In this study, 64% of children aged 7-12 years with sickle cell disease were found to have a parent-reported behavior problem, and 50% met the criteria for a Diagnostic and Statistical Manual of Mental Disorders (3rd ed.) diagnosis based on a structural clinical interview of the child. Internalizing types of behavior problems and diagnoses were the most frequent. Support was provided for a transactional stress and coping model in delineating the processes associated with child adjustment. In particular, maternal anxiety accounted for 16%-33% of the variance in mother-reported internalizing and externalizing behavior problems, respectively, and child pain-coping strategies accounted for 21% of the variance in child-reported adjustment problems.

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Assessed the psychological adjustment of 78 mothers of children and adolescents (7-17 years of age) with sickle cell disease. Support was provided for a transactional stress and coping model in delineating the processes associated with maternal adjustment. In particular, poor maternal adjustment was associated with use of palliative coping methods and high levels of stress related to daily hassles. Variables of the model accounted for 55% of the variance in maternal psychological distress.

Cognitive-developmental studies relevant to children's concepts of physical illness are reviewed and critiqued. Although numerous methodological weaknesses make firm conclusions difficult, most data appear to suggest that children's concepts of illness do evolve in a systematic and predictable sequence consistent with Piaget's theory of cognitive development. Methodological weaknesses identified include poor description of samples, assessment instruments, and procedures; lack of control over potential observer bias, expectancy effects, and other confounding variables; and minimal attention to reliability and validity issues. Increased methodological rigor and a further explication of the specific and unique ways in which children's concepts of illness develop over the course of cognitive development could substantially increase the value of these studies for professionals in pediatric health care settings.

The present exploratory study was designed to determine whether a sample of depressed adolescents differed from demographically similar samples of normal and non-depressed psychiatric controls as a function of their perceived patterns of parental bonding. All research participants were recruited from the general population. Diagnoses were based on a structured diagnostic interview keyed to DSM-III criteria. Parental bonding was assessed using the Parental Bonding Instrument [PBI; Parker, G. Tupling, H. & Brown, L.B. (1979). A parental bonding instrument. British Journal of Medical Psychology, 52, 1-10]. The results of this study suggest that parental bonding plays an important but non-specific role in the occurrence of adolescent psychopathology.