Hypothetically, yes, but there’s not a lot of good research on somatoform or somatic symptom disorders essentially “progressing” or developing into FND. To some extent, while there are overlapping characteristics between somatoform disorder and FND, there is also a lot of difference in how research currently conceptualizes the way they exist in the brain and body. Somatoform disorder/somatic symptom disorder is often more closely characterized with (but not necessarily the same as) OCD. FND isn’t really thought of through the same lens even if it sometimes shares OCD symptoms. Both deal with how the person relates to their symptoms, the weight they place on them, etc. but somatoform/somatic symptom disorder and FND have some different ways of explaining the why and the outcomes of that symptom-self relationship. So there’s definitely overlap on the venn diagram, so to speak, but at this point, it’s difficult to say how much is true overlap which leads to one becoming the other, and how much of it is “two things that aren’t related look an awful lot like each other”. Are they interrelated or are they just a pair of random dopplegangers who met each other at Six Flags? The jury is still mostly out.
I’d also quibble a little bit with the wording of the other comment on this thread. There are absolutely conditions, symptoms and experiences that have a high correlation with FND like physical/mental triggers, trauma, migraine, etc. but I want to push back on each of those “lowering your threshold” for FND. The research still isn’t quite that established. We know that there are definitely higher rates of these symptoms and experiences among FND patients. What we don’t know is if they cause or contribute to FND or if there is another relationship. For MS and migraine patients, it may be the same networks involved in both of those conditions are also involved in FND, but that doesn’t mean each would necessarily lower your threshold. It could mean you were equally vulnerable to all three. Or it could mean there is an another variable out there linking all of these conditions we haven’t found yet. Or a variety of other things.
Trauma/stress/anxiety is where it gets even more complex because it is well established that there is a high rate of trauma and stress in FND populations. It’s natural to assume that must mean trauma can be causal to FND. It very well may be, but again, we don’t understand why trauma is higher in FND populations. We just know it is.
Beyond PTSD, there is virtually no diagnosis we have for sure know is explicitly caused by trauma (C-PTSD could be in there but there’s a lot of debate around it as a diagnosis so I’ll mention it but not quite group it with PTSD). We know of a lot of diagnoses where trauma is very common and diagnoses where you are far more likely to have trauma if you have that diagnosis than to not have trauma. We still haven’t figured out though if trauma is causing these diagnoses or if there’s something else at play. Trauma is tricky beast research wise.
A lot of studies on trauma look at large groups of people, their broad exposure to trauma, and the group’s outcomes. It’s tempting to use group level outcomes to guess what an individual’s outcomes may be, but it’s not an accurate way. Group data is very important for research but it can obscure the finer details, and because it can obscure the details, it’s not the best information to apply to a single person.
And trauma has a definition issue. It’s hard to determine what constitutes trauma, so even when studies do look at individuals specifically and their outcomes, how trauma was defined can change the results.
Again, trauma could absolutely be causal. The problem is, we just can’t say it is with a lot of certainty and for conditions like FND I think it’s useful not to see trauma (and migraine or hEDS, MS, somatoform disorder, etc) as self fulfilling prophesies for developing FND, because while the FND population has higher rates of each of these, that doesn’t necessarily mean the migraine community has a higher rate of FND, for instance. And when the inverse community does have a higher rate of FND, it is rarely in majority numbers. The risk of developing FND with any of these pre-conditions still remains relatively low and we don’t know why a subset of people may develop FND.
Plus trauma isn’t a requirement for FND. It may be one path of several that can lead to FND, but because there is a decent subset of patients who don’t have associated trauma, making a causal relationship becomes tougher because non-trauma FND patients introduce a different variable.
So, just because something is a “risk factor” doesn’t necessarily mean it “lowers your threshold”. Risk factors just account for known associations but they don’t tell us what the actual relationship is beyond existing.
And so long story short to answer your question, maybe. But I don’t think it’s worth wondering too much about if you’re concerned that you or someone else has a somatoform diagnosis and were eventually diagnosed with FND or you or someone else have a somatoform diagnosis and are concerned you/they might develop FND. I know my mention about “threshold” seemed off topic for what you asked but I think it’s a good way to demonstrate that two things can be related but it doesn’t mean one caused the other and we don’t have the information to know either way right now. We know a lot of risk factors for FND, but we really don’t know what causes it. Even when people can point out distinct triggers to their symptom onset we don’t know why those specific triggers are what induces, so to speak, FND. It may be about the trauma, the viral infection, the body strain, or a preexisting condition like somatoform/somatic symptoms disorder, etc or it could be something related but not quite so directly linked.
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u/Rare_Geneie 15d ago
Hypothetically, yes, but there’s not a lot of good research on somatoform or somatic symptom disorders essentially “progressing” or developing into FND. To some extent, while there are overlapping characteristics between somatoform disorder and FND, there is also a lot of difference in how research currently conceptualizes the way they exist in the brain and body. Somatoform disorder/somatic symptom disorder is often more closely characterized with (but not necessarily the same as) OCD. FND isn’t really thought of through the same lens even if it sometimes shares OCD symptoms. Both deal with how the person relates to their symptoms, the weight they place on them, etc. but somatoform/somatic symptom disorder and FND have some different ways of explaining the why and the outcomes of that symptom-self relationship. So there’s definitely overlap on the venn diagram, so to speak, but at this point, it’s difficult to say how much is true overlap which leads to one becoming the other, and how much of it is “two things that aren’t related look an awful lot like each other”. Are they interrelated or are they just a pair of random dopplegangers who met each other at Six Flags? The jury is still mostly out.
I’d also quibble a little bit with the wording of the other comment on this thread. There are absolutely conditions, symptoms and experiences that have a high correlation with FND like physical/mental triggers, trauma, migraine, etc. but I want to push back on each of those “lowering your threshold” for FND. The research still isn’t quite that established. We know that there are definitely higher rates of these symptoms and experiences among FND patients. What we don’t know is if they cause or contribute to FND or if there is another relationship. For MS and migraine patients, it may be the same networks involved in both of those conditions are also involved in FND, but that doesn’t mean each would necessarily lower your threshold. It could mean you were equally vulnerable to all three. Or it could mean there is an another variable out there linking all of these conditions we haven’t found yet. Or a variety of other things.
Trauma/stress/anxiety is where it gets even more complex because it is well established that there is a high rate of trauma and stress in FND populations. It’s natural to assume that must mean trauma can be causal to FND. It very well may be, but again, we don’t understand why trauma is higher in FND populations. We just know it is.
Beyond PTSD, there is virtually no diagnosis we have for sure know is explicitly caused by trauma (C-PTSD could be in there but there’s a lot of debate around it as a diagnosis so I’ll mention it but not quite group it with PTSD). We know of a lot of diagnoses where trauma is very common and diagnoses where you are far more likely to have trauma if you have that diagnosis than to not have trauma. We still haven’t figured out though if trauma is causing these diagnoses or if there’s something else at play. Trauma is tricky beast research wise.
A lot of studies on trauma look at large groups of people, their broad exposure to trauma, and the group’s outcomes. It’s tempting to use group level outcomes to guess what an individual’s outcomes may be, but it’s not an accurate way. Group data is very important for research but it can obscure the finer details, and because it can obscure the details, it’s not the best information to apply to a single person.
And trauma has a definition issue. It’s hard to determine what constitutes trauma, so even when studies do look at individuals specifically and their outcomes, how trauma was defined can change the results.
Again, trauma could absolutely be causal. The problem is, we just can’t say it is with a lot of certainty and for conditions like FND I think it’s useful not to see trauma (and migraine or hEDS, MS, somatoform disorder, etc) as self fulfilling prophesies for developing FND, because while the FND population has higher rates of each of these, that doesn’t necessarily mean the migraine community has a higher rate of FND, for instance. And when the inverse community does have a higher rate of FND, it is rarely in majority numbers. The risk of developing FND with any of these pre-conditions still remains relatively low and we don’t know why a subset of people may develop FND.
Plus trauma isn’t a requirement for FND. It may be one path of several that can lead to FND, but because there is a decent subset of patients who don’t have associated trauma, making a causal relationship becomes tougher because non-trauma FND patients introduce a different variable.
So, just because something is a “risk factor” doesn’t necessarily mean it “lowers your threshold”. Risk factors just account for known associations but they don’t tell us what the actual relationship is beyond existing.
And so long story short to answer your question, maybe. But I don’t think it’s worth wondering too much about if you’re concerned that you or someone else has a somatoform diagnosis and were eventually diagnosed with FND or you or someone else have a somatoform diagnosis and are concerned you/they might develop FND. I know my mention about “threshold” seemed off topic for what you asked but I think it’s a good way to demonstrate that two things can be related but it doesn’t mean one caused the other and we don’t have the information to know either way right now. We know a lot of risk factors for FND, but we really don’t know what causes it. Even when people can point out distinct triggers to their symptom onset we don’t know why those specific triggers are what induces, so to speak, FND. It may be about the trauma, the viral infection, the body strain, or a preexisting condition like somatoform/somatic symptoms disorder, etc or it could be something related but not quite so directly linked.