Two studies tested the prediction that people who identify strongly with a group base leadership perceptions on the group prototypicality of the leader whereas leadership schemas diminish in importance. Leadership and prototypicality were operationalized as relational constructs grounded in people's salient social comparative frame of reference. Study 1 (N = 82) had participants nominate a group leader and measured perceptions of the leader relative to nonleaders on leadership effectiveness, group prototypicality, and leadership stereotypicality. In Study 2 (N = 164) prototypicality, stereotypicality, and group salience were experimentally manipulated. As predicted, leadership stereotypicality became a weaker basis for leadership among high identifiers. The role of prototypicality in leadership was complexly affected by identification, which (a) accentuated leader-follower similarity on perceived prototypicality and leadership effectiveness, (b) changed the salient frame of reference, and (c) thus changed relative prototypicality of group members and leadership perceptions.Where there are groups there are leaders. The ubiquity and social relevance of leadership has placed the study of leadership high on the agenda for social psychology (e.g.,
Background and purpose Chronic pain is a common comorbidity in those with functional neurological disorder (FND); however, the prevalence and characteristics of FND in those with chronic pain is unknown. Methods A retrospective electronic records review was made of consecutive new patients attending a chronic pain clinic of a regional service. Clinical features, medication for and outcome of chronic pain, any lifetime diagnoses of functional disorders, FND, and psychiatric disorders, and undiagnosed neurological symptoms were recorded. Results Of 190 patients attending the chronic pain clinic, 32 (17%) had a lifetime diagnosis of FND and an additional 11 (6%) had undiagnosed neurological symptoms. Pain patients with comorbid FND were more likely to have chronic primary pain (88% with FND, 44% without FND, p < 0.0001), widespread chronic primary pain (53%, 15%, p < 0.00001), and depression (84%, 52%, p < 0.005) and less likely to have a pain‐precipitating event (19% vs. 56%, p < 0.001). However, there was no significant difference between these patients in opiate prescription, benzodiazepine prescription, or pain outcome. Conclusions This first study of FND in a chronic pain patient population found a remarkably high prevalence of FND (17%) and is possibly an underestimation. The size of the overlap indicates that FND and chronic pain research fields are likely to have a lot to learn from each other.
Objectives/AimsChronic pain is commonly reported as a comorbidity in patients with functional neurological disorder (FND) however the prevalence of FND in those presenting with chronic pain is unknown. We aimed to estimate 1) the prevalence of FND in patients seen at a chronic pain clinic and 2) how patients with chronic pain and comorbid FND differ from those without FND in terms of pain characteristics, psychiatric comorbidity, pain management and pain outcome.MethodsRetrospective electronic records review of consecutive new patients attending chronic pain clinics of 8 pain specialists in Lothian from the 1st of August 2019 to the 19thSeptember of 2019. Mean duration of follow up was 25 months. We recorded the clinical features, medication, management and outcome of chronic pain, any lifetime (up to November 2021) diagnoses of functional, FND and psychiatric disorders and undiagnosed neurological symptoms (where it was unclear if symptoms related to FND or another condition).ResultsOf 190 patients attending a chronic pain clinic, 32 (17%) had at least one lifetime diagnosis of FND and an additional 8 (4%) had undiagnosed neurological symptoms. FND diagnoses were functional limb weakness (8%), functional sensory disorder (8%), dissociative seizures (6%), functional cognitive disorder (5%), functional movement disorder (4%) and others (2%). Chronic primary pain (p<0.001), widespread chronic primary pain (p<0.00001) and pain with no precipitating trigger (p<0.01) were more common in pain patients with comorbid FND. A history of depression (p<0.001), anxiety (p<0.05) and suicide attempt (p<0.05) were also more common in these patients. However, patients with chronic pain and comorbid FND did not differ significantly from patients without FND in age, gender, prescribed analgesia (opiates and benzodiazepines) or pain outcome (25% vs 34% pain improved).ConclusionsFND was found in a surprisingly high 17% of new patients at a chronic pain clinic. This may be an underestimate based on an additional 4% of patients with undiagnosed neurological symptoms. Patients with chronic pain and FND are significantly more likely to have chronic primary pain compared to other pain patients but do not experience different pain management or outcome. These results provide further evidence of the important overlap between FND and chronic pain conditions.
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