The self and social perception of adolescents in conversion disorder: Assessment with repertory grid technique

The aim of this study was to determine the relation between the perception of self and other important individuals', the ways of this perception and the self-esteem, comorbid psychopathologies and the traumatic experiences in adolescents took the diagnosis of Conversion Disorder (CD). A total of 20 adolescent girls aged 12-18 took the diagnosis of CD and have still being followed in outpatient clinic of Department of Child and Adolescent Psychiatry and Mental Health in Akdeniz University Faculty of Medicine were included in the study as experimental group. The control group was 20 healthy adolescents that have never referred to child psychiatry outpatient clinic for any reason and paired with the experimental group in the terms of age, gender, educational status. Repertory Grid Technique (RGT) was used to evaluate the self, families' and others' perception and construction systems of adolescents. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) was used to determine psychopathologies. Self-esteem was measured with Rosenberg Self-Esteem Scale (RSES). Conversion symptoms were investigated by Conversion Disorder Symptom Check List. In RGT assessment, the difference in construction of family and other important individuals between adolescents with CD and adolescents in control group has drawn attention. Adolescents with CD defined themselves close to their ideal self, mother and father mostly. On the other hand their healthy peers defined their mother and father remote but siblings, girlfriends and boyfriends near to themselves. The difference between these two groups has shown that adolescents with conversion disorder experience the process of separation-individuation and promotion of autonomy in a different pattern from adolescents in control group. In addition it was found that CD has negative effects on self-esteem. 85% of adolescents with CD have at least one psychiatric comorbidity. Depressive Disorder (DD), Oppositional Defiant Disorder (ODD) and Post-Traumatic Stress Disorder (PTSB) were the most common psychiatric comorbidities. In conclusion, adolescents with CD have more psychopathology levels and lower self-esteem. They can't experience a healthy separation-individuation and identity development process and continue to be dependent to their parents and also they can't achieve identification with their peers and idealization of others even themselves. The results of this study have shown that defining of comorbid psychiatric symptoms and the different construction of self and others and being aware of these entities in treatment approaches in adolescents with CD will reduce the negative effects of this disorder