Modern, highly technical health care systems increasingly remove patients from active participation in managing their own medical treatment. This is particularly true when serious or life-challenging illness occurs. Health psychology has much to contribute in the debate over the degree of patient self-determination necessary to achieve optimal treatment outcomes. Psychologists may directly influence this process through their professional contact with medical patients and their families. Through researching the behavioral skills of medical consumership, identifying the elements of effective patient-physician interaction, and encouraging physicians-in-training to adopt a propatient partnership attitude, psychology adds new dimensions to the provision of health care. This paper reviews some of the issues faced by patients with life-challenging illnesses through the writer's personal experience, and seeks to identify the requisite actions for informed, participatory involvement on the part of patients.
This study assessed psychometric properties of the Child Behavior Checklist (CBCL/1.5-5) and explored clinical insights from its use in a sample of adopted Chinese girls.
Parental ratings were obtained on 707 adopted Chinese girls, ages 1.50-5.92 years (M = 3.24, SD = 1.26). Confirmatory factor analysis (CFA), employing robust weighted least squares estimation, was used to evaluate the instrument's seven-factor correlated structure. Profiles of scores were analyzed descriptively for clinical insights.
The CFAs indicated that the fit of Achenbach and Rescorla's (2000 Manual for the ASEBA preschool forms & profiles. Burlington, VT: University of Vermont, Research Centre for Children, Youth, & Families) model to the data obtained from the adopted Chinese girls was acceptable using either a 2-point response scale or the original 3-point response scale for the 67 items from which the seven syndromes or correlated factors are derived. Values for the root mean square error of approximation (RMSEA) for the 2-point and 3-point response scales were .049 and .053, respectively. The RMSEA of .049 for the model using the dichotomously scored items was slightly better than what Achenbach and Rescorla (2000) reported for the same model (.06).
The study provides additional evidence of the factorial validity of the CBCL/1.5-5 and supports its use with Chinese girls adopted into North American families. While the Chinese girls showed similar or better behavioral adjustment, compared to a reference group from the CBCL's normative sample, they tended to manifest higher levels of sleep problems.
To examine the relationship between neonatal, periventricular brain damage and visuomotor performance in extremely-low-birthweight (ELBW) children of normal intelligence whose birthweights were appropriate for gestational age (AGA).
Seventy-eight ELBW and 23 control children, all six years of age, completed two "motor-free" tests of visual spatial ability and three tests requiring visuomotor control.
Full-term control children outperformed ELBW children with periventricular brain damage on all three tests requiring visuomotor guidance. No group differences were found on two "motor-free" tests of visual spatial ability. ELBW children without periventricular brain damage performed in a manner indistinguishable from controls on all tests included in this study.
The findings indicate that the presence and severity of periventricular brain injury are important factors to consider in predicting visuomotor development in ELBW children.
Prenatal alcohol exposure is associated with learning, behavioral, and academic problems even in children without the fetal alcohol syndrome (FAS).
To examine the prenatal alcohol exposure and ability, academic achievement, and school functioning in adolescence.
In a longitudinal cohort, intelligence, academic performance, and school functioning were evaluated in 265 low socioeconomic status (SES) adolescents (M age = 15.1 years), 128 prenatally exposed to alcohol, 53 controls, and 84 special education students by using the Wechsler Intelligence Scale for Children, 3rd edition (WISC-III) and the Wechsler Individual Achievement Test (WIAT). School records were abstracted for grade point averages (GPA), standardized achievement test scores, conduct, attendance, and special education placement.
Alcohol-affected youth had significantly lower IQs than those in the other three groups.
Although academic achievement (WIAT scores) was most impaired in the special education group who showed lower performance over all as well as in reading and spelling, alcohol-affected youth showed significant deficits on mathematics subtests. There was no increased incidence of conduct problems in school records related to alcohol exposure.
To validate a three-factor model for the Pediatric Symptom Checklist-17 (PSC-17) and evaluate its diagnostic accuracy with African-American and Caucasian children with and without a chronic illness.
Mothers of 723 youth diagnosed with either type I diabetes (n = 210) or sickle cell disease (n = 191) and a nonill peer group (n = 322) completed a demographic questionnaire, the PSC-17, and the Child Behavior Checklist (CBCL).
Confirmatory factor analyses and tests of measurement invariance validated a three-factor structure for the PSC-17 with African-American and Caucasian youth with and without a chronic illness. Receiver operating characteristic curves revealed optimal cut-off scores that are similar to published reports.
A three-factor solution was replicated for the PSC-17 with African-American and Caucasian children with and without a chronic illness. Cut-off scores for identifying children at risk for emotional/behavioral problems were evaluated using the CBCL as the gold standard and are discussed.
Screening for psychological distress is an important tool for improving survivors' access to psychosocial care. The Brief Symptom Inventory-18 (BSI-18) has been widely used to identify psychological distress in cancer survivors, but few studies have reported on its validity. This study evaluated validity of the BSI-18 by comparing it to the Symptom Checklist-90 (SCL-90).
Concordance of cases identified by the BSI-18 and SCL-90 was examined in a sample of 193 adult survivors of childhood cancer.
Receiver operating characteristics analysis showed strong diagnostic utility of the BSI-18 (area under curve = 0.922). However, the standard BSI-18 case-rule demonstrated low sensitivity (45.2%) against the SCL-90. An alternative case-rule showed better results; sensitivity (87.10%), specificity (83.33%).
The BSI-18 is a useful measure for evaluating distress in adult survivors of childhood cancers; however, the standard BSI-18 case-rule has not been validated for this population, and an alternative case rule should be considered.
To investigate the effect of child temperament, maternal psychologic symptoms, maternal chronic pain, and parenting stress on children's somatic complaints.
The study was embedded in the Generation R Study, a population-based cohort study. Child somatic complaints were assessed via mother-report in 5,171 children of 18 months of age. Questionnaires assessed maternal somatic symptoms, symptoms of depression, anxiety during pregnancy and 2 months after delivery, maternal chronic pain during pregnancy, parenting stress 18 months after birth, and mother-reported child temperament 6 months after birth, as the determinants.
Fearful temperament, temperamental falling reactivity, maternal somatic symptoms, anxiety symptoms, and parenting stress each independently and prospectively increased the likelihood of children's somatic complaints at 18 months of age.
In toddlers, temperament, maternal stress, and maternal somatic symptoms seem particularly important for the development of somatic complaints, but long-term research is needed to establish causality and predictive value of these factors.
To prospectively validate the Parent and Adolescent Medication Barriers Scales (PMBS and AMBS) for assessing perceived barriers to medication adherence in adolescent transplant recipients by examining the relations of perceived barriers to medication adherence and clinical outcomes at 18-month follow-up.
Of the 82 adolescent recipients enrolled in the initial cohort, 66 families participated in the follow-up. Relations among barriers, adherence, and clinical outcomes were examined.
Reported barriers demonstrated temporal stability over an extended span of time. Adolescent-perceived barriers of Disease Frustration/Adolescent Issues and parent-perceived barriers of Regimen Adaptation/Cognitive Issues were associated with poorer adherence to medication taking at follow-up. Interestingly, medical complications and mortality were significantly associated with both parent and adolescent-perceived ingestion issues barriers.
Barriers to adherence are essential to address in an effort to ameliorate adherence difficulties and potentially reduce the incidence of medical complications.
To identify historical trends in the field of pediatric psychology by examining the training origins of authors publishing in Journal of Pediatric Psychology since its formation in 1976.
The researchers sampled four publication years (1976, 1986, 1996, and 2006) and recorded the authors of each published article. They obtained each author's doctoral training institution using information provided in the article, the American Psychological Association Membership Directory, or the ProQuest Dissertations and Theses Database and counted authorship totals for each institution in each year.
Four institutions (Case Western Reserve University, University of Iowa, University of Kansas, and Purdue University) produced authorship entries in 3 of the 4 years sampled. The number of articles being published, the number of authors per article and the number of institutions consistently increased.
The current study provided a historical perspective on graduate training and scholarly productivity in the field of pediatric psychology. Future research should investigate interesting trends revealed, such as how core groups of pediatric psychology scholars have contributed to the notable growth in institutions, specific programs within institutions, and authors published over the last 30 years.
The purpose of the present investigation was to identify the top 100 most highly cited "classic" articles in the Journal of Pediatric Psychology, from 1976 to 2006.
The Cited Reference search option of the Web of Science(R) was used, which allows for identification of variations in citations.
One-hundred and four classic articles ranging in citations from 46 to 192 (M = 71.66, SD = 31.15) were identified. These articles were found to be mostly applied research that focused predominantly on children across several age groups with chronic illness. Citation trends among the classics revealed an inverted-u shape relationship between year since publication and citations per year, which peaked around seven years after publication.
The current findings highlight some of the influential works in the field, which have contributed to important advances not only the field of pediatric psychology but other fields as well.
To study prevalence changes of self-reported pain, sleep problems, and fatigue among 8-year-old children, and to examine the co-occurrence and associated psychosocial variables of these symptoms.
3 cross-sectional representative samples were compared in 1989, 1999, and 2005. The frequency of headache, abdominal pain, other pains, sleep problems, and fatigue were studied. In addition, sociodemographic information and child's psychiatric problems were inquired.
The prevalence of abdominal pain, sleep problems, and fatigue, in addition to headache in boys and other pains in girls increased significantly (p < .05) from 1989 to 2005, with cumulative odds ratio (95% confidence intervals) varying from 1.6 (1.2-2.1) to 2.4 (1.7-3.3). All symptoms were associated with each other and with the child's psychiatric problems. However, psychiatric problems did not explain the observed increase in the symptom frequencies.
Finnish children's self-reported pain, sleep problems, and fatigue have increased remarkably. Studies providing information on the causes and prevention possibilities are warranted.
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).
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.
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.
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.
The viability of pediatric psychology has been of concern over the last few years. In a recent survey Brown and Roberts (2000) anticipated that during the next decade pediatric psychologists will be ''concerned with pediatric psychology's ability to demonstrate viability, to integrate psychologists into primary care settings, and to demon- strate need for changes in reimbursement systems within managed care'' (p. 5). Pediatric psychology as a recog- nized field has progressed during the last several decades, but there has been erosion of financial viability for practitioners. In this article, the historical markers of pediatric psychology's financial stability and the value of the services that pediatric psychologists provide will be reviewed. The erosion of confidence in older models of the financial infrastructure and alternative models of financing hospital-based pediatric psychology clinical services will also be discussed. The Growth of Pediatric Psychology Pediatric psychology is a relatively young specialty. The Society of Pediatric Psychology (SPP) has been in existence for only 35 years, and during that time the field has undergone substantial changes. During the formative years of the profession, pediatric psychologists provided assessments for patients with developmental disabilities. Much of the early work of pediatric psychology centered on applied research in the area of innovative interventions designed to ameliorate medi- cally related problems. Other foci included assessment, intervention, prevention, and explicative research (Roberts & McNeal, 1995). Interventions tended to be symptom focused, behavioral, and brief. In the same way, treatment interventions had to be time-efficient, effective, and economical in order to be viable (Peterson & Harbeck, 1988). Early collaborations with pediatri- cians often reflected the action-oriented, brief interven- tions with patients typical of a pediatric practice. Shortly after SPP was founded, Lee Salk (1970) described the role of a psychologist in a pediatric setting. He explained how psychologists aid pediatric staff by providing help in the areas of diagnosis of developmental problems, prompt screening, timely consultation with staff, guidance in child rearing, and sensitizing staff to the emotional needs of children undergoing medical procedures or hospitalization. The early writings of pediatric psychologists also reflected the importance of collaboration and consultation with physicians and other pediatric health care professionals (Drotar, 1995). This trend continues, as evidenced by the fact that several years ago the president of the American Academy of Pediatrics, Robert Hannemann (1997), pronounced that every pediatric patient in the United States should be touched by a pediatric psychologist. Thus, these foci of assessment, collaboration, consulta- tion, empirical research, and intervention are at the core of pediatric psychology and have been the basis of the profession's identity and viability.
To assess rates of overweight/obesity and related health behaviors among rural and urban children using data from the National Health and Nutrition Examination Survey (NHANES).
Data were drawn from the 2003-2004 and 2005-2006 NHANES surveys regarding demographic characteristics, weight status, dietary behaviors and physical activity behaviors.
Significantly more rural children were found to be obese than urban children. Health behavior differences to explain this differential obesity rate were primarily not significant, but multivariate analyses indicate that for rural children meeting physical activity recommendations is protective and engaging in more than 2 hr/day of electronic entertainment promotes obesity.
There are modifiable health behavior differences between rural and urban children which may account for the significantly higher obesity rates among rural children.
The field of pediatric psychology has adjusted and adapted to fit the changing environment of healthcare and needs of children and their families over its history (Aylward, Bender, Graves, & Roberts, 2009). Although initially considered to have an overly narrow focus, pediatric psychology became novel and innovative in the 1960s and 1970s and ultimately developed into a creatively vibrant and productive force in research and practice in healthcare psychology. Although the field has achieved great accomplishments, there is the potential of stagnating or even being left behind if practitioners and researchers continue to exclusively maintain the ''status quo'' without further innovation. Therefore, current and rising professionals will need to focus their incredible intelligence and energies to move out of what are now the established routines and ways of doing ''things'' to become once again novel and innovative, responding to changes in health care. Rozensky and Janicke (2012) have contributed a significant vision for the future of pediatric psychology in a changing healthcare system. The significant points in this article are truly a call to action, a strategic plan as it were, for the field of practice and research in pediatric psychology. Rozensky and Janicke highlight several ripe and exciting opportunities for the field of pediatric psychology in terms of growth and expansion in light of current changes in the healthcare environment and in various other related fields and disciplines. In this commentary, we briefly attend to several of the issues raised by these visionaries as important areas for growth in the future of pediatric psychology. We have highlighted only a few of the major recommendations made by Rozensky and Janicke in order to provide the detailed discussion that each point warrants , and this selection should not be interpreted as an exhaustive list of the valuable points made in their discussion.
Examine the 24-hr Recall Interview (24RI) for assessing children's antiretroviral medication adherence.
Caregivers of 54 children with HIV (aged 2-12 years) completed a clinical adherence interview and the 24RI by telephone. Children's viral load and 3-month pharmacy records were obtained.
Thirty-seven percent of children missed > or = 1 dose of medicine over 3 days. In 22% of the samples, adherence varied across medications. The 24RI adherence scores (Frequency, Interval, and Dietary Adherence) were moderately reliable across the three interviews. Pharmacy refill rates were significantly related to viral load, and 24RI barriers were marginally significantly related to viral load.
The 24RI, with its systematic, cued recall, and decreased focus on adherence, may reduce socially desirable responding compared to other self-report methods, and reporting adherence barriers may indicate adherence difficulty. However, the validity of the 24RI must be improved to make it a useful measure to include in an adherence assessment battery.
To conduct a multimethod psychometric evaluation to refine the Children's Somatization Inventory (CSI) and to investigate its dimensionality.
The CSI was administered to 876 pediatric patients with chronic abdominal pain at their initial visit to a pediatric gastroenterology clinic. Tools from three psychometric models identified items that most effectively measured the construct of somatization and examined its dimensionality.
Eleven statistically weak items were identified and removed, creating a 24-item CSI (CSI-24). The CSI-24 showed good psychometrics according to the three measurement models and correlated .99 with the original CSI. The CSI-24 has one dominant general factor but is not strictly unidimensional.
The CSI-24 is a reliable and psychometrically sound refinement of the original CSI. Findings are consistent with the view that somatization has a strong general factor that represents a continuum of symptom reporting, as well as minor components that represent specific symptom clusters in youth with chronic abdominal pain.
We examined whether neonatal risks and maternal scaffolding (i.e., task changes and flexibility) during a 16-month post-term play interaction moderated the association between socioeconomic status (SES), visual-spatial processing and emerging working memory assessed at 24 months post-term among 75 toddlers born preterm or low birth weight.
SES and neonatal risk data were collected at hospital discharge and mother-child play interactions were observed at 16-month post-term. General cognitive abilities, verbal/nonverbal working memory and visual-spatial processing data were collected at 24 months.
Neonatal risks did not moderate the associations between SES and 24-month outcomes. However, lower mother-initiated task changes were related to better 24-month visual-spatial processing among children living in higher SES homes. Mothers' flexible responses to child initiated task changes similarly moderated the impact of SES on 24-month visual-spatial processing.
Our results suggest that mothers' play behaviors differentially relate to child outcomes depending on household SES.
To establish the normative data of the Bayley Scales of Infant Development-Second Edition (BSID-II) on Taiwanese infants from age 6 to 24 months and to explore the factors that relate to their mental and motor development.
Five hundred and seven Taiwanese full-term infants were prospectively examined with the BSID-II at 6, 12, 18, and 24 months of age.
Taiwanese infants' Bayley mental and motor raw scores were lower than the United States norms from age 6 to 24 months, however, the discrepancy gradually declined with increasing age. Gender, intrauterine growth status, birth order, region of residence, maternal education, and paternal occupation were shown to have longitudinal associations with their mental and/or motor scores.
Differences existed in the mental and motor development among Taiwanese and American infants. Our preliminary norms of the BSID-II may be more appropriate than the United States norms for Taiwanese children.
To prospectively assess the presence of posttraumatic stress disorder (PTSD) in children hospitalized following acute physical injury. The focus was identification of the incidence of PTSD, PTSD symptoms, and exploration of factors associated with development of PTSD symptoms and disorder.
Forty children ages 8-17 were interviewed approximately 1 month following a serious injury and assessed for PTSD, pretrauma behavior problems, levels of peritraumatic fear, and posttraumatic thought suppression.
Twenty-two and a half percent of participants met DSM-IV diagnostic criteria for PTSD; 47.5% met criteria for at least two of the three PTSD symptom clusters. Greater thought suppression was associated with increased symptoms of PTSD, as were the child's peritraumatic fear response and pretrauma internalizing behaviors.
Results suggest that many children who have been hospitalized for physical trauma may be experiencing clinically significant PTSD symptomatology and may benefit from psychological as well as medical intervention.
Pediatric somatization studies have used the 35-item Child Somatization Inventory (CSI-35) or psychometrically refined 24-item CSI (CSI-24). Exploratory factor analysis of the CSI-24 has identified a single factor that did not show good model fit in confirmatory factor analysis (CFA). Further evaluation of the CSI-24 factor structure is needed.
The present study examined alternative factor structures of the CSI-24 in a community sample (N = 233, ages 8-15).
The CFA showed good fit for a single CSI-24 factor, better fit for multiple factor models, and best fit for a single, six-item factor. Construct validity for that factor was found in significant correlations with anxiety, depression, functional disability, and quality of life.
Results are consistent with a single somatization factor, but research is needed to verify the factor structure in different, race/ethnic/demographic, and clinical groups.
The current investigation examined the accuracy of diabetic children's 24-hr recall data by comparing the 7- to 12-year-old children's reports to direct observations of their behavior. Observers' data evidenced sufficient reliability to serve as an acceptable standard to which the children's 24-hr recall data could be compared. The children exhibited excellent agreement with the observers' data on all measures of the occurrence/nonoccurrence of events, including insulin injections, exercise periods, glucose tests, meal, type and amount of insulin injected. Although somewhat poorer reporters on some behaviors, differences were small. Children underreported most dietary behaviors and some exercise behaviors.
To investigate whether adolescent siblings of childhood cancer survivors experience posttraumatic stress (PTS).
Participants included 78 adolescent siblings of adolescent cancer survivors who completed self-report measures of anxiety, PTS, and perceptions of the cancer experience.
Nearly half (49%) of our sample reported mild PTS and 32% indicated moderate to severe levels. One fourth of siblings thought their brother/sister would die during treatment; over half found the cancer experience scary and difficult. These perceptions were related to PTS. Siblings reported more PTS symptoms than a reference group of nonaffected teens but had similar levels of general anxiety.
Levels of PTS are elevated for siblings of childhood cancer survivors. Thus, PTS may be a useful model for understanding siblings' long-term reactions to cancer. Future research and clinical efforts should consider the needs of siblings of childhood cancer survivors in a family context.
Summarizes the research and intervention design of a new trial to evaluate an adaptation of Project Northland, a multicomponent, community-wide alcohol prevention program for culturally diverse youth living in a large city. The original Project Northland was successful in reducing alcohol use among a sample of mostly White, rural adolescents.
We highlight the steps taken to adapt the intervention strategies for culturally diverse inner-city youth, families, and neighborhoods. The research design is a randomized controlled trial to evaluate the effectiveness of the adapted Project Northland for reducing the early onset and prevalence of alcohol use among young urban adolescents.
The information gained from this trial, including the process of adaptation of prevention strategies, will be beneficial for alcohol-use prevention efforts within diverse urban communities across the country.
Children's sleep patterns, as recorded through parent diaries, were examined from 6 through 33 months of age. Total sleep per 24 hours and number of transitions between sleep and wakefulness declined with age, while longest periods of sleep and wakefulness increased. Total sleep and longest period of sleep were found to be stable individual characteristics over time. No sex differences were found in rate or stability of sleep pattern development.
To chart mothers' trajectories of mental health from pregnancy to 36 months postpartum in order to investigate the association between infants' congenital heart defects (CHD) and compromised maternal mental health.
Mothers of infants with mild, moderate, or severe CHD (n = 141) and mothers (n = 36,437) enrolled in the Norwegian Mother and Child Cohort Study were assessed at regular intervals from pregnancy up to 36 months postpartum, including measurements at 6 and 18 months, using an 8-item version of the Hopkins Symptom Checklist-25.
Mean score trajectories of SCL-8 for mothers of infants with severe CHD deviated significantly from cohort controls 6, 18, and 36 months postpartum, indicating heightened symptoms of depression and anxiety.
Mothers of infants with severe CHD are at risk of compromised mental health from delivery to 36 months postpartum. Strain due to CHD-related interventions is identified as a possible partial mediator of the distress.
To evaluate the reliability and validity of a commonly used measure of health-related quality of life (HRQOL), the Pediatric Quality of Life Inventory (PedsQL 4.0), in a sample of children with a recurrent headache syndrome.
Participants were 40 children aged 7-12 who completed measures of HRQOL, headache-related disability, and headache activity during a baseline period and following a self-directed cognitive-behavioral intervention.
The data are supportive of the reliability (internal consistency and test-retest) and validity (criterion related, convergent, known-groups, and responsiveness to intervention) of the PedsQL 4.0 within a pediatric headache sample.
We conclude that the PedsQL 4.0 is a reliable and valid measure of HRQOL in children with recurrent headache and captures important information not routinely evaluated in chronic pain populations.
The purposes of this study were to develop and to assess the psychometric properties of a Catalan self- and interviewer-administered version of the Pediatric Quality of Life Inventory Generic Core Scales (PedsQL) with a sample of schoolchildren, and to examine the equivalence between both versions.
511 schoolchildren aged between 9 and 17 years old participated in the study. In addition to completing a Catalan self-administered version of the PedsQL, each child was interviewed individually.
Confirmatory factor analysis did not support the original Varni's proposal. Instead, a short 12-item version was derived. The higher-order scales for both versions were internally consistent. Moreover, relationships between ratings of children's quality of life were generally significant; both versions were also found to be related with another measure of quality of life supporting their validity.
A new administration form for the PedsQL is presented in this study. The psychometric properties of both self- and interviewer-administered short 12-item versions are reassuring albeit with a few areas of improvement. Further studies are needed to investigate whether self- and interviewer-administered versions can really be considered to be comparable.
To evaluate the psychometric properties of the Family Impact Module (FIM), a parent self-report measure of health-related quality of life (HRQOL) and family functioning, among parents of youth with chronic pain.
Parents (N = 458) completed the FIM (Total Impact, HRQOL, and Family Functioning scales); parents and youth (N = 332) completed measures of pain catastrophizing, pediatric quality of life, and emotional/behavioral functioning.
The FIM demonstrated strong internal consistency and item-total correlations. All FIM scales were positively associated with pain catastrophizing, functional disability, and emotional/behavioral problems; and inversely related to pediatric quality of life. Mothers reported significantly worse HRQOL than fathers. Mothers and fathers did not differ on reports of Family Functioning. HRQOL and Family Functioning did not differ as a function of pain diagnosis.
The FIM appears to be a suitable measure of parent self-reported HRQOL and family functioning in pediatric chronic pain.
The objective of the present study was to examine the factorial invariance of the PedsQL 4.0 Generic Core Scales for child self-report across 11,433 children ages 5-18 with chronic health conditions and healthy children.
Multigroup Confirmatory Factor Analysis was performed specifying a five-factor model. Two multigroup structural equation models, one with constrained parameters and the other with unconstrained parameters, were proposed in order to compare the factor loadings across children with chronic health conditions and healthy children.
Metric invariance (i.e., equal factor loadings) was demonstrated based on stability of the Comparative Fit Index (CFI) between the two models, and several additional indices of practical fit including the root mean squared error of approximation, the Non-normed Fit Index, and the Parsimony Normed Fit Index.
The findings support an equivalent five-factor structure on the PedsQL 4.0 Generic Core Scales across healthy and chronic health condition groups. These findings suggest that when differences are found across chronic health condition and healthy groups when utilizing the PedsQL, these differences are more likely real differences in self-perceived health-related quality of life, rather than differences in interpretation of the PedsQL items as a function of health status.
Evaluated treatment for thumb-sucking in a randomized trial. Study included 22 children, ages 4–11, who displayed chronic
thumb-sucking. Treatment included aversive taste and a reward system. Significant results were obtained at posttest, with
12 cessations at 3-month follow-up and 20 at 1 year. Participating parents, pediatricians, and pediatric psychologists validated
treatment acceptability. Results support the treatment as an alternative to common medical and dental advice about thumb-sucking.
Directions for future research are discussed.
Recently, there has been a growing awareness of the importance of the roles of fathers in understanding normative developmental processes. Increased attention has been given to the roles of fathers in the area of clinical child research and therapy. However, the presence of fathers in research and treatment in pediatric psychology has not been fully examined.
To explore the status of including fathers in both research and treatment in the area of pediatric psychology.
An extensive review of published research.
The findings suggest that pediatric psychology research lags even farther behind clinical child research in including fathers in research designs and analyzing for maternal and paternal effects separately. There is also a concomitant lack of inclusion of fathers in family-based interventions in pediatric psychology.
These patterns are discussed, with an emphasis on strategies to increase the inclusion of fathers in research and treatment of pediatric psychology issues. Future directions for researchers and clinicians are also included.
Examined achievement, behavior, and neuropsychological outcomes at early school age in a regional population of children <750-g
birth weight who were neurologically intact and who scored in the broad average range on a test of cognitive ability. Comparison
groups included children of birth weight 750–1,499 g and children born at full-term. The children <750 g performed more poorly
than the higher birth weight groups on tests of math, even after adjusting for group differences in cognitive ability. Corresponding
group differences were found in language, perceptual motor, and attentional skills, but not in behavior outcomes. Findings
document specific weaknesses in achievement and neuropsychological skills in children <750 g birth weight and support the
need for early identification and special education interventions.
Examine correlates of asthma self-management among 12,154 adolescents with physician-diagnosed asthma.
All 7th and 8th grade students in North Carolina completed a survey to assess asthma prevalence and self-management behaviors among those with asthma.
Adolescents who were allowed to carry their inhaled medication at school, shown how to use a peak flow meter, and had access to more asthma care resources were more confident that they could prevent an asthma exacerbation. Adolescents who were allowed to carry their inhaled medication at school and who had a private doctor were more confident that they could control their symptoms. Adolescents taking anti-inflammatory medicine were less confident that they could prevent an exacerbation and control their symptoms.
Various indicators of autonomy and control were associated with greater self-efficacy for managing asthma. Adolescents who require anti-inflammatory medicines would benefit from additional intervention efforts to improve their asthma management self-efficacy.
The purpose of this study was to examine relationships among body mass index (BMI), self-perceptions, and body image discrepancy in African American (AA) girls.
Baseline self-perception and BMI data were collected by trained staff from 303 preadolescent AA girls participating in the girls health enrichment multi-site studies. Correlations and multivariable logistic regression analyses were performed to identify relationships of BMI with self-perception factors.
Girls with a BMI at or above the 85th percentile were more likely to have greater body image discrepancy and participate in weight control behaviors than girls with a BMI below the 85th percentile. Body image discrepancy was not related to self-esteem, but was positively correlated with physical activity self-concept and self-efficacy, and diet self-efficacy.
Girls with higher BMI had greater body image discrepancy and were less confident in abilities to be active and eat healthy. Findings may inform the development of obesity interventions for preadolescents.
To evaluate whether prenatal cocaine exposure (PCE), or the interaction between PCE and contextual variables, is associated with children's language at age 6 and 9.5 years, adjusting for relevant covariates.
Analyses were based on 160 low-income, urban children from a prospective study who completed a standardized language assessment at 6 and 9.5 years. PCE was determined using neonatal meconium assays and maternal self-report.
Significant interaction effects of PCE on language outcomes were found in multivariate longitudinal analyses using generalized estimating equations (GEE). Children with PCE had lower receptive language than unexposed children at 6 but not at 9.5 years, lower expressive language if they had lower birthweight, and lower expressive and total language if they were female. Other risk (e.g., violence exposure) and protective factors (e.g., preschool experience) were related to language outcomes regardless of PCE status.
Age, birthweight, and gender moderated the relation between PCE and school-aged children's language.
To report the results of a systematic review of randomized controlled trials (RCTs) of psychological interventions for children and adolescents undergoing needle-related procedures.
A variety of cognitive-behavioral psychological interventions for managing procedural pain and distress in children and adolescents between 2 and 19 years of age were examined. Outcome measures included pain and distress as assessed by self-report, observer report, behavioral/observational measures, and physiological correlates.
Twenty-eight trials met the criteria for inclusion in the review and provided the data necessary for pooling the results. Together, the trials included 1,039 participants in treatment conditions and 951 in control conditions. The largest effect sizes for treatment improvement over control conditions were found for distraction, combined cognitive-behavioral interventions, and hypnosis, with promising but limited evidence for several other psychological interventions.
Recommendations for conducting future RCTs are provided, and particular attention to the quality of trial design and reporting is highlighted.
Objective Evaluate the psychometric properties of child- and parent-report versions of the four-item Abdominal Pain Index (API) in
children with functional abdominal pain (FAP) and healthy controls, using a revised scoring method that facilitates comparisons
of scores across samples and time. Methods Pediatric patients aged 8–18 years with FAP and controls completed the API at baseline (N = 1,967); a subset of their parents (N = 290) completed the API regarding the child’s pain. Subsets of patients completed follow-up assessments at 2 weeks (N = 231), 3 months (N = 330), and 6 months (N = 107). Subsets of both patients (N = 389) and healthy controls (N = 172) completed a long-term follow-up assessment (mean age at follow-up = 20.21 years, SD = 3.75). Results The API demonstrated good concurrent, discriminant, and construct validity, as well as good internal consistency. Conclusion We conclude that the API, using the revised scoring method, is a useful, reliable, and valid measure of abdominal pain severity.
Surveyed general pediatricians (N = 116) regarding six content areas: (a) diagnostic procedures utilized during the initial
evaluation sequence of a child with recurrent abdominal pain (RAP); (b) factors that influence decisions to order additional
evaluations; (c) management practices following negative evaluation results; (d) factors influencing decisions about consultation
with or referral to a mental health professional; (e) attitudes about the etiology of RAP; and (f) the frequency in which
pediatricians encountered children with RAP and referred them to mental health services. Results of this survey are presented
and discussed from a biopsychosocial perspective. Limitations of the survey, implications of the results for integrating mental
health professionals into the evaluation and treatment process of RAP patients, and directions for future research are discussed.
To examine mothers' attributions for the causes and remedies of their children's abdominal pain, specifically whether attributions differed according to child diagnosis, reflected a dualistic or multidimensional view of pain, and changed following medical evaluation.
Mothers of children whose medical evaluation indicated peptic disease (n = 55) or unexplained pain without identifiable organic disease (n = 98) participated in telephone interviews prior to their children's medical evaluations and one year later.
About half of the mothers in each group endorsed both psychosocial and physical factors as important in the etiology of their children's abdominal pain. Following medical evaluation, mothers in both groups tended to maintain their attributions regarding the importance of psychosocial factors.
Many mothers acknowledged the contribution of psychosocial factors to their children's abdominal pain. They may be receptive to behavioral interventions if physicians present these remedies as an integral component of treatment.
Investigated relation of negative life events (NLE) to initial symptom severity and symptom resolution at 3 months in 2 patient
groups: (a) recurrent abdominal pain (RAP) without identifiable organic etiology, (b) abdominal pain with organic diagnosis.
Symptoms assessed were abdominal pain, somatization symptoms, anxiety, depression. Number of NLE was positively correlated
with anxiety and depression in both groups at clinic visit. NLE predicted resolution of abdominal pain for RAP patients only;
RAP patients with more NLE prior to or following the clinic visit were more likely to maintain their abdominal pain. More
NLE following clinic visit was associated with maintenance of anxiety and somatization symptoms at follow-up in RAP patients.
Results suggest a measure of NLE is not useful in differential diagnosis of patients with and without organic findings, but
is useful in predicting outcome in patients without organic findings.