Abstracts

Rationale: Pediatric non-epileptic seizures (NES) are associated with significant medical and psychiatric morbidity, increased health care utilization, and decreased functioning. To examine stress and coping, we hypothesized that, compared to their siblings, youth with NES would report significantly more anxiety sensitivity, somatic symptoms, daily hassles, parental rejection and over-protection, and ineffective coping strategies. Methods: This IRB-approved, multisite study includes 81 children (48 with NES and 33 siblings). Youth with NES were older than their siblings (p=0.01). Groups did not differ by gender or race/ethnicity. See Table 1. Participants completed several self-report scales: Childhood Anxiety Sensitivity Index (CASI) measures the tendency to view anxiety-related bodily sensations as dangerous; Children's Somatization Inventory (CSI) measures the severity of nonspecific somatic symptoms; Children's Hassles Scale (CHS) measures the frequency and impact of daily hassles; Parker Parental Bonding Instrument (PBI) measures care-rejection and parental overprotection-autonomy (each child completed this measure twice; once about each parent); and, Children's Coping Questionnaire (CCQ) measures child coping strategies with 14 subscales, reflecting three factors (monitoring, blunting, and venting). Youth with NES and siblings were compared on the measures using mixed models, with family as a random effect. Two-tailed tests of significance at the 0.05 level were used. Age was used as a covariate. Results: As predicted (Table 2), compared to siblings, youth with NES reported significantly more anxiety sensitivity and somatic symptoms (including more headaches, faintness/dizziness, body weakness, and trouble walking). Youth with NES and siblings reported their most bothersome problem was "schoolwork" (38.3% and 48.5%, respectively) or "family" (38.3% and 39.4%, respectively). Additionally 23.4% of youth with NES and 12.1% of siblings reported their most bothersome problem was "getting along with other kids." To cope with their most bothersome problem, youth with NES were more likely than siblings to report venting (coping via emotional expression, acting out, or worrying) and, specifically via solitary emotional expression (yelling, crying, hitting pillow, etc). Approaching significance, youth with NES reported more negative daily hassles than siblings. No significant differences were detected related to their reports of parental bonding. Within the NES group, no significant differences were found on any of the measures between those with epilepsy (n=35) and those without epilepsy (n=13). Conclusions: Consistent with research on children with other nonspecific somatic symptoms (e.g. chronic pain), youth with NES reported significantly more anxiety sensitivity, somatic symptoms, and ineffective coping. Youth with NES may benefit from development of interventions that teach them to more frequently utilize accommodative coping strategies (e.g., distraction, acceptance, positive thinking, cognitive restructuring), which has been found to be helpful for youth with other somatic symptoms.