Psychological Adjustment Problems Research Articles

The Incidence of Adolescent Maltreatment in Arab Society and Some of its Psychological Effects

The article deals with the incidence of adolescent maltreatment by parents and siblings and some of its psychological effects, as revealed by a cross-sectional survey conducted among a sample of 1,640 Arab adolescents in Israel. The results revealed that a high percentage of adolescents are psychologically and physically maltreated annually. Furthermore, regression and multiple regression analyses reveal that significant amounts of the variance in adolescents' feelings of hopelessness, psychological adjustment problems, and low self-esteem can be attributed to their maltreatment by parents and siblings. These levels of variance go beyond the amounts of variance in these psychological states that can be explained by the sociodemographic characteristics of the adolescents, their parents, and their families. The implications of these results for future research are discussed. The relevance of sociocultural and sociopolitical contexts of Arab society to child and adolescent maltreatment is also illuminated.

Psychological adjustment of 'surgery-only' pediatric neuro-oncology patients: a retrospective analysis.

A recent increase in diagnoses of pediatric neuro-oncology tumors combined with recent advancements in medical treatment of such tumors has resulted in a growing cohort of pediatric brain tumor survivors. These survivors are at risk for short and long-term psychological adjustment problems. Most studies regarding these survivors have focused on children who have received combinations of surgery, radiation, and chemotherapy as medical treatment. The sub-group of pediatric neuro-oncology patients who receive surgery as the only form of medical treatment has not been closely followed for adjustment problems. In this study, data were retrospectively collected from semi-structured clinical interviews with 34 'surgery-only' pediatric neuro-oncology patients who were 2 weeks to 5 years off medical treatment for their tumor. These data suggest that these survivors may be experiencing significant short and long-term mood, behavioral, and academic adjustment problems in comparison to national averages for children regarding these issues. Additional research examining the psychological adjustment process for surgery-only pediatric neuro-oncology patients is needed to validate these preliminary findings and facilitate the development of targeted interventions to address the identified adjustment problems.

Predictors of psychological adjustment in school-age children infected with HIV.

To assess for significant differences in psychological functioning between HIV-infected children and a demographically matched healthy control group and to examine the utility of applying a stress and coping model to children with HIV disease. Participants included HIV-infected children (ages 6-16) and their caregivers (n = 36) and a control group of healthy children and their caregivers (n = 32). During routine clinic visits, children completed measures of psychological adjustment, health locus of control, and coping style, and caregivers completed measures of their own and their child's psychological adjustment. Caregiver-reported and child self-reported psychological adjustment scores did not significantly differ between the HIV and control groups, with the exception of significantly more internalizing behavior problems reported in the control group. Hierarchical multiple regression analyses revealed that the stress and coping model accounted for 36% of the variance in HIV-infected children's self-reported psychological adjustment. In addition, child age and coping style were significant predictors of child self-reported psychological adjustment, but not of caregiver-reported child adjustment. Approximately 25% of children with HIV disease exhibited clinically significant emotional or behavioral problems; however, even higher rates of psychological adjustment problems were found in healthy children. Children with HIV disease who have not been told their diagnosis and children who endorse more emotion-focused coping strategies tend to exhibit more psychological adjustment problems.

Psychological adjustment in caregivers of school-age children infected with HIV: stress, coping, and family factors.

To assess for significant differences in psychological functioning between caregivers of HIV-infected children and caregivers of healthy children, and to examine the utility of applying a stress and coping model to caregivers of children with HIV disease. Participants included caregivers of HIV-infected children (n = 36) and caregivers of a demographically matched control group of healthy children (n = 32). During their child's pediatric clinic visits, caregivers completed measures of psychological adjustment, stress, coping style, and family resources and support. They also completed a measure of their child's psychological adjustment. Caregiver psychological distress scores did not significantly differ between the HIV and control groups, and clinically significant rates of psychological distress were reported by more than a third of caregivers in both groups. Hierarchical multiple regression analyses revealed that independent of their child's illness status, stress and coping style were significant predictors of caregiver's psychological adjustment. In addition, caregiver psychological distress was a significant predictor of children's maladjustment. High rates of psychological distress were observed in caregivers of children with HIV disease; however, similarly high rates of psychological adjustment problems were found in caregivers of healthy children. Caregivers who reported high levels of daily stress and emotion-focused coping styles tended to report more psychological distress. Further, caregivers who reported more psychological distress also reported more internalizing and more externalizing behavior problems in their children, regardless of the child's illness status. These findings reflect the impact of poverty and environmental stress on caregivers' adjustment.

The incidence of witnessing interparental violence and some of its psychological consequences among Arab adolescents

Objectives: The study had two aims. First, it sought to examine the incidence of interparental psychological aggression and physical violence witnessed by Arab adolescents. Second, it sought to assess the implications of such exposure on adolescents’ feelings of hopelessness, psychological adjustment problems, and self-esteem. Method: A cross-sectional survey was conducted among a sample of 1640 Arab adolescents from Israel. Different forms of the Conflict Tactics Scales (CTS) were utilized to measure the extent of interparental psychological aggression and physical violence witnessed by adolescents. The Hopelessness Scale for Children (HSC), the Psychological Adjustment Scale (PAS), and the Rosenberg Self-Esteem Scale (RSE) were used to measure the above-mentioned psychological states. Results: The results indicate that Arab adolescents witness high rates of psychological aggression and physical violence between their parents. Furthermore, regression and multiple regression analyses revealed that significant amounts of the variance in adolescents’ hopelessness, psychological adjustment problems, and low self-esteem are explained by witnessing different patterns of interparental psychological aggression and physical violence, beyond the amounts of variance in these criterion variables that can be attributed to some sociodemographic characteristics of the adolescents, their parents, and families. Conclusions: The results provided strong support for the hypothesis that witnessing interparental aggression and violence has a strong detrimental impact on adolescents’ psychological states. Furthermore, the results emphasize the need for further research into the effects of witnessing other patterns of psychological aggression and physical violence in adolescents’ nuclear and extended families. It would also be worthwhile to investigate the risk factors that predispose violence in the family and the consequences of those factors.

Psychological issues among children of hereditary breast cancer gene (BRCA1/2) testing participants.

Children growing up in hereditary breast cancer families may experience diminished psychological well-being. In addition to coping with having a cancer-affected parent or close relatives, these children may focus on their own health risks in light of shared genetic information. While knowledge of a parent's BRCA1/2 negative status may allay a subset of children's worries and fears about cancer, others could experience distressing thought patterns over positive test results. The purpose of this preliminary study is to explore conceptions of health, cancer risk, and psychological adjustment among children in families suggestive of carrying BRCA1/2 susceptibility genes. As part of a longitudinal investigation of the outcomes of BRCA1/2 testing in adults, 20 children of a highly select group of 15 mothers (80% previously affected by breast/ovarian cancer) completed a self-report survey of their beliefs and opinions regarding cancer and genetic testing, stress and worry about cancer, and anxiety, depression, and behavior problems. All information was completed at baseline, prior to the mother's receipt of her genetic test result. The data did not suggest unusually elevated cancer worries or psychological adjustment problems in these children at this point in the parental genetic testing process. However, children with more psychological distress symptoms did experience more frequent thoughts of becoming sick and greater cancer worries. To the extent that learning about a parent's positive test result could exacerbate these tendencies, recommendations to promote child psychological and family communications research that monitor such responses are offered.

Maternal acceptance and consistency of discipline as buffers of divorce stressors on children's psychological adjustment problems.

This study examines whether two aspects of mothering--acceptance and consistency of discipline--buffer the effect of divorce stressors on adjustment problems in 678 children, ages 8 to 15, whose families had divorced within the past 2 years. Children reported on divorce stressors; both mothers and children reported on mothering and internalizing and externalizing problems. Multiple regressions indicate that for maternal report of mothering, acceptance interacted with divorce stressors in predicting both dimensions of adjustment problems, with the pattern of findings supporting a stress-buffering effect. For child report of mothering, acceptance, consistency of discipline, and divorce stressors interacted in predicting adjustment problems. The relation between divorce stressors and internalizing and externalizing problems is stronger for children who report low acceptance and low consistency of discipline than for children who report either low acceptance and high consistency of discipline or high acceptance and low consistency of discipline. Children reporting high acceptance and high consistency of discipline have the lowest levels of adjustment problems. Implications of these results for understanding variability in children's postdivorce adjustment and interventions for divorced families are discussed.

Covert fears, anxiety and depression in congenital heart disease.

This study compared anxiety, fears, depression and behavioural problems as occurring in children with congenital heart disease, comparing them with samples of normal children. It further considered the influence of maternal anxiety, as well as analyzing a subgroup of children with cyanotic forms of congenital heart disease to determine if they were at higher risk than acyanotic children for the problems identified. We recruited 40 consecutive children with congenital heart disease without obvious psychosocial problems from the Cardiology clinic at the Alberta Children's Hospital. Of the 40 children, 39 families consented to have the children participate, of which 24 were cyanotic and 15 acyanotic. Children completed the revised versions of the Fear Survey Scale-Revised and the Child Manifest Anxiety Scale as well as the Child Depression Inventory. Mothers completed the Child Behaviour Checklist, and the State Trait Anxiety Scale. Children with congenital heart diseases demonstrated more medical fears, and more physiological anxiety, than the normative samples. More specifically, children with cyanotic forms of congenital heart disease demonstrated more fears of the unknown, physiological anxiety, depression, and delinquent behaviors than the acyanotic children with congenital heart disease. Mothers of the children with cyanotic forms of congenital heart disease scored higher on both the state and trait scales, with higher maternal anxiety correlating with higher anxiety, medical fears and behavioral problems in the child. In a clinical setting, children with congenital heart diseases who do not present with psychological adjustment problems are still at risk for covert physiological anxiety, medical fears, depression and behavioral problems. The children with cyanotic malformations represent a subgroup at higher risk for these problems, which may be further exacerbated by increased maternal anxiety.

Cognition, needs, satisfaction, and emotional responses for home care in bone marrow transplantation patients

Bone marrow transplantation (BMT) is an aggressive treatment which can induce considerable physical and psychological stresses. Patients face various problems in self care and psychological adjustment after discharge from the hospital. The purpose of this study was to explore the cognition, needs, satisfaction, and emotional responses toward home care in BMT patients and the factors influencing them. Forth BMT patients were enrolled from the outpatient clinic of BMT in a medical center. A descriptive research design was adopted. Cognition, needs, satisfaction, anxiety and depression for home care in these patients were collected by questionaires. The results showed that BMT patients had inadequate knowledge about how to care for themselves at home. High need and low satisfaction on disease adjustment and home care were found in these patients. All patients experienced anxiety and depression. Occupation, education, and socioeconomic status were found to affect patient's cognition. Religious belief influenced needs and satisfaction for home care in these patients. Sex and social-economic status emotional reaction of patients. This study will help health personnel understand the cognition, needs and satisfaction for home care in BMT patients. It can be used as a reference for organizing discharge plan and extending the continuity of care for BMT patients.

Models of Traumatic Experiences and Children's Psychological Adjustment: The Roles of Perceived Parenting and the Children's Own Resources and Activity

The relations between traumatic events, perceived parenting styles, children's resources, political activity, and psychological adjustment were examined among 108 Palestinian boys and girls of 11-12 years of age. The results showed that exposure to traumatic events increased psychological adjustment problems directly and via 2 mediating paths. First, the more traumatic events children had experienced, the more negative parenting they experienced. And, the poorer they perceived parenting, the more they suffered from high neuroticism and low self-esteem. Second, the more traumatic events children had experienced, the more political activity they showed, and the more active they were, the more they suffered from psychological adjustment problems. Good perceived parenting protected children's psychological adjustment by making them less vulnerable in two ways. First, traumatic events decreased their intellectual, creative, and cognitive resources, and a lack of resources predicted many psychological adjustment problems in a model excluding perceived parenting. Second, political activity increased psychological adjustment problems in the same model, but not in the model including good parenting.

Nature and Nurture Lessons from Swedish Adoption Surveys

The following article by Professor Michael Bohman begins with a brief historical analysis of child development theory in relation to adoption and fostering after the end of the Second World War. The author goes on to review research findings from a series of Swedish adoption surveys which began under his supervision in the 1960s and continue to this day. Much attention is given to the significance of genetic and environmental factors towards shaping the development of adopted children into adulthood. Problems of social and psychological adjustment are discussed, as are the genetic aspects of criminality and alcohol misuse in a group of adult adopted people.

Acculturation mode, identity variation, and psychosocial adjustment.

The hypothesis that it is the variability of a person's identity--as opposed to the particular combinations of identities--that produces stress during the acculturation process was examined. Two hundred ninety-five native Anglophone students at the University of Ottawa, Ontario, Canada, provided demographic data and completed the following measures: the Beck Depression Inventory (Beck & Beck, 1972), Rosenberg's Self-Esteem Scale (1965), the Situated Identity Measure (Clément & Noels, 1992), and the Psychological Stress Measure (Lemyre, Tessier, & Fillion, 1990). Results of ANOVAs contrasting level of identification and variability of identification indicated that an exclusively Anglophone identity was related to a higher level of depression, lower self-esteem, and a higher level of stress than the other modes of acculturation, but only when the variability in identity with the English group was high. Thus, the participants who identified strongly with the English group but were not committed to this identity experienced more psychological adjustment problems.

Does the Quality of Mother-Child Relationships Moderate the Effect of Postdivorce Interparental Conflict on Children's Adjustment Problems?

The purpose of this study was to determine if the quality of children's relationships with their primary residential par- ents interacts with interparental conflict to predict children's postdi- vorce psychological adjustment problems. It was predicted that a high quality relationship would moderate the relation between inter- parental conflict and children's psychological adjustment problems such that this relation would be significantly attenuated for children with high quality relationships, defined in terms of high levels of acceptance and high quality communication. No support was found for this hypothesis. Implications of these findings for the development of preventive intervention programs and directions for future research are discussed.

Perceptions of abuse: Effects on adult psychological and social adjustment

The present study examined perceptions of abuse (psychological, physical, and sexual) and later adult psychological and social adjustment in a nonclinical sample of 173 individuals. A subgroup of abused individuals were identified (Minimizers), who reported levels of abuse above the mean, but failed to acknowledge themselves as abused. Analyses of variance revealed that abused individuals, both Acknowledgers and Minimizers, consistently had more psychological and social adjustment problems than the Nonabused group. In addition, individuals who fell in the Minimizing subgroup had more detrimental outcome than the Abused (Acknowledgers) group in a few areas, suggesting that the perception of past events (abuse) may be an important factor in determining future psychological adjustment.

Mental health of mothers of children with juvenile rheumatoid arthritis: appraisal as a mediator.

Examined direct and mediated relations between condition parameters and maternal mental health for 53 mothers of 2- to 11-year-old children with juvenile rheumatoid arthritis (JRA). Multivariate analyses revealed that when considered simultaneously, indices of both biological severity and functional severity were associated significantly with maternal mental health. Further, mother's appraisals of the impact of the child's illness on the family partially mediated the effects of medication type and child's functional status on mother's mental health. Results provide support for conceptual models that emphasize the cognitive mechanisms by which condition parameters such as biological and functional severity might affect maternal mental health. Explicating the processes by which a child's JRA might lead to psychological adjustment problems in the parent has implications for developing preventive and treatment interventions.

Racial minorities and other high-risk groups with HIV and AIDS at increased risk for psychological adjustment problems in association with health locus of control orientation.

This study compared minority subjects (n = 45) with non-minority subjects (n = 49) with HIV and AIDS, examining levels of perceived locus of control over health status, and whether different health locus of control (HLOC) orientations (internal, powerful others, or chance) determined psychological adjustment as measured by depression levels, and intrusive and avoidant thoughts. Gender, lifestyle orientation, and socioeconomic status were also included as predictor variables. It was determined that minority subjects were significantly more likely to believe that their health status was in the hands of powerful others or chance. Further, an external HLOC orientation, in most instances, was associated with problems in psychological adjustment for subjects overall, and particularly for females and those of lower socioeconomic status. Additional findings and implications for social work are discussed.

Perceived physical appearance and adjustment of children with newly diagnosed cancer: A path analytic model

More intensive medical treatment protocols have been initiated with the goal of improving survival of pediatric cancer patients. Evaluation of the adjustment of this cohort of children with newly diagnosed cancer being treated with these modern regimens is essential in order to enhance quality of life. Children with cancer who experience disease and treatment-related changes in physical appearance are hypothesized to be at greater risk for psychological and social adjustment problems given society's attitudes toward visible physical differences. Within a risk and resistance theoretical framework, perceived physical appearance was investigated as a predictor of depressive symptoms, social anxiety, and general self-esteem in newly diagnosed pediatric cancer patients. In support of the a priori conceptual model, path analysis findings indicate that perceived physical appearance has direct and indirect effects on depressive symptoms and social anxiety with the indirect effects mediated by general self-esteem. Exploratory analysis suggests that the effect of perceived physical appearance on general self-esteem may be attenuated by modifiable competence/adequacy domains which have implications for the development of treatment interventions for children with newly diagnosed cancer.

Acculturation strategies, psychological adjustment, and sociocultural competence during cross-cultural transitions

The research examined host national and co-national identification in relation to sociocultural and psychological adaptation during cross-cultural transition. Ninety-eight sojourners (employees of a New Zealand organization and their spouses) completed questionnaires that included measurements of acculturation (host and co-national identification), social difficulty, and depression. Host and co-national identity scores were subjected to a median split, and 2 × 2 analyses of variance were performed; in this case, the interaction term represented four acculturation strategies: integration, separation, assimiliation, and marginalisation. Results revealed two main effects. Subjects with strong host national identification experienced less sociocultural adjustment difficulties (p < .001), whereas those with strong co-national identification evinced less psychological adjustment problems (p < .001). Interaction effects were also observed. For sociocultural adaptation (p < .05), the greatest amount of social difficulty was experienced by respondents who endorsed a separatist position, the least by assimilated and integrated subjects, and an intermediate level by the marginalized. For psychological adjustment (p < .04), integrated subjects experienced less depression than assimilated ones; however, there were no other significant differences among the four groups. The findings are discussed with reference to the quadri-modal model of acculturation attitudes and the conceptual distinction of psychological and sociocultural adjustment during cross-cultural transition.

SCREENING FOR BEHAVIORAL AND EMOTIONAL PROBLEMS IN CHILDREN AND ADOLESCENTS WITH CONGENITAL OR ACQUIRED LIMB DEFICIENCIES

• Children with chronic physical handicaps have been found to be at risk for psychological and social adjustment problems. Accurately identifying in a timely manner those physically handicapped children who are functioning at clinically significant levels of maladjustment may aid in preventing further psychosocial morbidity. The parents of 111 children and adolescents with congenital/acquired limb deficiencies completed the Child Behavior Checklist as a screening instrument to facilitate the identification of behavioral and emotional problems and social incompetence. Based on normalized T scores, the children manifested significantly greater behavioral and emotional problems and lower social competence than the normative community sample. Twenty-three percent of the children were reported to function in the clinically significant maladjustment range for behavioral and emotional problems; 14% were reported in the social maladjustment range. Correlations between parent report and child, adolescent, and teacher reports of adjustment ranged from r values of .23 to .41. The findings are discussed in terms of the new hidden morbidity in pediatric practice. ( AJDC . 1992;146:103-107)

Screening for behavioral and emotional problems in children and adolescents with congenital or acquired limb deficiencies.

Children with chronic physical handicaps have been found to be at risk for psychological and social adjustment problems. Accurately identifying in a timely manner those physically handicapped children who are functioning at clinically significant levels of maladjustment may aid in preventing further psychosocial morbidity. The parents of 111 children and adolescents with congenital/acquired limb deficiencies completed the Child Behavior Checklist as a screening instrument to facilitate the identification of behavioral and emotional problems and social incompetence. Based on normalized T scores, the children manifested significantly greater behavioral and emotional problems and lower social competence than the normative community sample. Twenty-three percent of the children were reported to function in the clinically significant maladjustment range for behavioral and emotional problems; 14% were reported in the social maladjustment range. Correlations between parent report and child, adolescent, and teacher reports of adjustment ranged from r values of .23 to .41. The findings are discussed in terms of the "new hidden morbidity" in pediatric practice.