The Emotional Responses of Psychogenic Nonepileptic Seizure Patients During Four Relived Emotion Tasks

Abstract Individuals with psychogenic nonepileptic seizures (PNES) experience seizure-like behaviors, but without the physiological aspect of a typical epileptic seizure. PNES patients are hypothesized to have seizures to cope with past trauma or current adverse life events. Also, avoidance of emotion may be implicated in the development and maintenance of this disorder, specifically with regard to emotional suppression. The current study examined different facets of PNES patients' emotional responses (self-report, physiological reactivity, and facial expressivity) using a relived emotion task. During this task, participants recalled specific memories related to four target emotions: neutral, angry, shame, and happy in a counterbalanced order for each participant. There was a total of 61 participants involved in the study: 11 PNES patients and two trauma-exposed comparison groups with either high (25) or low (25) levels of post-traumatic stress disorder (PTSD) symptoms. Patients were hypothesized to have greater physiological reactivity and self-reported intensity, but less overall emotional expressivity, than comparison groups. We explored these hypotheses based on descriptive analyses, or an examination of group means. Contrary to our first hypothesis, PNES patients showed smaller decreases in physiological reactivity, compared to controls during all conditions. Furthermore, PNES patients showed less expressiveness than comparison groups during the happiness condition, but greater expressiveness during the neutral and negative emotion conditions. Lastly, our third hypothesis was supported, as PNES patients reported greater emotional intensity than comparison groups to the neutral, shame, and happiness conditions. However, because of the small sample size of PNES patients, the results should be interpreted with caution. This research may have implications for therapeutic settings because clinicians will better understand the emotional experiences and behaviors of PNES patients during treatment.