Detection of maladaptive emotional regulation in the profile of patients diagnosed with psychogenic non-epileptic seizures (PNES) compared to healthy population
Abstract
Objectives: The term psychogenic non-epileptic seizures (PNES) refers to a conversion disorder (300.11 in DSM-5) imitating epileptic seizures that are psychological etiology (DSM-5). Recent studies report that in patients diagnosed with PNES, there is a significantly reduced understanding of emotions, inappropriate and negative beliefs about their own emotions, impulse control difficulties, and limited access to emotional regulation strategies that can be the driving force for maladaptive defense or coping response (Brown & Reuber, 2016).
Materials: Patients (N=51 F:M 42:9; mean age 34.84 years, disease duration 2 years) were assessed during their stay at the Epilepsy Center, Na Homolce Hospital, Prague. PNES diagnosis was based on normal EEG findings, habitual seizure capture, suggestive seizure provocation, and patients' history.
The clinical sample was compared with healthy volunteers (N=51 F:M 42:9; mean age 35 years). Method: We focused on the presence of maladaptive emotional regulation using Czech research version of Affective Style Questionnaire (ASQ) and Difficulties in Emotion Regulation Scale (DERS).
Results Compared to healthy population patients with PNES had greater emotion regulation impairments across all dimensions of the DERS - Nonacceptance = 16.86 (M=14.71.), Goals = 16.31 (M=11.73), Impulse control = 13.92 (M=11.76), Awareness = 16.14 (M=15.92), Strategies = 18.20 (M=13.45), Clarity = 11.98 (M=9.59) and of the total score of the DERS = 93.41 (M=77.16). Similar results were found in ASQ questionnaire (Concealing = 25.31 (M=23.21), Tolerating = 24.26 (M=14.61), Adjusting = 20.75 (M=22.59).
Discussion: Our theoretical and empirical investigation confirms maladaptive emotional regulation as one of a key psychological mechanism in PNES. Conclusions: These findings are important for psychoeducation and psychotherapy in PNES patients, and for psychiatric care.
References: Brown, R. J., & Reuber, M. (2016).
Psychological and psychiatric aspects of psychogenic non-epileptic seizures (PNES): A systematic review. Clinical Psychology Review, 45, 157-182.