The role of seizure -related variables in pediatric epilepsy: Perspectives from neuropsychology, psychiatry, and social and emotional cognition.
Item
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Title
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The role of seizure -related variables in pediatric epilepsy: Perspectives from neuropsychology, psychiatry, and social and emotional cognition.
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Identifier
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AAI3304551
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identifier
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3304551
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Creator
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Bender, Heidi Allison.
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Contributor
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Adviser: Joan C. Borod
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Date
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2007
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Language
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English
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Publisher
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City University of New York.
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Subject
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Psychology, Behavioral | Psychology, Clinical
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Abstract
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The role of seizure-related factors and psychopathology in neurocognitive functioning has been extensively studied throughout the literature. The present study, however, is the first to examine the multiple etiological determinants of neuropsychological dysfunction in pediatric epilepsy by assessing the individual and combined explanatory power of psychiatric status, behavioral social skills, and seizure-related factors. In so doing, our goal was to provide practitioners with an empirically-based guide for identifying children at elevated risk of impairment. It was hypothesized that seizure type, age of onset, and externalizing behavior problems would be robust predictors of neuropsychological dysfunction. Sixty participants, ranging from 6-17 years, comprised the sample. All subjects had a confirmed diagnosis of epilepsy; children with FSIQ scores <70 were excluded. A test battery assessing general intellectual, language, visuospatial, attentional, executive, and learning & memory abilities was administered. Two parent-report behavior rating scales (i.e., CBCL & BASC) were also completed. Covariance analysis was conducted to evaluate whether seizure-related variables moderate the effects of psychiatric and social impairment on neuropsychological test performance. Ratings on global measures of psychiatric and behavioral symptomatology significantly contributed to diminished language abilities (p ≤.05) after seizure variables were accounted for; seizure type (p ≤.05) and treatment regimen ( p ≤.05) both moderated this relationship. Elevated levels of depression, anxiety, and somatization contributed to language deficits and learning and memory impairment (p ≤.01); treatment regimen ( p ≤.01) emerged as a consistent moderator of these relationships. Externalizing behaviors (as measured by the BASC) was one of the most robust scales in showing group differences with respect to neurocognitive performance. This scale significantly contributed to performance on the Executive Functioning (p ≤.01), Language (p ≤.05), and Learning & Memory (p ≤.05) domains. Age at seizure onset and treatment regimen appeared to significantly moderate the relationship between the BASC and the Learning & Memory and Language domains, respectively. Parent-report ratings of behavioral social skills did not significantly contribute to neuropsychological functioning when seizure variables were applied as covariates. This investigation identified several subgroups of children with epilepsy at increased risk for neuropsychological dysfunction. To this end, frequent assessment, psychoeducation, psychotherapy, and/or cognitive remediation may be warranted.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
