Youth and Parent Illness Appraisals and Adjustment in Pediatric Inflammatory Bowel Disease

Abstract

Youth with inflammatory bowel disease (IBD) and their parents are at increased risk for psychological adjustment difficulties, potentially due to the uncertain and intrusive nature of IBD. However, empirical investigations have yet to assess the contribution of these unique disease features to adjustment outcomes. Our aim was to examine: 1) the influence of youth and parent perceptions of illness uncertainty and illness intrusiveness on youth adjustment; and 2) examine the influence of youth and parent perceived uncertainty and intrusiveness on parent adjustment. Youth with IBD (N = 107) and their primary caregiver completed measures of illness uncertainty, illness intrusiveness, and psychological adjustment. Results revealed that youth illness uncertainty was more closely associated with youth depressive symptoms than was youth perceived intrusiveness. Further, youth illness perceptions were more closely associated with youth depressive symptoms compared to parent perceptions; however, results also suggested that parent illness perceptions may indirectly impact youth adjustment through their influence on youth illness perceptions. Finally, parent illness intrusiveness demonstrated a more robust association with parent adjustment compared to parent illness uncertainty, and both youth and parent illness intrusiveness were independently related to parent adjustment. Findings highlighted the transactional nature of adjustment in pediatric IBD and the importance of examining clinically relevant youth and parent subjective illness perceptions, like uncertainty and intrusiveness, in investigations of youth and parent adjustment outcomes in this population.