Psychological Factors of ALS in Adults (Essay Sample)

Psychological Factors of ALS in Adults
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Abstract
This paper synthesizes and critiques current research on the psychological factors that are associated with amyotrophic lateral sclerosis (ALS) using the biopsychosocial model. The biopsychosocial models analyzes phenomena through the use of expansive criteria that take into account the biological, social, psychological, socio-economic and environmental factors (such as nutrition) that affect the management and treatment of ALS. Specific attention is paid to demographic conditions such as age, gender, type of prognosis and the psychosocial aspects related to the management of ALS. There are an expansive literature review and critical exposition that discusses present research from using a systematic approach. The paper concludes by acknowledging the important role played these biopsychosocial factors in the management of amyotrophic lateral sclerosis.
Keywords: ALS, Biopsychosocial factors, Psychological Stressors, Coping Mechanisms and Interdisciplinary care.
Psychological Factors of ALS in Adults
Introduction
Amyotrophic lateral sclerosis (ALS) is a highly degenerative disorder that affects the motor neurons, especially the upper and lower neurons, with the result that patients suffer from paralysis of the limbs, respiratory failures, and dysphagia. The disease has no clear cause and lacks an effective cure. The survival rate of most ALS patients is estimated to range from 3 to 5 years, although certain patients can survive for as long as ten years. The illness or disorder causes the brain/spinal neurons to die and in the process results in limb paralysis. The death of motor neurons is one of the main pathological hallmarks of ALS. Riluzole is the main drug that has been developed to help fight the effects of ALS, although the drug acts only to prolong the survival of patients but not to cure them (Bensimon, Lacomblez & Meininger, 1994). For these reasons, ALS is a highly dangerous disorder that has no effective cure. Different psychosocial factors may act to increase the survival chances of patients suffering from ALS. Speculations that the causative agents of ALS may include toxins such as insecticides, viral and non-viral infections as well as deficiencies of the autoimmune system are common.
To effectively deal with ALS and to prolong life once the symptoms of ALS are present, a combinational approach of bio-psychosocial factors is recommended to prolong the lives of those suffering from it as well as to reduce the pain and hardships on the individual. The gravamen of this essay, therefore, is to explore the various biopsychosocial factors that are connected with the prevention, treatment, and attenuation of the effects of the disease in adults. This essay will offer a synthesis and critical analysis of these biopsychosocial factors and explore their relationship with ALS. This paper will attempt to provide an exegesis of current knowledge and research on the factors that affect survival among patients suffering from ALS from a bio-psychosocial perspective. It will interrogate the environmental, socio-economic and psychological factors that affect the survival and treatment of ALS once the diagnosis is complete in a patient.
Analysis and Discussion
Biological/Clinical Factors
ALS has no effective treatment and even lacks a definitive causal path. The factors that cause ALS are yet to be understood by scientists, although there are certain connections with heredity, viral infections and toxins. According to studies based on pharmacological trials using placebos, prognostic surveys conducted on unselected portions of the population as well as the studies conducted on referral centers dealing with ALS patients, interesting outcomes can be noted (Matuz, Birbaumer, Hautzinger & Kübler, 2010). For instance, according to studies based on the age of the patients suffering from ALS, it has been found that those patients diagnosed with ALS before the age of 40 have higher chances of survival than those diagnosed after the age of 40. The studies indicate that those patients have a survival chance of up to 10 years when compared with older patients (above 40 years), where the survival period, once diagnosed with ALS stands at between 3-5 years (Matuz, Birbaumer, Hautzinger & Kübler, 2010). Patients were presenting the symptoms of ALS at the age of 80 years and above have a survival period of not more than two years from the date of diagnosis. The group represents males and females almost equally. When gender is used as a variable, studies have shown that it has no significant effect on the gender of a particular person. The likelihood of a man contracting ALS is the same as that of women. However, older women were highly likely to show symptoms of the onset of bulbar disease.
It is also important to study the impact of clinical factors such as site of onset of the disease and how this affected the survival rates for patients suffering from ALS. According to research, the onset of bulbar disease is associated with worse outcomes than the spinal onset (Paillisse, et al., 2005). According to one research that used the registry-based approach, the presence of bulbar symptoms plays an important factor in determining the outcomes of ALS in terms of survival and mitigation of the consequences. Another study indicates that patients with ALS who undergo a respiratory non-invasive ventilation procedure stood a better chance at survival than those who did not undergo the procedure. In terms of diagnostic delay, some research suggests that patients with a delayed transition from symptoms onset to diagnosis had better chances of survival than those without short time delays.
Patients who exhibit a short delay time tend to have more aggressive ALS symptoms that lead them to seek out the immediate diagnosis. Several studies indicate that there is no major difference between patients suffering from ALS as a result of heredity and those suffering from ALS as a result of a sporadic attack regarding survival rates and period (Matuz, Birbaumer, Hautzinger & Kübler, 2010). ALS is characterized by a linear decline in its patients (Caroscio, Calhoun & Yahr, 1984). Accordingly, some studies have found support for the proposition that each ALS patient has his or her "intrinsic rate of disease progression" which is usually maintained throughout the course of the disease.
Psychological Stressors
Psychosocial factors have long been ignored by clinicians in the treatment and containment of ALS among patients. However, current research indicates that clinicians are increasingly becoming aware of the impact of various psychological and socio-environmental factors in the successful containment of the disease. One study has found out that psychological stress (which is measured by a variety of psychological indicators such as depression, anger, and purpose of life, etc.) indicate that patients with psychological stress usually report lesser survival periods than those with a positive psychological disposition (McDonald, Wiedenfeld, Hillel, Carpenter & Walter, 1994). The same study indicates that low moods increased the progression of the symptoms of the disease and thus shortened the period one had to live with the illness. However, some studies reveal that the presence of low moods could also be directly connected to a highly advanced progression rate, which leads the individual to show low moods.
The marital status of the patients suffering from ALS also accounted for the progression of the disease and the survival chances of the patients. According to one study, patients with a spouse had better chances of survival and demonstrated a slightly lower rate of disease progression than those who lived alone. The explanation for this may lie in the fact that patients with a partner derive some emotional and physical support that reduces and slows down the rate of progression for the disease. The impact of nutrition on the treatment and containment of ALS deserves some attention. Research suggests that malnutrition affects the survival chances of patients living with ALS. According to Body Mass Index surveys, patients with low weight and mal-nutritional had shorter survival periods than those with normal Body Mass Indexes.
Role of Interdisciplinary Care
The type of care afforded to the patient suffering from ALS also had a significant impact on the survival of the patients. According to one study, patients that received interdisciplinary care (traditional as well as the use of a neurologist) had increased mortality and the survival chances of the patients. Patients that received traditional care, without more, had a shorter survival rate compared to those that received comprehensive care (Miller, et al., 2009). It is thus recommended that to prolong the survival chances of patients with ALS, it is important to offer them a more comprehensive and holistic degree of care that incorporates the traditional and non-traditional aspects of care. It is important to serve a caveat at this point: the study was conducted without a control group and based on post hoc synthesis. It is thus of critical significance that the results be treated with the utmost degree of circumspection. It is important to consider psychosocial markers in the treatment of ALS. For instance, a combination of factors such as the degree of professional care, family involvement, and nutrition, in addition to multidisciplinary care all have positive impacts on the treatment of patients suffering from ALS.
Studies into psychosocial factors and how they affect the treatment of ALS are few and scattered. The reason for this lies in the fact that these issues are usually multidimensional and multifaceted, making it difficult for the attainment of conclusive results on the subject. To correct this anomaly, it is recommended that healt...