{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T02:21:27Z","timestamp":1789611687260,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,8,3]],"date-time":"2020-08-03T00:00:00Z","timestamp":1596412800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K23 DK106570"],"award-info":[{"award-number":["K23 DK106570"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Our aim was to conduct a pilot randomized controlled trial of a novel cognitive behaviorally based intervention for pediatric PNES called Retraining and Control Therapy (ReACT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants were randomized to receive either eight sessions of ReACT or supportive therapy, and participants completed follow\u2010up visits at 7\u2010 and 60\u2010days posttreatment. The primary outcome measure was PNES frequency at 7\u2010days posttreatment. Eligibility criteria included children with video\u2010EEG confirmed PNES and participant\/parent or guardian willingness to participate in treatment. Exclusion criteria included substance use, psychosis, and severe intellectual disability. Forty\u2010two patients were assessed for eligibility and 32 were randomized. ReACT aimed to retrain classically conditioned, involuntary PNES by targeting catastrophic symptom expectations and a low sense of control over symptoms using principles of habit reversal. Supportive therapy was based on the assumption that relief from stress or problems can be achieved by discussion with a therapist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010nine participants (<jats:italic>M<\/jats:italic><jats:sub>age<\/jats:sub>\u00a0=\u00a015.1\u00a0years, SD<jats:sub>age<\/jats:sub>\u00a0=\u00a02.5; 72.2% female; 57.1% Caucasian, 28.6% African American) completed 7\u2010days postprocedures. For PNES frequency, the Wilcoxon Rank Sum test statistic was 273.5 yielding a normal approximation of <jats:italic>Z<\/jats:italic>\u00a0=\u00a04.725 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001), indicating a significant improvement in PNES frequency for ReACT at 7\u2010days posttreatment compared to supportive therapy. Participants with PNES in the 7\u2010days posttreatment were removed from the study for additional treatment, resulting in no 60\u2010day follow\u2010up data for supportive therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>ReACT resulted in significantly greater PNES reduction than supportive therapy, with 100% of patients experiencing no PNES in 7\u00a0days after ReACT. Additionally, 82% remained PNES\u2010free for 60\u00a0days after ReACT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.51138","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T03:29:51Z","timestamp":1596511791000},"page":"1410-1419","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":91,"title":["Retraining and control therapy for pediatric psychogenic non\u2010epileptic seizures"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9974-8534","authenticated-orcid":false,"given":"Aaron D.","family":"Fobian","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Neurobiology University of Alabama at Birmingham (UAB) Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dustin M.","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Alabama at Birmingham (UAB) Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5936-6627","authenticated-orcid":false,"given":"Jerzy P.","family":"Szaflarski","sequence":"additional","affiliation":[{"name":"Departments of Neurology, Neurosurgery and Neurobiology The UAB Epilepsy Center University of Alabama at Birmingham (UAB) Birmingham 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