Non-epileptic attack disorder (NEAD) is a disorder resembling epilepsy, but is caused by psychological processes rather than neurological disturbance. Approximately 15-30% of patients referred to specialist epilepsy centres have NEAD as opposed to epilepsy. Research into NEAD has largely focused on the differential diagnosis of NEAD and identifying risk factors, such as abuse and psychopathology. Whilst this is important, there remains a paucity of research exploring the processes involved in the development and maintenance of NEAD, which contributes to the lack of research investigating treatment effectiveness and prognosis. Furthermore, there remains a paucity of research investigating patient perceptions and experiences, despite such factors influencing prognosis. Subsequently, the current study used repertory grid methodology to explore the largely overlooked domain of how individuals with NEAD construe their world (i.e. how they perceive themselves, others and their disorder). Twelve individuals with a diagnosis of NEAD were recruited from a clinical neuropsychology department within North-West England. This study was an exploratory, cross-sectional study using the repertory grid technique to explore the participants' construals of themselves and others, including construals of their ideal self and self before NEAD. Based on personal construct theory, this method aimed to overcome some of the methodological limitations inherent within NEAD research, by minimising researcher bias, exploring implicit and explicit perceptions and exploring both individual and group perceptions.A case series of grids was presented. Individual and multiple analyses were used to explore participants' construct systems. A data driven approach enabled hypotheses to be developed from the individual grids, which were explored via a composite grid and SocioNet analysis. Despite some themes being identified, the findings revealed the uniqueness of the participants' ways of construing, including a lack of shared understanding amongst the participants. The participants were unhappy with their current self and no longer construed themselves to be the person they were before the onset of NEAD. They also construed themselves as being distinct and/or alienated from others, although some participants construed positive consequences as a result of their NEAD. Whilst most participants agreed with their NEAD diagnosis 'label', they were less accepting of the psychological factors that characterise the diagnosis. Finally, physical health difficulties were construed as being preferable to experiencing mental health difficulties. The findings were discussed in relation to previous research and theoretical implications were highlighted. Clinical implications were highlighted, particularly how the current diagnostic and treatment system for individuals with NEAD may threaten their self-identity. Methodological considerations and recommendations for future research were also suggested. The repertory grid technique was found to be a useful and effective method to investigate the subjective perceptions of individuals with NEAD.
|Date of Award||31 Dec 2011|
- The University of Manchester
|Supervisor||Rachel Calam (Supervisor) & Dougal Hare (Supervisor)|
- Non-epileptic attack disorder
- Repertory grid