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Self-protective organization in children with conversion and somatoform disorders
Kasia Kozlowska1, Leanne M Williams
1Psychological Medicine, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia. kasiak@chw.edu.au
Journal of Psychosomatic Research
|August 19, 2009
Summary
Childhood conversion reactions stem from two distinct emotional responses to threat: inhibitory and excitatory. These findings suggest conversion disorders are not a single entity, impacting clinical understanding and treatment.
Area of Science:
- Psychology
- Child Psychiatry
- Attachment Theory
Background:
- Clinical observations link conversion symptoms to intense emotions or threats to well-being.
- Childhood conversion reactions are hypothesized to represent motor-sensory aspects of emotional responses to relational threats.
Purpose of the Study:
- To test if childhood conversion reactions reflect motor-sensory components of distinct inhibitory and excitatory emotional responses.
- To explore the link between attachment strategies and emotional responses to interpersonal threats in children with conversion disorders.
Main Methods:
- Assessed emotional responses in 28 children with conversion disorders using Dynamic-Maturational-Model (DMM) attachment assessments.
- Analyzed attachment strategies (Type A - inhibitory, Type B - balanced, Type C - excitatory) and their relation to behavioral organization and information processing.
Main Results:
- 43% of children exhibited an inhibitory attachment strategy (Type A).
- 43% of children exhibited an excitatory attachment strategy (Type C).
- 14% of children alternated between strategies, with symptoms linked to the excitatory type.
Conclusions:
- Conversion reactions are not a monolithic clinical entity.
- Symptoms reflect motor-sensory components of two distinct emotional responses to threat: inhibition and excitation.
- This distinction may explain the varied presentation of conversion symptoms, including loss of function and positive symptoms.
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