{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:19:36Z","timestamp":1791483576418,"version":"4.3.4"},"reference-count":236,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T00:00:00Z","timestamp":1654128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000025","name":"NIMH","doi-asserted-by":"publisher","award":["K23MH111983"],"award-info":[{"award-number":["K23MH111983"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008835","name":"Ruhr University Bochum Research School","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008835","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Functional neurological disorder reflects impairments in brain networks leading to distressing motor, sensory and\/or cognitive symptoms that demonstrate positive clinical signs on examination incongruent with other conditions. A central issue in historical and contemporary formulations of functional neurological disorder has been the mechanistic and aetiological role of emotions. However, the debate has mostly omitted fundamental questions about the nature of emotions in the first place. In this perspective article, we first outline a set of relevant working principles of the brain (e.g. allostasis, predictive processing, interoception and affect), followed by a focused review of the theory of constructed emotion to introduce a new understanding of what emotions are. Building on this theoretical framework, we formulate how altered emotion category construction can be an integral component of the pathophysiology of functional neurological disorder and related functional somatic symptoms. In doing so, we address several themes for the functional neurological disorder field including: (i) how energy regulation and the process of emotion category construction relate to symptom generation, including revisiting alexithymia, \u2018panic attack without panic\u2019, dissociation, insecure attachment and the influential role of life experiences; (ii) re-interpret select neurobiological research findings in functional neurological disorder cohorts through the lens of the theory of constructed emotion to illustrate its potential mechanistic relevance; and (iii) discuss therapeutic implications. While we continue to support that functional neurological disorder is mechanistically and aetiologically heterogenous, consideration of how the theory of constructed emotion relates to the generation and maintenance of functional neurological and functional somatic symptoms offers an integrated viewpoint that cuts across neurology, psychiatry, psychology and cognitive-affective neuroscience.<\/jats:p>","DOI":"10.1093\/brain\/awac204","type":"journal-article","created":{"date-parts":[[2022,6,2]],"date-time":"2022-06-02T13:54:05Z","timestamp":1654178045000},"page":"2648-2663","source":"Crossref","is-referenced-by-count":166,"title":["A new science of emotion: implications for functional neurological disorder"],"prefix":"10.1093","volume":"145","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4846-8337","authenticated-orcid":false,"given":"Johannes","family":"Jungilligens","sequence":"first","affiliation":[{"name":"Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum , Bochum , Germany"},{"name":"Functional Neurological Disorder Unit, Division of Cognitive Behavioral Neurology, Department of Neurology, Massachusetts General Hospital, Harvard Medical School , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5163-4730","authenticated-orcid":false,"given":"Sara","family":"Paredes-Echeverri","sequence":"additional","affiliation":[{"name":"Functional Neurological Disorder Unit, Division of Cognitive Behavioral Neurology, Department of Neurology, Massachusetts General Hospital, Harvard Medical School , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stoyan","family":"Popkirov","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum , Bochum , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa Feldman","family":"Barrett","sequence":"additional","affiliation":[{"name":"Department of Psychology, Northeastern University , Boston, MA , USA"},{"name":"Psychiatric Neuroimaging Division, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School , Boston, MA , USA"},{"name":"Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2721-583X","authenticated-orcid":false,"given":"David L","family":"Perez","sequence":"additional","affiliation":[{"name":"Functional Neurological Disorder Unit, Division of Cognitive Behavioral Neurology, Department of Neurology, Massachusetts General Hospital, Harvard Medical School , Boston, MA , USA"},{"name":"Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School , Boston, MA , USA"},{"name":"Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,6,2]]},"reference":[{"key":"2023020803005172500_awac204-B1","doi-asserted-by":"crossref","first-page":"o64","DOI":"10.1136\/bmj.o64","article-title":"Diagnosis and management of functional neurological disorder","volume":"376","author":"Aybek","year":"2022","journal-title":"BMJ"},{"key":"2023020803005172500_awac204-B2","doi-asserted-by":"crossref","first-page":"102623","DOI":"10.1016\/j.nicl.2021.102623","article-title":"Neuroimaging in functional neurological disorder: State of the field and research agenda","volume":"30","author":"Perez","year":"2021","journal-title":"Neuroimage Clin"},{"issue":"10","key":"2023020803005172500_awac204-B3","doi-asserted-by":"crossref","first-page":"2878","DOI":"10.1093\/brain\/awp220","article-title":"Symptoms \u2018unexplained by organic disease\u2019 in 1144 new neurology out-patients: How often does the diagnosis change at follow-up?","volume":"132","author":"Stone","year":"2009","journal-title":"Brain"},{"key":"2023020803005172500_awac204-B4","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1001\/jamaneurol.2020.3753","article-title":"Assessment of emergency department and inpatient use and costs in adult and pediatric functional neurological disorders","volume":"78","author":"Stephen","year":"2021","journal-title":"JAMA Neurol"},{"key":"2023020803005172500_awac204-B5","doi-asserted-by":"crossref","first-page":"109907","DOI":"10.1016\/j.jpsychores.2019.109907","article-title":"Symptoms of posttraumatic stress disorder in patients with functional neurological symptom disorder","volume":"129","author":"Gray","year":"2020","journal-title":"J Psychosom Res"},{"key":"2023020803005172500_awac204-B6","doi-asserted-by":"crossref","first-page":"3591","DOI":"10.1111\/ene.15018","article-title":"International online survey of 1048 individuals with functional neurological disorder","volume":"28","author":"Butler","year":"2021","journal-title":"Eur J Neurol"},{"key":"2023020803005172500_awac204-B7","volume-title":"Traite clinique et terapeutique de l'hyst\u00e9rie","author":"Briquet","year":"1859"},{"key":"2023020803005172500_awac204-B8","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.nbd.2019.02.013","article-title":"Pathogenesis and pathophysiology of functional (psychogenic) movement disorders","volume":"127","author":"Baizabal-Carvallo","year":"2019","journal-title":"Neurobiol Dis"},{"key":"2023020803005172500_awac204-B9","volume-title":"Le\u00e7ons du mardi \u00e1 la Salp\u00eatri\u00e8re: policliniques, 1887\u20131888","author":"Charcot","year":"1887"},{"key":"2023020803005172500_awac204-B10","volume-title":"Studien \u00fcber Hysterie","author":"Breuer","year":"1895"},{"key":"2023020803005172500_awac204-B11","volume-title":"Gen\u00e8se et Nature de L\u00b4hyst\u00e9rie: Recherches Cliniques et Exp\u00e9rimentales de Psycho-Physiologie","author":"Sollier","year":"1897"},{"key":"2023020803005172500_awac204-B12","volume-title":"Diseases of the nervous system: A textbook for student and practitioner of medicine","author":"Oppenheim","year":"1900"},{"key":"2023020803005172500_awac204-B13","doi-asserted-by":"crossref","DOI":"10.1037\/10008-000","volume-title":"The major symptoms of hysteria: Fifteen lectures given in the Medical School of Harvard University","author":"Janet","year":"1907"},{"key":"2023020803005172500_awac204-B14","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/S0140-6736(00)52916-X","article-title":"Contribution to the study of shell shock","volume":"185","author":"Myers","year":"1915","journal-title":"The Lancet"},{"key":"2023020803005172500_awac204-B15","volume-title":"Hysteria or Pithiatism trans. 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