Overview: This thesis explored concepts important to the construct of psychological inflexibility within non-epileptic attack disorder (NEAD). NEAD is the presentation of seizure like attacks, which cannot be explained medically, and are thereby thought to be psychological in nature. Psychological inflexibility is defined as the view that one is unable to change their internal or external behaviour to be in accordance with their own desires and values. This exploration was done over the course of three separate papers: a systematic literature review, an empirical paper, and a critical appraisal of the thesis.
Systematic Literature Review: The systematic literature review explored avoidance within NEAD, through narrative synthesis and quantitative meta-analyses. The review identified that individuals with NEAD utilise avoidance more than individuals with epilepsy or healthy controls. Avoidance appears to be an important component of NEAD.
Empirical Paper: The empirical paper included 285 individuals with NEAD and utilised an online, one group observational design. Variables relevant to psychological inflexibility: cognitive fusion, experiential avoidance and mindfulness were explored in regards to relationships with three outcome variables in NEAD: somatisation, impact of NEAD upon life, and non-epileptic attack (NEA) frequency. It was found that all of the psychological inflexibility variables were correlated with somatisation and impact upon life. Only mindfulness was found to be correlated, with NEA frequency. Mindfulness was the only psychological variable which uniquely and independently predicted somatisation in NEAD. Somatisation in turn contributes significantly to the impact upon life and NEA frequency.
Critical Appraisal: Further background on the theory which was considered in the conceptualisation of this thesis are provided and future directions of research are discussed.