Posttraumatic Stress Symptoms and Distress Among Parents of Children With Cancer

In this study, we compared levels of posttraumatic stress symptoms (PTSS) and general psychological distress between parents of childhood cancer survivors and parents of children with Type 1 diabetes mellitus (DM1). In this study, we also examined potential risk factors for PTSS. Participants included 47 parents of childhood cancer survivors and 31 parents of children with DM1. Participants completed self-report measures of posttraumatic stress, general psychological distress, coping strategies, social network size, and perceived illness uncertainty. Findings revealed that parents of children surviving cancer reported higher levels of PTSS and general distress than parents of children with DM1. In the total sample, lower levels of emotion-focused coping and greater perceived uncertainty were associated with increased frequency of both PTSS and general psychological distress after we accounted for demographic and illness variables. Having a child with cancer may increase the risk for experiencing PTSS. Interventions are warranted that focus specifically on the reduction of PTSS in parents of children surviving cancer.     

Posttraumatic Stress Symptoms and Distress Among Parents of Children With Cancer

In this study, we compared levels of posttraumatic stress symptoms (PTSS) and general psychological distress between parents of childhood cancer survivors and parents of children with Type 1 diabetes mellitus (DM1). In this study, we also examined potential risk factors for PTSS. Participants included 47 parents of childhood cancer survivors and 31 parents of children with DM1. Participants completed self-report measures of posttraumatic stress, general psychological distress, coping strategies, social network size, and perceived illness uncertainty. Findings revealed that parents of children surviving cancer reported higher levels of PTSS and general distress than parents of children with DM1. In the total sample, lower levels of emotion-focused coping and greater perceived uncertainty were associated with increased frequency of both PTSS and general psychological distress after we accounted for demographic and illness variables. Having a child with cancer may increase the risk for experiencing PTSS. Interventions are warranted that focus specifically on the reduction of PTSS in parents of children surviving cancer.     

Course of Depressive Symptoms Following a Workplace Injury: A 12-Month Follow-Up Update

Introduction To estimate the prevalence, incidence and course of depressive symptoms, their relationship with return-to-work, and prevalence of depression diagnosis/treatment 12 months following a lost-time workplace musculoskeletal injury. Methods In a prospective cohort study, 332 workers’ compensation claimants with a back or upper extremity musculoskeletal disorder completed interviews at 1, 6 and 12 months post-injury. Participants self-reported they had not received a depression diagnosis 1 year pre-injury. Cutoff of 16 on the CES-D defined a high level of depressive symptoms. Self-reported data on depression diagnosis and treatment and work status since injury were collected. Results Cumulative incidence of high depressive symptom levels over 12 months was 50.3 % (95 % CI 44.9–55.7 %). At 12 months, 24.7 % (95 % CI 20.1–29.3 %) of workers exhibited high levels. Over 12 months, 49.7 % (95 % CI 44.3–55.1 %) had low levels at all 3 interviews, 14.5 % (95 % CI 10.7–18.2 %) had persistently high levels, and 25.6 % (95 % CI 20.9–30.3 %) demonstrated improvements. Among workers with low baseline levels, incidence of high levels at 12 months was 6.0 % (95 % CI 2.7–9.3 %). For workers with high baseline levels, 36.1 % (95 % CI 27.9–44.3 %) exhibited persistent high symptoms at 6 and 12 months, while 38.4 % (95 % CI 30.1–46.6 %) experienced low levels at 6 and 12 months. Problematic RTW outcomes were common among workers with a poor depressive symptom course. Among workers with persistent high symptoms, 18.8 % (95 % CI 7.7–29.8 %) self-reported receiving a depression diagnosis by 12 months and 29.2 % (95 % CI 16.3–42.0 %) were receiving treatment at 12 months. Conclusions Depressive symptoms are common in the first year following a lost-time musculoskeletal injury and a poor depressive symptom course is associated with problematic RTW outcomes 12 months post-injury. While symptoms appear to improve over time, the first 6 months appear to be important in establishing future symptom levels and may represent a window of opportunity for early screening.     

Physical Distress and Depressive Symptomatology Among Children With Cancer

To establish the relationship between physical distress and depression, we assessed the severity of physical symptoms as well as depressive symptoms on the Children's Depression Inventory (CDI; Kovacs, 1983), a modified version of the CDI excluding physical symptoms (CDI-23), maternal reports on the Depression scale of the Child Behavior Checklist (Achenbach & Edelbrock, 1983), and maternal ratings twice within a 6-week interval among 92 children with cancer. Fewer than 10% of children ever exhibited symptomatology at or above threshold for diagnosis of mild depression. Approximately 40% of children displayed changes in severity of their depressive symptoms in the same direction as changes in severity of their physical symptoms. Children who were more vulnerable to continuing symptoms of depression following improvement in physical condition were correctly classified on the basis of their initial symptoms with 66% to 73% accuracy. These results can assist in discriminating children who may benefit from psychological intervention before it is obvious that their mood will not improve commensurate with physical condition.     

Physical Distress and Depressive Symptomatology Among Children With Cancer

To establish the relationship between physical distress and depression, we assessed the severity of physical symptoms as well as depressive symptoms on the Children's Depression Inventory (CDI; Kovacs, 1983), a modified version of the CDI excluding physical symptoms (CDI-23), maternal reports on the Depression scale of the Child Behavior Checklist (Achenbach & Edelbrock, 1983), and maternal ratings twice within a 6-week interval among 92 children with cancer. Fewer than 10% of children ever exhibited symptomatology at or above threshold for diagnosis of mild depression. Approximately 40% of children displayed changes in severity of their depressive symptoms in the same direction as changes in severity of their physical symptoms. Children who were more vulnerable to continuing symptoms of depression following improvement in physical condition were correctly classified on the basis of their initial symptoms with 66% to 73% accuracy. These results can assist in discriminating children who may benefit from psychological intervention before it is obvious that their mood will not improve commensurate with physical condition.     

安徽留守儿童抑郁状况及其影响因素分析

目的了解安徽省留守儿童抑郁症状的性别差异及其与父母打工类型的关系,为改善儿童心理健康提供依据。方法采用无记名面对面的调查方式,以城乡留守儿童为目标人群,共在安徽省城乡调查941人,使用儿童抑郁量表(CDI)评定其抑郁症状,运用多因素Logistic回归分析探讨留守儿童抑郁症状的影响因素。结果留守儿童抑郁症状检出率(15.8%)高于非留守儿童(10.9%),男生抑郁症状检出率高于女生。多因素Logistic回归分析结果表明,父亲外出打工是女生抑郁症状发生的危险因素。结论留守儿童抑郁症状较为普遍,研究留守儿童心理卫生问题时应考虑到性别差异和父、母的角色。     

Topical Anesthesia Versus Distraction for Infants' Immunization Distress: Evaluation With 6-Month Follow-Up

Topical anesthetic and distraction are effective pain management techniques, yet they have not been fully evaluated for infants. Eighty-four 1-year-olds undergoing immunizations were randomized to distraction, topical anesthetic, or control. The 42 infants who returned for their 18-month injections were evaluated for long-term treatment gains. An observational scale revealed that infants demonstrated lower distress with distraction than topical anesthetic or control during the recovery phase of the injection at 12 months, and parents and nurses rated infants as more distressed at 12 than 18 months. Distress measures were positively associated across time.     

Factors Related to Depressive Symptoms Among Long-Term Survivors of Cervical Cancer

In this article we describe depressive symptoms among survivors of cervical cancer. Study participants were previously diagnosed and treated with cervical cancer 5 to 25 years prior to the completion of a telephone survey. Through a population-based survey of women identified via a state tumor registry in southern New England, the investigators learned that depressive symptoms are prevalent among a subgroup of long-term survivors long after diagnosis and treatment. The at-risk participants included those who were at a lower economic status and whose marital status and ability to work had changed, and who continued to experience pain and diarrhea caused by radiotherapy. Findings from this study warrant additional research with this potentially vulnerable group of women.     

Skin Cancer Prevention Behaviors Among Parents of Young Children

We examined the relation between several relevant variables and parents' (n = 88) skin cancer prevention behaviors on behalf of their young children (ages 3 to 8 years). Results show that stable demographic factors (e.g., child age, socioeconomic status) are most predictive of parents' skin cancer knowledge and that healthier attitudes and perceptions about sun exposure are most predictive of effective sun protection behaviors by parents. These findings highlight the need for awareness and dissemi- nation of sun exposure and skin cancer information as well as for effective prevention behaviors.     

Disasters and Depressive Symptoms in Children: A Review

Background

Disasters are destructive, potentially traumatic events that affect millions of youth each year.

Objective

The purpose of this paper was to review the literature on depressive symptoms among youth after disasters. Specifically, we examined the prevalence of depression, risk factors associated with depressive symptoms, and theories utilized in this research area.

Methods

We searched MEDLINE, PsycInfo, and PubMed electronic databases for English language articles published up to May 1, 2013. Reference lists from included studies were reviewed to capture additional studies. Only quantitative, peer reviewed studies, conducted with youth under the age of 18 years, that examined postdisaster depressive symptoms were included. Seventy-two studies met inclusion criteria. Prevalence of depressive symptoms, disaster type, correlates of depressive symptoms, and theories of depressive symptoms were reviewed.

Results

Only 27 studies (38 %) reported on prevalence rates among youth in their sample. Prevalence rates of depression among youth postdisaster ranged from 2 to 69 %. Potential risk factors were identified (e.g., female gender, exposure stressors, posttraumatic stress symptoms). Theories were examined in less than one-third of studies (k = 21).

Conclusions

Given the variability in prevalence rates, difficulty identifying a single profile of youth at risk for developing depressive symptoms, and lack of a unifying theory emerging from the studies, recommendations for future research are discussed. Use of established batteries of assessments could enable comparisons across studies. Merging existing theories from children’s postdisaster and depression literatures could aid in the identification of risk factors and causal pathways.     

Health Care Concerns Among Parents of Children With Mental Retardation

This preliminary study compared concerns of parents of children with moderate mental retardation and parents of children with severe mental retardation, on four health care variables, using a questionnaire format Parents of children with severe impairments and those with school-aged children, had significantly more concerns regarding the hospitalization of those children, than did parents of children with moderate mental retardation or those with preschool children Similarly, parents of children with severe disabilities had significantly more concerns on the parent-professional relationship variable than did individuals with moderately affected offspring A high level of concern on the professional competence variable was expressed by all respondents Study results suggested that severity of intellectual impairment is an important determinant of the number and nature of concerns that are experienced by parents when seeking health care services for their children with mental retardation Suggestions for improving professional knowledge and service delivery are provided.     

Teacher, Parent, and Child Evaluative Ratings of a School Reintegration Intervention for Children With Newly Diagnosed Cancer

The disruption of school participation and accompanying social expenences because of cancer and its treatment has been related to major problems in adaptation to the disease For the child with cancer contiuation of his/her social and academic activities provides an important opportunity to normalize as much as possible a very difficult expenence The present study reports on the childrens, parents, and teachers subjective evaluations of the benefits of a comprehensive school reintegration intervention Forty-nine children, newly diagnosed with cancer received comprehensive school reintegration consisting of supportive counseling, educational presentations, systematic haison between the hospital and the school, and periodic follow-ups Children, parents, and teachers were asked to rate their perceptions of the utility and value of the intervention approach Overall subjective evaluations were very positive, providing support for the social validity of the school reintegration approach for children with newly diagnosed cancer.     

A Cognitive Diathesis-Stress Model of Depressive Symptoms in Children and Adolescents With Juvenile Rheumatic Disease

In this study we tested a cognitive diathesis-stress theory of depressive symptoms (i.e., learned hopelessness theory) in children with juvenile rheumatic disease (JRD). Participants ages 9 to 17 with JRD completed measures of depressive symptoms, perceived control over daily illness symptoms, and attributions for disease-unrelated negative events. Results revealed that general negative attributions were associated with greater depressive symptoms only under conditions of low perceived control, after controlling for disease and demographic variables. Findings support a cognitive diathesis-stress conceptualization of depressive symptoms in children with JRD, suggesting the importance of interventions that target both illness-related (i.e., perceived control) and unrelated cognitive appraisals (i.e., general negative attributions).     

Parent-Reported Habitual Snoring and Depressive Symptoms Among Children and Adolescents Who Are Obese

Sleep disordered breathing (SDB) is associated with medical and psychological problems, including obesity and depression. Snoring is the most common complaint for SDB. We hypothesized that children and adolescents who are obese and snore would have more depressive symptoms than those who do not snore. Participants (ages 6–17) evaluated for a weight management program (n?=?247) were divided into parent-reported habitual snorers (34%) and non-snorers (65%). Habitual snorers had significantly more self-reported symptoms of depression than did non-snorers (0.041); a trend remained after controlling for BMI z-scores (0.053). Clinicians should be aware of depressive symptoms in this high-risk population.     

A Cognitive Diathesis-Stress Model of Depressive Symptoms in Children and Adolescents With Juvenile Rheumatic Disease

In this study we tested a cognitive diathesis-stress theory of depressive symptoms (i.e., learned hopelessness theory) in children with juvenile rheumatic disease (JRD). Participants ages 9 to 17 with JRD completed measures of depressive symptoms, perceived control over daily illness symptoms, and attributions for disease-unrelated negative events. Results revealed that general negative attributions were associated with greater depressive symptoms only under conditions of low perceived control, after controlling for disease and demographic variables. Findings support a cognitive diathesis-stress conceptualization of depressive symptoms in children with JRD, suggesting the importance of interventions that target both illness-related (i.e., perceived control) and unrelated cognitive appraisals (i.e., general negative attributions).     

Coping-Health Inventory for Parents: Assessing Coping Among Iranian Parents in the Care of Children With Cancer and Introductory Development of an Adapted Iranian Coping-Health Inventory for Parents

The factorial structure of the Coping-Health Inventory for Parents (CHIP) instrument was investigated. Predictive, discriminative, and concurrent validity was also examined. A sample of 75 mothers and fathers in the care of adolescents diagnosed with cancer living in Iran completed the CHIP as part of a large battery of measures. Exploratoty factor analysis yielded a 13-item, 3-factor model that conceptually replicated the dimensional structure of the original CHIP instrument. The newly adapted scales predicted adolescents' psychological adjustment beyond religious coping and gender of parent, and differentially predicted adaptive and nonadaptive coping styles. The 3-factor adapted CHIP measure offers preliminary evidence for generalizability of the dimensional structure of the CHIP to the Iranian social and cultural situation.