A randomised controlled trial to investigate if Focused Expressive Writing reduces symptoms in patients with epilepsy and Non-Epileptic Attack Disorder

Supervisors

Professor Markus Reuber (Medicine), Professor Brendan Stone (English), and Dr Ian Brown (Psychology)

Project

This project is one of three in a University-funded network studying the impact of shame and stigma in a variety of diseases. All projects are interdisciplinary collaborative projects coordinated by Medical Humanities Sheffield. The projects will run in a network with regular meetings, providing cross-discipline insights into clinically relevant problems, with a translational humanities perspective.

This is a multidisciplinary project, which will forge a closer collaboration between the departments of Neurology, English and Psychology. The project will involve an intervention called Focused Emotional Writing (FEW). FEW about traumatic, stressful or emotional events has previously been found to result in improvements in both physical and psychological health, in healthy people and in patients with mental and physical health disorders. In FEW interventions, participants may be asked to write about distressing events for 15–20 minutes on 3–5 occasions. Several studies have shown that participants who have engaged in this sort of task have better physical and psychological outcomes than those who have written about neutral topics.

In this project, we will compare the effects of FEW and writing about neutral topics in two groups of patients in which this intervention has not been used in the past: patients with epilepsy and patients with non-epileptic attack disorder (NEAD). Whereas epileptic seizures result from abnormal electrical activity in the brain, non-epileptic attacks (NEAs) are caused by an abnormal response to distress. The use of FEW in these patient groups is of particular interest because many patients with epilepsy feel that there seizures are triggered by stress and most NEAs are interpreted as an abnormal response to distress (often occurring in patients with a history of significant traumatisation).

To assess the effects of FEW, patients in both groups will be randomised to complete an FEW task or to write about emotionally neutral topics. We will measure health-related quality of life (HRQoL), anxiety, depression, seizure frequency / severity and healthcare usage before the intervention and three and six months afterwards. We will look for differences in outcomes between the FEW and neutral writing groups as well as for differences between patients with epilepsy and NEAD.

Uniquely, we intend to combine this randomised intervention with a detailed language analysis of the material participants in the FEW groups have written. By carrying out a very careful examination of the texts provided by the study participants we intend to learn more about the psychological problems of patients with seizures and hope to develop ideas for more effective treatments for the distress which is often associated with seizure disorders.

Entry Requirements

Candidates must have a relevant first or upper second class honors degree or significant research experience.

Enquiries

Interested candidates should in the first instance contact Professor Markus Reuber.

How to apply

Please send your cover letter, CV, references and transcripts to Ms Jodie Burnham (j.a.burnham@sheffield.ac.uk).

Closing date

18 April 2014