Dissociation in patients with dissociative seizures: relationships with trauma and seizure symptoms

Pick, Susannah; Mellers, John D. C.

doi:10.1017/s0033291716003093

Cited by 54 publications

(62 citation statements)

References 68 publications

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“…An alternative possibility is that the presence of conflict, abuse, and neglect in the histories of some patients with the diagnosis [17,22,52,53] may have contributed to more frequent than average exposure to negative facial expressions, potentially sensitising them to signs of anger/hostility and/or signs of social acceptance or approval. Of relevance to this interpretation are our findings reported elsewhere [17,38] in this same sample, of higher rates of self-reported trauma (including total lifetime traumas, sexual and physical abuse), greater impact of traumas, and more current interpersonal conflict and abandonment concerns, relative to controls. It should be noted; however, that in preliminary correlational analyses, there were no significant relationships between these factors and the AB observed in this experiment.…”

Section: Discussionmentioning

confidence: 99%

“…Abnormal responses to emotional distress or bodily arousal have been hypothesised to contribute to DS occurrence, in at least a proportion of cases [12][13][14]. Affective manifestations and dissociative experiences during seizures are reported frequently [15][16][17], alongside more general elevations in psychological and somatoform dissociation [13,[17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

“…Heightened scores on measures of a range of affect-related variables have been observed commonly in this group, including alexithymia [25][26][27][28], emotional dysregulation [17,[28][29][30][31][32][33], anxiety [15,17,25,27,28,34,35], and depression [17,19,25,27,28,34,36]. Additionally, a limited number of experimental studies have indicated abnormalities in emotional processing in patients with DS, most commonly in responses to facial affect.…”

Section: Introductionmentioning

confidence: 99%

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Implicit attentional bias for facial emotion in dissociative seizures: Additional evidence

Pick

Mellers

2018

Epilepsy & Behavior

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This study sought to extend knowledge about the previously reported preconscious attentional bias (AB) for facial emotion in patients with dissociative seizures (DS) by exploring whether the finding could be replicated, while controlling for concurrent anxiety, depression, and potentially relevant cognitive impairments. Patients diagnosed with DS (n=38) were compared with healthy controls (n=43) on a pictorial emotional Stroop test, in which backwardly masked emotional faces (angry, happy, neutral) were processed implicitly. The group with DS displayed a significantly greater AB to facial emotion relative to controls; however, the bias was not specific to negative or positive emotions. The group effect could not be explained by performance on standardized cognitive tests or self-reported depression/anxiety. The study provides additional evidence of a disproportionate and automatic allocation of attention to facial affect in patients with DS, including both positive and negative facial expressions. Such a tendency could act as a predisposing factor for developing DS initially, or may contribute to triggering individuals' seizures on an ongoing basis. Psychological interventions such as Cognitive Behavioral Therapy (CBT) or AB modification might be suitable approaches to target this bias in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Implicit attentional bias for facial emotion in dissociative seizures: Additional evidence

Pick

Mellers

2018

Epilepsy & Behavior

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“…The inventory assesses these symptoms in relation to patients' most severe and most recent seizure separately. The questionnaire was described in a related publication (Pick, Mellers, & Goldstein, 2017).…”

Section: Self-report Measuresmentioning

confidence: 99%

Autonomic and subjective responsivity to emotional images in people with dissociative seizures

Pick

Mellers

Goldstein

2017

Journal of Neuropsychology

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People with dissociative seizures (DS) report a range of difficulties in emotional functioning and exhibit altered responding to emotional facial expressions in experimental tasks. We extended this research by investigating subjective and autonomic reactivity (ratings of emotional valence, arousal and skin conductance responses [SCRs]) to general emotional images in 39 people with DS relative to 42 healthy control participants, whilst controlling for anxiety, depression, cognitive functioning and, where relevant, medication use. It was predicted that greater subjective negativity and arousal and increased SCRs in response to the affective pictures would be observed in the DS group. The DS group as a whole did not differ from controls in their subjective responses of valence and arousal. However, SCR amplitudes were greater in 'autonomic responders' with DS relative to 'autonomic responders' in the control group. A positive correlation was also observed between SCRs for highly arousing negative pictures and self-reported ictal autonomic arousal, in DS 'autonomic responders'. In the DS subgroup of autonomic 'nonresponders', differences in subjective responses were observed for some conditions, compared to control 'non-responders'. The findings indicate unaffected subjective responses to emotional images in people with DS overall. However, within the group of people with DS, there may be subgroups characterized by differences in emotional responding. One subgroup (i.e., 'autonomic responders') exhibit heightened autonomic responses but intact subjective emotional experience, whilst another subgroup (i.e., 'autonomic non-responders') seem to experience greater subjective negativity and arousal for some emotional stimuli, despite less frequent autonomic reactions. The current results suggest that therapeutic interventions targeting awareness and regulation of physiological arousal and subjective emotional experience could be of value in some people with this disorder.

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“…Thus, it is also referred to as multiple personality disorder [ 3 ]. There are several conditions found to be associated with this disorder, including depression, self-harm, post-traumatic stress disorder (PTSD), substance use disorder, borderline personality disorder or anxiety [ 4 - 5 ], and conversion or somatoform disorder [ 6 ]. DID also includes the unexplained loss of personal information from one's memory [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

A Strange Case of Dissociative Identity Disorder: Are There Any Triggers?

Rehan

Kuppa

Ahuja

et al. 2018

Cureus

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Dissociation in patients with dissociative seizures: relationships with trauma and seizure symptoms

Cited by 54 publications

References 68 publications

Implicit attentional bias for facial emotion in dissociative seizures: Additional evidence

Implicit attentional bias for facial emotion in dissociative seizures: Additional evidence

Autonomic and subjective responsivity to emotional images in people with dissociative seizures

A Strange Case of Dissociative Identity Disorder: Are There Any Triggers?

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