Investigating self-perception of emotion in individuals with non-epileptic seizures (NES)

Emotional processing difficulties are hypothesised to be involved in the aetiology and maintenance of non-epileptic seizures (NES). This thesis aimed to explore the relationship between aspects of emotional processing: interoception, alexithymia and executive functioning, in people with NES in comparison with healthy controls and to understand how people with NES experience their symptoms, live with their condition, and perceive the role of life events in relation to their seizures. Study 1 reviewed the evidence for a relationship between interoception and other key emotional factors in studies which employed heartbeat perception tasks to measure interoception. Study quality was found to be generally poor, with no consistent evidence for significant findings between interoception and emotional factors, including alexithymia, depression, and anxiety. Study 2 was a cross-sectional, online, study to investigate an interactional model of emotion processing, exploring relationships between interoceptive sensibility, alexithymia, and executive functioning (attentional bias) in NES participants and healthy controls. Measures included the Body Perception Questionnaire (BPQ-VSF), the Toronto Alexithymia Scale-20 (TAS-20) and the emotional Stroop task (eStroop). The NES group, compared to controls, reported higher BPQ-VSF and TAS-20 scores. There were no significant correlations between any of the measures of interest in either the NES or control group. There was no evidence to support the proposed model. Study 3 was a qualitative study using Interpretative Phenomenological Analysis to explore: how individuals with NES respond emotionally to recent life events; and how these events impact on seizures. Six themes were developed from the analysis which described how NES affected many aspects of people’s lives. Four models captured the different ways in which people perceived the relationship between life stressors, their emotional responses, and their seizures: event->emotional response-> seizure; event-> emotional response -x-> no seizure; no event ->emotional reaction/experience -> seizure; and no event -x->no emotional response->seizure.