Tallentire, Liz and Fletcher, Ian (2016) Psychological characteristics related to epileptic and non-epileptic seizures. PhD thesis, Lancaster University.
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Abstract
This thesis consists of a quantitative systematic review, a quantitative empirical research paper, and a reflective critical appraisal. The review included 16 published empirical research papers. It examined how psychological characteristics have been used to differentiate subgroups of people who experience non-epileptic seizures (NES) and contextualised subgroup differences in theories of NES aetiology. Results indicated that trauma experiences, alexithymia, and presence of intellectual disability were characteristics that were important in differentiating subgroups. The aims of the empirical paper were to check data against hypotheses based on previous research, before comparing the psychological characteristics of people who reported experiencing NES and epileptic seizures (ESs). Data were collected via online surveys. NES subgroups were formed using cluster analysis of alexithymia and childhood trauma data. Subgroups were found to differ on childhood trauma, alexithymia, and adult attachment style. There were parallels between the subgroups indicated in the review and empirical paper, which are explored further in the empirical paper discussion and critical appraisal. The empirical paper and systematic review emphasised the complexity of NESs and the importance of assessing and understanding individual differences in research and clinical settings. The alexithymia and adult attachment measures used in the empirical project may be useful as part of an assessment of individual differences. These measures could form a basis for psychological assessment and formulation for NES patients, and may help identify ES patients with attachment and/or alexithymia difficulties who may benefit from psychological assessment and therapy. The two research papers also make recommendations for research relating to treatments appropriate to the identified subgroup characteristics. The critical appraisal reflects on the impact of mind-body dualism in the other two papers and discusses how such considerations may influence clinical practice.