Family Influences on Coping Processes in Children and Adolescents with Sickle Cell Disease

Examined the contribution of parenting and family variablesto the general coping processes of 39 children and adolescentswith sickle cell disease (SCD). In home interviews, parentsreported on their child's health history, the coping suggestionsthey make to their children, their own coping strategies, andfamily cohesion. Children rated their general coping strategiesand level of hope. Partial support was obtained for each ofthe three models of family influences tested in this study.After accounting for the effects of age, gender, family structure,and type of SCD, children's hope was positively associated withactive coping suggestions by parents. Children's active copingwas associated with a cohesive family environment, and avoidancecoping was predicted by less parental use of restructuring coping,and greater parental use of active coping strategies. Takentogether, this study provides evidence for the influence ofparental coaching and modeling and the family environment oncoping processes in children with SCD.     

Psychological Adjustment of Adolescents With Sickle Cell Disease: Relations With Demographic, Medical, and Family Competence Variables

Objective: Investigate the hypothesis that family competencein addressing challenges associated with sickle cell disease(SCD) contributes to adolescents' adjustment. Method: During routine clinic appointments, 80 adolescents (Mage = 14·4 years) and their parents independently completedthe Self-Report Family Inventory (SFI), which assesses familycompetence, and measures of adolescent adjustment problems.Information related to disease severity was obtained from clinicfiles. Results: Regression analyses controlling for demographic andmedical variables revealed that higher family competence wasassociated with fewer internalizing and externalizing behaviorsby the adolescent; these relations were particularly true foryounger adolescents and for girls. Parental reports of somaticcomplaints in girls were predicted by parental ratings of familycompetence. Discussion: Interventions for adolescents with SCD should befamily-centered and should focus on strengthening the family'sability to manage stressors associated with parenting an adolescentwith a chronic illness.     

Psychological Adjustment of Mothers of Children and Adolescents with Sickle Cell Disease: The Role of Stress, Coping Methods, and Family Functioning

Assessed the psychological adjustment of 78 mothers of childrenand adolescents (7–17 years of age) with sickle cell disease.Support was provided for a transactional stress and coping modelin delineating the processes associated with maternal adjustment.In particular, poor maternal adjustment was associated withuse of palliative coping methods and high levels of stress relatedto daily hassles. Variables of the model accounted for 55% ofthe variance in maternal psychological distress.     

Psychological Adjustment of Children with Sickle Cell Anemia

The psychological adjustment of 30 children with sickle cellanemia (ages 6–16) was evaluated and compared to a groupsof 30 healthy control subjects who attended a family medicalclinic for routine health problems. As expected, the groupsdiffered on several measures related to medical problems (e.g.,number of clinic visits, medication intake, and length of illness).However, no group differences emerged regarding psychologicalproblems. Behavioral problems were found for both groups whentheir scores were compared to the normative samples for variouspsychological measures. Thus, the children of both groups werefound to have more behavioral problems than the normative samples.Since the groups were equivalent in terms of low socioeconomicstatus (SES), it was suggested that the hypothesized maladjustmentof children with sickle cell anemia is more likely to be a resultof the generally low SES of these black children rather thana result of the illness of sickle cell anemia.     

A Multiperspective Investigation of Social Competence in Children with Sickle Cell Disease

Compared the social competence and self-perceptions of 4- to8-year-old children with sickle cell disease (SCD) to a comparisongroup of healthy children. Social competence ratings were obtainedfrom multiple perspectives, including parents, teachers, andclinic staff members; children provided ratings of self-perceivedacceptance and competence. Children in the SCD group were ratedas socially competent as their peers in the comparison groupand the normative group. Differences across raters were found,however, with parents in the SCD group giving higher ratingsthan clinic staff members. No differences were revealed betweenchildren in the SCD group and the comparison group in theirself-perceptions of competence and acceptance. Implicationsfor future studies addressing the situational specificity ofsocial competence and its relevance to health care of chronicallyill children are discussed.     

Psychological and Social Concomitants of Sickle Cell Anemia in Adolescents

Based on the hypothesis that adolescents with sickle cell anemiaexperience difficulty in mastering the normal developmentaltasks of adolescence because of the characteristics of theirdisease, this study examined body satisfaction, depression,and social withdrawal in 24 adolescents with sickle cell anemia.They were compared to 24 healthy adolescents matched on sex,race, age, and socioeconomic status. As predicted, the sicklecell anemic adolescents reported less satisfaction with theirbodies and more symptoms of depression than their healthy peers.In addition, they were found to spend less time in social andnonsocial activities. These results support the hypothesis thatadolescents with sickle cell anemia are at risk for psychosocialadjustment problems and suggest at least three areas of adjustmentthat may be affected.     

Psychosocial Adjustment in Children and Adolescents with Sickle Cell Disease

This study investigated the degree to which the stress of chronicillness impacted on adjustment of a sample of 50 children andadolescents with sickle cell disease. The sample was selectedfrom patients seen in a Sickle Cell Center over an extendedperiod of time, with symptoms ranging from mild to severe. Thecharacteristics of the illness in terms of perceived pain, hospitalizations,and emergency room visits was evaluated, as well as the natureof presenting symptoms and levels of adjustment. Results indicatedthat there were problems in a range of adjustment variables,particularly for adolescent males, and most significantly inthe areas of behavior problems and social adjustment. The implicationsfor adaptive coping with adolescent developmental processeswere noted.     

Relation Between Severity of Chronic Illness and Adjustment in Children and Adolescents With Sickle Cell Disease

Tested the relationship between illness severity and adjustmentin 70 sickle cell patients, aged 8–16. Illness severitywas measured by frequency of hospitalization and emergency roomvisits, frequency and intensity of pain crises, and durationof illness. Adjustment variables were IQ, self-esteem, socialand personal adjustment, behavioral problems, school performance,and peer relations. Medical variables–associated illnesspatterns and type of hemoglobinopathy–were also considered.Sex and age were covariates. The hypothesis that illness severitywould affect adjustment was generally not supported. Other factorssuch as SES, family structure, or support systems may affectadjustment and suppress the hypothesized relationship. The needfor a more global intervention approach than using illness severityto measure need for psychotherapeutic assistance is suggested.     

Enhanced Parenting Knowledge and Skills in Mothers of Preschool Children with Sickle Cell Disease

Compared 25 preschool children with sickle cell disease (SCD)to demographicalty matched healthy comparison children on maternalreports of child-rearing beliefs and practices and maternaland child behaviors related to social adjustment. Mothers ofchildren with SCD possessed significantly more knowledge ofappropriate discipline techniques. The groups did not differon maternal reports of socially relevant child behavior. However,when mother-child interactions were observed in free play andstructured play settings, mothers of children with SCD treatedtheir children as competent significantly more, and treatedtheir children as incompetent significantly less, than comparisonmothers. Mothers of children with SCD also used significantlymore reinforcement during the final toy pick-up condition. Therewere no observed differences between groups in the children'sbehavior.     

大学生家庭功能、孤独感与领悟社会支持的关系

目的 了解大学生家庭功能、孤独感与领悟社会支持的关系.方法 采用家庭功能评定量表、UCLA孤独感量表和领悟社会支持量表对某大学206名大学生进行问卷调查.结果 ①大学生在家庭功能的角色扮演、情感介入和总的功能得分以及孤独感、领悟社会支持的家庭内支持与社会总支持上存在性别差异(t=2.643,2.661,2.812,2....     

Psychosocial and Family Functioning in Children with Insulin-Dependent Diabetes at Diagnosis and One Year Later

Examined the initial impact and subsequent adjustment to thediagnosis of insulin-dependent diabetes mellitus (IDDM). Childrenbetween 1 and 14 years of age and their families were assessedseveral weeks after diagnosis and again a year later using standardizedmeasures of child behavior, parental mental health, and familyfunctioning. Immediately after diagnosis, the children and bothparents exhibited mild symptoms of psychological distress butthese had largely resolved at 12-month follow-up. The impactof IDDM diagnosis on family functioning varied with informant,SES, and the age of the child, with an overall tendency forfamilies to become less flexible over the year. Findings suggestthat most children and their parents exhibit satisfactory individualadjustment after a period of initial stress but family functioningis affected in complex ways. Serial follow-up of the cohortis planned to establish whether the current findings are predictiveof longer term outcome.     

Hope, Coping, and Adjustment Among Children with Sickle Cell Disease: Tests of Mediator and Moderator Models

Tested mediator and moderator models of hope, coping, and adjustmentin 39 children with sickle cell disease. In home interviewsparents provided information on demographics and functionaladjustment. Children self-reported levels of hope, coping strategies,and psychological adjustment. Coping strategies moderated, butdid not mediate, the relationship between hope and adjustment.Hope was negatively associated with anxiety when active coping,support coping, and distraction coping was high. Avoidance copingdid not moderate the hope-adjustment relationship but was positivelyrelated to anxiety. No effects were found for depressive symptomsor for the functional measures of adjustment.     

The Influence of Disabling Condition Visibility on Family Functioning

Examined whether the level of family functioning and the componentscontributing to adaptive family functioning differed in familiesof visibty handicapped children (cerebral palsy) when comparedto families of nonvisibly disabled children (diabetes). Otherfactors included effect of disability severity on family functioning,comparison of families of disabled children to families of able-bodiedchildren, and comparison of mothers' and fathers' perceptionsof family functioning. The sample comprised 139 two-parent familiesof children with cerebral palsy (n = 48), diabetes (n = 46),and able-bodied children (n = 45) (all 5–11 years old).Results showed that neither visibility nor severity of disabilitydifferentially impacted family functioning. Furthermore, familiesof the disabled children exhibited high levels of family functioningwhich were similar to control families. Differences were notfound between the ways mothers and fathers perceived familyfunctioning.     

社区精神分裂症家属生存质量与患者社会功能相关分析

目的探讨社区精神分裂症患者社会功能对家属生存质量的影响。方法对179例社区精神分裂症患者进行社会功能缺陷筛选表(SDSS)评定,对患者家属用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)进行评定,并对患者的社会功能与家属生存质量进行相关分析。结果社区精神分裂症患者的SDSS总分及各分量表分与WHOQOL-BREF分呈显著负相关(r=-0.247,P<0.001)。结论社区精神分裂症患者的社会功能与家属的生存质量密切相关,社区精神分裂症患者的社会功能损失越重,家属的生活质量越差。     

Sickle Cell Disease Pain in Children and Adolescents: Change in Pain Frequency and Coping Strategies Over Time

Examined 9-month follow-up data obtained from children and adolescentswith sickle cell disease (SCD) and their parents participatingin a longitudinal study of pain coping strategies. Of 87 subjectscompleting the baseline assessment of pain coping strategies,70 (80%) of their parents completed a structured pain interviewassessing their child's health care use and activity reductionduring painful episodes over the follow-up period. Regressionanalyses controlling for age and pain frequency revealed thatbaseline Coping Attempts were associated with higher levelsof school, household, and social activity during painful episodes.Baseline Passive Adherence was associated with more frequenthealth care contacts during the subsequent 9 months. Increasesin Negative Thinking over time were associated with furtherincreases in health care contacts during the follow-up period.Comparing pain coping strategies assessed at baseline to paincoping strategies measured at follow-up revealed that pain copingstrategies were relatively stable over time for younger childrenbut changed more for adolescents.     

The Role of Family Functioning in the Development of Executive Functions in Preschool Children with Sickle Cell Anemia

ABSTRACT

Executive functions are compromised in children with sickle cell anemia. There is limited research on the development of executive functions in preschool children with sickle cell anemia and the factors that contribute to executive dysfunction. We looked at the relation between biomedical and environmental factors, including family functioning and socioeconomic status, and executive functions in 22 preschool children with sickle cell anemia. We found that family functioning was the strongest predictor of executive outcomes in young children with sickle cell anemia with no evidence for an influence of disease severity at this early stage.     

Psychological Adaptation and Adjustment of Mothers of Children With Congenital Heart Disease: Stress, Coping, and Family Functioning

Objective: Investigate support for the transactional stressand coping model for mothers of children with congenital heartdefects, in accounting for the variance in maternal adjustment. Methods: Participants were 52 mothers of children recruitedfrom a university medical center. Measures included illnessvariables, cognitive processes (i.e., appraisals of stress,expectations, methods of coping, family functioning, and maternalpsychological adjustment). Results: Maternal adjustment was associated with high levelsof daily stress and palliative coping techniques and was notsignificantly associated with severity of the cardiac defect.Together, the variables of the model accounted for approximately38% of the variance in maternal adjustment. Conclusions: The findings are in accord with previous researchamong other chronically ill populations in suggesting an associationbetween stress, coping, and maternal adjustment. Within thelimitations of the study, the data were interpreted to supportthe utility of theoretical models in identifying areas in needof intervention across chronic illness groups.     

Spina Bifida Children and Their Parents: A Population Prone to Family Dysfunction?

Spina bifida children of normal intelligence and their parentswere compared with a carefully matched control group of nondisabledchildren and their parents in a hierarchically oriented assessmentof individual, marital, and family functioning. Contrary topopular hypotheses that families with a handicapped child areespecially vulnerable to stress and psychological problems,results across all measures revealed no differences betweenthe two groups. Further, no differences were found between mothersand fathers on the various measures. These results support theview that nonretarded spina bifida children and their parentshave no special psychological characteristics that distinguishthem from nonhandicapped children and their parents. The findingsalso underscore the strengths and coping skills of handicappedchildren and their families. The tendency of researchers andclinicians to focus on the deviant aspects of these populationsmay obscure the fact that many may be adapting successfully.     

青少年家庭功能的发展特点及其与心理健康的关系

目的考察青少年家庭功能的发展特点及其与心理健康的关系。方法采用家庭功能量表和SCL-90对西安市的928名中学生进行问卷调查。结果在家庭功能的沟通、父母控制和父母关注维度上,女生得分低于男生(2.34±0.86/2.48±0.84,t=5.86,1.29±0.64/1.30±0.55,t=4.77,1.99±0.99/2.25±1.00,t=15.8,P<0.05、0.01);在沟通维度上不同年级学生得分差异有显著性(F=3.43,P<0.05),高一学生得分高于初一(2.51±0.85/2.32±0.86),在父母控制维度各年级得分差异有显著性(F=7.5,P<0.01),初一年级得分多于高一年级(2.35±1.04/2.04±0.98)。回归分析发现,家庭功能的冲突与和谐、沟通及父母控制维度可正向预测个体心理健康状况(标准回归系数=6.155、0.144、0.124)。结论女生的家庭功能状况好于男生,初一年级的家庭功能状况最好;家庭功能的冲突与和谐、沟通和父母控制维度均可显著预测个体心理健康水平。