Interbacterial binding among strains of pathogenic and commensal oral bacterial species

OBJECTIVE: Family resources and coping skills are important to adaptation to pediatric chronic illness. Psychological and educational interventions have been found to enhance the coping skills of children with juvenile rheumatic disease (JRD) and their families. We examined the efficacy of a 3-day family retreat as a multidisciplinary, comprehensive treatment. METHODS: Children with JRD and their caregivers completed questionnaires assessing the children's behavioral and emotional functioning, pain, strain on caregivers' work and leisure activities, and caregivers' psychological distress before and 6 months after the family retreat. Principal caregivers were both parents for 16 children, mothers only for 10 children, and an aunt for 1 child. RESULTS: Improvements were found in children's emotional functioning, strain on caregivers' work, and strain on caregivers' leisure activities. Reductions in reported pain were not consistently revealed. CONCLUSIONS: Family retreats are an efficacious, multidisciplinary approach to helping families of children with JRD cope with the disease and its manifestations. Importantly, retreats offer a comprehensive intervention package that might not be available to families on an individual basis.     

Stress, coping, and psychological adjustment of adults with sickle cell disease.

Examined a transactional model of psychological adjustment to chronic illness with 109 African-American adults with sickle cell disease (SCD). Good psychological adjustment was associated with lower levels of perceived daily stress and stress regarding SCD illness tasks, higher efficacy expectations, less use of palliative coping methods, less use of negative thinking/passive adherence pain-coping strategies, and family functioning characterized by high levels of support and low levels of conflict and control. Overall, the underlying stress and coping conceptual model accounted for 44–50% of the variance in psychological adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting adjustment in children and adolescents with sickle cell disease: A test of the risk-resistance–adaptation model.

Objective: A theoretical model was used to examine the impact of risk and resistance factors on the psychological adjustment of children and adolescents with sickle cell disease (SCD). Participants: One hundred eighteen children and adolescents with SCD receiving treatment at a comprehensive sickle cell center and their mothers. Measures: Included risk factors (condition parameters, functional independence, and disability stressors), resistance factors (stress processing, intrapersonal factors, and social ecological factors), and adjustment. Results: Adaptive behavior was associated with child maladjustment, severity of disability was associated with disability stress, and child competence was associated with child maladjustment. Coping did not moderate the association between stress and maladjustment, and adaptive behavior and stress did not mediate the association between severity of disability and maladjustment, as the model had predicted. Conclusions: Results support the continued use of theoretically driven models to investigate the adjustment of children and adolescents with chronic conditions and to promote comparisons of different chronic illnesses and disabling conditions… (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parent Functioning in Families of Preadolescents With Spina Bifida: Longitudinal Implications for Child Adjustment.

The purpose of this study was to test a strength-of-association model regarding possible longitudinal and bidirectional associations between parent functioning and child adjustment in families of children with spina bifida (n = 68) and families of able-bodied children (n = 68). Parent functioning was assessed across 3 domains: parenting stress, individual psychosocial adjustment, and marital satisfaction. Child adjustment was indexed by teacher-reported internalizing and externalizing symptoms, self-reported depressive symptoms, and observed adaptive behavior. Findings revealed that all 3 parent functioning variables predicted child adjustment outcomes, and that such results were particularly strong for externalizing symptoms. Associations between parent functioning and child adjustment tended to be in the direction of parent to child and were similar across both groups. These findings have implications for potential interventions targeted at helping families manage the transition into early adolescence in families of children with spina bifida as well as families of healthy children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping with illness: Interrelationships across family members and predictors of psychological adjustment.

This study examined coping in families in which there was a chronically ill parent. Husbands, wives, and one child (aged 7–18 yrs) from 75 families in which the husband had hemophilia participated. Coping styles and psychological adjustment were assessed, and patterns of coping among family members were examined. Avoidant coping was associated with poorer adjustment for all family members. In addition, the coping style of one family member was found to be related to the psychological adjustment of other family members. Avoidant coping by one spouse related to poorer psychological functioning in the other spouse, and avoidant coping by either parent related to greater child adjustment problems for girls and boys. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family functioning and social support in the adaptation of caregivers of children with sickle cell syndromes

OBJECTIVE: To examine moderating effects of family functioning and social support on the relationship of child-related stressors to caregivers' psychological adaptation in a sample of caregivers of children with a chronic illness. METHOD: Participants were 67 caregivers of children and adolescents with sickle cell syndromes. We conducted MANOVAs and subsequent effect size calculations to determine if family functioning would buffer the effects of caring for difficult-to-manage children with this illness. RESULTS: Findings supported a moderator effect of family functioning on the association of children's externalizing behavioral problems to caregivers' symptoms of hostility. Greater levels of cohesive and adaptive family functioning buffered the potential detrimental effects of caring for children perceived as hard to manage. No significant associations were obtained between measures of caregivers' psychological adaptation and the severity of their children's disease. CONCLUSIONS: We make recommendations for family systems interventions, particularly for caregivers of children with behavior problems.     

A longitudinal examination of the parent–child distress relationship in children with juvenile rheumatic disease.

Objective: To examine the longitudinal relationships between parent and child distress in a sample of children with juvenile rheumatic diseases (JRDs). Design: Cross-lagged panel correlation analysis tested the temporal precedence of parent distress versus child distress over a 1-year period. Participants: Thirty-seven children (ages 9–17 years; 22 girls) diagnosed with JRD and their parents completed self-report measures on 2 occasions (assessment interval M = 12 months). Primary Outcome Measures: Child Depression Inventory and Brief Symptom Inventory. Results: Significant cross-sectional parent–child distress associations were observed at both time points. Moreover, Time 1 parent distress predicted child distress at Time 2 after child-reported functional ability was controlled; Time 1 child distress was unrelated to Time 2 parent distress. Cross-lagged panel correlations demonstrated the temporal precedence of parent distress relative to child distress in the parent–child distress relationship. Conclusions: These preliminary findings underscore the importance of parent distress in parent–child transactional adjustment, and suggest a predominant role for parent distress in children's adjustment to JRDs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Child health psychology": Erratum.

Reports an error in "Child health psychology" by Dennis Drotar, Suzanne Bennett Johnson, Ron Iannotti, Norman Krasnegor, Karen A. Matthews, Barbara G. Melamed, Sharon Millstein, Rolf A. Peterson, Debbie Popiel and Donald K. Routh (Health Psychology, 1989, Vol 8[6], 781-784). The name of the author, Sharon Millstein, should be Susan Millstein. It appears correctly in this record. (The following abstract of the original article appeared in record 2008-09118-001.) The term child health psychology refers to the field of research on the behavioral aspects of children's health and illness. At this time we need to continue the work of the child health psychology special interest group and to draw into the Division of Health Psychology a much larger number of developmental psychologists, who need to be informed about the relevance of their scientific training to child health issues. We call the Division's attention and that of granting agencies such as the National Institute of Child Health and Human Development to the following high-priority child health research issues: adherence to pediatric medical regimens; child health promotion; family influences on child and adolescent health and disease; and stress and coping in childhood illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hope and social support as resilience factors against psychological distress of mothers who care for children with chronic physical conditions.

On the basis of the multivariate conceptual model proposed by J. L. Wallander et al (1989), perceptions of hope and social support were hypothesized to serve as resilience factors against distress in mothers of children with chronic physical conditions. Relationships among these variables were tested. Ss were 111 mothers of 5 to 18-yr-old children who had cerebral palsy, spina bifida, or insulin-dependent diabetes mellitus. Tests used included the Hope Scale, Social Support Questionnaire-6, Brief Symptom Inventory, and Parents of Children With Disabilities Inventory. There were no differences in distress among mothers raising children with different conditions. Both hope and social support were associated negatively and uniquely with distress in these mothers. Perceptions of hope moderated the relationship between disability-related stress and maladjustment, suggesting a buffering effect when stress is high. However, hope did not appear to be a mediator of the relationship between social support and distress. These findings enhance our conceptual understanding of distress in maternal caregivers of children with a chronic physical condition. They also support improving sense of hope as is done in some problem-solving training programs to enhance coping in distressed individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived social support, psychological adjustment, and functional ability in youths with physical disabilities.

Objective: To examine the relationship between perceived social support and psychological adjustment and functional ability in youths with physical disabilities. Participants: Thirty-seven youths with neuromuscular disease and 33 with spina bifida. Measures: Demographic and disability-related questions, Child Health Questionnaire, Functional Disability Inventory, and Multidimensional Scale of Perceived Social Support. Results: Social support from family, but not from friends, was significantly associated with better psychological adjustment. Significant interactions emerged between family support and age, as well as between friend support and gross motor functioning, in the prediction of functional ability. Conclusions: Social support appears to play an important role in psychological adjustment and functional ability in this population, and the nature of this role may be moderated, to some extent, by age and gross motor functioning. Future research and clinical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Appraisal, coping, and social support as mediators of well-being in Black and White family caregivers of patients with Alzheimer's disease.

Family caregivers of patients with Alzheimer's disease (AD) commonly have high levels of psychological distress. Black caregivers often report less depression than White caregivers, but the process underlying this difference is poorly understood. With the use of a stress process model, 123 White and 74 Black family caregivers of patients with AD and other progressive dementias were studied. Black caregivers appraised patient problems as less stressful and reported higher self-efficacy in managing caregiving problems and less depression than did White caregivers. White and Black caregivers also differed significantly in coping responses but not in social supports. Structural equation analyses indicated that the correlational structure of the stress process was similar in White and Black caregivers. Caregiving stressors and race did not affect well-being through direct paths, but they were mediated by effects for appraisal, social support and activity, and coping. Possible cultural mechanisms explaining the better adjustment among Black caregivers are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of self-blame and responsibility in adjustment to inflammatory bowel disease.

Objective: S. C. Roesch and B. Weiner's (2001) theoretical model of adjustment to chronic illness was adapted to examine the role of attributions, avoidant coping strategies, and disease severity in the psychological adjustment of people with inflammatory bowel disease (IBD). Research Method and Design: People with IBD (N = 259) completed an online survey including measures of health-related self-blame and responsibility attributions, disease severity, avoidant coping strategies, and psychological adjustment indexes (coping efficacy, acceptance, and helplessness). Results: Structural equation modeling revealed that avoidant coping mediated the relationship between attributions and psychological adjustment. Attributions of self-blame were directly related to increased avoidant coping, which was in turn associated with poor adjustment. Beliefs about responsibility were associated with decreased use of avoidant coping strategies and subsequently improved psychological adjustment. Higher scores on disease severity were linked to the use of avoidant coping strategies and poor psychological adjustment. Conclusions: Distinguishing between self-blame and responsibility attributions has important implications for understanding the psychological adjustment of individuals with IBD and may be useful for creating intervention strategies aimed at enhancing the psychological functioning of people with IBD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parent Differentiation of Self and Child Competence in Low-Income Urban Families.

In this study, the author examined whether family system functioning was associated with resilience in children exposed to negative environmental stress. In a sample of 55 low-income, urban families, greater differentiation of self among mothers predicted child competence--that is, better verbal and math achievement scores and lower aggression--after considering the effects of neighborhood violence and family life stress. No relations were observed between parent functioning and child academic self-concept. Furthermore, mothers' differentiation-of-self scores predicted children's cognitive skills, even after controlling for parent level of education. Implications, limitations, and directions for further research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family functioning processes and diabetic ketoacidosis in youths with type I diabetes.

Purpose/Objective: To examine relations between episodes of diabetic ketoacidosis (DKA) and parental warmth, parental negativity, and lack of responsibility for diabetes-related tasks in a sample of youths with Type 1 diabetes (T1D). Research Method/Design: 100 youths with T1D and their caregivers, recruited from an inpatient diabetes unit and an outpatient diabetes clinic, participated. Participants completed disease-specific measures of family functioning (e.g., parental warmth, parent and child perceptions of negativity, family responsibility for diabetes regimen), and medical information (e.g., glycosylated hemoglobin and incidences of DKA) was obtained from medical records. Results: Results showed that higher child perceptions of parental warmth and caring related to the regimen were associated with decreased odds of experiencing a DKA episode. Child reports of higher parental negativity about the regimen were associated with increased odds of experiencing a DKA episode. Reports of who in the family was responsible for the diabetes regimen were not related to episodes of DKA. Conclusions/Implications: Findings suggested that family factors play a significant role in the occurrence or absence of DKA in children's long-term management of diabetes. Future intervention efforts should focus on warmth, caring, and negativity when children and their parents are problem solving and communicating about the diabetes regimen. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stability and change in the psychological adjustment of mothers of children and adolescents with cystic fibrosis and sickle cell disease

Found moderate stability in the classification of maternal adjustment in two longitudinal studies of mothers of children and adolescents with cystic fibrosis and sickle cell disease. In terms of the transactional stress and coping model, stable poor maternal adjustment was associated with higher levels of appraisal of daily stress and palliative coping and low levels of family supportiveness. With initial levels of maternal adjustment, demographic parameters, and follow-up interval controlled, concurrent levels of daily stress accounted for significant portions of variance in maternal adjustment at follow-up for both illness groups. In addition, illness severity, child psychological adjustment, and family conflict added significant increments to maternal adjustment at follow-up in the cystic fibrosis group. Findings are discussed in terms of a basis for subsequent intervention studies to enhance the adjustment of mothers of children with chronic illness.     

Reciprocal influences in children's and families' adaptation to early childhood wheezing.

Objective: The objective of the present study was to demonstrate the reciprocal relationships between family adaptation to illness and children's medication use over time among children who presented with wheezing illness in infancy but have varying illness outcomes by age 4. Design: A longitudinal design and latent growth curve models (LGM) were used to predict change in family and caregiver adaptation to illness and children's medication use over three years among 140 infants with wheezing, among families from low socioeconomic, multi-ethnic backgrounds. Main Outcome Measures: One LGM predicted level and change (slope) of family adaptation to illness from children's baseline medication use. The second LGM predicted level and change (slope) of children's medication use from baseline family adjustment to illness. In both models, illness severity, caregivers' psychological resources, and emergency department use were covaried with the independent variable. Results: Two latent growth models were found to adequately fit the data and demonstrate full reciprocal relations between family adaptation to illness and children's medication use while accounting for baseline variables. Baseline measures of caregiver psychological functioning and illness severity were also significant predictors of family adaptation and children's medication use over time. The two models were not statistically different for children with and without active asthma at 4 years of age. Conclusion: Findings support the reciprocal effects model of child and family influences on pediatric illness and underscore the importance of early indicators of individual and family functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's Perceived Illness Uncertainty as a Moderator in the Parent-Child Distress Relation in Juvenile Rheumatic Diseases.

Objective: Examine children's perceived illness uncertainty as a potential moderator in the parent-distress/child-depressive-symptom relation in youths with juvenile rheumatic disease (JRD). Participants and Study Design: 50 youths between the ages of 9 and 17 and their parents completed self-report measures. Main Outcome Measures: Parents completed the Brief Symptom Inventory (L. R. Derogatis & N. Melisaratos, 1983); youths completed the Children's Depression Inventory (M. Kovacs, 1992) and the Children's Uncertainty in Illness Scale (L. L. Mullins & V. L. Hartman, 1995). Results: Children's perceived illness uncertainty moderated the parent-distress/child-depressive-symptom relation. Parent distress was associated with child depressive symptoms only under conditions of high child-perceived uncertainty; under conditions of low illness uncertainty, parent distress was unrelated to child depressive symptoms. Conclusions: Results highlight the role of children's cognitive appraisals in parent-child adjustment relations in JRD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child health psychology.

[Correction Notice: An erratum for this article was reported in Vol 9(6) of Health Psychology (see record 2008-09119-001). The name of the author, Sharon Millstein, should be Susan Millstein.] The term child health psychology refers to the field of research on the behavioral aspects of children's health and illness. At this time we need to continue the work of the child health psychology special interest group and to draw into the Division of Health Psychology a much larger number of developmental psychologists, who need to be informed about the relevance of their scientific training to child health issues. We call the Division's attention and that of granting agencies such as the National Institute of Child Health and Human Development to the following high-priority child health research issues: adherence to pediatric medical regimens; child health promotion; family influences on child and adolescent health and disease; and stress and coping in childhood illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Political violence and child adjustment in Northern Ireland: Testing pathways in a social–ecological model including single-and two-parent families.

Moving beyond simply documenting that political violence negatively impacts children, we tested a social–ecological hypothesis for relations between political violence and child outcomes. Participants were 700 mother–child (M = 12.1 years, SD = 1.8) dyads from 18 working-class, socially deprived areas in Belfast, Northern Ireland, including single- and two-parent families. Sectarian community violence was associated with elevated family conflict and children's reduced security about multiple aspects of their social environment (i.e., family, parent–child relations, and community), with links to child adjustment problems and reductions in prosocial behavior. By comparison, and consistent with expectations, links with negative family processes, child regulatory problems, and child outcomes were less consistent for nonsectarian community violence. Support was found for a social–ecological model for relations between political violence and child outcomes among both single- and two-parent families, with evidence that emotional security and adjustment problems were more negatively affected in single-parent families. The implications for understanding social ecologies of political violence and children's functioning are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping style, perceived uncertainty in illness, and distress in individuals with Parkinson's disease and their caregivers.

Examined the relationship of coping style and illness uncertainty to psychological distress in individuals with Parkinson's disease (PD) and their primary caregivers. Design: Correlational methods, within-group theory-driven hierarchical regression analyses, and transactional analyses. Ss were 44 dyads composed of individuals with PD and their caregivers. Main Outcome Measures: Hoehn and Yahr Clinical Disability Rating Scale, Instrumental Activities of Daily Living Scale, Symptom Distress Checklist-90—Revised, Mischel Uncertainty in Illness Scale-Community Form, and Revised Ways of Coping Checklist. Results: Emotion-focused coping was associated with higher levels of distress for persons with PD, whereas both emotion-focused coping and perceived uncertainty were associated with distress for the caregivers. Transactional analyses between patients and caregivers indicated that higher levels of patient problem-focused coping and perceived uncertainty in illness were associated with increased problems in caregiver distress. Adjustment to PD is influenced by several patient and caregiver variables. The results warrant consideration of a variety of clinical interventions involving patient and caregiver education about the disease and methods for managing the associated symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)