Perceived stigma and adherence in epilepsy: evidence for a link and mediating processes

Marie Chesaniuk, Hyunmi Choi, Paul Wicks, Gertraud Stadler

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)


OBJECTIVE: This study tested whether perceived epilepsy-related stigma is associated with adherence in people living with epilepsy and if information, motivation, and behavioral skills are potential pathways underlying the stigma-adherence link.

METHODS: We surveyed persons living with epilepsy between the ages of 18 and 65 (N = 140) using an online questionnaire to assess medication adherence and perceived epilepsy-related stigma. In addition, participants reported their level of information, motivation, and behavioral skills.

RESULTS: Higher perceived epilepsy-related stigma was associated with lower medication adherence (r = -0.18, p < .05). Higher perceived stigma was associated with lower levels of information (r = -0.28, p < .05), motivation (r = -0.55, p < .05), and behavioral skills (r = -0.41, p < .05), and the link between stigma and adherence was fully explained by information, motivation, and behavioral skills, i.e., the effect of stigma on adherence was fully mediated (c = -0.18, p < .05 reduced to c' = 0.06, p = .48).

CONCLUSION: Perceived epilepsy-related stigma is problematic for maintaining the prescribed medication regimen in people living with epilepsy. The information-motivation-behavioral skills model is a useful framework for understanding the pathways linking perceived stigma and adherence in this population.

Original languageEnglish
Pages (from-to)227-231
Number of pages5
JournalEpilepsy and Behavior
Publication statusPublished - Dec 2014

Bibliographical note

This study was supported by the Behavioral Science Student Fellowship from the Epilepsy Foundation of America (#214619). The authors thank Michelle Herrera, Vanessa Spano, and all the participants and members of the project team for assistance in collecting the data. We also thank Niall Bolger for advice on analyzing data. This study was registered at as NCT01566500.


  • Adult
  • Epilepsy
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Medication Adherence
  • Middle Aged
  • Motivation
  • Social Stigma
  • Young Adult
  • Journal Article
  • Research Support, Non-U.S. Gov't


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