Lancaster Medical School, Furness College, Lancaster University, LA1 4YF, United Kingdom of Great Britain and Northern Ireland.
Psychology Department, Fylde College, Lancaster University, LA1 4YF, United Kingdom of Great Britain and Northern Ireland.
Epilepsy Behav. 2019 Jul;96:6-12. doi: 10.1016/j.yebeh.2019.03.052. Epub 2019 May 8.
Child psychopathology involves inappropriate or biased attributions of others' mental states (mentalizing), and parents' assessment of their children's mentalizing significantly predicts the latter's psychosocial outcomes. Behavioral difficulties are frequent in children with epilepsy (CWE) yet biased mentalizing and parental accuracy in understanding their child's mental states reasoning have not been addressed.
This study compared the performance of 34 CWE aged 9 to 16 years with 67 language age-matched controls on a biased mentalizing task. The task required children to infer on the mental states of peers in stories involving social scenarios. Responses were scored as positive, negative, or rational mentalizing attributions. To measure parental accuracy, a parent version was administered in the patient group that required a parent to identify their child's responses correctly. Relationships with the child's cognitive, behavioral, and epilepsy-related factors were examined.
Patients made greater negative mental states attributions compared with control children. This negative mentalizing bias was accurately identified by parents and was associated with children's behavioral problems. Parental accuracy was reduced for patients with lower cognitive abilities. Parents did not accurately identify an overly positive (OP) bias in their child's mental states attributions. Children's positive response bias correlated with their lower executive function (EF) skills. Epilepsy factors predicted cognitive deficits but not biased mentalizing or behavioral problems.
Biased mentalizing characterizes social cognition in CWE with behavioral problems. Further investigation of the mentalizing biases and parental awareness of children's mental states reasoning is required to fully understand the greater psychosocial and behavioral difficulties found in CWE.
儿童精神病理学涉及对他人心理状态的不恰当或有偏差的归因（心理化），父母对子女心理化的评估显著预测后者的心理社会结果。行为困难在癫痫儿童（CWE）中很常见，但对其偏倚的心理化和父母理解孩子心理状态推理的准确性尚未得到解决。
本研究比较了 34 名 9 至 16 岁的 CWE 与 67 名语言年龄匹配的对照组在一个有偏差的心理化任务上的表现。该任务要求儿童在涉及社交场景的故事中推断同伴的心理状态。反应被评为积极、消极或理性的心理化归因。为了测量父母的准确性，在患者组中进行了一个家长版本的测试，要求家长正确识别孩子的反应。还检查了与儿童认知、行为和癫痫相关因素的关系。
与对照组儿童相比，患者做出了更多的消极心理状态归因。这种消极的心理化偏差被父母准确识别，并与儿童的行为问题相关。认知能力较低的患者父母的准确性降低。父母无法准确识别孩子在心理状态归因上的过度积极（OP）偏差。儿童的积极反应偏差与较低的执行功能（EF）技能相关。癫痫因素预测认知缺陷，但不预测偏倚的心理化或行为问题。
偏倚的心理化特征是有行为问题的 CWE 的社会认知。需要进一步研究心理化偏差和父母对孩子心理状态推理的意识，以充分了解 CWE 中发现的更大的心理社会和行为困难。
