Predicting wellbeing among people with epilepsy using illness cognitions

- Greater variance was observed in quality of life than psychological wellbeing.
- Stigma, threat, and maladaptive illness responses all predicted quality of life.
- Perceived illness threat was the strongest predictor of poorer quality of life.
- Greater threat was perceived by individuals with maladaptive illness responses.

ObjectiveThis study sought to examine the synergistic contribution of illness-related perceptions (stigma, severity, and threat) and illness behavior to wellbeing among people with epilepsy. Poorer wellbeing was expected among those who perceived greater stigma, illness severity, and threat and had more extreme illness behavior.MethodsIndividuals with a diagnosis of epilepsy (N = 210), recruited through local and online support groups, completed a questionnaire comprising demographic and epilepsy-specific information, and validated measures of illness perceptions and behavior, epilepsy-related quality of life, and general psychological health.ResultsBivariate associations among illness cognition, illness behavior, and wellbeing were all as expected. Structural equation modeling highlighted the strong, direct effect of illness threat on quality of life, with other contributions from perceived stigma and an abnormal illness behavior syndrome (i.e., maladaptive illness responses). Significant variance was accounted for in both quality of life (64%) and psychological health (34%).ConclusionPreliminary evidence of the contributions of illness threat and maladaptive illness responses to wellbeing highlights the need for longitudinal research to examine the dynamic nature of such findings. Clinicians are encouraged to consider the potential value of screening for both illness threat and abnormal illness behavior to facilitate interventions.