{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:51:16Z","timestamp":1789671076646,"version":"4.0.1"},"reference-count":119,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T00:00:00Z","timestamp":1698105600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Previous studies suggest that subjective distress in children with functional neurological disorder (FND) is associated with stress-system dysregulation and modulates aberrant changes in neural networks. The current study documents illness-promoting psychological processes in 76 children with FND (60 girls and 16 boys, aged 10.00\u221217.08 years) admitted to the Mind\u2013Body Program. The children completed a comprehensive family assessment and self-report measures, and they worked with the clinical team to identify psychological processes during their inpatient admission. A total of 47 healthy controls (35 girls and 12 boys, aged 8.58\u201317.92 years) also completed self-report measures, but were not assessed for illness-promoting psychological processes. Children with FND (vs. controls) reported higher levels of subjective distress (total DASS score, t(104.24) = 12.18; p \u02c2 0.001) and more adverse childhood experiences across their lifespans (total ELSQ score, t(88.57) = 9.38; p \u02c2 0.001). Illness-promoting psychological processes were identified in all children with FND. Most common were the following: chronic worries about schoolwork, friendships, or parental wellbeing (n = 64; 84.2%); attention to symptoms (n = 61; 80.3%); feeling sad (n = 58; 76.3%); experiencing a low sense of control (helplessness) in relation to symptoms (n = 44; 57.9%); pushing difficult thoughts out of mind (n = 44; 57.9%); self-critical rumination (n = 42; 55.3%); negative\/catastrophic-symptom expectations (n = 40; 52.6%); avoidance of activities (n = 38; 50%); intrusive thoughts\/feelings\/memories associated with adverse events (n = 38, 50%); and pushing difficult feelings out of mind (n = 37; 48.7%). In children with FND\u2014disabled enough to be admitted for inpatient treatment\u2014illness-promoting psychological processes are part of the clinical presentation. They contribute to the child\u2019s ongoing sense of subjective distress, and if not addressed can maintain the illness process. A range of clinical interventions used to address illness-promoting psychological processes are discussed, along with illustrative vignettes.<\/jats:p>","DOI":"10.3390\/children10111724","type":"journal-article","created":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T06:28:25Z","timestamp":1698128905000},"page":"1724","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Illness-Promoting Psychological Processes in Children and Adolescents with Functional Neurological Disorder"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9578-0753","authenticated-orcid":false,"given":"Kasia","family":"Kozlowska","sequence":"first","affiliation":[{"name":"Department of Psychological Medicine, The Children\u2019s Hospital at Westmead, Westmead, NSW 2145, Australia"},{"name":"Child and Adolescent Heath and Specialty of Psychiatry, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia"},{"name":"Brain Dynamics Centre, Westmead Institute of Medical Research, Faculty of Medicine and Health, University of Sydney, Westmead, NSW 2145, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Schollar-Root","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, The Children\u2019s Hospital at Westmead, Westmead, NSW 2145, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanche","family":"Savage","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, The Children\u2019s Hospital at Westmead, Westmead, NSW 2145, Australia"},{"name":"Golden Wattle Clinical Psychology, 20 Jarrett St, Leichhardt, NSW 2040, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Hawkes","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, The Children\u2019s Hospital at Westmead, Westmead, NSW 2145, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Chudleigh","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, The Children\u2019s Hospital at Westmead, Westmead, NSW 2145, Australia"},{"name":"Golden Wattle Clinical Psychology, 20 Jarrett St, Leichhardt, NSW 2040, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyoti","family":"Raghunandan","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, The Children\u2019s Hospital at Westmead, Westmead, NSW 2145, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3069-7593","authenticated-orcid":false,"given":"Stephen","family":"Scher","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA 02115, USA"},{"name":"Specialty of Psychiatry, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1622-6285","authenticated-orcid":false,"given":"Helene","family":"Helgeland","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Mental Health in Hospitals, Oslo University Hospital, 0424 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,24]]},"reference":[{"key":"ref_1","first-page":"436","article-title":"Conversion disorder in childhood-diagnosed too late, investigated too much","volume":"96","author":"Leary","year":"2003","journal-title":"J. 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