{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T05:28:53Z","timestamp":1792301333231,"version":"4.4.0"},"reference-count":49,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2017,9,28]],"date-time":"2017-09-28T00:00:00Z","timestamp":1506556800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Child Psychol Psychiatry"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:p>Psychogenic non-epileptic seizures (PNES) are a nonspecific, umbrella category that is used to collect together a range of atypical neurophysiological responses to emotional distress, physiological stressors and danger. Because PNES mimic epileptic seizures, children and adolescents with PNES usually present to neurologists or to epilepsy monitoring units. After a comprehensive neurological evaluation and a diagnosis of PNES, the patient is referred to mental health services for treatment. This study documents the diagnostic formulations \u2013 the clinical formulations about the probable neurophysiological mechanisms \u2013 that were constructed for 60 consecutive children and adolescents with PNES who were referred to our Mind-Body Rehabilitation Programme for treatment. As a heuristic framework, we used a contemporary reworking of Janet\u2019s dissociation model: PNES occur in the context of a destabilized neural system and reflect a release of prewired motor programmes following a functional failure in cognitive-emotional executive control circuitry. Using this framework, we clustered the 60 patients into six different subgroups: (1) dissociative PNES (23\/60; 38%), (2) dissociative PNES triggered by hyperventilation (32\/60; 53%), (3) innate defence responses presenting as PNES (6\/60; 10%), (4) PNES triggered by vocal cord adduction (1\/60; 2%), (5) PNES triggered by activation of the valsalva manoeuvre (1\/60; 1.5%) and (6) PNES triggered by reflex activation of the vagus (2\/60; 3%). As described in the companion article, these diagnostic formulations were used, in turn, both to inform the explanations of PNES that we gave to families and to design clinical interventions for helping the children and adolescents gain control of their PNES.<\/jats:p>","DOI":"10.1177\/1359104517732118","type":"journal-article","created":{"date-parts":[[2017,9,28]],"date-time":"2017-09-28T07:43:44Z","timestamp":1506584624000},"page":"140-159","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":62,"title":["Psychogenic non-epileptic seizures in children and adolescents: Part I \u2013 Diagnostic formulations"],"prefix":"10.1177","volume":"23","author":[{"given":"Kasia","family":"Kozlowska","sequence":"first","affiliation":[{"name":"Department of Psychological Medicine, The Children\u2019s Hospital at Westmead, NSW, Australia"},{"name":"Brain Dynamics Centre at at Westmead Institute for Medical Research, NSW, Australia"},{"name":"Sydney Medical School, The University of Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Chudleigh","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, The Children\u2019s Hospital at Westmead, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Cruz","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, The Children\u2019s Hospital at Westmead, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, The Children\u2019s Hospital at Westmead, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia","family":"McClure","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, The Children\u2019s Hospital at Westmead, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanche","family":"Savage","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, The Children\u2019s Hospital at Westmead, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ubaid","family":"Shah","sequence":"additional","affiliation":[{"name":"Sydney Medical School, The University of Sydney, NSW, Australia"},{"name":"TY Nelson Department of Neurology, The Children\u2019s Hospital at Westmead, NSW, Australia"},{"name":"Lady Cilento Children\u2019s Hospital, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Averil","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, The Children\u2019s Hospital at Westmead, NSW, Australia"},{"name":"Child and Adolescent Mental Health Service Macarthur (ICAMHS) Macarthur, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Scher","sequence":"additional","affiliation":[{"name":"Sydney Medical School, The University of Sydney, NSW, Australia"},{"name":"Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Carrive","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Medical Sciences, University of NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Gill","sequence":"additional","affiliation":[{"name":"Sydney Medical School, The University of Sydney, NSW, Australia"},{"name":"TY Nelson Department of Neurology, The Children\u2019s Hospital at Westmead, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,9,28]]},"reference":[{"key":"bibr1-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1038\/nn.4087"},{"key":"bibr2-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2014-309483"},{"key":"bibr3-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2010.10.032"},{"key":"bibr4-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropsychologia.2016.11.005"},{"key":"bibr5-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852900001954"},{"key":"bibr6-1359104517732118","first-page":"A353","volume":"149","author":"Brugman S. M.","year":"1994","journal-title":"American Journal of Respiratory Critical Care Medicine"},{"key":"bibr7-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1097\/HRP.0000000000000131"},{"key":"bibr8-1359104517732118","volume-title":"Journal of researches into the geology and natural history of the various countries visited by H.M.S. Beagle","author":"Darwin C.","year":"1839"},{"key":"bibr9-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1037\/10001-000"},{"key":"bibr10-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1038\/nrn1683"},{"key":"bibr11-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1605044113"},{"key":"bibr12-1359104517732118","doi-asserted-by":"publisher","DOI":"10.2478\/s13380-013-0117-2"},{"key":"bibr13-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62226-X"},{"key":"bibr14-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1177\/088626093008001008"},{"key":"bibr15-1359104517732118","first-page":"815","volume-title":"The epilepsies: Handbook of clinical neurology","volume":"15","author":"Gastaut H.","year":"1974"},{"key":"bibr16-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1007\/BF01487068"},{"key":"bibr17-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-012-0278-3"},{"key":"bibr18-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1080\/10673220590956519"},{"key":"bibr19-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1126\/science.1209603"},{"key":"bibr20-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.4728.382"},{"key":"bibr21-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2006.052522"},{"key":"bibr22-1359104517732118","volume-title":"L\u2019Automatisme psychologique","author":"Janet P.","year":"1889"},{"key":"bibr23-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1126\/science.aaf8924"},{"key":"bibr24-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1037\/10581-000"},{"key":"bibr25-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1097\/HRP.0000000000000008"},{"key":"bibr26-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0b013e318286be43"},{"key":"bibr27-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1177\/1359104512447314"},{"key":"bibr28-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1177\/1359104517730116"},{"key":"bibr29-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2016.10.016"},{"key":"bibr30-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0000000000000184"},{"key":"bibr31-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-017-0976-0"},{"key":"bibr32-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1097\/HRP.0000000000000065"},{"key":"bibr33-1359104517732118","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2010.tb03673.x"},{"key":"bibr34-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1983.04050120070012"},{"key":"bibr35-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1891\/9780826106322"},{"key":"bibr36-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13174"},{"key":"bibr37-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2015.03.017"},{"key":"bibr38-1359104517732118","volume-title":"Fear","author":"Mosso A.","year":"1896"},{"key":"bibr39-1359104517732118","doi-asserted-by":"publisher","DOI":"10.5005\/jp\/books\/12121"},{"key":"bibr40-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1177\/1550059414555905"},{"key":"bibr41-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1017\/S109285291600002X"},{"key":"bibr42-1359104517732118","volume-title":"The boy who was raised as a dog: What traumatized children can teach us about loss, love, and healing","author":"Perry B. D.","year":"2006"},{"key":"bibr43-1359104517732118","volume-title":"The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation","author":"Porges S. W.","year":"2011"},{"issue":"5","key":"bibr44-1359104517732118","first-page":"1","volume":"19","author":"Silberg J.","year":"2001","journal-title":"The International Society for the Study of Dissociation NEWS"},{"key":"bibr45-1359104517732118","volume-title":"Fits and faints","author":"Stephenson J. B.","year":"1990"},{"key":"bibr46-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2004.064477"},{"key":"bibr47-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2016.11.003"},{"key":"bibr48-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-40764-7_1"},{"key":"bibr49-1359104517732118","doi-asserted-by":"publisher","DOI":"10.1016\/j.it.2015.08.008"}],"container-title":["Clinical Child Psychology and Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1359104517732118","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1359104517732118","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1359104517732118","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:19:15Z","timestamp":1777385955000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1359104517732118"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,28]]},"references-count":49,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,1]]}},"alternative-id":["10.1177\/1359104517732118"],"URL":"https:\/\/doi.org\/10.1177\/1359104517732118","relation":{},"ISSN":["1359-1045","1461-7021"],"issn-type":[{"value":"1359-1045","type":"print"},{"value":"1461-7021","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,28]]}}}