Variation of Functional Neurological Symptoms and Emotion Regulation with Time

Abstract

IntroductionThe present study addressed the variation of emotion regulation in the context of functional neurological symptom disorder (FNSD) by examining changes of functional neurological symptoms (FNS), general psychological strain, alexithymia, emotion regulation strategies, and cortical correlates of emotion regulation in the context of a standard inpatient treatment program.Methods and materialsSelf-report data on FNS, general psychological strain, alexithymia, emotion regulation strategies, and cortical correlates of an experimentally induced emotion regulation task (participants either passively watched unpleasant and neutral pictures or regulated their emotional response to unpleasant pictures using pre-trained reappraisal, while an electroencephalogram was recorded) were compared between 19 patients with FNSD and 19 healthy comparison participants (HC) before and after a 4-week standard treatment protocol that included a combination of (individual and group) psychotherapies and functional treatments (such as physiotherapy) or a 4-week interval in HC, respectively.ResultsGeneral psychological strain did not decrease significantly in FNSD patients. Changes in emotion regulation in FNSD patients were constrained to an increase in self-reported use of cognitive reappraisal strategies. Subjective symptom intensity in FNSD patients varied with alexithymia pretreatment, but did not decrease significantly. Cortical activity in the time and frequency-domain distinguished passive watching of neutral and unpleasant pictures and regulating emotional responses upon unpleasant pictures from passively watching them without difference between groups and/or time.DiscussionOver the investigated time interval, augmented habitual cognitive emotion regulation suggests an alleviation of emotion processing deficits, but no significant symptom decrease. More controlled and prolonged treatment studies would be needed to determine whether and how a specific contribution of treatment-related changes of emotion regulation and FNS might be inferred.

Emotion regulation in patients with somatic symptom and related disorders: A systematic review

“…On the other hand, two studies with functional neurological symptoms, one study with functional dyspepsia and another one with SSD found evidence for an association between reappraisal and SSD: Patients with functional dyspepsia reported less frequent use of positive reappraisal, but more use of rumination and other-blame compared to healthy controls [136]. One study in patients with functional neurological symptoms and another with SSD reported a lower tendency to use cognitive reappraisal compared to healthy controls [100,137]. Similarly, patients with PNES tend to utilize cognitive reappraisal to a lesser extent than controls, which was also associated with cognitive inflexibility [78].…”

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

“… 68 Significant positive associations between severity of dissociation and various psychological features were reported in several samples of FND subtypes, including measures of alexithymia, emotion dysregulation, fearful attachment style and post-traumatic avoidance symptoms. 55 , 75 , 90 , 104 , 117 Other associations included significant positive correlations between dissociation and number of FND symptoms, early onset of FND, in-patient treatment and rates of comorbid psychiatric illnesses. 14 , 45 , 96 …”

“…Two studies employed electroencephalography (EEG) to investigate brain connectivity in FND participants. 106 , 117 Xue and colleagues performed EEG with 15 participants with FND-seizures and 15 matched controls; all participants additionally completed the SDQ-20. 106 The FND-seizures group had less linkage between frontal and posterior brain areas relative to controls; no significant associations between clustering coefficients and SDQ-20 scores were found.…”

“…Kienle et al investigated possible cortical indices of emotion regulation in a mixed FND sample and matched controls during an emotion regulation task. 117 Participants performed one of three emotionally arousing tasks during EEG recording and completed the SDQ-20. This protocol was repeated after a 4 week treatment period of physiotherapy and psychological therapy.…”

Die interdisziplinäre – integrative – Versorgung von funktionellen neurologischen Störungen

“…Mit Blick auf begleitende Forschungsaktivitäten, aber auch auf die Lehre und die Vermittlung spezifischer Qualifikationen an nachkommende Fachleute aus Psychologie und Funktionstherapien erweisen sich enge Verbindungen zum Lurija-Institut für Rehabilitationswissenschaften und Gesundheitsforschung sowie eine enge Zusammenarbeit mit der Universität Konstanz als hilfreich und produktiv [14]. Forschungsvorhaben und -ergebnisse [15][16][17][18][19][20][21][22][23][24][25][26][27][28] Neben der Behandlung dient es auch der (Weiter-) Entwicklung an den Kontext angepasster Behandlungskonzepte [26]. Begleitende wissenschaftliche Aktivitäten sind im Aufbau, erste Veröffentlichungen erschienen [29][30][31].…”