Maternal Distress and Discrepancy in Reports of Psychopathology in Chronically Ill Children

Canning, E H; Hanser, Suzanne B.; Shade, Kathryn A.; Boyce, W. Thomas

doi:10.1016/s0033-3182(93)71825-3

Cited by 33 publications

(14 citation statements)

References 24 publications

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“…The extent to which parental distress affects child functioning and parental perceptions of the dysfunction remains to be determined by future studies. 38,39 However, the findings are consistent with those of studies based on representative national pediatric samples of psychosocial dysfunction. 23,26 The clinical implications of the internalizing and externalizing indicators and the impact of comorbidity should be understood, and future analyses should address these issues in greater depth.…”

Section: Commentsupporting

confidence: 84%

Psychosocial Morbidity

Bernal¹,

Estroff²,

Aboudarham³

et al. 2000

Arch Pediatr Adolesc Med

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Objectives: To evaluate psychosocial morbidity in pediatric primary care and to determine displaced health care utilization. Design and Setting:A cross-sectional sample of parentchild dyads was screened using the Pediatric Symptom Checklist (PSC) at 6 pediatric sites of a health maintenance organization (HMO). Cost and utilization data were retrieved from regional databases for this sample.Participants: Parent-child dyads from an HMO in northern California (N = 1840). The children ranged in age from 2 to 18 years.Results: In all, 13.0% of children exhibited psychosocial dysfunction. The rate of children's chronic illness was 18.4%. Multiple regression analyses measured utilization and cost of health and psychiatric care for the selected population for the previous year; the average log cost of health care per child was $393. The average health care cost for children with anxious, depressed symptoms was $805. Chronically ill children were the highest utilizers of health care, with an average log cost of $1138. When psychosocial dysfunction was present, regression models showed that health care spending was highest for young children.Conclusions: Health care utilization was higher for children with psychosocial morbidity, was higher among younger children, and decreased with age as psychiatric costs progressively increased.Arch Pediatr Adolesc Med. 2000;154:261-266

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Section: Commentsupporting

confidence: 84%

Psychosocial Morbidity

Bernal¹,

Estroff²,

Aboudarham³

et al. 2000

Arch Pediatr Adolesc Med

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“…A possible interpretation for the discrepancy between the parents’ and children’s reports may relate to the fact that the parents of medically ill children are likely to be quite distressed, and as such may overestimate the externalizing behaviors (i.e., disobedience or other behavior problems) of their children or may underestimate their children’s ability to adapt to illness [46]. On the other hand, medically ill children may minimize and underreport their distress or symptoms as part of their adaptation to illness [47]. …”

Section: Discussionmentioning

confidence: 99%

Psychosocial distress and functioning of Greek youth with cystic fibrosis: a cross-sectional study

Kostakou

Giannakopoulos

Diareme

et al. 2014

BioPsychoSocial Med

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BackgroundTo assess psychosocial functioning and distress of children and adolescents with cystic fibrosis compared to healthy controls.MethodsThirty-six patients with cystic fibrosis aged 8–18 years (24 boys, mean age ± SD: 11.5 ± 2.6 years) and 31 sex- and age-matched healthy control subjects (18 boys, mean age ± SD: 12 ± 2.5 years) were enrolled in the study. In order to assess the self-esteem, social adjustment, and family functioning of these young people, the Culture-free Self-esteem Inventory, the Social Adjustment Scale–Self-Report, and the Family Assessment Device were administered. Emotional/ behavioral problems were assessed through the Youth Self Report and the Child Behavior Checklist given to both the subjects and their parents.ResultsNo significant differences were found for self-esteem between the two study groups. Regarding social adjustment, children with cystic fibrosis reported significantly worse friendship and overall adjustment (P < 0.05). Moreover, no difference was found in the levels of family functioning between the two groups. No significant differences between the groups were found in emotional/ behavioral problems from the self-reports. On the contrary, parents of children with cystic fibrosis reported significantly higher levels of withdrawal/ depression, thought problems, and delinquent behavior (P ≤ 0.01) as compared to controls.ConclusionsChildren and adolescents with cystic fibrosis appear to be a psychosocially vulnerable group. A biopsychosocial approach should emphasize the assessment and treatment of the psychosocial distress of these patients alongside multiple somatic treatments.

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“…For example, medically ill :hildren may minimize and underreport their distress or symptoms as part of their adaptation to illness (15). Alternatively, distressed or depressed parents may be more in tune with, or overestimate, symptoms in their children (16).…”

Section: Discussionmentioning

confidence: 99%

Mental disorders in chronically ill children: case identification and parent-child discrepancy.

Canning

1994

Psychosomatic Medicine

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Children, like adults and parents, depend on primary care physicians to identify, treat, or refer those with mental disorders. Mental health concerns are also germane to the growing number of chronically ill children in pediatric care. This paper focuses on: 1) the level of agreement between children and parents about the presence of a mental disorder and the impact of informant on case identification; and 2) the extent to which pediatricians agree with reports by chronically ill children and/or their parents regarding such problems. The study sample includes 112 children, ages 9 to 18, with cancer, cystic fibrosis, inflammatory bowel disease, and insulin-dependent diabetes and a control group of 35 healthy subjects. Subject and a parent were interviewed separately using a highly standardized, structured interview that generates DSM-III-R diagnoses by computer algorithms. Pediatricians completed a questionnaire asking about the presence of any mental disorders. Agreement between parent and child was poor for both groups. In the medically ill group, more cases were identified by the parent interview than by child interview alone for all types of disorders. In contrast, children in the comparison group more often reported symptoms sufficient for a diagnosis than did their parents. The difference in prevalence between the two groups was significant only for the parent-identified cases, and physicians were more likely to recognize child-identified disorders. The choice of informant(s) has clear implications for case identification and case recognition in both clinical care and research in pediatric settings.

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Maternal Distress and Discrepancy in Reports of Psychopathology in Chronically Ill Children

Cited by 33 publications

References 24 publications

Psychosocial Morbidity

Psychosocial Morbidity

Psychosocial distress and functioning of Greek youth with cystic fibrosis: a cross-sectional study

Mental disorders in chronically ill children: case identification and parent-child discrepancy.

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