Exploring the Link Between Personality and Therapy Effectiveness in Psychogenic Non-Epileptic Seizures (PNES)

Abstract

Psychogenic non-epileptic seizures (PNES) are seizure-like episodes without epileptiform activity, often linked to trauma, stress, and psychiatric comorbidities. Psychotherapy is the preferred treatment, but patients vary in response. Personality traits, especially those in the Big Five model (openness, conscientiousness, extraversion, agreeableness, neuroticism), may help explain these differences. This study used survey data from 25 people with PNES. Participants reported therapies tried, the most helpful therapy, its effectiveness on a 1–5 scale, comorbid diagnoses, seizure frequency, and personality trait scores. Trauma-focused therapy was most often rated as helpful (48%), followed by CBT (12%). Average effectiveness was 2.9 out of 5. Higher openness, conscientiousness, and agreeableness were associated with higher effectiveness, while neuroticism was negatively associated. Participants reported frequent seizures and high comorbidity, averaging 4.2 conditions. These results suggest personality, particularly the Big Five, may influence therapy outcomes in PNES.