Highlights
- •PNES frequency strongly correlates with implicit anxiety scores.
- •PNES frequency strongly correlates with explicit anxiety scores and experiential avoidance.
- •PNES is associated with significantly larger discrepancies in implicit and explicit anxiety scores compared with epilepsy.
- •PNESs could be a manifestation of cognitive dissonance.
Abstract
This study examined implicit and explicit anxiety in individuals with epilepsy and
psychogenic nonepileptic seizures (PNESs) and explored whether these constructs were
related to experiential avoidance and seizure frequency. Based on recent psychological
models of PNESs, it was hypothesized that nonepileptic seizures would be associated
with implicit and explicit anxiety and experiential avoidance. Explicit anxiety was
measured by the State-Trait Anxiety Inventory; implicit anxiety was measured by an
Implicit Relational Assessment Procedure; and experiential avoidance was measured
with the Multidimensional Experiential Avoidance Questionnaire. Although both groups
with epilepsy and PNESs scored similarly on implicit measures of anxiety, significant
implicit–explicit anxiety discrepancies were only identified in patients with PNESs
(p < .001). In the group with PNESs (but not in the group with epilepsy), explicit anxiety
correlated with experiential avoidance (r = .63, p < .01) and frequency of seizures (r = .67, p < .01); implicit anxiety correlated with frequency of seizures only (r = .56, p < .01). Our findings demonstrate the role of implicit anxiety in PNESs and provide additional
support for the contribution of explicit anxiety and experiential avoidance to this
disorder.
Keywords
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Article info
Publication history
Accepted:
February 13,
2014
Received in revised form:
February 11,
2014
Received:
October 5,
2013
Identification
Copyright
© 2014 Published by Elsevier Inc. All rights reserved.
