Psychosocial well-being in young adults with chronic illness since childhood: the role of illness cognitions

Abstract

BackgroundMore and more pediatric patients reach adulthood. Some of them are successfully integrating in adult life, but many others are not. Possibly Illness cognitions (IC) - the way people give meaning to their illness/disability – may play a role in individual differences on long-term adjustment. This study explored the association of IC with disease–characteristics and Health Related Quality of Life (HRQoL), anxiety and depression in young adults with a disability benefit due to childhood-onset chronic condition.MethodsIn a cross-sectional study, young adults (22–31 years, N = 377) who claimed a disability benefit because of a somatic condition since childhood, completed the Illness Cognition Questionnaire (acceptance-helplessness-benefits), RAND-36 (HRQoL) and HADS (anxiety and depression) online. Besides descriptive statistics, linear regression analyses were conducted to predict (1) illness cognitions by age, gender and disease-characteristics, and (2) HRQoL (Mental and Physical Component Scale), Anxiety and Depression by illness cognitions, controlling for disease-characteristics, age and gender.ResultsRespectively 90.2%, 83.8% and 53.3% of the young adults with a disability benefit experienced feelings of acceptance, benefits and helplessness. Several disease-characteristics were associated with IC. More acceptance and less helplessness were associated with better mental (β = 0.31; β = −0.32) and physical (β = 0.16; β = −0.15) HRQoL and with less anxiety (β = −0.27; β = 0.28) and depression (β = −0.29; β = 0.31).ConclusionsIC of young adult beneficiaries were associated with their HRQoL and feelings of anxiety and depression. Early recognition of psychological distress and negative IC might be a key to the identification of pediatric patients at risk for long-term dysfunction. Identification of maladaptive illness cognitions enables the development of psychosocial interventions to optimise their well-being and adaptation to society.

Research Review: Childhood chronic physical illness and adult emotional health – a systematic review and meta‐analysis

“…A possible explanation for our findings is that children with chronic physical illnesses have increased vulnerability for emotional problems during their childhood (Pinquart & Shen, ) which may persist over time, and research suggests that emotional problems in childhood and adolescence precede and predict adulthood problems (Zahn‐Waxler, Klimes‐Dougan, & Slattery, ). For example, the psychological distress of going through an illness or treatment, such as feelings of loss of control over the body (Pinquart & Shen, ), and maladaptive illness cognitions (Verhoof, Maurice‐Stam, Heymans, Evers, & Grootenhuis, ), may contribute to the development of emotional problems in adulthood. Another possible explanation is that the illness symptoms or treatment methods these children endure may alter the brain development that can have long‐term effects on their mental health.…”

Striving to Live a Normal Life: A Review of Children and Young People’s Experience of Feeling Different when Living with a Long Term Condition

“…Children and young people with long term conditions are expected to go through the same developmental stages as their healthy peers (Taylor, Gibson, & Franck, 2008;Verhoof, Maurice-Stam, Heymans, Evers, & Grootenhuis, 2014). Young people in particular must deal with the complex developmental tasks associated with adolescence while also dealing with their condition and its treatment and learning to manage their own illness as they prepare for the transition to adulthood (Jedeloo, van Staa, Latour, & van Exel, 2010;Nylander, Seidel, & Tindberg, 2014).…”

The impact of living with long‐term conditions in young adulthood on mental health and identity: What can help?

“…Acceptance has been described as a gradual and difficult on‐going process requiring time and reflection, and has been emphasized as important for living well with LTCs . Acceptance has also been found to be associated with better emotional functioning amongst young adults specifically …”