{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T20:55:56Z","timestamp":1789764956470,"version":"4.0.1"},"reference-count":117,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T00:00:00Z","timestamp":1658880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Huntington\u2019s disease (HD) is an inherited, life-limiting neurodegenerative condition. People with HD experience changes in cognitive, motor and emotional functioning, and can also, mainly at later stages, exhibit behaviours that professionals and carers might find distressing such as hitting others, throwing objects, swearing or making inappropriate comments. While clinical formulation (an individualised approach used by mental health professionals to describe an individual\u2019s difficulties) is a helpful tool to conceptualise patients\u2019 wellbeing, a specific formulation framework has not yet been developed for HD. However, evidence has shown that formulation can help guide clinical interventions and increase consistency of approach across multi-disciplinary teams, refine risk management, and improve staff or carers\u2019 empathic skills and understanding of complex presentations. As a consequence, this paper proposes a new clinical formulation model for understanding distress among people with HD, based on a biopsychosocial framework. More specifically, this includes key elements centring on an individual\u2019s past experience and personal narratives, as well as anticipatory cognitions and emotions about the future. In-depth discussions regarding the components of the model and their importance in HD formulations are included, and a fictional yet representative case example is presented to illustrate their application within the context of personalised care.<\/jats:p>","DOI":"10.3390\/jpm12081222","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T03:21:16Z","timestamp":1658978476000},"page":"1222","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Using a Clinical Formulation to Understand Psychological Distress in People Affected by Huntington\u2019s Disease: A Descriptive, Evidence-Based Model"],"prefix":"10.3390","volume":"12","author":[{"given":"Maria","family":"Dale","sequence":"first","affiliation":[{"name":"Huntington\u2019s Disease Service, Leicestershire Partnership NHS Trust, Mill Lodge, The Rise, Narborough, Leicester LE19 4SL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashleigh","family":"Wood","sequence":"additional","affiliation":[{"name":"Huntington\u2019s Disease Service, Leicestershire Partnership NHS Trust, Mill Lodge, The Rise, Narborough, Leicester LE19 4SL, UK"},{"name":"Department of Neuroscience, Psychology and Behaviour, University of Leicester, University Road, Leicester LE1 7RH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8129-6151","authenticated-orcid":false,"given":"Nicol\u00f2","family":"Zarotti","sequence":"additional","affiliation":[{"name":"Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1484-2703","authenticated-orcid":false,"given":"Fiona","family":"Eccles","sequence":"additional","affiliation":[{"name":"Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8492-060X","authenticated-orcid":false,"given":"Sarah","family":"Gunn","sequence":"additional","affiliation":[{"name":"Huntington\u2019s Disease Service, Leicestershire Partnership NHS Trust, Mill Lodge, The Rise, Narborough, Leicester LE19 4SL, UK"},{"name":"Department of Neuroscience, Psychology and Behaviour, University of Leicester, University Road, Leicester LE1 7RH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Kiani","sequence":"additional","affiliation":[{"name":"Huntington\u2019s Disease Service, Leicestershire Partnership NHS Trust, Mill Lodge, The Rise, Narborough, Leicester LE19 4SL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Mobley","sequence":"additional","affiliation":[{"name":"Huntington\u2019s Disease Service, Leicestershire Partnership NHS Trust, Mill Lodge, The Rise, Narborough, Leicester LE19 4SL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noelle","family":"Robertson","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Psychology and Behaviour, University of Leicester, University Road, Leicester LE1 7RH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5071-4077","authenticated-orcid":false,"given":"Jane","family":"Simpson","sequence":"additional","affiliation":[{"name":"Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/S0140-6736(07)60111-1","article-title":"Huntington\u2019s Disease","volume":"369","author":"Walker","year":"2007","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1016\/S1474-4422(18)30294-1","article-title":"Biological and Clinical Manifestations of Juvenile Huntington\u2019s Disease: A Retrospective Analysis","volume":"17","author":"Fusilli","year":"2018","journal-title":"Lancet Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"95","DOI":"10.3233\/JHD-170247","article-title":"What Do We Know about Late Onset Huntington\u2019s Disease?","volume":"6","author":"Chaganti","year":"2017","journal-title":"J. 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