Drop attacks as a subtype of FND: A cognitive behavioural model using grounded theory

Area of Science:

• Neurology
• Psychiatry
• Psychology

Background:

• Idiopathic drop attacks are poorly understood falls without warning or loss of consciousness.
• Recent research suggests a link between idiopathic drop attacks and functional neurological disorder (FND).

Purpose of the Study:

• To test a cognitive behavioral model for idiopathic drop attacks.
• To inform the formulation and treatment of idiopathic drop attacks within the FND spectrum.

Main Methods:

• Qualitative data approach using grounded theory.
• Analysis of interviews and diaries from seven individuals experiencing drop attacks.

Main Results:

• A cognitive behavioral model for drop attacks was identified.
• Initial falls (mechanical or medical) were the main precipitating event.
• Situational triggers, stress, and dissociation were additional factors.
• A maintaining cycle of thoughts, emotion, and behavior was outlined.

Conclusions:

• The proposed model aligns with existing cognitive behavioral models of FND.
• Understanding drop attacks within FND aids clinical formulation.
• Cognitive behavioral therapy interventions for FND may be applicable to drop attack patients.