Development and validation of the Epilepsy Perceived Stress Inventory for Adults (EPSI-A): A pilot study

Abstract

Introduction: Stress is one of the most common trigger factors for epileptic seizures and is strongly related to clinical and emotional variables. Despite its influence in the course of the disease, there is an absence of instruments for measuring perceived stress in people with drug-resistant epilepsy. Therefore, this study develops and validates the Epilepsy Perceived Stress Inventory for Adults (EPSI-A), a self-report inventory in Spanish designed to quantify perceived chronic stress in this population. Method: The sample consisted of 236 patients with drug-resistant epilepsy who underwent a neuropsychological assessment in which anxiety, depression, and quality of life were explored. In addition, from 125 patients in the sample, 9 measures of salivary cortisol were collected during the evaluation. Results: The EPSI-A consisted of 15 items, with higher scores indicating higher perceived stress. The exploratory factor analysis showed a four-factor solution: epilepsy concerns (5 items); impact on daily performance (4 items); social consequences (3 items); and epilepsy severity (3 items). These factors explained 63.3 % of the total variance. Internal consistency reliability measured with McDonald’s omega and Cronbach’s alpha coefficients was satisfactory, with values ≥ 0.78 (except for epilepsy severity with values of 0.59 and 0.58, respectively). Construct validity was demonstrated by its correlation with several psychological scales and clinical variables. Conclusions: The results showed that the EPSI-A is a reliable and valid tool for assessing perceived chronic stress in people with epilepsy. Its conciseness, rapid administration time, and specificity make it an appropriate instrument for this population.