Search

Purpose: Patients with hematologic malignancies (HM) typically rely on informal caregivers for support. Caregivers experience distress, poorer health, and lower quality of life. This study aimed to understand caregivers' experiences adapting to, and making meaning of, their family members' cancer diagnosis and treatment. Approach: Qualitative, constructivist approach. Participants: Caregivers (N = 28) of patients with HM within three months of diagnosis. Methods: A descriptive content analysis was used to analyze semi-structured interview responses and generate themes. Findings: Six themes emerged: power and control (powerlessness, empowerment, relinquishing control/accepting help), protection (gatekeeping, protective buffering), integrating the diagnosis, tolerating uncertainty, preparedness for the caregiver role, and maintaining positivity. Conclusions: Findings highlight challenges and resilience-promoting processes for caregivers adapting to HM diagnosis and treatment. Implications for Psychosocial Providers: Psychological and supportive care interventions can promote acceptance of the diagnosis, preparation for caregiving, navigation of power and control, and targeted coping strategies. [ABSTRACT FROM AUTHOR]

Peer victimization (PV) is a common problem for many adolescents with autism spectrum disorder (ASD) and can negatively impact the mental health and well-being of these youth. Results of the current study of 105 adolescents with ASD (n = 50 girls, 55 boys) indicated that girls and boys experience similar types of PV at similar frequencies. However, relational victimization accounted for a significant portion of variance in anxiety symptoms, above and beyond social communication deficits and restricted and repetitive behaviors, in girls but not in boys. Findings provide preliminary evidence suggesting that the impact of PV on mental health symptoms may be different for girls and boys with ASD, highlighting the need for more research focused on understanding potentially unique social processes for adolescent girls with ASD.

Cumulative exposure to ACEs is associated with internalizing disorders throughout life. Efforts to move beyond the cumulative risk framework call for assessment of various aspects of adversity (e.g., timing) to improve identification of mechanistic outcomes and accuracy in predicting individual health risk following ACEs. Here, we test whether a cumulative ACE score, an average score of perceived negative effect, or their interaction, are associated with internalizing symptoms among young adults. Six hundred undergraduates (Mage = 19.05; 75% female; 69% Black) completed questionnaires related to ACEs, anxiety, and depressive symptoms. The perceived negative effect score was independently associated with anxiety and depressive symptoms, whereas a cumulative ACE score was only associated with depressive symptoms. No interactions were detected. The findings highlight the value in assessing perception as one aspect of exposure to ACEs. Future research should consider other contextual factors, and how they may interact with perception to influence health outcomes. [ABSTRACT FROM AUTHOR]

We aimed to assess the feasibility and acceptability of mobile ecological momentary assessment (mEMA) for youth with craniopharyngioma and evaluate daily associations among family functioning, affect, and sleep difficulties. Youth completed two mEMA diaries per day for one week. Thirty-nine youth who underwent surgery and proton radiotherapy (when indicated) for craniopharyngioma. Descriptive statistics and multi-level modeling were used to examine feasibility and acceptability of mEMA and daily associations among family functioning, affect, and sleep. Youth reported satisfaction and minimal burden from completing daily mEMA diaries. Poorer family functioning was not related to lower sleep efficiency. mEMA is an acceptable and feasible method for evaluating sleep and related variables in children and adolescents with craniopharyngioma. Results highlight the utility of gathering mEMA data in youth at elevated risk for sleep difficulties as a function of their illness/treatment. [ABSTRACT FROM AUTHOR]

Robust associations between adverse childhood experiences and shortened telomere length exist, but few studies have examined factors that may moderate this association, particularly with a resilience framework. The present study examined the association between exposure to childhood sexual abuse (and abuse severity) and mean telomere length, and whether social support and optimism moderated this association. The sample included 99 White monozygotic female twins, ranging in age from 35 to 70 (M.sub.age = 52.74, SD = 8.55 years), who provided a blood sample for telomere assay, and data on their childhood sexual abuse history, trait optimism, and current social support. Linear mixed effects models were employed to test study hypotheses. There were no effects of exposure to abuse or abuse severity on mean telomere length, nor were there main or moderating effects of optimism, in analyses of the full sample. However, in analyses that only included women exposed to abuse, there was an abuse type x support interaction: among women who experienced abuse in forms other than intercourse, higher levels of social support were associated with longer mean telomere length. Findings from the current study clarify the role of childhood sexual abuse in telomere attrition, and identify one factor that may protect against the negative biological effects of childhood sexual abuse., Author(s): David W. Sosnowski [sup.1] , Wendy Kliewer [sup.1] , Timothy P. York [sup.2] , Ananda B. Amstadter [sup.3] , Colleen K. Jackson-Cook [sup.4] , Marcia A. Winter [sup.1] Author [...]

Medical misinformation and unverifiable content about the coronavirus disease (COVID-19) pandemic have been propagated at an alarming rate, particularly on social media (1). Such misinformation may confer increased risk for [...]

We investigated sleep-related challenges and their association with family functioning in children and adolescents previously treated for craniopharyngioma. Quantitative approach using psychometrically validated measures. Thirty-nine children and adolescents who had been treated for craniopharyngioma and their primary caregivers. Caregivers and youth completed measures of family functioning, family routines, daytime sleepiness, and children's sleep patterns. Children and adolescents with craniopharyngioma had significantly higher ratings of self-reported excessive daytime sleepiness, bedtime fears/worries, and restless legs symptoms compared to their relatively healthy peers. Lack of family routines and poor family functioning were related to poor sleep-related outcomes and increased excessive daytime sleepiness. Providers should consider assessing sleep difficulties in pediatric brain tumor survivors from a family systems perspective. Intervening on family-related factors may help improve sleep and other health-related outcomes, whereas intervening on sleep may help improve family functioning. [ABSTRACT FROM AUTHOR]

Introduction: Family factors are directly associated with the psychosocial adjustment of children with chronic illnesses such as asthma (Kaugars, Klinnert, & Bender, 2004). Research indicates that negative family factors may also contribute to child disease severity via bio-behavioral mechanisms of effect. For instance, children from more conflicted families often experience greater internalizing symptoms that subsequently impact their asthma severity (Wood et al., 2006). These pathways have yet to be examined with a comprehensive focus on strength-based family factors. This study examined whether factors such as family cohesion, problem-solving abilities, and communication influence asthma severity via their effects on child depression and anxiety symptoms. Method: Participants were 215 children (136 males and 79 females), ages 5 to 12 years old, and their families. Primary caregiver, child, and teacher ratings of child and family functioning in addition to objective measures of parent-child interactions and asthma severity were collected. Results: Using structural equation modeling, the authors identified significant indirect associations between family factors and child asthma severity via child depressive symptoms; however, these associations were not present in models with child anxiety symptoms. Discussion: Results suggest an indirect effect of family functioning on children's lung function, with differential roles of anxiety and depression in these pathways. This article also highlights the importance of incorporating multirater multimethod measures to understand children's experiences in pediatric asthma. Keywords: pediatric asthma, family functioning, depression, anxiety, adaptation, Despite available preventative treatments, asthma prevalence continues to increase, with roughly 14% of children affected around the world (Global Asthma Network, 2014). In 2014, pediatric asthma affected more than seven [...]

Family mealtimes have the potential to promote healthy child development. This observational study of 200 family mealtimes examined the relation between child health in a group of children (ages 5 to 12) with persistent asthma and 3 dimensions of mealtime interaction: Action, Behavior Control, and Communication. Percent time spent in Action and Positive Communication varied by asthma severity, child quality of life, and sociodemographic variables. Positive communication during mealtimes predicted child quality of life. Significant interactions between demographic variables and behavior control suggested that higher levels of behavior control affected child quality of life in the context of lower maternal education. Guidance is offered for practitioners and policy makers toward promoting healthy family mealtimes as a public health priority. (Contains 3 tables and 3 figures.)

Background: Respiratory problems have been shown to be associated with the development of panic anxiety. Family members play an essential role for children to emotionally manage their symptoms. This study aimed to examine the relation between severity of respiratory symptoms in children with asthma and separation anxiety. Relying on direct observation of family interactions during a mealtime, a model is tested whereby family interactions mediate the relation between asthma severity and separation anxiety symptoms. Methods: Sixty-three children (ages 9-12 years) with persistent asthma were interviewed via the Diagnostic Interview Schedule for Children IV; family interactions were assessed via direct observation of a mealtime; primary caregivers completed the Childhood Asthma Severity Scale; youth pulmonary function was ascertained with pre- and post-bronchodilator spirometry; adherence to asthma medications was objectively tracked for six weeks. Results: Poorer pulmonary function and higher functional asthma severity were related to higher numbers of separation anxiety symptoms. Controlling for medication adherence, family interaction patterns mediated the relationship between poorer pulmonary function and child separation anxiety symptoms. Conclusions: Family mealtime interactions may be a mechanism by which respiratory disorders are associated with separation anxiety symptoms in children, potentially through increasing the child's capacity to cognitively frame asthma symptoms as less threatening, or through increasing the child's sense of security within their family relationships.

This study examined how children's insecure internal representations of interparental and parent-child relationships served as explanatory mechanisms in multiple pathways linking interparental conflict and parent emotional unavailability with the emotional and classroom engagement difficulties the children had in their adjustment to school. With their parents, 229 kindergarten children (127 girls and 102 boys, mean age = 6.0 years, SD = 0.50, at Wave 1) participated in this multimethod, 3-year longitudinal investigation. Findings revealed that children's insecure representations of the interparental relationship were a significant intervening mechanism in associations between observational ratings of interparental conflict and child and teacher reports on children's emotional and classroom difficulties in school over a 2-year period. Moreover, increased parental emotional unavailability accompanying high levels of interparental conflict was associated with children's insecure representations of the parent-child relationship and children's difficulties in classroom engagement at school entry. The findings highlight the importance of understanding the intrinsic processes that contribute to difficulties with stage-salient tasks for children who are experiencing interparental discord.

This study examined the role of attention difficulties as a mediator of associations between children's insecure representations of the interparental relationship and their school adjustment in a sample of two hundred and sixteen 6-year-old children. Consistent with hypotheses, findings from structural equation models indicated that observer ratings of children's insecure representations of interparental relationships in a story completion task predicted computerized task assessments and parent reports of children's attention difficulties 1 year later. Children's attention difficulties, in turn, were associated with concurrent levels of school problems and increases in school problems over a 1-year period as indexed by teacher reports. Attention difficulties accounted for an average of 34% of the association between insecure internal representations and school problems.

Background: Expressed emotion is the affective attitudes and behaviors of an individual toward another. In this preliminary study, we described expressed emotion among caregivers of children with asthma living in low-income urban area and evaluated its association with child asthma control. Methods: Forty-one children (90.2% African American/Black) and their caregivers participated. Measures included the Childhood Asthma Control Test and the Five-Minute Speech Sample coded for overall expressed emotion, emotional over-involvement, and criticism. Results: Most caregivers were rated borderline (31.7%) or high (48.8%) for expressed emotion, borderline (31.7%) or high (39.0%) for emotional overinvolvement, and low for criticism (73.2%). The association between criticism and asthma control neared statistical significance [U(Nlow = 30, NB/high = 11) = 100, z = −1.922, P = 0.055]. Conclusion: Findings suggest an examination into expressed emotion coding procedures for caregivers in low-income urban areas, and culturally specific adaptations may be necessary. Future research should confirm findings in a larger sample and consider how parental criticism affects children's asthma management. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Hematologic malignancies (HMs) are life-threatening cancers that frequently entail aggressive, long, inpatient treatment protocols. This can result in numerous concurrent symptoms and decreased quality of life for patients and can affect family caregivers (FCs). This study examined the impact of an HM diagnosis on patients and on their FCs. SAMPLE & SETTING: A descriptive design was used to explore the experiences of 28 newly diagnosed patients and their FCs. All patients were receiving treatment on an inpatient acute oncology unit at a National Cancer Institute-designated cancer center. METHODS & VARIABLES: Semistructured, separate interviews with patients and FCs were recorded and transcribed verbatim. Textual and content analyses were conducted to generate common themes. RESULTS: Patients and FCs reported how diagnosis and treatment affected them physically, emotionally, logistically, and financially. They described the effects of their experiences with the health system and providers in areas such as diagnostic process, trust in the medical team, support needs, and hospitalization. IMPLICATIONS FOR NURSING: Understanding the parallel experiences of patients with HMs and their designated FCs allows researchers to develop targeted interventions and enables clinicians to provide personalized patient- and family-centered care. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the associations between child health, parent racial regard, and parent physical health in 87 African American and Black parents/caregivers of children with and without asthma from a low-income, under-resourced urban area. Participants completed the Private and Public Regard subscales of the Multidimensional Inventory of Black Identity (MIBI) and 12-item Short Form Health Survey (SF-12). Parents of children with asthma reported having poorer physical health, while those with higher public and private racial regard reported better physical health. The association between public regard and physical health was surpassed by an interaction of child asthma status and public regard: as public regard decreased, so did physical health, but only for parents raising a child with asthma. Findings suggest that the stresses associated with raising a child with chronic illness and perceiving lower public racial regard may together confer additional risk for poor physical health in African American and Black parents. [ABSTRACT FROM AUTHOR]

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1545-5300.2008.00239.x Byline: BARBARA FIESE ([dagger]), MARCIA WINTER ([dagger]), RAN ANBAR (*), KIMBERLY HOWELL ([dagger]), SCOTT POLTROCK ([dagger]) Keywords: Pediatric Asthma; Family Routines; Family Interaction; Family Burden Abstract: This preliminary report links the literatures on family asthma management practices and on the characteristics of family interaction patterns thought to influence children's adjustment to a chronic physical illness. Specifically, this study of 60 families with a child with asthma examined the extent to which perceived burden of routine asthma care affected child mental health via its influence on parent-child interaction patterns. Mothers completed a measure of asthma management routine burden, mother and child were observed in a 15-minute interaction task, and children completed measures of child anxiety and asthma quality of life (QOL). Perceived routine burden significantly predicted child anxiety and QOL through its effect on mother-child rejection/criticism. The same pattern did not hold for mother intrusiveness/control. The results are discussed in terms of how overall family climate and regulation of routines affects child well-being. Implications for clinical practice and limitations of the study are provided. Abstract (French) RESUMEN Clima Familiar y Cuidado Rutinario del Asma: Relacion entre el Bienestar del nino/de la nina y la Percepcion de Carga y la Relacion entre Madre e Hijo/a Este informe preliminar conecta las publicaciones sobre practicas familiares de control del asma y las caracteristicas de los patrones de interacciones familiares, consideradas influyentes en la adaptacion de los ninos a enfermedades fisicas cronicas. En especial, este estudio de 60 familias con un hijo o una hija a con asma examino el punto hasta el cual la consideracion de los cuidados rutinarios del asma como una carga afectaba a la salud mental del nino o de la nina a traves de su influencia en los patrones de interaccion entre padres e hijos. A las madres se les evaluo la carga rutinaria del control del asma, se observo a las madres y los ninos en una tarea de interaccion de 15 minutos, y a los ninos se les hizo la prueba de calidad de vida de la ansiedad y el asma. Los resultados demostraron que el percibir la rutina como una carga tenia relacion con la ansiedad y calidad de vida del nino o de la nina, a causa del efecto que tiene sobre el rechazo y la critica en la relacion entre madres e hijos. Este patron no resulto ser el mismo que para la intrusion y el control de las madres. Los resultados se discutieron en cuanto a como el clima familiar y la regulacion de la rutina afectan el bienestar del nino o de la nina. Se incluyen implicaciones para practica clinica y limitaciones del estudio. Author Affiliation: ([dagger])Department of Psychology, Syracuse University, Syracuse, NY (*)Department of Pediatrics, Upstate Medical University, Syracuse, NY. Article note: Correspondence concerning this article should be addressed to Barbara Fiese, Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244. E-mail: bhfiese@syr.edu