Utility of the Adverse Childhood Events (ACE) questionnaire and self-report of childhood stressors for patients with epileptic and functional seizures on an Epilepsy Monitoring Unit
Abstract number :
2.029
Submission category :
11. Behavior/Neuropsychology/Language / 11A. Adult
Year :
2025
Submission ID :
176
Source :
www.aesnet.org
Presentation date :
12/7/2025 12:00:00 AM
Published date :
Authors :
Presenting Author: Carol Schramke, PhD – Allegheny Health Network
Alexa Bennetch, MA – Allegheny Health Network
James Valeriano, MD – Allegheny Health Network
Timothy Quezada, DO – Allegheny Health Network
Navnika Gupta, MD – Allegheny Health Network
LeeAnn Chang, MD – Allegheny Health Network
Kevin Kelly, MD – Allegheny Health Network
Rationale: Adversity during childhood has been found to increase risk of multiple psychiatric and physical health problems, including intractable epilepsy. Data have also shown that adversity during childhood is more common in patients with functional seizures (FS) compared with patients with epileptic seizures (ES). This study compares the results of the Adverse Childhood Events (ACE) questionnaire to patient report of adversity during a standardized psychological evaluation. We hoped to determine how strongly these two types of evaluations for childhood adversity are correlated in our patient population and to test for the relative ability of these measures to predict FS in patients with documented FS and ES during video EEG monitoring (vEEG). These data will be helpful in determining if a standardized questionnaire adds additional useful information when conducting psychological evaluations.
Methods: Data were collected through a retrospective chart review of electronic records of patients seen for a psychological or neuropsychological evaluation at Allegheny General Hospital Epilepsy between January 2023 and October 2024 and who had vEEG monitoring. Data included: age at time of monitoring, gender, race, EEG results, ACE score and description of childhood. Descriptions of childhood were rated as positive (patients used positive adjectives and did not report any significant stressors), neutral (patients used no positive adjectives and reported no significant stressors), mixed (patients used both positive and negative adjectives and reported significant stressors), or negative (patients used no positive adjectives and reported significant stressors). Data were analyzed with descriptive statistics, nonparametric statistics, and regression analyses as appropriate.
Results: 104 patients were identified with complete data available in electronic records following vEEG. Mean age was 38.5 (s.d. =12.1), 60% were female and 91% were white. During video EEG 16% had no events, 19% had FS, 54% had EE, and 11% had both FS and ES. Mean ACE score was 2.5 (s.d.=2.6) for the group as a whole. Ratings of childhood were 46% positive, 13% neutral, 17% mixed and 24% negative. There was a significant association between the ACE and childhood ratings (Kruskal-Wallis H=27.95, p< .001). When comparing only the patients who had FS or ES during monitoring, mean ACE was 3.4 (s.d.=3.1) and 1.8 (s.d.=2.0) respectively. Childhood ratings were 45% positive, 5% neutral, 25% mixed and 24% negative for FS patients and 54% positive, 16% neutral, 13%mixed and 18% negative for EE patients. Regression analysis found ACE score was a significant predictor of PNES (p=.029) and that ratings of childhood descriptions did not add to the model (p=.695).
Conclusions: This study verifies that patient reports of adversity during childhood are common in patients with FS and ES and that ACE scores are strongly correlated with patient report of adversity during psychological evaluations. These data also suggest that adding a standardized rating of adverse events when conducting psychological evaluations provides the most useful information for differentiating ES from FS.
Funding: none
Behavior