Timothy L van Dijl, Hugo P Aben, Nathalie E Synhaeve, Dieuwertje A de Waardt, Rob van Dijk, Arjan C Videler, Willem J Kop
{"title":"The Nature and Prevalence of Anger and Interpersonal Conflicts Among Patients With Functional Neurological Disorder.","authors":"Timothy L van Dijl, Hugo P Aben, Nathalie E Synhaeve, Dieuwertje A de Waardt, Rob van Dijk, Arjan C Videler, Willem J Kop","doi":"10.1176/appi.neuropsych.20240123","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Interpersonal conflicts are among the most prevalent stressors before the onset of functional neurological disorder (FND), possibly reflecting maladaptive anger regulation. The authors examined whether FND patients have higher scores on anger-related measures compared with healthy control individuals and how anger regulation relates to personality factors.</p><p><strong>Methods: </strong>FND patients (N=73, mean±SD age=44.2±16.7 years, 67% women) and healthy control individuals (N=43, mean age=43.3±17.0 years, 56% women) completed the State-Trait Anger Expression Inventory-2 (STAXI-2) to measure state and trait components of anger. Personality factors were assessed with the Personality Inventory for DSM-5-Brief Form and a structured interview to explore conflict and anger-related measures.</p><p><strong>Results: </strong>Compared with control individuals, FND patients had significantly higher levels of state anger (U=1,031.5). After adjustment of analyses for trait anger, patients with FND still had higher levels of state anger than did control individuals (Wald χ<sup>2</sup>=6.97), an association that remained statistically significant after adjustment for other personality factors (Wald χ<sup>2</sup>=7.69). Exploration of the Alternative Model of Personality Disorders factors showed that FND patients scored significantly higher on negative affectivity, disinhibition, detachment, and psychoticism but not on antagonism (U=1,244.0). Trait anger, assessed with the STAXI-2, did not differ significantly between FND patients and control individuals (U=1,317.5). Interview data analysis revealed that patients had more anger outbursts during childhood compared with control individuals (U=1,141.0).</p><p><strong>Conclusions: </strong>FND patients reported higher levels of state anger than did healthy control individuals, even after analyses were adjusted for demographic and personality factors and trait anger. These findings emphasize the importance of anger regulation and personality factors in FND assessment and management.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20240123"},"PeriodicalIF":2.4000,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neuropsychiatry and Clinical Neurosciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1176/appi.neuropsych.20240123","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Interpersonal conflicts are among the most prevalent stressors before the onset of functional neurological disorder (FND), possibly reflecting maladaptive anger regulation. The authors examined whether FND patients have higher scores on anger-related measures compared with healthy control individuals and how anger regulation relates to personality factors.
Methods: FND patients (N=73, mean±SD age=44.2±16.7 years, 67% women) and healthy control individuals (N=43, mean age=43.3±17.0 years, 56% women) completed the State-Trait Anger Expression Inventory-2 (STAXI-2) to measure state and trait components of anger. Personality factors were assessed with the Personality Inventory for DSM-5-Brief Form and a structured interview to explore conflict and anger-related measures.
Results: Compared with control individuals, FND patients had significantly higher levels of state anger (U=1,031.5). After adjustment of analyses for trait anger, patients with FND still had higher levels of state anger than did control individuals (Wald χ2=6.97), an association that remained statistically significant after adjustment for other personality factors (Wald χ2=7.69). Exploration of the Alternative Model of Personality Disorders factors showed that FND patients scored significantly higher on negative affectivity, disinhibition, detachment, and psychoticism but not on antagonism (U=1,244.0). Trait anger, assessed with the STAXI-2, did not differ significantly between FND patients and control individuals (U=1,317.5). Interview data analysis revealed that patients had more anger outbursts during childhood compared with control individuals (U=1,141.0).
Conclusions: FND patients reported higher levels of state anger than did healthy control individuals, even after analyses were adjusted for demographic and personality factors and trait anger. These findings emphasize the importance of anger regulation and personality factors in FND assessment and management.
期刊介绍:
As the official Journal of the American Neuropsychiatric Association, the premier North American organization of clinicians, scientists, and educators specializing in behavioral neurology & neuropsychiatry, neuropsychology, and the clinical neurosciences, the Journal of Neuropsychiatry and Clinical Neurosciences (JNCN) aims to publish works that advance the science of brain-behavior relationships, the care of persons and families affected by neurodevelopmental, acquired neurological, and neurodegenerative conditions, and education and training in behavioral neurology & neuropsychiatry. JNCN publishes peer-reviewed articles on the cognitive, emotional, and behavioral manifestations of neurological conditions, the structural and functional neuroanatomy of idiopathic psychiatric disorders, and the clinical and educational applications and public health implications of scientific advances in these areas. The Journal features systematic reviews and meta-analyses, narrative reviews, original research articles, scholarly considerations of treatment and educational challenges in behavioral neurology & neuropsychiatry, analyses and commentaries on advances and emerging trends in the field, international perspectives on neuropsychiatry, opinions and introspections, case reports that inform on the structural and functional bases of neuropsychiatric conditions, and classic pieces from the field’s rich history.