Retraining and Control Therapy (ReACT): Sense of Control and Catastrophic Symptom Expectations as Targets of a Cognitive Behavioral Treatment for Pediatric Psychogenic Non-epileptic Seizures (PNES)

What this Trial Is About

This research aims to evaluate sense of control and catastrophic symptom expectations as key targets for Retraining and Control Therapy (ReACT), a cognitive behavioral treatment for children and adolescents aged 11 to 18 diagnosed with pediatric psychogenic non-epileptic seizures (PNES). PNES are episodes that resemble epileptic seizures but have no medical explanation. The study assesses these psychological factors to better understand and treat PNES. Healthy controls matched by age, gender, race, and family income also participate for comparison. Participants undergo a baseline laboratory visit with their parent, completing questionnaires on mood, relationships, trauma, and PNES symptoms. They perform the cold pressor test (CPT) twice, before and after applying either a pain relief or pain sensitivity lotion, to measure catastrophic symptom expectations. Participants then complete 12 weekly ReACT therapy sessions, mostly via telehealth, aimed at improving sense of control. After treatment, half receive two booster sessions at 3 and 9 months. Healthy controls have two similar visits for comparison. Throughout the study, participants complete tasks measuring cognitive functions and symptom tracking, including sleep and PNES frequency monitored by diaries and wearable devices. Follow-up visits occur one week after the 8th and 12th therapy sessions, with long-term follow-ups at 6 and 12 months via secure video calls. The study measures outcomes such as sense of control, pain tolerance, cortisol response, PNES frequency, and quality of life to understand the therapy's impact over time.

Retraining and Control Therapy (ReACT): Sense of Control and Symptom Expectations as Targets of a Treatment for PNES