PSYCHOSOCIAL AND SEIZURE-RELATED FACTORS AS PREDICTORS OF COGNITIVE FUNCTIONING CHANGES AMONG NEWLY CLINICALLY DIAGNOSED CHILDREN AND ADOLESCENTS WITH SEIZURE DISORDER IN LAGOS, NIGERIA

Abstract

Cognitive decline is a concern among individuals diagnosed with seizure disorder. Duration of the illness before commencing treatment, seizure frequency, and medication are also factors that have been associated with the condition. The nature, characteristics, course, and effects of these factors are of growing interest among newly diagnosed children and adolescents with seizure disorders. These factors can have adverse psychological consequences on this population, thus compromising the capacity to acquire adequate skills for survival and increasing the possibility of ending up as a burden to caregivers. Extant literature focused on seizure disorders among adults; this study, therefore, investigated psychosocial predictors (age, perceived stigmatization, perceived discrimination, and self-esteem) of changes in cognitive function among children and adolescents newly diagnosed with seizure disorder. Cognitive Reserve, Passive models, Functional Working Memory, Self-concept, and Sociometer theories guided the study, while a descriptive survey design was adopted. Sixty children between the ages of five years and sixteen years newly diagnosed with seizure disorder at the Child and Adolescents Mental Health Centre of Federal Neuropsychiatric Hospital were purposively selected. A structured questionnaire comprising Children’s self-concept scale (?=0.73), Weschler Intelligence Scale for Children version 4 (WISC-IV) Verbal (?=0.94), Performance (?=0.90), and Full scale (?=0.96) was administered to the participants. Data were analyzed using ANOVA, Pearson Product Moment Correlation, and Hierarchical regression at p<0.05. The participants’ age was 12.3 years ± 2.3. There was a significant positive relationship between age (r = .38), perceived discrimination (r = .59), and cognitive functioning. Perceived discrimination, self-esteem, and perceived stigmatization significantly predicted cognitive functioning among children and adolescents with seizure disorder. (R²= 0.35, ?R² = 0.32. F = 10.76, df = 3,6). Perceived discrimination (?= .67, t =3.72), age (? = 9.6, t =2.49), self-esteem (?=.02, t= 0.98), and Perceived stigmatization (? = .082. t =2.75) had independent significant contributions to cognitive functioning changes among children and adolescents with seizure disorder. Seizure disorder factors revealed that type of seizure, onset of seizure, and frequency of seizure contributed significantly to the change observed in the prediction of cognitive functioning (R2= 0.41, ?R2 = 0.34, F = 6.52, df =6,57). Perceived stigmatization, Perceived discrimination, and self-esteem were decisive factors that determine cognitive function changes among newly clinically diagnosed children and adolescents with seizure disorder in Lagos. The public should be enlightened about the danger of stigmatization and discrimination of children and adolescents with seizure disorder through psycho-educational programs for parents and caregivers.   Keywords: Cognitive functioning, Perceived discrimination, Self-esteem, Perceived stigmatization, Seizure