van Dijl T L, Videler A C, Aben H P, Kop W J
Department of Medical and Clinical Psychology, Center for Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, the Netherlands; Clinical Centre of Excellence for Body, Mind, and Health, GGz Breburg, Tilburg, the Netherlands; Department Tranzo, Tilburg University, Tilburg, the Netherlands; Department of Psychiatry, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands; Department of Child and Adolescent Psychiatry, De Hoop ggz, Dordrecht, the Netherlands.
Clinical Centre of Excellence for Body, Mind, and Health, GGz Breburg, Tilburg, the Netherlands; Department Tranzo, Tilburg University, Tilburg, the Netherlands.
Gen Hosp Psychiatry. 2024 May-Jun;88:30-47. doi: 10.1016/j.genhosppsych.2024.02.014. Epub 2024 Mar 2.
Functional neurological disorder (FND) has been associated with predisposing psychological factors, including dysregulation of anger-related processes. This paper provides a systematic review of the literature on anger regulation in FND. We evaluated anger-related research on patient self-report, observational, and laboratory based measures in FND. The review also addresses adverse childhood experiences and their relation with anger regulation, and the effects of therapies targeting anger regulation in FND.
MEDLINE, EMBASE, and PsycINFO were searched for both quantitative and qualitative research, published in a peer-reviewed journal with a sample size of at least 5 (registered under Prospero protocol CRD42022314340).
A total of 2200 articles were identified. After screening, 54 studies were included in this review (k = 20 questionnaire-based studies, k = 12 laboratory studies, k = 21 using other methods, and k = 1 used both questionnaires and other methods) representing data of 2502 patients with FND. Questionnaire-based studies indicated elevated levels of state anger and trait hostility in patients with FND. Laboratory studies showed a higher tendency to avoid social threat cues, attentional bias towards angry faces, difficulties reliving anger, and preoccupation with frustrating barriers among FND patients versus controls. No specific childhood experiences were identified related to anger regulation in FND, and too few small and uncontrolled studies were available (k = 2) to assess the effects of anger-related interventions in FND. The overall quality of the studies was fair (k = 31) to poor (k = 18). Five studies (k = 5) were rated as having a good quality.
This review suggests that patients with FND have maladaptive anger regulation compared to individuals without FND. The findings also highlight the need for further research on the prevalence and consequences of anger-related processes in the development, diagnosis and treatment of FND.
功能性神经障碍（FND）与易患心理因素有关，包括与愤怒相关过程的失调。本文对FND中愤怒调节的文献进行了系统综述。我们评估了FND中与愤怒相关的关于患者自我报告、观察和实验室测量的研究。该综述还探讨了不良童年经历及其与愤怒调节的关系，以及针对FND中愤怒调节的治疗效果。
检索了MEDLINE、EMBASE和PsycINFO数据库，查找发表在同行评审期刊上的定量和定性研究，样本量至少为5（根据Prospero协议CRD42022314340注册）。
共识别出2200篇文章。筛选后，本综述纳入了54项研究（k = 20项基于问卷的研究，k = 12项实验室研究，k = 21项使用其他方法的研究，k = 1项同时使用问卷和其他方法的研究），代表了2502例FND患者的数据。基于问卷的研究表明，FND患者的状态愤怒和特质敌意水平升高。实验室研究表明，与对照组相比，FND患者更倾向于避免社会威胁线索，对愤怒面孔存在注意力偏差，难以重现愤怒情绪，且过度关注令人沮丧的障碍。未发现与FND中愤怒调节相关的特定童年经历，且仅有两项小型且未设对照的研究（k = 2）可用于评估FND中与愤怒相关干预措施的效果。研究的整体质量为中等（k = 31）至较差（k = 18）。五项研究（k = 5）被评为高质量。
本综述表明，与无FND的个体相比，FND患者存在适应不良的愤怒调节。研究结果还强调了在FND的发展、诊断和治疗中，需要进一步研究与愤怒相关过程的患病率和后果。
