Somatoform dissociation and posttraumatic stress syndrome – two sides of the same medal? A comparison of symptom profiles, trauma history and altered affect regulation between patients with functional neurological symptoms and patients with PTSD

In DSM-V these subtypes of dissociative disorder are part of the diagnosis of conversion disorder or functional neurological symptom disorder (FNSD).

The present sample partially overlaps with the one reported in [29].

The 20-item self-report instrument assesses the frequency of somatoform dissociation experienced in the preceding 1 months. It includes negative symptoms of dissociation like sensory losses and loss of motor control as well as positive symptoms of dissociation like alterations of vision, audition, taste and smell. Items are evaluated on a 5-point Likert Scale (from “This applies to me not at all” to “This applies to me extremely”), resulting in possible sum-scores between 20 and 100.

The DES is a 28-item self-report measure covering the domains amnesia, absorption and derealisation/depersonalisation. The percentage of experienced symptoms across lifetime is evaluated on a continuum between 0% (“never”) to 100% (“always”). Mean values are ranging from 0 to 100.

The PDS-symptom scale comprises 17 items, severity of each symptom being scored on a scale from 0 to 3, resulting in sum-scores between 0 and 51.

The KERF includes 70 items covering ten domains of experience (parental verbal abuse, parental non-verbal emotional abuse, parental physical abuse, emotional neglect, physical neglect, familial and non-familial sexual abuse, witnessed physical violence towards parents, witnessed violence towards siblings, peer emotional and peer physical violence), together with age of onset and duration of the respective experience up to age 18. The following analyses include all experience until individual onset of puberty, determined by first menarche/puberty vocal change. Convergent validity of the KERF was verified by correlation with the Childhood Trauma Questionnaire and good test-retest reliability was established (r_tt = .91 at 10 weeks [42]). For the present analyses sum-scores of subscales were collapsed to three broader categories: emotional abuse/neglect (KERF_Emo) with a range from 0 to 720 (including parental verbal abuse, parental non-verbal emotional abuse, emotional neglect, peer emotional violence), physical abuse/neglect (KERF_Phy) with a range from 0 to 900 (including parental physical abuse and neglect, witnessed physical violence towards parents, witnessed violence towards siblings, peer physical violence) and sexual violence (KERF_Sex) with a range from 0 to 180 (including familial and non-familial sexual abuse). In addition, the overall severity of exposure to childhood adversities until individual onset of puberty (KERF_Sum), ranging from 0 (“no childhood adversities at all”) to 1800 (“maximal exposure to all types of childhood adversities”) was calculated.

The 26-item self-report questionnaire assesses alexithymia on three dimensions: “difficulty identifying feelings”, “difficulty describing feelings” and “externally oriented thinking”. Overall mean values, ranging from 1 to 5 are reported.