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

• Published in: Epilepsy & behavior Vol. 80; pp. 296 - 302
• Main Authors: Pick, Susannah, Mellers, John D.C., Goldstein, Laura H.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2018
• Subjects: Adult; Anger; Anxiety - psychology; Attention - physiology; Attentional Bias; Case-Control Studies; Conversion disorder; Conversion Disorder - complications; Depression - psychology; Dissociative Disorders - complications; Dissociative seizures; Emotion; Emotions - physiology; Facial Expression; Female; Functional neurological disorder; Humans; Male; Psychogenic nonepileptic seizures; Seizures - etiology; Seizures - physiopathology; Seizures - psychology; Psychogenic nonepileptic seizures; Dissociative seizures; Attentional bias; Conversion disorder; Functional neurological disorder; Emotion
• ISSN: 1525-5050; 1525-5069
• DOI: 10.1016/j.yebeh.2018.01.004

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. •Implicit facial emotion processing was studied in people with dissociative seizures (DS).•The design accounted for cognitive functioning and psychological symptoms.•The group with DS showed greater attentional bias for facial emotion than controls.•Dissociative seizure frequency correlated with attentional bias for happy expressions.