Abstracts

Objective: At the end of this presentation the participants will be able to understand the utility of the Personality Assessment Inventory (PAI) in predicting nonepileptic seizures.
The Minnesota Multiphasic Personality Inventory (MMPI) has been used extensively as an aid in distinguishing nonepileptic seizures (NES) from epileptic seizures (ES). The Personality Assessment Inventory (PAI) is a relatively new measure of personality which has been developed based on contemporary diagnostic theory. The PAI may be of greater value than the MMPI in developing a psychiatric treatment plan. We present the first reported application of the PAI to patients undergoing long-term video-EEG (VEEG) and will show the utility of the PAI in predicting ES versus NES as demonstrated by VEEG.
METHODS: Of 50 consecutive admissions for VEEG in which there was a complete data set, 18 patients were diagnosed as NES and 9 had ES, based on VEEG findings. Cases of mixed NES and ES were excluded from study. All patients were adults with a mean age of 35.4 years. The PAI was administered to each patient and scored in conventional fashion.
RESULTS: T-test group comparisons showed no group difference on any of the validity scales. Group differences were found on the Depression (p [lt] 0.032), Treatment Rejection (p [lt] 0.029), and Dominance (p [lt] 0.043) scales. While the Somatization scale showed no group differences (p [lt] 0.215), the subscale Conversion Disorder showed large group differences (p [lt] 0.010). For the NES group, these results reflected greater physiologic signs of depression, greater willingness to endorse the need for personal psychological change, and a modest and retiring personality style.
Most striking was the NES group tendency to endorse functional impairment due to symptoms associated with sensory and/or motor deficits (conversion). Using the Conversion subscale alone, a sensitivity of 67% and a specificity of 89% were found in classifying patients as NES versus ES.
CONCLUSIONS: The Personality Assessment Inventory shows promise in making the distinction between NES and ES. Applied to patients with NES, PAI may also assist in the formulation of psychiatric treatment, based on contemporary psychology theory.