Parent–child mentalizing in pediatric epilepsy

Judith Lunn,Charlie Lewis,Emily Gannon

doi:10.1016/j.yebeh.2019.03.052

Judith Lunn, Charlie Lewis + Show 1 more

Open Access

https://doi.org/10.1016/j.yebeh.2019.03.052

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Abstract

BackgroundChild 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. MethodsThis 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. ResultsPatients 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. ConclusionBiased 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.

Highlights

Mentalizing is the ability to recognize and think about the cause of one's own or another's thoughts, feelings, and intentions [1]
The repeated measures generalized linear model (GLM) on the response patterns demonstrated a significant main effect of response type F (1.73, 183.7) = 97.90, p = b 0.001, η2p = 0.48 that was qualified by a significant group × response type interaction F (1.73, 183.7) = 22.04, p = b 0.001, η2p = 0.17
The multivariate analyses in the control group found that a higher language age significantly predicted a reduced number of negative attributions F (1, 71) = 6.63, p = 0.01, η2p = 0.09 and, an increase in number of rational attributions F (1, 71) = 9.05, p = b 0.01, η2p = 0.11

Summary

Introduction

Mentalizing is the ability to recognize and think about the cause of one's own or another's thoughts, feelings, and intentions [1]. Psychiatric disorders, and behavioral problems are frequently observed in children with epilepsy (CWE) and are known determinants of adverse social outcomes in adulthood [3]. Show lower-order attentional biases toward social stimuli — an attribute that predicts psychiatric problems. 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. 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. 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

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