Editorial: Functional Neurological (Conversion) Disorder: A Core Neuropsychiatric Disorder, 2020,

Andy

Andy

Retired committee member
While this has previously been discussed here, I think it's a good idea to have this as a thread of it's own, given it makes clear the FND=conversion disorder thinking.
Functional neurological disorder (FND), also known as conversion disorder, constitutes individuals with neurological symptoms precipitated and/or perpetuated by maladaptive cognitive, affective, behavioral, psychological, and perceptual processes. As such, FND is a core neuropsychiatric disorder that exists at the intersection of the mind and brain. Furthermore, FND challenges the artificial divide between physical and mental health and can benefit greatly from an interdisciplinary approach across the clinical neurosciences (2, 3). A figurative conceptualization of this interdisciplinary approach to FND, as discussed in this special issue of the Journal, is featured on the cover of this issue.

FND is among the most common conditions encountered by neurologists and neuropsychiatrists today (4) and is often misidentified as “medical mysteries” in human interest stories (5). Importantly, the neuropsychiatric perspective that incorporates biopsychosocial aspects at the individual level, including consideration of community and spiritual aspects when relevant (3), is key for treatment and research for this complex condition.

For this special issue of the Journal, an international group of guest coeditors and authors organized to detail the depth and breadth of advancement in the field of FND, while also identifying areas of need. Several articles advance our understanding of the phenomenology of FND, including the development of a conceptual model for acute functional paralysis (6) (a common stroke mimic) and the intersection of Parkinson’s disease and functional movement disorders (7). Other articles identify predisposing vulnerabilities and perpetuating factors for FND (8) and characterize roles for locus of control (frame of reference) (9), impaired action inhibition (10), and altered emotional reactivity (11) among persons with FND. A new questionnaire for the concurrent assessment of adverse life events, negative emotions, and attachment styles among individuals with FND across the lifespan is also introduced (12). Additionally, another article integrates psychological and neurobiological models in the service of bridging the gap between the historical conversion model and modern systems-level neuroscience insights into FND (13).
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Open access, https://neuro.psychiatryonline.org/doi/10.1176/appi.neuropsych.19090204
 
How do they "know" what precipitates and perpetuates these conditions? Should they not say something such as "thought to be precipitated and/or perpetuated by"? Admittedly that would give rise to the question "by whom is this thought?".

EDIT if this proviso is not accepted then the discussion is merely an analytical one regarding the definition of FND and conversion disorder. It would have nothing to with anything of importance.
 
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Evaluation of LiNES: A New Measure of Trauma, Negative Affect, and Relationship Insecurity Over the Life Span in Persons With FND
The authors evaluated potential predisposing vulnerabilities and perpetuating factors among individuals with functional neurological disorder (FND) by using the novel Lifespan Negative Experiences Scale (LiNES), which assesses retrospective self-report of interpersonal trauma, negative affect, and relationship insecurity at three developmental stages: childhood, adolescence, and adulthood.
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A brief new measure of trauma, relationship security, and affect across the lifespan: Development and initial validation of the Lifespan Negative Experiences Scale (LiNES)
Background. Negative experiences across the lifespan – particularly interpersonal trauma (e.g., abuse/neglect), negative affective states (e.g., feeling afraid or anxious), and relationship insecurity (e.g., not feeling secure) have been associated with a range of adverse physical and mental health outcomes in adulthood. However, negative previous life experiences are not always assessed when people present to services, particularly physical health services, and there are problems with existing measures, which are long and intrusive, and only ask about either current or childhood experiences without capturing other factors likely to affect resilience.
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To anyone paying attention, this is literally the same thing as the "refrigerator mother" model of autism, just repurposed to MUS. So the lesson was to make it more vague, even less specific and apply it to an even larger target population.

LiNES.png


And because mistakes in psychosomatic ideology rarely happen in isolation, the counterpart to the negative effect of bad parents is essentially a repackaged concept of "hysterical paralysis", taken from MS but repurposed to MUS.

And of course we have our recent IBD/IBD flawed personality nonsense (it's too much perfectionism, wait no it's too little, whatever your thoughts are impure and you must be reeducated) is literally taking the same peptic ulcers nonsense and moving it a few centimeters down but otherwise keeping everything nearly identical.

So really the field is essentially taking all the mistakes it did in the past, pureeing them together and shaping some strawmen, caricatures of human misbehavior, from that mush and Week-end at Bernies' them in an elaborate kabuki theatre that essentially amounts to the equivalent of medical astrology.

I don't know how closely you follow the forum, @dave30th, but this is an impressive mishmash of all the concepts that have been discussed all rolled into one gigantic mistake make from the concentrates of past mistakes.
 
rvallee said:
Evaluation of LiNES: A New Measure of Trauma, Negative Affect, and Relationship Insecurity Over the Life Span in Persons With FND



A brief new measure of trauma, relationship security, and affect across the lifespan: Development and initial validation of the Lifespan Negative Experiences Scale (LiNES)

To anyone paying attention, this is literally the same thing as the "refrigerator mother" model of autism, just repurposed to MUS. So the lesson was to make it more vague, even less specific and apply it to an even larger target population.

View attachment 9751


And because mistakes in psychosomatic ideology rarely happen in isolation, the counterpart to the negative effect of bad parents is essentially a repackaged concept of "hysterical paralysis", taken from MS but repurposed to MUS.

And of course we have our recent IBD/IBD flawed personality nonsense (it's too much perfectionism, wait no it's too little, whatever your thoughts are impure and you must be reeducated) is literally taking the same peptic ulcers nonsense and moving it a few centimeters down but otherwise keeping everything nearly identical.

So really the field is essentially taking all the mistakes it did in the past, pureeing them together and shaping some strawmen, caricatures of human misbehavior, from that mush and Week-end at Bernies' them in an elaborate kabuki theatre that essentially amounts to the equivalent of medical astrology.

I don't know how closely you follow the forum, @dave30th, but this is an impressive mishmash of all the concepts that have been discussed all rolled into one gigantic mistake make from the concentrates of past mistakes.
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This looks like the ACEs theorising writ large.
Note the lack of modulation for these events - is rape/ abuse by a family member the same as by a stranger?
does anger have the same effect on a 2 year old as a 7 year old as a 16 year old?
Do male and females have different responses to different forms of trauma/ abuse?

there is little context.

ACEs were devised as an educational construct - they are now being used predictively.
this is more of the same with a slightly different badge.
Chuck enough stuff in the mix and you can make correlations with anything.
 
I presume the the table is of things they scored then they find the total and say this is meaningful. If I have read it wrong, sorry.

The problem I see is that they are not independent things. If you are being physically abused it would be a miracle if you did not feel worried, anxious, stressed and afraid. So 9 things you can score for adversity and only 4 for a happy childhood. Take into account that the happiest childhood still includes times of feeling anxious stressed and worried and the scale can't help but show adversity.
 
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