Performance of Patients with Epilepsy or Psychogenic Non-Epileptic Seizures on Four Measures of Effort

Cragar, Dona E.; Berry, David T. R.; Fakhoury, Toufic; Cibula, Jean E.; Schmitt, Frederick A.

doi:10.1080/13854040590947380

Cited by 56 publications

(25 citation statements)

References 28 publications

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“…AUC area under the curve, LR likelihood ratio, PPP positive predictive power, NPP negative predictive power consistent with the results of previous studies (Cragar, Berry, Fakhoury, Cibula, & Schmitt, 2006;Dodrill, 2008). The data analysis can be reduced to a number of clinically relevant findings: (1) CIM scores were consistently lower in patients who failed reference PVTs.…”

Section: Discussionsupporting

confidence: 83%

The BDAE Complex Ideational Material—a Measure of Receptive Language or Performance Validity?

Erdődi

Tyson

Abeare

et al. 2016

Psychol. Inj. and Law

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Scores on the Complex Ideational Material (CIM) were examined in reference to various performance validity tests (PVTs) in 106 adults clinically referred for neuropsychological assessment. The main diagnostic categories, reflecting a continuum between neurological and psychiatric disorders, were epilepsy, psychiatric disorders, postconcussive disorder, and psychogenic non-epileptic seizures. Cross-validation analyses suggest that in the absence of bona fide aphasia, a raw score ≤9 or T score ≤29 on the CIM is more likely to reflect non-credible presentation than impaired receptive language skills. However, these cutoffs may be associated with unacceptably high false positive rates in patients with longstanding, documented neurological deficits. Therefore, more conservative cutoffs (≤8/23) are recommended in such populations. Contrary to the widely accepted assumption that psychiatric disorders are unrelated to performance validity, results were consistent with the psychogenic interference hypothesis, suggesting that emotional distress increases the likelihood of PVT failures even in the absence of apparent external incentives to underperform on cognitive testing.

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Section: Discussionsupporting

confidence: 83%

The BDAE Complex Ideational Material—a Measure of Receptive Language or Performance Validity?

Erdődi

Tyson

Abeare

et al. 2016

Psychol. Inj. and Law

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“…Similarly, Locke et al 125 showed that performance on the TOMM had a better correlation with cognitive outcomes than did neuropathology or psychopathology. However, Cragar et al 126 used four different symptom validity tests including the PDRT, Digit Memory Test, Letter Memory Test, and TOMM, showing similar poor effort in PNES (N=21; 24%), ES (N=41; 22%), and PNES plus ES (N=18; 11%); these results suggest that these measures would not be useful in discriminating clinical diagnostic categories. Williamson et al 127 showed that failure on the WMT among patients with PNES (N=90; 35%) was associated with a history of physical or emotional abuse (reported as yes or no to the different abuse types) and was not associated with obvious financial incentive.…”

Section: Cognitionmentioning

confidence: 99%

Functional Neuroanatomy and Neurophysiology of Functional Neurological Disorders (Conversion Disorder)

Voon¹,

Cavanna²,

Coburn³

et al. 2016

JNP

131

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Much is known regarding the physical characteristics, comorbid symptoms, psychological makeup, and neuropsychological performance of patients with functional neurological disorders (FNDs)/conversion disorders. Gross neurostructural deficits do not account for the patients' deficits or symptoms. This review describes the literature focusing on potential neurobiological (i.e. functional neuroanatomic/neurophysiological) findings among individuals with FND, examining neuroimaging and neurophysiological studies of patients with the various forms of motor and sensory FND. In summary, neural networks and neurophysiologic mechanisms may mediate "functional" symptoms, reflecting neurobiological and intrapsychic processes. J Neuropsychiatry Clin Neurosci 2016; 28:168-190; doi: 10.1176/appi.neuropsych.14090217 Functional neurological disorders (FNDs; or psychogenic neurological symptoms), also known as conversion disorder, are a classic neuropsychiatric disorder, existing in the border between neurology and psychiatry. Unexplained neurological symptoms are common, occurring in up to one-third of patients in neurological outpatient clinics.1 Relative to disorders such as Parkinson's disease, FND is associated with similar levels of disability and physical quality of life with poorer mental health quality of life. 2 The prognosis is poor, with a recent reviewshowing that up to 40% of patients with FND report similar or worse outcomes at 7-year follow-up. 3 Given the frequency, consequences, prognosis, and burden, FND has been called a "crisis for neurology." 4 Despite this, FND is poorly understood. In the last decade, an increasing number of studies have focused on underlying neurobiological mechanisms. FND is defined in DSM-5 as the presence of one or more symptoms of altered voluntary or sensory function, with clinical findings providing evidence of incompatibility between the symptom and recognized neurological or medical conditions.5 The DSM-5 diagnosis differs from that of the DSM-IV diagnosis of conversion disorder by adding the criterion of incorporating physical diagnostic features and by relegating to the accompanying text the criteria requiring (a) an association with psychological stressors and (b) the exclusion of malingering or factitious disorder to make the diagnosis. DSM-5 FND diagnosis criteria now allow for potential greater interrater reliability, making them appropriate for research studies and greater compatibility with specialtyspecific diagnoses including psychogenic movement disorder (PMD) and psychogenic nonepileptic seizures (PNES). 6The putative biopsychosocial mechanisms underlying FND are complex and have been extensively reviewed.7 Our review focuses on the physiological mechanisms that may underlie FND and does not specifically focus on the extensive literature on the antecedents of early childhood experiences and temperament (Figure 1). At the outset, regarding the proposed model, we acknowledge that predisposing factors for functional neurological symptoms are not limited to genetics, te...

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“…A Dutch study of nearly 2000 healthy subjects found that as many as 29% of people aged [25][26][27][28][29][30][31][32][33][34][35] considered themselves forgetful, rising to 34% (40-50 years), 41% (55-65) years and 52% between 70-85 years [3]. High proportions (47-60%) of these respondents said they were worried to some extent about their forgetfulness Complaints of forgetfulness were correlated with depression and poor subjective health.…”

Section: Memory Symptoms In the General Populationmentioning

confidence: 99%

Functional (Psychogenic) Cognitive Disorders: A Perspective from the Neurology Clinic

Stone

Pal

Blackburn

et al. 2015

JAD

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Performance of Patients with Epilepsy or Psychogenic Non-Epileptic Seizures on Four Measures of Effort

Cited by 56 publications

References 28 publications

The BDAE Complex Ideational Material—a Measure of Receptive Language or Performance Validity?

The BDAE Complex Ideational Material—a Measure of Receptive Language or Performance Validity?

Functional Neuroanatomy and Neurophysiology of Functional Neurological Disorders (Conversion Disorder)

Functional (Psychogenic) Cognitive Disorders: A Perspective from the Neurology Clinic

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