Psychogenic nonepileptic seizures (PNES) are characterized by paroxysmal alterations in motor and sensory functions resembling epileptic seizures, but are not caused by epileptiform activity. In recent years, there has been increasing scientific interest in emotion dysregulation in patients with PNES (pwPNES), but the literature has not yet been interpreted within a broader model of emotion dysregulation. The aim of this review was therefore to synthesize the existing literature on emotion dysregulation in pwPNES within the extended process model (EPM) of emotion regulation. METHODS:PubMed and Web of Science were searched for studies relevant to emotion dysregulation as defined by the EPM. These studies were subjected to a bespoke quality appraisal tool. Studies of acceptable quality were categorized to the different stages of the EPM and critically appraised. RESULTS:Studies of emotion regulation in pwPNES were generally of low quality - a finding largely driven by small sample sizes. However, there was evidence of emotion dysregulation characterized by deficits in the identification of patients' own emotional states, as well as the selection and implementation of maladaptive regulatory strategies, and altered exteroceptive emotional processing. However, heterogeneity in findings suggests that emotion dysregulation is likely linked to other psychological factors and not common to all pwPNES. SIGNIFICANCE:This review suggests that while pwPNES are likely to experience emotion dysregulation as defined by the EPM, there is variability in the distribution of regulatory deficits in this patient population, and a person-centered approach should be taken when working with these patients. There is a need for more high quality and better-powered studies in this area.

译文

:精神性非癫痫性发作(PNES)的特征是运动和感觉功能呈阵发性变化,类似于癫痫性发作,但并非由癫痫样活动引起。近年来,对PNES患者(pwPNES)的情绪失调的科学兴趣不断增长,但是尚未在更广泛的情绪失调模型中对文献进行解释。因此,本综述的目的是在情绪调节的扩展过程模型(EPM)中综合有关pwPNES中情绪失调的现有文献。
方法:搜索PubMed和Web of Science,以查找与EPM定义的情绪失调相关的研究。这些研究均接受了量身定制的质量评估工具。可接受质量的研究被归类为EPM的不同阶段,并进行了严格评估。
结果:pwPNES中的情绪调节研究通常质量低下-这一发现主要是由小样本量驱动的。然而,有证据表明,情绪失调的特征在于患者自身情绪状态的识别不足,以及不良适应性调节策略的选择和实施,以及外在感受性情绪处理的改变。然而,发现的异质性表明情绪失调可能与其他心理因素有关,并非所有pwPNES所共有。
重要性:这项评价表明,尽管pwPNES可能会出现EPM定义的情绪失调,但该患者人群中调节缺陷的分布存在差异,在与这些患者一起工作时应采取以人为本的方法。在这一领域需要更高质量和更强大的研究。

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