LSRP: Defence styles, alexithymia, illness perceptions, and HRQOL in IBD. Systematic lit: Neurodegenerative diseases and third wave therapies

  • Liam Reilly

Student thesis: Doctoral ThesisDoctor of Philosophy


The effectiveness of third wave therapies on neurodegenerative diseases.
Objectives: Previous research has identified the effectiveness of third wave therapies in reducing the symptoms of a variety of physical and psychological presentations. This systematic review will assess the efficacy of third wave therapies for adults with neurodegenerative diseases.
Methods: The selected electronic databases, Medline, PsychInfo, Embase and Cinahl, were used to search for studies that were published from the inception of each database to January 2018. Third wave therapies (e.g. Acceptance and Commitment Therapy, Dialectical Behaviour Therapy, Mindfulness-Based Cognitive Therapy) and neurodegenerative diseases (e.g. Alzheimer disease, Parkinson’s disease, Prion disease) were included as search terms.
Results: The systematic literature search revealed 570 potentially relevant papers. From this number, seven studies were found to be eligible for inclusion in the narrative synthesis. These studies reported on four neurodegenerative diseases and five adapted third wave therapy interventions. There were found to be mixed results on the effectiveness of third wave therapies for improving both physical and psychological symptoms in a variety of neurodegenerative diseases.
Conclusions: At this stage, it is not possible to deem whether third wave therapies are feasible in offering psychological or physical benefits to the neurodegenerative disease population. However, despite not being able to draw any firm conclusions, the use of third wave therapies has shown some potential benefits. Further randomised controlled trials to assess the effectiveness of adapted third wave therapies are required.
Practitioner Points
+ Three studies identified improvements in cognitive functioning in the intervention group in comparison with the control group.
+ Some studies also found improvements in anxiety, depression, quality of life, and mindfulness following third wave therapy interventions.
- However, an increase in depression, stress and a reduction in quality of life found following third wave therapies.
- As this is the first review of this population and third wave therapies, it has not been possible to focus more closely on just one specific third wave therapy or neurodegenerative disease. Further research on the effectiveness of third wave therapies in this population is required.

LSRP: Defence styles, alexithymia, illness perceptions, and HRQOL in IBD
Background/aims: The role of psychological factors in the development and progression of Inflammatory Bowel Disease (IBD) is not completely understood. Several studies have suggested that defence styles, alexithymia and illness perceptions each individually influence the way a person experiences their disease, thereby impacting on health related quality of life (HRQoL). The study aimed to expand the knowledge base and assist in offering a better understanding of these variables.
Methods: The study employed a survey design and used opportunity sampling to recruit participants with IBD from a Regional Crohn’s and Colitis support group and outpatient Gastroenterology clinics. Participants were given questionnaire packs containing measures and were asked to post them back to the researcher.
One hundred and thirty-nine participants were included in the study, of these 73.5% were female and 26.5% were males. 53.6% of participants reported being diagnosed with Crohn’s disease, where as 41.3% were diagnosed with Ulcerative Colitis, 1.4% were diagnosed with both, and 3.6% had a diagnosis of IBD but did not have a clear diagnosis of either Crohn’s or Colitis. The majority of participants identified that they were diagnosed with IBD between the ages of 20 and 29. Most participants (60.4%) felt that stress and worry was the cause of their IBD.
Results: The study found that defence styles, alexithymia and illness perceptions were all correlated with HRQoL. However, multiple regression analysis revealed that the alexithymia subtest, “difficulty identifying feelings” and the neurotic defence style were the only variables that had a significant relationship with HRQoL. It was also found that females and people that were recently diagnosed also had a worse HRQoL.
Conclusion: These findings suggest that females who are recently diagnosed with IBD and have difficulty identifying feelings as well as a reliance on neurotic defence styles have a worse HRQoL. Therefore, screening of this population and the introduction of psychotherapy to assist with emotional care might be beneficial in improving HRQoL.
Practitioner Points
+ Gender, time since diagnosis, neurotic defence styles and difficulties identifying own emotional experiences found to potentially contribute to poorer HRQoL.
+ Therefore, therapy using emotional identification, especially when a person is just diagnosed, might be beneficial to people with IBD.
- The study used a cross sectional design, therefore it is not possible to infer causation. Future research should use a prospective design.

Date of AwardMay 2018
Original languageEnglish
Awarding Institution
  • Queen's University Belfast
SupervisorNoleen McCorry (Supervisor), Emma Berry (Supervisor) & Martin Dempster (Supervisor)

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