Negative Emotions in Children with Newly Diagnosed Epilepsy

Abstract

Summary:Purpose: To understand the emotional predicament in children with recently diagnosed idiopathic or cryptogenic epilepsy.Methods: We used the well-tried method of structured projection for the first time in children with epilepsy. Thirty-six children with epilepsy, aged 7-15 years (mean age, 9.5 years) and in 35 control children aged 7-15 years (mean age, 9.4 years), attributed shame and guilt in relation to three types of situation (non-illness related, illness related, and epilepsy related). Children were evaluated twice: shortly after diagnosis, before antiepileptic drug (AED) use and after an interval of 3 months.Results: Children with epilepsy and healthy controls were similar in their way of attributing shame and guilt. However, the type of situation was of influence: Both children with epilepsy and healthy children attributed more shame to incompetence due to epilepsy than to incompetence due to other illnesses.Conclusions: Increased affective problems in childhood epilepsy cannot be explained by excessive attribution of shame and guilt, affects known to be important precursors of psychopathology, yet both healthy children and children with epilepsy attribute more shame to epilepsy than to other illnesses. Epilepsy is not like any other disease. Key Words: EpilepsyChildren-Shame-Guilt-Ps ychopathology .In epilepsy, affective problems abound (1-4). More than 25% of children with normal intelligence and relatively benign epilepsy have signs of depression, but these are apparently not always recognized by carers (5). We have attempted to understand the affective predicament of children with epilepsy by concentrating on the affects of shame and guilt. Both are negative but normal adaptive affects (6). The question addressed by this study is whether children with recently diagnosed epilepsy differ from healthy matched control children in their attributions of shame and guilt. Currently it is reasoned that psychopathology develops from intrinsically normal affective reactions. Recurring affects induce a proneness to react to these affects (7). Proneness distorts cognition, biases action and perception, and thus leads to maladaptiveness. Maladaptiveness in turn leads to affective distress (8). The relevance of the affects of shame and guilt for later psychopathology has been noted since Freud (cited in 6). In children, proneness to shame and/or

Behavioral Problems in Children with Newly Diagnosed Idiopathic or Cryptogenic Epilepsy Attending Normal Schools Are in Majority Not Persistent

“…Moreover, children with "epilepsy only" felt less socially accepted at school than their healthy classmates. This finding is in concordance with our earlier work (28). Using the method of structured projection, we showed that epilepsy-related situations are experienced as more shame provoking than are situations caused by other illnesses.…”

Factors Associated with Academic Achievement in Children with Controlled Epilepsy

“…Children who demonstrate both decreases in school self-concept and highseverity epilepsy have been found to be at most risk for educational problems over time (12). Lower selfesteem may result from the significant stigma that continues to be attached to epilepsy as both children with epilepsy and controls have been found to attribute more shame and guilt to incompetence due to epilepsy than to incompetence due to other illnesses (14).…”

Health‐related Quality of Life and Self‐perceived Competence of Children Assessed before and up to Two Years after Epilepsy Surgery

“…Medically intractable epilepsy has repercussions that by far transgress the medical domain. Because of their unpredictability and their behavioral manifestations, seizures signify a loss of control that, if recurring in children, may foster a feeling of uncertainty (3,4). Feelings of not being in control of one's life are likely to be reinforced both by the necessity of antiepileptic drug (AED) use to prevent seizures and by the restrictions in activities of daily life that are imposed on children who are unaware of their seizures and, hence, of the cause of the restrictions.…”