A Hopelessness Model of Depressive Symptoms in Youth with

Objective To test the cognitive diathesis-stress and mediational components of the theory of learned hopelessness in youth with epilepsy. Methods Seventy-seven participants ages 9–17 (35 girls, 42 boys) completed measures of depressive symptoms, hopelessness, self-efficacy for seizure management, and attitude toward epilepsy. Caregivers provided information on seizure activity. Diagnostic and treatment information was obtained via medical record review. Results Regression analyses revealed that hopelessness mediated the attitude towards epilepsy–depressive symptom relationship. While attitude toward epilepsy and self-efficacy were independent predictors of depressive symptoms, the relationship of attitudes toward epilepsy and depressive symptoms was not enhanced with low self-efficacy for seizure management. Conclusions Findings support the mediation component of the learned hopelessness theory in youth with epilepsy, suggesting the importance of interventions that assist youth in identifying epilepsy-related aspects of functioning over which they can realistically exercise control and challenging negative thoughts about situations they cannot control. Key words depression; epilepsy; learned hopelessness. Epilepsy affects between 0.2 % and 0.6 % of children (Cowan, 2002) and is associated with significant behav-ioral and psychiatric symptoms (Caplan et al., 2004; Rodenburg, Stams, Meiler, Aldenkamp, & Dekovic, 2005). With prevalence rates of 21–60 % for psychopathology in children with seizures, symptoms are 4.8 times greater in children with epilepsy than the general population and 2.5 times greater than in children with other chronic illnesses not involving the central nervous system (CNS) (see Austin & Caplan, 2007 for review). More specifically, prevalence rates have been reported to range between 10 % and 30% for clinically significant depressive symptoms and DSM diagnoses of depression (Alwash, Hussein, & Matloub