Risk For Psychological Maladjustment Research Articles

Profiles of cognitive appraisals and triangulation into interparental conflict: Implications for adolescent adjustment.

Youth appraisals and triangulation into conflicts are key mechanisms by which interparental conflict places youth at risk for psychological maladjustment. Although evidence suggests that there are multiple mechanisms at work (e.g., Fosco & Feinberg, 2015; Grych, Harold, & Miles, 2003), this body of work has relied on variable-centered analyses that are limited to the unique contributions of each process to the variance in outcomes. In reality, it is possible that different combinations of these risk mechanisms may account for multifinality in risk outcomes. Using latent profile analysis (LPA) we examined profiles of threat appraisals, self-blaming attributions, and triangulation in relation to internalizing and externalizing problems in a sample of 285, ethnically diverse high school students. The current analyses revealed 5 distinct profiles of appraisals and triangulation, including an overall low-risk group and a global high-risk group, in which all 3 processes were below average or above average, respectively. Additional profiles included combinations of threat and blame, threat and triangulation, and blame and triangulation. Links between these profiles and emotional distress, problem behavior, and academic outcomes are discussed. (PsycINFO Database Record

Are patients at risk for psychological maladjustment during fertility treatment less willing to comply with treatment? Results from the Portuguese validation of the SCREENIVF

Do patients at risk for psychological maladjustment during fertility treatment present lower intentions to comply with recommended treatment than patients not at risk? Patients at risk of psychological maladjustment present similar high intentions to comply with recommended fertility treatment to those not at risk but their intentions are conditioned by the degree of control they perceive over their fertility and its treatment and their capacity to accept a future without biological children. Infertile couples refer to the psychological burden of treatment as one of the most important reasons for withdrawal from recommended treatment. The SCREENIVF can be used before treatment to screen patients at risk for psychological maladjustment by assessing five risk factors: anxiety, depression, helplessness and lack of acceptance cognitions and social support. Cross-sectional study. First, we investigated the psychometric properties of the Portuguese version of the SCREENIVF. Secondly, we investigated associations between risk for psychological maladjustment and intentions to comply with treatment. Two hundred and ninety-one women and 92 men undergoing any stage of fertility treatment at Portuguese infertility clinics were recruited online or in the clinical setting (55% response rate). Participants completed questionnaires that assessed their emotional adjustment, quality of life and compliance intentions. The confirmatory factor analysis for the SCREENIVF indicated good fit [χ(2) = 188.50, P < 0.001; comparative fit index = 0.97; root-mean-square error of approximation = 0.06 (90% CI 0.05-0.07)] and all dimensions were reliable (α ≥ 0.70, except depression for men: α = 0.66). Fifty-two percent of women and 30% of men were at risk for maladjustment. Women and men at risk and not at risk for maladjustment reported similar intentions to comply with treatment (P > 0.05). Cognitive risk factors moderated negative associations found between distress and compliance intentions. Higher anxiety was associated with lower compliance intentions for patients with lower helplessness cognitions (β = -0.45, P = 0.01) and men with higher acceptance cognitions (β = -0.60; P = 0.03), but not for patients with higher helplessness cognitions (β = 0.25, P = 0.13) and men with lower acceptance cognitions (β = 0.38; P = 0.21). Higher depression was associated with lower compliance intentions for patients with higher helplessness cognitions (β = -0.33, P = 0.02), but not for patients with lower helplessness cognitions (β = 0.19, P = 0.30). Few men participated and thus only medium-to-large effect sizes could be detected for them. Forty-eight percent of participants were recruited online and this could have resulted in higher rates of patients at risk. The SCREENIVF is not useful to identify patients at risk for non-compliance. However, the clinic staff should be aware that patients who score high on helplessness cognitions and low on acceptance may need additional decisional aid to make autonomous and satisfying decisions about uptake of treatment. The Portuguese version of the SCREENIVF is valid and reliable and can be used with women undergoing any type of fertility treatment. S.G. received a postdoctoral fellowship from the Portuguese Foundation for Science and Technology (FCT-SFRH/BPD/63063/2009). There are no conflicts of interest to declare.

Psychological adjustment and quality of life in children and adolescents following open-heart surgery for congenital heart disease: a systematic review

BackgroundChildren with congenital heart defects (CHD) requiring open-heart surgery are a group at high risk for health-related sequelae. Little consensus exists regarding their long-term psychological adjustment (PA) and health-related quality of life (QoL). Thus, we conducted a systematic review to determine the current knowledge on long-term outcome in this population.MethodsWe included randomized controlled trials, case control, or cohort studies published between 1990–2008 evaluating self- and proxy-reported PA and QoL in patients aged between two and 17 years with a follow-up of at least two years after open heart surgery for CHD.ResultsTwenty-three studies assessing psychological parameters and 12 studies assessing QoL were included. Methodological quality of the studies varied greatly with most studies showing a moderate quality. Results were as follows: (a) A considerable proportion of children experienced psychological maladjustment according to their parents; (b) studies on self-reported PA indicate a good outcome; (c) the studies on QoL suggest an impaired QoL for some children in particular for those with more severe cardiac disease; (d) parental reports of psychological maladjustment were related to severity of CHD and developmental delay.ConclusionA significant proportion of survivors of open-heart surgery for CHD are at risk for psychological maladjustment and impaired QoL. Future research needs to focus on self-reports, QoL data and adolescents.

When Mom or Dad has cancer: Markers of psychological distress in cancer patients, spouses, and children.

This study assessed anxiety/depression and stress response symptoms in adult cancer patients (n = 117), spouses (n = 76), and their children (n = 110, ages 6 to 30 years old) near the patients' diagnoses to identify family members at risk for psychological maladjustment. Patients' and family members' distress was related to appraisals of the seriousness and stressfulness of the cancer but not related to objective characteristics of the disease. Patients and spouses did not differ in anxiety/depression or in stress-response symptoms. Both stress-response and anxiety/depression symptoms differed in children as a function of age, sex of child, and sex of patient. Adolescent girls whose mothers had cancer were the most significantly distressed. Implications for understanding the impact of cancer on the family are highlighted.

Are Children with One Parent at Psychological Risk? A Methodological Review

Is the child reared by one parent at risk for psychological maladjustment? Four decades of research have not provided conclusive information. Design errors include poor control over extraneous natural covariates of family type, particularly socioeconomic status; unrepresentative samples; and invalid dependent measures. Conceptual blind spots include equation of conventional with healthy behavior and failure to anticipate either developmental lag or beneficial effects among children reared by one parent. Should findings of no difference attributable to number of parents and cause qf parent absence continue to result from well-controlled studies, the hypothesis of risk among children with one parent will have to be judged without empirical support.