Emotional Adjustment of Early Adolescents with Cystic Fibrosis

Abstract

Eighty-five 12- to 15-year-old adolescents regularly attending the cystic fibrosis (CF) clinic of The Hospital for Sick Children were asked to complete the Children's Health Locus of Control and the Tennessee Self Concept Scale. Their parents were requested to complete the Child Behavior Checklist. Thirty-four males (72%) and 28 females (74%) participated in the study. This study found that adolescents with CF are able to maintain a good self concept, be socially competent, and perceive that they are in control of their health while showing an increase in behavior problems. Females rely heavily on denial and are more behaviorally compliant, whereas boys use less denial but show more behavior problems. Males appear to integrate having a physical disorder into their self concept, whereas females do not. The findings demonstrate a difference in mechanisms of coping with cystic fibrosis between male and female adolescents with CF, which may contribute to the decline in physical status in females and better survival of males.

Adolescents With Cystic Fibrosis: Family Reports of Adolescent Health-Related Quality of Life and Forced Expiratory Volume in One Second

“…6 These findings represent a partial contradiction to earlier reports of denial of physical symptoms as a protective strategy for psychosocial adaptation to CF. 3,13 The adolescents in this study reported moderate to strong relationships between their pulmonary function and self-reports of general health, pain, and limitations in activities at school and with friends because of physical health problems. This demonstrates an awareness of physical symptoms and contradicts previous reports of denial of symptoms in adolescents and adults with CF.…”

“…Previous research has reported that female adolescents with CF rely more heavily on denial than do adolescent males with CF. 13 Therefore, our findings may be biased by the high male to female ratio of adolescents in this study. Future research may need to examine the relationship between perceived HRQL and the gender-specific use of denial.…”

“…This demonstrates an awareness of physical symptoms and contradicts previous reports of denial of symptoms in adolescents and adults with CF. 3,13 Adolescent pulmonary function, however, was not related to adolescent self-reports of physical functioning or emotional or behavioral health. This inconsistent pattern may be because of protective denial, or it may represent a psychosocial or emotional resiliency not explained by protective denial.…”

Children's Experiences of Cystic Fibrosis: A Systematic Review of Qualitative Studies

“…40,41 Of note, girls with CF have reported more emotional symptoms and greater pain, spend more time in the hospital than boys with a similar level of illness, [41][42][43] and have a worse prognosis than boys. [44][45][46][47][48] Our findings suggest that boys may emphasize taking responsibility for their treatments and maintaining a positive attitude, whereas some girls expressed the value of sharing responsibility for their health management with, for example, their parent or doctor.…”

Psychopathology in cystic fibrosis and anorexia nervosa: A controlled comparison

“…Despite the chronic nature of CF and the certainty of a shortened life expectancy, the most recent literature indicates that CF patients do not display psychopathology inevitably in response to their illness. On the one hand, a series of investigations, looking predominantly at adaptive skills and self-concept, report no difficulties in these patients (Simmons, Corey, Cowen, Keenan, Robertson, & Levison, 1985;Drotar, Doershunk, Stern, Boar, Boyse, & Matthews, 1981;Venters, 1981;Kellerman, Zeltzer, Ellenberg, Dash, & Rigler, 1979;Straker, & Kuttner, 1980;Bywater, 1981). Other studies, however, (Steinhausen, Schindler, & Stephan, 1983;Breslour, 1985;Pumariega, Pursell, Spock, & Jones, 1986) focusing on assessment of psychiatric disturbance by either observer or self-report, have found higher levels of morbidity which, however are still quite below those with other illnesses, e.g.…”