Table 1

Potential predisposing, precipitating and perpetuating factors for FND (adapted from Stone50)

Predisposing vulnerabilitiesIllness and disease.
History of previous functional symptoms.
Personality traits.
Poor attachment/coping style.
Emotional disorder.
Adverse life events or stressors.
Childhood neglect.
Difficulties in interpersonal relationships.
Symptom modelling.
Financial difficulties/deprivation.
Precipitating mechanismsPhysical injury or state (eg, drug side effect).
Abnormal physiological event (eg, hyperventilation and sleep paralysis).
Panic attack.
Perception of life event as traumatic/negative.
Adverse life events or stressors.
Perpetuating factorsPlasticity in sensory and motor pathways leading to abnormal movement patterns.
Chronic pain.
Illness beliefs (person and significant others).
Feeling disbelieved.
Maladaptive behaviours.
Co-morbidities including anxiety and depression.
Diagnostic uncertainty (eg, ongoing medical investigations).
Reliance on care and benefits.
Compensation claims.
Ongoing social stressors (eg, relationship difficulties, financial hardship and loss of roles).