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Journal of Pediatric Psychology - RSS feed of current issue

Journal of Pediatric Psychology 19 Aug 2010

Subscriptions 19 Aug 2010

Journal of Pediatric Psychology: Volume 35, Number 8 * September 2010 19 Aug 2010

Editorial: A Call for Replications of Research in Pediatric Psychology and Guidance for Authors 19 Aug 2010

How Do Mothers and Fathers Influence Pediatric Injury Risk in Middle Childhood? 19 Aug 2010

Objectives Parental influences are among the strongest behavioral correlates to unintentional injury outcome in early childhood, but are less well understood as children develop. We implemented a prospective research design to study how parenting style, parent–child relationships, and parental mental health influence injury during middle childhood. We also considered the roles of parent and child gender. Methods Parental influences were assessed from a sample of 584 first graders, plus their mothers and fathers. Injuries requiring medical treatment were assessed regularly over the subsequent 5 years. Logistic regression models examined how maternal and paternal parenting factors predicted injury among all children, just boys, and just girls. Results Fathers who reported more positive relationships with their children had children protected from injury. This was particularly true of father–son relationships. No maternal traits predicted injury. Conclusions A positive father–child, and especially a positive father–son relationship, may protect children from injury during middle childhood.

Risk Factors Associated with Depressive Symptoms in Caregivers of Children with Type 1 Diabetes or Cystic Fibrosis 19 Aug 2010

Objective Evaluate depressive symptoms in caregivers of children with type 1 diabetes (T1D) or cystic fibrosis (CF) and identify associated risk factors. Methods A total of 195 caregivers completed demographic, stress, and depressive symptoms questionnaires. Children’s health status was obtained from medical records. Results Approximately 33% of caregivers reported elevated symptoms of depression (i.e., exceeded clinical cutoff of 16 on the Center for Epidemiological Studies-Depression Scale). For caregivers of children with T1D, elevations were associated with less caregiver education, more family stress, older child age, and worse glycemic control. For caregivers of children with CF, more family stress and lack of employment outside of the home were associated with elevated depressive symptoms. Conclusions Many caregivers of children with T1D or CF experience depressive symptoms, although risk factors may differ in these two populations. Screening of caregiver depressive symptoms as part of routine clinic visits may provide opportunities for needed intervention.

Development of a Group Intervention to Improve School Functioning in Adolescents with Chronic Pain and Depressive Symptoms: A Study of Feasibility and Preliminary Efficacy 19 Aug 2010

Objective To establish feasibility and preliminary efficacy of "Coping with Pain in School" (CPS), an intervention to improve school functioning in adolescents with chronic pain and depressive symptoms. Methods Forty adolescents and parents participated in this uncontrolled trial. Participants completed measures of pain severity, depression, and school attendance at baseline and one month after participating in a manualized group intervention. Several other indicators of school functioning were explored. Results CPS was generally acceptable and satisfying to families and feasible to implement but participation was low. Post-treatment analyses suggest that pain, some dimensions of depression, and school attendance improved after treatment. Conclusions CPS is feasible and holds promise in terms of its effects on pain and school attendance. Addressing enrollment challenges, refining the role of depression and its treatment, and further developing treatments with a school-functioning focus for adolescents with chronic pain are key areas for continued research.

A Pilot Study to Assess the Efficacy of Biofeedback-Assisted Relaxation Training as an Adjunct Treatment for Pediatric Functional Dyspepsia Associated with Duodenal Eosinophilia 19 Aug 2010

Objectives To conduct a pilot study examining whether adding biofeedback-assisted relaxation training (BART) to medication treatment results in better clinical outcomes than medication treatment alone for children with functional dyspepsia (FD) associated with duodenal eosinophilia, a subgroup of children with recurrent abdominal pain. Methods Twenty children were randomly assigned to receive a standardized medication treatment or medication plus 10 sessions of BART. Children and parents completed psychosocial functioning and quality of life measures at baseline, posttreatment, and 6 months. Children rated pain daily via PDA. Physicians provided biweekly assessments of clinical improvement. Results Children receiving medication plus BART demonstrated better outcomes on pain intensity, duration of pain episodes, and clinical improvement than children receiving medication alone. Conclusions BART is a promising adjunctive treatment for pediatric FD associated with duodenal eosinophilia. Electronic daily diaries appear to be a useful approach to assessing changes in self-reported pain ratings in this population.

A Camp-based Intervention Targeting Independence Among Individuals with Spina Bifida 19 Aug 2010

Objective To design and evaluate a camp-based intervention, the goal of which was to increase independence among children, adolescents, and adults with spina bifida. Methods An intervention targeting independence was embedded within a typical week long camp experience. The intervention consisted of the following: collaborative (i.e., parent and camper) goal identification, group sessions consisting of psycho-education and cognitive tools, and goal monitoring by camp counselors. Camper and parent report of demographic variables, goal attainment, spina bifida knowledge, and independence were gathered. Interventionist report of adherence to the treatment manual was also collected. Results Campers made significant gains in individual goals, management of spina bifida responsibilities, and independence with general spina bifida tasks, with medium effect sizes observed in goal attainment. Conclusions Results indicated that significant progress was made on individually oriented goals from pre- to post-camp. Design issues are discussed.

A Meta-analytic Review of the Psychosocial Adjustment of Youth with Inflammatory Bowel Disease 19 Aug 2010

Objective To conduct a meta-analytic review of psychosocial adjustment of youth with inflammatory bowel disease (IBD). Methods Nineteen studies with a total of 1167 youth with IBD (M age = 14.33, 50% female) were included. Effect size (ES) estimates were calculated for anxiety symptoms & disorders, depressive symptoms & disorders, internalizing symptoms & disorders, externalizing symptoms, quality of life (QOL), social functioning, and self-esteem. Separate ESs were calculated for comparisons between IBD and youth with chronic illnesses versus healthy youth. Results Youth with IBD had higher rates of depressive disorders and internalizing disorders than youth with other chronic conditions. Youth with IBD had higher parent-reported internalizing symptoms, lower parent- and youth-reported QOL, and lower youth-reported social functioning compared to healthy youth. Conclusions Clinical attention to depressive disorders, QOL, and social functioning may be particularly salient in the context of pediatric IBD.

Using Structural Equation Modeling to Understand Child and Parent Perceptions of Asthma Quality of Life 19 Aug 2010

Objective Using structural equation modeling, test a conceptual model of associations between constructs predicting parent and child asthma quality of life. Methods Children with a confirmed asthma diagnosis and their parents completed measures of health status and independently reported on psychological functioning, family functioning, and quality of life. Results Measurement and structural models for predicting parent and child quality of life provided a good fit of data to the conceptual model. Parent and child independent reports of quality of life are dependent upon family functioning and child psychological functioning. Long-term asthma symptom control is the only health status variable that impacts quality of life. Conclusions With minor modifications, both parent and child data fit the conceptual model. Child psychological functioning and long-term asthma control jointly contribute to quality of life outcomes. Findings suggest that both acute and long-term asthma health status outcomes have different determinants.

The Relationship Among Child Weight Status, Psychosocial Functioning, and Pediatric Health Care Expenditures in a Medicaid Population 19 Aug 2010

Objectives To examine the association between weight status and health service use, while considering the influence of psychosocial functioning and demographic variables. Methods Two hundred child–parent dyads were recruited from pediatric primary care clinics and completed measures of height, weight, and questionnaires assessing psychosocial functioning. Claims and expenditure data over a 12-month retrospective period were extracted from the Medicaid claims database. Results Children who were obese incurred greater health service use and expenditures than children who were of a healthy weight, even after controlling for psychosocial functioning and other demographic variables. Children who were overweight (but not obese) did not have differing levels of claims or expenditures than their healthy weight peers. Conclusions Understanding the impact of pediatric obesity on long-term expenditures is critical. These results provide some indication of the financial savings that might be achieved if obese children were supported to achieve a healthier weight status.

Relationships between Somatic Growth and Cognitive Functioning in Young Children with Sickle Cell Disease 19 Aug 2010

Objective Children with sickle cell disease (SCD) exhibit poor somatic growth due to nutritional and metabolic effects, but potential relationships between growth and other areas of development are unclear. We examined whether growth is related to cognition and whether growth might be one marker of neurocognitive risk. Methods Sixty-four children with SCD and eighty-one demographically similar controls, ages 4 to 8 years, completed cognitive and anthropometric measures. Results Height-for-age partially accounted for cognitive decrements related to SCD on all cognitive measures. Higher body-mass-index was a significant predictor of higher visual-motor and academic achievement scores in children with SCD, but not in controls. Conclusions In some children with SCD, especially those with HbSS and Hb Sβ⁰, low height-for-age may help to explain neurocognitive risk. Higher body-mass-index may be related to better cognitive outcomes in children with SCD. Nutrition deficits in SCD could explain the association between somatic growth and cognitive deficits.

The Benefits of Reciprocated Friendships for Treatment-seeking Obese Youth 19 Aug 2010

Objective The current study examined the attributes of the reciprocated friends (RF) of a group of clinically referred obese children and the impact of these friendships on emotional well-being. Methods Classroom visits for 87 obese youth [body mass index (BMI) >95th percentile; 8- to 16-years old) were completed to obtain peer reports of social functioning, including reciprocated friendships, and to identify a demographically similar non-overweight comparison peer (CPO, n = 76). Subsequently, data regarding self-reported emotional well-being were collected from 84 obese children and 74 CPOs. Results Most obese children (68%) had at least one RF in their classroom. RFs were similar socially to CPOs and functioned more adaptively in the peer environment relative to obese children. Among obese youth, having at least one reciprocated friendship moderated the effect of sensitive-isolated behavior on loneliness. Conclusion Friendships may be a source of support for better psychosocial outcomes for obese youth.

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