Parent-child mentalizing in pediatric epilepsy

Judith Lunn; Charlie Lewis; Emily Gannon

doi:10.1016/j.yebeh.2019.03.052

Parent-child mentalizing in pediatric epilepsy

Epilepsy Behav. 2019 Jul:96:6-12. doi: 10.1016/j.yebeh.2019.03.052. Epub 2019 May 8.

Authors

Judith Lunn¹, Charlie Lewis², Emily Gannon³

Affiliations

¹ Lancaster Medical School, Furness College, Lancaster University, LA1 4YF, United Kingdom of Great Britain and Northern Ireland. Electronic address: j.lunn1@lancaster.ac.uk.
² Psychology Department, Fylde College, Lancaster University, LA1 4YF, United Kingdom of Great Britain and Northern Ireland.
³ Sheffield Health and Social Care NHS Foundation Trust, Sheffield S10 3TH, United Kingdom of Great Britain and Northern Ireland.

PMID: 31075650
DOI: 10.1016/j.yebeh.2019.03.052

Abstract

Background: Child psychopathology involves inappropriate or biased attributions of others' mental states (mentalizing), and parents' assessment of their children's mentalizing significantly predicts the latter's psychosocial outcomes. Behavioral difficulties are frequent in children with epilepsy (CWE) yet biased mentalizing and parental accuracy in understanding their child's mental states reasoning have not been addressed.

Methods: This study compared the performance of 34 CWE aged 9 to 16 years with 67 language age-matched controls on a biased mentalizing task. The task required children to infer on the mental states of peers in stories involving social scenarios. Responses were scored as positive, negative, or rational mentalizing attributions. To measure parental accuracy, a parent version was administered in the patient group that required a parent to identify their child's responses correctly. Relationships with the child's cognitive, behavioral, and epilepsy-related factors were examined.

Results: Patients made greater negative mental states attributions compared with control children. This negative mentalizing bias was accurately identified by parents and was associated with children's behavioral problems. Parental accuracy was reduced for patients with lower cognitive abilities. Parents did not accurately identify an overly positive (OP) bias in their child's mental states attributions. Children's positive response bias correlated with their lower executive function (EF) skills. Epilepsy factors predicted cognitive deficits but not biased mentalizing or behavioral problems.

Conclusion: Biased mentalizing characterizes social cognition in CWE with behavioral problems. Further investigation of the mentalizing biases and parental awareness of children's mental states reasoning is required to fully understand the greater psychosocial and behavioral difficulties found in CWE.

Keywords: Executive function; Internalizing; Language; Mentalizing; Theory of Mind (ToM).

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Epilepsy / diagnosis
Epilepsy / psychology*
Epilepsy / therapy*
Female
Humans
Male
Mentalization* / physiology
Parent-Child Relations*
Parents / psychology*
Social Behavior
Social Perception*