Socioemotional self- and co-regulation in functional seizures: comparing high and low posttraumatic stress

Nicole A Roberts; Lucia Dayana Villarreal; Mary H Burleson

doi:10.3389/fpsyt.2023.1135590

Socioemotional self- and co-regulation in functional seizures: comparing high and low posttraumatic stress

Front Psychiatry. 2023 May 15:14:1135590. doi: 10.3389/fpsyt.2023.1135590. eCollection 2023.

Authors

Nicole A Roberts¹, Lucia Dayana Villarreal¹, Mary H Burleson¹

Affiliation

¹ School of Social and Behavioral Sciences, Arizona State University, Phoenix, AZ, United States.

Abstract

Functional seizures (FS) are seizure-like symptoms without electroencephalogram (EEG)-based epileptic activity. Those with FS often show emotion-related dysfunction and disrupted interpersonal relationships, in which posttraumatic stress disorder symptoms (PTS) may play a role. We sought to better understand trauma comorbidities and socioemotional processes in FS, including affectionate touch, a form of social connection linked to emotion regulation and awareness. We administered questionnaires online to a community sample of 89 trauma-exposed FS participants (FS diagnoses were self-reported), 51 with and 38 without clinical-level PTS (FS-PTShi, FS-PTSlo) and 216 seizure-free matched trauma-exposed controls (TCs), 91 with and 125 without clinical-level PTS (TC-PTShi, TC-PTSlo) per the Posttraumatic Stress Disorder Symptom Checklist (PCL). As hypothesized, both FS-PTShi and FS-PTSlo reported more emotional avoidance (Brief Experiential Avoidance Questionnaire), more emotion regulation difficulties (Difficulties in Emotion Regulation Scale), and more perceived stress (Perceived Stress Scale) than PTS-matched counterparts. FS-PTShi also reported less reappraisal (Emotion Regulation Questionnaire), more loneliness (UCLA Loneliness Scale), and less frequent affectionate touch (Physical Affection Scale) during waking and surrounding sleep than TC-PTShi, whereas FS-PTSlo and TC-PTSlo did not differ. Neither FS group differed from PTS-matched controls in emotion suppression (Emotion Regulation Questionnaire) or comfort with social touch (Social Touch Questionnaire). Among FS, FS-PTShi reported more difficulties than FS-PTSlo on nearly all measures (non-significant trend for social support). Findings underscore potential synergistic effects of FS and PTS clinical symptoms in shaping experiences of one's emotions and social world, suggesting fostering meaningful connections with others, including via affectionate touch, is an important treatment target.

Keywords: affectionate touch; emotion regulation; functional seizures; posttraumatic stress disorder; psychogenic nonepileptic seizures; social connection.