Volume 22, Issue 9 p. 1265-1271
Research Article

Abnormal affective startle modulation in individuals with psychogenical movement disorder

Paul J. Seignourel PhD

Corresponding Author

Paul J. Seignourel PhD

Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA

Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, 1300 Moursund St., Houston, TX 77030Search for more papers by this author
Kimberly Miller MS

Kimberly Miller MS

Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA

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Ida Kellison MS

Ida Kellison MS

Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA

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Ramon Rodriguez MD

Ramon Rodriguez MD

Department of Neurology, University of Florida, Gainesville, Florida, USA

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Hubert H. Fernandez MD

Hubert H. Fernandez MD

Department of Neurology, University of Florida, Gainesville, Florida, USA

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Russell M. Bauer PhD

Russell M. Bauer PhD

Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA

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Dawn Bowers PhD

Dawn Bowers PhD

Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA

Department of Neurology, University of Florida, Gainesville, Florida, USA

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Michael S. Okun MD

Michael S. Okun MD

Department of Neurology, University of Florida, Gainesville, Florida, USA

Department of Neurosurgery, University of Florida, Gainesville, Florida, USA

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First published: 07 May 2007
Citations: 49

Abstract

Despite recent advances, psychogenic movement disorder (PMD) remains a poorly understood phenomenon. Emotional functioning and responsiveness to stress are believed to play a role in the development of psychogenic symptoms, but empirical studies examining emotional responsiveness in PMD and other conversion disorders are lacking. We investigated modulation of the startle eyeblink reflex by affective pictures in 12 patients with PMD and 12 age- and education-matched control participants. Participants viewed positive, neutral, and negative pictures, while eyeblink responses to white noise bursts were recorded. Control participants showed the expected pattern of startle modulation, with significant potentiation by negative pictures and slight (nonsignificant) inhibition by positive pictures. In the PMD group, however, both positive and negative pictures yielded significantly greater startle responses than neutral pictures. Depression and anxiety symptomatology did not correlate with startle modulation, and the two groups did not differ in self-reported emotional reactions to the pictures. Our findings suggest that individuals with PMD show aversive physiological reactions to positive as well as negative stimuli. Abnormal affective startle modulation may be used to help distinguish between malingering and PMD. Future studies using larger samples are needed to better understand the role of emotions in conversion disorder. © 2007 Movement Disorder Society