title: Reducing excess stiffness in Stiff Person Syndrome using CBT: A case study.
abstract: BACKGROUND
  Stiff Person Syndrome (SPS) is a rare neurological condition, characterised by rigidity in the trunk and limbs. Comorbid anxiety is common and known to exacerbate stiffness.
  
  
  OBJECTIVE
  This case study examines the extent to which psychological treatment of comorbid anxiety alleviated stiffness in a patient whose condition was exacerbated by social anxiety.
  
  
  METHODS
  A patient was treated using cognitive behavioural therapy, focussing on reducing anxiety and therefore stiffness by addressing rumination, self-focussed attention, and distressing cognitions relating to walking in public. The patient's walking, stiffness, and anxiety were assessed during and post-therapy using questionnaires.
  
  
  RESULTS
  Walking, stiffness, and anxiety improved during treatment. At five months' follow up, while the improvement in anxiety was maintained, walking and stiffness had deteriorated. The patient and his Neurologist felt that this deterioration was biological, rather than psychological in nature.
  
  
  CONCLUSIONS
  This is the first published case where SPS has been ameliorated (albeit temporarily) using psychological therapy, and has important implications for future research and treatment.
authors.affiliation: Department of Clinical Psychology, University of Bath, Bath, UK.
authors.forename: Lottie L
authors.initials: LL
authors.lastname: Morris
authors.affiliation: Sirona Care & Health Community Neuro and Stroke Service, St Martin's Hospital, Bath, UK.
authors.forename: Leon
authors.initials: L
authors.lastname: Dysch
authors.affiliation: Department of Clinical Psychology, University of Bath, Bath, UK.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Salkovskis
authors.affiliation: Neurology Department, Royal United Hospital Bath NHS Trust, Bath, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Giffin
mesh_terms: D001007:Anxiety / Q000150:complications / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D018450:Disease Progression; D006801:Humans; D008297:Male; D010698:Phobic Disorders / Q000150:complications / Q000523:psychology; D016750:Stiff-Person Syndrome / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome; D016138:Walking / Q000523:psychology
keywords: Stiff Person Syndrome; cbt; psychotherapy; stiff man syndrome