Experiences of self-conscious emotions in temporal lobe epilepsy

Self-conscious emotions (SCEs) with a negative valence (such as shame and guilt) or a positive valence (such as pride) are moral emotions that emerge from self-reflection and self-evaluation processes in social contexts. In some neurologic and psychiatric disorders, experiences of SCEs are dysregulated. The objectives of the present study were to (i) evaluate whether patients with temporal lobe epilepsy (TLE) experience SCEs in the same way as nonclinical (control) participants and (ii) probe the relationships between experiences of SCEs on the one hand and the psychological symptoms frequently diagnosed in patients with TLE (anxiety and depression), the patients' clinical characteristics, and their functional outcomes in everyday life on the other. Sixty-one patients with TLE and 61 matched controls completed a self-questionnaire (the Positive and Negative Affect Schedule (PANAS)) that enabled us to evaluate the extent to which they experienced shame, guilt, and pride. Demographic data, cognitive data, the severity of anxiety symptoms, and the severity of depressive symptoms were recorded for all participants. In patients with TLE, data of clinical characteristics and quality of life were also evaluated. Relative to controls, patients with TLE were more likely to experience negative-valence SCEs to a higher extent and positive SCEs to a lesser extent. The patients who experienced negative-valence SCEs to a higher extent (rather than to a lesser extent) had a higher frequency of seizures, more severe anxiety and depressive symptoms, and a greater prevalence of anxiety and depressive disorders. Furthermore, patients who experienced positive-valence SCEs to a lesser extent (rather than to a higher extent) displayed a higher level of anxiety. Lastly, differences in experiences of SCEs by patients with TLE were associated with a lower quality of life. In conclusion, experiences of SCEs can be dysregulated in patients with TLE. This dysregulation is linked to the patients' clinical and psychological symptoms and quality of life. In this context, SCEs might be a target of interest in the management of epilepsy.