King's College London

This study sought to extend knowledge about the previously reported preconscious attentional bias for facial emotion in patients with dissociative seizures (DS) by exploring whether the finding could be replicated, whilst controlling for concurrent anxiety, depression and potentially relevant cognitive impairments. Patients diagnosed with DS (n = 38) were compared to healthy controls (n = 43) on a pictorial emotional Stroop test, in which backwardly-masked emotional faces (angry, happy, neutral) were processed implicitly. The DS group displayed a significantly greater attentional bias to facial emotion relative to controls; however, the bias was not specific to negative or positive emotions. The group effect could not be explained by performance on standardised cognitive tests or self-reported depression/anxiety. The study provides additional evidence of a disproportionate and automatic allocation of attention to facial affect in patients with DS, including both positive and negative facial expressions. Such a tendency could act as a predisposing factor for developing DS initially, or may contribute to triggering individuals’ seizures on an ongoing basis. Psychological interventions such as CBT or attentional bias modification might be suitable approaches to targeting this bias in clinical practice.