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'I just need to know what they are and if you can help me': Medicalization and the search for legitimacy in people diagnosed with non-epileptic attack disorder
Peacock, Marian Bissell, Paul Ellis, Julie Dickson, Jon M. Wardrope, Alistair Grünewald, Richard Reuber, Markus
Peacock, Marian
Bissell, Paul
Ellis, Julie
Dickson, Jon M.
Wardrope, Alistair
Grünewald, Richard
Reuber, Markus
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Other Contributors
EPub Date
Publication Date
2023-10-17
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Abstract
This paper focuses on the struggles for legitimacy expressed by people with non-epileptic attack disorder (NEAD), one of the most common manifestations of functional neurological disorder presenting to emergency and secondary care services. Nonepileptic attacks are episodes of altered experience, awareness, and reduced self-control that superficially resemble epileptic seizures or other paroxysmal disorders but are not associated with physiological abnormalities sufficient to explain the semiological features. "Organic" or medicalized explanations are frequently sought by patients as the only legitimate explanation for symptoms, and consequently, a diagnosis of NEAD is often contested. Drawing on narrative interviews with patients from a small exploratory study and using a sociological perspective, we propose that a psychological account of NEAD does not provide a sufficiently legitimate path into a socially sanctioned sick role. This is a reflection of the dominance of biomedicine and the associated processes of medicalization. These processes are, we argue, the sole route to achieving legitimacy. The stress-based or psychologically oriented explanations offered to patients in contemporary medical models of the etiology of NEAD engender an uncertain identity and social position and fail to provide many patients with an account of the nature or origin of their symptoms that they find satisfactory or convincing. These struggles for legitimacy (shared by others with functional or somatoform conditions) are sharpened by key features of the contemporary healthcare landscape, such as the increasing framing of health through a lens of 'responsibilization'. [Abstract copyright: Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.]
Citation
Peacock, M., Bissell, P., Ellis, J., Dickson, J. M., Wardrope, A., Grünewald, R., & Reuber, M. (2023). 'I just need to know what they are and if you can help me': Medicalization and the search for legitimacy in people diagnosed with non-epileptic attack disorder. Epilepsy & Behavior, 148, article-number 109485. https://doi.org/10.1016/j.yebeh.2023.109485
Publisher
Elsevier
Journal
Epilepsy & Behavior
Research Unit
DOI
10.1016/j.yebeh.2023.109485
PubMed ID
PubMed Central ID
Type
Article
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Description
Series/Report no.
ISSN
1525-5050