Children's Coping Research Articles

Stress related correlates of anxiety and depression in girls with chronic headache

Chronic headache in adolescents is frequent and often associated with anxiety and depression. The present study investigated, whether psychological and physical stress symptoms have an infl uence on the occurrence of anxiety and depression and what is the role of stress coping. The sample consisted of 77 15 years old girls with chronic headache and 72 girls, who served as controls. Stress symptoms and stress coping were measured with the Stressverarbeitungsfragebogen für Kinder und Jugendliche (Coping with Stress Questionnaire for Children and Adolescents), depression was assessed by the Depression Inventory for Children and Adolescents, anxiety by the State-Trait Anxiety Inventory for Children. Linear regression was used to analyze the relationship between stress factors and anxiety resp. depression. Physical stress symptoms were related to anxiety, but not to depression. Coping strategies of the depressed as well as the anxious children were characterized by stress reinforcing behaviors. The results point to focusing on physical symptoms in the anxious headache patients and to avoidance coping in the depressed children.

Multidisciplinary treatment in children with problematic severe asthma: A prospective evaluation.

For children with problematic severe asthma, achieving adequate control of asthma is difficult. The aim of this prospective observational study was to evaluate the effects of intensive multidisciplinary inpatient treatment on multiple outcome variables in children with problematic severe asthma. Participants were 89 children with problematic severe asthma (mean age 13.6 ± 2.5 years) treated in tertiary care clinics at high altitude (Switzerland) or sea level (Netherlands) and their parents (85 mothers, 55 fathers). The primary outcome variable was the Childhood Asthma Control Test (C-ACT). Other outcome variables were forced expiratory volume in 1 sec (FEV1 ), fractional concentration of exhaled nitric oxide (FeNO), quality of life [PAQLQ(S)], children's coping (UCL-A), parents' report of behavioral problems (CBCL), and parenting stress (PSI/NOSI). Evaluations were taken pre-treatment, post-treatment, and 3-6 months follow-up. Median [P25;P75] treatment duration 74 [56;80] days; Median follow-up interval 131 [103;177] days. The percentages of children showing controlled asthma (C-ACT) were 18% (pre-treatment), 69% (post-treatment), and 44% (follow-up). The vast majority of the children (80%) showed an improvement on C-ACT with 4% showing a deterioration. On C-ACT, FeNO, quality of life, and behavioral problems, improvements at post-treatment were highly significant. Improvements generally remained at a functional level at follow-up. Children's coping and parenting stress in parents did not change. The improvement in asthma control and other outcome variables suggests that multidisciplinary inpatient treatment is an effective approach for a heterogeneous group of children with asthma that remained uncontrolled in secondary care. Pediatr Pulmonol. 2017;52:588-597. © 2016 Wiley Periodicals, Inc.

The Non-linear Trajectory of Change in Play Profiles of Three Children in Psychodynamic Play Therapy.

Aim: Even though there is substantial evidence that play based therapies produce significant change, the specific play processes in treatment remain unexamined. For that purpose, processes of change in long-term psychodynamic play therapy are assessed through a repeated systematic assessment of three children’s “play profiles,” which reflect patterns of organization among play variables that contribute to play activity in therapy, indicative of the children’s coping strategies, and an expression of their internal world. The main aims of the study are to investigate the kinds of play profiles expressed in treatment, and to test whether there is emergence of new and more adaptive play profiles using dynamic systems theory as a methodological framework.Methods and Procedures: Each session from the long-term psychodynamic treatment (mean number of sessions = 55) of three 6-year-old good outcome cases presenting with Separation Anxiety were recorded, transcribed and coded using items from the Children’s Play Therapy Instrument (CPTI), created to assess the play activity of children in psychotherapy, generating discrete and measurable units of play activity arranged along a continuum of four play profiles: “Adaptive,” “Inhibited,” “Impulsive,” and “Disorganized.” The play profiles were clustered through K-means Algorithm, generating seven discrete states characterizing the course of treatment and the transitions between these states were analyzed by Markov Transition Matrix, Recurrence Quantification Analysis (RQA) and odds ratios comparing the first and second halves of psychotherapy.Results: The Markov Transitions between the states scaled almost perfectly and also showed the ergodicity of the system, meaning that the child can reach any state or shift to another one in play. The RQA and odds ratios showed two trends of change, first concerning the decrease in the use of “less adaptive” strategies, second regarding the reduction of play interruptions.Conclusion: The results support that these children express different psychic states in play, which can be captured through the lens of play profiles, and begin to modify less dysfunctional profiles over the course of treatment. The methodology employed showed the productivity of treating psychodynamic play therapy as a complex system, taking advantage of non-linear methods to study psychotherapeutic play activity.

The distinctive sequelae of children's coping with interparental conflict: Testing the reformulated emotional security theory.

Two studies tested hypotheses about the distinctive psychological consequences of children's patterns of responding to interparental conflict. In Study 1, 174 preschool children (M = 4.0 years) and their mothers participated in a cross-sectional design. In Study 2, 243 preschool children (M = 4.6 years) and their parents participated in 2 annual measurement occasions. Across both studies, multiple informants assessed children's psychological functioning. Guided by the reformulated version of emotional security theory, behavioral observations of children's coping with interparental conflict assessed their tendencies to exhibit 4 patterns based on their function in defusing threat: secure (i.e., efficiently address direct instances of threat), mobilizing (i.e., react to potential threat and social opportunities), dominant (i.e., directly defeat threat), and demobilizing (i.e., reduce salience as a target of hostility). As hypothesized, each profile predicted unique patterns of adjustment. Greater security was associated with lower levels of internalizing and externalizing symptoms and greater social competence, whereas higher dominance was associated with externalizing problems and extraversion. In contrast, mobilizing patterns of reactivity predicted more problems with self-regulation, internalizing symptoms, externalizing difficulties, but also greater extraversion. Finally, higher levels of demobilizing reactivity were linked with greater internalizing problems and lower extraversion but also better self-regulation. (PsycINFO Database Record

Guest Editorial: Laughter for Communication and Coping in Children

Guest Editorial: Laughter for Communication and Coping in Children

Trust in and Perception of Parents in Children with Different Coping Strategies

The article reviews the problem of children's trust in relation to children's perception of parents. Children of different age (N= 119). The following methods: the projective techniques «Kinetic family drawing»; «The Sacks sentence completion test»; «Children's coping questionnaire». Data processing: content analysis, correlation analysis (Spearman's rho), IBM SPSS Statistics 20.0. The study has revealed that as children grow older their perception and understanding of trust shifts from family relationships to friendships. Relationships with peers start to “oust” close family relationships spurred by the emerging need to share information and to find an object of trust which would demonstrate specific qualities.

Coping and posttraumatic stress symptoms in children with food allergies

Coping and posttraumatic stress symptoms in children with food allergies

A novel adaptation of a parent–child observational assessment tool for appraisals and coping in children exposed to acute trauma

BackgroundMillions of children worldwide are exposed to acute potentially traumatic events (PTEs) annually. Many children and their families experience significant emotional distress and/or functional impairment following PTEs. While current research has begun to highlight a role for early appraisals and coping in promoting or preventing full recovery from PTEs, the exact nature of the relationships among appraisals, coping, and traumatic stress reactions as well as how appraisals and coping behaviors are influenced by the child's environment (e.g., parents) remains unclear; assessment tools that reach beyond self-report are needed to improve this understanding.ObjectiveThe objective of the current study is to describe the newly created Trauma Ambiguous Situations Tool (TAST; i.e., an observational child–parent interview and discussion task that allows assessment of appraisals, coping, and parent–child processes) and to report on initial feasibility and validation of TAST implemented with child–parent dyads in which children were exposed to a PTE.MethodAs part of a larger study on the role of biopsychosocial factors in posttraumatic stress reactions, children (aged 8–13) and parents (n=25 child–parent dyads) completed the TAST during the child's hospitalization for injury.ResultsChildren and parents engaged well with the TAST. The time to administer the TAST was feasible, even in a peri-trauma context. The TAST solicited a wide array of appraisals (threat and neutral) and coping solutions (proactive and avoidant). Forced-choice and open-ended appraisal assessments provided unique information. The parent–child discussion portion of the TAST allowed for direct observation of parent–child processes and demonstrated parental influence on children's appraisals and coping solutions.ConclusionsThe TAST is a promising new research tool, which may help to explicate how parents influence their child's developing appraisals and coping solutions following a PTE. More research should examine the relationships of appraisals, coping, and parent–child processes assessed by the TAST with traumatic stress outcomes.Highlights of the articleThe Trauma Ambiguous Situations Tool (TAST) is a promising method to assess children’s appraisals and coping solutions and how parents influence these following a potentially traumatic event.The use of open-ended and forced-choice response sets yielded different results regarding child’s appraisals of events as either neutral or threatening.More research is needed to determine how the TAST assessment aligns with child health outcomes (e.g., current or subsequent traumatic stress reactions).

Evaluation of a multidisciplinary consultation for children's upper limb amputation

Congenital agenesis and acquired amputations of upper limb in children are a great traumatic experience in affected families. Patients, families and caregivers are then exposed to many functional and social difficulties. These states require accurate analysis of functional impairment, child's coping skills and therapeutic plan to implement for optimal social integration. These children and their families must be supported since early childhood by multidisciplinary teams. This can require psychological support, the use of an aesthetic and/or functional prosthesis, and occupational therapy. Rehabilitation will be focused on grip function. For 1 year, we set up in Saint-Étienne University Hospital a dedicated clinic that meet every 1 to 2 months, three families affected by these conditions. Every child benefits a multidisciplinary clinic including medical examination, physiotherapist evaluation and prosthetist assessment. Then, children participate in an experience-sharing group coordinated by a nurse, and parents share their own experiences with a psychologist. We present the organization of this specialized clinic and the assessments of the fifteen families who already participated.

Effects of a Cognitive Behavioral Therapy Intervention Trial to Improve Disease Outcomes in Children with Inflammatory Bowel Disease.

Studies testing the efficacy of behavioral interventions to modify psychosocial sequelae of inflammatory bowel disease in children are limited. This report presents outcomes through a 6-month follow-up from a large randomized controlled trial testing the efficacy of a cognitive behavioral intervention for children with inflammatory bowel disease and their parents. One hundred eighty-five children aged 8 to 17 years with a diagnosis of Crohn's disease or ulcerative colitis and their parents were randomized to one of two 3-session conditions: (1) a social learning and cognitive behavioral therapy condition or (2) an education support condition designed to control for time and attention. There was a significant overall treatment effect for school absences due to Crohn's disease or ulcerative colitis (P < 0.05) at 6 months after treatment. There was also a significant overall effect after treatment for child-reported quality of life (P < 0.05), parent-reported increases in adaptive child coping (P < 0.001), and reductions in parents' maladaptive responses to children's symptoms (P < 0.05). Finally, exploratory analyses indicated that for children with a higher level of flares (2 or more) prebaseline, those in social learning and cognitive behavioral therapy condition experienced a greater reduction in flares after treatment. This trial suggests that a brief cognitive behavioral intervention for children with inflammatory bowel disease and their parents can result in improved child functioning and quality of life, and for some children may decrease disease activity.

Harmed? Harmful? Experiencing Abusive Adult Children With Mental Disorder Over the Life Course.

Older parents of an adult child coping with a mental disorder that is expressed by violent deviant behavior face significant parenting challenges. The purpose of this article is to explore the ways older parents exposed to abuse by their adult children with mental disorder (ACMD) perceived their child's violent deviant behavior along the life course. In a qualitative-phenomenological study, 16 parents aged 58 to 90 were interviewed in depth. Three major themes emerged: (a) ongoing total care for the child's needs along the life course, (b) constructions and perceptions of the child through the years-Parents perceived their children over two continua, reflecting their experience of the child's deviant behavior: the child as more harmed versus more harmful, the child as normative versus pathological-and (c) the parent's emotional world toward the harmed-harmful child. The findings enable a deeper understanding of the various ways in which parents cope with living with deviant behaviors of their ACMD. Hence, this study can serve as a framework for developing tailored and differential intervention methods.

Better to know than to imagine: Including children in their health care

ABSTRACTBackground: This article describes the overall attitudes of children, their parents, and attending physicians toward including or excluding pediatric patients in medical communication and health care decision-making processes. Methods: Fifty-two interviews were carried out with pediatric patients (n = 17), their parents (n = 19), and attending oncologists (n = 16) in eight Swiss pediatric oncology centers. The interviews were analyzed using thematic coding. Results: Parenting styles, the child's personality, and maturity are factors that have a great impact upon the inclusion of children in their health care processes. Children reported the desire to be heard and involved, but they did not want to dominate the decision-making process. Ensuring trust in the parent–child and physician–patient relationships and respecting the child as the affected person were important values determining children's involvement. These two considerations were closely connected with the concern that fantasies are often worse than reality. Seeking children's compliance with treatment was a practical but critical reason for informing them about their health care. The urge to protect them from upsetting news sometimes resulted in their (partial) exclusion. Conclusions: The ethical imperative for inclusion of children in their health care choices was not so much determined by the right for self-determination, but by the need to include them. If children are excluded, they imagine things, become more isolated, and are left alone with their fears. Nevertheless, the urge to protect children is innate, as adults often underestimate children's coping capacities.

Caregiver-Reports of Internet Exposure and Posttraumatic Stress Among Boston-Area Youth Following the 2013 Marathon Bombing

ABSTRACTAlthough practitioners and researchers have considered children’s television-based terrorism exposure, Internet-based exposure has not been sufficiently examined. We examined the scope and correlates of children’s Internet-based exposure following the Boston Marathon bombing among Boston-area youth (N = 460; 4–19 years), and the potential moderating role of age. Further exploratory analyses examined patterns of caregiver attempts to regulate child Internet exposure. Caregivers reported on child Internet-based and direct exposure to traumatic bombing-related events, and youth posttraumatic stress. Online youth consumed on average more than 2 daily hr of Internet coverage, and roughly one third consumed more than 3 daily hr of coverage. Internet exposure was particularly high among children older than 12. Greater Internet-based exposure was associated with posttraumatic stress, and 12- to 15-year-olds were particularly vulnerable. Further exploratory analyses found that although most caregivers reported believing media exposure can cause children further trauma, a considerable proportion of caregivers made no attempt to restrict or regulate their child’s Internet-based exposure. These findings help practitioners clarify forms of indirect exposure that can place youth at risk following terrorism. Future work is needed to examine the important roles that caregivers play as media regulators and as promoters of child coping and media literacy following terrorism.

A Multi-Informant Multi-Method Investigation of Family Functioning and Parent-Child Coping During Children's Acute Pain.

To explore relations between family functioning and child acute pain, including pain ratings, coping, and parent–child behaviors. Community sample of 171 dyads including one child aged 8–12 years (52% girls) and one parent (79% mothers). Family functioning was assessed via child and parent self-report, and observation during a conflict discussion task. Children and parents rated pain catastrophizing at baseline, and child pain and distress following a cold pressor task (CPT). Parent–child interactions during the CPT were coded for observed behaviors during child pain. Self-report of poorer family functioning predicted greater child and parent pain catastrophizing, and parent distress. Less observed family negativity/conflict and cohesiveness, and greater family focus of problems and parent emotional support predicted more child symptom complaints. Family functioning was not associated with child pain or distress. Family functioning influenced parent and child coping and child behavioral responses, but not the experience, of acute pain.

Resilience in perinatal HIV+ adolescents in South Africa

ABSTRACTIncreasing numbers of perinatally HIV (PHIV+)-infected youth are surviving into adulthood with better access to treatment. However, few studies examine positive outcomes in the face of adversity (resilience) for PHIV+ youth. Social Action Theory (SAT) provided the theoretical framework for this study of PHIV + youth in South Africa (SA), allowing examination of contextual, social, and self-regulatory factors that influence behavioral health. Data were from youth and caregiver baseline interviews, simply pooled from a pilot (N=66) and larger (n=111) randomized control trial (RCT) of the VUKA Family program. For this analysis, outcomes included emotional and behavioral functioning (total difficulties), and prosocial behaviors. Potential SAT correlates included socio-demographics; caregiver health and mental health; parent-child relationship factors; stigma, and child coping, support; and self-esteem. Regression analyses adjusted for age, gender, and study revealed significant associations at the contextual, social, and self-regulation level. Lower total child difficulties scores were associated with lower caregiver depression (β = 3.906,p < .001), less caregiver-reported communication about difficult issues (β = 1.882, p = .009) and higher youth self-esteem (β = -0.119, p = .020). Greater prosocial behaviors were associated with greater caregiver-reported communication (β = 0.722, p = .020) and child use of wishful thinking for coping (β = 5.532, p = .009). Less youth depression was associated with higher caregiver education (β =−0.399, p = .010), greater caregiver supervision (β = −1.261, p = .012), more social support seeking (β = −0.453, p = .002), higher youth self-esteem (β = −0.067, p < .001), lower internalized stigma (β = 0.608, p = .040), and child use of resignation for coping (β = 1.152, p = .041). Our data support evidence-based family interventions that also promote youth self-regulation skills to enhance the health and mental health of PHIV+ youth.

Child and Parent Stress Association with Obesity and Media Use

PURPOSE: To examine the association between child stress, parent stress, media use, and overweight and obesity in children in the United States ages 10-17 years. METHODS: 2011-12 National Survey of Children’s Health (n=33,683; 13.5 ± 0.03 years; 51.1% male) was analyzed. Predictor variables included Adverse Childhood Events (ACEs) and parenting stress (“usually “ or “ always” response to: 1) the child being harder to care for than most children; 2) does things that really bother parent a lot; 3) felt angry with child). Outcome variables included >1hr/day TV viewing, >1hr/day electronic device use, and classification of overweight and obesity based on Centers for Disease Control and Prevention percentiles. RESULTS: 10.5% of parents reported one or more “usually” or “always” responses to the three questions. Mean (SE) ACEs was 1.1 ± 0.02 out of possible nine. 28.2% of children had at least 2 ACEs. Parenting stress was positively associated with ACEs score representing child stress (β=0.60, SE 0.07, p1hr/day TV in fully adjusted models. Child stress (OR=1.13, 95% CI 1.08, 1.19) and parenting stress (OR=1.26, 95% CI 1.02, 1.57) were associated with >1hr/day electronic device use. Parenting stress was not associated with overweight and obesity. Child stress was associated with overweight and obesity (OR=1.07, 95% CI 1.02, 1.13), even when adjusting for high media use. High TV viewing time was associated with higher odds of overweight and obesity (OR=1.26, 95% CI 1.11, 1.44), however high electronic device use was not (OR=1.06, 95% CI 0.93, 1.21). CONCLUSIONS: The study findings illuminate the role of stress on obesity and child coping behaviors. Child and parent stress were associated with high use of electronic devices, but not with high TV viewing. Only child stress was associated with overweight and obesity. High TV viewing time was associated with greater likelihood of overweight and obesity although high electronic device use was not.

Prediction of Anxiety Based on Children's Coping Behavior

The purpose of this study was to predict anxiety in children based on their coping behaviors. Participants included 400 children aged 9-13 years enrolled in a summer camp in Dubai from different nationalities (Iranian, Arab, European) in both genders. The sample consisted of 150 children (50 from Iran, 50 From Europe and 50 Arabs) who were randomly selected. Subjects completed children's anxiety and coping behaviors questionnaires. To analyze the data, correlation and stepwise regression analysis were performed using SPSS software. Results of regression analysis showed a significant effect of dealing with the problem and destructive behavior on anxiety. However, the effect of diversion of problem was not significant on anxiety. The results showed that the coping behaviors of children are able to predict anxiety. DOI: 10.5901/mjss.2016.v7n2s1p387

The mental health of military children: A review

There is a paucity of research exploring the mental health of British military children. This article seeks to answer the question: what is the stress experience of British military children whose parent(s) are serving in Germany? Methods included a critical literature review and reflections from my own practice as a community psychiatric nurse. It was found that military children are presented with a number of situations and stressors associated with and unique to their parent's job. Increased stress among military children is a potential trigger for the development of mental health problems. Key issues identified included: deployment, frequent relocation and regular changes of schools. It can be concluded that current research tends to focus on the stress and coping of children during operational deployment and not on the day-to-day stresses. Further research is needed into the impacts of recurrent separations, frequent relocations, regular changes of schools, potential injury or fatality of parent, disruption to friendships, social networks and activities.

The Relation Between Parenting Stress, Locus of Control and Child Outcomes: Predictors of Change in a Parenting Intervention

This study examines the relationship among parent stress, parent locus of control, child disruptive behaviors, and child coping competence over the course of an 8-week parenting program. We predicted that parent stress and parent locus of control are correlated, decreases in parent stress and increases in parent internal locus of control predict increases in child coping competence, and decreases in child disruptive behavior and higher levels of internal parent LOC would relate to decreases in parent stress level. Measures and data from the original Parenting Our Children to Excellence study were used. The study found decreasing parent stress and increasing parent internal locus of control lead to positive changes in child outcomes, and decreasing parent stress changes their attributions of control. To our knowledge, this is the first study to examine changes in parent stress and locus of control, regarding child coping competence and child disruptive behavior, over time.

Review of Coping in Children Exposed to Mass Trauma: Measurement Tools, Coping Styles, and Clinical Implications.

Evidence-based practice requires the use of data grounded in theory with clear conceptualization and reliable and valid measurement. Unfortunately, developing a knowledge base regarding children's coping in the context of disasters, terrorism, and war has been hampered by a lack of theoretical consensus and a virtual absence of rigorous test construction, implementation, and evaluation. This report presents a comprehensive review of measurement tools assessing child and adolescent coping in the aftermath of mass trauma, with a particular emphasis on coping dimensions identified through factor analytic procedures. Coping measurement and issues related to the assessment of coping are reviewed. Concepts important in instrument development and psychometric features of coping measures used in disasters, terrorism, and war are presented. The relationships between coping dimensions and both youth characteristics and clinical outcomes also are presented. A discussion of the reviewed findings highlights the difficulty clinicians may experience when trying to integrate the inconsistencies in coping dimensions across studies. Incorporating the need for multiple informants and the difference between general and context-specific coping measures suggests the importance of a multilevel, theoretical conceptualization of coping and thus, the use of more advanced statistical measures. Attention also is given to issues deemed important for further exploration in child disaster coping research.