What Does Neuroscience Tell Us About the Conversion Model of Functional Neurological Disorders?

Cretton, Alexandre; Brown, Richard J; LaFrance, W Curt; Aybek, Selma (2019). What Does Neuroscience Tell Us About the Conversion Model of Functional Neurological Disorders? (In Press). The journal of neuropsychiatry and clinical neurosciences, appineuropsych19040089. American Psychiatric Association 10.1176/appi.neuropsych.19040089

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A dualistic mind-body understanding of functional neurological disorders (FNDs), also known as conversion disorders, has led to the view that the cause of the symptom should be either psychological (psychogenic) or physical (neurogenic-“organic”). One of the most influential psychological approaches is the Freudian model of conversion, which suggests that FNDs arise from a defense process in which emotional stress is converted into physical symptoms. This conversion theory has been challenged in recent years, accompanied by a shift in emphasis toward neuropathophysiological models of FND and away from historical psychological concepts. In this review, the authors consider the contemporary relevance of the conversion model from the neuroscientific perspective to reconcile the role of both psychological and biological factors in FND. A narrative review of recent neuroscientific findings pertaining to the conversion model of FND, encompassing neuroimaging, cognitive psychology, biological markers, and epigenetic studies, was performed. Research on the role of psychological stressors is discussed. Neurobiological mechanisms of repression of traumatic memories and their translation into physical symptoms are then explored. Finally, the role of physical symptoms as a potential protective defense mechanism against social stressors is considered. The authors argue that the conversion concept is consistent with recent neuroscientific research findings, and the model allows psychological and neurobiological concepts to be reconciled within a single account of FND that begins to resolve the dualistic mind-body dichotomy.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Aybek, Selma

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1545-7222

Publisher:

American Psychiatric Association

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

26 Nov 2019 10:08

Last Modified:

27 Nov 2019 01:33

Publisher DOI:

10.1176/appi.neuropsych.19040089

PubMed ID:

31619119

Uncontrolled Keywords:

Conversion Disorder Functional Neurological Disorder Neurology Psychodynamic Neurobiology Somatoform Disorders

BORIS DOI:

10.7892/boris.134865

URI:

https://boris.unibe.ch/id/eprint/134865

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