Emotional adaptation of children undergoing bone marrow transplantation.

Abstract

To examine stress reactions and psychic adaptation of children aged 8-12 years in single-room treatment under isolation conditions after bone marrow transplantation (BMT). The prospective longitudinal study included free diagnostic interviews and a large test battery. We used a mixture of projective tests questionnaires and an intelligence test (the German version of the revised Wechsler Intelligence Scale for Children) to evaluate different adaptation processes. The questionnaires clearly showed children's strong tendencies to adapt to the situation and to normalize their behaviour under isolation conditions. In contrast, the psychoanalytic interview and the projective tests demonstrated a very differentiated emotional adjustment: Before transplantation, coming to terms with the life-threatening situation was deferred. After transplantation, very intensive emotional examination of the situation and superficial adaptation (protective denial) were observed. It is very important to intensify the child's and the family's psychosocial support before admitting the child for hospital treatment. Family conflicts and neurotic developments should be regarded as risk factors for marked and potentially dangerous stress reactions.