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Unformatted text preview: A randomized trial of a group based cognitive behavior therapy program for older adults with epilepsy: the impact on seizure frequency, depression and psychosocial well-being Deirdre P. McLaughlin Ken McFarland Received: April 28, 2010 / Accepted: September 13, 2010 / Published online: October 7, 2010 Springer Science+Business Media, LLC 2010 Abstract Few studies have examined the effectiveness of cognitive behavior therapy to manage seizures and improve psychosocial functioning in older adults with epilepsy. This study evaluated the efficacy of a 6 week group CBT pro- gram in community dwelling adults with epilepsy who were aged over 60 years. A total of 37 participants were randomly assigned to either a CBT group or a control group. Measures of depression, dysthymia, psychosocial functioning and seizure frequency were completed at pre and post intervention. Seizure frequency was significantly reduced in the CBT group compared to the control group (Cohens d 0.63). The results suggest that the relationship between seizure frequency and psychological and psycho- social well being in older adults requires further investi- gation. Although there were no significant between group differences on measures of depression and psychosocial functioning, both the CBT and control groups improved significantly from baseline. Keywords Epilepsy Cognitive behavior therapy CBT Older adults Older adults with epilepsy are at increased risk of depres- sion, impaired psychosocial function and reduced quality of life, especially when seizures are uncontrolled (McLaughlin et al. 2008a , b ). Mechanisms which can in- duce seizures have been identified and documented in the literature, including emotional state, alcohol and drug use, poor temperature control, metabolic and hormonal imbal- ances, fatigue, and poor hydration (Aird 1983 ; Antebi and Bird 1993 ; Spector et al. 2000 ; Spector et al. 1994 ; Wolf 2002 ). A number of researchers have also investigated whether people with epilepsy can utilise this information to abort seizure genesis (Dahl 1992 ; Janszky et al. 2004 ; Spector et al. 1999 ; Spector et al. 2001 ). In recent years, psychological management of seizures has become an area of clinical interest and subsequent empirical research (Cull and Goldstein, 2002 ; Fenwick 1990 ; Goldstein 1997 ; Goldstein et al. 2003 ), however, no research has been di- rected specifically at older adults, although epilepsy is one of the most common neurological disorders of late adult- hood, increasing in both incidence and prevalence after the age of 60 (Kotsopoulos et al. 2002 ). Cognitive behavior therapy (CBT) for the treatment of epilepsy has been the focus of some research attention, both because of its amenity to a randomized controlled design and because of the postulated association of cognitive tasks on seizure activity. A recent study examined the effects of cognitive-motor tasks on electroencephalograph (EEG) discharges consistent with seizure activity (Matsuoka et al.discharges consistent with seizure activity (Matsuoka et al....
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