Resilience linked to personality dimensions, alexithymia and affective symptoms in motor functional neurological disorders

Rozita Jalilianhasanpour; Benjamin Williams; Isabelle Gilman; Matthew J Burke; Sean Glass; Gregory L Fricchione; Matcheri S Keshavan; W Curt LaFrance Jr; David L Perez

doi:10.1016/j.jpsychores.2018.02.005

Resilience linked to personality dimensions, alexithymia and affective symptoms in motor functional neurological disorders

J Psychosom Res. 2018 Apr:107:55-61. doi: 10.1016/j.jpsychores.2018.02.005. Epub 2018 Feb 13.

Authors

Rozita Jalilianhasanpour¹, Benjamin Williams¹, Isabelle Gilman¹, Matthew J Burke², Sean Glass³, Gregory L Fricchione⁴, Matcheri S Keshavan⁵, W Curt LaFrance Jr⁶, David L Perez⁷

Affiliations

¹ Department of Neurology, Functional Neurology Research Group, Cognitive Behavioral Neurology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
² Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
³ Department of Neurology, Functional Neurology Research Group, Cognitive Behavioral Neurology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Neuropsychiatry Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
⁴ Department of Psychiatry, Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA, USA.
⁵ Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
⁶ Neuropsychiatry and Behavioral Neurology Division, Rhode Island Hospital, Departments of Psychiatry and Neurology, Brown University, Alpert Medical School, Providence, RI, USA.
⁷ Department of Neurology, Functional Neurology Research Group, Cognitive Behavioral Neurology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Neuropsychiatry Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: dlperez@partners.org.

Abstract

Objective: Reduced resilience, a construct associated with maladaptive stress coping and a predisposing vulnerability for Functional Neurological Disorders (FND), has been under-studied compared to other neuropsychiatric factors in FND. This prospective case-control study investigated self-reported resilience in patients with FND compared to controls and examined relationships between resilience and affective symptoms, personality traits, alexithymia, health status and adverse life event burden.

Methods: 50 individuals with motor FND and 47 healthy controls participated. A univariate test followed by a logistic regression analysis investigated group-level differences in Connor-Davidson Resilience Scale (CD-RISC) scores. For within-group analyses performed separately in patients with FND and controls, univariate screening tests followed by multivariate linear regression analyses examined factors associated with self-reported resilience.

Results: Adjusting for age, gender, education status, ethnicity and lifetime adverse event burden, patients with FND reported reduced resilience compared to controls. Within-group analyses in patients with FND showed that individual-differences in mental health, extraversion, conscientiousness, and openness positively correlated with CD-RISC scores; post-traumatic stress disorder symptom severity, depression, anxiety, alexithymia and neuroticism scores negatively correlated with CD-RISC scores. Extraversion independently predicted resilience scores in patients with FND. In control subjects, univariate associations were appreciated between CD-RISC scores and gender, personality traits, anxiety, alexithymia and physical health; conscientiousness independently predicted resilience in controls.

Conclusion: Patients with FND reported reduced resilience, and CD-RISC scores covaried with other important predisposing vulnerabilities for the development of FND. Future research should investigate if the CD-RISC is predictive of clinical outcomes in patients with FND.

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

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Affective Symptoms / complications
Affective Symptoms / psychology*
Case-Control Studies
Female
Humans
Male
Motor Activity*
Nervous System Diseases / complications
Nervous System Diseases / physiopathology*
Nervous System Diseases / psychology*
Personality*
Resilience, Psychological*

Grants and funding

K23 MH111983/MH/NIMH NIH HHS/United States