Attachment style of patients diagnosed with psychogenic non-epileptic seizures at a tertiary Epilepsy Center in the Czech Republic.

Objective: Quality and type of early relationships with primary caregivers is considered one of the key factors in the etiopathogenesis of many mental disorders including depression, anxiety, and conversion disorders. This study focused on the type and quality of attachment style in adult patients with psychogenic non-epileptic seizures (PNES). Materials and methods: We evaluated the demographic data and profiles of PNES patients (n = 262) and group of healthy volunteers (n = 51) measured by the Parental Bonding Inventory (PBI) and Experiences in Close Relationships (ECR) and Experiences in Close Relationships-Relationship Structure (ECR-RS). Results: Significant differences in measured values between the two groups were identified; specifically, differences in the caregiver style-father and mother overprotection (PBI) was higher in the PNES group. The most frequent type of attachment in PNES was type 2 (preoccupied). Correlations between the PBI and ECR results were also found. Conclusion: This study highlighted certain attachment styles in patients with PNES and statistically significant differences between patients with PNES and a healthy sample. Some correlations between the results of the questionnaires with socio-demographic factors were found. The identification of specific patterns in attachment may be useful for further use in reaching a differential diagnosis and administering tailored psychotherapy of patients with PNES.

Neuropsychological performance and effort in patients diagnosed with psychogenic nonepileptic seizures - Descriptive study of a Czech sample.

PURPOSE: The aim of the study was to examine the neuropsychological performance and effort in patients with a confirmed PNES diagnosis. The second aim of the study was to investigate the relationship between validity indicators from the cognitive battery with validity and clinical scales from a personality scale. METHOD: Patients with PNES (N = 250; F:M 186:64; mean age 38.32 (13.23)) were assessed utilizing the RBANS (Czech Research version) to evaluate cognitive performance and to obtain the Effort Index. The MMPI-2 was used to evaluate personality and psychopathology. RESULTS: Global cognitive performance was 0.92 SD below average (according to the Gaussian distribution) in patients with PNES. The lowest scores in the sample were in the Attention domain (-1.7SD). Insufficient effort was detected in 10% of patients. Education correlated negatively with the Effort index (rs = -0.25, p = 0.01). A mild significant correlation in Scale 7 (rs = 0.21, p = 0.01) and Scale 8 (rs = 0.24, p = 0.01), and a significant correlation between Effort Index and Back F Scale (rs = 0.23, p = 0.01) were noted. CONCLUSIONS: Assessment of cognitive performance and effort is an essential part of the comprehensive evaluation of patients with PNES during their hospitalization at Epilepsy centers. Many aspects of the neuropsychological assessment can offer useful indications for reaching a differential diagnosis, including clinical history, behavioral observations, cognitive and symptom validity testing, and structured psychological inventories.

Diagnostic utility of the Minnesota multiphasic personality inventory-2 in patients diagnosed with psychogenic non-epileptic seizures in the Czech Republic.

PURPOSE: The purpose of the present study is to examine the Minnesota Multiphasic Personality Inventory 2 (MMPI-2) scores of individuals diagnosed with psychogenic non-epileptic seizures (PNES) in a tertiary epilepsy center in the Czech Republic. METHOD: Patients (F:M 130:45; mean age 36.8 years; 12.7 years of education, frequency of seizures 0.37 per day, illness duration 5.75 years) were assessed while inpatients at the Epilepsy Center, Na Homolce Hospital, Prague. Patients underwent video-EEG testing and comprehensive neuropsychological testing and personality assessment which included the MMPI-2. RESULTS: Elevated (+1.5SD) F and Back F (Fb) validity scales were observed along with elevated clinical scales Hypochondriasis (Hs), Depression (D), Hysteria (Hy), Psychasthenia (Pt), and Schizophrenia (Sc). Scores higher than 1 SD were found in Psychopathic Deviate (Pd), Paranoia (Pa), Hypomania (Ma) andSocial Introversion (Si) scales and on validity scales True Response Inconsistency Scale (TRIN) and Variable Response Inconsistency Scale (VRIN). CONCLUSION: Patients diagnosed with PNES exhibit numerous elevations on the MMPI-2. Understanding the underlying psychological constructs of the patient with PNES more accurately improves predictive utility (for the presence of PNES) and allows the clinician to offer interventions that are more customized. Minnesota Multiphasic Personality Inventory results may be useful to exclude other possible diagnoses and to further determine the individual's characteristics that may be helpful when tailoring treatment, including psychotherapy.

Maladaptive emotional regulation in patients diagnosed with psychogenic non-epileptic seizures (PNES) compared with healthy volunteers.

PURPOSE: The term PNES refers to a conversion disorder that mimics epileptic seizures but has a psychological etiology. Recent studies report that in patients with PNES, there is reduced understanding of emotions, impulse control difficulties, and limited access to emotional regulation strategies. The aim of this study was to compare patients diagnosed with PNES with healthy volunteers on the presence of maladaptive emotional regulation. METHOD: Patients (N = 64 F:M 52:12; mean age 35.5 years; duration ≥ 2 years) were assessed while inpatients at the Epilepsy Center, Na Homolce Hospital, Prague. PNES diagnosis was based on normal EEG findings, habitual seizure capture, suggestive seizure provocation, neuropsychological assessment and patients´ history. The clinical sample was compared with healthy volunteers (N = 64 F:M 52:12; mean age 35.8 years). The presence of maladaptive emotional regulation was assessed through the Czech research version of the ASQ and DERS. RESULTS: Compared with a healthy sample, patients with PNES had greater emotion regulation impairments across nearly all dimensions of the DERS - Nonacceptance = 17.0 (M = 14.5), p = 0.006, Goals = 16.0 (M = 11.5), p < 0.001, Impulse control = 13.8 (M = 11.5), p = 0.005, Awareness = 16.4 (M = 15.3), p = 0.183, Strategies = 17.9 (M = 13.0), p < 0.001, Clarity = 11.8 (M = 9.5), p < 0.001 and the total score of the DERS = 92.9 (M = 75.3), p < 0.001. Similar results were found in ASQ questionnaire scales - Concealing = 24.5 (M = 21.0), p = 0.002, and Adjusting = 20.9 (M = 22.8), p = 0.076 but not on the Tolerating Scale = 14.5 (M = 14.7), p = 0.873. CONCLUSION: Our results highlight that maladaptive emotional regulation is a key psychological mechanism in PNES. Emotional dysregulation may represent an important target when designing psychoeducational and psychotherapeutic approaches for patients with PNES.

Testing the Level of Social Desirability During Job Interview on White-Collar Profession.

Social desirability as a tendency to present oneself in a better light rather than in a truthful manner is common feature presented during job interviews. Previous studies mainly focused on blue-collar professions and therefore authors researched contrary set of white-collar professions in three sub-studies with four different participant groups (legal professions; police officers; controls and university students influenced by scenarios; overall N = 636). It was hypothesized that candidates for legal profession would show similar tendency toward social desirability, when compared with controls. Furthermore, police officers were hypothesized to show similar levels of social desirability as legal professions. Lastly, participants in the instruction manipulation condition were hypothesized to show increased levels of social desirability in tender situation as compared to the honest situation. All groups were tested with balanced Inventory of Desirable Responding (BIDR, Paulhus, 1984). Statistical analyses revealed statistically significant differences for both subscales of BIDR when comparing legal professions and control group. Similarly, increased levels of social desirability were detected in police officer candidates as well as in university students in the tender situation compared with students in the honest situation. The overall results indicated that it is typical for white-collar candidates to adapt to the testing situation and it cannot be expected to see different behavior from legal profession candidates as was originally expected.