Social cognition and psychological measures in adults with Epilepsy: An exploratory study using Theory of Mind tasks

This study explores the relationship between social cognition, psychological well-being, and self-compassion in patients with epilepsy, aiming to generate hypotheses for future research on the role of social cognition in epilepsy.

Including 38 patients with epilepsy and 21 healthy controls, the research assessed psychological well-being using the Flourishing Scale, self-compassion with the Self-Compassion Scale, and social cognition through the Reading the Mind in the Eyes Test (RMET), Facial Emotion Recognition Test (FERT), and Faux-Pas Test.

Compared to healthy controls, patients with epilepsy (PWE) performed significantly lower on all social cognition tasks, including FERT (53.09 ± 5.94 vs. 50.07 ± 4.50, p = 0.032), RMET (23.19 ± 3.98 vs. 20.05 ± 4.82, p = 0.014), and the Faux-Pas Test (19.57 ± 4.27 vs. 15.18 ± 6.90, p = 0.11), with effect sizes ranging from d = 0.60 to d = 0.72, indicating small-to-moderate group differences. PWE with generalized seizures performed lower on the Over-Identification and Isolation subdimensions of the Self-Compassion Scale than those with focal seizures, whereas no significant differences in social cognitive performance were observed across seizure types. Patients experiencing fewer than one seizure per month performed higher on the Faux-Pas Test. Correlation analyses revealed that education positively correlated with FERT, and lower perceived Isolation emerged as a strong predictor of better FERT and Faux-Pas performance, independent of demographic or clinical factors. RMET performance was significantly associated with epilepsy diagnosis but was not predicted by psychological variables.

Lower perceived isolation emerged as a strong and independent predictor of better social cognitive performance, with patients experiencing fewer than one seizure per month also exhibiting higher Faux-Pas Test scores, suggesting that both psychological well-being and seizure frequency are important determinants of social cognition in PWE. Findings may inform the development of psychosocial interventions aimed at reducing isolation and supporting self-compassion in people with epilepsy.