Autistic Characteristics in Adults with Epilepsy

  • Sallyann Wakeford

Student thesis: Doctoral ThesisPhD


The prevalence of autism spectrum disorders [ASD] in epilepsy is approximately 20%-32%, with previous research reporting high rates of under-diagnosis of ASD in epilepsy. Current psychological assessments were adapted to provide epilepsy-specific measures of behaviour, which increased validity by addressing specific methodological problems highlighted by several researchers. The initial experiments provided a comprehensive investigation of autistic traits and characteristics in a heterogeneous group of adults with epilepsy without any ASD diagnosis to quantify the extent to which autistic characteristics are related to seizure activity. Adults with epilepsy showed higher autistic traits and impaired social responsiveness while systemizing and empathising abilities remained intact. Further, autistic traits and impaired social responsiveness increased again during seizure activity. Social responsiveness positively correlated with anti-epileptic drug [AED] control. Adults with epilepsy and seizure remission demonstrated significant improvements in restricted, repetitive behaviours compared to adults with current epileptic seizures. Together, these results demonstrate a relationship between seizure activity and autistic characteristics, and are consistent with previous suggestions that AEDs may mask autistic characteristics. The impaired social skills and communication are consistent with research suggesting that the pathogenesis of epilepsy may disrupt social functioning. However, whether this can be directly attributed to social cognitive deficits remains uncertain. The main research addresses this uncertainty by conducting three experiments to assess the Somatic Marker Hypothesis and the mechanisms which underpin it. The rationale is to establish whether this is a valid explanatory model for disrupted neurobiological factors implicated in social cognitive processing. This hypothesis is appropriate for investigating adults with epilepsy, some who may have developed typical social abilities in early life before epilepsy onset. Results from the IOWA Gambling Task demonstrated that adults with epilepsy had impaired decision making abilities compromising somatic marker formation, crucial for social cognition. However, this deficit occurred in the absence of other socio-emotional and memory impairments. In conclusion, adults with epilepsy have a higher rate of autistic characteristics, and their social difficulties may be associated with compromised somatic marker formation. Future research needs to determine the heritability of these autistic traits and characteristics.
Date of Award30 Nov 2012
Original languageEnglish
Awarding Institution
  • University of Bath
SupervisorMark Brosnan (Supervisor) & Neal Hinvest (Supervisor)


  • autism
  • epilepsy
  • autistic traits
  • social cognition
  • seizures

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