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Journal of Pediatric Psychology Advance Access originally published online on February 23, 2005
Journal of Pediatric Psychology 2005 30(3):273-286; doi:10.1093/jpepsy/jsi037
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Journal of Pediatric Psychology vol. 30 no. 3 © Society of Pediatric Psychology 2005; all rights reserved.

Adjustment to Chronic Arthritis of Childhood: The Roles of Illness-Related Stress and Attitude Toward Illness

Jennifer Soriano LeBovidge, PhD1, John V. Lavigne, PhD2 and Michael L. Miller, MD3

1 Department of Psychiatry, Children’s Hospital Boston, 2 Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, and 3 Department of Pediatrics, Northwestern University Feinberg School of Medicine

All correspondence concerning this article should be addressed to Jennifer S. LeBovidge, Children’s Hospital Boston, Department of Psychiatry, Fegan 8, 300 Longwood Avenue, Boston, Massachusetts 02115. E-mail: jennifer.lebovidge{at}childrens.harvard.edu

Objective To examine the relationship of psychosocial stress and attitude toward illness to psychological adjustment among youth with chronic arthritis. Methods Seventy-five youths with chronic arthritis aged 8–18 years were administered a semi-structured interview assessing illness-related and nonillness-related stressors in important life domains. Children also completed measures of attitude toward illness, depressive symptoms, and anxiety. Parents completed a measure of child psychosocial adjustment. Results Higher levels of illness-related and nonillness-related stress were associated with higher levels of anxiety and depressive symptoms and parent-reported adjustment problems, while a more positive attitude toward illness was associated with lower levels of anxiety and depressive symptoms. Attitude toward illness moderated the relationship between stress and depressive symptoms. Conclusions Results suggest the importance of assessing life stress and attitude toward illness among youth with arthritis and developing interventions to help children cope with arthritis-related stressors and promote a more positive attitude toward illness.

Key words: chronic arthritis; juvenile rheumatoid arthritis; pediatric chronic illness; psychological adjustment; stress; attitudes toward illness.


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