%0 Journal Article
%T Reformulating Psychological Difficulties in People with Parkinson¡¯s Disease: The Potential of a Social Relational Approach to Disablism
%A Jane Simpson
%A Helen McMillan
%A Donna Reeve
%J Parkinson's Disease
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/608562
%X 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. 1. Introduction In addition to motor symptoms, people with Parkinson¡¯s disease (PD) can experience psychological difficulties such as depression [1], anxiety [2], apathy [3], psychosis [4], and problems with impulse control [5] (see [6] for further details). Such nonmotor difficulties can be as, if not more, challenging as motor difficulties to people with PD [7] and their caregivers [8] and are a major contributor to patient perceptions of quality of life (e.g., see [9, 10]). In terms of frameworks for understanding the psychological difficulties experienced by people with PD, Brown and Jahanshahi [11] highlighted that neurobiological conceptualisations dominate. Neurobiological conceptualisations assume that psychological difficulties occur as a direct result of pathological neurobiological processes within an individual, such as changes in dopaminergic systems; for example, see [12]. Indeed, this assumption is fundamental in that much psychiatrically driven research on psychological outcomes in people with PD, the primary role given to neurobiological dysfunction is not even questioned, for example, [13, 14]. However, it has been argued that there is a need to broaden conceptualisations of psychological difficulties associated with PD beyond neurobiological models; for example, see [11, 15, 16] and psychological approaches assessing variables such as illness cognitions, personality, and coping styles have
%U http://www.hindawi.com/journals/pd/2013/608562/