Predictors of adjustment to Ménière's disease

High levels of distress are often reported among people with Ménière's disease (MD). The aim of the research programme was to identify modifiable psychological factors that influence adjustment, to inform future support for people with MD. Part of the research programme was nested within a randomised controlled trial assessing the effectiveness of physical or psychological based self-treatment. Expectations and beliefs about illness and intolerance of uncertainty assessed at baseline were found to be correlated with baseline anxiety, and predicted adjustment outcomes at the end of the 3 month self-treatment period. Few studies have considered psychological mechanisms that might explain MD related distress. Therefore a systematic review on the role of psychological factors in MD was carried out and examined the literature for the possible presence of components of four mechanisms of distress (post-traumatic stress disorder (PTSD), worry, health anxiety and anxiety sensitivity). The most evidence was found for the possible presence of PTSD and health anxiety. These mechanisms were therefore measured explicitly. A greater proportion of participants with MD had clinical levels of distress on measures of anxiety, depression and PTSD than in the general population. Participants with MD were also significantly more distressed than healthy controls in terms of anxiety, depression, health anxiety, and health anxiety related beliefs about the negative consequences of illness. Adjustment to MD appears to be influenced by expectations and beliefs about illness, intolerance of uncertainty, PTSD, and health anxiety in different ways. With further development of empirically sound research including more longitudinal and qualitative research, a greater understanding of the mechanisms linking MD with adjustment may enable psychological treatment and support to be more effectively tailored to the particular problems of people with MD.