chapter  1
Specificity of Brain-Behavioural Relationships Revisited: From Epileptic Personality to Behavioural Phenotypes
Pages 18

An important early phase in Barbara Tizard's career was concerned with research in the field of epilepsy. Her key review of the concept of a characteristic epileptic personality, together with her systematic appraisal of the relevant empirical evidence, did much both to clarify the issues and to cast doubt on the stereotypes that prevailed at the time. Although it is now more than three decades since her review, the paper continues to be cited as marking a significant turning point in the way the topic was thought about (see e.g. Taylor and Eminson, 1994). In her review, Barbara Tizard highlighted five main issues (Tizard, 1962). First, there was the question of whether psychopathological disorders were more frequent among epileptic subjects than in the general population. The evidence at that time was fragmentary and inconclusive but Tizard suggested that there might be a true increase. Second, there was the rather different question of whether such psychological disturbances took a characteristic form in people suffering from epilepsy. Tizard noted the unsatisfactory quality of much of the evidence but concluded that the disturbances were quite varied in type and there was no indication that there was such a thing as a characteristic epileptic personality. Accordingly, there was a need for research to identify the variables - whether they be psychosocial, neurophysiological or structural-that accounted for the heterogeneity. Third, she considered the possibility that there might be either different levels of psychiatric risk, or different forms of psychopathology, associated with the type of epilepsy, the location of an epileptic focus or the presence of organic brain pathology. She concluded that there might well be associations of this kind but the evidence was insufficient to lead to any kind of firm conclusion. Fourth, she drew attention to the inadequacy of the measuring instruments available to assess either levels of psychopathology or (most especially) specific types of psychological dysfunction. Finally, Tizard underlined the problems of inferences based on selected clinic samples. She urged the need for good epidemiological data using discriminating and wellvalidated measures.