Melbourne School of Psychological Sciences - Theses
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ItemThe assessment and treatment of concerns and anxiety in patients undergoing pre-surgical monitoring for epilepsy( 2006)The aim of the present study was to investigate the efficacy of an information package on reducing pre-surgical anxiety and concerns in patients with intractable epilepsy. Adverse psychological and social effects of temporal lobe epilepsy (TLE) are instrumental in anxiety and distress in these patients. This is brought into the hospital setting and exacerbated by the monitoring process and concomitant possibility of surgery where many patients prematurely curtailed the process at cost to themselves and the hospital.
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ItemThe ‘burden of normality’ following relief of chronic medical illness: a comparison of narcolepsy and epilepsy( 2001)Medical and technical advances have played a major role in the relief of chronic, lifestyle limiting medical illnesses. Issues relating to patient wellbeing and the ability to cope following the successful treatment of chronic illness have been addressed in recent years. This research endeavour has resulted from an increased recognition of the importance of the psychosocial issues in maximising treatment outcome. Recent research (Bladin, 1992; Wilson et. al., in press) has addressed the clinical features of psychosocial adaptation and adjustment following surgical treatment of chronic epilepsy. These features have been characterised as a syndrome, the 'burden of normality', comprising psychological, behavioural, affective and sociological change as patients discard roles associated with chronic illness and learn to become "well". The present study addresses the applicability of the burden of normality to another chronically ill population in which there is a chance for a dramatic relief of symptoms, that of narcolepsy. There has been no previous research into psychosocial adjustment following successful treatment of this condition. Importantly, narcolepsy and temporal lobe epilepsy (TLE) share a number of similar features which provide the rationale for this comparison. Most notably, both conditions have similar precursory features for the burden of normality. It was hypothesised that the symptoms of the burden of normality would be present in patients treated with stimulant medication (ritalin) for the relief of narcolepsy and patients who have undergone ATL for the relief of intractable seizures. It was also hypothesised that any differences in manifestations of symptoms would be related to 'disease-specific' features of the two conditions. Thirty three narcolepsy and 31 temporal lobectomy patients were recruited through routine outpatient followup at the Austin and Repatriation Medical Centre, Melbourne. All patients underwent in depth psychosocial review using the Austin CEP Interview. This is a formally coded, semi-structured interview that covers a broad range of issues, including symptoms of the burden of normality. The Beck Depression Inventory - Second Edition (BDI-II), and the State Trait Anxiety Inventory (STAI S-Anxiety) were also administered to assess mood states. This study documented the occurrence of symptoms of the burden of normality in the successfully treated narcolepsy and epilepsy populations. Symptoms of the burden of normality were proposed to stem from the psychological transition involved in discarding roles associated with "illness" and learning to become "well". Differences in symptom manifestation were argued to reflect 'disease specific' factors, including the later diagnosis and treatment of narcolepsy patients and issues related to differences in the nature of the treatment of the two conditions. It was concluded that the burden of normality appears to arise out of a general process of adjustment following relief of chronic medical illness. This indicates a strong need for preoperative counselling and psychosocial followup as potentially crucial services for patients with chronic illness who are offered the life-altering relief of their condition.