Anne Marie Meijer

Family factors and psychopathology in children with epilepsy: A literature review

PURPOSEnFrom a social interactional and ecological framework, studies were reviewed that (1) compared family factors in children with epilepsy with those in children from normative groups, healthy children, children with a chronic illness, or siblings; and (2) examined the relationship between distinct family factors and child psychopathology.nnnRESULTSnCompared with control groups, families with a child with epilepsy generally fare worse on the whole range of family factors, indicating lower parent-child relationship quality, more depression in mothers, and problems with family functioning. Significant associations were apparent between distinct family factors, especially parental psychological control, parental attributions about epilepsy, and family members satisfaction with family relationships, and psychopathology in children with epilepsy.nnnCONCLUSIONnFuture childhood epilepsy research might benefit from the examination of the simultaneous contribution of distinct family factors to child psychopathology, within a broad multifactorial framework that also includes neurological and medication factors.

Chronic sleep reduction, functioning at school and school achievement in preadolescents

This study investigates the relationship between chronic sleep reduction, functioning at school and school achievement of boys and girls. To establish individual consequences of chronic sleep reduction (tiredness, sleepiness, loss of energy and emotional instability) the Chronic Sleep Reduction Questionnaire has been developed. A total of 436 children (210 boys, 214 girls, 2 missing; mean ageu2003=u200311u2003years and 5u2003months) from the seventh and eight grades of 12 elementary schools participated in this study. The inter‐item reliability (Cronbach’s alpha = 0.84) and test–retest reliability (ru2003=u20030.78) of the Chronic Sleep Reduction Questionnaire were satisfactory. The construct validity of the questionnaire as measured by a confirmative factor analysis was acceptable as well (CMIN/DFu2003=u20031.49; CFIu2003=u20030.94; RMSEAu2003=u20030.034). Cronbach’s alpha’s of the scales measuring functioning at school (teacher’s influence, self‐image as pupil, and achievement motivation) were 0.69, 0.86 and 0.79. School achievement was based on self‐reported marks concerning six school subjects. To test the models concerning the relations of chronic sleep reduction, functioning at school, and school achievement, the covariance matrix of these variables were analysed by means of structural equation modelling. To test for differences between boys and girls a multi‐group model is used. The models representing the relations between chronic sleep reduction – school achievement and chronic sleep reduction – functioning at school – school achievement fitted the data quite well. The impact of chronic sleep reduction on school achievement and functioning at school appeared to be different for boys and girls. Based on the results of this study, it may be concluded that chronic sleep reduction may affect school achievement directly and indirectly via functioning at school, with worse school marks as a consequence.

Family Predictors of Psychopathology in Children with Epilepsy

Summary:u2002 Purpose: To examine the contribution of epilepsy‐related factors, proximal (parent–child relationship quality), distal (parental characteristics), and contextual (quality of other family relationships) family factors to psychopathology (both broad‐band and narrow‐band syndromes) in children with epilepsy and normal intelligence.

Eye movement desensitization and reprocessing in an adolescent with epilepsy and mild intellectual disability

Intellectual disability is a comorbid condition in epilepsy. People with epilepsy and intellectual disability are at high risk of developing behavioral problems. Among the many contributors to behavioral problems in people with epilepsy and intellectual disability are those of traumatic experiences. As such, behavioral problems can be seen as a reflection of these traumatic experiences. Among established trauma therapies, eye movement desensitization and reprocessing (EMDR) is an emerging treatment that is effective in adults and also seems to be effective in children. This article is a case report of EMDR in an adolescent with epilepsy and mild intellectual disability, in whom the EMDR childrens protocol was used. The aim was to assess whether clinical trauma status significantly diminished to nonclinical status posttreatment. Change in trauma symptoms was evaluated with the Reliable Change Index (RCI). Results showed a significant decrease in trauma symptoms toward nonclinical status from pretreatment to posttreatment. EMDR consequences for epilepsy and intellectual disability are discussed.

Sleep in children with asthma: results of the PIAMA study

Children with asthma are thought to have impaired sleep quality and quantity. In this study, we investigated which of the many sleep aspects are associated with asthma. Our sample consisted of 2529 children (aged 11 years) who participated in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study. Parents reported about asthma symptoms (wheezing, dyspnoea, prescription of inhaled corticosteroids and asthma diagnosis) and children reported about different aspects of sleep (bedtime, rise time, sleep quality and daytime sleepiness/tiredness). Results were analysed with (logistic) regression analysis. Children with frequent asthma symptoms significantly more often reported that they felt sleepy or tired during the day (34.4% experienced daytime sleepiness/tiredness at least once a week) than children without asthma symptoms (22.2%) and children with infrequent asthma symptoms (21.9%). This association was not confounded by sex, age of the child, parental educational level or smoking inside the house; the effect was also not modified by sex. There were no associations between asthma and bedtime, time spent in bed or sleep quality. Children with frequent asthma symptoms experienced daytime sleepiness/tiredness more often than children with infrequent or no asthma symptoms. Otherwise, children with asthma did not differ much from children without asthma with regard to sleep.

Parenting and restrictions in childhood epilepsy

PURPOSEnFrom the overprotection literature, the predictive and interactional (moderation) effects of controlling and indulgent parenting on restrictions in children with epilepsy were examined.nnnMETHODSnParents of 73 children with epilepsy completed questionnaires on parenting, restrictions, and functional status. Predictive and moderation effects were tested using multiple regression analysis. Moderation was tested with interactive computational methods.nnnRESULTSnRestrictions were significantly (R(2)=.38, FΔ=6.59***, p<.001) predicted from seizure frequency (β=.24*, p<.05), functional status (β=-.42***, p<.001), and interaction between controlling and indulgent parenting (β=.28**, p<.01). Moderation occurred predominantly for high values of control: controlling parents who were not indulgent imposed fewer restrictions. In contrast, controlling parents who were indulgent imposed more restrictions.nnnCONCLUSIONnParents who were controlling and more indulgent imposed more restrictions. Clinicians should ask parents about parenting and restrictions. Future research should examine whether the current studys findings can be replicated.