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Observational study finds higher hostility bias in genetic generalised epilepsyPeople with genetic generalised epilepsy show higher hostility bias than healthy controls

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Key Takeaway
Consider that altered attributional style may contribute to social difficulties in genetic generalised epilepsy, but causal conclusions are not supported.

This primary research article reports an observational study comparing attributional bias across epilepsy syndromes. The study included 96 participants with genetic generalised epilepsy (GGE), temporal lobe epilepsy (TLE), and healthy controls (HC). The primary outcome was hostility bias and blame scores, with secondary outcomes including depressive symptoms, disease duration, seizure frequency, and antiseizure medication use.

Results showed that hostility bias scores were significantly higher in the GGE group compared to HC (adjusted p = 0.014; 95% CI 0.12-0.38). The difference between TLE and HC groups was moderate and not statistically significant (adjusted p = 0.059; 95% CI 0.12-0.58). Blame scores were positively associated with depressive symptoms (p = 0.016).

The authors note that attributional bias has not been systematically compared across epilepsy syndromes, highlighting a gap in the literature. The study is limited by its observational design, and no causal inferences can be drawn from the association between blame scores and depressive symptoms. The moderate, non-significant difference between TLE and HC groups should not be overstated.

Clinically, altered attributional style may represent an under-recognised factor contributing to social difficulties in people with epilepsy. Further investigation is warranted to explore attributional bias as a potential target for psychosocial interventions.

Living with epilepsy can change how you see the world. A recent study looked at how people with genetic generalised epilepsy and temporal lobe epilepsy attribute blame compared to healthy people. The researchers found that those with genetic generalised epilepsy scored higher on hostility bias. This means they were more likely to blame others for negative events. The difference between people with temporal lobe epilepsy and healthy controls was moderate but not statistically significant. This suggests the effect might not be strong enough to be certain in that group. Blame scores were also linked to depressive symptoms. This connection highlights how mental health struggles can shape how patients view their condition. The study involved 96 participants. It did not report safety issues or side effects because it was an observational study. The authors note that this type of bias has not been systematically compared across different epilepsy syndromes. This gap in knowledge limits what we can say for sure. Understanding these patterns matters because altered attributional style may represent an under-recognised factor contributing to social difficulties. Further investigation is needed to see if this could be a target for psychosocial interventions. We must be careful not to overstate the clinical significance of the moderate, non-significant difference between groups. Do not infer causation from the association between blame scores and depressive symptoms. More research is required to confirm these findings.

What this means for you:
People with genetic generalised epilepsy show higher hostility bias than healthy controls, which may affect social interactions.

Study Details

Sample sizen = 96
EvidenceLevel 5
PublishedApr 2026
View Original Abstract ↓
Background Attributional bias, a tendency to overinterpret others' intentions as hostile (rather than situational or accidental), represents a component of social cognition and may affect everyday functioning. Neural models link attributional processing to fronto-temporal circuits and the default mode network, which are frequently altered in epilepsy. Difficulties in social participation and employment are common in people with epilepsy, and maladaptive attributional styles may contribute to these challenges. Attributional bias has not been systematically compared across epilepsy syndromes. Methods We examined attributional bias in 96 participants comprising 26 individuals with genetic generalised epilepsy (GGE), 27 with temporal lobe epilepsy (TLE), and 43 healthy controls (HC). Attributional style was assessed using the Ambiguous Intentions Hostility Questionnaire. Depressive symptoms were evaluated using the Neurological Disorders Depression Inventory in Epilepsy. Group differences were analysed, and potential clinical and demographical correlates were explored. Results The GGE group exhibited higher hostility bias scores than HC (95% CI: 0.12-0.38, adjusted p = 0.014), whereas the difference between TLE and HC groups was moderate and not statistically significant (95% CI: 0.12-0.58, adjusted p = 0.059). Higher blame scores were positively associated with depressive symptoms (p = 0.016). Disease duration, seizure frequency, and antiseizure medication were not significantly associated with attributional bias. Conclusions These findings suggest that some individuals with genetic generalised epilepsy are more likely to interpret ambiguous situations as hostile. Altered attributional style may represent an under-recognised factor contributing to social difficulties in people with epilepsy and warrants further investigation as a potential target for psychosocial interventions.
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