Seth A Margolis1, Luba Nakhutina2, Sarah G Schaffer3, Arthur C Grant2, Jeffrey S Gonzalez4. 1. Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 222 Richmond St., Providence, RI 02903, USA; Rhode Island Hospital, 593 Eddy St., Providence, RI 02903, USA; Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Ave., Bronx, NY 10461, USA. Electronic address: seth_margolis@Brown.edu. 2. State University of New York (SUNY) Downstate Medical Center, 450 Clarkson Ave., Brooklyn, NY 11203, USA. 3. Northwell Health, Cushing Neuroscience Institute, 611 Northern Blvd., Great Neck, NY 11021, USA. 4. Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Ave., Bronx, NY 10461, USA; Albert Einstein College of Medicine, Yeshiva University, 1300 Morris Park Ave., Bronx, NY 10461, USA.
Abstract
INTRODUCTION: Perceived epilepsy stigma and reduced social well-being are prevalent sources of distress in people with epilepsy (PWE). Yet, research on patient-level correlates of these difficulties is lacking, especially among underserved groups. MATERIALS AND METHODS: Racially/ethnically diverse adults with intractable seizures (N=60, 62% female; 79% Black, 20% Hispanic/Latino, 8% White) completed validated measures of personality (NEO Five Factor Inventory, NEO-FFI-3), perceived epilepsy stigma (Epilepsy Stigma Scale, ESS), and quality of life (Quality of Life Inventory in Epilepsy, QOLIE-89). Controlling for covariates, ordinary least-squares (OLS) regression evaluated the total, direct, and indirect effects of NEO-FFI-3 neuroticism and extraversion scores on epilepsy-related social well-being (i.e., combination of QOLIE-89 social isolation and work/driving/social function subscales, α=0.87), mediated through perceived stigma. RESULTS: In separate models, higher levels of neuroticism (N) and lower levels of extraversion (E) were significantly and independently associated with greater perceived stigma (N path a=0.71, p=0.005; E path a=-1.10, p<0.005). Stigma, in turn, was significantly and independently associated with poorer social well-being (N path b=0.23, p<0.001; E path b=-0.23, p<0.001). Bias-corrected bootstrap confidence intervals (CIs) showed that neuroticism and extraversion were indirectly associated with social well-being through their respective associations with perceived stigma (N path ab=-0.16, 95% CIs [-0.347, -0.044]; E path ab=0.25, 95% CIs [0.076, 0.493]). CONCLUSION: Higher neuroticism and lower extraversion covaried with stigma beliefs, and these may be markers of poor social outcomes in PWE. Mediation models suggest that targeting epilepsy stigma beliefs may be a particularly useful component to incorporate when developing interventions aimed at promoting social well-being in diverse PWE.
INTRODUCTION: Perceived epilepsy stigma and reduced social well-being are prevalent sources of distress in people with epilepsy (PWE). Yet, research on patient-level correlates of these difficulties is lacking, especially among underserved groups. MATERIALS AND METHODS: Racially/ethnically diverse adults with intractable seizures (N=60, 62% female; 79% Black, 20% Hispanic/Latino, 8% White) completed validated measures of personality (NEO Five Factor Inventory, NEO-FFI-3), perceived epilepsy stigma (Epilepsy Stigma Scale, ESS), and quality of life (Quality of Life Inventory in Epilepsy, QOLIE-89). Controlling for covariates, ordinary least-squares (OLS) regression evaluated the total, direct, and indirect effects of NEO-FFI-3 neuroticism and extraversion scores on epilepsy-related social well-being (i.e., combination of QOLIE-89 social isolation and work/driving/social function subscales, α=0.87), mediated through perceived stigma. RESULTS: In separate models, higher levels of neuroticism (N) and lower levels of extraversion (E) were significantly and independently associated with greater perceived stigma (N path a=0.71, p=0.005; E path a=-1.10, p<0.005). Stigma, in turn, was significantly and independently associated with poorer social well-being (N path b=0.23, p<0.001; E path b=-0.23, p<0.001). Bias-corrected bootstrap confidence intervals (CIs) showed that neuroticism and extraversion were indirectly associated with social well-being through their respective associations with perceived stigma (N path ab=-0.16, 95% CIs [-0.347, -0.044]; E path ab=0.25, 95% CIs [0.076, 0.493]). CONCLUSION: Higher neuroticism and lower extraversion covaried with stigma beliefs, and these may be markers of poor social outcomes in PWE. Mediation models suggest that targeting epilepsy stigma beliefs may be a particularly useful component to incorporate when developing interventions aimed at promoting social well-being in diverse PWE.
Authors: Charlene N Rivera Bonet; Bruce Hermann; Cole J Cook; Gyujoon Hwang; Kevin Dabbs; Veena Nair; Courtney Forseth; Jedidiah Mathis; Linda Allen; Dace N Almane; Karina Arkush; Rasmus Birn; Lisa L Conant; Edgar A DeYoe; Elizabeth Felton; Colin J Humphries; Peter Kraegel; Rama Maganti; Andrew Nencka; Onyekachi Nwoke; Manoj Raghavan; Megan Rozman; Umang Shah; Veronica N Sosa; Aaron F Struck; Neelima Tellapragada; Candida Ustine; B Douglas Ward; Vivek Prabhakaran; Jeffrey R Binder; Mary E Meyerand Journal: Epilepsy Behav Date: 2019-08-03 Impact factor: 2.937
Authors: Charlene N Rivera Bonet; Gyujoon Hwang; Bruce Hermann; Aaron F Struck; Cole J Cook; Veena A Nair; Jedidiah Mathis; Linda Allen; Dace N Almane; Karina Arkush; Rasmus Birn; Lisa L Conant; Edgar A DeYoe; Elizabeth Felton; Rama Maganti; Andrew Nencka; Manoj Raghavan; Umang Shah; Veronica N Sosa; Candida Ustine; Vivek Prabhakaran; Jeffrey R Binder; Mary E Meyerand Journal: Epilepsy Behav Date: 2020-06-14 Impact factor: 2.937