Tuesday, October 20, 2009

Study Addresses Stress in Families of Children with Seizures

There is little research exploring the impact of having a sibling with epilepsy. Mims (1997) explored sibling concerns about epilepsy between two groups of children: siblings of children with frequent seizures (n=10) and siblings of children with infrequent seizures (n=10). The author also compared family stress among families of children with frequent seizures, families of children with infrequent seizures, and families of children with no chronic illness (n=11). Case subjects included children, between the ages of 8 to 12 years, with siblings who have had epilepsy for at least three years and were being treated through The Minnesota Epilepsy Group outpatient clinic. Control subjects were recruited from a neighborhood public school. An additional three control subjects were recruited after suggestion of enrolled subject families. Case siblings were matched to control siblings based on age, gender, and birth order. The dependent variables of self-esteem and behavior of unaffected siblings were compared among the three groups. Self-esteem and behavioral and social functioning were measured using the Piers-Harris Self-Concept Scale and the Child Behavior Checklist, respectively. Family stress was measured using the Family Inventory of Life Events. Sibling concerns were measured using the Sibling Concern About Seizure Scale. The author hypothesized that there would be a relationship between epilepsy and adverse affects in siblings, including lowered self-esteem, increased behavior problems, and more concerns surrounding epilepsy; yet there were no significant differences among any of these variables. Nevertheless, statistically significant levels of family stress were reported in families of children with frequent seizures compared to families of children with infrequent seizures. The finding that the majority of siblings of children with epilepsy have concerns surrounding epilepsy has implications for policy, in that programs for children with epilepsy should also address the needs of siblings.

The author attempts to control for secondary variables (age, gender, birth order) that might confound the results by designing and implementing a cross-sectional case control study. Because of the cross-sectional nature of the study, causal relationships cannot be determined. The author doesn’t describe the procedures for data collection in detail, making it difficult to determine if there were any threats to internal validity, which may have compromised the study. The author does indicate that all study participants were “pleased to be included” indicating that there may be a sampling bias based on self-selection. Perhaps most notable is that the small sample size (n=31) decreases the study’s power and makes it difficult to detect any differences among the groups. Further research with a larger sample size should be conducted to compare to findings from this study.

Mims, J. (1997). Self-esteem, behavior, and concerns surrounding epilepsy in siblings of children with epilepsy. Journal of Child Neurology, 12(3), 187-192.

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