Psychological resilience and stress coping methods in patients presenting with conversive symptoms and general medical symptoms

Öz

To investigate the differences between the levels of psychological resilience and coping with stress among individuals presenting with conversion symptoms and general medical symptoms to the emergency department. A comparative-descriptive research study was conducted on 118 patients (n = 59) who presented with conversion symptoms (n = 59) and general medical symptoms (n = 59) from the Kafkas University Health, Practice and Research Hospital, Emergency Department. The research data were collected using a general information form, the Stress Coping Styles Scale (SCSS) and the Brief Resilience Scale (BRS). In addition to descriptive statistical methods, chi-square analysis and t-test were used in the evaluation of differences between groups. The mean age of the participants in the conversion symptoms group was 28.10 ± 13.49 and 25.69 ± 7.85 in the control group. The mean score obtained by the participants in the control group on the BRS was found to be significantly higher than that of the participants in the conversion symptoms group (p <0.05). There was no significant difference between the groups in terms of the mean scores on the subscales of the SCSS (p > .05). Psychological resilience levels were low in patients presenting with conversion symptoms. Based on this finding, individuals presenting to health centers with conversion symptoms would greatly benefit from the development of therapeutic interventions that aim to improve psychological resilience.

Anahtar Kelimeler

• Conversion
• psychological resilience
• coping skills

Kaynakça

1. Roy S, Roy GK, Begum M, Karim ME, Akhter MS, Begum O. Psycho-social stressors and life events of the patients with conversion disorder: A study in a tertiary care hospital in north east zone of Bangladesh. Bang J Psychiatry. 2014;28(2):41-4. doi: 10.3329/bjpsy.v28i2.32734.
2. Yücel B. Somatoform disorders. Psychiatry, Tükel R, Çakır S, Ertekin E (Ed) İstanbul: Nobel Medical Bookstores. 2017, 71-7 p.
3. Aybek S, Nicholson TR, O’Daly O, Zelaya F, Kanaan RA, David AS. Emotion-motion interactions in conversion disorder: An FMRI study. PLoS One. 2015;10(4):e0123273. doi: 10.1371/journal.pone.0123273.
4. Farooq A, Yousaf A. Childhood trauma and alexithymia in patients with conversion disorder. J Coll Physicians Surg Pak. 2016;26(7):606-10.
5. Amerikan Psikiyatri Birliği, Ruhsal Bozukukların Tanısal ve Sayımsal El Kitabı, Beşinci Baskı, (DSM-5), Tanı Ölçütleri Başvuru El Kitabı’ndan çev. (in Turkish) Köroğlu E, Hekimler Yayın Birliği: Ankara, 2013.
6. Stone J, Edwards MJ. How “psychogenic” are psychogenic movement disorders? Mov Disord. 2011;26(10):1787-8. doi: 10.1002/mds.23882.
7. Edwards MJ, Adams RA, Brown H, Parees I, Friston KJ. A Bayesian account of ‘hysteria’. Brain. 2012;135(11):3495-512. doi: 10.1093/brain/aws129.
8. Beltran NP. Long-term psychological consequences of child sexual abuse. Papeles del Psicologo. 2010;1(2):191-201.

9. Baslet G. Psychogenic non-epileptic seizures: A model of their pathogenic mechanism. Seizure. 2011:20(1);1-13. doi: 10.1016/j.seizure.2010.10.032.
10. Nicholson TR, Stone J, Kanaan RA. Conversion disorder: A problematic diagnosis. J Neurol Neurosurg Psychiatry. 2010:82(11);1267-73. doi: 10.1136/jnnp.2008.171306.
11. Doğan T. Adaptation of the brief resilience scale into Turkish: A validity and reliability study. J Happiness Well-Being. 2015:3(1);93-102.
12. Lazarus RS, Folkman S. Stress, appraisal and coping. New York: Springer Publishing Company Inc: 1984.
13. Myers L, Fleming M, Lancman M, Perrine K, Lancman M. Stress coping strategies in patients with psychogenic non-epileptic seizures and how they relate to trauma symptoms, alexithymia, anger and mood. Seizure. 2013:22(8);634-9. doi: 10.1016/j.seizure.2013.04.018.
14. Cronje G. Coping styles and quality of life in patients with psychogenic nonepileptic seizures (PNES): A South African perspective. Doctoral dissertation, Stellenbosch: Stellenbosch University, 2013.
15. Mehta, R, Mittal A, Singh DC, Patel C. Perceived stress and coping strategies in females with psychogenic non-epileptic seizures in a tertiary care hospital, New Delhi. Delhi Psychiatry J. 2019;22(1):82-8.
16. Ahmad QA, Bokharey IZ. Resilience and coping strategies in the patients with conversion disorder and general medical conditions: A comparative study. MJP. 2013;22(1):39-50.
17. Alpat B. Konversiyon bozukluğunda psikolojik dayanıklılığın ve başa çıkma tarzlarının etkisi, Yayınlanmamış Yüksek Lisans Tezi (in Turkish). Işık Üniversitesi. İstanbul, 2017.
18. Sempértegui GA, Karreman A, van Hout GC, Bekker MH. Functional status in patients with medically unexplained physical symptoms: Coping styles and their relationship with depression and anxiety. J Health Psychol. 2017;22(13):1743-54. doi: 10.1177/1359105316638548.
19. Testa SM, Krauss GL, Lesser RP, Brandt J. Stressful life event appraisal and coping in patients with psychogenic seizures and those with epilepsy. Seizure. 2012;21(4):282-7. doi: 10.1016/j. seizure.2012.02.002.
20. Van Beilen M, Griffioen BT, Leenders KL. Coping strategies and IQ in psychogenic movement disorders and paralysis. Mov Disord. 2009;24(6):922-5. doi: 10.1002/mds.22428.
21. Roy A, Carli V, Sarchiapone M. Resilience mitigates the suicide risk associated with childhood trauma. J Affect Disord. 2011;133(3): 591-4. doi: 10.1016/j. jad.2011.05.006.
22. Jalilianhasanpour R, Williams B, Gilman I, Burke MJ, Glass S, Fricchione G, et al. Resilience linked to personality dimensions, alexithymia and affective symptoms in motor functional neurological disorders. J Psychosom Res. 2018;107:55-61. doi: 10.1016/j.jpsychores.2018.02.005.
23. Campbell-Sills L, Cohan SL, Stein MB. Relationship of resilience to personality, coping, and psychiatric symptoms in young adults. Behav Res Ther. 2006;44(4):585-99. doi: 10.1016/j. brat.2005.05.001.
24. Asad S, Saeed S, Kausar R. Level of frustration tolerance and coping strategies used by women with conversion disorder vs those with general medical conditions. JPPS. 2016;13(2):35-8.
25. Şahin NH, Durak A. Stressc coping styles scale: Adaptation for university students. Turkish J Psy. 1995;10(34):56-73.
26. Pourkalbassi D, Patel P, Espinosa PS. Conversion disorder: The brain’s way of dealing with psychological conflicts. Case report of a patient with non-epileptic seizures. Cureus. 2019;11(1):e3902. doi: 10.7759/cureus.3902.
27. Ali S, Jabeen S, Pate RJ, Shahid M, Chinala S, Nathani M, et al. Conversion disorder-mind versus body: A review. Innov Clin Neurosci. 2015;12(5-6):23-7.
28. Akyüz F, Gökalp PG, Erdiman S, Oflaz S, Karşidağ Ç. Conversion disorder comorbidity and childhood trauma. Arch Neuropsychiatry. 2017;54(1):15-20. doi: 10.5152/npa.2017.19184.
29. Kazemi M. Prediction of mental health in MS patients: The role of psychological resilience and cognitive integration. Adv Nurs Midwifery. 2019;28(2):29-32.
30. Russell DW, Russell CA, Chen HY, Cacioppo S, Cacioppo JT. To what extent is psychological resilience protective or ameliorative: Exploring the effects of deployment on the mental health of combat medics. Psychol Serv. 2021;18(1):51-63. doi: 10.1037/ser0000343 .
31. Reh L. Perceived stress, depression and anxiety in university students: The role of resilience. Bachelor’s thesis, University of Twente. NL:2019.
32. Cong EZ, Wu Y, Cai YY, Chen HY, Xu YF. Association of suicidal ideation with family environment and psychological resilience in adolescents. CJCP. 2019;21(5):479-84. doi: 10.7499/j.issn.1008 8830.2019.05.016.
33. Lee JH, Nam SK, Kim AR, Kim B, Lee MY, Lee SM. Resilience: a meta ‐analytic approach. J Couns Dev. 2013;91(3):269-79. doi: 10.1002/j.1556- 6676.2013.00095.x.
34. Echezarraga A, Las Hayas C, López de Arroyabe E, Jones SH. Resilience and recovery in the context of psychological disorders. J Humanist Psychol. 2019. doi: 10.1177/0022167819851623.
35. Encyclopedia of mental disorders. Conversion disorder. https://www.encyclopedia.com/ medicine/diseases-and-conditions/pathology/ conversion-disorder
36. Evrin T, Kaykısız E. Assessment of the patients diagnosed with conversion disorder in the emergency department. Ortadogu Med J. 2018;10(3):348-55. doi: 10.21601/ ortadogutipdergisi.449211.