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The integration of mental health and pediatric health care services has long been a goal for both research and practice. With the advent of federal policies developed to mandate clinical efficiency across the health care spectrum, this issue is becoming more salient. Applied literature on this topic is only recently emerging, however, and there are limited contextual examples to guide program development, research, and refinement. This article presents background information relevant to the development of such a program (the Center for Advancement of Youth). The cultural and organizational contexts for the project are discussed, with particular emphasis on models for cooperation among several institutions of varying size and scope. The implications for the future of tangible research in this area are also discussed, with attention to extending lessons learned to diverse settings motivated to integrate various aspects of health care service provision.
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Terapia Cognitivo-Conductual/métodos , Atención a la Salud/normas , Adolescente , Niño , HumanosRESUMEN
Although cognitive behavioral treatments (CBTs) have been recommended as first-line interventions for trichotillomania (hair-pulling disorder [HPD]), research on CBT for young children with HPD is limited. We illustrate the use of family-based CBT for HPD in an 8-year-old boy. The client had a 5-year history of chronic HPD and several large bald spots on the crown of his head. Treatment primarily comprised habit reversal training (HRT) and function-based interventions. The child showed significant improvement in HPD severity and impairment after 8 weekly sessions, although complete abstinence was not achieved. The findings underscore the importance of parental involvement in the treatment and show that children as young as 8 years of age can successfully use strategies taught in HRT.
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Terapia Cognitivo-Conductual/métodos , Tricotilomanía/terapia , Niño , Humanos , MasculinoRESUMEN
BACKGROUND: Pediatric cancer is associated with a host of negative psychosocial consequences; however, outcomes vary extensively suggesting a need to better understand this variation. Empirical research suggests a positive association between time since diagnosis (TSD) and Quality of Life (QoL). In addition to TSD, family stressors have been found to be particularly important in predicting QoL among children. The current study examined parental chronic stress beyond TSD in explanation of QoL functioning among a sample of pediatric patients with cancer. PROCEDURE: Participants included 43 pediatric patients aged 5-18 years (M(age) = 10.2 ± 3.6) who were undergoing oncological treatment. Parents reported on TSD, child's QoL, and their own chronic stress. RESULTS: TSD was associated with greater physical functioning (r = 0.30, P < 0.05). Parental chronic stress was associated with poorer emotional (r = -0.54, P < 0.01), physical (r = -0.41, P < 0.01), and social functioning (r = -0.44, P < 0.01). Further, hierarchal linear regression analyzes indicated parental chronic stress contributed incrementally beyond TSD in the explanation of physical (ß = -0.37, t = -2.58, P < 0.01), emotional (ß = -0.47, t = -3.51, P < 0.00), and social functioning (ß = -0.38, t = -2.67, P < 0.01). CONCLUSIONS: Parental chronic stress is associated with reduced levels of emotional, physical, and social functioning among pediatric patients. Future research is needed to further investigate the process by which chronic stress within the family interferes with adaptive coping among pediatric patients. In addition, clinical services may benefit from increased consideration of family factors, such as parental chronic stress, during oncological treatment.
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Adaptación Psicológica , Neoplasias/psicología , Padres/psicología , Calidad de Vida , Estrés Psicológico , Adolescente , Niño , Preescolar , Enfermedad Crónica , Femenino , Humanos , Masculino , Neoplasias/diagnóstico , Relaciones Padres-Hijo , Encuestas y CuestionariosRESUMEN
BACKGROUND: To examine associations between frequency of emergency room (ER) visits and various parenting styles, both conjointly and interactively, and psychopathological outcomes among pediatric patients with sickle cell disease (SCD). PROCEDURES: Ninety-eight parents/caregivers of 6- to 18-year-old patients with SCD completed instruments assessing parenting style, child psychopathology, and reported on the frequency of ER visits during the previous year. RESULTS: ER visits were found to significantly explain Withdrawn/Depressed problems and parenting styles were found to incrementally contribute to the explanation of all forms of psychopathology. Further, Permissive parenting was found to explain Rule Breaking Behavior for those patients with low ER visit frequency but not for those with high ER visit frequency. CONCLUSIONS: Results of the current study confirm the importance of considering both the frequency of ER visits and parenting style in the explanation of psychopathology among pediatric patients with SCD. Results have important implications for both research and treatment.
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Anemia de Células Falciformes/psicología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Responsabilidad Parental/psicología , Adolescente , Niño , Recolección de Datos , Femenino , Humanos , MasculinoRESUMEN
Given the barriers to conducting long-term assessment of neurocognitive and psychosocial functioning of those treated in infancy for central nervous system (CNS) tumors, a multi-site feasibility study was conducted. The primary objective was to demonstrate that it is feasible to identify, locate and assess the functioning of children treated on the same protocol 10-years post-treatment. Six sites obtained institutional approval, identified and recruited subjects, and obtained comprehensive neurocognitive and psychosocial data. All feasibility objectives were met. Barriers to participation included length of time for Institutional Review Board submission and review, clinical demands, limited eligible participants at individual institutions, difficulty locating long-term subjects and stipend/reimbursement concerns. Results indicate that long-term studies are feasible and essential given the need to address long-term issues of children treated at a young age for CNS tumors, especially as they relate to later academic and vocational planning, but require significant coordination and commitment of cooperative group and institutional resources.
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Neoplasias del Sistema Nervioso Central/psicología , Ensayos Clínicos como Asunto/métodos , Conducta Cooperativa , Recolección de Datos/métodos , Estado de Salud , Salud Mental/estadística & datos numéricos , Cooperación del Paciente/estadística & datos numéricos , Adolescente , Neoplasias del Sistema Nervioso Central/terapia , Niño , Preescolar , Escolaridad , Función Ejecutiva/fisiología , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Inteligencia/fisiología , Masculino , Memoria/fisiología , Procesos Mentales/fisiología , Resultado del TratamientoRESUMEN
OBJECTIVE: To evaluate the Psychosocial Assessment Tool 2.0 (PAT) as an appropriate screening measure of risk for patient and family psychological distress in pediatric sickle cell disease (SCD). METHODS: 219 caregivers completed the PAT during regular hematology clinic visits. Confirmatory factor analysis and tests of reliability were conducted. Multilevel modeling examined change and predictors of risk scores across four assessments. RESULTS: Confirmatory factor analysis factor loadings ranged from .03 to .81, and reliability coefficients ranged from .43 to .83. Risk for patient and sibling emotional problems, family problems, and parent stress reaction decreased over time. Increased patient age, chronic blood transfusion, lower caregiver education, caregivers being divorced, fewer adults and more children in the home, and greater financial difficulties were independent predictors of psychosocial risk. CONCLUSIONS: Results suggest that the PAT has utility in a pediatric sickle cell disease sample. Most caregivers reported low distress and high resiliency factors in this population.
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Adaptación Psicológica , Anemia de Células Falciformes/psicología , Familia/psicología , Resiliencia Psicológica , Estrés Psicológico/psicología , Adolescente , Cuidadores/psicología , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Reproducibilidad de los Resultados , Apoyo Social , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To retrospectively examine the relationship of single-parent status to parenting capacity variables in mothers of youth with a chronic health condition. METHODS: Parental overprotection, perceived vulnerability, and parenting stress were assessed in 383 mothers (308 married and 75 single parents) of youth with one of six chronic health conditions (i.e., type 1 diabetes, asthma, cancer, cystic fibrosis, hemophilia, or sickle cell disease). RESULTS: Single mothers evidenced higher levels of both perceived vulnerability and parenting stress, but not overprotection, than married parents. These differences disappeared in the presence of income as a predictor. CONCLUSIONS: Single parents appear to evidence differences in parenting capacity; however, low income appears to account in large part for the higher level of risk associated with single-parent status.
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Enfermedad Crónica , Renta , Madres , Responsabilidad Parental , Padres Solteros , Estrés Psicológico , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Pobreza , Clase Social , Apoyo Social , Encuestas y CuestionariosRESUMEN
This study aimed to identify the impact of neurocognitive functioning on academic and psychological domains using a novel person-centered latent profile analysis approach. We further examined the contribution of identified risk factors (e.g., age at diagnosis, treatment) on latent class membership. 101 pediatric oncology patients and survivors (M age = 11.2, 35.6% female; 47.5% African American; M time since diagnosis = 3.4 years) completed neuropsychological evaluations at a university medical center between February 2004 and June 2017. Neurocognitive, academic, and emotional-behavioral functioning were examined using validated measures. Discreet, homogenous neurocognitive subgroups (latent classes) were identified using latent profile analysis. Demographic and medical factors were evaluated as predictors of latent class. A 3-class model indicated excellent class separation (range: .00-.04) and homogeneity (range: .94-.99). Classes were distinguished by differential cognitive patterns. Class 2 (52%) and Class 3 (25%) displayed overall normative functioning; however, Class 3 displayed significantly poorer attention than the other two classes. Class 1 (23%) demonstrated Borderline neurocognitive, low average academic, and poorer emotional-behavioral and inhibition/executive control functioning. Class membership was predicted by race and whole brain radiation dose. Latent profile analysis identified discrete groups in neurocognitive functioning in this heterogeneous pediatric cancer population. Class membership was predicted by race, whole brain radiation dose, and referral source. Other medical variables (e.g., diagnosis, age at diagnosis) were not significant predictors of neurocognitive function in our sample.
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Trastornos del Conocimiento/etiología , Función Ejecutiva/fisiología , Neoplasias/complicaciones , Calidad de Vida/psicología , Sobrevivientes/psicología , Adolescente , Niño , Preescolar , Trastornos del Conocimiento/psicología , Emociones , Femenino , Humanos , Análisis de Clases Latentes , Masculino , Pruebas NeuropsicológicasRESUMEN
BACKGROUND: Given adolescent cancer survivors' increased susceptibility to late effects, it is imperative that we understand factors that influence their engagement in healthy and unhealthy behaviors. The purpose of this exploratory study was to identify significant predictors of health-harming and health-protective behaviors in adolescent cancer patients. PROCEDURE: Forty-two adolescents (ages 12-19 years) currently on-treatment for cancer and their parents were recruited from outpatient pediatric cancer clinics. Adolescents completed a battery of questionnaires that assessed their health-behaviors, quality of life, and psychological distress, while parents completed a demographic questionnaire. RESULTS: Regression analyses indicated that specific demographic, illness, and psychosocial variables significantly predicted health-harming and health-protective behaviors. Older adolescent age and unmarried parent status emerged as the best predictors of adolescent health-harming behaviors, whereas married parent status, increased adolescent time since diagnosis, increased adolescent-rated quality of life, and increased distress emerged as the best predictors of health-protective behaviors. CONCLUSIONS: Demographic, illness, and psychosocial variables may help inform the development of interventions designed to promote the initiation and/or maintenance of good health practices among adolescents on-treatment for cancer. Interventions are needed that target health behaviors while adolescents are approaching treatment completion, in order to help facilitate the practice of good health practices in survivorship.
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Conductas Relacionadas con la Salud , Neoplasias/psicología , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Valor Predictivo de las Pruebas , Encuestas y CuestionariosRESUMEN
OBJECTIVE: This preliminary study investigated prevalence rates of multiple health-related behaviors (ie, tobacco, alcohol, and other drug use; sexual risk-taking; nutrition/physical activity; overweight and dietary behaviors; sun safety) among 42 adolescents on active treatment for cancer, as compared with healthy adolescent norms. METHODS: Health-related behaviors were assessed using the 2005 National Youth Risk Behavior Survey, for which healthy adolescent norms were publicly available. RESULTS: Adolescents with cancer reported significantly lower current and lifetime rates of tobacco, alcohol, and other drug use; fruit/vegetable consumption; physical activity; and dietary behavior, in addition to lower rates of lifetime sexual intercourse, early-onset sexual intercourse, and alcohol/drug use before last sexual intercourse, compared with healthy peers. Among those who have previously engaged in sexual intercourse, there appeared to be a trend toward increased partners, current sexual activity, and lack of protection at last episode of sexual intercourse. Adolescents with cancer also reported significantly higher rates of television watching compared with healthy peers. CONCLUSIONS: Adolescents on active treatment for cancer are engaging in multiple health-risk behaviors, including sedentary behavior, poor nutrition, lack of sun safety, and sexual risk-taking (eg, multiple partners, lack of protection at last sexual intercourse). Health promotion interventions are needed during active treatment to facilitate the acquisition of good health practices as adolescents transition into survivorship.
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Conducta del Adolescente , Conductas Relacionadas con la Salud , Neoplasias/psicología , Adolescente , Consumo de Bebidas Alcohólicas/epidemiología , Niño , Dieta , Femenino , Humanos , Masculino , Neoplasias/epidemiología , Prevalencia , Factores de Riesgo , Asunción de Riesgos , Conducta Sexual/estadística & datos numéricos , Fumar/epidemiología , Trastornos Relacionados con Sustancias/etiología , Estados Unidos/epidemiología , Adulto JovenRESUMEN
To evaluate current and lifetime prevalence rates of nocturnal enuresis and psychosocial problems among children with sickle cell disease (SCD) in comparison with sibling controls, a structured interview and the Pediatric Symptom Checklist were administered to primary caretakers regarding 126 of their children aged 5 to 17 with SCD and 47 sibling controls. Lifetime rates of enuresis among children with SCD were comparable to similar studies, and exceeded population prevalence and sibling control rates. In addition, enuretic children had higher levels of total psychosocial problems on the Pediatric Symptom Checklist regardless of group status, although patterns of subscale differences varied by group and enuresis history after controlling for child age. These findings replicate and extend previous findings and provide further evidence to support a need for monitoring of hydration levels and screening for psychosocial problems among children with SCD and enuresis, as well as evaluation of the psychometric properties of psychosocial screening measures and identification of efficacious treatments for enuresis in children with SCD.
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Anemia de Células Falciformes/complicaciones , Enuresis/epidemiología , Trastornos Mentales/epidemiología , Adolescente , Anemia de Células Falciformes/psicología , Déficit de la Atención y Trastornos de Conducta Disruptiva/epidemiología , Estudios de Casos y Controles , Niño , Preescolar , Enfermedad Crónica/epidemiología , Enfermedad Crónica/psicología , Enuresis/psicología , Femenino , Humanos , Masculino , Análisis Multivariante , Prevalencia , Hermanos , Estados Unidos/epidemiologíaRESUMEN
The psychometric properties and factor structure of a widely used screening measure for behavioral and emotional dysfunction, the Pediatric Symptom Checklist (PSC), was extended to a population of chronically ill children. Parents of 404 children ranging from 6 to 17 years of age and diagnosed with either insulin-dependent diabetes mellitus (IDDM) or sickle cell disease (SCD) completed the PSC while waiting for a routine medical appointment. The measure's internal consistency was found to be high, Cronbach's alpha = .89, and test-retest reliability across 4 months was observed to be acceptable, r = .77. A principal components analysis with an oblique (promax) rotation yielded a four-factor solution with factors that included items representative of internalizing, externalizing, attention, and chronic illness-related problems, respectively. Cronbach alpha estimates ranged from .78 to .83 for the first three factors but was lower for the chronic illness-related problems factor (Cronbach's alpha = .60). A three-factor solution and reliability estimates were recomputed without the chronic illness items that yielded the same reliability estimates for each of the three factors and for the full scale. The three-factor solution was also found to be similar to a published factor structure obtained with a primary care sample, r(c) = .90-.91. The findings lend support to extending the PSC's clinical utility to tertiary care pediatric settings. Further research is recommended with a broader range of chronic illness groups to increase generalizability.
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Enfermedad Crónica/clasificación , Encuestas y Cuestionarios , Anemia de Células Falciformes/diagnóstico , Anemia de Células Falciformes/epidemiología , Niño , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/epidemiología , Análisis Factorial , Humanos , Tamizaje Masivo/métodos , Trastornos Mentales/diagnóstico , Trastornos Mentales/epidemiología , Psicometría , Reproducibilidad de los ResultadosRESUMEN
This paper reviews the literature on the psychological adjustment and quality of life in children who survive brain tumors. A total of 31 studies were reviewed. Findings are discussed in terms of the rates of general psychological adjustment, internalizing behavior problems, externalizing behavior problems, social competence, correlates or predictors of adjustment, and quality of life among survivors. Although these survivors appear to be at risk for compromised social competence and long-term quality of life, reports in the literature on rates of psychological adjustment in this population vary widely. Limitations in the current literature are discussed including inadequate assessment techniques, lack of appropriate comparison groups, and small sample sizes. Directions for future research are offered.
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Adaptación Psicológica , Neoplasias Encefálicas/psicología , Ajuste Social , Sobrevivientes/psicología , Niño , Conducta Infantil , Humanos , Calidad de VidaRESUMEN
Congenital heart disease (CHD) is often associated with intellectual, developmental, and academic late effects related to the diagnosis itself and treatment. This literature review examines what is currently understood about these intellectual and academic deficits. It appears that children with CHD, and particularly those with cyanotic CHD, are at risk for significant impairments in visual spatial skills, visual motor skills, and overall processing speed. Early neurocognitive interventions, especially with younger children, may prove beneficial for remediating some of these deficits.
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Discapacidades del Desarrollo/etiología , Cardiopatías Congénitas/complicaciones , Discapacidad Intelectual/etiología , Trastornos de la Destreza Motora/etiología , Factores de Edad , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Procedimientos Quirúrgicos Cardíacos/métodos , Preescolar , Discapacidades del Desarrollo/epidemiología , Femenino , Estudios de Seguimiento , Cardiopatías Congénitas/diagnóstico , Cardiopatías Congénitas/cirugía , Humanos , Incidencia , Lactante , Recién Nacido , Discapacidad Intelectual/epidemiología , Masculino , Trastornos de la Destreza Motora/epidemiología , Medición de Riesgo , Índice de Severidad de la Enfermedad , Factores SexualesRESUMEN
Evidence suggests that maternal borderline personality (BP) pathology increases offspring risk. This study examined the relations between maternal BP pathology and related emotional dysfunction (including emotion regulation [ER] difficulties and emotional intensity/reactivity) and infant ER difficulties. Specifically, we examined both self-focused and caregiver-focused ER behaviors and the modulation of emotional expressions (one indicator of ER in young children) in response to fear- and anger-eliciting stimuli among 101 infants (12 to 23 months old) of mothers with and without clinically relevant BP pathology. The authors also examined the moderating role of mother-infant attachment. Findings of a series of multiple regression mediation analyses revealed an indirect effect of maternal BP pathology on infant ER difficulties through maternal emotional dysfunction, with maternal ER difficulties facilitating an indirect effect of maternal BP pathology on expressivity-related indicators of infant ER difficulties and maternal emotional intensity/reactivity linking maternal BP pathology to lower self-focused ER for infants in insecure-resistant attachment relationships.
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Trastorno de Personalidad Limítrofe/patología , Hijo de Padres Discapacitados , Emociones , Conducta del Lactante/psicología , Relaciones Madre-Hijo , Madres/psicología , Apego a Objetos , Estrés Psicológico/psicología , Adulto , Ansiedad/psicología , Trastorno de Personalidad Limítrofe/complicaciones , Trastorno de Personalidad Limítrofe/psicología , Depresión/psicología , Femenino , Humanos , Lactante , Masculino , Conducta Materna , Mississippi , Pruebas PsicológicasRESUMEN
BACKGROUND: Neurocognitive impairment occurs in children and adults with sickle cell anemia, but little is known about neurodevelopment in very young children. We examined the neurodevelopmental status of infants participating in the Pediatric Hydroxyurea Phase III Clinical Trial (Baby Hug) to determine relationships with age, cerebral blood flow velocity, and hemoglobin concentration. METHODS: Standardized measures of infant neurodevelopment were administered to 193 infants with hemoglobin SS or hemoglobin S-ß(0) thalassemia between 7 and 18 months of age at the time of their baseline evaluation. Associations between neurodevelopmental scores and age, family income, parent education, hemoglobin concentration, and transcranial Doppler velocity were examined. RESULTS: Mean functioning on the baseline neurodevelopment scales was in the average range. There were no mental development scores <70 (impaired); 22 children had scores in the clinically significant range, 11 with impaired psychomotor scores and 11 with problematic behavior rating scores. Significantly poorer performance was observed with older age at baseline. Behavior rating scores were an average of 2.82 percentile points lower per month of age, with similar patterns observed with parent report using adaptive behavior scales. Parent-reported functional abilities and hemoglobin were negatively associated with higher transcranial Doppler velocities. CONCLUSIONS: Whereas overall functioning was in the normal range, behavioral and adaptive function was poorer with older age, even in this very young group of children. Explanatory mechanisms for this association between poorer developmental function and older age need to be identified.
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Anemia de Células Falciformes/diagnóstico , Daño Encefálico Crónico/diagnóstico , Trastornos de la Conducta Infantil/diagnóstico , Trastornos Psicomotores/diagnóstico , Actividades Cotidianas/clasificación , Adaptación Psicológica/efectos de los fármacos , Adaptación Psicológica/fisiología , Factores de Edad , Anemia de Células Falciformes/tratamiento farmacológico , Antidrepanocíticos/efectos adversos , Antidrepanocíticos/uso terapéutico , Velocidad del Flujo Sanguíneo/efectos de los fármacos , Velocidad del Flujo Sanguíneo/fisiología , Encéfalo/irrigación sanguínea , Daño Encefálico Crónico/tratamiento farmacológico , Trastornos de la Conducta Infantil/tratamiento farmacológico , Método Doble Ciego , Femenino , Hemoglobinometría , Humanos , Hidroxiurea/efectos adversos , Hidroxiurea/uso terapéutico , Lactante , Masculino , Determinación de la Personalidad , Trastornos Psicomotores/tratamiento farmacológico , Socialización , Evaluación de Síntomas , Ultrasonografía Doppler TranscranealRESUMEN
Evidence-based practices, such as motivational interviewing (MI), are not widely used in community alcohol and drug treatment settings. Successfully broadening the dissemination of MI will require numerous trainers and supervisors who are equipped to manage common barriers to technology transfer. The aims of the our survey of 36 MI trainers were: 1) to gather opinions about the optimal format, duration, and content for beginning level addiction-focused MI training conducted by novice trainers and 2) to identify the challenges most likely to be encountered during provision of beginning-level MI training and supervision, as well as the most highly recommended strategies for managing those challenges in addiction treatment sites. It is hoped that the findings of this survey will help beginning trainers equip themselves for successful training experiences.
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The authors studied pediatric patients with B-precursor acute lymphocytic leukemia (ALL) to determine whether Mississippi's gender incidences correlate with national statistics. Furthermore, data on gender incidences in each of the risk categories of low, standard, and high were collected. A retrospective chart review was performed of pediatric B-precursor ALL patients diagnosed at the Children's Cancer Clinic at the University of Mississippi Medical Center from 1995 to 2005. The gender incidences in Mississippi were found to be comparable with the national average for ALL (1.34:1 vs 1.3:1) overall. However, the national average includes T-cell ALL, which is known to be significantly more prevalent in boys. Of greater significance, boys were noted to present with high-risk B-precursor ALL 4 times more than girls, suggesting the need for further investigation into possible causes of this phenomenon.
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Leucemia-Linfoma Linfoblástico de Células Precursoras B/epidemiología , Centros Médicos Académicos , Sesgo , Causalidad , Distribución de Chi-Cuadrado , Niño , Femenino , Humanos , Incidencia , Masculino , Mississippi/epidemiología , Vigilancia de la Población , Leucemia-Linfoma Linfoblástico de Células Precursoras B/clasificación , Leucemia-Linfoma Linfoblástico de Células Precursoras B/etiología , Leucemia-Linfoma Linfoblástico de Células T Precursoras/epidemiología , Prevalencia , Estudios Retrospectivos , Medición de Riesgo , Distribución por Sexo , Estados Unidos/epidemiologíaRESUMEN
BACKGROUND: Food allergy affects up to 8% of children and is increasingly common. Although adult caregivers initially assume the primary role in children's daily allergy management activities, as children approach school age they assume greater responsibility for the prevention of allergic exposures. The ways that parents prepare children for this transition are likely to influence children's subsequent risk for allergic exposures, yet few studies have examined parent behaviors in the context of pediatric food allergy. OBJECTIVE: To develop a brief measure to evaluate specific parenting practices related to caring for a child with food allergy. METHODS: A total of 292 primary caregivers of food-allergic children completed an Internet-based survey that included the Parenting Children with Food Allergy (PCFA) questionnaire. RESULTS: Factor analysis of the PCFA items suggested 3 factors that accounted for 98% of the variance: autonomy support, protection/monitoring, and emergency education. Internal consistencies for the 3 scales were acceptable (alpha = .79, .73, and .82, respectively). Child age and medical variables (history of emergency epinephrine use, perceived severity of worst allergic reaction, and number of different food allergies) were associated with parenting practices. CONCLUSION: Although additional psychometric data for the PCFA are needed, preliminary findings suggest that this measure may be useful in evaluating parenting within the context of pediatric food allergy.
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Conducta , Crianza del Niño/psicología , Hipersensibilidad a los Alimentos/psicología , Responsabilidad Parental/psicología , Encuestas y Cuestionarios/normas , Adulto , Niño , Preescolar , Análisis Factorial , Femenino , Hipersensibilidad a los Alimentos/terapia , Encuestas Epidemiológicas , Humanos , Internet , Masculino , Persona de Mediana Edad , Relaciones Padres-Hijo , PsicometríaRESUMEN
Several investigations have found support for the role of behavioral inhibition in the etiology of childhood anxiety and depression disorders. However, nothing is known about how this relation extends to children with a chronic, life-threatening illness. The purpose of the current study was to examine behavioral inhibition and its relation to anxiety and depression symptoms among 30 adolescents with sickle cell disease (SCD). Adolescents with SCD and their primary caregivers completed instruments assessing demographic information, behavioral inhibition, and anxiety and depression symptoms. A majority of adolescents with SCD classified themselves as middle or low on behavioral inhibition. Adolescents with SCD who classified themselves as high on behavioral inhibition displayed higher levels of anxiety and depression than adolescents with SCD who classified themselves as low on behavioral inhibition; adolescents with SCD endorsing the middle behavioral inhibition category generally scored in between. These data extend previous work with healthy children and adolescents and suggest that early and continued assessment of behavioral inhibition may be important in preventing adverse psychological outcomes among a group that is already at risk for internalizing disorders.