B - 6 The BRIEF-2A Pattern of Self and Informant Executive Functioning Difficulties in Adults with Epilepsy

Abstract Objective People with epilepsy (PWE) commonly have executive functioning (EF) difficulties on objective testing. However, less is known about subjective EF difficulties in everyday life. We examined self- and informant-rated EF in PWE using the Behavior Rating Inventory of Executive Function for Adults-2 (BRIEF-2A). We hypothesized that PWE and their informants would endorse greater EF difficulties relative to healthy participants. Method Participants included 43 PWE who completed comprehensive clinical neuropsychological evaluation at a large Northeastern academic medical center, which included BRIEF-2A Informant and Self Report Forms (Age M = 40.4 ± 17.2 years, 53% female, Education M = 13.0 ± 1.8 years). Twenty-four participants completed self-reports, while 19 had both self and informant reports. The comparison sample included 43 age- and gender-matched healthy controls (HC). We analyzed BRIEF-2A subscales using MANOVAs, where elevated T scores indicated worse EF. Repeated measures ANOVAs compared self and informant ratings. Multi-rater comparisons (90% CIs) and chi-squares analyzed patterns of discrepant ratings. Results Self-reported EF difficulties in PWE were elevated across all scales, compared to HC (p’s0.25), with greatest difference observed for working memory (PWE = 69.7 ± 12.7, HC = 44.5 ± 16.7, ηp2 = 0.61). Similar elevations across all scales were observed for PWE informant reports (p’s0.14). PWE rated greater self-monitoring (p = 0.03, ηp2 > 0.23) and emotional control (p = 0.08, ηp2 > 0.16) difficulties than informants. There was 42.1–68.4% concordance between self and informant reports for PWE, compared to 84–95% in HC. Patterns of self and informant ratings were similar between PWE and HC for initiation, planning/organization, and task-monitoring (p’s > 0.20). Conclusions PWE and their informants report high, yet relatively similar, levels of EF difficulties in daily life.