title: Family factors contributing to emotional and behavioral problems in Korean adolescents with epilepsy.
abstract: OBJECTIVE
  We aimed to determine whether different aspects of family functioning are associated with emotional and behavioral problems in adolescents with epilepsy and, if not, to document any indirect associations mediated by other family factors.
  
  
  METHODS
  This was a cross-sectional, multicenter study. A total of 297 adolescents with epilepsy and their parents participated. Adolescent psychopathology was measured using the Youth Self-Report. Family factors were classified into proximal (parent-child interaction), distal (parent characteristics), and contextual factors (family characteristics) in accordance to their level of proximity to the adolescent's everyday life. Regression analyses were used to analyze the unique and combined predictive power of family factors in relation to psychopathology.
  
  
  RESULTS
  In total, 44 (14.8%) and 51 (17.2%) adolescents with epilepsy scored above the borderline cutoff (T-score ≥ 60) of internalizing and externalizing problems, respectively. Proximal and distal factors were independently associated with both internalizing and externalizing problems. High levels of parental depressive mood and parental overcontrol were the strongest factors contributing to internalizing and externalizing problems, respectively. Contextual factors were indirectly associated with both internalizing and externalizing problems through more proximal factors.
  
  
  CONCLUSIONS
  Both proximal and distal family factors affect psychopathology in Korean adolescents with epilepsy. Parental feelings of depression and parental overcontrol are the strongest factors contributing to internalizing and externalizing problems, respectively.
authors: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors: Su-Hyun
authors: SH
authors: Han
authors: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address: salee@amc.seoul.kr.
authors: Sang-Ahm
authors: SA
authors: Lee
authors: Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Soyong
authors: S
authors: Eom
authors: Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Heung-Dong
authors: HD
authors: Kim
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology; D000066553:Problem Behavior / Q000523:psychology*; D056910:Republic of Korea / Q000453:epidemiology; D057566:Self Report
keywords: Adolescents with epilepsy; Family environment; Mediator; Parental depression; Parent–adolescent relationship; Psychopathology