4.4 Article

Implicit attentional bias for facial emotion in dissociative seizures: Additional evidence

Journal

EPILEPSY & BEHAVIOR
Volume 80, Issue -, Pages 296-302

Publisher

ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.yebeh.2018.01.004

Keywords

Attentional bias; Dissociative seizures; Emotion; Psychogenic nonepileptic seizures; Conversion disorder; Functional neurological disorder

Funding

  1. Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (King's College London)
  2. Central Research Fund (University of London)
  3. National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust
  4. King's College London

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This study sought to extend knowledge about the previously reported preconscious attentional bias (AB) for facial emotion in patients with dissociative seizures (DS) by exploring whether the finding could be replicated, while controlling for concurrent anxiety, depression, and potentially relevant cognitive impairments. Patients diagnosed with DS (n = 38) were compared with healthy controls (n 43) on a pictorial emotional Stroop test, in which backwardly masked emotional faces (angry, happy, neutral) were processed implicitly. The group with DS displayed a significantly greater AB to facial emotion relative to controls; however, the bias was not specific to negative or positive emotions. The group effect could not be explained by performance on standardized cognitive tests or self-reported depression/anxiety. The study provides additional evidence of a disproportionate and automatic allocation of attention to facial affect in patients with DS, including both positive and negative facial expressions. Such a tendency could act as a predisposing factor for developing DS initially, or may contribute to triggering individuals seizures on an ongoing basis. Psychological interventions such as Cognitive Behavioral Therapy (CBT) or AB modification might be suitable approaches to target this bias in clinical practice. (C) 2018 Elsevier Inc. All lights reserved.

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