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Title: Illness Experience of Obsessive Compulsive Disorder: A Family Systems Understanding
Authors: Chak, Arushi
Keywords: Centre for Human Ecology
Chetna Duggal
School of Social Sciences
Issue Date: 2013
Publisher: TISS
Abstract: The lifetime prevalence rate of Obsessive Compulsi ve Disorder in India is 0.6%. It figures in the World Health Organization’s top ten causes for disability in the world . While research had focused on phenomenology and etiology of the disorder, the subjective experience as well as the systemic impact has not been documented. The present study aimed to develop a family systems understanding of the illness experience of Obsessive Compulsive Disorder (OCD). A qualitative study was designed to explore the family experience, family illness beliefs and systemic response to the illness. Three four member nuclear families, with a family member between the ages of 18 - 25 years, diagnosed with OCD for at least six months, were selected using purposive sampling from the Natio nal Capital Region. Using the case study method, in – depth interviews were conducted with all family members. Data obtained was analysed using thematic analysis which yielded thematic networks with four broad domains - illness experience, impact, response and beliefs. Convergences and divergences within narratives of family members and across families were examined through within case and cross case analyses. Convergences across the families revealed that client s focused on symptom descriptions and the emotional distress they experienced due to the illness. While the burden on the primary caregiver was evident across families, the impact of the illness on other family members was also reported, clients, however, believed that other family members were not impacted by their illness. Within the family, there was an increased focus on clients and communication within the family was problem focused. Family dynamics saw increased conflict between parents and decreased interaction between siblings in all three families. Families responded by concealing the illness to avoid stigma associated with mental health problems. Family sought professional help from recommended health providers when in crisis. Reduction in symptomology was the primary recovery belief. Divergences in narratives of families were understood through the Rolland’s Family Systems Illness Model keeping in mind the nature and the phase of the illness and how it impacted family functioning. Implications of the study lie in exploring the systemic impact of the illness as well as implementing family interventions when working with OCD.
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