Correlation between perceived stigma and EEG paroxysmal abnormality in childhood epilepsy

The effect of parental regulatory focus on the loneliness stigma of college children

BACKGROUND

The present study aimed to examine the relationship between regulatory focus and loneliness stigma, as well as the intergenerational transmission of the two. Specifically, the study analyzed the effects of fathers' and mothers' regulatory focus on their own and their spouses' stigma of loneliness. In addition, a mediation model was constructed to explore how parents' regulatory focus influences their children's stigma of loneliness and the potential mediating mechanisms involved.

METHODS

Questionnaires were distributed to 470 college students and their parents, employing the Regulatory Focus Questionnaire (RFQ) and the Stigma of Loneliness Scale (SLS) to collect data.

RESULTS

The analysis of intergenerational transmission effects revealed that parents' regulatory focus and loneliness stigma significantly and positively predicted children's regulatory focus and loneliness stigma, respectively. The Actor-Partner Interdependence Model (APIM) elucidated that both fathers' and mothers' promotion focus exerted significant influence on both actor and partner's loneliness stigma. Furthermore, the mediation model analysis indicated that parents' loneliness stigma, along with children's regulatory focus operate as mediators in the influence of parental regulatory focus on loneliness stigma of their college-aged offspring.

CONCLUSIONS

From a familial context, this study, investigated the association between regulatory focus and loneliness stigma, along with the mediating roles within parent-child groups and couples. The findings enhanced our comprehension of the interrelation between regulatory focus and loneliness stigma, underpinned by empirical evidence.

Therapeutic Strategies in Children with Epilepsy: A Quality-of-Life-Related Perspective

Back ground: Children with epilepsy are affected by several factors, including clinical and social variables. Among these variables, cognitive decline and behavioral disturbances, perceptions of stigma, and fatigue can lead to reductions in quality of life (QOL). Epileptic activities, including seizure severity, frequent seizures, and status epilepticus (SE), have been identified as important predictors of QOL. In addition, the frequency of interictal epileptiform discharges (IEDs) on electroencephalogram (EEG) may also be an important predictor of QOL, because IEDs can lead to cognitive decline and behavioral disturbances. Moreover, frequent seizures and/or IEDs may play a role in emotional mediators, such as stigma and fatigue, in childhood epilepsy. Seizure severity and/or IEDs are, therefore, important QOL-related factors in childhood epilepsy. Seizure severity as a QOL-related factor: Frontal lobe dysfunctions, such as cognitive decline and behavioral disturbances, can result in reduced QOL for both the child and their family. Frontal and prefrontal lobe growth disturbances can be present during active-phase epilepsy in some children with neuropsychological impairments. Recovery from prefrontal lobe growth disturbances may depend on the active seizure period. Children with a shorter active seizure period can recover from disturbances in prefrontal lobe growth more rapidly. In contrast, recovery may be delayed in children with a longer active seizure period. Moreover, frequent seizures can lead to seizure-associated headaches, perceptions of self-stigma and parental stigma, and fatigue. Accordingly, severe seizures can lead to neuropsychological impairments in association with prefrontal lobe growth disturbances in children with epilepsy. EEG abnormalities as QOL-related factors: IEDs on EEG, representing persistent pathological neuronal discharges, may be associated with several pathological aspects. Frontal IEDs can be a risk factor for recurrent seizures, cognitive decline, and behavioral disturbances, and they may also play a role as emotional mediators similar to stigma. In addition, behavioral disturbances may result in the presence of secondary bilateral synchrony (SBS) on EEG. Behavioral disturbances can be improved in association with a reduction in IEDs in children with frontal IEDs and SBS. Therefore, EEG abnormalities, such as frontal IEDs and SBS, can also lead to neuropsychological impairments in children with epilepsy. Therapeutic strategies in children with epilepsy: Seizure severity and IEDs on EEG may be associated with neuropsychological impairments, leading to QOL reduction. Therapeutic management may be desirable to reduce seizures and EEG abnormalities, such as frontal IEDs and SBS, as early as possible to improve QOL in children with epilepsy. During antiseizure medication (ASM) selection and adjustment, physicians should strategize the therapeutic approach to controlling seizures and suppressing EEG abnormalities in children with epilepsy. Among various ASMs, novel ASMs, such as levetiracetam and perampanel, may suppress both clinical seizures and IEDs on EEG; thus, these novel ASMs may represent an important addition to the treatments available for epileptic children presenting with frontal IEDs and SBS.

Systematic review of frequency of felt and enacted stigma in epilepsy and determining factors and attitudes toward persons living with epilepsy-Report from the International League Against Epilepsy Task Force on Stigma in Epilepsy

OBJECTIVE

To review the evidence of felt and enacted stigma and attitudes toward persons living with epilepsy, and their determining factors.

METHODS

Thirteen databases were searched (1985-2019). Abstracts were reviewed in duplicate and data were independently extracted using a standardized form. Studies were characterized using descriptive analysis by whether they addressed "felt" or "enacted" stigma and "attitudes" toward persons living with epilepsy.

RESULTS

Of 4234 abstracts, 132 met eligibility criteria and addressed either felt or enacted stigma and 210 attitudes toward epilepsy. Stigma frequency ranged broadly between regions. Factors associated with enacted stigma included low level of knowledge about epilepsy, lower educational level, lower socioeconomic status, rural areas living, and religious grouping. Negative stereotypes were often internalized by persons with epilepsy, who saw themselves as having an "undesirable difference" and so anticipated being treated differently. Felt stigma was associated with increased risk of psychological difficulties and impaired quality of life. Felt stigma was linked to higher seizure frequency, recency of seizures, younger age at epilepsy onset or longer duration, lower educational level, poorer knowledge about epilepsy, and younger age. An important finding was the potential contribution of epilepsy terminology to the production of stigma. Negative attitudes toward those with epilepsy were described in 100% of included studies, and originated in any population group (students, teachers, healthcare professionals, general public, and those living with epilepsy). Better attitudes were generally noted in those of younger age or higher educational status.

SIGNIFICANCE

Whatever the specific beliefs about epilepsy, implications for felt and enacted stigma show considerable commonality worldwide. Although some studies show improvement in attitudes toward those living with epilepsy over time, much work remains to be done to improve attitudes and understand the true occurrence of discrimination against persons with epilepsy.

Public awareness and experiences associated with epilepsy in Japan, 2013-2017

BACKGROUND

Public attitudes and stigma toward epilepsy may limit people with epilepsy (PWE) in seeking treatment and participating in social activities. The prevalence of epilepsy is approximately 0.8% in Japan, similar to rates reported in other countries. Although epilepsy is relatively common, few studies have investigated public awareness about epilepsy in Japan. Recently, several serious car accidents in Japan involving PWE resulted in pedestrian fatalities. Traffic accidents involving PWE have been reported extensively and repeatedly in the media since 2011. In 2013 and 2017, our research group conducted a large investigation of awareness about epilepsy targeting the general public. Previous studies have reported that knowledge is one of the factors involved in improving attitudes and reducing stigma. The aim of the current study was to compare survey results, especially regarding knowledge of epilepsy, and capture changes in public awareness between 2013 and 2017.

METHODS

A total of 2160 people (1080 in each year) participated, with a total of 540 women in each year, aged 20-79 years. Participants lived in the greater Tokyo area as well as the Tohoku and Kansai regions of Japan. All participants answered survey questions online in January 2013 and April 2017. We analyzed five questions regarding the participants' demographic data, nine questions regarding knowledge about epilepsy, and five questions regarding experiences with epilepsy. For questions investigating the respondents' knowledge about epilepsy, we counted only the correct answers and scored these for each respondent.

RESULTS

Knowledge scores decreased from 2013 to 2017, demonstrated by statistical analysis. However, the effect size was very small. Knowledge scores among the following groups were higher in both 2013 and 2017: people who had read or heard about epilepsy, those who had witnessed people having an epileptic seizure, people who had acquaintances who were PWE, those who had PWE in their family, and people who had studied medicine or worked in a medical profession.

CONCLUSION

We revealed that participants who had some experience with epilepsy had higher knowledge levels in both 2013 and 2017. This suggests that such experiences could be important for motivating people to seek appropriate and accurate knowledge about epilepsy, and could result in a reduction of stigma. Greater awareness is needed among the general public in Japan about various aspects of epilepsy.

Longitudinal investigation into implicit stigma of epilepsy among Japanese medical students before and after mass media coverage of car accidents associated with people with epilepsy

OBJECTIVE

Public attitudes and stigma toward epilepsy may limit patient motivation for treatment and participation in social activities. Stigma research requiring individuals to report personal beliefs is useful but is subject to social desirability bias. Self-reporting methods often do not capture implicit attitudes; therefore, in this study, implicit stigma was measured using the implicit association test (IAT), which is a word sorting task to minimize this bias. Recently, in Japan, several serious car accidents caused by people with epilepsy (PWE) resulted in pedestrian fatalities. Traffic accidents involving PWE have been reported extensively and repeatedly in the media since 2011. The present study aimed to examine differences in implicit stigma toward epilepsy among medical students in 2010, 2013, and 2016.

METHODS

We recruited 41 medical students in 2010, 44 medical students in 2013 and 42 medical students in 2016. We investigated the strength of conceptual associations between the words "Epilepsy" or "Hypertension", and "Safety" or "Danger" in the IAT.

RESULTS

The association between the words "Epilepsy" and "Danger" was stronger in 2013 compared with that in 2010; however, the association was weaker in 2016 compared with that in 2013. There was no significant difference between 2010 and 2016.

CONCLUSION

The change in IAT results between 2010 and 2013 might be due to the traffic accident involving PWE in Japan. However, the result in 2016 might indicate that the implicit attitudes toward epilepsy were improved to the same level as those in 2010.