Lay concepts of health and illness from a developmental perspective

Abstract

The concepts of children, adolescents and their mothers with regard to different aspects of health and illness in general and five specific diseases were explored in this study. An exploration with fully standardised questions and open answers was subjected to a content analysis. A reliable rating system was developed to score the sophistication of the answers. The study included 99 Ss of the age groups 5, 8, 12 and 16 years, as well as 48 mothers of the children. Many children and adolescents were able to define health positively (well-being) and not merely as the absence of illness. The definition of illness in general was frequently composed of somatic symptoms and disorders, feeling poorly and things one would like to accomplish but can't. The causality explanations of illness in general were dominated by contagion. The concepts of the older children and the mothers were richer, more elaborated, less concrete and less action-oriented than those of the younger children. However, abstract formulations and complex aspects of illness were very rarely expressed. In addition, concepts regarding the characteristics (definition, symptoms, causality, treatment and prevention) of five diseases (cold, measles, heart infarction, cancer and AIDS) were measured. The pattern of results was strongly influenced by age. By and large, the development of most disease concepts was linear with significant differences between age groups. Conversely, within a given age group, significant differences were found in the cognitive level of disease characteristics, either with respect to the same disease or between different diseases (“horizontal shifts”).     

The influence of external stimulation on airflow detection by children with asthma

Abstract

The relevance and significance of the concept of a ‘competition of cues’ for the understanding of symptom perception in childhood asthma was investigated during detection of externally applied resistive loads on breathing. The concept predicts that subjects would respond less frequently and less accurately during external stimulation. The sample consisted of 36 children with and 36 without asthma, aged 7-18 years. Detection of airflow was measured in a neutral and in an external stimulation condition. The children breathed through a facemask and responded to changes in airflow by pressing a button. The stimulus presented and withdrawn was analogous to a decrease in lung function (Forced Expiratory Volume in one second) of 39%. Accuracy of detection of airflow was defined as correct minus false positive responses to load stimuli.

The results showed that children with and without asthma responded significantly less frequently during external stimulation than in the neutral condition. However, the accuracy of detection among non-asthmatics was not affected by external stimulation. Children with asthma responded significantly more accurately during external stimulation. The results are discussed in the light of children's accuracy to perceive actual airways obstruction.     

Smoking-specific communication and children's smoking onset: An extension of the theory of planned behaviour

The aim of this study was to test whether maternal smoking-specific communication and parental smoking related to smoking cognitions (i.e. attitude, self-efficacy and social norm) derived from the Theory of Planned Behaviour in association with smoking onset during preadolescence. A total of 1478 pairs of mothers and children participated (mean age: 10.11; standard deviation?=?0.78). Structural equation models in Mplus were used to examine whether smoking-specific communication influences children's smoking cognitions, which in turn, affect smoking onset. A positive association was found between pro-smoking attitudes and smoking onset. Smoking-specific communication and parental smoking were related to smoking cognitions. Specifically, frequency of communication was negatively associated with pro-smoking attitudes, social norms of mother and best friend. Quality of communication related negatively to pro-smoking attitudes and positively to self-efficacy and norms of friends. Parental smoking was positively associated with pro-smoking attitudes and norms of mother and (best) friends. Additionally, more frequent communication and higher levels of parental smoking were associated with higher smoking onset. In conclusion, smoking-specific communication and parental smoking were associated with smoking cognitions and smoking onset. Already during preadolescence, parents contribute to shaping the smoking cognitions of their children, which may be predictive of smoking later in life.     

Parental experience of childhood cancer using Interpretative Phenomenological Analysis

Whilst survival rates for childhood cancer have improved dramatically over the past three decades, it is still a devastating diagnosis for family members and an illness which severely disrupts the lifestyle of the family unit. Developing an understanding of the impact of the illness on the family is crucial to better support families’ deal with the demands of the illness. In this study nine families in which a child was diagnosed with cancer were interviewed twice over a 12 month period, approximately 6 months apart. Using Interpretative Phenomenological Analysis, a semi-structured interview was used to explicate parent's experience of childhood cancer. The results revealed five super-ordinate themes; (1) a pivotal moment in time, (2) the experience of adaptation in relation to having a sick child, (3) the nature of support, (4) re-evaluation of values during a critical life experience and (5) the experience of optimism and altruism. Findings indicate that parents express both negative and positive experiences as they re-evaluate the meaning and purpose of life, seek to redefine themselves, often in terms of priorities, relationships, sense of community and achieve degrees of optimism and altruism. Implications for addressing the needs of parents and for further research are discussed.     

Predictors of reading fluency in Italian orthography: Evidence from a cross-sectional study of primary school students

This study investigates the role of linguistic and visuospatial attentional processes in predicting reading fluency in typical Italian readers attending primary school. Tasks were administered to 651 children with reading fluency z scores > ?1.5 standard deviation to evaluate their phonological awareness, rapid automatized naming (RAN), verbal short-term memory, vocabulary, visual search skills, verbal-visual recall, and visual-spatial attention. Hybrid models combining confirmatory factor analysis and path analysis were used to evaluate the data obtained from younger (first and second grade) and older (third–fifth grade) children, respectively. The results showed that phonological awareness and RAN played a significant role among younger children, while also vocabulary, verbal short-term memory, and visuospatial attention were significant factors among older children.     

ADHD Assessment

Abstract

This study examined effects of negative versus positive symptom formats on the assessment and subsequent classification of ADHD in children in public schools. Symptoms associated with the disorder based on the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) were presented to parents and teachers of referred children according to both types of formats. Informants were then asked to indicate whether the symptoms described the child's behavior over the last six months. Overall, the negatively phrased symptoms appeared to generate response bias which resulted in an increased percentage of children meeting the DSM-IV criteria for ADHD. Additionally, the decision reliability or classification agreement between the two formats was low, suggesting the possibility of confirmation bias in the assessment process. Implications for practice and future research are discussed.     

Influence of response time frame on mood assessment

Abstract

Dental anxiety and the related avoidance of dental treatment can result in severe impairment of health. We investigated the influence on avoidance behavior of phobic severity, gender, characteristics related to generalized anxiety and depression, such as dysfunctional cognitions and sensitivity of bodily symptoms, as well as personality traits of self-efficacy and locus of control. Forty-eight dental phobics were given an initial assessment and avoidance behavior was determined by the degree of observance of three subsequent dental appointments. Principal component analysis revealed separate factors for trait and phobic anxiety as well as for avoidance and dysfunctional cognitions. Women showed a higher degree of avoidance than men. Regression analysis revealed a high desire for control over dental treatment combined with a low level of perceived control as the only significant predictor variable of avoidance. The results suggest that avoidance behavior in dental phobia could be reduced by extending patients’ control over treatment conditions.     

Parental Hostility and Depression as Predictors of Young Children's Aggression and Conduct Problems

Parental hostility and parental depression are associated with childhood behavior problems, but these have been studied independently in the literature. This study examined the relationships between parental hostility and depression and childhood aggression and conduct problems. Parental hostility was hypothesized to predict children's current and future (two months later) aggression and conduct problems. Participants were primary caregivers of children 0 to 10 years of age. Results indicate that hostility is a better predictor of present and future childhood aggression and conduct problems than depression. Implications of this finding for preventing and treating childhood aggression and conduct problems are discussed.     

Foster Care Youth Share Stories of Trauma Before,During, and After Placement: Youth Voices for Building Trauma-Informed Systems of Care

Many research studies address child trauma experiences that take place before foster care placement. However, few studies focus on the types and patterns of trauma experiences that reportedly take place during and after foster care placement; that is, after entry into adult living. This study examined the testimony of 43 foster care youth who spoke to a listening panel comprised of state legislators, child welfare professionals, and university educators. Qualitative analyses of transcribed text data revealed 3 main themes. First, the youth reported experiencing trauma before, during, and after placement. Second, the youth described trauma events and situations that were chronic (i.e., intense, composite, or cumulative). Third, youth offered suggestions for reducing traumatic experiences for foster care youth. They recommended earlier family interventions, access to people who listen and care, improved parenting skills for foster parents, continuity of relationships, and opportunities for leadership for foster youth. Foster youth voices offer important suggestions for building, strengthening, and evaluating trauma-informed systems of care.