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. (November 2020)

• Record Type: Journal Article
• Authors: Silberg, Tamar; Ahoniska-Assa, Jaana; Bord, Ayelet; Levav, Miram; Polack, Orli; Tzadok, Michal; Heimer, Gali; Bar-Yosef, Omer; Geva, Ronny; Ben-Zeev, Bruria
• Is Part Of: Seizure. Volume 82(2020)
• Page Start: 31
• Page End: 38
• Publication Date: 2020-11
• Subjects: Pediatric neurology -- Neuropsychology -- Multiple informants: CBCL -- TRF -- Emotional and behavioral problems; Epilepsy -- Periodicals; Epilepsy -- Periodicals; Seizures -- Periodicals; Épilepsie -- Périodiques; Electronic journals; Electronic journals; 616.853
• DOI: 10.1016/j.seizure.2020.09.002
• Languages: English
• ISSNs: 1059-1311

Abstract

Highlights: High levels of psychosocial problems are reported among children with epilepsy. Teachers report on relatively higher psychosocial symptoms than parents. Cognition plays an important factor in teachers' reports on a child's psychological symptoms. School placement should be considered when examining a child's psychosocial status. A multiple-informant approach is the gold-standard when assessing children with epilepsy. Abstract: Purpose: 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.