Title:
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Children's cognitive representations of epilepsy
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Epilepsy is a common paediatric neurological disorder. It has been linked with poor psychosocial outcome, though many children with epilepsy show remarkable resilience. Improved methodologies have outlined the contributions of many factors to variance in psychosocial outcome, but inadequate theoretical frameworks mean these findings are difficult to interpret. Researchers are increasingly considering cognitive-perceptual factors in relation to adjustment and it is widely agreed that both children and adults organise their illness cognitions along five dimensions - cause, identity/label, cure/control, timeline and consequences. Based on Leventhal's Self-Regulatory Model, the Illness Perception Questionnaire-Revised (IPQ-R) has helped elucidate the role of adult illness cognitions in adjustment to epilepsy. This thesis describes a study that evaluated the utility of an IPQ-R modified for children (chIPQ-R) with a paediatric epilepsy sample. Fifty children completed the chIPQ-R in a cross-sectional postal questionnaire design. The chIPQ-R showed good internal consistency. Intra-subscale correlations agreed with predictions, indicating that children organise their illness representations in a similar way to adults. Relationships between chIPQ-R subscales and outcome measures were in hypothesised directions. Hierarchical multiple regressions found that chIPQ-R subscales added significant amounts of explanatory power to models of behavioural disturbance and psychosocial impact after demographic and epilepsy-related variables had been controlled for. Interpretation of these findings was cautious, because the sample was drawn from a clinic rather than the community, but it was concluded that the chIPQ-R is acceptable to children as young as seven, and is a reliable and meaningful tool for the exploration of adjustment to paediatric epilepsy.
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