Reformulating Psychological Difficulties in People with Parkinson’s Disease: The Potential of a Social Relational Approach to Disablism

Abstract

Research investigating the psychological difficulties experienced by people with Parkinson's disease (PD) is dominated by individualistic neurobiological and psychological perspectives. Therefore, this opinion paper draws on a reformulation of the social model of disability, Thomas' (1999) and (2007) social relational approach to disablism, to offer an alternative way of conceptualising psychological difficulties experienced by people with PD. This opinion paper explores the ways in which socially imposed restrictions and stigma may contribute to psychological difficulties by using Thomas' (2007) concept of psychoemotional disablism. By using the lens of psychoemotional disablism, this paper demonstrates that people with PD can be exposed to stigmatising attitudes and interactions which could contribute to restrictions, feelings of shame, and psychological difficulties such as depression. Accordingly, it is argued that further attention to the link between psychological difficulties and social dimensions of disablism in PD is needed in both research arenas and clinical practice to broaden understandings and interventions for people with PD.

Social Comparisons, Social Support, and Self-Perceptions in Group Exercise for People With Parkinson's Disease

“…Symptoms such as uncontrolled movement can be embarrassing and stigmatizing, and people with PD often try to conceal symptoms or retreat from public life (Bramley & Eatough, 2005), which can result in social isolation and depression (Simpson, McMillan, & Reeve, 2013). Group exercise provides several resources to help cope.…”

Impulse control disorders in Parkinson’s disease: Predominant role of psychological determinants

“…Given the demonstrated importance of psychological factors in ICDs in PD, psychological therapies in the future could form the basis for a significant improvement in the management of these problematic symptoms. Indeed, further use of support groups may allow the opportunity to for patients to discuss and explore the personal story behind their behaviour without a priori medicalisation, and at the same time reduce psycho-emotional problems arising from stigma (Simpson, McMillan, & Reeve, 2013;Simpson, & Thomas, 2015) that may be themselves be disabling via depression (Simpson, et al, 2013b) and hence the subsequent impact on quality of life (Simpson et al, 2014).…”

Psychological Predictors of Anxiety and Depression in Parkinson's Disease: A Systematic Review

“…Anxiety and depression in PD have typically been considered as “nonmotor symptoms” resulting from the neurochemical changes found in the brains of people with PD (Chaudhuri et al., ; Chaudhuri & Schapira, ; Leentjens, Dujardin, Martinez‐Martin, Richard, & Starkstein, ). However, there is an increasingly large body of evidence that psychological factors are useful determinants of the presence and level of anxiety and depression in people with PD (e.g., Brown & Jahanshahi, 1990; Simpson, MacMillan & Reeve, ). Furthermore, achieving a more comprehensive understanding of the psychosocial predictive factors for anxiety and depression in PD could pave the way for developing interventions to support and improve quality of life and reduce levels of psychological distress in this group of people (Fitzpatrick, Simpson, & Smith, ).…”

“…For example, Simpson et al. () highlight the importance of taking a multifaceted stance to encompass the various effects of PD on the person's well‐being and mental health rather than following guidelines for what would “typically” be expected for people with PD or those in the general population.…”

“…A wider understanding of the range (and relative frequency) of psychological determinants of (and their intrastructural relationship to) anxiety and depression would enable interventions to be formulation‐based after an informed assessment process (Simpson et al., ). Consequently, the current systematic review, using the robust search methodology described in a previous review on psychological adjustment in people with multiple sclerosis (MS; Dennison, Moss‐Morris, & Chalder, ), provides a narrative synthesis of the quantitative evidence assessing the relationship between psychological factors and two measures of psychological distress, depression and anxiety, in people with PD.…”