The Development of a Method to Assess Patients' Cognitive Representations of Epilepsy

Objective. The study describes the development of a new method for assessing cognitive representations of epilepsy.Methods. The study was a cross-sectional design contrasting the cognitive representations of three groups of epilepsy patients, varying in recency of onset (acute vs chronic) and the location of medical management (hospital vs community). A total of 94 patients were studied: 21 recent onset, 47 patients with chronic epilepsy attending the clinic and 26 patients with chronic epilepsy seen by general practitioners. An interview that combined open questions and structured questionnaire items was devised to assess six illness representation components; identity, beliefs about symptoms; causal beliefs; timeline, beliefs about temporal course; consequences, beliefs about the implications of epilepsy; control beliefs; and self-illness relationship, or the impact of epilepsy on patients' self perceptions.Results. The scales formed by the questionnaire items had satisfactory internal consistency. Further, the scales demonstrated logical interrelationships, and significant differences were found between the scales on group difference tests.Conclusions. Overall, the data provide support for the approach of administering quantitative illness representation scales within a brief structured interview format. The measure provides a way to elicit the health beliefs that determine patients' psychosocial reactions to epilepsy. Such insights are important in the development of effective psychological interventions.