Parent-Child Mentalizing in Pediatric Epilepsy

Lunn, Judith Fiona and Lewis, Charles Neville and Gannon, Emily (2019) Parent-Child Mentalizing in Pediatric Epilepsy. Epilepsy and Behavior, 96. pp. 6-12. ISSN 1525-5050

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. Behavioural difficulties are frequent in children with epilepsy, 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 children with epilepsy 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, behavioural and epilepsy-related factors were examined. Results: Patients made greater negative mental states attributions compared to 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 bias in their child’s mental states attributions. Children’s positive response bias correlated with their lower executive function skills. Epilepsy factors predicted cognitive deficits but not biased mentalizing or behavioural problems. Conclusion: Biased mentalizing characterises social cognition in children with epilepsy 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 behavioural difficulties found in children with epilepsy.