The impact of trauma in functional neurological disorder

Section A is a narrative review that examined a) the differences in psychological characteristics between individuals with FND based on the presence or absence of trauma-exposure and b) the psychological correlates of trauma-exposure in FND. The review found that exposure to traumatic events, especially in childhood, was associated with greater psychological distress, such as depression, anxiety, PTSD, dissociation, and emotional dysregulation. Subgroup analyses found significant differences on most psychological characteristics except somatoform dissociation and alexithymia, which may reflect a common underlying mechanism for all individuals with FND. This review highlighted the relevance of trauma-exposure in this population, which should be integrated into treatment and inform future research. Clinical and research implication are provided. Section B is a multiple baseline single-case experimental design (SCED) study that examined the effectiveness of EMDR in alleviating FND symptomatology, functional impairment, and psychological distress in participants with FND who also reported a history of trauma. The findings presented a mixed picture regarding treatment effectiveness. Most participants reported significant treatment gains with relatively few sessions on all outcome measures, while some participants reported little or no improvement. Despite methodological limitations and inconclusive findings, this study offers tentative evidence for the use of EMDR in this client group that warrants further empirical investigation. Clinical and research implications are provided. Section C is a list of appendices