Pro Persona Integrated Mental Health Care, Pro Persona Behavioral Science Institute, Nijmegen, The Netherlands.
Department of Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands.
Clin Psychol Psychother. 2022 May;29(3):933-940. doi: 10.1002/cpp.2671. Epub 2021 Oct 12.
The psychological underpinnings of functional neurological symptom disorders (FNSD) remain poorly understood. A disintegration of explicit and implicit information processing in patients with FNSD has previously been suggested; however, this suggestion has so far received little empirical support. Trauma and maladaptive schemas probably reinforce disintegration in FNSD. The present study explored the occurrence of maladaptive schemas and investigated the impact of trauma-related maladaptive schemas in patients with FNSD.
Forty-eight FNSD patients were assessed at the start of treatment using the Young Schema Questionnaire (YSQ-2) to explore maladaptive schemas. The Life Event Checklist (LEC-5) and the PTSD Checklist for DSM-5 (PCL-5) were used to explore trauma states, and the Sickness Impact Profile (SIP-68) was used to measure health dysfunction.
The self-sacrifice schema scored within a clinically relevant range where no increased scores were found in other maladaptive schemas. Linear regression models showed a positive association between mistrust/abuse and severity of health dysfunction.
Results suggest that maladaptive schemas play a modest role in FNSD at the start of treatment. It is suggested to examine the occurrence of maladaptive schemas in FNS-disordered patients with a longitudinal design.
功能性神经症状障碍(FNSD)的心理基础仍知之甚少。先前有人提出,FNSD 患者的显性和隐性信息处理出现解体;然而,这一说法迄今几乎没有得到实证支持。创伤和适应不良模式可能会加剧 FNSD 中的解体。本研究探讨了适应不良模式的发生情况,并研究了创伤相关适应不良模式在 FNSD 患者中的影响。
48 名 FNSD 患者在治疗开始时使用 Young 模式问卷(YSQ-2)进行评估,以探讨适应不良模式。使用生活事件检查表(LEC-5)和DSM-5 创伤后应激障碍检查表(PCL-5)来探讨创伤状态,使用疾病影响量表(SIP-68)来衡量健康功能障碍。
自我牺牲模式的得分处于临床相关范围内,其他适应不良模式没有发现得分增加。线性回归模型显示,不信任/虐待与健康功能障碍严重程度呈正相关。
结果表明,适应不良模式在治疗开始时对 FNSD 起着适度的作用。建议采用纵向设计来检验 FNS 障碍患者中适应不良模式的发生情况。