Executive Functioning and Social Competence as Predictors of Resilience in Emotional Functioning in Youth Diagnosed with Epilepsy

Abstract

Given the prevalence of mental health problems within the pediatric epilepsy population, and the negative impact of stigma, this study aimed to investigate resiliency in this at-risk population. The current study proposed that social competence and executive functioning would help alleviate emotional symptoms of Internalizing and Externalizing problems in a sample of youth diagnosed with epilepsy. Youth (ages 9 through 16, with a primary diagnosis of epilepsy) and their caregivers were recruited through a major New York hospital epilepsy center to participate. They completed the Wechsler Abbreviated Scale of Intelligence, 2^nd Edition (Wechsler, 2011), Tower of London-Drexel, 2 ^nd Edition (Culbertson & Zillmer, 2000), and Child Stigma Scale (Austin et al., 2004). Caregivers completed a demographics questionnaire, Behavior Rating Inventory of Executive Functions (Gioia, Isquith, Guy, & Kenworthy, 2000), Child Behavior Check List (Achenbach, 1978), and Social Responsiveness Scale (Constantino & Gruber, 2003). The current study demonstrated a significant positive relationship between perceived stigmatization and both internalizing and externalizing problems. The current study also found that children and adolescents, regardless of seizure frequency, experience mental health problems. Seizure frequency was unrelated to perceived stigmatization and both internalizing and externalizing problems. There were significant interaction effects on externalizing problems such that social competence and executive functioning played moderating roles in the relationship between perceived stigmatization and externalizing problems. Furthermore, low executive functioning and low social competence were risk factors for those who perceive stigmatization and experience externalizing problems. Limitations include a lack of heterogeneity in the sample selected, and the use of parent report and self-report questionnaires, which may have affected reporting of symptoms and perceived stigmatization. Future research should address additional sources of resiliency in the pediatric epilepsy population.