韧性与运动性功能性神经障碍的人格维度、述情障碍和情感症状有关。
Resilience linked to personality dimensions, alexithymia and affective symptoms in motor functional neurological disorders.
机构信息
Department of Neurology, Functional Neurology Research Group, Cognitive Behavioral Neurology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
出版信息
J Psychosom Res. 2018 Apr;107:55-61. doi: 10.1016/j.jpsychores.2018.02.005. Epub 2018 Feb 13.
OBJECTIVE
Reduced resilience, a construct associated with maladaptive stress coping and a predisposing vulnerability for Functional Neurological Disorders (FND), has been under-studied compared to other neuropsychiatric factors in FND. This prospective case-control study investigated self-reported resilience in patients with FND compared to controls and examined relationships between resilience and affective symptoms, personality traits, alexithymia, health status and adverse life event burden.
METHODS
50 individuals with motor FND and 47 healthy controls participated. A univariate test followed by a logistic regression analysis investigated group-level differences in Connor-Davidson Resilience Scale (CD-RISC) scores. For within-group analyses performed separately in patients with FND and controls, univariate screening tests followed by multivariate linear regression analyses examined factors associated with self-reported resilience.
RESULTS
Adjusting for age, gender, education status, ethnicity and lifetime adverse event burden, patients with FND reported reduced resilience compared to controls. Within-group analyses in patients with FND showed that individual-differences in mental health, extraversion, conscientiousness, and openness positively correlated with CD-RISC scores; post-traumatic stress disorder symptom severity, depression, anxiety, alexithymia and neuroticism scores negatively correlated with CD-RISC scores. Extraversion independently predicted resilience scores in patients with FND. In control subjects, univariate associations were appreciated between CD-RISC scores and gender, personality traits, anxiety, alexithymia and physical health; conscientiousness independently predicted resilience in controls.
CONCLUSION
Patients with FND reported reduced resilience, and CD-RISC scores covaried with other important predisposing vulnerabilities for the development of FND. Future research should investigate if the CD-RISC is predictive of clinical outcomes in patients with FND.
目的
与功能性神经障碍（FND）的适应不良压力应对和易患脆弱性相关的韧性降低，与 FND 中的其他神经精神因素相比，研究得较少。本前瞻性病例对照研究比较了 FND 患者和对照组的自我报告韧性，并研究了韧性与情感症状、人格特质、述情障碍、健康状况和不良生活事件负担之间的关系。
方法
50 名运动性 FND 患者和 47 名健康对照者参与了本研究。单变量检验后进行逻辑回归分析，以调查 Connor-Davidson 韧性量表（CD-RISC）评分在组间的差异。对于 FND 患者和对照组分别进行的组内分析，采用单变量筛选检验后进行多元线性回归分析，以检查与自我报告韧性相关的因素。
结果
在调整年龄、性别、教育程度、种族和终生不良生活事件负担后，FND 患者的韧性较对照组下降。FND 患者的组内分析显示，心理健康、外向性、尽责性和开放性的个体差异与 CD-RISC 评分呈正相关；创伤后应激障碍症状严重程度、抑郁、焦虑、述情障碍和神经质与 CD-RISC 评分呈负相关。外向性独立预测 FND 患者的韧性评分。在对照组中，CD-RISC 评分与性别、人格特质、焦虑、述情障碍和身体健康之间存在单变量相关性；尽责性独立预测了对照组的韧性。
结论
FND 患者报告的韧性降低，CD-RISC 评分与 FND 发展的其他重要易患脆弱性相关。未来的研究应该调查 CD-RISC 是否可以预测 FND 患者的临床结局。
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