The impact of epilepsy on the psychosocial functioning of young people

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 > .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.