Adjustment to threatening events: A theory of cognitive adaptation.

Introduces a multidimensional framework for examining the development and adaptation of children with chronic illness, encompassing biomedical, psychological, and socio-ecological factors. Illnesses discussed are asthma, cancer, cystic fibrosis, diabetes, sickle cell disease and spina bifida.

Adaptation to Chronic Childhood Illness

This research compares the family environments of diabetic adolescents in good (HbA1c less than 10), fair (10 greater than or equal to HbA1c less than or equal to 14), and poor (HbA1c greater than 14) control. Fifty-eight adolescents diagnosed with type 1 diabetes and their parents (mothers) were independently assessed with structured interviews, the Moos Family Environment Scale, and adolescents also completed the Piers-Harris Children's Self-Concept Scale. As compared with adolescents in poor control, those in good control reported fewer diabetes-related symptoms and had less anxiety and a more positive self-concept. Well-controlled youths also reported more cohesion and less conflict among family members. More parents of well-controlled youths stated that family members were encouraged to behave independently. In addition, more parents of poorly controlled adolescents believed that diabetes had negatively affected the child's personality, physical well-being, schooling, and participation in activities away from home. These findings suggest a complex interplay between the diabetic adolescent's psychological and physical functioning, metabolic control, and the family environment.

Family characteristics of diabetic adolescents: relationship to metabolic control

Psychological effects of illness in adolescence. I. Anxiety, self-esteem, and perception of control.

Objective: This article explores the relationship between a repressive style of adaptation and depressive symptomatology. Methods: Thirty-one adolescent cancer patients were compared with 83 healthy high school students. Subjects with repressive adaptation were identified as those reporting low anxiety and high defensiveness. Depressive symptomatology was measured by self-report. Results: Patients with cancer reported significantly lower levels of depression, and a significantly higher proportion were identified as repressors. Repressor status accounted for significant variance in depression over that explained by illness. Conclusions: Adaptive style may be common in medically ill children and may directly and indirectly influence psychological and medical outcome.

Depressive symptoms and adaptive style in children with cancer.

The study evaluated the psychosocial functioning levels of a group of chronically ill (diabetic, asthmatic, cystic fibrotic, and hearing-impaired) children across a battery of standardized personality instruments. The assessments were performed to provide a rigorous test of the popular hypothesis that chronically ill children are especially vulnerable to psychopathology. In contrast to this stereotype, results across measures demonstrated the normalcy rather than the deviance of these children. Although exceptions were noted, the children's functional strengths and coping abilities noticeably outweighed their weaknesses.

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P. M. Slater

Papers

Chronically ill children. A psychologically and emotionally deviant population