Evaluation of the relationships between emotional schemas, emotion regulation problems, and subjective complaints in cases of juvenile myoclonic epilepsy and pediatric migraine and comparison of emotional schemas and emotion regulation problems with a control group

Aim: The aim of this study was to evaluate emotional schemas (early maladaptive schemas), emotion regulation skills, and subjective psychiatric complaints in adolescents aged 12–18 years diagnosed with juvenile myoclonic epilepsy (JME) and pediatric migraine; to examine the relationships among these variables; and to compare the clinical groups with healthy adolescents. Methods: The single-center, clinic-based case–control study was conducted between 01.09.2024 and 01.02.2025 at the outpatient clinic of the Department of Pediatric Neurology and the Department of Child and Adolescent Psychiatry, Faculty of Medicine, Bolu Abant Izzet Baysal University. Adolescents diagnosed with JME (n=30) and pediatric migraine (n=30), and an age- and sex-matched healthy control group (n=20), were included (total N=80). Participants were administered the Young Schema Questionnaire Short Form-3 (YSQ-S3), Emotion Regulation Scale for Adolescents (REQ), Brief Symptom Inventory (BSI), and Stroop Test–TBAG Form (SCWT); functional disability in the migraine group was evaluated with the Pediatric Migraine Disability Assessment Scale (PedMIDAS). Psychiatric diagnoses were determined via the K-SADS-PL interview, and symptom severity was rated by clinician assessment using the Clinical Global Impression–Severity scale (CGI-S). Data were evaluated using between-group comparisons and correlation analyses. Results: In the YSQ-S3 subscales, the enmeshment score of the JME group was higher than that of the migraine and control groups (p=0,009). Self-sacrifice and vulnerability/pessimism (vulnerability to harm—pessimism) schemas were higher in both clinical groups compared with the control group (p=0,026 and p=0,029, respectively). Mean REQ subscale scores did not differ significantly among groups (p=0,452); however, in both the migraine and JME groups, certain schema domains and dysfunctional emotion regulation scores were positively correlated with subjective complaints such as anxiety, depression, and negative self, as measured by the BSI. No significant between-group difference was found in BSI subscale mean scores. In contrast, symptom severity assessed by the clinician using the CGI differed across groups, with higher severity levels observed in the clinical groups (p<0,001). In the neuropsychological evaluation, error and correction counts—particularly in SCWT-2—were higher in the patient groups; and in the interference condition (SCWT-5), completion time was longer in the JME group. Conclusion: The more pronounced presence of certain early maladaptive schemas in adolescents diagnosed with JME and pediatric migraine, and the association of these schemas with subjective psychiatric complaints, supports the importance of a biopsychosocial approach in chronic neurological disorders. Therefore, in addition to neurological follow-up and treatment, adolescents may need to be evaluated psychosocially; and schema-focused approaches and psychosocial interventions targeting emotion regulation skills may need to be integrated into the treatment plan. Keywords: Juvenile myoclonic epilepsy, pediatric migraine, adolescent, early maladaptive schemas, emotion regulation, Stroop test