Do ACEs, childhood relational trauma and interoception predict emotional regulation, self-stigma and wellbeing in FND and is this moderated by self-compassion?

Paper one is a literature review of 5 databases, yielding 8 studies looking at the impact of attachment security on psychological symptomology, coping and wellbeing in those with a diagnosis of FND. The CCAT was used to appraise the quality of the studies and findings synthesised using narrative synthesis. Results found higher levels of insecure attachment patterns in FND population, which is positively correlated with depression, anxiety, mental health, PTSD symptomology, personality pathology, alexithymia, pain catastrophizing, somatoform dissociation, dissociative experiences and negatively correlated with resilience. There was no relationship found within the FND population between attachment and quality of life. Limitations of studies include representativeness of sample, multicollinearity, selfreport nature of measures and lack of validity in measures used for FND population. It is suggested that further study to clarify causality and distinguish between concepts would be helpful as well as evaluation of psychometric measures for use in the FND population.

Paper two is a cross-sectional, questionnaire study investigating predictive roles of adverse childhood experiences (ACEs), early relational trauma, and interoception on emotional regulation, wellbeing, and self-stigma in individuals with FND. A total of 91 people with a diagnosis of FND completed seven validated measures, as well as demographics. Results indicate that higher early life relational trauma and lower interoceptive ability significantly predicted greater emotional dysregulation and wellbeing; and early life relational trauma significantly predicted higher self-stigma. Average scoring on the self-compassion measure fell between low-moderate levels. Self-compassion did not significantly moderate any of the relationships but was associated with interoception and emotional regulation. Findings suggest that screening prior to intervention planning in FND would help tailor interventions towards what would be most beneficial. Research into interoceptive, compassion-based and relational interventions are supported. Key limitations include high dropout rate due to cognitive demands of questionnaires and self-report nature of measures.

Paper three is an executive summary of paper two aimed at people living with a diagnosis of FND, people who may care for someone with FND and professionals who are caring for those with FND.