Epilepsy Information

American Epilepsy Society Poster (Abst. 1.083)

Stress coping strategies in patients with epilepsy and how they relate to mood

Authors: Keren Isaacs Lebeau, Lorna Myers, Marcelo Lancman and M. Lancman

Stress has been described as a perceived trigger factor of seizures in persons with epilepsy . As such, examination of how epilepsy patients cope with stressful events has the potential to inform our understanding of the condition and identify potential targets for treatment. Coping describes the manner by which people deal with stress. In prior studies, patients with epilepsy have been observed to employ emotion-focused patterns of coping, as opposed to more problem-focused strategies. Ineffective coping strategies can have a variety of unhealthy consequences, particularly with regard to mental health. While coping styles have been associated with certain demographic, clinical, and psychosocial variables, to our knowledge, no study has examined the relationship between particular coping strategies and psychopathological features. The current study was guided by the theory that less effective coping styles in epilepsy will be associated with higher levels of psychopathology while adaptive coping strategies may have a protective factor in reducing levels of psychopathology.


All consecutive patients with ES who completed our standard epilepsy neuropsychological evaluation between January 2012 and May 2014 were initially included (n=211). Thirteen patients who earned a Full Scale IQ of < 70 (potentially impacting their ability to respond to the questionnaires) were excluded and the final sample size was reduced to 198. Patients had undergone video-EEG monitoring and had a confirmed diagnosis of epilepsy. The mean age of the sample was 38.6 (14.4) and the mean education level was 13.8 (2.34) years. All subjects completed measures of Coping Inventory for Stressful Situations (CISS), State Trait Anger Expression Inventory-2 (STAXI-2), Stait Trait Anxiety Inventory (STAI), and Center for Epidemiological Studies—Depression (CES-D), and as part of a comprehensive neuropsychological battery. The CISS is a coping strategies scale that has three main subscales: Task-Oriented (TO), Emotion-Focused (EF), and Avoidance (AV).

Findings indicate that 85% of patients endorsed using elevated EF coping strategies (T>65) and 77% endorsed underusing TO strategies (T<35). Elevations in AV strategies were endorsed by 87% of the patients. Patients with high scores on EF coping strategies also had significantly high scores on several psychopathology factors including depression, anger, and anxiety. In contrast, those who used the TO strategy tended to have reduced symptoms of state anxiety, anger, and depression.

These findings have substantial implications for the mental health professionals who are part of the epilepsy treatment team as the majority of ES patients were observed to over-utilize maladaptive coping strategies and underutilize adaptive strategies. In addition, the maladaptive strategies tended to be associated with higher degrees of psychopathology. Findings support the relevance of assessing coping strategies in patients with ES and utilizing findings for treatment purposes.