Journal of Pediatric Psychology, Vol. 28, No. 1, 2003, pp. 29-39
© 2003 Society of Pediatric Psychology
Psychological Adjustment of Children and Adolescents With Chronic Arthritis: A Meta-analytic Review
1 Northwestern University Feinberg School of Medicine, 2 University of Illinois at Chicago, Institute for Juvenile Research
All correspondence should be sent to John V. Lavigne, Department of Child Psychiatry #10, Children's Memorial Hospital, 2300 Children's Plaza, Chicago, Illinois 60614. E-mail: jlavigne{at}childrensmemorial.org.
Objective To review studies of psychological adjustment among children and adolescents with chronic arthritis to determine whether they are at more risk for development of adjustment problems than controls. Methods We used meta-analytic techniques to review 21 studies reporting overall adjustment problems, internalizing symptoms, externalizing symptoms, or self-concept among youths with arthritis. Results Youths with arthritis displayed increased risk for overall adjustment problems and internalizing symptoms, but not for externalizing symptoms or poor self-concept. Risk was greater in studies making comparisons to study controls rather than to norms and in studies including mixed disease samples (arthritis plus other rheumatic diseases) rather than samples of youths with arthritis only. Conclusions Results suggest the importance of assessing for internalizing problems among youths with chronic arthritis. Future research may benefit from inclusion of child self-report of adjustment problems, diagnostic specificity in reporting results, and use of adjustment measures without somatic items.
Key words: chronic arthritis; juvenile rheumatoid arthritis; pediatric chronic illness; psychological adjustment; meta-analysis.
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