Non-epileptic attack disorder (NEAD): trauma and life events, context and meaning

This paper makes the case for a re-consideration of the role of trauma and life events – and crucially, their social and political context – in relation to non-epileptic attack disorder (NEAD). Trauma and adverse life events have well established links with many health conditions and whilst they are acknowledged to play a part in NEAD, more recent research suggests that such events are not ubiquitous. Currently, when events are seen as salient this is most commonly interpreted in relation to properties of the individual and their agency. Context – social and political factors - are seldom integrated or considered. This paper presents findings from a study which examined how trauma and life events were understood by participants, how frequently trauma and life events were present in participants’ accounts and in what ways they may be salient as predisposing, precipitating or perpetuating factors in NEAD. Employing a validated a life history questionnaire to purposively sample participants with high and low levels of self-reported trauma, we deployed a narrative interview approach which elicited rich descriptions of life experiences. We found that descriptions of trauma or adverse life events were present in all our participants and that these events were shaped by social contexts of their lives. We propose that the method used to collect trauma data is central to what is found and that a recognition of the social and political context, and their meanings, results in a more nuanced understanding of the place of trauma and life events. • Trauma or serious and significant life events are present in the majority of people with NEAD. • Social context and meaning are key in understanding trauma. • Narrative approaches elicit information not identified by questionnaires. • Sexualised and violent trauma are frequently found. • Trauma- and violence-informed approaches to treatment should be considered.