The cause of impulse control behaviours (ICBs) in Parkinson's disease (PD) has recently become the focus of research attention. However, 'this research is limited to a biomedical model, centring on the role of dopamine replacement therapy in causing these behaviours. Furthermore, gaps remain in our understanding of ICBs. The first section of this work presents a narrative review of current evidence regarding the etiology of ICBs in people with PD. The review highlights areas of methodological and theoretical discrepancy in the current biomedical understanding. It is argued that a biopsychosocial model may provide a more adequate explanation of these behaviours within PD and thereby inform individual, formulation based approaches to assessment and treatment. Furthermore, research to date has failed to consider perceptions of cause in people with PD who have experienced these behaviours. Therefore, the second part of this work concerns a qualitative investigation which explored how people with PD perceive the cause and controllability of their ICBs. Interpretative phenomenological analysis (IPA) was carried out on data gathered via semi-structured interviews with 10 participants. The resulting themes were 1) 'It does seem to open a whole Pandora 's Box of who we are and why we do what we do; Conflicting views on causality.'; 2) 'Better to live like a tiger for a day than like a lamb for a year; Impulse control behaviours as a coping strategy.'; and 3) 'Just a thing I couldn't control, like a greater power than me; Relationship between causal attribution and perceived controllability.' Causal attributions were found to be fundamental to the perceived controllability of ICBs. In addition, ICBs were linked to coping with PD. Implications for clinical practice and future research are discussed. The final section of this work reflects on methodological, professional and ethical issues which arose throughout the research process.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:552824 |
| Date | January 2010 |
| Creators | Delaney, Mary |
| Publisher | Lancaster University |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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