Division of Health Research, Lancaster University, UK.
Psychol Psychother. 2018 Jun;91(2):216-231. doi: 10.1111/papt.12157. Epub 2017 Oct 3.
This study sought to investigate how people who had tested positive for the Huntington's disease (HD) gene mutation understood and experienced psychological distress and their expectations of psychological therapy.
A qualitative methodology was adopted involving semi-structured interviews and interpretative phenomenological analysis (IPA).
A total of nine participants (five women and four men) who had opted to engage in psychological therapy were recruited and interviewed prior to the start of this particular psychological therapeutic intervention. Interviews were transcribed verbatim and analysed using IPA whereby themes were analysed within and across transcripts and classified into superordinate themes.
Three superordinate themes were developed: Attributing psychological distress to HD: 'you're blaming everything on that now'; Changes in attributions of distress over time: 'in the past you'd just get on with it'; and Approaching therapy with an open mind, commitment, and hope: 'a light at the end of the tunnel'.
Understandings of psychological distress in HD included biological and psychological explanations, with both often being accepted simultaneously by the same individual but with biomedical accounts generally dominating. Individual experience seemed to reflect a dynamic process whereby people's understanding and experience of their distress changed over time. Psychological therapy was accepted as a positive alternative to medication, providing people with HD with hope that their psychological well-being could be enhanced.
People with the Huntington's disease gene mutation have largely biomedical understandings of their psychological distress. This largely biomedical understanding does not, however, preclude them for being interested in the potential gains resulting from psychological therapy. The mechanisms of psychological therapy should be explained in detail before therapy and explored along with current attributions of distress.
本研究旨在探讨亨廷顿病(HD)基因突变检测呈阳性的人如何理解和体验心理困扰,以及他们对心理治疗的期望。
采用定性方法,包括半结构式访谈和解释现象学分析(IPA)。
共招募了 9 名参与者(5 名女性和 4 名男性),他们选择接受心理治疗,并在开始进行这种特定的心理治疗干预之前接受了采访。采访内容逐字记录,并使用 IPA 进行分析,即通过对转录本进行分析,将主题分为超主题。
提出了三个超主题:将心理困扰归因于 HD:“现在你把一切都归咎于它了”;随着时间的推移,痛苦归因的变化:“过去你只是继续下去”;以及以开放的心态、承诺和希望接受治疗:“隧道尽头有光”。
HD 中的心理困扰理解包括生物学和心理学解释,同一人通常同时接受这两种解释,但生物医学解释通常占主导地位。个人经历似乎反映了一个动态过程,即人们对自己痛苦的理解和体验随着时间的推移而变化。心理治疗被视为药物治疗的一种积极替代方法,为 HD 患者提供了希望,即他们的心理健康可以得到改善。
携带亨廷顿病基因突变的人对他们的心理困扰有很大的生物医学理解。然而,这种主要的生物医学理解并没有排除他们对心理治疗可能带来的好处的兴趣。在治疗前,应详细解释心理治疗的机制,并与当前的痛苦归因一起探讨。