Experiences of Functional Neurological Disorder: Sensory Processing and the Lived Experiences of Autistic People with Functional/dissociative Seizures

Understanding the experiences of sensory processing in Functional Neurological Disorder: A Systematic Review and Qualitative Evidence Synthesis

Objectives
Sensory processing differences have been increasingly studied for those with functional neurological disorder (FND), implicating them in the development of FND and demonstrating this as an avenue for treatment. Several systematic reviews have synthesised the lived experiences of those with FND, but none have addressed the sensory processing experiences directly. Dunn’s model is a common model of sensory processing, which has been applied to those with FND. However, studies on sensory processing utilise measures which may neglect sensory processing experiences which exist outside of Dunn’s model. Therefore, this review aims to synthesise the sensory processing experiences of people with FND from broader accounts to test Dunn’s model.
Design and Methods
Five databases were systematically searched for peer-reviewed qualitative studies which referenced sensory processing experiences. Twelve studies with 224 people with FND were included and analysed in accordance with Dunn’s model using ‘best fit’ framework synthesis. The CASP tool was used to assess quality.
Results
Support was provided for all four quadrants of Dunn’s model: ‘low registration’, ‘sensation seeking’, ‘sensory sensitivity’ and ‘sensation avoiding’. Further evidence was found for two additions to the model: ‘emotional-sensory processing’ and ‘impaired integration via dissociation’.
Conclusions
This review supports an adapted version of Dunn’s sensory processing model for FND, supporting the model’s a priori elements alongside novel elements. The model highlights how emotional arousal and sensory processing interact bidirectionally, and how dissociation may disrupt sensory integration, impairing registration and response to sensory input. These findings have implications for the psychological formulation and multidisciplinary treatment of FND and underscore the need for further research into sensory processing mechanisms and their clinical applications.

“All or Nothing”: An exploration into the emotional experience of autistic people with functional/dissociative seizures using Interpretative Phenomenological Analysis

Objectives
Sensory processing differences have been increasingly studied for those with functional neurological disorder (FND), implicating them in the development of FND and demonstrating this as an avenue for treatment. Several systematic reviews have synthesised the lived experiences of those with FND, but none have addressed the sensory processing experiences directly. Dunn’s model is a common model of sensory processing, which has been applied to those with FND. However, studies on sensory processing utilise measures which may neglect sensory processing experiences which exist outside of Dunn’s model. Therefore, this review aims to synthesise the sensory processing experiences of people with FND from broader accounts to test Dunn’s model.
Design and Methods
Five databases were systematically searched for peer-reviewed qualitative studies which referenced sensory processing experiences. Twelve studies with 224 people with FND were included and analysed in accordance with Dunn’s model using ‘best fit’ framework synthesis. The CASP tool was used to assess quality.
Results
Support was provided for all four quadrants of Dunn’s model: ‘low registration’, ‘sensation seeking’, ‘sensory sensitivity’ and ‘sensation avoiding’. Further evidence was found for two additions to the model: ‘emotional-sensory processing’ and ‘impaired integration via dissociation’.
Conclusions
This review supports an adapted version of Dunn’s sensory processing model for FND, supporting the model’s a priori elements alongside novel elements. The model highlights how emotional arousal and sensory processing interact bidirectionally, and how dissociation may disrupt sensory integration, impairing registration and response to sensory input. These findings have implications for the psychological formulation and multidisciplinary treatment of FND and underscore the need for further research into sensory processing mechanisms and their clinical applications.