Mental Adjustment Research Articles

Emotion malleability beliefs and coping with the college transition.

First-year students navigating the transition to undergraduate life experience an increase in psychopathology, yet some students thrive while others struggle. The current study examined whether first-year students' beliefs about emotion's malleability predicted emotion regulation and mental health during this critical period. First-year college students completed a battery of self-report questionnaires at the beginning and end of the fall semester. Students who held more malleable views of emotion at the semester's onset reported more of a decrease in depression, more of an increase in the use of cognitive reappraisal, and decreased reliance on rumination as emotion regulation strategies during the fall semester. As hypothesized, emotion regulation played a significant role linking emotion malleability beliefs to depression. Students' beliefs that emotions were more malleable at the beginning of the semester predicted less depression at the end of the semester through greater use of cognitive reappraisal and less use of rumination. These results suggest that emotion malleability beliefs are systematically related to emotion regulation and mental health adjustment during this stressful transition and could be targets for intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Patanjali Yoga Practice and its Effect on Mental Health and Moral Judgment Amongst Juvenile Delinquents

Research awareness and involvement in yoga for health-related results are growing worldwide. PatanjaliYoga relieves stress and fatigue which haves turned into one of the few major challenges confrontingthe medical fraternity in present times. Yoga let go the body from any type of muscular or chronic strainand rejuvenates the body from exhaustion, body aches, stress, aids to ease the body and mind, enhancesconcentration and alertness, and frees the soul. It helps one to create integrity amongst his outward selfas well as his innermost self. If the practices are followed meticulously then Patanjali Yoga develops aconstructive effect both in the inward and outer selves of an organism. Patanjali’s yoga practice aims tobind the individual self with the Ultimate One and one can achieve this union by regulating and discardingthe ever- arising ‘vrittis’ or amendments of the mind. With Patanjali Yoga mind can be balanced throughthe exact kind of discipline and training. The purpose of this paper was to study the effect of Patanjali Yogapractice on mental health and moral judgment of experimental group of juvenile delinquents. Pre and postexperimental design was used in this research work. Patanjali Yoga practices were used as independentvariables whereas mental health and moral judgments of delinquents as dependent variables. A sample of 70delinquents of age group (13-18 years) from Government Observation Home in Agra district was chosen withrandom selection method. There were two groups –experimental group (n=35) and control group (n=35).Patanjali Yoga practices were imparted to delinquents for 90 days with duration of one hour each day. Formeasuring the moral judgment of delinquents, moral judgment test by Juri Baruh (2004) and for measuringmental health, mental health battery by A.K. Singh and Alpana SenGupta (2008) were used. Mean, Standarddeviation and t-test were carried out for data analysis. The findings suggest that mental health factors likeemotional stability, adjustment, autonomy, security-insecurity and self-concept were found to be of averagelevel and intelligence ranged from average to low in experimental and control group delinquents. It was alsofound that Patanjali Yoga plays a significant role by strengthening emotional stability, adjustment and self-concept in delinquents, however, the Patanjali yoga does not significantly affects mental health factors likeautonomy, security-insecurity and intelligence in delinquents. The findings also concluded that PatanjaliYoga does not affect moral judgments of delinquents.

Association of personality profiles with coping and adjustment to cancer among patients undergoing chemotherapy.

Specific personality traits are associated with differential use of various coping strategies. Few studies have examined the relationship between personality and coping in oncology patients undergoing chemotherapy. We, therefore, examined the relationship between previously identified personality profiles (ie, Distressed [14.3% of total sample], Normative [53.8%], Resilient [31.9%]) and measures of coping and adjustment. Patients (n = 1248) undergoing chemotherapy for breast, gastrointestinal, gynecological, or lung cancer completed measures of personality (NEO-Five Factor Inventory), coping (Brief COPE), and psychological adjustment to cancer (Mental Adjustment to Cancer [MAC] scale). Differences in coping and adjustment among the three personality profiles were evaluated using analysis of variance. On the Brief COPE, the Distressed class endorsed lower use of Active Coping, Positive Reframing, Acceptance, Emotional Support (ie, "engagement" coping); and greater use of Denial, Venting, Behavioral Disengagement, Self-Blame (ie, "disengagement" coping) compared to the Normative and Resilient classes. On the MAC scale, the Distressed class scored higher on Anxious Preoccupation, Helplessness/Hopelessness, Fatalism, and Avoidance, and lower on Fighting Spirit, compared to the other two classes. In this sample of oncology patients receiving chemotherapy, patients in the Distressed personality class showed a reduced repertoire of adaptive coping strategies, while those in the Resilient class reported greater use of adaptive or engagement coping strategies. Further work should examine the potential mediating or moderating role of coping and adjustment in the relationships between personality and patient outcomes. Interventions to enhance beneficial and reduce harmful coping strategies in cancer patients should be evaluated.

The effct of peer education on the self-efficy and mental adjustment of breast cancer patients undergoing chemotherapy

Background: Breast cancer ranks the first common cancer in women in Iran and is the fifth mostcommon cause of death. Peer education on the self-efficacy and mental adjustment of breastcancer patients undergoing chemotherapy can contribute to their easier adaptation to the disease.This study aimed to determine the improved mental adjustment and self-efficacy for womenundergoing chemotherapy through peer education.
 Study Design: This study was conductedusing pre- and post-test follow up and control design approach. 70 women with breast cancerwho underwent chemotherapy in Nemazi hospital participated in this study.
 Method: Usingconvenient sampling, the participant were selected and randomly assigned into two groups. Theexperimental group was randomly assigned to four groups and peer education was conductedone educational session per week for 6 weeks. To assess mental adjustment and self-efficacybefore and after the study, Mini-Mental Adjustment to Cancer Scale (Mini-MAC) and Self-Efficacy Scale for Self-Management of Breast Cancer (SESSM-B) questionnaires were used.Chi-square and t-test were used to analyze the data.
 Results: For the experimental group, theresults showed statistically significant improvement in self-efficacy (p<0.000) while the controlgroup showed no significant difference in self-efficacy. Mental adjustment inside each groupshowed a significant increase over the time, but no statistically difference was observed betweenthe groups.
 Conclusion: It is suggested that peer led education is a useful teaching strategy asa supportive intervention for women undergoing chemotherapy to improve their self-efficacyregarding breast cancer.
 Bangladesh Journal of Medical Science Vol.19(3) 2020 p.558-566

Illness representations and quality of life in French patients suffering from lung cancer

ABSTRACT Numerous studies have shown the impact of lung cancer disease on patient quality of life (QoL), but no research has yet examined the impact of illness representations (IR) in the assessment of QoL in lung cancer. Our goal is to explore the role of IR as adeterminant of QoL for lung cancer patients. Data were collected from 162 French patients who completed aself-administered questionnaire including ageneric measure of QoL. It also contains aspecific measure of psychological distress, mental adjustment to cancer, and socio-demographic and medical data. Regression analysis revealed that consequences, treatment control, identity and understanding predicted QoL and the activity dimension of QoL. Perceived consequences and identity seemed to have adeleterious impact on QoL, while treatment control predicted abetter QoL, related to the level of psychological distress and education level. The results suggest the importance of considering IR as adeterminant of QoL. They corroborate earlier findings on the relationship between IR and QoL associated with other pathologies. Psychosocial variables appeared to have more impact on QoL than socio-demographic and clinical variables, which shows the importance of considering IR in order to improve the QoL of patients.

Conservatives Are Happier than Liberals: the Mediating Role of Perceived Goal Progress and Flow Experience \u2014 a Pilot Study

Authors presume that conservatives would be happier than liberals because they would develop better mental adjustment especially under contextual threat. The present study aimed at examining whether self-regulatory factors (i.e., dispositional self-control, perception of goal progress, dispositional flow, and dispositional neurotic self-attentiveness) could mediate the link between conservatism and subjective well-being (SWB). It also aimed at testing the view that contextual threat (operationalized through undesired unemployment) may moderate the relationship between conservatism and the mediators under study. In order to examine this, 418 North-American participants from the United States (66.7% females and 33.3% males; Mage = 33.63, SDage = 11.64) answered questionnaires via an online platform, and structural equation model or path analyses were conducted. Main results revealed that: (a) conservatism positively predicted SWB, whereas undesired unemployment negatively predicted SWB; (b) perception of goal progress and dispositional flow fully mediated the conservative-SWB gap; and (c) dispositional self-control was highest in conservatives under contextual threat of undesired unemployment. Finally, this study suggests that conservatives can experience higher SWB because of adaptive cognitive adjustments. Moreover, this study suggests that the rationalization of inequality can have a self-enhancement function that bolsters self-regulation process when exposed to threatening contexts.

Relationship between Older persons with cancer' Coping Attitudes and Mental Adjustment.

Objective Purpose is to examine the relationship between older persons with cancer coping attitudes and patterns of mental adjustment during treatment. Methods : Coping attitudes and patterns of mental adjustment were measured using an original questionnaire and the Mental Adjustment Cancer Scale (MAC) in 193 patients with cancer aged 65 or over under treatment with surgical therapy, chemotherapy, or radiotherapy. Results : The mean scores for "Do my best to cope with cancer" ,"Make my own decisions on treatment" in coping attitudes showed a significant positive correlation with [fighting spirit] scores in MAC, and "Cancer is just a part of my life", "At my age, no complaint about cancer development", "Face cancer in an easy-going manner", "Do my best to cope with cancer" "Be anxious about my future" were significantly correlated with [fatalism] scores. Conclusions : In conclusion, [fighting spirit] [fatalism] were shown to form the basis for elderly's mental adjustment. [Fatalism] was shown to be a main component of mental adjustment for elderly to develop affirmative coping skills based on their life experiences. In addition, [fighting spirit] was also essential to fulfill their lives, and it may be necessary to support them to keep [fighting spirit] to the end of their lives. J. Med. Invest. 67 : 44-50, February, 2020.

Becoming flexible: Increase in parent psychological flexibility uniquely predicts better well-being following participation in a pediatric interdisciplinary pain rehabilitation program

Parents of youth with chronic pain are at risk for depression, anxiety, and poor health-related quality of life. Research indicates Acceptance and Commitment Therapy (ACT) is effective at reducing symptoms of depression and stress for parents of youth with chronic concerns such as asthma and cerebral palsy. However, it is unclear whether these interventions are effective in improving the mental health and adjustment of parents of youth with chronic pain. ObjectiveThe current study took place in a three-week interdisciplinary pediatric pain rehabilitation program. The primary aim of the study was to examine whether the change in parent psychological flexibility and pain catastrophizing from admission to follow-up uniquely predicted parent depressive symptoms and health-related quality of life at follow-up. MethodsParticipants in this single-arm pre-posttest clinical study included 268 adolescents and young adults and their parents, who completed measures assessing depressive symptoms, health-related quality of life, pain catastrophizing, and psychological flexibility. ResultsPaired t-tests with Bonferroni correction found significant improvements in parents' mental health, functioning, and psychological flexibility, as well as lower levels of parents’ pain catastrophizing from admission to follow-up, with most effect sizes in the small to medium range. Findings from multiple regression analyses suggest that when controlling for depressive symptoms, quality of life, physical symptoms, catastrophizing, and psychological flexibility at admission, change in parent psychological flexibility uniquely predicted improved parent mental health and quality of life at follow-up. Specifically, change in emotional acceptance was the strongest unique predictor of the psychological flexibility subscales when controlling for admission scores. ConclusionsInterventions that help parents of youth with chronic pain learn to accept uncomfortable emotions and engage in valued action may help support better parent mental health.

A Call to Action: Screening Fathers for Perinatal Depression.

* Abbreviations: AAP — : American Academy of Pediatrics PPD — : postpartum depression In early 2019, the American Academy of Pediatrics (AAP) released a policy statement1 recognizing that “maternal depression affects the whole family” and urging pediatric providers to “incorporate recognition and management of perinatal depression into pediatric practice.” Soon after, the US Preventive Services Task Force issued new recommendations on interventions to prevent perinatal depression.2 The convergence of these 2 statements from nationally recognized bodies of experts in evidence-based medicine underscores the urgency of a heightened focus on screening and making referrals for perinatal depression in pediatric practice. The new recommendations do not go far enough and risk being out of touch with contemporary American families. The US Preventive Services Task Force evidence review and recommendations are focused exclusively on interventions to prevent maternal depression. The AAP statement acknowledged paternal postpartum depression (PPD) as an established clinical problem yet called for pediatricians to screen solely mothers at the 1-, 2-, 4-, and 6-month well-child visits and “consider screening the partner as well” at the 6-month visit. We believe it is inadequate to treat the recognition and management of paternal depression as extra or optional. To promote optimal outcomes for children, pediatric providers must assess the mental health and adjustment to parenting of all new parents, regardless of gender or marital status, and make appropriate referrals for needed care. Fathers’ time spent with children has nearly tripled since 19653; even among unmarried couples, fathers typically want to be and are involved with their children. … Address correspondence to Tova B. Walsh, PhD, School of Social Work, University of Wisconsin, 1350 University Ave, Madison, WI 53706. E-mail: tbwalsh{at}wisc.edu

Pandemic and mental adjustment disorders. Therapy options

The article considers the main triggers of adjustment and anxiety disorders in the time of pandemic that brings significant changes in all life dimensions with the high uncertainty level. The article highlights a role of coronavirus infodemic in the development of anxiety disorders. The main targets for cognitive, emotional and behavioral interventions are suggested. Recommendations for anxiety adjustment disorders psychopharmacotherapy with the use of tranquillizers as treatment of choice are given. Prevention measures for medical doctors working in conditions of pandemic are proposed.

The physical and mental adjustment of recovered patients affected by COVID-19: a report of 3 cases

The physical and mental adjustment of recovered patients affected by COVID-19: a report of 3 cases

Prevalence of adjustment disorder among cancer patients, and the reach, effectiveness, cost-utility and budget impact of tailored psychological treatment: study protocol of a randomized controlled trial

BackgroundInformation on the prevalence of adjustment disorders among cancer patients and the value of psychological interventions in this group of patients is limited. This study investigates the prevalence of adjustment disorders among cancer patients as well as the reach, effectiveness, cost-utility and budget impact of a tailored psychological intervention.MethodThis study consists of two parts. Part 1 is an observational study among a representative group of mixed cancer patients after cancer treatment on the prevalence of adjustment disorder as well as the uptake (i.e. reach) of psychological treatment. In Part 2, patients diagnosed with an adjustment disorder are invited to participate in a randomized controlled trial. Patients will be randomized to the intervention (access to the tailored psychological intervention) or control group (waitlist period of 6 months). The psychological intervention consists of three modules: one module containing psycho-education (3 sessions, all patients) and two additional modules (maximum of 6 sessions per module) provided as continuum, in case needed. Module 2 and 3 can consist of several evidence-based interventions (e.g. group interventions, mindfulness, eHealth) The primary outcome is psychological distress (HADS). Secondary outcomes are mental adjustment to cancer (MAC) and health-related quality of life (EORTC QLQ-C30). To assess the cost-utility and budget impact, quality of life (EQ-5D-5 L) and costs (iMCQ and iPCQ) will be measured. Measures will be completed at baseline and 3 and 6-months after randomization.DiscussionThis study will provide data of the prevalence of adjustment disorders and the reach, effectiveness, cost-utility and budget impact of a tailored psychological intervention.Trial registrationNetherlands Trial Register identifier: NL7763. Registered on 3 June 2019.

Factors That Dictate Mental Coping Strategies Used By Patients with Acute Myeloid Leukemia

Introduction: How patients cope with a new diagnosis of a serious/life threatening disease has been studied in a variety of settings and diseases, but not in acute myeloid leukemia (AML). In AML patients are confronted with a unique situation of a life-threatening diagnosis and the prospect of intensive prolonged treatments ahead of them. The aim of the current study is to assess different modes of coping with the diagnosis of AML, and whether these strategies remain stable over time. Methods: Adult patients with a new diagnosis of AML who were candidates for intensive chemotherapy and agreed to participate in this study were enrolled. The second author (Dr. Dorfman), a trained psychiatrist, and the chief of the Psycho-Oncology service in our institute, interviewed the patients at diagnosis and 3 months later. In these sessions the patients completed the Mental Adjustment to Cancer (MAC) questionnaire. The Hebrew version of this instrument was previously validated and consists of 40 items that assess the ability to cope with cancer and provides information on four major coping styles: fighting spirit, hopelessness/helplessness, anxious preoccupation and fatalistic acceptance. For each scale we calculated the standard (Z) score. The internal reliability measure (Cronbach's alpha) was above 0.7 for all scales. The sociodemographic interview gathered information on age, education, marital status, living arrangements, country of birth, religion and financial status. Additional medical information was obtained from the electronic medical record of each patient. We compared continuous variables using paired T-test and χ2 to compare categorical variables. We used a multivariate linear regression model to predict which of the baseline characteristics is associated with the coping strategy score. Results: We enrolled 18 patients with a recent diagnosis of AML. The median age was 55 years, and 12 (67%) were males. At time of diagnosis women, single patients (non-married or divorced), and patients with the lowest or highest income levels were significantly more anxious. Those who experienced a major life event within the previous year expressed lowers levels of hopelessness and a lesser degree of a fatalistic mode of coping. On the other hand, male patients, as well as unemployed or patients with low income, tended to express a higher degree of fatalistic feelings. Female patients were less likely to have high levels of fighting spirits. The mode of coping did not remain constant over time, and scores in all 4 scales changed over time. In fact, MAC scores in our cohort at 3 months correlated with baseline scores only in the fatalistic scale ( rp = 0.67, p = 0.006). Conclusion: In patients with newly diagnosed AML facing intensive chemotherapy, socioeconomics factors and life experience dictate, at least in-part, the coping strategy. However, 3 months after starting treatment, these factors become less influential. It is possible that at this stage, other factors, such as response to treatment, residual physical and mental resources and long-term prognosis become more important. Disclosures Wolach: Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Speaker; AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Speaker.

META-ANALYSIS OF THE EFFECTS OF THE EDUCATIONAL AND COUNSELING INTERVENTIONS ON MENTAL ADJUSTMENT AND QUALITY OF LIFE IN BREAST CANCER

Background: Education and counselling are widely used independently or as supplementary components in the psychosocial interventions. However, there is a certain level of ambiguity if used separately. In this analysis, we attempted to answer the following question; “Does the education and counseling support improve of the adjustment to cancer in women diagnosed with breast cancer?” Methods: An online search was undertaken in 12 databases for the longitudinal studies for the period from January 2007 to March 2018. The effects of the interventions on the adjustment to breast cancer, were calculated based on the results of the mental adjustment and quality of life (QoL). Three distinct periods were examined; baseline, three months, and six months. The methodological quality, risk of bias, publication bias, and attrition rate were examined. Meta-analysis was carried out using Review Manager 5.3 with the results graphically presented. Results: A comprehensive systematic review was conducted for 5,464 titles, of which 22 studies fulfilled the inclusion criteria, however 14 studies completed the data and included in the qualitative synthesis; included 3,419 patients. The mean of overall attrition rate in both groups was 14.37% (SE= 2.87, median= 12.28). In mental adjustment, the total mean differences for the three trials were statistically significant 0.40 (0.24 to 0.57). For the QoL, the mean differences of the three trials were statistically non-significant 0.18 (-0.48 to 0.84). Conclusion: The educational and/or counseling interventions can be beneficial and useful for patients to adapt with the breast cancer, however, it is less effective on the QoL. Keywords: mental adjustment, quality of life, education, counseling

Ethnic identity in our global society: Supporting youth physical and mental health and adjustment

Ethnic identity development is a normative developmental process that youth experience in adolescence. Ethnicity refers to an individual's membership into a group with a common ancestry, including shared culture, place of origin, language, kinship, or values. Ethnic identity refers to one's identity or sense of self as a member of an ethnic group. Research evidence on ethnic identity in children and adolescents overwhelmingly points to its importance in supporting positive mental and physical health, academic, and social outcomes for youth. In this article, we describe the process of ethnic identity development and discuss strategies for caregivers, clinicians, and educators to support positive ethnic identity development in our youth.

A Self-Compassion Group Intervention for Patients Living With Chronic Medical Illness: Treatment Development and Feasibility Study.

Self-compassion is a psychological skill associated with good mental health and adjustment to illness in the second half of life, but to date, few self-compassion-based interventions have been developed specifically for use in midlife and older adult cohorts. The purpose of this study was to develop and test the feasibility of a 4-week group self-compassion-based intervention designed to improve self-report and biological markers of well-being in midlife and older adult patients living with chronic illness. Treatment development drew on existing literature, expert input, and qualitative interview data. Eight patients in outpatient treatment for a chronic illness were recruited from a rehabilitation hospital (during September and October 2017 and again during February and March 2018) to test feasibility. Participants attended a 1-hour group self-compassion-based intervention once per week for 4 weeks. Feasibility was assessed on 6 domains. Measures of well-being and heart rate variability (HRV), an index of nervous system functioning, were also collected. Recruitment was feasible and occurred within the expected time frame. Attendance at sessions was high (84.4%), with no dropouts. Participants found that the intervention was acceptable, rating sessions as enjoyable (6.8/7) and relevant to daily life (6.6/7). There were no adverse events. Secondary analysis revealed pre-post improvements for some well-being outcomes, such as a significant reduction in depressive symptoms (Hedges' g = -1.18, 95% CI, -0.18 to -2.16). A 4-session group self-compassion-based intervention was found to be feasible and acceptable to midlife and older adult patients in treatment for a chronic illness. A larger, randomized pilot trial is needed to explore the efficacy of this intervention. Australian New Zealand Clinical Trials Registry (ANZCTR) identifier: ACTRN12619000709145​.

The Psychological Impact of Cancer (PIC) Scale: development and comparative psychometric testing against the Mini-MAC Scale in UK and Australian cancer survivors

Abstract Background: Clinicians and researchers make considerable use of both the Mental Adjustment to Cancer (MAC) Scale, and the shorter Mini-MAC, to measure psychological adjustment in cancer patients. The length of the scale is problematic when used clinically, and its psychometric properties have been criticized. This article presents two studies leading to the development of a novel scale, the Psychological Impact of Cancer (PIC) Scale, using items drawn from the MAC. Methods: Study 1 used standard item-reduction techniques to shorten the Mini-MAC in a sample of 160 cancer patients of mixed diagnosis, recruited an average 46 days post-diagnosis. This resulted in a 12-item scale with a 4-factor structure, similar to that derived from a 2012 re-analysis of the Mini-MAC. Study 2 presents confirmatory factor analysis (CFA) of this new measure and tests its construct validity and test–retest reliability in a sample of 183 mixed cancer survivors. Results: This study indicated that the shorter scale performed well on CFA indicators (RMSEA = .083; ECVI = .923; PNFI = .604; AGFI = .857) and tests of internal consistency (all >.623), and comparable concurrent validity with longer versions. The 4 factors were labeled cognitive distress, cognitive avoidance, emotional distress, and fighting spirit. Conclusions: Given its shorter length and acceptable psychometrics, the PIC offers a useful clinical and research tool to assess the psychological impact of cancer. Psychometric properties of one subscale (fighting spirit) remain poor, but no worse than in the original scale; directions for further development of the scale are described.

The oral language and reading comprehension skills of adolescents in flexible learning programmes

Purpose: Access to flexible learning programmes (FLPs) for students who have been excluded or diverted from mainstream school settings is increasing internationally. While still technically “engaged with education” such students face long-term vulnerability with respect to acquiring marketable employment skills post-school. Language and literacy skills are central to such training; hence, this study describes the oral language and reading comprehension profiles of a sample of flexible learning programmes (FLP) students.Method: Fifty young people (mean age 16 years) enrolled in three FLPs in Victoria, Australia were assessed by a speech-language pathologist in order to profile their oral language and reading comprehension skills.Result: Seventy-two percent of participants had oral language skills that placed them in an at-risk range on standardised measures, and 47.5% had reading comprehension ages of ≤12 years. A moderate significant association existed between oral language and reading comprehension skills.Conclusion: Language and reading comprehension difficulties are prevalent in this population and may be missed in the context of the mental health and adjustment difficulties experienced by this group, but are likely to be key to academic engagement and success. Speech-language pathology scope of practice needs to include FLP settings.

Impact of family-related factors on mental health and adjustment of adolescents

Background: Adolescence is believed to be a period of great stress and storm, as rapid physical and mental changes occur during this period with a lot of problems in adjustment of children. Objective: The objective of this study was to assess the impact of family-related factors on mental health and adjustment in adolescents. Materials and Methods: This is a cross-sectional study involving 175 school-going boys and girls of age 14–17 years. The students were administered a sociodemographic pro forma, general health questionnaire-28 (GHQ-28), and adjustment inventory for school students (AISS) by one-to-one interview method. Family-related factors such as maternal education and occupation, relationship of the primary caregiver, type of family, and number of siblings were analyzed with the scores of GHQ and AISS by Student’s Mann–Whitney U-test and Kruskal–Wallis test using the SPSS 20.0. Results: Poorer maternal education is associated with greater anxiety and insomnia than those of mothers with better education (p=0.008), while maternal occupation had a negative impact on overall adjustment scores (p<0.0001). Children from nuclear family and children reared by grandparents showed significantly greater social dysfunction (p<0.0001). Emotional adjustment, educational adjustment, and overall adjustment scores were significantly higher in children from nuclear family. Significant increase in the educational adjustment scores is seen in children brought up by parents. Social dysfunction was more among students who had two siblings when compared to children with one sibling (p=0.01). Conclusion: Family-related factors significantly affect the mental health and coping nature of the adjustment-related problems.

SAT-237 PSYCHOPATHOLOGY AND PSYCHOSOCIAL ADJUSTMENT IN PEDIATRIC CHRONIC KIDNEY DISEASE: RESULTS FROM THE KNOW-Ped CKD

Chronic kidney disease (CKD) requires management in daily life; accordingly, psychosocial development of pediatric patients with CKD is greatly affected due to delayed growth, frequent absences from school, and difficulties engaging in normal activities of peer relationships due to CKD. This study was to investigate the mental health problems of children and adolescent with CKD in KoreaN cohort study for Outcome in patients with Pediatric Chronic Kidney Disease (KNOW-Ped CKD). In KNOW-PedCKD, 437 children with stage 1 to 5 of CKD were enrolled. We evaluated 167 CKD patients aged from 6-18 years (mean age, 10.6±3.9 years, male, 117 (70.1%)). Demographic data and clinical history were collected. And the parents of subject completed the Korean-Child Behavioral Checklist (K-CBCL). We compared the clinical characteristics according to the clinical group defined as one or more abnormal finding in the subscale of K-CBCL. Of the total patients, 13.2% of children had a clinically significant internalizing problem such as depression, anxiety and somatic symptoms and 9.0% of children had an externalizing problem such as rule breaking or aggressive behavior. The distribution of clinical group was 33.5% in our cohort. In the clinical group, height Z score and weight Z score were lower, and growth hormone was more used than the non-clinical group. Developmental delay and preterm birth history were more common in the clinical group. Logistic regression analysis revealed that the growth retardation and history of developmental delay was significantly correlated with the clinical group in terms of psychopathology and adjustment problem. Significant proportions of children and adolescents with CKD suffer from mental health problem and adjustment problem. Combined physical illness and growth retardation associated with CKD may be more important than CKD stage, etiology, and the complications associated with the progression of CKD in terms of mental health.