Abstracts

Rationale: Children with epilepsy have higher rates of anxiety disorders compared to children in the general population. However, anxiety disorders in these children often remain under-diagnosed and under-treated. This study presents the preliminary results of the computer-assisted cognitive-behavioral therapy (CBT) intervention, Camp Cope-A-Lot, developed by Khanna and Kendall (2008). This is the first time this intervention has been used in children with epilepsy.Methods: Children diagnosed with epilepsy for at least 6 months were invited to participate. Seventeen children met DSM-IV criteria for an anxiety disorder based on the Kiddie-SADS interview. Three of these children did not complete the intervention. The remaining 14 children, ranging in age from 8-13 years (M = 10.93, SD = 1.54), completed the 12 week intervention and 3 month follow-up visit. None of the children were currently being treated for anxiety. However, 1 child had received previous treatment for selective mutism. The CBT intervention consisted of 12 levels. Children completed 1 level each week in an individual therapy session with their therapist. The first 6 weeks included building skills such as identifying thoughts and feelings, challenging anxious thoughts, muscle relaxation, and problem solving. In weeks 7-12, children applied the new skills and completed tasks specific to their worries. Common fears reported were being or sleeping alone, social situations, school, and perfectionism. Interestingly, seizures were not a common worry. Each child completed the anxiety self-report measures, the Multidimensional Anxiety Scale for Children (MASC) and the Screen for Child Anxiety Related Disorders (SCARED), and each parent completed the parent version of the SCARED. Measures were completed at baseline, week 7, week 12, and at the 3 month follow-up. T-tests were used to measure change in anxiety symptoms at these time points.Results: The majority of children had localization related epilepsy (LRE n= 10, GRE n= 4). Age of onset of epilepsy ranged from 2-12 years (M = 7, SD = 3.11). The mean duration of epilepsy was 3.98 years (SD = 2.88). In the past 12 months, the majority of children were seizure-free or had 1 seizure (0-1 seizures, n = 10; more than one seizure, n=4). Eleven children were taking 1 AED, and 3 were not taking any AEDs. When compared to baseline, children reported reduced anxiety symptoms at week 7 (SCARED-Child: p = .001), after completing the intervention at week 12 (SCARED-Child: p = .009; MASC: p = .008), and at the 3 month follow-up (SCARED-Child: p = .013; MASC: p = .018). Parents reported a reduction in their child s symptoms of anxiety from week 7 to the 3 month follow-up (SCARED-Parent: p=.005).Conclusions: The preliminary data of this pilot study suggests that this cognitive-behavioral (CBT) intervention developed for children in the general population reduces anxiety in children with epilepsy.