This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Salmon, P. Articles by Reilly, J. Search for Related Content PubMed PubMed Citation Articles by Salmon, P. Articles by Reilly, J. Related Collections Social Support Somatoform

Childhood Family Dysfunction and Associated Abuse in Patients With Nonepileptic Seizures: Towards a Causal Model

From the Departments of Clinical Psychology and Neurosciences, University of Liverpool, Liverpool, England.

Address reprint requests to: Peter Salmon, DPhil, University of Liverpool, Department of Clinical Psychology, The Quadrangle, Brownlow Hill, Liverpool, L69 3GB, England. Email: psalmon{at}liv.ac.uk

Received for publication July 3, 2002; revision received October 25, 2002.

OBJECTIVE: A history of childhood sexual abuse is thought to characterize patients with nonepileptic seizures (NES). We tested the hypotheses: 1) that history of sexual abuse is more prevalent in patients with NES than in controls with epilepsy; 2) that such abuse is associated with NES, not directly but because it is a marker of family dysfunction; and 3) that family dysfunction and abuse are, in turn, linked to NES because they increase a general tendency to somatize.

METHODS: We compared 81 patients with NES with 81 case-matched epilepsy patients, using questionnaires to elicit recollections of sexual, physical, and psychological abuse and family atmosphere and to quantify current somatization.

RESULTS: Although each form of abuse was more prevalent in NES patients, only child psychological abuse uniquely distinguished NES from epilepsy. However, its association with NES was explained by family dysfunction. A general tendency to somatize explained part of the relationship of abuse to NES.

CONCLUSIONS: Abuse therefore seems to be a marker for aspects of family dysfunction that are associated with – and may therefore cause – somatization and, specifically, NES.

Key Words: epilepsy, • nonepileptic seizures, • somatization, • abuse, • family dysfunction.

Abbreviations: CFI = comparative fit index;; CI = confidence interval;; EEG = electroencephalogram;; NES = nonepileptic seizures;; OR = odds ratio.

This article has been cited by other articles:

				M. L. Paras, M. H. Murad, L. P. Chen, E. N. Goranson, A. L. Sattler, K. M. Colbenson, M. B. Elamin, R. J. Seime, L. J. Prokop, and A. Zirakzadeh Sexual Abuse and Lifetime Diagnosis of Somatic Disorders: A Systematic Review and Meta-analysis JAMA, August 5, 2009; 302(5): 550 - 561. [Abstract] [Full Text] [PDF]

				M. Reuber, S. Howlett, A. Khan, and R. A. Grunewald Non-Epileptic Seizures and Other Functional Neurological Symptoms: Predisposing, Precipitating, and Perpetuating Factors Psychosomatics, June 1, 2007; 48(3): 230 - 238. [Abstract] [Full Text] [PDF]

				M Reuber, A J Mitchell, S J Howlett, H L Crimlisk, and R A Grunewald Functional symptoms in neurology: questions and answers J. Neurol. Neurosurg. Psychiatry, March 1, 2005; 76(3): 307 - 314. [Abstract] [Full Text] [PDF]