Predicting medical compliance among adolescents with cystic fibrosis

This investigation evaluated the utility of a new assessment tool based on a competency/coping skills model in predicting medical compliance of adolescents with cystic fibrosis. The Medical Compliance Incomplete Stories Test (M-CIST) was administered to 40 adolescent and young adult inpatients aged 13 to 23. These data were compared to objective measures of the patient's medical compliance. The M-CIST was positively correlated with compliance (multiple R = .72, p less than .001) and discriminated compliant from noncompliant patients. Data derived from patients' responses on the assessment tool could also be used projectively to provide information useful to clinicians treating adolescents with cystic fibrosis.     

Parent routines for managing cystic fibrosis in children

Management of cystic fibrosis (CF) is burdensome and adherence is often suboptimal. Family routines are associated with adherence and health outcomes in other disease populations. Few studies have examined routines in CF. The study’s aim was to describe parent experiences developing and utilizing CF care routines. Semi-structured interviews with a convenience sample of 25 parents of children under 13 years of age with CF were analyzed using phenomenological analysis. Three domains emerged: parent experiences developing a routine, support systems facilitating maintenance of routines, and challenges with maintaining care routines. Parents found routines difficult to establish, used trial and error, encountered barriers, and found support helpful to manage care demands. Some parents chose to deviate from their routine. Providing anticipatory guidance to promote the use of care routines and strategies to manage potential challenges may facilitate use of routines and improve CF management.     

Longitudinal concomitants of incorrect weight perception in female and male adolescents

The aim of the present study was to analyse the longitudinal concomitants of incorrect weight perception, depressive symptoms, social anxiety, self-esteem, and eating disorders in adolescents. A prospective follow-up study on 283 female and 312 male adolescents aged 15 comprising questionnaires directed at the whole study population and subsequent personal interviews with adolescents found to be screen-positive for eating disorders, at both baseline and three-year follow-up. Body mass index was combined with weight perception to classify adolescents with incorrect weight perception. Twenty-nine percent of females incorrectly perceived themselves as overweight and 14% of males incorrectly as underweight. Incorrect weight perception was in females related to depressive symptoms, social anxiety, eating disorders, and low self-esteem. Males with incorrect weight perception experienced more social anxiety at the follow-up than their counterparts with correct weight perception. Recognition of incorrect weight perception is important for prevention of depression, social anxiety, and eating disorders.     

Psychological treatment of physical maltreatment and negligence in children and adolescents: a meta-analysis

The results of a meta-analysis about the efficacy of psychological treatment for children who have suffered physical maltreatment and neglect by their parents or tutors are presented. Sixteen studies that met our selection criteria were included, providing 22 treated groups and 8 control groups. The results showed an absence of clear differences among the diverse treatments, although all of them exhibited a low-to-medium practical significance. The longer they are, the more effective are the treatments and also when neglect was the type of maltreatment suffered by the children. The effect estimates do not seem to be affected by biases. Finally, the clinical implications of the results, as well as those for future research, are discussed.     

Psychological consequences of rheumatic diseases in children and adolescents: A first exploratory study

The objective of our study was to make a first exploratory study about the psychological status of children and adolescents with rheumatic diseases exploring, also, the significant differences between girls and boys. A total of 123 children (81 girls and 42 boys) with rheumatic diseases, between the ages of 1 and 19 years old were assessed using different measures for evaluating behavioral and emotional problems. The results showed a picture of a mild or moderate degree of psychological problems in the different measures of anxiety, depression, general distress and behavioral problems. Girls, compared to boys, scored higher in most of the measures used, showing more internalizing than externalizing kinds of symptoms. The results suggest the importance of making a more detailed study of these children, comparing them with matched controls and making prospective, longitudinal studies in order to detect psychological problems, and to explore the influence of predictive variables.     

Family and childhood adjustment in cystic fibrosis

Family adaptation has been commonly associated with the psychological adjustment of chronically ill children. However, few studies have attempted to systematically evaluate this association and its relationship to illness severity. We studied 44 children ages 7 to 15 and their families at a large cystic fibrosis center and obtained measures of 1) impact of illness on the family; 2) family functioning; 3) behavioral adjustment; 4) social competence; 5) ratings of anxiety, depressive, and eating disorder symptoms; and 6) ratings of illness severity and duration. Impact of illness on the family and overall family dysfunction were significantly correlated with illness severity, but not duration. However, impact of illness on the family was significantly correlated with internalizing behavioral symptoms, while family dysfunction was correlated with depressive symptomatology. These findings suggest that illness-related stress is primarily reflected in general emotional and behavioral symptoms, with familial adaptation either ameliorating or exacerbating their development into depressive symptomatology.     

Homeostatic interactions: a longitudinal study of biological, psychosocial and family variables in children with cystic fibrosis

A two-Year longitudinal study of thirty-five children used data gathered from pulmonary function tests, clinical measurements and standardized tests of depression, self-esteem and family environment to illustrate homeostatic interactions among biological and psychosocial adaptation to cystic fibrosis. Despite physical deterioration over the course of the study, children with cystic fibrosis reported lower depression and higher self-esteem than population norms, and improvements in psychological functioning. Decline in biological indicators of health was associated with increases on an index based on Family Environmental Scales (FES), subscales of cohesion, expressiveness and organization, and maintenance of high self-esteem and low depression. Presence of additional major life stressors was associated with deterioration in pulmonary function, higher levels of depression and poorer scores on the FES. These findings suggest that homeostatic interactions between children's health status and family functioning may moderate the physical and psychological sequelae of cystic fibrosis.     

Psychological essentialism in children

Psychological essentialism is the idea that certain categories, such as "lion" or "female", have an underlying reality that cannot be observed directly. Where does this idea come from? This article reviews recent evidence suggesting that psychological essentialism is an early cognitive bias. Young children look beyond the obvious in many converging ways: when learning words, generalizing knowledge to new category members, reasoning about the insides of things, contemplating the role of nature versus nurture, and constructing causal explanations. These findings argue against the standard view of children as concrete thinkers, instead claiming that children have an early tendency to search for hidden, non-obvious features.     

Bipolar disorder in children and adolescents

There is increased recognition that bipolar disorder has an early age of onset. The prevalence of bipolar disorder in prepubertal children has not been determined, however the prevalence in adolescence is approximately 1%. Bipolar disorder in children poses a diagnostic challenge since the symptoms may differ from those in late adolescence and adulthood. Comorbid disorders, such as attention-deficit/hyperactivity disorder, further complicate both the diagnosis and course of the disorder. There is increasing evidence of the chronicity and severity of this disorder in youths. Bipolar disorder significantly disrupts a child's psychosocial development including impairments in academic functioning, family functioning, and relationship with peers. Although this disorder has significant morbidity in children and adolescents, there is a paucity of controlled studies to assess the efficacy and safety of mood stabilizers in the treatment of this disorder in youths. The treatment literature consists largely of case studies, retrospective chart reviews, and open-label studies. There is a compelling need for double-blind, placebo-controlled trials to determine whether commonly used medications to treat this disorder are significantly superior to placebo. Since many children in clinical practice require more than one psychotropic medication to adequately manage this disorder, studies of combination treatments are warranted. This review will provide an overview of the literature of bipolar disorder in children and adolescents, including discussion of the prevalence, diagnosis, epidemiology, course of the illness, and treatment issues.     

Inhibition of return in children and adolescents

Inhibition of return (IOR), slowed responding to targets at a cued location after attention is removed from this location, has been shown to occur both in adults and in infants. To explore suggestion that the timecourse of IOR depends on factors that might affect the efficiency with which attention is removed from the cued location, we compared the performance of young children (5-10-year-olds, N=49, M=8 years, 4 months) to older children and adolescents (11-17-year-olds, N=61, M=14 years) in single and double cue procedures. Cue-target interval was varied to measure the timecourse of IOR in this within-subjects localization task. Whereas no IOR was found in the young group unless a double cue procedure was used, in the older group, we found IOR at all intervals with the double cue procedure and the typical crossover pattern, with early facilitation followed by inhibition in the single cue procedure.     

Body image and cystic fibrosis: a critical review

A slight frame and poor appetite are common among patients with cystic fibrosis (CF) yet healthy body weight has been related to a better prognosis. A review of studies exploring body image (BI) among adults and adolescents with CF was conducted. Seven electronic databases were searched for potential papers. They located 128 references, of which 24 were read in full and 12 included in the review. Accepted papers suggested females with CF had a better BI compared to males, but this could compromise survival, given their preference for a low body weight. Males may be more motivated to adhere to nutritional advice because they favor a larger form. Practitioners should broach the topic of BI at clinic appointments to ensure this does not have a detrimental impact on self-management, although more research is required to guide professionals in this task.