Self-esteem mediates mental health outcomes in young people with epilepsy
Peter T. Cahill
School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
Search for more papers by this authorMark A. Ferro
School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
Search for more papers by this authorWenonah N. Campbell
School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
Search for more papers by this authorCorresponding Author
Gabriel M. Ronen
CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
Department of Paediatrics (Neurology), McMaster University, Hamilton, ON, Canada
Correspondence
Gabriel M. Ronen, MD, Department of Paediatrics (Neurology), McMaster University, 1200 Main St. West HSC 3A, Hamilton, ON, Canada L8N 3Z5.
Email: [email protected]
Search for more papers by this authorPeter T. Cahill
School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
Search for more papers by this authorMark A. Ferro
School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
Search for more papers by this authorWenonah N. Campbell
School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
Search for more papers by this authorCorresponding Author
Gabriel M. Ronen
CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
Department of Paediatrics (Neurology), McMaster University, Hamilton, ON, Canada
Correspondence
Gabriel M. Ronen, MD, Department of Paediatrics (Neurology), McMaster University, 1200 Main St. West HSC 3A, Hamilton, ON, Canada L8N 3Z5.
Email: [email protected]
Search for more papers by this authorSummary
Objective
To evaluate the extent to which self-esteem mediates the impacts of epilepsy-specific and environmental factors on mental health outcomes in young people with epilepsy.
Methods
A prospective cohort of 480 young people with epilepsy and their families participated in five visits over 28 months. We collected data on clinical seizure burden, cognitive comorbidity, peer and parental support, self-esteem, and self-reported mental health symptoms. We used structural equation modeling to specify and test relationships among these constructs simultaneously. Direct, indirect, and total effects were estimated with confidence intervals constructed through bias-corrected bootstrapping.
Results
Self-esteem mediated the effects of clinical seizure burden ( = 0.23, 95% confidence interval [0.05, 0.42]) and peer support ( = −0.15, 95% CI [−0.28, −0.03]) on mental health. There were no mediating effects of parental support ( = −0.07, 95% CI [−0.14, 0.00]) or cognitive comorbidity ( = −0.01, 95% CI [−0.02, 0.01]) on mental health.
Significance
We found evidence that self-esteem mediates the impact that both clinical seizure burden and peer support have on mental health outcomes, indicating that assessment of and interventions targeting self-esteem may be appropriate for young people with epilepsy. Supporting self-esteem could mitigate negative influences on mental health, whether from resistant epilepsy or low peer support.
CONFLICTS OF INTEREST
None of the authors has any conflict of interest to disclose.
Supporting Information
| Filename | Description |
|---|---|
| epi17006-sup-0001-AppendixS1-S3.pdfPDF document, 214.3 KB | Appendix S1-S3 |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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