Abstracts

Epilepsy, perhaps more than any other chronic illness, has the potential to impact experience across the range of physical, psychological, and social domains of living. Understanding the mechanisms through which epilepsy affects psychosocial function, and the processes that people employ to adapt to this impact are a critical focus of epilepsy research toward effective clinical intervention. This research evaluates the disability centrality model, a multi-dimensional quality of life-based model of psychosocial impact and adaptation among persons with epilepsy., This research employed a web-based survey methodology to test the assumptions of the disability centrality model. Adults were recruited through Epilepsy Foundation affiliates in the Southeast United States. A total of 42 adults with epilepsy completed a questionnaire that included the Disability Centrality Scale, which assesses the respondents[apos] level of satisfaction, epilepsy-related impact, perceived control, and the level of importance ascribed to each of ten empirically derived quality of life domains. Additionally, demographic information, duration since diagnosis, and two well-established measures of quality of life and psychosocial adaptation were employed. Hypothesized relationships among these variables, based on the model, were assessed in a series of multiple regression analyses., A number of elements of the proposed model were supported. Domain control and satisfaction mediated the relationship between perceived impact and overall QOL, and psychosocial adaptation. Domain importance moderated the relationship between epilepsy-impact and adaptation. The relationships between QOL, adaptation, and duration and demographic variables were also explored., The results of this preliminary investigation are consistent with larger scale investigations among persons with multiple sclerosis and other chronic conditions, and support the proposed model. There are a number of important clinical and research implications. The results suggest that the psychosocial impact of epilepsy is experienced multidimensionally, across a range of life domains. Perceived domain control over the impact of epilepsy acts as an important mediator in the relationship between the experiences associated with epilepsy and one[apos]s overall QOL. In addition, the individual[apos]s perception of the personal importance of the domains moderates the impact of epilepsy. The results suggest two important venues for clinical intervention in enhancing quality of life among individuals with epilepsy: interventions aimed at enhancing perceived control, such as self-management and patient education, as well as those that expand the individual[apos]s means of attaining satisfaction.,