Perceived epilepsy stigma mediates relationships between personality and social well-being in a diverse epilepsy population.

Abstract

Introduction: Perceived epilepsy stigma and reduced social well-being are prevalent sources of distress in people with epilepsy (PWE). Yet, research on patient-level correlates of these difficulties is lacking, especially among underserved groups.

Materials and methods: Racially/ethnically diverse adults with intractable seizures (N = 60, 62% female; 79% Black, 20% Hispanic/Latino, 8% White) completed validated measures of personality (NEO Five Factor Inventory, NEO-FFI-3), perceived epilepsy stigma (Epilepsy Stigma Scale, ESS), and quality of life (Quality of Life Inventory in Epilepsy, QOLIE-89). Controlling for covariates, ordinary least-squares (OLS) regression evaluated the total, direct, and indirect effects of NEO-FFI-3 neuroticism and extraversion scores on epilepsy-related social well- being (i.e., combination of QOLIE-89 social isolation and work/driving/social function subscale s, α =0.87), mediated through perceived stigma.

Results: In separate models, higher levels of neuroticism (N) and lower levels of extraversion (E) were signifi- cantly and independently associated with greater perceived stigma (N path a = 0.71, p = 0.005; E path a = − 1.10, p b 0.005) . Stigma, in turn, was significantly and independently associated with poorer soc ial well- being (N path b =0.23,p b 0.001; E path b = − 0.23, p b 0.001). Bias-corrected bootstrap confidence intervals (CIs) showed that neuroticism and extraversion were indirectly associated with social well-being through their respective associations with perceived stigma (N path ab = − 0.16, 95% CIs [− 0.347, − 0.044]; E path ab = 0.25, 95% CIs [0.076, 0.493]).

Conclusion: Higher neuroticism and lower extraversion covaried with stigma b eliefs, and these may be markers of poor social outcomes in PWE. Mediation models s uggest that targeting epilepsy stigma beliefs may be a particularly useful component to incorporate when developing interventions aimed at promoting social well-being in diverse PWE. © 2017 Elsevier Inc. All rights reserved