Division of Health Research, Lancaster University, Lancaster LA1 4YW, UK.
Department of Clinical Neuropsychology, Salford Royal Hospital, Salford M6 8HD, UK.
Epilepsy Behav. 2020 Oct;111:107155. doi: 10.1016/j.yebeh.2020.107155. Epub 2020 Jun 17.
There is no clear understanding of what causes and maintains nonepileptic attack (NEA) disorder (NEAD), or which psychological therapies may be helpful. The relationships between variables of psychological inflexibility: experiential avoidance (EA), cognitive fusion (CF), mindfulness, and key outcome variables in NEAD: somatization, impact upon life, and NEA frequency were investigated.
Two hundred eighty-five individuals with NEAD completed validated measures online. Linear regression was used to explore which variables predicted somatization and impact upon life. Ordinal regression was used to explore variables of interest in regard to NEA frequency.
Mindfulness, EA, CF, somatization, and impact upon life were all significantly correlated. Mindfulness uniquely predicted somatization when considered in a model with EA and CF. Higher levels of somatization increased the odds of experiencing more NEAs. Individuals who perceived NEAD as having a more significant impact upon their lives had more NEAs, more somatic complaints, and more EA.
Higher levels of CF and EA appear to be related to lower levels of mindfulness. Lower levels of mindfulness predicted greater levels of somatization, and somatization predicted NEA frequency. Interventions that tackle avoidance and increase mindfulness, such as, acceptance and commitment therapy, may be beneficial for individuals with NEAD. Future directions for research are suggested as the results indicate more research is needed.
目前尚不清楚是什么导致并维持了非癫痫性发作障碍(NEAD),也不清楚哪种心理治疗可能会有所帮助。本研究旨在调查心理灵活性的变量(经验回避、认知融合、正念)与 NEAD 的关键结果变量(躯体化、对生活的影响和 NEA 频率)之间的关系。
285 名 NEAD 患者在线完成了有效的评估量表。采用线性回归分析探讨哪些变量可以预测躯体化和对生活的影响。采用有序回归分析探讨与 NEA 频率相关的变量。
正念、经验回避、认知融合、躯体化和对生活的影响均显著相关。当在考虑包括经验回避和认知融合的模型中时,正念可以独立预测躯体化。更高的躯体化水平会增加经历更多 NEA 的几率。那些认为 NEAD 对他们的生活有更大影响的人,经历的 NEA 更多,躯体化症状更多,经验回避也更多。
较高的认知融合和经验回避似乎与较低的正念水平有关。较低的正念水平预测了更高的躯体化水平,而躯体化又预测了 NEA 的频率。接受和承诺疗法等可以解决回避和提高正念的干预措施可能对 NEAD 患者有益。由于研究结果表明需要进一步研究,因此提出了未来的研究方向。