosis and their families. A supportive social environment is important for people with ALS to adopt effective coping strategies and health behaviours, and reduce depressive symptoms. Peer support can provide a supportive social environment and can happen in-person and online. Advantages of online peer support are that people can engage from their own home, at their own time and pace, and that it offers a variety of different platforms and modes of communication. Objectives To (1) explore the benefits and challenges of online peer support for people with ALS, and (2) identify successful elements of online peer support for people with ALS. Methods The method selected for this systematic review was a narrative synthesis. Six databases were systematically searched in April 2020 for articles published between 1989 and 2020. The search was updated in June 2022. The quality of the included studies was assessed with the Critical Appraisal Skills Programme qualitative research checklist. Results 10,987 unique articles were identified through the systematic database search. Of those, 9 were included in this review. One of the main benefits of online peer support was that people could communicate using text rather than needing verbal communication, which can be challenging for some with ALS. Successful elements included using profile pages and graphics to identify others with similar or relevant experiences. Challenges included ALS symptoms which could make it difficult to use technological devices. Conclusions Peer support can provide a non-judgmental and supportive environment for people with ALS, in which they can exchange experiences and emotional support, which can help people in developing adaptive coping strategies. However, ALS symptoms may make it more difficult for people to use technological devices and engage in online peer support. More research is needed to identify what kind of specific barriers people with ALS experience, and how these could be overcome.
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Affiliation(s)
- Esther Vera Gerritzen
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Abigail Rebecca Lee
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Orii McDermott
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Neil Coulson
- Population and Lifespan Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Martin Orrell
- Institute of Mental Health, Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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5
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Pinto C, Geraghty AWA, McLoughlin C, Pagnini F, Yardley L, Dennison L. Experiences of psychological interventions in neurodegenerative diseases: a systematic review and thematic synthesis. Health Psychol Rev 2023; 17:416-438. [PMID: 35546326 DOI: 10.1080/17437199.2022.2073901] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 05/01/2022] [Indexed: 11/04/2022]
Abstract
Background: Psychological interventions for managing emotional distress in neurodegenerative diseases are needed, but progressive worsening of symptoms and increasing disability might pose difficulties with engagement. We aimed to synthesise the experiences of engaging with and using psychological interventions in neurodegenerative diseases and identify relevant barriers and facilitators. Methods: Systematic searches were conducted in six electronic databases and results were screened. We included qualitative and mixed methods studies reporting patient or caregivers' views or experiences of psychological interventions. Qualitative data were extracted and thematically synthesised. Results: 34 papers were included, covering a range of diseases and interventions. Engagement was facilitated by flexible intervention formats and tailoring to the specific needs of people with neurodegenerative diseases. Interventions were sometimes inaccessible or burdensome because of physical and cognitive symptoms, and the time and effort required for the intervention. Participants' levels of acceptance and readiness often differed and influenced engagement with the intervention. Across different interventions, participants experienced wide-ranging benefits including changes in insight, perspective, self-efficacy, emotions and relationships. Conclusion: Although people with neurodegenerative diseases and caregivers experience benefits from psychological interventions, burden-reducing adaptations and sensitive tailoring to the specific disease context is required to improve acceptability and engagement.
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Affiliation(s)
- Cathryn Pinto
- Department of Psychology, University of Southampton, Southampton, UK
| | - Adam W A Geraghty
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | | | - Francesco Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Lucy Yardley
- Department of Psychology, University of Southampton, Southampton, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Laura Dennison
- Department of Psychology, University of Southampton, Southampton, UK
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Gould RL, Rawlinson C, Thompson B, Weeks K, Gossage-Worrall R, Cantrill H, Serfaty MA, Graham CD, McCracken LM, White D, Howard RJ, Bursnall M, Bradburn M, Al-Chalabi A, Orrell R, Chhetri SK, Noad R, Radunovic A, Williams T, Young CA, Dick D, Lawrence V, Goldstein LH, Young T, Ealing J, McLeod H, Williams N, Weatherly H, Cave R, Chiwera T, Pagnini F, Cooper C, Shaw PJ, McDermott CJ. Acceptance and Commitment Therapy for people living with motor neuron disease: an uncontrolled feasibility study. Pilot Feasibility Stud 2023; 9:116. [PMID: 37420261 DOI: 10.1186/s40814-023-01354-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/27/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Motor neuron disease (MND) is a fatal, progressive neurodegenerative disease that causes progressive weakening and wasting of limb, bulbar, thoracic and abdominal muscles. Clear evidence-based guidance on how psychological distress should be managed in people living with MND (plwMND) is lacking. Acceptance and Commitment Therapy (ACT) is a form of psychological therapy that may be particularly suitable for this population. However, to the authors' knowledge, no study to date has evaluated ACT for plwMND. Consequently, the primary aim of this uncontrolled feasibility study was to examine the feasibility and acceptability of ACT for improving the psychological health of plwMND. METHODS PlwMND aged ≥ 18 years were recruited from 10 UK MND Care Centres/Clinics. Participants received up to 8 one-to-one ACT sessions, developed specifically for plwMND, plus usual care. Co-primary feasibility and acceptability outcomes were uptake (≥ 80% of the target sample [N = 28] recruited) and initial engagement with the intervention (≥ 70% completing ≥ 2 sessions). Secondary outcomes included measures of quality of life, anxiety, depression, disease-related functioning, health status and psychological flexibility in plwMND and quality of life and burden in caregivers. Outcomes were assessed at baseline and 6 months. RESULTS Both a priori indicators of success were met: 29 plwMND (104%) were recruited and 76% (22/29) attended ≥ 2 sessions. Attrition at 6-months was higher than anticipated (8/29, 28%), but only two dropouts were due to lack of acceptability of the intervention. Acceptability was further supported by good satisfaction with therapy and session attendance. Data were possibly suggestive of small improvements in anxiety and psychological quality of life from baseline to 6 months in plwMND, despite a small but expected deterioration in disease-related functioning and health status. CONCLUSIONS There was good evidence of acceptability and feasibility. Limitations included the lack of a control group and small sample size, which complicate interpretation of findings. A fully powered RCT to evaluate the clinical and cost-effectiveness of ACT for plwMND is underway. TRIAL REGISTRATION The study was pre-registered with the ISRCTN Registry (ISRCTN12655391).
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Affiliation(s)
- Rebecca L Gould
- Division of Psychiatry, University College London, Wing B, 6th Floor Maple House, 149 Tottenham Court Rd, London, W1T 7NF, UK.
| | - Charlotte Rawlinson
- Division of Psychiatry, University College London, Wing B, 6th Floor Maple House, 149 Tottenham Court Rd, London, W1T 7NF, UK
| | - Ben Thompson
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Kirsty Weeks
- Division of Psychiatry, University College London, Wing B, 6th Floor Maple House, 149 Tottenham Court Rd, London, W1T 7NF, UK
| | - Rebecca Gossage-Worrall
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Hannah Cantrill
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Marc A Serfaty
- Division of Psychiatry, University College London, Wing B, 6th Floor Maple House, 149 Tottenham Court Rd, London, W1T 7NF, UK
- Priory Hospital North London, London, UK
| | - Christopher D Graham
- Strathclyde Psychology, Department of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | | | - David White
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Robert J Howard
- Division of Psychiatry, University College London, Wing B, 6th Floor Maple House, 149 Tottenham Court Rd, London, W1T 7NF, UK
| | - Matt Bursnall
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Mike Bradburn
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Ammar Al-Chalabi
- Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK
| | - Richard Orrell
- Department of Clinical and Movement Neurosciences, Institute of Neurology, University College London, London, UK
| | - Suresh K Chhetri
- Lancashire Teaching Hospitals NHS Foundation Trust, Lancashire, UK
| | - Rupert Noad
- Department of Neuropsychology, Derriford Hospital, Plymouth, UK
| | | | - Tim Williams
- The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | | | - David Dick
- Norfolk and Norwich University Hospital, Norwich, UK
| | - Vanessa Lawrence
- Health Services & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Laura H Goldstein
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Tracey Young
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - John Ealing
- Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK
| | - Hamish McLeod
- Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Nicola Williams
- Primary Care Clinical Trials Unit, Oxford University, Oxford, UK
| | | | - Richard Cave
- Language and Cognition, University College London, London, UK
| | - Theresa Chiwera
- Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK
| | - Francesco Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Cindy Cooper
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Pamela J Shaw
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
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7
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Thomas PT, Warrier MG, Arun S, Bhuvaneshwari B, Vengalil S, Nashi S, Preethish-Kumar V, Polavarapu K, Rajaram P, Nalini A. An individualised psychosocial intervention program for persons with MND/ALS and their families in low resource settings. Chronic Illn 2023; 19:458-471. [PMID: 35469482 DOI: 10.1177/17423953221097076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To develop individualised psychosocial intervention program for people with MND and their families in India. METHODS People with MND and healthcare staff were constructively involved in co-designing the intervention program in four phases adapted from the MRC framework: 1. A detailed need assessment phase where 30 participants shared their perceptions of psychosocial needs 2. Developing the intervention module (synthesis of narrative review, identified needs); 3. Feasibility testing of the intervention program among seven participants; 4. Feedback from participants on the feasibility (acceptance, practicality adaptation). The study adopted an exploratory research design. RESULTS Intervention program of nine sessions, addressing psychosocial challenges through the different stages of progression of the illness and ways to handle the challenges, specific to the low resource settings, was developed and was found to be feasible. People with MND and families who participated in the feasibility study shared the perceived benefit through feedback interviews. CONCLUSION MND has changing needs and challenges. Intervention programme was found to be feasible to be implemented among larger group to establish efficacy.
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Affiliation(s)
- Priya Treesa Thomas
- Department of Psychiatric Social Work, 29148National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Manjusha G Warrier
- Department of Psychology, 119667CHRIST (Deemed to be University), Bangalore
| | - S Arun
- Department of Counselling Psychology, Montfort College, Bangalore
| | - B Bhuvaneshwari
- Department of Psychiatry, 236748St John's Medical college and hospital, Bangalore, India
| | - Seena Vengalil
- Department of Neurology, 29148National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Saraswati Nashi
- Department of Neurology, 29148National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Veeramani Preethish-Kumar
- Department of Neurology, 29148National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Kiran Polavarapu
- Department of Neurology, 29148National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Prakashi Rajaram
- Department of Psychiatric Social Work, 29148National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Atchayaram Nalini
- Department of Neurology, 29148National Institute of Mental Health and Neuro Sciences, Bangalore, India
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8
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Pinto C, Geraghty AWA, Pagnini F, Yardley L, Dennison L. How do people with MND and caregivers experience a digital mental health intervention? A qualitative study. Front Psychiatry 2023; 14:1083196. [PMID: 36816411 PMCID: PMC9932191 DOI: 10.3389/fpsyt.2023.1083196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/12/2023] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE We urgently need to develop and evaluate more psychological interventions to support people with Motor Neurone Disease (MND) and caregivers. We used the person-based approach to develop a digital mental health intervention and conducted two studies to explore people's experiences of using it. METHODS In Study 1, we conducted think-aloud interviews with 9 people with MND and 8 caregivers, and used findings to refine the intervention. In Study 2, 18 people with MND and 9 caregivers used the intervention for 6 weeks after which in-depth interviews were conducted. Data from both studies were combined and analysed using thematic analysis. RESULTS We developed 3 main themes around intervention acceptability, engagement, and usefulness. Participants highlighted the importance of accessibility and realistic presentation of information and support. Tailoring and timing intervention use to suit own needs, preferences, and disease stage was also important. Participants used the strategies presented to develop a positive outlook and regain some control. They also faced some challenges using these strategies in the context of dealing with progressive loss. CONCLUSION People with MND and caregivers can find digital mental health interventions useful. Intervention accessibility and flexibility are important for developing acceptable and engaging interventions for MND.
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Affiliation(s)
- Cathryn Pinto
- School of Psychology, University of Southampton, Southampton, United Kingdom
| | - Adam W A Geraghty
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom
| | - Francesco Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Lucy Yardley
- School of Psychology, University of Southampton, Southampton, United Kingdom.,School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Laura Dennison
- School of Psychology, University of Southampton, Southampton, United Kingdom
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9
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Gould RL, Thompson BJ, Rawlinson C, Kumar P, White D, Serfaty MA, Graham CD, McCracken LM, Bursnall M, Bradburn M, Young T, Howard RJ, Al-Chalabi A, Goldstein LH, Lawrence V, Cooper C, Shaw PJ, McDermott CJ. A randomised controlled trial of acceptance and commitment therapy plus usual care compared to usual care alone for improving psychological health in people with motor neuron disease (COMMEND): study protocol. BMC Neurol 2022; 22:431. [PMID: 36380299 PMCID: PMC9664029 DOI: 10.1186/s12883-022-02950-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/28/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Motor neuron disease (MND) is a rapidly progressive, fatal neurodegenerative disease that predominantly affects motor neurons from the motor cortex to the spinal cord and causes progressive wasting and weakening of bulbar, limb, abdominal and thoracic muscles. Prognosis is poor and median survival is 2-3 years following symptom onset. Psychological distress is relatively common in people living with MND. However, formal psychotherapy is not routinely part of standard care within MND Care Centres/clinics in the UK, and clear evidence-based guidance on improving the psychological health of people living with MND is lacking. Previous research suggests that Acceptance and Commitment Therapy (ACT) may be particularly suitable for people living with MND and may help improve their psychological health. AIMS To assess the clinical and cost-effectiveness of ACT modified for MND plus usual multidisciplinary care (UC) in comparison to UC alone for improving psychological health in people living with MND. METHODS The COMMEND trial is a multi-centre, assessor-blind, parallel, two-arm RCT with a 10-month internal pilot phase. 188 individuals aged ≥ 18 years with a diagnosis of definite, laboratory-supported probable, clinically probable, or possible familial or sporadic amyotrophic lateral sclerosis, and additionally the progressive muscular atrophy and primary lateral sclerosis variants, will be recruited from approximately 14 UK-based MND Care Centres/clinics and via self-referral. Participants will be randomly allocated to receive up to eight 1:1 sessions of ACT plus UC or UC alone by an online randomisation system. Participants will complete outcome measures at baseline and at 6- and 9-months post-randomisation. The primary outcome will be quality of life at six months. Secondary outcomes will include depression, anxiety, psychological flexibility, health-related quality of life, adverse events, ALS functioning, survival at nine months, satisfaction with therapy, resource use and quality-adjusted life years. Primary analyses will be by intention to treat and data will be analysed using multi-level modelling. DISCUSSION This trial will provide definitive evidence on the clinical and cost-effectiveness of ACT plus UC in comparison to UC alone for improving psychological health in people living with MND. TRIAL REGISTRATION ISRCTN Registry, ISRCTN12655391. Registered 17 July 2017, https://www.isrctn.com/ISRCTN12655391 . PROTOCOL VERSION 3.1 (10/06/2020).
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Affiliation(s)
- Rebecca L Gould
- Division of Psychiatry, University College London, Wing B, 6th floor Maple House, 149 Tottenham Court Rd, W1T 7NF, London, UK.
| | - Benjamin J Thompson
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Charlotte Rawlinson
- Division of Psychiatry, University College London, Wing B, 6th floor Maple House, 149 Tottenham Court Rd, W1T 7NF, London, UK
| | - Pavithra Kumar
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - David White
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Marc A Serfaty
- Division of Psychiatry, University College London, Wing B, 6th floor Maple House, 149 Tottenham Court Rd, W1T 7NF, London, UK
- Priory Hospital North London, London, UK
| | | | | | - Matt Bursnall
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Mike Bradburn
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Tracey Young
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Robert J Howard
- Division of Psychiatry, University College London, Wing B, 6th floor Maple House, 149 Tottenham Court Rd, W1T 7NF, London, UK
| | - Ammar Al-Chalabi
- Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK
| | - Laura H Goldstein
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Vanessa Lawrence
- Health Services & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Cindy Cooper
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Pamela J Shaw
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
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10
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Glennie N, Harris FM, France EF. Perceptions and experiences of control among people living with motor neurone disease: a systematic review and thematic synthesis. Disabil Rehabil 2022:1-13. [PMID: 35915574 DOI: 10.1080/09638288.2022.2104942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Current research suggests that feeling a lack of control is common among people living with Motor Neurone Disease (plwMND). This systematic review explores and synthesises evidence about: (1) What factors contribute towards perceptions of control in plwMND (2) How do plwMND attempt to maintain control in their daily lives? METHODS A systematic search from inception to January 2022 for peer-reviewed journal articles in English reporting qualitative and mixed-method primary studies or reviews of plwMND's perceptions or experiences of control was conducted on CINAHL, MEDLINE, PsycINFO, ASSIA, Embase and AMED. Eligible articles underwent quality appraisal, data extraction and a thematic synthesis was carried out. RESULTS Twenty publications, 19 primary studies and one review, from nine countries, reporting the views of 578 participants aged from 20 to 90 years were included. Two key analytical themes were identified (1) diagnosis can lead to a disruption of previously held control beliefs (2) plwMND use a range of control strategies to attempt to retain control in their lives. CONCLUSION This is the first systematic review and qualitative evidence synthesis to reveal the strategies plwMND use to regain control and that control beliefs about health, fate, identity and bodily control are significantly altered by the diagnosis. Implications for rehabilitationOutcome measures for plwMND should consider personal values and preferences as well as objective clinical measurements.plwMND use a range of control strategies which may alter and change over time therefore healthcare professionals may also need to review and adapt treatment decisions over time.The differing viewpoints of healthcare professionals and plwMND should be considered in clinical situations to reduce the potential for conflict.
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Affiliation(s)
- Nicola Glennie
- Postgraduate Researcher, NMHAP Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Fiona M Harris
- School of Health and Life Sciences, University of West of Scotland, Paisley, UK
| | - Emma F France
- NMHAP Research Unit, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
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11
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Ando H, Cousins R, Young CA. Flexibility to manage and enhance quality of life among people with motor neurone disease. Disabil Rehabil 2022; 44:2752-2762. [PMID: 33226867 DOI: 10.1080/09638288.2020.1846797] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To identify influential factors for quality of life (QoL) among individuals with motor neurone disease (MND) and explore how regulatory flexibility and psychological flexibility may contribute towards maintaining and improving QoL. METHODS Semi-structured interviews were conducted with 26 individuals with MND. Thematic analysis, using both inductive and deductive analyses, was employed to examine subjective QoL in view of previous understanding of QoL. RESULTS Four factors were important for the QoL of participants: perceived illness prognosis, sense of self, concerns for significant others, and life to enjoy. These factors reflected psychological stress caused by MND, the participant's value system, and their beliefs about life. In optimising QoL, both regulatory flexibility and psychological flexibility were essential to maintain and enhance QoL. Often, regulatory flexibility was perceived among those employing a mindful approach, and psychological flexibility was found to involve savouring positive experiences. CONCLUSIONS People with MND reported that seeking ways to both maintain and enhance their QoL is crucial, and that this may be accomplished by increasing flexibility through mindfulness and savouring. (171/200 words)Implications for rehabilitationPeople with motor neurone disease (MND) seek to maintain quality of life (QoL) following changes caused by the condition, whilst attempting to enhance QoL by maximising their positive experiences.Regulatory flexibility is essential to maintain QoL and it was closely associated with mindful approach so that MND is not perceived as an inevitable threat to QoL.Psychological flexibility was found to enhance QoL and it involves savouring positive experiences, while abandoning fault-finding of the current situation.Positive inter-personal interactions can encourage people with MND to engage with mindfulness and savouring for favourable outcomes in terms of QoL; current support services should orient towards both mindfulness and savouring.
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Affiliation(s)
- Hikari Ando
- The Walton Centre NHS Foundation Trust, Liverpool, UK.,Department of Psychology, Liverpool Hope University, Liverpool, UK
| | - Rosanna Cousins
- Department of Psychology, Liverpool Hope University, Liverpool, UK
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12
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Caregivers' View of Socio-Medical Care in the Terminal Phase of Amyotrophic Lateral Sclerosis-How Can We Improve Holistic Care in ALS? J Clin Med 2022; 11:jcm11010254. [PMID: 35011995 PMCID: PMC8745628 DOI: 10.3390/jcm11010254] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/28/2021] [Accepted: 12/30/2021] [Indexed: 11/18/2022] Open
Abstract
Multidimensional socio-medical care with an early integration of palliative principles is strongly recommended in amyotrophic lateral sclerosis (ALS), but provided inconsistently. We conducted telephone interviews with 49 former caregivers of deceased ALS patients to examine their experience of care in the terminal phase including caregiver burden. Patients who received specialized palliative care (45% of patients) were more likely to die at home (p = 0.004) and without burdening symptoms (p = 0.021). The majority of caregivers (86%) reported deficits in socio-medical care. Most frequently mentioned were problems receiving medical aids (45%) and a lack of caregiver support (35%). A higher level of deficits experienced by caregivers was associated with negative health outcomes on the side of the caregivers (reported by 57% of them; p = 0.002) and stronger caregiver burden (p = 0.004). To provide good quality of dying to patients and reduce the burden on caregivers, multidimensional—including palliative—care in ALS urgently needs to be strengthened in the healthcare structures.
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13
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Pinto C, Geraghty AWA, Yardley L, Dennison L. Emotional distress and well-being among people with motor neurone disease (MND) and their family caregivers: a qualitative interview study. BMJ Open 2021; 11:e044724. [PMID: 34404695 PMCID: PMC8372816 DOI: 10.1136/bmjopen-2020-044724] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE We aimed to get an in-depth understanding of the emotions experienced by people with motor neurone disease (MND) and their caregivers, and to explore what impacts emotional distress and well-being. DESIGN Qualitative study using semi-structured interviews with people with MND and caregivers. SETTING Participants were recruited from across the UK and took part in interviews conducted either face to face, by telephone or email to accommodate for varying levels of disability. PARTICIPANTS 25 people with MND and 10 caregivers took part. Participants were purposively sampled based on their MND diagnosis, symptoms and time since diagnosis. DATA ANALYSIS Data were analysed using inductive reflexive thematic analysis. RESULTS Eight broad themes were generated (20 subthemes). Participants described the emotional distress of losing physical function and having a threatened future because of poor prognosis. Keeping up with constant changes in symptoms and feeling unsupported by the healthcare system added to emotional distress. Finding hope and positivity, exerting some control, being kinder to oneself and experiencing support from others were helpful strategies for emotional well-being. CONCLUSION The study provides a broad understanding of what impacts emotional distress and well-being and discusses implications for psychological interventions for people with MND and caregivers. Any communication and support provided for people with MND and their caregivers, needs to pay attention to concepts of hope, control and compassion.
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Affiliation(s)
- Cathryn Pinto
- Department of Psychology, University of Southampton, Southampton, UK
| | - Adam W A Geraghty
- Primary Care and Population Sciences, University of Southampton, Southampton, Hampshire, UK
| | - Lucy Yardley
- Department of Psychology, University of Southampton, Southampton, UK
- School of Health Sciences, University of Bristol, Bristol, UK
| | - Laura Dennison
- Department of Psychology, University of Southampton, Southampton, UK
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14
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Munawar K, Choudhry FR, Lee SH, Siau CS, Kadri NBM, Binti Sulong RM. Acceptance and commitment therapy for individuals having attention deficit hyperactivity disorder (ADHD): A scoping review. Heliyon 2021; 7:e07842. [PMID: 34466706 PMCID: PMC8385395 DOI: 10.1016/j.heliyon.2021.e07842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/28/2021] [Accepted: 08/17/2021] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Acceptance and commitment therapy (ACT) has accumulated increasing evidence-base for a broad range of mental health issues. Considering that ACT encourages broad and flexible patterns of behaviour and neutralizes the pervasive psychological processes proposed to be caused by most individuals' distress, such a modality may be effective for ADHD. This review aimed to give a synthesis of the studies, so far, focusing on the usefulness of ACT approaches among individuals having ADHD. DESIGN/METHODS This scoping review searched studies exploring the effectiveness of ACT approaches for individuals with ADHD across eight electronic databases (Medline, Embase, PsycInfo, ScienceDirect, PubMed, Emcare, Scopus, and Google Scholar). This review was based on a total of two quasi-experimental and four experimental studies. RESULTS A thematic analysis was suggested based on the PRISMA guidelines. Overall, the review presented preliminary evidence demonstrating the use of ACT among individuals with ADHD. It was found that the ACT was used to treat a variety of behavioural and psychosocial outcomes, which included reducing ADHD symptoms (e.g., impulsivity, inattention, inflexibility, etc.) and other sequelae related to the ADHD diagnosis such as poor quality of life, academic procrastination, depression and anxiety symptoms, and psychological maladjustment. CONCLUSIONS This review revealed that ACT was a flexible approach that could be adapted to deliver both targeted treatment of ADHD symptomatology and more general psychosocial issues. It could also be delivered in group or individual formats. Nevertheless, although the findings of the present scoping review indicate promising results, more research is needed.
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Affiliation(s)
- Khadeeja Munawar
- Department of Psychology, Faculty of Social Sciences & Liberal Arts, UCSI University Malaysia, UCSI Heights 1, Jalan Puncak Menara Gading, Taman Connaught, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Fahad Riaz Choudhry
- Department of Psychology, Kulliyyah of Islamic Revealed Knowledge and Human Sciences, International Islamic University Malaysia, Kuala Lumpur, 53100, Malaysia
| | - Sook Huey Lee
- Department of Psychology, Faculty of Social Sciences & Liberal Arts, UCSI University Malaysia, UCSI Heights 1, Jalan Puncak Menara Gading, Taman Connaught, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Ching Sin Siau
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Nursyuhaidah Binti Mohd Kadri
- Department of Psychology, Faculty of Social Sciences & Liberal Arts, UCSI University Malaysia, UCSI Heights 1, Jalan Puncak Menara Gading, Taman Connaught, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Rose Manisah Binti Sulong
- Department of Psychology, Faculty of Social Sciences & Liberal Arts, UCSI University Malaysia, UCSI Heights 1, Jalan Puncak Menara Gading, Taman Connaught, Cheras, 56000, Kuala Lumpur, Malaysia
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15
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Dodd R, Fisher PL, Makin S, Moore P, Cherry MG. The Association Between Maladaptive Metacognitive Beliefs and Emotional Distress in People Living With Amyotrophic Lateral Sclerosis. Front Psychol 2021; 12:609068. [PMID: 33716871 PMCID: PMC7953059 DOI: 10.3389/fpsyg.2021.609068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 02/03/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Approximately half of all people living with amyotrophic lateral sclerosis (ALS) experience persistent or recurrent emotional distress, yet little is known about the psychological processes that maintain emotional distress in this population. The self-regulatory executive functioning (S-REF) model specifies that maladaptive metacognitive beliefs and processes are central to the development and maintenance of emotional distress. This study explored whether maladaptive metacognitive beliefs are associated with emotional distress after controlling for demographic factors, time since diagnosis, and current level of physical functioning. DESIGN In a cross-sectional design, 75 adults with a diagnosis of ALS completed self-report questionnaires. Participants had a mean age of 60.40 years, mean duration of symptoms 63.92 months, and male:female gender ratio of 14:11. MAIN OUTCOME MEASURES Questionnaires assessed emotional distress (HADS, adapted for ALS), physical functioning (ALSFRS-R), repetitive negative thinking (RTQ-10), metacognitive beliefs (MCQ-30), and demographic factors. RESULTS Maladaptive metacognitive beliefs explained additional variance in emotional distress after controlling for age, gender, time since diagnosis, physical functioning, and repetitive negative thinking. Repetitive negative thinking partially mediated the relationships between positive and negative metacognitive beliefs and emotional distress. CONCLUSIONS These data support the utility of the metacognitive model in understanding emotional distress in people with ALS. Examination of the temporal relationship between maladaptive metacognitive beliefs and emotional distress in people living with ALS may help to guide the development of therapeutic approaches.
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Affiliation(s)
- Rachel Dodd
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Peter L. Fisher
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Selina Makin
- Salford Royal NHS Foundation Trust, Salford, United Kingdom
| | - Perry Moore
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
- Salford Royal NHS Foundation Trust, Salford, United Kingdom
| | - Mary Gemma Cherry
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
- Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom
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16
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Zarotti N, Mayberry E, Ovaska-Stafford N, Eccles F, Simpson J. Psychological interventions for people with motor neuron disease: a scoping review. Amyotroph Lateral Scler Frontotemporal Degener 2020; 22:1-11. [PMID: 32657152 DOI: 10.1080/21678421.2020.1788094] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Motor neuron disease (MND) is a rapidly progressive neurodegenerative condition with no known cure. MND can affect every aspect of a person's life and has been associated with a wide range of psychological difficulties, which can occur from pre-diagnosis through to the condition's later stages. However, very little research has been conducted on psychological interventions for people with MND (pwMND). This paper aimed to provide the first review specifically targeting psychological interventions in MND and offer potential directions for future research. Methods: A scoping review was carried out across five major databases (PubMed, PsycINFO, CINAHL, Academic Search Ultimate, and Cochrane Library) until 1st of March 2020. Results: From an initial return of 1278 citations, 10 papers were included in the review. These included three randomized controlled trials (RCTs), two quasi-experiments, three uncontrolled pretest-post-test designs, one single case study, and one qualitative secondary analysis. The existing studies focused on a limited number of psychological outcomes and did not take into account site of MND onset or level of depression/anxiety before intervention. Implications for clinical practice are discussed and suggestions for future research are provided. Conclusions: The literature on psychological interventions is still extremely sparse. Mindfulness-based stress reduction (MBSR) and cognitive behavioral therapy (CBT) based on the stress-coping model show promise in RCTs, but require further evaluation. The need for further development and evaluation of psychological interventions to improve the well-being of pwMND cannot be overstated, particularly as the struggle toward the discovery of an effective treatment for MND continues.
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Affiliation(s)
- Nicolò Zarotti
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Emily Mayberry
- Sheffield Motor Neuron Disease Care Centre, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | | | - Fiona Eccles
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Jane Simpson
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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17
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Kruitwagen-van Reenen ETH, Post MWM, van Groenestijn A, van den Berg LH, Visser-Meily JMA. Associations between illness cognitions and health-related quality of life in the first year after diagnosis of amyotrophic lateral sclerosis. J Psychosom Res 2020; 132:109974. [PMID: 32155469 DOI: 10.1016/j.jpsychores.2020.109974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 02/17/2020] [Accepted: 02/19/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To describe illness cognitions among patients with amyotrophic lateral sclerosis (ALS), to study cross-sectional associations between illness cognitions and health-related quality of life (HRQoL) and to study the predictive value of illness cognitions measured shortly after the diagnosis for HRQoL at follow-up. METHODS Prospective longitudinal design. We administered Self-report questionnaires at study onset (n = 72) and follow-up (n = 48). Median follow-up period was 10.0 months. At baseline median ALS Functional Rating Scale-Revised was 43, median time since onset of symptoms was 13.6 months, 79% of patients presented with spinal onset. Illness cognitions Helplessness, Acceptance and Disease Benefits were measured with the Illness Cognitions Questionnaire (ICQ) and HRQoL with the ALS Assessment Questionnaire (ALSAQ-40). Correlational and regression analyses were used. RESULTS Patients experienced more Helplessness at follow-up. We found no significant changes in Acceptance or Disease Benefits at follow-up. In cross-sectional analyses, Helplessness was independently related to worse HRQoL at baseline (β = 0.44; p = .001) and Acceptance and Disease Benefits were independently related to worse HRQoL at follow-up (β = -0.17, p = .045) and (β = -0.186, p = .03 respectively). Longitudinal analyses showed that, adjusted for disease severity at baseline, Helplessness at baseline was a predictor of worse HRQoL at follow-up (β = 0.43; p = .006). None of the illness cognitions were a significant predictor of HRQoL with adjustment for baseline HRQoL. CONCLUSION Helplessness was independently associated with HRQoL in the cross-sectional and longitudinal analyses. These results can help us identify patients shortly after diagnosis who might benefit from psychological interventions.
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Affiliation(s)
- E T H Kruitwagen-van Reenen
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, the Netherlands; Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.
| | - M W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - A van Groenestijn
- Department of Rehabilitation, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - L H van den Berg
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - J M A Visser-Meily
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, the Netherlands; Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
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