Personality traits in psychogenic nonepileptic seizures (PNES) and psychogenic movement disorder (PMD): Neuroticism and perfectionism

Vindhya Ekanayake; Sarah Kranick; Kathrin LaFaver; Arshi Naz; Anne Frank Webb; W Curt LaFrance Jr; Mark Hallett; Valerie Voon

doi:10.1016/j.jpsychores.2017.03.018

Personality traits in psychogenic nonepileptic seizures (PNES) and psychogenic movement disorder (PMD): Neuroticism and perfectionism

J Psychosom Res. 2017 Jun:97:23-29. doi: 10.1016/j.jpsychores.2017.03.018. Epub 2017 Mar 27.

Authors

Vindhya Ekanayake¹, Sarah Kranick², Kathrin LaFaver², Arshi Naz³, Anne Frank Webb³, W Curt LaFrance Jr⁴, Mark Hallett², Valerie Voon⁵

Affiliations

¹ National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA. Electronic address: vindhya.k.ekanayake.ctr@mail.mil.
² National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
³ Division of Neuropsychiatry and Behavioral Neurology, Rhode Island Hospital, USA.
⁴ Division of Neuropsychiatry and Behavioral Neurology, Rhode Island Hospital, USA; Departments of Psychiatry and Neurology, Brown University, Providence, RI, USA.
⁵ Department of Psychiatry, University of Cambridge, Cambridge, UK.

Abstract

Objective: Psychogenic movement disorder (PMD) and psychogenic nonepileptic seizures (PNES) are two subtypes of conversion disorder (CD). In this case-control study, we asked whether these subtypes varied as a function of personality and history of childhood abuse.

Methods: Fifty-nine patients with PMD from the Human Motor Control Section Clinic at the National Institutes of Health, 43 patients with PNES from the Rhode Island Hospital Neuropsychiatry and Behavioral Neurology Division, and 26 healthy volunteers (HC) received a battery of neurological, psychiatric and psychological assessments, including the NEO Personality Inventory Revised (NEO PI-R), the Childhood Trauma Questionnaire (CTQ), and the Traumatic Life Events Questionnaire (TLEQ).

Results: One-way ANOVA between the three groups indicated significant differences in overall domains of Neuroticism (p=0.001) and Conscientiousness (p=0.009): Patients with PNES reported significantly greater levels of Neuroticism (p=0.002) and lower levels of Conscientiousness (p=0.023) than patients with PMD. Levels of Neuroticism remained significantly higher in both PMD and PNES than HC following correction for multiple comparisons. Patients with PNES reported greater levels of depressive and anxiety symptoms, overall psychopathology, greater history of sexual abuse, greater levels of alexithymia, higher levels of dissociative symptoms, and an earlier age at which they experienced their most distressing traumatic event than patients with PMD.

Conclusions: These findings suggest that personality traits, type of abuse and age of onset of trauma varies as a function of CD subtype. Patients with PNES rated greater Neuroticism and lower Conscientiousness than patients with PMD. These differing psychological profiles may inform differing treatment approaches such as psychological therapies for PNES and physiotherapy (with/without psychotherapy) for PMD.

Keywords: Conversion disorder; Functional disorders; Nonepileptic seizures; Personality; Psychogenic movement disorder.

MeSH terms

Adult
Affective Symptoms / psychology*
Case-Control Studies
Conversion Disorder / psychology*
Dissociative Disorders / psychology*
Female
Humans
Male
Middle Aged
Movement Disorders / psychology*
Neuroticism / physiology*
Perfectionism*
Personality Tests / standards*
Psychopathology / methods*
Seizures / etiology*
Seizures / psychology

Abstract

MeSH terms

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