Emotion regulation profiles in psychogenic non-epileptic seizures

BackgroundPsychogenic non-epileptic seizures (PNES) are frequently encountered in epilepsy referral centers, yet there is limited understanding of the emotion processing style in this psychiatrically heterogeneous population. Understanding profiles of emotion regulation in PNES will provide further evidence of the psychogenic nature of the disorder and will potentially inform psychotherapeutic interventions.MethodsFifty-five patients with PNES underwent a neuropsychiatric evaluation and completed self-report questionnaires that measured difficulties in emotion regulation, psychopathology severity and quality of life.ResultsThrough the use of cluster analysis, two groups were identified; Cluster 1 represented a highly emotion dysregulated group while Cluster 2 represented a low emotion dysregulated group. Additional analyses revealed that each group significantly differed from normative data. Finally, Cluster 1 was significantly associated with several measures of psychiatric symptoms, higher rates of comorbid psychiatric diagnoses and impairment in quality of life.ConclusionsThese findings suggest that patients with PNES may be subject to high levels of emotion dysregulation, severe psychiatric symptomatology and impaired quality of life, or to low emotion dysregulation characterized by emotional unawareness or avoidance. These profiles clearly differ from normative data regarding emotion regulation and their identification may help tailor psychotherapeutic interventions.

► This study examines those diagnosed with psychogenic non-epileptic seizures (PNES). ► Two clusters were found: above (1) and below (2) average emotionally dysregulated. ► Cluster 1 was associated with psychiatric symptomatology and low quality of life. ► Cluster 2 may be characterized by emotion avoidance. ► Results support differential psychiatric presentations of those with PNES.