Dysfunctional personality beliefs and executive performance in patients with juvenile myoclonic epilepsy

Abstract

Background: This article intends to verify the association of dysfunctional beliefs of personality disorders with the executive performance in people with juvenile myoclonic epilepsy (JME). Methods: Fifty-two patients (35 women, 67.3%) with JME aged 18-50 yrs. (32.3 ± 9.7) were evaluated between May 2017 and April 2018 and compared with controls. All subjects were submitted to the Personality Beliefs Questionnaire (PBQ) (Beck & Beck, 1991;Savoia et al., 2006), Dysexecutive Questionnaire (DQ; Wilson et al., 1996;Macuglia et al., 2016), estimated intelligence quotient (IQ) using Vocabulary and Block Design tests, attention and executive functions evaluation (Controlled Oral Word Association (COWA), Digit Span, Trail Making Tests (TMT) A and B, Stroop and Wisconsin Card Sorting Test (WCST)). The inclusion criteria were as follows: diagnosis of JME (ILAE, 1989); age ≥18 yrs., schooling ≥ 11 yrs. and IQ ≥70. The inclusion criteria for the control group were the same except diagnosis of epilepsy. Results: Compared with controls, patients presented higher scores in PBQ for personality disorders, namely Narcissistic (z = −0.79; p b 0.001), Borderline (z = −0.58; p = 0.002), Paranoid (z = −0.43; p = 0.017), and Histrionic (z = −0.39; p = 0.041). Executive functions were impaired when compared with controls in TMT A (z = −0.97; p = 0.038), TMT B (z = −0.65; p = 0.023), and COWA (z = −0.51; p = 0.001). Patients showed higher WCST scores for Errors (z = −1.

Impulsiveness, personality traits and executive functioning in patients with juvenile myoclonic epilepsy

“…The sum of these factors can be interpreted, in behavior, as an impulsive and unwanted motor act, due to excessive motor stimulus, associated with a deficit in inhibitory capacity, strengthening the findings of BIS-11. Further cognitive processes underlying impulsivity may be present in these patients such as dysfunctional beliefs of personality which have been recently shown by our group to be associated to executive dysfunction in JME [20]. Nevertheless, WCST results were not correlated with BIS-11, probably because patients' performance in this test was strongly impaired.…”

“…Deficits involving abstraction, concept formation and word fluency, among others, can be called executive dysfunction which leads to difficulties in maintaining a productive and independent social life [13,16]. Impairment of executive functions have been described in patients with JME [17][18][19][20] but without analysis of the relationship with personality features.…”

ILAE definition of the Idiopathic Generalized Epilepsy Syndromes: Position statement by the ILAE Task Force on Nosology and Definitions

“…There are also higher rates of anxiety and depression in patients with JME compared with the general population 98,99,101 . Additionally, several studies have documented higher rates of impulsivity, which may lead to social or psychiatric problems 102–104 …”

Similar Profile and Magnitude of Cognitive Impairments in Focal and Generalized Epilepsy: A Pilot Study

“…In adults with genetic generalized epilepsy impaired results for cognitive ability, acquired knowledge, long-term retrieval and information processing were demonstrated in one study ( 26 ) and attention was impaired in another ( 27 ). Executive functions were also described to be negatively affected in juvenile myoclonic epilepsy ( 28 ), but also in other generalized epilepsies ( 29 , 30 ).…”