Anxiety in pediatric epilepsy : the role of stigma and illness cognitions

Youth with epilepsy are at an increased risk for developing anxiety when compared to healthy youth (Alwash, Hussein, & Matloub, 2000; Jones et al., 2007; Russ et al., 2012) and when compared to youth with other chronic health conditions (Pinquart & Shen, 2011). Parents have become a significant focus of research examining the environmental risk and protective factors for anxiety in healthy children (Creswell, Murray, & Cooper, 2011; Gregory & Eley, 2007), and this is an area of growing research in youth with epilepsy (Jones & Reilly, 2016; Rodenburg, Meijer, Dekovic, & Aldenkamp, 2006; Schraegle & Titus, 2017a). The following study aimed to examine the medical and psychosocial risk factors for anxiety in youth with epilepsy.

Participants included 121 children and adolescents with epilepsy at a tertiary outpatient clinic in Central Texas who were referred by their neurologists for a neuropsychological evaluation to assist with treatment planning. Parent perceptions of stigma and parent illness cognitions were examined to determine their relationship with parent report of anxiety, seizure-related variables, and parent history of psychopathology.

Using multiple regression, parent perceptions of stigma were a statistically significant predictor of parent reported child anxiety. Additional moderation analysis suggested that there is an interaction between parent perceptions of stigma and seizure severity; at higher levels of seizure severity, higher parent perceptions of stigma were related to higher parent reported features of anxiety. This suggests the potential for parent perceptions of stigma to play an important role in anxiety in pediatric epilepsy, particularly in the context of high seizure severity. Additionally, parent perceptions of stigma, parent illness cognitions, and parent reported child anxiety were all related to parent reported quality of life, suggesting the importance of addressing these psychosocial factors to improve quality of life in youth with epilepsy.