The influence of attachment style and relationship quality on quality of life and psychological distress in carers of people with epileptic and nonepileptic seizures

Wardrope, Alistair; Green, Becky; Norman, Paul; Reuber, Markus

doi:10.1016/j.yebeh.2019.01.028

Cited by 11 publications

(14 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Very often, patients of PNES have dysfunctional attachment and relationships with family and friends, leading to emotional distress, social avoidance, and feelings of insecurity. 35,36 Surprisingly, our study noted a very low prevalence of trauma or sexual and physical abuse as compared to other Original Article ic events of childhood and also that if trauma has occurred too early in life, it may not be explicitly remembered. Trauma can have an impact on brain maturation.…”

Section: Discussioncontrasting

confidence: 62%

Dissociation, Stressors, and Coping in Patients of Psychogenic Nonepileptic Seizures

Sawant

Umate

2020

Indian Journal of Psychological Medicine

View full text Add to dashboard Cite

Background: Psychogenic nonepileptic seizures (PNES) commonly present both to neurologists and psychiatrists and include a wide range of psychopathology. In order to understand the demographics, dissociative experiences, stressful life events, abuse, and coping in these patients, this study was undertaken. Methods: This was a cross-sectional, observational study. A total of 71 patients of PNES, referred from neurology, were assessed on Dissociative Experience Scale (DES), Scale For Trauma and Abuse, Presumptive Stressful Life Events Scale (PSLES), and Ways of Coping Questionnaire to ascertain the dissociative experiences; the prevalence of trauma, abuse, and stressful life events, and the coping mechanisms. Results: Females predominated, with the duration of PNES up to 2 years. The mean ± SD total DES score was 38.14 ± 14.1, indicating high dissociation. On the PSLES, for the stressful life events in the last one year, the mean score was 98.28 ± 87.1. Marital and family conflicts and death were reported more. History of childhood or adult physical and sexual abuse was less reported. History of head trauma was present in 13 patients. Emotion-focused coping was used more than problem-solving strategies. Conclusions: Very few Indian studies have looked into these nuances. This study has helped in improving the understanding of the various risk factors of PNES and the coping strategies, and in sensitizing psychiatrists and neurologists to enquire into trauma and abuse of these patients.

show abstract

Section: Discussioncontrasting

confidence: 62%

Dissociation, Stressors, and Coping in Patients of Psychogenic Nonepileptic Seizures

Sawant

Umate

2020

Indian Journal of Psychological Medicine

View full text Add to dashboard Cite

show abstract

“…In a British study, attachment styles were explored to better explain the complexity of dyadic relationships in patients with seizures [4]. Patient distress was highlighted to significantly influence the quality of life of carers [4], supporting the recommendations that health care services be tailored to include the physical and emotional wellbeing of primary caregivers [11].…”

Section: Introductionmentioning

confidence: 92%

“…Due to uncontrolled seizures, poor memory and cognitive deficits, family caregivers have to be relied upon for disease management and emotional support [1]. As a consequence, epilepsy is as much a focus of the lives of caregivers, as it is for those diagnosed with the condition [2][3][4]. Caregiving is frequently subtle and varied, both with respect to how carers identify with the role and the tasks they undertake.…”

Section: Introductionmentioning

confidence: 99%

“…In DRE, caregiverpatient dyads are described as vital to illness management, yet the dynamics of caregiving, especially in adults with epilepsy, appear understudied and focused mostly on the perspective of carers and their needs [8,11]. In a British study, attachment styles were explored to better explain the complexity of dyadic relationships in patients with seizures [4]. Patient distress was highlighted to significantly influence the quality of life of carers [4], supporting the recommendations that health care services be tailored to include the physical and emotional wellbeing of primary caregivers [11].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Reciprocal burden: Adults with drug-resistant epilepsy reflect upon informal caregiver support

Dewar¹,

Ranit

Pieters³

2021

Seizure

View full text Add to dashboard Cite

To explore how a sample of people with uncontrolled seizures describe their experiences of receiving informal supportive care. Methods: Using constructivist grounded theory, in-person, semi-structured interviews were conducted in 35 adults with drug-resistant epilepsy. These 20 (57%) women and 15 (43%) men were aged 18-68 years (mean= 35.6 years), with a range of verbal comprehension scores. The majority, 28 (80%) lived in nuclear family settings. Results: Unpredictable seizures disrupted personal autonomy and generated unique challenges for everyday life. While supportive care was deemed necessary to survival, subjective reflections around the implications of care-receiving and caregiving, were ultimately experienced as mutually burdensome. Four dynamic and interactive dimensions revealed a mirrored, interactive perspective of what it meant to be a care-recipient: assuming responsibility; protecting and supervising; acknowledging reliance and setting boundaries. Care-recipience was not one-sided, but included actively hiding personal struggles as a way to shield the caregiver from the emotional and physical demands of caregiving. Relationship dynamics between caregivers and care-recipients played a major role in treatment decisionmaking. A clinically useful Theory of Reciprocal Burden resulted from our study. Conclusions: This study adds an explanatory dimension to the concept of illness burden from the perspective of care-recipients. Relationship dynamics play a key role in patient-centered epilepsy care, with clinical implications for guiding supportive caregiving, fostering independence and promoting self-management strategies.

show abstract

“…At least a subgroup of patients with PNES is characterized by insecure attachment and particular anxieties about interpersonal relationships . There is also evidence that carers differ in affective expression and that they experience their relationships with patients with seizure disorders differently, depending on whether the seizures are epileptic or nonepileptic …”

Section: Introductionmentioning

confidence: 99%

Peri‐ictal responsiveness to the social environment is greater in psychogenic nonepileptic than epileptic seizures

Wardrope

Wong

McLaughlan³

et al. 2020

Epilepsia

Self Cite

View full text Add to dashboard Cite

Objective: To look for evidence of peri-ictal social interaction in psychogenic nonepileptic seizures (PNES) and epileptic seizures exploring the notion of PNES as a form of nonverbal communication. Methods: Video recordings of typical seizures experienced by patients with epilepsy and PNES were obtained in a naturalistic social setting (residential epilepsy monitoring unit). Video analysis by three nonexpert clinicians identified 18 predefined semiological and interactional features indicative of apparent impairment of consciousness or of peri-ictal responsiveness to the social environment with assessment of interrater reliability using Fleiss κ. Features were compared between epileptic seizures and PNES. Results: One hundred eighty-nine seizures from 50 participants (24 epilepsy, 18 PNES, eight combined) were analyzed. At least fair (κ > 0.20) interrater agreement was achieved for 14 features. The PNES and epileptic seizures compared were of similar severity in terms of ictal impairment of consciousness (κ = 0.34, odds ratio [OR] = 1.11, 95% confidence interval [CI] = 0.62-1.96) and responsiveness (κ = 0.52, OR = 1.01, 95% CI = 0.55-1.86). PNES were more likely to be preceded by attempts to alert others (κ = 0.52, OR = 12.4, 95% CI = 3.2-47.7, P < .001), to show intensity affected by the presence of others (κ = 0.44, OR = 199.4, 95% CI = 12.0-3309.9, P < .001), and to display postictal behavior affected by the presence of others (κ = 0.35, OR = 91.1, 95% CI = 17.2-482.1, P < .001). Significance: Nonexpert raters can, with fair to moderate reliability, rate features characterizing ictal impairment of consciousness and responsivity in video recordings of seizures. PNES are associated with greater peri-ictal responsiveness to the social environment than epileptic seizures. These findings are consistent with a potential communicative function of PNES and could be of differential diagnostic significance. K E Y W O R D S communication, dissociative disorders, nonepileptic seizures, psychology | 759 WARDROPE Et Al. How to cite this article: Wardrope A, Wong S, McLaughlan J, Wolfe M, Oto M, Reuber M. Peri-ictal responsiveness to the social environment is greater in psychogenic nonepileptic than epileptic seizures. Epilepsia. 2020;61:758-765. https://doi.

show abstract

The influence of attachment style and relationship quality on quality of life and psychological distress in carers of people with epileptic and nonepileptic seizures

Cited by 11 publications

References 34 publications

Dissociation, Stressors, and Coping in Patients of Psychogenic Nonepileptic Seizures

Dissociation, Stressors, and Coping in Patients of Psychogenic Nonepileptic Seizures

Reciprocal burden: Adults with drug-resistant epilepsy reflect upon informal caregiver support

Peri‐ictal responsiveness to the social environment is greater in psychogenic nonepileptic than epileptic seizures

Contact Info

Product

Resources

About