title: Theory of mind abilities in patients with psychogenic nonepileptic seizures.
abstract: BACKGROUND
  Psychogenic nonepileptic seizures (PNES) have been frequently linked to deficits in affect regulation and altered processing of emotionally salient information. However, less is known about how patients suffering from PNES actually process and interpret affective social stimuli. Thus, the present study aimed to investigate basal facial affect recognition as well as mind-reading skills in a sample of patients with PNES and matched control subjects.
  
  
  METHODS
  Patients with PNES (N=15) and healthy controls (N=15) completed self-report questionnaires that measured alexithymia and perceived stress vulnerability. Affect perception was tested using a series of computerized movies of models whose facial expressions slowly change from neutral to full-blown emotions (anger, fear, sadness, happiness, disgust, and surprise), allowing for a fine-grained assessment of facial emotion recognition impairments. Further, all participants were presented with the Movie for the Assessment of Social Cognition, a well-validated video-based test for the evaluation of subtle mind-reading deficits.
  
  
  RESULTS
  Data analyses revealed increased alexithymic traits and, impaired mentalizing skills in individuals with PNES, while basal facial expression recognition was not compromised.
  
  
  CONCLUSIONS
  The present findings are the first to demonstrate that patients with PNES exhibit several deficits in reasoning about their own and other people's mental states. Patients with PNES may benefit from psychotherapeutic interventions that focus on disturbed affect regulation and aim to enhance emotional awareness.
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Tübingen, Germany. Electronic address: michael.schoenenberg@uni-tuebingen.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Schönenberg
authors.affiliation: LEAD Graduate School, University of Tübingen, Germany.
authors.forename: Aiste
authors.initials: A
authors.lastname: Jusyte
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Tübingen, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Höhnle
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Tübingen, Germany.
authors.forename: Sarah Verena
authors.initials: SV
authors.lastname: Mayer
authors.affiliation: Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, Tübingen, Germany.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Weber
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Tübingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Hautzinger
authors.affiliation: Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, Tübingen, Germany; Department of Neurology, Hospital Steinenberg, Reutlingen, Germany.
authors.forename: Caroline
authors.initials: C
authors.lastname: Schell
mesh_terms: D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000523:psychology*; D001364:Awareness; D016022:Case-Control Studies; D004644:Emotions / Q000502:physiology; D005149:Facial Expression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D012640:Seizures / Q000523:psychology*; D011795:Surveys and Questionnaires; D056345:Theory of Mind
keywords: Alexithymia; Facial affect recognition; Psychogenic nonepileptic seizures; Theory of mind