Insecure and Unresolved/Disorganized Attachment in Patients With Psychogenic Nonepileptic Seizures

Gerhardt, C.; Hamouda, Karim; Irorutola, Freddy; Rose, Matthias; Hinkelmann, Kim; Buchheim, Anna; Senf-Beckenbach, Philine

doi:10.1016/j.psym.2020.05.014

Cited by 9 publications

(8 citation statements)

References 35 publications

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“…56,79,102,106 However, this was not consistent, as four FND-seizures groups had scores above 35. 53,62,76,80 Twenty-two studies included control groups; some studies had multiple control groups, amounting to a total of thirty different control groups. 53,55,56,59,60,62,65,[74][75][76]79,86,88,90,92,95,96,98,99,101,102,106 Of these, five studies controlled for anxiety, depression or other psychopathology.…”

Section: Perceptual Alteration Scale 110mentioning

confidence: 99%

“…53,62,76,80 Twenty-two studies included control groups; some studies had multiple control groups, amounting to a total of thirty different control groups. 53,55,56,59,60,62,65,[74][75][76]79,86,88,90,92,95,96,98,99,101,102,106 Of these, five studies controlled for anxiety, depression or other psychopathology. 76,88,90,96,101 In eighteen studies, SDQ-20 scores were statistically higher for FND participants relative to control groups.…”

Section: Perceptual Alteration Scale 110mentioning

confidence: 99%

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Dissociation and its biological and clinical associations in functional neurological disorder: systematic review and meta-analysis

et al. 2022

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Background Studies have reported elevated rates of dissociative symptoms and comorbid dissociative disorders in functional neurological disorder (FND); however, a comprehensive review is lacking. Aims To systematically review the severity of dissociative symptoms and prevalence of comorbid dissociative disorders in FND and summarise their biological and clinical associations. Method We searched Embase, PsycInfo and MEDLINE up to June 2021, combining terms for FND and dissociation. Studies were eligible if reporting dissociative symptom scores or rates of comorbid dissociative disorder in FND samples. Risk of bias was appraised using modified Newcastle–Ottawa criteria. The findings were synthesised qualitatively and dissociative symptom scores were included in a meta-analysis (PROSPERO CRD42020173263). Results Seventy-five studies were eligible (FND n = 3940; control n = 3073), most commonly prospective case–control studies (k = 54). Dissociative disorders were frequently comorbid in FND. Psychoform dissociation was elevated in FND compared with healthy (g = 0.90, 95% CI 0.66–1.14, I2 = 70%) and neurological controls (g = 0.56, 95% CI 0.19–0.92, I2 = 67%). Greater psychoform dissociation was observed in FND samples with seizure symptoms versus healthy controls (g = 0.94, 95% CI 0.65–1.22, I2 = 42%) and FND samples with motor symptoms (g = 0.40, 95% CI −0.18 to 1.00, I2 = 54%). Somatoform dissociation was elevated in FND versus healthy controls (g = 1.80, 95% CI 1.25–2.34, I2 = 75%). Dissociation in FND was associated with more severe functional symptoms, worse quality of life and brain alterations. Conclusions Our findings highlight the potential clinical utility of assessing patients with FND for dissociative symptomatology. However, fewer studies investigated FND samples with motor symptoms and heterogeneity between studies and risk of bias were high. Rigorous investigation of the prevalence, features and mechanistic relevance of dissociation in FND is needed.

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Section: Perceptual Alteration Scale 110mentioning

confidence: 99%

Section: Perceptual Alteration Scale 110mentioning

confidence: 99%

Dissociation and its biological and clinical associations in functional neurological disorder: systematic review and meta-analysis

et al. 2022

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“…Longitudinal studies have demonstrated a robust association between adult attachment representations and child attachment patterns, particularly in parent-infant dyads with maternal unresolved attachment and children with disorganized attachment (Fonagy et al, 1991;Benoit and Parker, 1994;van IJzendoorn, 1995;Steele et al, 1996;Behrens et al, 2016). The rate of unresolved as compared to organized attachments is significantly higher in CM in both clinical and non-clinical groups (Bakermans-Kranenburg and van IJzendoorn, 2009;Bauriedl-Schmidt et al, 2017;Buchheim et al, 2017;Buchheim and Diamond, 2018;Gander et al, 2018Gander et al, , 2020Gerhardt et al, 2021) and associated with adverse outcomes after experiencing CM.…”

Section: Intergenerational Cycle Of Maltreatment and Parental Attachm...mentioning

confidence: 99%

Identifying Risk and Resilience Factors in the Intergenerational Cycle of Maltreatment: Results From the TRANS-GEN Study Investigating the Effects of Maternal Attachment and Social Support on Child Attachment and Cardiovascular Stress Physiology

Buchheim

Ziegenhain

Kindler

et al. 2022

Front. Hum. Neurosci.

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IntroductionChildhood maltreatment (CM) is a developmental risk factor and can negatively influence later psychological functioning, health, and development in the next generation. A comprehensive understanding of the biopsychosocial underpinnings of CM transmission would allow to identify protective factors that could disrupt the intergenerational CM risk cycle. This study examined the consequences of maternal CM and the effects of psychosocial and biological resilience factors on child attachment and stress-regulatory development using a prospective trans-disciplinary approach.MethodsMother-child dyads (N = 158) participated shortly after parturition (t0), after 3 months (t1), and 12 months later (t2). Mothers’ CM experiences were assessed at t0, attachment representation at t1 and psychosocial risk and social support were assessed at t1 and t2. At t2, dyads participated in the Strange Situation Procedure (SSP). Children’s attachmen status were classified as organized vs. disorganized, including their level of disorganized behavior, and heart rate (HR) and respiratory sinus arrhythmia (RSA) were recorded as stress response measures of the autonomic nervous system. Maternal caregiving during SSP was assessed using the AMBIANCE scale. Child’s single nucleotide polymorphisms rs2254298 within the oxytocin receptor (OXTR) and rs2740210 of the oxytocin gene (OXT) were genotyped using DNA isolated from cord blood.ResultsMaternal CM experiences (CM+) were significantly associated with an unresolved attachment status, higher perceived stress and more psychological symptoms. These negative effects of CM were attenuated by social support. As expected, maternal unresolved attachment and child disorganized attachment were significantly associated. Maternal caregiving did not mediate the relationship between maternal and child attachment but influenced children’s HR and RSA response and disorganized behavior. Moreover, the rs2254298 genotype of the OXTR gene moderated the stress response of children from mothers with CM. Children carrying the rs2740210 risk allele of the OXT gene showed more disorganized behavior independent from maternal CM experiences.ConclusionWe replicated and extended existing CM and attachment models by co-examining maternal attachment, social support, and child genetic susceptibility on child attachment and cardiovascular stress regulation. The findings contribute to an extended understanding of risk and resilience factors and enable professionals to target adequate services to parents and children at risk.

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“…We reported interim results of our study only from the intervention group in an earlier publication [10]. Based on the patient collective of our study some other studies with a cross-sectional design were performed and published [28][29][30].…”

Section: Publicationsmentioning

confidence: 99%

Evaluation of a new body-focused group therapy versus a guided self-help group program for adults with psychogenic non-epileptic seizures (PNES): a pilot randomized controlled feasibility study

et al. 2021

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Objective Psychogenic non-epileptic seizures (PNES), a common phenomenon in neurological settings, are regarded as a paroxysmal type of functional neurological disorder (FND). In a substantial proportion, PNES are disabling with poor long-term outcomes and high economic costs. Despite the clinical and financial consequences of PNES, there is still a lack of controlled clinical trials on the treatment of this challenging disorder. The study aims to evaluate the feasibility and collect first evidence of the efficacy of a group based-intervention in PNES-patients. Methods A pilot randomized controlled feasibility study with a parallel-group design was performed in adult outpatients with PNES to evaluate a new body-focused group therapy (CORDIS) versus guided self-help groups. Self-assessment of dissociation (Dissociation Experience Scale—DES-20) and seizure severity (Liverpool Seizure Severity Scale—LSSS) were assessed two weeks before and two weeks after the treatment intervention and also six months after treatment as primary outcome parameters. Results A total of 53 patients were recruited from a specialized outpatient clinic, and out of those, 29 patients completed either the body-focused group therapy program (n = 15) or a guided self-help group (SHG) therapy (n = 14). When analyzing the ITT sample (n = 22 CORDIS group, n = 20 SHG), both groups showed an effect on seizure severity and level of dissociation. In the per protocol sample (n = 13 CORDIS group, n = 12 SHG), CORDIS was superior to the self-help group for reducing seizure severity 6 months after the treatment. Significance CORDIS is a newly developed body-focused group therapy program for adults with PNES. Further studies should include a multicentric design with a higher number of participants.

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Insecure and Unresolved/Disorganized Attachment in Patients With Psychogenic Nonepileptic Seizures

Cited by 9 publications

References 35 publications

Dissociation and its biological and clinical associations in functional neurological disorder: systematic review and meta-analysis

Dissociation and its biological and clinical associations in functional neurological disorder: systematic review and meta-analysis

Identifying Risk and Resilience Factors in the Intergenerational Cycle of Maltreatment: Results From the TRANS-GEN Study Investigating the Effects of Maternal Attachment and Social Support on Child Attachment and Cardiovascular Stress Physiology

Evaluation of a new body-focused group therapy versus a guided self-help group program for adults with psychogenic non-epileptic seizures (PNES): a pilot randomized controlled feasibility study

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