Fear perception and social behavioral problems in children with epilepsy: An explorative study

Introduction Nassau and Drotar (1997) state that children with epilepsy often show emotional and behavioral problems. They also hypothesize that these problems may be caused by impaired social competences. Golouboff et al. (2008) show that in children with temporal lobe epilepsy, impaired recognition of fearful facial emotions is associated with deviant behavior. The present clinical study describes behavioral problems in children with epilepsy and investigates the relationship of these problems with recognition of fearful facial emotion expression. Method In the University medical center of Groningen, 55 children with epilepsy were seen by a neuropsychologist from 2007 to 2013. For 18 of them parents filled in the Child Behavior Checklist 6-18 (CBCL). A subgroup of children (3 boys, 4 girls, 7.3-13.2 years, M=10.34, SD=2.42) also completed a Dutch shortened version of the Facial Expression of Emotions - Stimuli and Tests by Young et al. (2002) (FEEST-36). These data were compared to a healthy control group. The relationship between T scores of the CBCL (social competences and all problem scales) and the fear recognition scores from the FEEST-36 was investigated. Results About half the children show deviant social competences and social problems. All parents stated at least one social problem and one problem with aggressive behavior. Children with epilepsy are less accurate than healthy children in recognizing fear. This result was not significant but recognition scores are significantly correlated with T scores of social problems, attention problems and thought problems. Conclusion The majority of children with epilepsy show social problems. In these children, impaired emotion recognition is related to behavioral problems. Especially the detection of fearful facial emotions is related to behavior. It seems that children who are less accurate in recognizing fear, show greater social problems and have more difficulties with attention, and thoughts than healthy children.