Abstracts

Depression is a major comorbidity of epilepsy that contributes to unemployment, underemployment, medical expenses, and reduced self-reported quality of life (Bishop et al., 2002). The etiology of depression remains controversial and rarely have causal modeling techniques been used in this literature. The purpose of this study is to test the applicability of Lewinsohn et al.[apos]s (1985) integrative model of depression to epilepsy. This model views depression as the end result of environmentally initiated changes in behavior, affect, and cognition as the primary triggers to episodes of depression., 100 individuals with temporal lobe epilepsy underwent structured interviews to obtain sociodemographic and epilepsy related information, and completed self-report measures of related handicap (Subjective Handicap of Epilepsy scale), Quality of Life (Quality of Life in Epilepsy-89), and depression (Beck Depression Inventory). Path analysis was used to (a) evaluate the general compatibility (i.e., goodness of fit) of the model with the data, and (b) examine relationships between epilepsy related variables, disruptions in daily activities, self-perception, stress, social support, employment status, and depression among individuals with epilepsy., In path analysis, acceptable fit is indicated by a nonsignificant chi-square value (i.e., p[gt].05; Bollen, 1989), and by comparative fit index (CFI) and normed fit index (NFI) values great than .90 (Tabachnik [amp] Fidell, 2001). The model tested revealed a non-significant chi-square, [italic][chi]²[/italic](16, N=100) = 19.398, P[gt].05, suggesting a good-fit. CFI and NFI were .98 and .90, respectively, both of which are greater than the cutoff of .90. The root mean square error of approximation (REMSA) was .46, which represents [ldquo]a close fit[rdquo] recommended by Quintana and Maxwell (1999)., Overall, the findings provide preliminary support for the applicability of the integrative model of depression proposed by Lewinson et al (1985) to epilepsy. The three main fit indices indicated that the model fits the data well, suggesting that epilepsy related negative events, self-perception of epilepsy, and stress play an important role in triggering depression. In contrast, employment and especially social support are found to provide buffering effects for depression. The strength of the model is the utilization of a more adequate and comprehensive representation of vulnerabilities as well as immunities that have been shown in the literature to be relevant to the process of depression in the general and epilepsy literatures., (Supported by NIH NS R01-44351, F32 MH649882, MO1 RR03186 (GCRC), and Epilepsy Foundation J.W.G. Memorial Fellowship.)