Abstracts

RATIONALE: This study examines the question of whether or not reporting a history of abuse during childhood is associated with increased psychosocial problems in adulthood as evaluated by the Washington Psychosocial Seizure Inventory (WPSI). The ojective of this paper is to discuss the various impacts of abuse during childhood on psychosocial functioning as an adult in epilpepsy patients.
METHODS: Detailed psychosocial interviews were conducted with 192 patients as a regular part of long-term EEG monitoring on an in-patient epilepsy unit. History of physical, sexual, emotional abuse or no abuse prior to age 18 was obtained. Of the 192 patients examined, 106 reported no abuse, 63 reported abuse in one of the three abuse categories (26 physical, 23 sexual, 14 emotional), and 23 reported abuse in all three categories. Patients[ssquote] WPSI scores for each scale were obtained and the groups were compared to determine significant differences in scores across the groups. Mean eduacation, age, intellignece as well as seizure diagnosis were taken into account as well.
RESULTS: The results showed that there were significant differences on 6 of the 8 WPSI clinical scales between patients who did and who did not report abuse in childhood. Patients with any type of reported abuse history prior to age 18 showed more difficulty in Family Background (p[lt].0001), Emotional Adjustment (p[lt].001), Interpersonal Adjustment (p[lt].01), Adjustment to Seizures (p[lt].001), Medicine and Medical Managment (p[lt].05), and Overall Psychosocial Functioning (p[lt].001) as reported on the WPSI. The statistically significant finding on the Family Background scale is of particular interest because of the large differences between all three groups. This represents an external validation of the WPSI Family Background scale. Furthermore, this scale was able to differentiate between patient groups with no abuse, one area of abuse, and more than one area of abuse. No other WPSI scale was able to make this differentiation statistically. Finally, reported abuse in even one of the three areas (physical, sexual, emotional) was associated with diminshed psychosocial functioning in adulthood with no evidence for differences in psychosocial functioning in adulthood depending on the area of abuse in childhood.
CONCLUSIONS: Patients who reported any type of abuse during childhood in the psychosocial interview by the epilepsy social worker reported increased difficulty with adjustment and functioning in adulthood compared to those without an abuse history. This shows us that among our patients, childhood abuse is having a long-term impact on psychosocial functioning. With the growing poularity of offering comprehensive epilepsy services, this information is useful in creating a successful treatment plan for patients that addresses not only the medical aspects of epilpesy, but also the social and emotional aspects as well.