Both medical and psychological factors have an important impact upon the psychosocial functioning of young people with epilepsy. The key purpose of this thesis was to identify factors that significantly distinguish young people with epilepsy who function well from those who do not. A total of 114 young people (40 males, 74 females) with active epilepsy and a mean age of 17.92 years (SD = 3.90) participated. They completed either a paper (60.5%) or an Internet based survey (39.5%) that comprised demographic, medical and psychosocial measures. These included the Family Assessment Device, Adolescent Coping Scale, Orientation of Life Scale, Hospital and Anxiety Scale, Quality of Life in Epilepsy for Adolescents Scale and Seizure Concerns Scale. Good and poor psychosocial functioning groups were identified via latent class cluster analysis using anxiety, depression, concerns about epilepsy and health-related quality of life scores. To predict membership of the poor psychosocial functioning group, independent variables were entered into a hierarchical logistical regression. The final model was a good fit with the data (Hosmer-Lemeshow test: χ(8) =5.24, p %gt; .05), explaining 66 per cent of the variance and correctly predicting 84.1 per cent of the cases. Young people were more likely to be members of the poor psychosocial functioning group if they had a seizure in the last month (Wald = 5.63, p %lt; .05), came from families with lower levels of functioning (Wald = 5.28, p %lt; .05) and made greater use of non-productive coping strategies such as wishful thinking, withdrawal and worry (Wald = 12.00, p %lt; .01). The significant contribution of comorbid conditions was reduced when the family functioning variable was added to the model, suggesting that young people with multiple chronic illnesses may have lower psychosocial functioning because of ineffective communication and unsuccessful problem solving within their families. Similarly, when the non-productive coping strategy variable was added to the model, the previous significant contribution of sense of coherence was reduced, indicating that a lower sense of coherence may be a function of the greater use of nonproductive coping strategies. The findings suggest that in addition to medical treatment, clinicians can promote better outcomes for young people with epilepsy by encouraging them to decrease their use of non-productive coping strategies and increase the levels of communication and problem solving within their families. The thesis concludes with a review of the methodological limitations of the study and possible future research directions, including suggestions regarding potential interventions that may assist the psychosocial functioning of young people with epilepsy.

Thesis (M.D.)--University of Hong Kong, 2002. / Includes bibliographical references (leaves 185-230).

Thesis (M.D.)--University of Hong Kong, 2002. / Includes bibliographical references (leaves 185-230) Also available in print.

No description available.

published_or_final_version / Medicine / Master / Doctor of Medicine

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Thesis (Ph. D.)--Georgia State University, 2009. / Title from file title page. Tricia Z. King, committee chair; Robin Morris, Christopher Henrich, Thomas G. Burns, committee members. Description based on contents viewed Sept. 2, 2009. Includes bibliographical references (P. 121-134).

The occurrence of spikes during an electroencephalogram is a basic feature of Benign Epilepsy of Childhood (BREC). In this thesis we analyze several problems related to the structure of such spikes. The currently used mathematical model describing the spike assumes that all the inter-spike variations are due to background activity. We show that non-negligible additional variability is present during the spike and propose a slightly richer model which takes such variability into account. In particular we conclude that background noise may not be used to assess the precision of the estimates of the signal. The technique of spike averaging is presently used to obtain more precise estimates of the signal. By comparing averaging with trimmed mean, median and the "lowess" smoother, we find no discrepancies indicating the presence of skewness or long tails in the underlying distribution of the data and conclude that spike averaging is an adequate method for estimating the deterministic part of the spike. Next, three automated procedures for the detection of the peak of the spike are compared to the existing method, which is based on a visual analysis of the EEG tracing. None of the alternative methods is found to be superior, but the methodology developed for this problem is rather general and could be applied to other similar comparisons. Finally we address the question of whether "atypical" BREC patients, who are characterized by having other neurological abnormalities besides seizures, have a spike structure different from that of the "typical" patients. The non parametric method of "classification trees" is discussed and then applied to find whether certain features of the spike can discriminate between typical and atypical patients. The location and amplitude of the spike are found to provide a satisfactory classification rule, suggesting that the two groups may be affected by different types of epilepsy. We have used, throughout the thesis, simple methods which do not require strong assumptions. In particular we have tried to avoid assumptions of normality and linearity and to rely mostly on non parametric methods. / Science, Faculty of / Statistics, Department of / Graduate

The main aim of the current study was to examine risk and protective factors associated with the development ofpsychological problems in children with epilepsy. The study aimed to answer the broader question of "Why do some children with epilepsy develop psychological problems while others do not?" A number of risk and protective factors were investigated in children with epilepsy between the ages of 8 - 13 years of age. Three main sets of variables were investigated to determine their association with risk ofpsychological problems in children with epilepsy: 1) family variables ie. family adaptability, family cohesion and family coping 2) illness variables ie. type of seizures, seizure frequency, type of medication, length oftime of diagnosis and 3) demographic variables (including child variables) ie. socio-economic status, number of siblings, age and gender ofthe child with epilepsy. 45 mothers were interviewed and required to complete questionnaires that provided information related to their child's illness, family functioning and demographic factors. In addition, mothers were requested to provide further information related to behavioural and emotional problems that were experiencing with their epileptic child. Broadly the study concluded that a number of risk factors were found to be associated with the development of psychological problems in children with epilepsy. Specifically grandmaI seizures were associated with an increased risk of disorder when compared to petit mal seizures. Higher levels of family adaptability and cohesion were associated with a decreased risk of disorder, and children from families classified as functioning at balanced levels were additionally associated with a lower risk of disorder. Family coping in contrast did not appear to be associated with risk of disorder. The use of poly-medication by children with epilepsy also increased the risk of disorder when compared to those children who used only one type of medication. Children from families falling within the classification of low socioeconomic status were also at an increased risk of disorder as well as those children with epilepsy who came from families where they had a larger number of siblings. The study additionally developed a model of risk and protective factors using logistic regression. It was found that there was a "good fit" of the combined illness variables (type of epilepsy, type of medication), family variables (family type) and demographic variables (SES) with the predicted dependent variable 'risk of disorder'. These results suggest that disease, demographic, family and contextual factors all interacted and overlapped to some extent in predicting the psychological adjustment of epileptic children in the current study. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 1999.

Thesis (Ph.D)--Boston University. / The purpose of this study was to investigate repressive handling of conflicts around hostility in epileptic children. There has been a considerable amount of evidence, from clinical material, of severe conflicts around hostility in epileptics. It has been further indicated that epileptics utilize repressive methods of handling the conflicts and that they appear to be in a pent-up state emotionally. It has been demonstrated, from previous research, that conflict in a given area, which is handled by repressive methods of defense, will lead to the inhibition of learning of material related to the conflict. The general hypothesis formulated from these considerations was that epileptics would show cognitive inhibition of material with a hostile connotation and would show increased cognitive inhibition when hostility was induced. An epileptic group of twenty-five children and a normal group of thirty-two children, of ages seven-and-a-half to twelve-and-a-half, were selected. They were given the Rorschach Test followed by four word lists, two consisting of neutral words and two of hostile words, presented on a Gerbrand's design memory drum. The method of serial anticipation was used in presenting the lists. Half of each group was criticized before the second pair of lists was presented, in a manner calculated to induce hostility. The operational predictions were as follows: Prediction 1· The epileptics will require more trials than will the normal group in learning the hostile list of words before hostility is induced. Prediction 2. The epileptic and normal groups will require more trials in learning the second list of neutral words after hostility is induced. Prediction 3· The epileptic and normal groups will both require more trials in learning the second list of hostile words after hostility is induced. Prediction 4. The normal group will have equal difficulty in learning the second neutral and hostile lists after hostility is induced. Prediction 5· The epileptic group will require more trials in learning the second list of hostile words than the second list of neutral words after hostility is induced. The results of the experiment supported only the fourth prediction, which was not a central one in the study. Further statistical analyses, which took into account hostile drive strength scores as well as management of hostility and rate of learning, also failed to show group differences in these measures or differential learning of the hostile and neutral material within or between the two experimental groups. Criticism of performance was found to have a significant detrimental effect on the learning of the second hostile list but not on the second neutral list, when the data for all subjects were combined. Thus the clinical finding of repressive handling of conflicts around hostility in epileptics was not experimentally confirmed in children with idiopathic epilepsy. The results of the present study do not disprove the possibility that hostility is involved in the development and precipitation of seizures, but they do indicate t hat children with idiopathic epilepsy do not show significant differences from normal children on measures of hostile drive strength or of the management of hostility. The findings leave open several possibilities for alternative explanation of the relationship between hostility and epilepsy. One among such alternatives is that of a hypothesis which would relate hostility to a more immediate and direct discharge in a seizure than would be involved in the repression hypothesis. [TRUNCATED]