Abstracts

Rationale: Prior research with patients with psychogenic non-epileptic seizures (PNES) has examined aspects of psychological functioning including approaches to coping with stressors, difficulties identifying and describing emotions, and tendencies for suppressing thoughts, memories, and emotions. No research to date has examined patients' affective styles, which involve regulation of emotions. Prior work has suggested three general approaches for handling emotions: concealing, adjusting, and tolerating them. The authors suggested that an elevated level of concealing behaviors could be maladaptive and associated with a higher level of physiological arousal. An elevated level of adjusting behaviors could be viewed as positive, suggesting increased flexibility for adapting emotionally. An elevated level of tolerating behaviors could also be viewed as positive, suggesting increased ability to handle emotional distress. This study examines potential differences between patients with epilepsy and those with (PNES) regarding these tendencies when reacting to emotionally intense situations.

Methods: This is a retrospective study of 20 patients (14 female, 6 male) diagnosed with epilepsy (ES) and 18 patients (15 female, 3 male) diagnosed with PNES. Diagnosis was confirmed with video EEG. All patients were administered the Affective Styles Questionnaire (ASQ) during a comprehensive neuropsychological evaluation. Means and proportions were compared using t-tests.

Results: No significant differences were seen on the three different measures of affective style: Concealing (p = 0.91), Adjusting (p = 0.37), or Tolerating (p = 0.23). However, trends were seen when proportions of the groups were examined scoring above or below the mean in the area of Adjusting. A trend was seen for more patients with epilepsy to score above the mean than those with PNES (p = .10). A trend was also seen for more patients with PNES to score below the mean than those with epilepsy (p = .10).

Conclusions: Patients with PNES often present with difficulties coping with stressful situations in their lives—both ongoing in the present and originating in the past. Patients with PNES also often present with a history of difficulties identifying, describing, and expressing their emotions as related to chronic stressors in their lives or emotionally traumatic experiences from their past. While no significant differences were seen when comparing means between patients with epilepsy and those with PNES on the various affective style measures, some trends were seen. More patients with epilepsy seemed to demonstrate some strength for adjusting and adapting to emotionally charged situations. Whereas, more patients with PNES seemed to demonstrate some weakness for this. This inflexibility can be seen as maladaptive. This finding is not unexpected given prior findings of patients with PNES tending to use less effective coping strategies when dealing with stress. These findings illustrate the importance of examining approaches towards handling emotionally intense situations when planning for working with PNES patients—specifically identifying potential weaknesses/difficulties calming down and letting go of strong emotions.

Funding: Please list any funding that was received in support of this abstract.: N/A