心理性非癫痫性发作（PNES）和心理性运动障碍（PMD）中的人格特质：神经质和完美主义。
Personality traits in psychogenic nonepileptic seizures (PNES) and psychogenic movement disorder (PMD): Neuroticism and perfectionism.
作者信息
Ekanayake Vindhya, Kranick Sarah, LaFaver Kathrin, Naz Arshi, Frank Webb Anne, LaFrance W Curt, Hallett Mark, Voon Valerie
机构信息
National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
出版信息
J Psychosom Res. 2017 Jun;97:23-29. doi: 10.1016/j.jpsychores.2017.03.018. Epub 2017 Mar 27.
OBJECTIVE
Psychogenic movement disorder (PMD) and psychogenic nonepileptic seizures (PNES) are two subtypes of conversion disorder (CD). In this case-control study, we asked whether these subtypes varied as a function of personality and history of childhood abuse.
METHODS
Fifty-nine patients with PMD from the Human Motor Control Section Clinic at the National Institutes of Health, 43 patients with PNES from the Rhode Island Hospital Neuropsychiatry and Behavioral Neurology Division, and 26 healthy volunteers (HC) received a battery of neurological, psychiatric and psychological assessments, including the NEO Personality Inventory Revised (NEO PI-R), the Childhood Trauma Questionnaire (CTQ), and the Traumatic Life Events Questionnaire (TLEQ).
RESULTS
One-way ANOVA between the three groups indicated significant differences in overall domains of Neuroticism (p=0.001) and Conscientiousness (p=0.009): Patients with PNES reported significantly greater levels of Neuroticism (p=0.002) and lower levels of Conscientiousness (p=0.023) than patients with PMD. Levels of Neuroticism remained significantly higher in both PMD and PNES than HC following correction for multiple comparisons. Patients with PNES reported greater levels of depressive and anxiety symptoms, overall psychopathology, greater history of sexual abuse, greater levels of alexithymia, higher levels of dissociative symptoms, and an earlier age at which they experienced their most distressing traumatic event than patients with PMD.
CONCLUSIONS
These findings suggest that personality traits, type of abuse and age of onset of trauma varies as a function of CD subtype. Patients with PNES rated greater Neuroticism and lower Conscientiousness than patients with PMD. These differing psychological profiles may inform differing treatment approaches such as psychological therapies for PNES and physiotherapy (with/without psychotherapy) for PMD.
目的
精神性运动障碍（PMD）和精神性非癫痫性发作（PNES）是转换障碍（CD）的两种亚型。在这项病例对照研究中，我们探讨了这些亚型是否因人格和童年虐待史的不同而有所差异。
方法
来自美国国立卫生研究院人类运动控制科诊所的59例PMD患者、罗德岛医院神经精神病学和行为神经病学部门的43例PNES患者以及26名健康志愿者（HC）接受了一系列神经学、精神病学和心理学评估，包括修订版大五人格量表（NEO PI-R）、儿童创伤问卷（CTQ）和创伤性生活事件问卷（TLEQ）。
结果
三组之间的单因素方差分析表明，神经质（p=0.001）和尽责性（p=0.009）的总体领域存在显著差异：与PMD患者相比，PNES患者报告的神经质水平显著更高（p=0.002），尽责性水平更低（p=0.023）。在进行多重比较校正后，PMD和PNES患者的神经质水平仍显著高于HC。与PMD患者相比，PNES患者报告的抑郁和焦虑症状水平更高、总体精神病理学更严重、性虐待史更多、述情障碍水平更高、分离症状水平更高，且经历最痛苦创伤事件的年龄更早。
结论
这些发现表明，人格特质、虐待类型和创伤发作年龄因CD亚型而异。与PMD患者相比，PNES患者的神经质得分更高，尽责性得分更低。这些不同的心理特征可能为不同的治疗方法提供依据，如针对PNES的心理治疗和针对PMD的物理治疗（有无心理治疗）。
Zotero 插件