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Journal of Pediatric Psychology 13(3) pp. 409-421, 1988
© 1988 Society of Pediatric Psychology

research-article

The Impact of Stress and Temperament on Medical Utilization by School-Age Children1

Donald Wertlieb2, Carol Weigel and Michael Feldstein

Institute for Health Research, Harvard Community Health Plan and Eliot-Pearson Department of Child Study, Tufts University, Institute for Health Research, Harvard Community Health Plan, Department of Biostatistics, Harvard School of Public Health

2All correspondence should be sent to Donald Wertlieb, Eliot-Pearson Department of Child Study, Tufts University, Medford, Massachusetts 02155

A child's temperament and the stressful life events he or she experiences influence a child's health. Efforts to understand stress and illness processes have suggested that a range of sociodemographic andpsychosocial variables influence the degree to which a child uses medical services. In this sample of 140 families in a health maintenance organization, medical utilization by school-age children was related to age, family size, stress, and temperament. Fewer relationships were evident in bivariate correlational analyses than in multiple regression analyses which allowed for simultaneous consideration of the variables. Two highly statistically significant multiple regression models each accounted for 20% of the variance in medical utilization over a 4-yearperiod. Evidence for independent main effects as well as mediating or interacting effects of stress and temperament dimensions of mood and distractibility was generated. health care providers and health policy planners efforts can be informed by research which increasingly articulates the relationships among variables influencing the use of medical services.

Key words: stress; stressful life events; temperament; medical utilization; health maintenance organization.


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