Automatic avoidance tendencies in patients with psychogenic non-epileptic seizures

Area of Science:

• Psychoneuroimmunology
• Clinical Psychology
• Behavioral Neuroscience

Background:

• Psychogenic Non-Epileptic Seizures (PNES) are theorized to stem from learned avoidant behaviors to manage stress.
• Previous evidence relies heavily on self-reports, lacking objective behavioral data on avoidance tendencies in PNES.
• This study investigates automatic threat avoidance in PNES patients compared to healthy controls (HCs).

Purpose of the Study:

• To objectively test automatic threat avoidance tendencies in PNES patients.
• To examine the relationship between avoidance behavior, stress, and cortisol levels in PNES.
• To compare behavioral responses between PNES patients and matched healthy controls.

Main Methods:

• The Approach and Avoidance (AA) task was used to assess behavioral responses to emotional faces.
• Participants included 12 PNES patients and 20 HCs, tested at baseline and after stress induction (Cold Pressor Test).
• Salivary cortisol levels were measured throughout the experiment to correlate with behavioral avoidance.

Main Results:

• PNES patients, unlike HCs, displayed increased avoidance of angry faces at baseline, indicated by slower approach.
• This heightened avoidance in PNES was associated with basal cortisol levels.
• The observed avoidance effect in PNES patients diminished after the stress induction procedure.

Conclusions:

• Findings objectively confirm that PNES patients exhibit increased avoidance tendencies towards social threat cues.
• Behavioral assessment of threat avoidance may offer valuable clinical insights for PNES treatment effectiveness.
• Measuring avoidance behavior could potentially aid in predicting PNES prognosis.