Comparisons of childhood trauma, alexithymia, and defensive styles in patients with psychogenic non-epileptic seizures vs. epilepsy: Implications for the etiology of conversion disorder
Comparisons of childhood trauma, alexithymia, and defensive styles in patients with psychogenic non-epileptic seizures vs. epilepsy: Implications for the etiology of conversion disorder
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DOI：
10.1016/j.jpsychores.2013.06.005
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发表时间：
2013-08-01
影响因子：
4.7
通讯作者：
Bowman, Michelle
中科院分区：
文献类型：
--
作者：
Kaplan, Marcia J.;Dwivedi, Alok K.;Bowman, Michelle
背景资料：理论上，转换障碍是无法有意识地体验为感觉状态或用语言表达的情绪的结果（即，述情障碍），但几乎没有证实的经验证据。我们使用心因性非癫痫性发作（PNES）与癫痫（ES）的模型，对儿童创伤经历、述情障碍和心理防御策略的成熟度进行测量，试图将转换障碍受试者与具有不同医学疾病的受试者进行比较。方法：辛辛那提大学医学中心癫痫监测中心的所有受试者都接受了自我报告问卷调查（儿童创伤问卷，多伦多述情障碍量表-20和反应评价测量-71）。每个主题的诊断证实了视频脑电图，我们比较了受试者与PNES与ES上these measures.Results：82例受试者ES和96 PNES。PNES患者更有可能在所有领域经历童年创伤（p = 0.005至p = 0.05），并且更有可能患有述情障碍（p = 0.0267）。有一个显着的差异，在能力识别的感觉，和一个趋势的意义能力描述的感觉。两组之间的防御风格没有差异。结论：PNES诊断与女性性别，较高的述情障碍评分和较高的儿童创伤率，但不与防御风格相比，ES的差异。这些发现为转换障碍的病因理论提供了经验证据，并可能有助于转换障碍患者前瞻性治疗试验的设计。(C)2013 Elsevier Inc. All rights reserved.
Background: It has been theorized that conversion disorder is the result of emotion that cannot be experienced consciously as feeling states or put into words (i.e., alexithymia), but there is little confirming empirical evidence. We sought to characterize subjects with conversion disorder compared to subjects with a distinct medical illness, using the model of psychogenic non-epileptic seizures (PNES) vs. epilepsy (ES), on measures of childhood traumatic experience, alexithymia and maturity of psychological defensive strategies.Methods: All subjects admitted to the Epilepsy Monitoring Unit of the University of Cincinnati Medical Center were offered self-report questionnaires (Childhood Trauma Questionnaire, Toronto Alexithymia Scale-20 and Response Evaluation Measure-71) at the outset of evaluation. Diagnosis of each subject was confirmed by video-EEG and we compared subjects with PNES to those with ES on these measures.Results: 82 subjects had ES AND 96 had PNES. Those with PNES were significantly more likely to have experienced childhood trauma in all domains (p = .005 to p = .05), and were significantly more likely to have alexithymia (p = .0267). There was a significant difference in the capacity to identify feelings, and a trend towards significance in capacity to describe feelings. There were no differences in defensive styles between the two groups.Conclusions: PNES diagnosis was associated with female sex, higher alexithymia scores and higher rates of childhood trauma, but not with differences in defensive styles compared to ES. These findings add empirical evidence for theories regarding the cause of conversion disorder and may aid in the design of prospective treatment trials in patients with conversion disorder. (C) 2013 Elsevier Inc. All rights reserved.