Do patients with psychogenic nonepileptic seizures have positive covert attitudes toward sickness?

Some individuals with psychogenic nonepileptic seizures (PNES) are seen as having adopted a "sick role" that relinquishes them of responsibility for meeting stressful life demands. Thus, patients with PNES may have positive, albeit unrecognized, attitudes toward seizures, or perhaps illness in general. Because such covert attitudes may not be amendable to self-report, the current study used the Implicit Association Test (IAT), a methodology by which attitudes toward illness and disability can be inferred from performance on an ostensibly neutral task. Individuals with PNES did not have a reduced interference effect when responding to sickness-related and pleasant words on the same response key. Exploratory analyses revealed that a pronounced somatic focus and higher extraversion were associated with more neutral attitudes toward illness among patients with PNES. This IAT methodology found little support for the notion that patients with PNES harbor positive attitudes toward illness. Limitations of the IAT methodology are reviewed and recommendations are provided.