Symptom Validity Test Failure Signals Worse History of Abuse but Not Worse Psychopathology in Patients with Psychogenic Nonepileptic Seizures
Abstract number :
1.221
Submission category :
Neuropsychology/Language Cognition-Adult
Year :
2006
Submission ID :
6355
Source :
www.aesnet.org
Presentation date :
12/1/2006 12:00:00 AM
Published date :
Nov 30, 2006, 06:00 AM
Authors :
1,2David J. Williamson, 3,4Daniel L. Drane, 3,4Elizabeth S. Stroup, 4Maria Holsman, 3,4Naomi Chaytor, 3,4Mark D. Holmes, and 3,4John W. Miller
Our group has demonstrated that patients with psychogenic nonepileptic seizures (PNES), rather than scoring equivalently to patients with epilepsy, actually bifurcate into two groups: one that scores worse than patients with epilepsy and one that scores better. Symptom validity testing, specifically the Word Memory Test, has demonstrated utility in identifying these groups (Drane et al., 2006). However, the patients constituting these two groups of patients with PNES have yet to be described beyond their neurocognitive performances. Through examination of psychological test results and clinical histories, we sought to determine if these groups differed in either the pattern or severity of neurological or psychological symptomatology., One-hundred four patients with PNES, 66 of whom passed WMT and 38 of whom did not, were compared across a variety of historical and psychological measures. We examined expected points of difference on the MMPI (scales 1, 3, 7 and 8) as well as historical variables that are reported to occur more frequently in patients with PNES (e.g., sexual, physical, and emotional abuse). A comparison sample of 34 patients with epilepsy who passed WMT was examined as well., The groups with PNES did not differ from each other on scales 1, 3, 7, or 8 on the MMPI, nor did they differ from each other in terms of the frequency with which they reported disorders often comorbid with somatic symptoms of unknown etiology (i.e., fibromyalgia, chronic pain). However, the group that failed symptom validity testing reported significantly higher frequencies of reported physical (p[lt].05) and emotional (p[lt].01) abuse, and there was a similar trend for sexual abuse (p=.08)., In other populations, failure of symptom validity testing has been associated with greater report of a variety of different types of self-reported problems. Based upon the findings in this sample, failing the Word Memory Test does not portend greater complaint of somatoform problems in patients with PNES, but it does relate to a higher frequency of reported abuse.,
Behavior/Neuropsychology