Psychological Resilience Factors in Huntington's Disease and Other Neurodegenerative Diseases

Background: Psychological distress is frequently observed in neurodegenerative diseases (NDDs), including Huntington’s disease (HD), impacting function, quality of life (QOL), caregiver burden, and illness cost. As psychological resilience can protect against negative outcomes and aid in successful adjustment to illness, understanding what enhances psychological resilience allows us to offer support to people with NDDs. In addition, although executive functioning (EF) has been linked to resilience / psychological wellbeing, its psychological distress buffering qualities in HD have not been studied.

Literature review: Eighteen articles were reviewed to investigate factors associated with psychological resilience in NDDs. Studies with varied aims and methodologies were found. Resilience factors were divided into core, internal and external categories. Contradicting evidence was found regarding relationships between resilience and physical function. Fatigue appears to be associated with less resilience. Positive associations were found between resilience and mental health and various psychological / QOL factors. Social connectedness and intervention were discovered to be linked to resilience. The evidence for resilience enhancing interventions suggests that resilience can be modified.

Research report: This quantitative longitudinal study explored whether EF abilities predict psychological resilience in HD. The secondary aim was to investigate characteristics of the sample and make comparisons between premanifest and manifest HD groups. Enroll-HD study dataset (N=495) was used to run analyses including descriptive statistics, t-tests / Mann-Whitney U tests, Pearson correlation, and multiple regression. Less EF related problem behaviours were found to predict higher psychological resilience. Less psychological distress, lower BMI and non-smoking were also found to predict higher resilience. The sample had clinically relevant levels of depression/anxiety and physical/functional impairment. The pre-manifest HD group was significantly less impaired than the manifest group in all domains.

Critical appraisal: The research process, learning points, implications, and limitations were considered.