DYSFUNCTIONAL SCHEMA MODES AND COMORBIDITY OF PSYCHIATRIC SYMPTOMS IN INDIVIDUALS WITH EPILEPSY: AN EXPLORATORY STUDY

Abstract

The current research purported to examine the association between dysfunctional schema modes and comorbidity of psychiatric symptoms in Individuals with Epilepsy. To meet the objectives, the research comprised of three studies. In study-1, the Symptom Checklist-90 (SCL-90; Derogatis, Lipman, & Covi, 1973) a multidimensional screening tool of nine primary symptoms including somatization (SOM), obsessive-compulsive (OCD), interpersonal sensitivity (INT), depression (DEP), anxiety (ANX), hostility (HOS), phobic (PHOB), paranoid ideation (PAR), and psychoticism (PSY) were translated and validated in Urdu in three phases. In phase 1, the scale was translated by using the forward and back translation method. While in phase II, the psychometric properties for SCL-90 were established on the purposive sample of N=367 university students with age (M= 21.46, SD=2.08) ranged from 18 to 30 years. The Cronbach alpha coefficients of all the subscales and overall scale were satisfactory ranged from .71 to .98. Moreover, the Confirmatory Factor analysis determined that each subscale of the SCL-90 had shown the acceptable goodness of fit index (GFI) ranging from .96 to .99 and all items were found inter-correlated. The concurrent validity of SCL-90 specified the significant correlation with the subscales of Urdu Version of Minnesota Multiple Personality Inventory (MMPI; Mirza, 1977), and Depression Anxiety Stress Scales (DASS; Zafar, 2014). In phase III, the comparison was made on the sample of 100 individuals with psychiatric disorders and 100 were healthy matched based on gender and age. Results showed that individual with psychiatric problems significantly scored high on all the subscales of SCL-90 as compared to the healthy individuals. The study-II aimed to find the association between the broad arrays of dysfunctional schema modes and psychiatric symptoms in individuals with epilepsy. Furthermore, the effect of various demographics and clinical variables on dysfunctional modes and psychiatric symptoms were examined. A total of 108 people with epilepsy (PWE) mean age (M=24.91, SD=7.42) ranged from 18 to 60 years recruited from the neurology ward of hospitals located in Islamabad and Rawalpindi through purposive sampling technique. A brief history of illness and other demographics were taken through the semi-structured interview accompanied with the Schema Mode Inventory, and the SCL-90 from the respondents. Regression analyses showed that Detached Protector, punishing parent and Vulnerable child significantly predicted DEP, ANX, HOST, INT, PHOB, PAR, PSY, OCD, and SOM. Whereas Angry protector was the significant predictor of DEP, ANX, INT, and HOS. The Angry child was found to be the only predictor of OCD, and the Compliant surrender was the inverse predictor of HOS. Moreover, the Enraged child significantly predicted HOS and OCD whereas Bully and Attack predicted PHOB. A One-way variance analysis revealed significant differences between the lower, middle and upper socio-economic classes on Dysfunctional Modes. The lower class had significantly utilized the modes detached protector, bully, and attack, angry protector, angry child, enraged child, impulsive child, undisciplined child and punishing the parent. However, Hostility was found in the lower class as compared to upper or middle classes. Moreover, gender differences indicated that males had significantly higher means of Self-aggrandizer, Bully and Attack, Impulsive child and Undisciplined child. Additionally, duration of epilepsy had significantly moderated the relationship between dysfunctional child modes and hostility. The mode graph showed that hostility increases in the acute stage of epilepsy. In addition, during the semi-structured interview, the questions regarding attitude and self-disclosure were asked. 84 (77.8%) PWE developed a fear of having a seizure, whereas (67.6%) could not share their illness with others and did not inform about their disease at the workplace due to stigmatization. In Study-III, the comparison was made between two groups matched on the basis of Age, Gender, and Education. Both groups consisted of 60 individuals with and without epilepsy. T-test analysis revealed that PWE significantly had high scores on Enraged Child and low scores on Adaptive modes. The present study is significantly contributing to the Neuropsychology which is the most neglected part of the research field in Pakistan.