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Use of a Psychophysiological Script-driven Imagery Experiment to Study Trauma-related Dissociation in Borderline Personality Disorder
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Life events and escape in conversion disorder.

T R Nicholson1, S Aybek1, T Craig2

  • 1Section of Cognitive Neuropsychiatry,Institute of Psychiatry Psychology & Neuroscience, King's College,London,UK.

Psychological Medicine
|July 6, 2016
PubMed
Summary
This summary is machine-generated.

Psychosocial stressors and escape from them are linked to conversion disorder (CD). Thorough evaluation is crucial for identifying potential causes in CD patients.

Keywords:
Conversion disorderfunctional neurological disorderlife eventsstresstrauma

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Area of Science:

  • Psychiatry
  • Psychology
  • Neuroscience

Background:

  • Psychological models of conversion disorder (CD) traditionally link symptom onset to identifiable psychosocial stressors.
  • These traditional models are increasingly challenged due to limited supporting evidence.

Purpose of the Study:

  • To investigate the role of severe life events and 'escape' from stressors in conversion disorder.
  • To test the Freudian theory of 'secondary gain' where symptoms provide escape from difficult situations.

Main Methods:

  • Assessed 43 motor CD patients, 28 depression patients, and 28 healthy controls using the Life Events and Difficulties Schedule.
  • Developed and applied a novel 'escape' rating for life events to assess their potential to provide relief from stressors.

Main Results:

  • CD patients experienced significantly more severe life events and 'escape' events compared to controls.
  • A higher percentage of CD patients (56%) reported severe events in the month before symptom onset versus depression patients (21%) and controls (18%).
  • Childhood trauma, particularly sexual abuse, was more common in CD patients and relevant to symptom onset in some cases.

Conclusions:

  • Findings support the psychological model of CD and the Freudian concept of symptoms as a means of escape.
  • Thorough psychosocial evaluation is essential for uncovering potential etiological stressors in conversion disorder.
  • Childhood traumas may play a role in the development of CD for some individuals.