Adult attachment style and childhood interpersonal trauma in non-epileptic attack disorder

Holman, Natalie; Kirkby, Antonia; Duncan, Susan E.; Brown, Richard J.

doi:10.1016/j.eplepsyres.2007.12.015

Cited by 39 publications

(22 citation statements)

References 43 publications

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“…Given that both epilepsy and PNESs may be associated with stigma [45] and [46], the lower explicit SE observed in individuals with PNESs is perhaps more likely to be the product of childhood trauma, emotional abuse or neglect, and insecure attachment than of having a stigmatizing seizure disorder [12], [47] and [48]. Low explicit SE may be relevant in terms of understanding the etiology of PNESs, psychological formulation, and treatment outcome: as reported in patients with PTSD, it may be that low SE contributes to the chronification of PNESs [49] and/or mediates the relationship between attachment and psychopathology [10]; however, these hypotheses have yet to be tested in this patient group.…”

Section: Discussionmentioning

confidence: 99%

“…The measure comprises 15 somatic symptoms, each scored 0 ("not bothered at all"), 1 ("bothered a little"), or 2 ("bothered a lot"). Total scores range from 0 to 30 and are classified as reflecting minimum (0-4), mild (5-9), moderate (10)(11)(12)(13)(14), or severe (15 +) somatization. The measure was not developed as a stand-alone diagnostic tool but was used to supplement other clinical information.…”

Section: Patient Health Questionnaire-15 (Phq-15)mentioning

confidence: 99%

“…Self-esteem has also been found to mediate the relationship between insecure attachment and PTSD symptomatology in survivors of interpersonal trauma, emotional abuse, and psychopathology [10] and [11]. Despite these links and the documented association of PNESs with trauma and increased rates of insecure attachment [12], there is only limited evidence of SE levels in PNESs.…”

Section: Introductionmentioning

confidence: 99%

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Implicit and explicit self-esteem discrepancies in people with psychogenic nonepileptic seizures

Dimaro

Roberts

Moghaddam

et al. 2015

Epilepsy & Behavior

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Purpose: Self-esteem (SE), or one's sense of competence and worth, is reduced in many mental and physical\ud disorders. Low SE is associated with perceived stigma and disability and poor treatment outcomes. The present\ud study examined implicit and explicit SE (automatic and deliberate views about the self) in people with epilepsy\ud and people with psychogenic nonepileptic seizures (PNESs). Discrepancies between implicit SE and explicit SE\ud have been found to correlate with psychological distress in disorders often associated with PNESs but are\ud relatively unexplored in PNESs. We hypothesized that, compared with epilepsy, PNESs would be associated\ud with lower self-reported SE and greater discrepancies between implicit SE and explicit SE.\ud Methods: Thirty adults with PNESs, 25 adults with epilepsy, and 31 controls without a history of seizures were\ud asked to complete the Rosenberg Self-esteem Scale as a measure of explicit SE and an Implicit Relational\ud Assessment Procedure as a measure of implicit SE. The State–Trait Anxiety Inventory and Patient Health\ud Questionnaire—15 (a somatic symptom inventory) were also administered.\ud Results: We found significant group differences in explicit (p b 0.001) but not implicit SE. Patients with PNESs\ud reported lower SE than the other groups. No group differences were found in implicit SE. Implicit–explicit SE\ud discrepancies were larger in the group with PNESs than in the other groups (p b 0.001). Higher frequency of\ud PNESs (but not epileptic seizures) was associatedwith lower explicit SE (rs=−.83, p b 0.01) and greater SE discrepancies\ud (i.e., lower explicit relative to implicit SE; rs = .65, p b 0.01). These relationships remained significant\ud when controlling for anxiety and somatization.\ud Conclusion: Patients with PNESs had lower explicit SE than those with epilepsy or healthy controls. In keeping\ud with our expectations, there were greater discrepancies between implicit SE and explicit SE among patients\ud with PNESs than in the other groups. Our results, including the strong relationship between PNES frequency,\ud anxiety, and explicit–implicit SE discrepancies, support the interpretation that PNESs serve to reduce cognitive\ud dissonance, perhaps protecting patients' implicit SE

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Section: Discussionmentioning

confidence: 99%

Section: Patient Health Questionnaire-15 (Phq-15)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Implicit and explicit self-esteem discrepancies in people with psychogenic nonepileptic seizures

Dimaro

Roberts

Moghaddam

et al. 2015

Epilepsy & Behavior

View full text Add to dashboard Cite

show abstract

“…However, in contrast to our study others have described differences in predominant attachment styles between patients with PNES and epilepsy. [11] Inconsistencies in the literature may be due to other factors such as small sample sizes and differences in the conceptualisation and measurement of attachment (e.g., category-based versus dimensional).…”

Section: Discussionmentioning

confidence: 99%

“…[9] The absence of this experience from a primary caregiver could impair the development of a positive internal working model of the self as loveable and worthy and of others as trustworthy and responsive with adverse consequences on interpersonal relationships in later life. [10] Indeed, patients with PNES have been found to be more likely to have fearful attachment styles and a history of abuse and neglect, compared to patients with epilepsy, [11] and trauma history, fearful attachment style, psychopathology, and dissociation have been observed to be associated with PNES but not epileptic seizure frequency. [12] Relatedly, family dysfunction has also been proposed as an important predisposing factor for PNES.…”

Section: Introductionmentioning

confidence: 99%

Attachment style, relationship quality, and psychological distress in patients with psychogenic non-epileptic seizures versus epilepsy

Green

Norman

Reuber

2017

Epilepsy & Behavior

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Attachment State of Mind and complex traumatization in patients with Functional Motor Disorder (Motor Conversion Disorder)

Civilotti,

Nisticò,

Tedesco

et al. 2024

Brain, Behavior, & Immunity - Health

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Adult attachment style and childhood interpersonal trauma in non-epileptic attack disorder

Cited by 39 publications

References 43 publications

Implicit and explicit self-esteem discrepancies in people with psychogenic nonepileptic seizures

Implicit and explicit self-esteem discrepancies in people with psychogenic nonepileptic seizures

Attachment style, relationship quality, and psychological distress in patients with psychogenic non-epileptic seizures versus epilepsy

Attachment State of Mind and complex traumatization in patients with Functional Motor Disorder (Motor Conversion Disorder)

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