In the eye of the beholder: Using a multiple-informant approach to examine the mediating effect of cognitive functioning on emotional and behavioral problems in children with an active epilepsy

Abstract

Childhood epilepsy is often associated with cognitive impairments and psychosocial problems. However, it is not clear which factors mediate symptom severity and child's resilience. Emotional and behavioral problems have been associated with various home and school environments, suggesting that information collected may vary depending on both context and informant. In this study we examined the mediating effect of child's cognitive functions on the association between child and epilepsy-related factors and psychosocial problems. Additionally, the differences in psychosocial problems reported by various informants (parents, teachers) in different school settings were explored. Methods: Participants were 155 children with epilepsy (50 % girls), age range 5-18 years who completed a brief neuropsychological battery. Parents completed the Child Behavior Checklist (CBCL) and teachers completed the corresponding Teacher's Rating Form (TRF), to assess a child's emotional and behavior problems. Results: The cognitive profile of the sample was within average to low-average range. Parents and teachers both reported high levels of emotional and behavioral problems, and teachers reported relatively higher levels of symptoms. A mediation effect of cognition on the association between child and epilepsy-related factors (i.e., number of antiseizure medications and illness duration) and child's emotional and behavioral problems was evident only for teachers' reports. Conclusions: The results emphasize that the complex interactions between epilepsy, cognition and psychosocial outcomes are perceived differently in diverse contexts by different informants. The incongruities in informants' perceptions regarding the role of cognition in child's psychological state should be acknowledged and incorporated when planning effective educational and rehabilitation interventions for children with epilepsy.

Neurite density of white matter significantly correlates with tuberous sclerosis complex disease severity

“…Cognitive function was evaluated according to indices of visuomotor, executive functions, attention and memory, which were determined by validated neuropsychological tests. Teacher's and parent's report were also considered ( Silberg et al, 2020 ).…”

Felbamate for pediatric epilepsy—should we keep on using it as the last resort?

“…(2)(3)(4)(5)(6). Intractable epilepsy may have severe consequences, from psychosocial disabilities and educational underachievement which may impair quality of life, to mortality (7)(8)(9). A dozen newer ASMs have been introduced in recent years, but therapeutic response rates were not dramatically modified (3).…”

“…However, only 58–80% of epilepsy patients become seizure free with either the first- or second-line ASMs, and the others may be defined as having a “drug-resistant” epilepsy ( 2 – 6 ). Intractable epilepsy may have severe consequences, from psychosocial disabilities and educational underachievement which may impair quality of life, to mortality ( 7 – 9 ).…”