Challenges to the Diagnosis of Functional Neurological Disorder: Feigning, Intentionality, and Responsibility 2022 Mason

Abstract

The diagnosis of Functional Neurological Disorder (FND) requires differentiation from other neurologic diseases/syndromes, and from the comparatively rare diagnosis of feigning (Malingering and Factitious Disorder). Analyzing the process of diagnosing FND reveals a necessary element of presumption, which I propose underlies some of the uncertainty, discomfort, and stigma associated with this diagnosis. A conflict between the neurologist’s natural social cognition and professional judgement (cognitive dissonance) can be understood by applying a framework originally designed for the determination of moral responsibility. Understanding the source of this cognitive dissonance may effect its alleviation, and in turn, allow more compassionate treatment of patients with FND.

Open access, https://link.springer.com/article/10.1007/s12152-022-09509-8

 

Oooo, I'm no expert but I can see so many red flags in just your excerpt alone...

This seems to be saying it's a made-up diagnosis or at least one they have no reliable way of making.

This then in turn would be sort of a good thing. Better would be to just stick to his professional judgement I'd imagine. That is after all his moral responsibility. Then the cognitive dissonance should dissipate.

Making this bit obsolete.

 

Are practitioners doing MRI brain scans and like neurological and cognitive testing before they dismiss people with the label FND?

I doubt it.

It's the same for pwME. Despite recounting perhaps several neurological and cognitive symptoms and challenges, a sizeable number of pwME don't get any testing in this area.

 

Aside from the vacuity of this mumbojumbo, I think I'm seeing the grand strategy: they're looking for the "neural circuits" of agency, of conscious thought, when people decide to do something and act on this will.

They think that's we're failing. Because reasons. Probably having to do with how difficult this is, how it fuels an endless effort that could go on and on for decades. But the mythical conversion disorder is being bet on having everything to do with this. Basically: we can do anything we want if we want to, it's just that something in will/agency is stopping us. Or whatever. We can, we just don't want to. Subconsciously, of course. Not because it's rational, but simply because it's another turtle down. You cannot prove that there isn't a teapot out there orbiting the sun, therefore I'm right. Logical fallacies, so hot in healthcare right now.

And probably someone, definitely not in the process of working on pseudoscience, will find something, although probably little to do with a specific set of circuits, network or areas of the brain. And it won't be relevant to us, every assumption about it will be disproved. But they will go on about this for many more years, until they just move on to some other BS fad and do the same loop all over again.

But the thing is that this nonsense could go on for decades. It will simply never stop until it's made obsolete, and the research that will make this obsolete is being blocked by the endless obsession with what is basically medicine's Philosopher's stone, a desperate quest out of pure myth and legend.

This is really, truly, the golden age of medical pseudoscience. It's never been more popular and influential. Despite there being no evidence at all. But evidence-based medicine. We sure live in interesting times.

 

"Analyzing the process of diagnosing FND reveals a necessary element of presumption"... OK, so it's a made up 'thing', so perhaps cognitive dissonance would be reduced in neurologists if they rejected FND as it has no objective truth or validity or reliability or face validity or anything at all - other than words someone wrote down one day and tried to make into a 'thing'.

 

It would logically follow that "health care practitioners" who believe in this mumbo-jumbo would also be more susceptible to signing up for human potential courses themselves. As in, you can think your way to whatever you want.

"Thinner thighs in 30 thoughts."