Epilepsy, Self-Management, and Separation-Individuation: Their Relationships

G. Channing Harris, School of Psychology

While research regarding the effects of other chronic illnesses on psychological (i.e., intrapsychic & psychosocial) development has been well established, less is known about the influence of epilepsy on the psychological development of young adults (aged 18 – 40) and how this affects epilepsy self-management. This study evaluated the relationships among epilepsy characteristics, parental overprotection, separation-individuation, psychopathology, peer attachment, and self-management in an international sample of young adult people with epilepsy (PWE). The project was approached drawing from both psychoanalytic and attachment perspectives. One-hundred eighty-five participants between the ages of 18 and 40 completed an online survey, which included a demographic and epilepsy variables survey, the Neurological Disorders Depression Inventory for Epilepsy, the Generalized Anxiety Disorder 7-item scale, the Epilepsy Self-Management Scale, the Inventory of Parent and Peer Attachment, the Separation-Individuation Process Inventory, and the Parental Bonding Instrument. A model, which states that parental overprotection in childhood influences the separation-individuation process and how well young adult PWE manage the illness as they mature into adulthood, was evaluated using structural equation modeling (SEM). Findings indicate that the model fit the data collected quite well. The results indicate that parental overprotection prior to age 16 exerted a direct effect on separation-individuation, which exerted a direct effect on poor self-management, psychopathology, and peer attachment. Separation-individuation also mediated the effects of parental overprotection on poor self-management, psychopathology, and peer attachment. These findings may prove useful for psychology and other disciplines hoping to improve psychosocial wellbeing and self-management in PWE. The results should be used to inform interventions designed to help young adult PWE work through separation-individuation issues and better manage their illness.

KEY WORDS: Epilepsy, Self-Management, Separation-Individuation, Intrapsychic Development, Psychosocial Development, Psychoanalytic Theory, Psychodynamic Theory, Attachment Theory, Parental Overprotection, Epilepsy Self-Management Scale, People with Epilepsy, Younger Adults