Children's Psychosocial Adjustment Research Articles

P03-272 Psychosocial adjustment and assessment of healthy-related quality of life on children with newly diagnosed cancer and their family

Aims:To assess healthy-related quality of life and psychosocial adjustment in children with newly diagnosed cancer and their parents immediately and 6 months after diagnosis and treatment of cancer.Method:A prospective, case control study was conducted on eighty-nine children with newly diagnosed cancer, aged between 6 months to 16.7 years (mean, 8.2 years), and ninety healthy children of matched age group and social background. The children were assessed with the Child Behavior Checklist (CBCL), and the Parenting Stress Index (PSI) and the SF-36 questionnaire were administered to their parents immediately after diagnosis of cancer, 3 months after chemotherapy, and 6 months after chemotherapy.Results:No matter at the period immediately after diagnosis of cancer, 3 months or 6 months after starting chemotherapy, the parents of children with cancer scored significantly worse on every domains of SF-36 except body pain and every subscales of PSI except distractibility/hyperactivity and attachment when compared with the control group. The cancer group scored consistently lower on all CBCL syndrome scales than the control group, with anxiety, depression and body pain being significantly different. After starting chemotherapy, the parents reported improved scores on quality of life and decreasing parenting stress in both parent and child domains since 3 months or 6 months after starting chemotherapy.Conclusion:Considerable distress was experienced by both children with newly diagnosed cancer and their parents during the period immediately after diagnosis. However, parents can adjust gradually since 3 months after starting chemotherapy and experience improved quality of life.

Remission of Maternal Depression: Relations to Family Functioning and Youth Internalizing and Externalizing Symptoms

Family functioning and parenting were hypothesized to mediate the relation between remission of maternal depression and children's psychosocial adjustment. Participants were 114 mother–child dyads participating in the Sequenced Treatment Alternatives to Relieve Depression Child 3-month follow-up. All mothers had been diagnosed with major depressive disorder and were treated initially with citalopram; 33% of mothers experienced remission of depressive symptoms. Youth ranged in age from 7 to 17. Remission of maternal depression was associated with changes in children's reports of their mothers' warmth/acceptance, which in turn partially mediated the relation between maternal depression remission and youth internalizing symptoms, accounting for 22.9% of the variance.

Outcome after renal transplantation. Part II: Quality of life and psychosocial adjustment

Knowledge of health-related quality of life (QOL) and psychosocial adjustment (PA) in children after renal transplantation (RTPL) is limited. QOL and PA were evaluated by standardized tests in patients after RTPL. Thirty-seven children of median age 14.5 years (range 6.5-17 years) were investigated a mean 4.5 years (range 0.5-12.8 years) after RTPL. Child- and parent-rated QOL was evaluated with the Child Quality of life Questionnaire of The Netherlands Organization for Applied Scientific Research Academical Medical Centre (TNO-AZL). PA was assessed by the Child Behaviour Checklist (CBCL) providing parental reports of a child's behaviour. In patients' self-ratings, the QOL dimension physical complaints (P < 0.0005) scored significantly better than that of healthy controls, whereas the dimension positive emotional functioning was impaired (P = 0.02). Parents rated motor functioning (P = 0.002), autonomy (P = 0.01), cognition (P = 0.04) and positive emotions (P < 0.0005) as significantly impaired. Parents also assessed PA significantly (P = 0.02) impaired with regard to internalizing behaviour. Dialysis duration, young age at RTPL, living-related donation, steroid treatment, adverse family relationships and maternal distress had a significantly negative impact on QOL and PA (P < 0.05). Patients rated QOL higher than did healthy controls. Parents evaluated their children's QOL and PA more pessimistically than did the patients themselves. Both illness-related variables and family environment played an important role.

Child Psychosocial Adjustment and Parenting in Families Affected by Maternal HIV/AIDS

Child adjustment and parenting were examined in twenty-three 9–16-year-old youth from families affected by maternal HIV infection and 20 same-age peers whose mothers were not infected. Children whose mothers were seropositive reported significantly more externalizing problems. Infected mothers reported less age-appropriate supervision/monitoring relative to non-infected mothers. Better mother-child relationship quality and less impairment in parental supervision/monitoring of age-appropriate youth behaviors were associated with fewer externalizing difficulties among the HIV-positive group only. Similarly, only among HIV-infected mothers was refraining from engaging in inconsistent disciplinary tactics associated with lower reports of internalizing and externalizing problems. These data highlight the promise of programs targeting parenting skills to prevent or ameliorate child difficulties.

Mother-Child Dyadic Synchrony in European American and African American Families during Early Adolescence: Relations with Self-Esteem and Prosocial Behavior

Mother-child relationships characterized by dyadic synchrony, a mutually responsive and interconnected interaction style, have been consistently linked to children's psychosocial adjustment in early childhood, but it is unclear whether such interaction patterns remain conducive to positive outcomes in early adolescence. The aim of the present investigation was to examine mother-child synchrony and its link to early adolescents' self-esteem and prosocial behavior. Data were collected from 268 early adolescents and their mothers from both European American and African American families. Four components of dyadic synchrony were assessed during a structured mother-child interaction session. In addition, assessments of early adolescents' self-esteem and prosocial behavior were conducted approximately one year later. Results indicated that mother-child shared positive affect and conversational equality were highly intercorrelated components of dyadic synchrony. Moreover, early adolescents from dyads with high levels of dyadic synchrony and conversational equality had higher self-esteem. Early adolescents from dyads with high levels of shared positive affect were more prosocial with peers. Although the patterns of association were similar for African American and European American preadolescents, ethnicity did interact with certain components of synchrony in predicting early adolescents' self-esteem and prosocial behavior.

Cooccurrence of problems in activity level, attention, psychosocial adjustment, reading and writing in children with developmental coordination disorder

The purpose of this paper was to investigate the cooccurrence of problems in activity level, attention, reading, writing and psychosocial adjustment of children with developmental coordination disorder (DCD). A parent-report questionnaire, the Developmental Coordination Disorder Questionnaire - Chinese version (DCDQ-C), was used to screen first to third graders from 13 mainstream schools in Taipei. Two standardized motor tests were then administered to those who scored below 10% on the DCDQ-C. Tests of activity level, attention, reading, writing and psychosocial adjustment were then administered to this sample. Thirty-eight children identified as DCD, 32 as suspect for DCD and 82 as normal comparison were included in the final sample. Multivariate analysis of variance comparing the three groups (DCD, suspect DCD, and comparison) revealed that both children with DCD and suspect for DCD obtained significantly poorer scores on measures of attention and reading, and were more hyperactive than comparison children. Children with DCD and suspect for DCD were also reported to have more internalizing and social problems than children without motor problems. No significant differences, however, were noted between children with different degree of motor coordination problems (categorized as DCD and suspect for DCD) on any measure. Furthermore, a high percentage of children in both the DCD and suspect groups fell in the clinical range of attention, activity level and psychosocial adjustment problems. The results revealed a high risk for these problems in nonreferred children with motor coordination problems. The high percentage of clinical range behavioral problems warrants attention of clinicians who work with children with motor coordination difficulties to the need to promote early identification and referral.

Mediators of Depressive Symptoms in Children with Type 1 Diabetes and their Mothers

To examine the relationships among maternal and child depressive symptoms and child and family psychosocial factors. Secondary analysis of baseline data for a coping skills intervention for school-age children (ages 8-12) with type 1 diabetes (T1D) and their mothers. Children and mothers completed measures of depressive symptoms, coping, quality of life, and family functioning. There was a strong relationship between maternal and child depressive symptoms (r = .44, p < .001). Maternal depressive symptoms were negatively related to child quality of life, perceptions of coping, and family functioning. Impact of diabetes on quality of life, finding coping with diabetes upsetting, and family warmth mediated the relationship between maternal and child depressive symptoms. Maternal depression may negatively affect child adjustment through its influence on quality of life, coping, and family functioning. Implications for interventions to improve psychosocial adjustment in children with T1D are discussed.

Peer victimization in children with attention-deficit hyperactivity disorder

This study examined the correlation of peer victimization to psychosocial adjustment in a sample of children diagnosed with attention-deficit hyperactivity disorder (ADHD). A total of 303 files of youth who received a psycho-educational assessment were reviewed; of these, 116 had an ADHD diagnosis. The data collected included the Child Behavior Checklist (which includes items assessing peer victimization), Conner's Parent Rating Scale, Revised Children's Manifest Anxiety Scale and Children's Depression Inventory. Peer victimization was positively correlated with parent reports of anxiety, depression, social problems, delinquent behavior and aggressive behavior. Children with a comorbid psychiatric diagnosis with ADHD reported higher rates of peer victimization than those without a comorbid diagnosis. Children diagnosed with ADHD along with a comorbid externalizing psychiatric diagnosis experienced higher rates of peer victimization than those with a comorbid internalizing psychiatric diagnosis. The implications of this study concerning peer victimization and psychosocial adjustment in children with ADHD are discussed.

Developmental outcome and psychosocial adjustment in children after surgery for congenital heart disease during infancy

The aim of the present study was to explore developmental outcome, psychosocial adjustment and self‐regulation of children who underwent corrective surgery for congenital heart disease (CHD) in early infancy and a possible association with type and procedural characteristics of the intervention. Two groups of children with CHD aged 2 to 6 years operated in infancy for ventricular septal defect (n = 19) or as neonates for transposition of the great arteries (n = 25) and a reference group (n = 35) underwent developmental and psychological testing. Vagal tone as an index for emotional self‐regulation capabilities was measured during baseline and challenge conditions. The study shows that children who underwent surgery for CHD in early infancy were at a disadvantage for cognitive, emotional, and motor development compared to the reference group at preschool age. Behavioural outcome and psychosocial adjustment were generally positive in our sample and we conclude that surgical procedures leave no discernable trace in the vagal regulation system. Developmental and behavioural outcome were moderately related to oesophageal temperature and total support time during the surgery, but not uniformly across different areas of development. It seems likely that familial and environmental factors have a mediating influence.

Well-adjusted children: An alternate view of children with inflammatory bowel disease and functional gastrointestinal complaints

Previous studies have suggested impaired psychosocial adjustment in children and adolescents with inflammatory bowel disease (IBD). We examined 62 subjects referred to a regional Pediatric Gastroenterology Clinic with IBD or functional gastrointestinal (FGI) complaints. Characteristics of the clinic include a unified team approach, regularly scheduled appointments at 3-month intervals, proactive medical care emphasizing maintenance of full functioning, and close medicalsurgical interaction (joint clinics). A research assistant administered a questionnaire regarding children's perceptions of their illness, as well as the Child Depression Inventory (CDI), the Piers-Harris (PH) test of self-concept, and the Child Behaviour Checklist (CBCL). The 36 children with IBD (25 Crohn's disease, 11 ulcerative colitis, mean age 13.3 ± 3.0 years) were compared with 26 patients with FGI complaints (16 recurrent abdominal pain, 10 functional megacolon, mean age 11.4 ± 2.8 years). The scores on the standardized tests were not clinically significant for either group. In comparison, however, children with IBD were less depressed and had fewer behaviour problems than the FGI group. Surprisingly, only 19% (7 of 36) of children with IBD described their illness as a problem to them, compared with 65% (17 of 26) of children with FGI symptoms. The latter children also considered themselves significantly sicker than did those with IBD. We conclude that normal psychosocial adjustment is possible in pediatric patients with IBD. We speculate that this group benefitted from the professional supports that our clinic specifically provides to patients with IBD. The FGI group may have suffered from a lack of such professional supports, as well as from the absence of a specific diagnosis.

A life skills intervention improved psychosocial adjustment in children with cystic fibrosis

A life skills intervention improved psychosocial adjustment in children with cystic fibrosis

The disturbed parent-child communication after parental separation and its impact on the child's psychosocial adjustment

The disturbed parent-child communication after parental separation and its impact on the child's psychosocial adjustment

Knowledge of Maternal HIV/AIDS and Child Adjustment: The Moderating Role of Children’s Relationships with their Mothers

The current study examined whether child-reported maternal warmth and support moderated the association between knowledge of maternal illness and child psychosocial adjustment among 86 low-income, African American mothers with HIV/AIDS and their non-infected children. Mother-child relationship quality moderated the association between children's knowledge of maternal HIV/AIDS and children's externalizing, but not internalizing, difficulties. Consistent with the stress-buffering hypothesis, a warm and supportive mother-child relationship afforded a more robust buffer against externalizing difficulties for children who knew of their mother's illness than for children who did not. Clinical implications and future directions are discussed.

Longitudinal Associations Between Fathers’ Heavy Drinking Patterns and Children’s Psychosocial Adjustment

Psychosocial adjustment in children of alcoholics (N = 114) was examined in the year before and at three follow-ups in the 15 months after their alcoholic fathers entered alcoholism treatment, testing the hypothesis that children's adjustment problems will vary over time as a function of their fathers' heavy drinking patterns. Three unique patterns of heavy drinking in alcoholic fathers were identified through cluster analysis. The results demonstrated significant and meaningful associations between these drinking patterns in fathers and adjustment problems in children over time. Overall, children whose fathers remained mostly abstinent following their treatment showed lowest and decreasing adjustment problems, while children whose fathers continued and increased heavy drinking following their treatment showed greatest and increasing adjustment problems over time.

Imagining your child's mind: Psychosocial adjustment and mothers' ability to predict their children's attributional response styles

One class of parent–child interaction that has recently received attention is a mother's engagement with her child at a mental level. The current study operationalizes this notion by asking the mothers of 354 7‐ to 11‐year‐old children drawn from a larger community sample (N=659) to guess the responses of their children, who, in turn, were asked to attribute thoughts to their peers in distressing peer‐related scenarios. The following predictions were made: (1) mothers would be above chance in the accuracy by which they predicted their children's overall attributional styles; (2) increased maternal accuracy would be an important correlate of reduced psychopathology symptoms in children; and (3) poor maternal accuracy would associate with a maladaptive child attributional response style characterized by unrealistic and overly positive attributions. Results suggested that maternal accuracy was normally distributed with mothers accurately guessing the responses of their children for about half of the social scenarios. Furthermore, mothers were shown to be above chance in the accuracy by which they predicted their children's overall attributional styles. Maternal accuracy was found to be related to child psychosocial adjustment (reduced scores on child psychopathology measures), whilst poor maternal accuracy was associated with ineffective social‐cognitive reasoning, as indexed by an unrealistic and overly positive child attributional style. Findings are discussed within the context of the burgeoning literature linking attachment, family talk about feelings and thoughts, and parental mind‐mindedness.

Does individual treatment for alcoholic fathers benefit their children? A longitudinal assessment.

Psychosocial adjustment in children of alcoholics (COAs; N=125) was examined before and at 3 follow-ups in the 15 months after their fathers entered alcoholism treatment. Before their fathers' treatment, COAs exhibited greater overall and clinical-level symptomatology than children from the demographically matched comparison sample, but they improved significantly following their fathers' treatment. Children of stably remitted fathers were similar to their demographic counterparts from the comparison sample and had fewer adjustment problems than children of relapsed fathers, even after accounting for children's baseline adjustment. Thus, COAs' adjustment improved when their fathers received treatment for alcoholism, and fathers' recovery from alcoholism was associated with clinically significant reductions in child problems.

Pilot Study on the “Quality of Life” as Reflected by Psychosocial Adjustment of Children with Thalassemia Major Undergoing Iron-Chelating Treatment in Western Taiwan

Comprehensive care for thalassemia major (TM) patients has achieved great advances in the world, yet psychosocial developmental aspects of care in families with afflicted members has made only limited progress. Besides confronting the disease itself, a major task for children with TM is to develop into autonomous, healthy, and functioning adults. An emerging concept in considering the adjustment of children with chronic physical disorders is “quality of life”(QL).To study the QL with regard to reflection by psychosocial adjustment in TM children, we enrolled 55 TM patients undergoing intravenous (IV) and/or oral iron chelation, 39 of whom completed the content on issues related to QL according to Cramer and Devinsky. It was concluded that oral iron chelation can be better adjusted than IV iron chelation for a thalassemic child. This favors its use, but not necessarily in combination with IV iron chelation. Perception gaps that arise from age or generation merit concern. This approach to the study of QL, as reflected by psychosocial adjustment in children with TM, is an excellent method for learning about parental-child adjustment regarding a chronic physical condition such as TM.

Percepção de apoio social na adolescência: análise fatorial confirmatória da escala Social Support Appraisals

Durante a adolescência, a percepção de apoio social parece estar relacionada com o ajustamento psicossocial do adolescente e com o processo de desenvolvimento da sua auto-estima e da sua identidade. Este estudo aprecia algumas das qualidades psicométricas de um instrumento construído por Vaux para avaliar a percepção dos adolescentes do apoio emocional recebido da família, dos amigos e dos professores, o Social Support Appraisal (SSA). A sua consistência interna em estudantes portugueses do 7º ao 12º ano de escolaridade é satisfatória e melhora com a progressão na escolaridade. A sua estrutura, evidenciada graças ao recurso à técnica de modelação de estruturas covariantes (análise fatorial confirmatória, com o programa EQS, Bentler) revelou-se multidimensional e hierárquica, formada por um fator de segunda ordem e por três fatores de primeira ordem, que diferenciam a percepção de apoio social dos amigos, dos professores e da família.

Parenting Stress in Infancy and Psychosocial Adjustment in Toddlerhood: A Longitudinal Study of Children with Craniofacial Anomalies

To evaluate the association between parenting stress during infancy and child psychosocial adjustment during toddlerhood, within a sample of children with craniofacial anomalies (CFAs). Retrospective chart review. Urban medical center department of reconstructive plastic surgery. Parents of 47 children aged birth to 24 months at time 1 and 24 to 46 months at time 2. Parenting Stress Index/Short Form completed at times 1 and 2; Child Behavior Checklist completed at time 2. Relative to norms, more parents of children with CFAs experienced serious levels of parenting stress at times 1 and 2; however, fewer children with CFAs experienced serious levels of adjustment problems. Parenting stress during infancy predicted psychosocial adjustment in toddlerhood but was mediated by parenting stress in toddlerhood. Parents high on stress at both assessments showed clinical levels of total parenting stress and parent-child dysfunctional interaction when their children were infants; their toddlers showed higher levels of maladjustment than those with parents elevated on parenting stress during only infancy. Elevated levels of parenting stress during infancy may be stable through toddlerhood for families having a child with a CFA. The relation between parenting stress and child adjustment is likely to be reciprocal. These findings should be replicated with a larger sample and multiple informants.

Psychosocial Adjustment in Children and Adolescents with a Craniofacial Anomaly: Age and Sex Patterns

To examine rates of psychosocial adjustment problems and competencies in a sample of children with congenital craniofacial anomalies (CFAs). Retrospective chart review. Urban hospital plastic surgery primary care unit. A total of 724 children aged 2 to 18 years with completed Child Behavior Checklists in their medical charts. Child Behavior Checklist. Higher rates of problems in the clinical range were seen for withdrawn, attention, social, thought, and internalizing problems and lower rates for externalizing and somatic complaints; specific patterns varied according to age and sex. Elevated rates of competency deficits were seen in some groups. Most children with CFAs do not appear to experience psychosocial adjustment problems. Although elevated risk may be seen for certain problems, this group may be protected in other areas. Research identifying the mechanisms responsible for varying age and sex patterns of adjustment is needed.