PsyArXiv
Dissociation as a candidate mechanism in functional neurological disorder: Evidence from digital remote monitoring in everyday life
By Jemima Uloyok-Job, Sorawit Wainipitapong, Trudie Chalder and 18 others.
Abstract
Background
Affective hyperarousal and dissociation are possible mechanisms underlying symptom occurrence in functional neurological disorder (FND), although evidence is limited by retrospective and cross-sectional measurement. We aimed to examine these mechanisms in everyday life with digital remote monitoring technologies in functional seizures (FS) and functional motor symptoms (FMS).
Methods
Smartphone-based ecological momentary assessment (EMA) tracked subjective functional neurological symptoms (FNS), subjectively significant daily events, affect, dissociation, and subjective arousal six times daily over 14 days, alongside wearable heartrate monitoring (Fitbit Charge 5). Participants were aged 18-65 years with FS (n=45) or FMS (n=48). Healthy (HC, n=45) and clinical controls with anxiety/depressive disorders (CC=47) were included for comparison. We used linear mixed-effects models to compare groups and to interrogate concurrent and time-lagged temporal relationships between variables.