Journal of Pediatric Psychology - recent issues

Cultural Factors and Family-Based HIV Prevention Intervention for Latino Youth

Lescano, C. M., Brown, L. K., Raffaelli, M., Lima, L.-A. — Thu, 05 Nov 2009 05:48:20 PST

Latino youth are the fastest growing ethnic group in the United States and are at considerable risk for HIV and other sexually transmitted infections (STIs), given that they have an earlier onset of sexual activity and use condoms less consistently than European American adolescents. Theorists and scholars have emphasized the importance of taking culture into account in sexuality interventions with Latino adolescents, yet few culturally tailored interventions have been developed for this population. Given the emphasis on familismo and collectivism among Latinos, family-based programs are likely to be well received and could contribute to long-term maintenance of adolescent safety. In this synthesis of the relevant literature, cultural factors that have been identified as relevant to Latino sexuality are reviewed and implications for family-based intervention with Latinos are addressed.

Parental HIV/AIDS and Psychosocial Adjustment among Rural Chinese Children

Thu, 05 Nov 2009 05:48:20 PST

Objective To assess the relationship between parental HIV/AIDS and psychosocial adjustment of children in rural central China. Methods Participants included 296 double AIDS orphans (children who had lost both their parents to AIDS), 459 single orphans (children who had lost one parent to AIDS), 466 vulnerable children who lived with HIV-infected parents, and 404 comparison children who did not experience HIV/AIDS-related illness and death in their families. The measures included depressive symptoms, loneliness, self-esteem, future expectations, hopefulness about the future, and perceived control over the future. Results AIDS orphans and vulnerable children consistently demonstrated poorer psychosocial adjustment than comparison children in the same community. The level of psychosocial adjustment was similar between single orphans and double orphans, but differed by care arrangement among double orphans. Conclusion The findings underscore the urgency and importance of culturally and developmentally appropriate intervention efforts targeting psychosocial problems among children affected by AIDS and call for more exploration of risk and resilience factors, both individual and contextual, affecting the psychosocial wellbeing of these children.

Brief Report: Young Children's Risk of Unintentional Injury: A Comparison of Mothers' and Fathers' Supervision Beliefs and Reported Practices

Morrongiello, B. A., Walpole, B., McArthur, B. A. — Thu, 05 Nov 2009 05:48:20 PST

Objective There is increasing interest in understanding how parent supervision influences young children's risk of injury, but nearly all of this research has been conducted with mothers. The present study compared first-time mothers’ and fathers’ supervisory beliefs and reported practices, and related these scores to parental reports of their child's history of injuries. Methods Mothers and fathers of children 2–5 years each independently completed a telephone interview and previously validated questionnaires about their supervisory beliefs and practices and their child's history of injuries. Results Mothers and fathers provided similar reports of their child's injuries (minor, medically attended) and scored similarly on various supervision indices. Despite these similarities, the way mothers’ and fathers’ supervision indices related to children's injury history scores differed. Children's frequency of minor and medically attended injuries was predicted from maternal supervisory scores but not from paternal scores. Conclusions Maternal supervision has more impact on children's risk of injury than paternal supervision, possibly because mothers spend more time with children than fathers.

A Mediation Analysis of the ATHENA Intervention for Female Athletes: Prevention of Athletic-Enhancing Substance Use and Unhealthy Weight Loss Behaviors

Thu, 05 Nov 2009 05:48:20 PST

Objective To explain, through mediation analyses, the mechanisms by which ATHENA (Athletes Targeting Healthy Exercise and Nutrition Alternatives), a primary prevention and health promotion intervention designed to deter unhealthy body shaping behaviors among female high school athletes, produced immediate changes in intentions for unhealthy weight loss and steroid/creatine use, and to examine the link to long-term follow-up intentions and behaviors. Methods In a randomized trial of 1668 athletes, intervention participants completed coach-led peer-facilitated sessions during their sport season. Participants provided pre-test, immediate post-test, and 9-month follow-up assessments. Results ATHENA decreased intentions for steroid/creatine use and intentions for unhealthy weight loss behaviors at post-test. These effects were most strongly mediated by social norms and self-efficacy for healthy eating. Low post-test intentions were maintained 9 months later and predicted subsequent behavior. Conclusions ATHENA successfully modified mediators that in turn related to athletic-enhancing substance use and unhealthy weight loss practices. Mediation analyses aid in the understanding of health promotion interventions and inform program development.

Brief Report: Don't Kiss a Sleeping Dog: The First Assessment of "The Blue Dog" Bite Prevention Program

Meints, K., de Keuster, T. — Thu, 05 Nov 2009 05:48:21 PST

Objective The authors attempted to remedy the current lack of empirically evaluated dog-bite prevention programs for children under 7 by assessing children's learning success with the "Blue Dog" CD. Methods Ninety-six 3-, 4-, 5-, and 6-year-old children used the interactive CD in an initial exposure phase, a training and a testing phase. Half received verbal feedback, and the other half additional practice with parents. All children were re-tested after 2 weeks. Results There were significant increases in safe choices after the training phase at all ages, with older children performing better than younger children. Children still retained their ability to make safe choices after 2 weeks. Interestingly, children practicing with parents performed better than others when under 6 years. Verbal feedback did not play a role, the CD is equally effective without. Conclusions Children learned successfully about safe behavior with dogs; thus, the CD can help educate children about dog-bite prevention.

A Randomized Controlled Trial of Massage Therapy in Children with Sickle Cell Disease

Lemanek, K. L., Ranalli, M., Lukens, C. — Thu, 05 Nov 2009 05:48:21 PST

Objective This randomized controlled trial investigated the short-term effects of massage therapy on youth with SCD and their parents. Methods Thirty-four children and adolescents, and their parents were assigned to a massage therapy or an attention control group. Parents were trained in massage in their homes once a week for 4 weeks, with instructions to provide nightly massages. Families in the control group were visited weekly by a research assistant. Participants completed measures of depression and anxiety, functional status, pain intensity, medication use, and service utilization. Results Parents in the massage therapy group reported higher levels of depression and anxiety following the intervention. Youth in this group showed higher levels of functional status, and lower levels of depression, anxiety, and pain. Health service utilization rates were unchanged from pre- to post-intervention. Conclusions These results offer preliminary support for parent-delivered massage therapy as an intervention for SCD pain.

Family Therapy for Adolescents with Poorly Controlled Diabetes: Initial Test of Clinical Significance

Harris, M. A., Freeman, K. A., Beers, M. — Thu, 05 Nov 2009 05:48:21 PST

Objective We examined a structured family therapy approach in promoting clinically meaningful improvements in parent–adolescent conflict in adolescents with poorly controlled diabetes. Method Eighteen adolescents with poorly controlled diabetes and their parent(s) participated in 10 sessions of home-based Behavioral Family Systems Therapy (BFST). Outcome comparisons were made using a sample of adolescents with poorly controlled diabetes (n = 40) from a previous study. Clinically significant improvements were determined by calculating SD differences between treatment and comparison groups on measures of diabetes-related and general parent–adolescent conflict. Results Home-based BFST produced change in diabetes-related family conflict ranging from 1/3 to 1/2 SD and general family conflict ranging from 1/3 to 3/4 SD. Conclusions BFST produced change in family conflict, a variable shown through previous research to relate to treatment adherence in adolescents with diabetes. The test of clinical significance represents an example of a method useful for pediatric research.

A Group Social Skills Intervention Program for Survivors of Childhood Brain Tumors

Barrera, M., Schulte, F. — Thu, 05 Nov 2009 05:48:21 PST

Objective The purpose of this study was to evaluate the feasibility and preliminary outcomes of a social skills group intervention program for child brain tumor survivors. Methods Participants were 32 survivors (14 females) aged 8–18 years. Medulloblastoma (28%) was the main diagnosis. The intervention consisted of eight 2-hr weekly sessions focused on social skills including friendship making and assertion. Survivors and parents completed measures of social skills, quality of life, behavior and depression, at baseline, pre- and post-intervention, and 6 months later. Results Feasibility analyses revealed promising acceptability, retention, recruitment, and treatment fidelity. Significant improvement was found after intervention based on parents’ reports of self-control [F(1,27) = 5.97, p <.05], social skills [F(1,28) = 5.70, p <.05], and quality of life [F(1,15) = 17.98, p <.01]. Conclusions The intervention is feasible and outcomes based on parental reports provide preliminary support for the efficacy of the program.

Survivors of Childhood Cancer and Comparison Peers: The Influence of Peer Factors on Later Externalizing Behavior in Emerging Adulthood

Thompson, A. L., Gerhardt, C. A., Miller, K. S., Vannatta, K., Noll, R. B. — Thu, 05 Nov 2009 05:48:21 PST

Objective To examine group differences and predictors of externalizing behavior and substance use during the transition to emerging adulthood (i.e., ages 18–25) among survivors of childhood cancer and comparison peers. Methods Peer acceptance and social behavior were assessed in classrooms of 55 children (ages 8–15) during cancer treatment. Children with cancer, comparison peers (n = 60), and parents completed measures of externalizing behavior and/or substance use during an initial home visit and soon after participants turned 18. Results At follow-up, survivors and peers exhibited similar externalizing behaviors and substance use, except peers were more likely to use marijuana. Substance use was associated with earlier peer acceptance and social behavior. Survivors who were older at diagnosis were at greater risk for later externalizing behavior and substance use. Conclusions Mean externalizing behaviors and substance use generally fell within normative ranges for both survivors and peers. Some survivors may benefit from interventions to reduce risk behavior.

Brief Report: Children's Response to Serious Illness: Perceptions of Benefit and Burden in a Pediatric Cancer Population

Currier, J. M., Hermes, S., Phipps, S. — Thu, 05 Nov 2009 05:48:21 PST

Objective To examine a revised measure of benefit finding for children, in relation to perceptions of illness-related burden, and other measures of child psychological functioning. Methods A sample of 78 children with cancer completed the newly revised Benefit/Burden Scale for Children (BBSC) and measures of optimism/pessimism, positive/negative affect, anxiety and defensiveness. Results Factor analysis of the BBSC revealed a clear two-factor solution, with benefit finding and illness-related burden representing orthogonal factors. Both scales were internally consistent and demonstrated different patterns of correlation with the other measures assessed in the study. Conclusion The BBSC is internally reliable and preliminary data supports the validity of separate benefit and burden constructs. Children report positive and negative aspects of their illness simultaneously, and perceptions of benefit and burden function as independent constructs. The BBSC is a useful measure for pediatric cancer patients that could be applied to children experiencing other significant life events.

The Role of Coping and Temperament in the Adjustment of Children with Cancer

Thu, 05 Nov 2009 05:48:21 PST

Objective To examine the extent to which stress, coping, and temperament accounted for variability in adjustment among children with cancer. Methods Seventy-five mothers of children with cancer (ages 5–17) completed questionnaires regarding their child's cancer-related stress; coping; temperament characteristics including positive affect (PA), negative affect (NA), and effortful control (EC); and symptoms of anxiety and depression. Assessments occurred within one year of initial diagnosis or relapse (M = 5.74 months; SD = 4.72). Results Cancer-related stress was positively associated with symptoms of depression in children. NA was positively associated with symptoms of anxiety and depression. Primary control coping moderated the association between NA and depression, and primary and secondary control coping mediated this association. Conclusion Results partially support the utility of an integrated model including cancer-related stress, coping, and NA in identifying children at risk for internalizing symptoms during treatment. Additional research is needed to inform interventions for this population.

Self-perception and Body Image Associations with Body Mass Index among 8-10-year-old African American Girls

Thu, 05 Nov 2009 05:48:21 PST

Objectives The purpose of this study was to examine relationships among body mass index (BMI), self-perceptions, and body image discrepancy in African American (AA) girls. Methods Baseline self-perception and BMI data were collected by trained staff from 303 preadolescent AA girls participating in the girls health enrichment multi-site studies. Correlations and multivariable logistic regression analyses were performed to identify relationships of BMI with self-perception factors. Results Girls with a BMI at or above the 85th percentile were more likely to have greater body image discrepancy and participate in weight control behaviors than girls with a BMI below the 85th percentile. Body image discrepancy was not related to self-esteem, but was positively correlated with physical activity self-concept and self-efficacy, and diet self-efficacy. Conclusion Girls with higher BMI had greater body image discrepancy and were less confident in abilities to be active and eat healthy. Findings may inform the development of obesity interventions for preadolescents.

Increasing Parent-Pediatrician Communication about Children's Psychosocial Problems

Hayutin, L. G., Reed-Knight, B., Blount, R. L., Lewis, J., McCormick, M. L. — Thu, 05 Nov 2009 05:48:21 PST

Objective To examine the differential effects of two scoring procedures for a parent-completed measure, the Pediatric Symptom Checklist (PSC), designed to assess children's behavioral and emotional functioning, on parent–pediatrician communication concerning psychosocial issues. Methods Prior to their medical appointment, 174 parents of children aged 4–16 were assigned to one of three experimental conditions: (1) typical medical care control, (2) Staff-Scored PSC administration, or (3) Parent-Scored PSC administration. Following the appointment, parent perception of parent–pediatrician communication was assessed. Results For children with more emotional and behavioral problems, participants in the Parent-Scored group and the Staff-Scored group had better parent–pediatrician communication scores than those in the control group. Conclusions Both the Staff-Scored and Parent-Scored administrations of the PSC improved parent–pediatrician communication on psychosocial issues. The Parent-Scored PSC removed the scoring burden on the medical personnel.

Brief Report: Adherence to Fluid Recommendations in Children Receiving Treatment for Retentive Encopresis

Kuhl, E. S., Felt, B. T., Patton, S. R. — Thu, 05 Nov 2009 05:48:21 PST

Objective Limited data are available regarding whether children being treated for retentive encopresis are adherent to recommendations to increase their daily fluid intake. The purpose of this study was to examine fluid adherence in children who received treatment for retentive encopresis. Methods A retrospective chart review was performed using diet diary data for 26 children (ages 3–12) who completed a group behavioral intervention for retentive encopresis. Results Mean daily intake of clear fluid increased significantly during treatment and children relied primarily on water and juice to make this dietary change. However, adherence rates to clear fluid goals were <50%. Conclusions Children's increased clear fluid intake did not equate to high fluid adherence. Children's high juice consumption is concerning as it could place them at risk for other negative health consequences. Future research should examine whether enhanced fluid education and use of behavior change strategies yield higher fluid adherence.

Brief Report: Psychosocial Factors and Pediatric Noncardiac Chest Pain

Thu, 05 Nov 2009 05:48:21 PST

Objective To investigate the associations between children's perceived chest pain severity, somatization symptoms, depressive symptoms, anxiety sensitivity, and maternal somatization symptoms in children and adolescents with noncardiac chest pain (NCCP). Methods Measures of chest pain and psychosocial functioning were collected from 35 participants (M age = 12.5 years, 54% female) with NCCP and their parents during evaluation at cardiology clinics. Results Among children presenting for cardiac evaluations, wide variation in ranges of pain severity, episode frequency, and history were observed. Children's somatic symptoms and fear of physiological arousal predicted significant variance in children's chest pain severity. Additionally, children's depressive symptoms and maternal somatization were both significant predictors of children's somatic symptoms. Conclusions These results suggest NCCP may be part of a broader pattern of somatic responding and sensitivity to physiological arousal. This pattern is associated with both child and maternal functioning. Suggestions for future research are provided.

Relationships Among Sleepiness, Sleep Time, and Psychological Functioning in Adolescents

Thu, 05 Nov 2009 05:48:21 PST

Objective This study examined associations among adolescent sleepiness, sleep duration, variability in sleep duration, and psychological functioning (symptoms of anxiety, depression, externalizing behaviors, and perceived health). Methods This was a cross-sectional analysis of data from a community-based cohort study of sleep and health. Participants were 247 adolescents (48.6% female, 54.3% ethnic minority, mean age of 13.7 years). Sleep duration and variability in sleep duration were measured by actigraphy and sleepiness was measured by adolescent questionnaire. Primary outcomes were measured by parent, teacher, and adolescent questionnaires. Results Sleepiness was associated with higher scores on measures of anxiety (Adjusted partial r² = .28, p < .001), depression (Adjusted partial r² = .23, p < .001), and perceived health (indicating more negative outcomes) (Adjusted partial r² = .19, p < .01). Significant associations between sleep duration or variability in sleep duration with psychological variables were not found. Conclusions Findings highlight the inter-relationships between sleepiness and psychological functioning and the potential importance of addressing sleepiness in health and psychological evaluations of adolescents.

Putting Research in Context: Understanding Confidence Intervals from One or More Studies

Finch, S., Cumming, G. — Tue, 15 Sep 2009 06:10:30 PDT

Objectives To support wider use and higher quality interpretation of confidence intervals (CIs) in psychology. Methods We discuss the meaning and interpretation of CIs in single studies, and illustrate the value of CIs when reviewing and integrating research findings across studies. We demonstrate how to find CIs from summary statistics and published data in some simple situations. Results We provide the ESCI graphical software, which runs under Microsoft Excel, to assist with calculating and plotting CIs. (www.latrobe.edu.au/psy/esci) Conclusions The wider use of CIs in psychology should support quality research communication and integrated interpretation of findings in context.

How to Select, Calculate, and Interpret Effect Sizes

Durlak, J. A. — Tue, 15 Sep 2009 06:10:30 PDT

The objective of this article is to offer guidelines regarding the selection, calculation, and interpretation of effect sizes (ESs). To accomplish this goal, ESs are first defined and their important contribution to research is emphasized. Then different types of ESs commonly used in group and correlational studies are discussed. Several useful resources are provided for distinguishing among different types of effects and what modifications might be required in their calculation depending on a study's purpose and methods. This article should assist producers and consumers of research in understanding the role, importance, and meaning of ESs in research reports.

Exercise Effects on Depressive Symptoms and Self-Worth in Overweight Children: A Randomized Controlled Trial

Petty, K. H., Davis, C. L., Tkacz, J., Young-Hyman, D., Waller, J. L. — Tue, 15 Sep 2009 06:10:30 PDT

Objective To test the dose–response effects of an exercise program on depressive symptoms and self-worth in children. Method Overweight, sedentary children (N = 207, 7–11 years, 58% male, 59% Black) were randomly assigned to low or high dose (20 or 40 min/day) aerobic exercise programs (13 ± 1.6 weeks), or control group. Children completed the Reynolds Child Depression Scale and Self-Perception Profile for Children at baseline and posttest. Results A dose–response benefit of exercise was detected for depressive symptoms. A race x group interaction showed only White children's global self-worth (GSW) improved. There was some evidence that increased self-worth mediated the effect on depressive symptoms. Conclusions This study shows dose–response benefits of exercise on depressive symptoms and self-worth in children. However, Blacks did not show increased GSW in response to the intervention. Results provide some support for mediation of the effect of exercise on depressive symptoms via self-worth.

ADHD and Anger Contexts: Electronic Diary Mood Reports from Mothers and Children

Tue, 15 Sep 2009 06:10:30 PDT

Objective Using electronic diaries (eDiaries), this study examined temporal links between child and maternal anger, as well as positive mood and perceived stress, in children with attention–deficit/hyperactivity disorder (ADHD) versus comparison peers. Methods Across 7 days, half-hourly eDiaries were completed independently by mothers and their 8–12-year-old children (51 receiving medication for ADHD and 58 comparison peers). Results Cross-informant analyses revealed systematic patterns of negative maternal moods in relation to child anger in both groups along with evidence of slower recovery in the ADHD group. Analogously, for both groups, children's anger reports increased and good-mood reports decreased in relation to maternal anger, whereas elevated stress in relation to maternal anger was restricted to children with ADHD. Conclusions The findings indicate that a negative affective climate is more likely to persist in ADHD than in comparison families. They also affirm the utility of child as well as parent eDiary reports and suggest that children may be willing to report low positive mood when reluctant to report negative mood. The promise of incorporating real-time data on mood patterning into tailored treatments for children with ADHD and their families is discussed.

Health-Related Hindrance of Personal Goal Pursuit and Well-Being of Young Adults with Cystic Fibrosis, Pediatric Cancer Survivors, and Peers without a History of Chronic Illness

Schwartz, L. A, Drotar, D. — Tue, 15 Sep 2009 06:10:30 PDT

Objective Study examined content of personal goals, health-related hindrance (HRH; i.e., impact of health on goals), and relationship of HRH to health status and psychological well-being in young adults with cystic fibrosis (CF; n = 48), who survived childhood cancer (n = 57), and without history of chronic illness (n = 105). Methods Participants completed measures of life events, quality of life, psychological well-being, and goals. Results No group differences were found on goal content. HRH significantly related to subjective well-being and distress after controlling for demographics, negative life events, physical health-related quality of life, disease status, and self-efficacy. HRH related to health status variables. Cancer survivors without cancer late effects had significantly less HRH than the other groups. Conclusions Health status may affect pursuit of personal goals and relate to well-being of young adults. The assessment of HRH has potential clinical utility for targeting interventions and warrants further research.

Development and Initial Validation of a Pictorial Quality of Life Measure for Young Children with Asthma

Everhart, R. S, Fiese, B. H — Tue, 15 Sep 2009 06:10:30 PDT

Objective To develop and assess the psychometric properties of a pictorial version of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). Methods A pictorial PAQLQ was administered to 101 children with mild to severe asthma between 5 and 7 years of age. A subgroup of 48 children followed longitudinally completed the established version of the PAQLQ. Results A confirmatory factor analysis with modifications supported the factor structure of the established PAQLQ. The pictorial measure exhibited internal consistency reliability and convergent, discriminant, and predictive validity. Conclusions Results suggest that the pictorial version of the PAQLQ has an underlying factor structure that is similar to that of the established PAQLQ. Future research with larger and diverse samples is needed to confirm the factor structure of the pictorial PAQLQ.

Generic and Diabetes-specific Parent-Child Behaviors and Quality of Life Among Youth with Type 1 Diabetes

Tue, 15 Sep 2009 06:10:30 PDT

Objective To evaluate associations among parent–child behaviors and generic and diabetes-specific health-related quality of life (HRQOL) in a multi-site sample of youth with type 1 diabetes. Method One hundred and twenty-one youth and their primary caregivers completed measures of parent–child behaviors, child HRQOL, and participated in an observed family interaction task. Results Diabetes-specific parent–child variables were associated significantly with both generic and diabetes-specific HRQOL above and beyond the contributions of demographic and generic parent-child variables, accounting for between 13% and 31% of the variance in HRQOL. Diabetes-specific family conflict and negative diabetes-specific family communication were associated with lower HRQOL. Collaborative parent involvement in diabetes care was associated with higher levels of HRQOL. Conclusions Interventions that target diabetes-specific family interactions will be beneficial to the quality of life of children with type 1 diabetes.

Assessment of Somatic Symptoms in British Secondary School Children Using the Children's Somatization Inventory (CSI)

Tue, 15 Sep 2009 06:10:30 PDT

Objective To present normative and psychometric data on somatic symptoms using the Children's Somatization Inventory (CSI) in a nonclinical sample of British young people, and to assess associations with stress and functional impairment. Methods A total of 1,173 students (11- to 16-years old) completed the CSI and self-report psychopathology measures. Results The median CSI total score was 12 (5, 23). Headaches, feeling low in energy, sore muscles, faintness, and nausea were most frequent. Girls scored higher than boys, and respondents aged 13–14 years lower than younger children. The CSI showed good internal consistency and exploratory factor analysis yielded three factors: pain/weakness, gastrointestinal, and pseudoneurological. A quarter of respondents reported somatic symptoms were made worse by stress. CSI scores were moderately significantly correlated with impairment and emotional symptoms. Conclusions The CSI, complemented by information on functional impairment and stress is an appropriate measure of recent somatic symptoms and somatization risk in young people for use in the UK.

Validity and Reliability of an Adolescent and Parent Rating Scale of Type 1 Diabetes Adherence Behaviors: The Self-Care Inventory (SCI)

Tue, 15 Sep 2009 06:10:31 PDT

Objective Accurate assessment of diabetes regimen adherence behaviors in youth is a challenging endeavor and is limited by a paucity of empirically supported measures. The purpose of this research is to further demonstrate the validity and reliability of the Self-Care Inventory (SCI), a youth and parent report measure of adherence with diabetes self-care behaviors. The SCI was chosen given its ease of implementation, applicability to multiple diabetes regimens, and dual parent/youth formats. Methods Participants were 164 youth with type 1 diabetes and a parent. Measures were administered at regular office visits to a tertiary care diabetes clinic. Results The SCI has strong psychometric properties, including adequate internal consistency, parent–youth agreement, and test-retest agreement. Relations between the SCI and a structured interview of diabetes adherence (the Diabetes Self-Management Profile; DSMP) and hemoglobin A1c (HbA1c) were strong. Conclusions In addition to demonstrating strong psychometrics, this research provides independent support for the SCI. Thus, the SCI is consistent with recent criteria proposed by Quittner et al. (Journal of Pediatric Psychology, 33, 916–936) for an empirically supported measure of regimen adherence. Although other methods of accessing adherence may provide more comprehensive assessments, the brevity, ease-of-implementation, and robustness for multiple regimens makes the SCI an ideal tool for clinicians and researchers.

The Role of Parental Monitoring in Metabolic Control: Effect on Adherence and Externalizing Behaviors During Adolescence

Horton, D., Berg, C. A., Butner, J., Wiebe, D. J. — Tue, 15 Sep 2009 06:10:31 PDT

Objective We examined the role of parental monitoring (general and diabetes specific) on metabolic control through better adherence and lower externalizing behaviors for adolescents with type 1 diabetes. Methods Adolescents aged 10–14 (n = 252) completed assessments of general and diabetes-specific mothers’ and fathers’ monitoring, adherence, and the Youth Self Report (YSR). Glycosylated hemoglobin (HbA1c) indexed diabetes control. Results Path analyses revealed that perceived mothers’ general monitoring was indirectly associated with lower HbA1c through lower externalizing behaviors and higher adherence. Perceived fathers’ general monitoring was associated with HbA1c differently at the extremes: low fathers’ monitoring was associated with higher HbA1c through higher externalizing behaviors; high fathers’ monitoring was associated with HbA1c through higher adherence. Diabetes-specific monitoring was not associated with externalizing behaviors. Conclusion Perceived mothers’ and fathers’ general parental monitoring facilitates metabolic control through a similar process, with parental differences largely seen at the extremes.

Brief Report: Nature and Implications of Personal Projects Among Adolescents With and Without Diabetes

Helgeson, V. S, Takeda, A. — Tue, 15 Sep 2009 06:10:31 PDT

Objective We examined the relation of adolescent goals to psychological well-being and diabetes health. Method We used personal project analysis to elicit the goals that adolescents with (n = 110) and without type 1 diabetes (n = 117) have. Adolescents evaluated several project dimensions (progress, stress, typicality, happiness, extent desired by others). Psychological well-being and diabetes health were assessed. Results Adolescents with and without diabetes described similar projects, with academic projects being most frequently named. Adolescents with diabetes were more likely to identify appearance projects, and healthy adolescents were more likely to identify self-improvement projects. Among the project dimensions, project progress was associated with better psychological and diabetes health, and project stress was associated with poorer psychological and diabetes health. Conclusion Results suggest that aspects of the general goals that adolescents set for themselves may have implications for their psychological well-being as well as how they care for their diabetes.

Brief Report: Hope, Perceived Maternal Empathy, Medical Regimen Adherence, and Glycemic Control in Adolescents with Type 1 Diabetes

Lloyd, S. M., Cantell, M., Pacaud, D., Crawford, S., Dewey, D. — Tue, 15 Sep 2009 06:10:31 PDT

Objective The relationships among hope, perceived maternal empathy, medical regimen adherence, and glycemic control in adolescents with type 1 diabetes were examined. Method Twenty-nine girls and 21 boys with type 1 diabetes completed measures of hope, perceived maternal empathy, and medical regimen adherence. Each participant's most recent hemoglobin A1c, a measure of glycemic control, was obtained from the diabetes clinic database. Results Significant correlations were found among hope, perceived maternal empathy, and medical regimen adherence. Significant correlations were also found among hope, perceived maternal empathy, and glycemic control. Adolescents’ perceptions of maternal empathy were positively correlated with level of hope. Hope appeared to mediate the relationship between perceived maternal empathy and adherence, as well as between perceived maternal empathy and glycemic control. Conclusions The results of this study affirm the need for longitudinal research that examines the associations among hope, perceived maternal empathy, medical regimen adherence, and glycemic control.

Exploring Psychophysiological Markers of Vulnerability to Somatic Illnesses in Females

Hipwell, A. E, Keenan, K., Marsland, A. — Tue, 15 Sep 2009 06:10:31 PDT

Objective To examine the association between biological stress regulation and somatic complaints in young girls prior to the onset of clear psychopathology such as somatization disorder. Methods Salivary cortisol, heart rate variability (HRV), and negative mood were assessed in 48 12-year-old girls in response to the Trier Social Stress Test for Children (TSST-C). Parent and child report on the Children's Somatization Inventory was used to identify girls with high and low somatic complaints. Results Girls with high levels of somatic complaints had significantly higher initial levels of cortisol, which decreased over time, and showed a trend for a more limited HRV in response to the TSST-C than girls with low levels of somatic complaints. Conclusions High levels of cortisol and possibly low HRV among girls with somatic complaints may interfere with flexibility in responding to typical psychosocial stressors, which may increase vulnerability to the onset of somatic illnesses in females.

Editorial: Case Studies and Series: A Call for Action and Invitation for Submissions

Drotar, D. — Thu, 20 Aug 2009 08:55:34 PDT

Conducting a Randomized Clinical Trial of an Psychological Intervention for Parents/Caregivers of Children with Cancer Shortly after Diagnosis

Thu, 20 Aug 2009 08:55:34 PDT

Objective To report acceptability, feasibility, and outcome data from a randomized clinical trial (RCT) of a brief intervention for caregivers of children newly diagnosed with cancer. Method Eighty-one families were randomly assigned following collection of baseline data to Intervention or Treatment as Usual (TAU). Recruitment and retention rates and progression through the protocol were tracked. Measures of state anxiety and posttraumatic stress symptoms served as outcomes. Results Difficulties enrolling participants included a high percentage of newly diagnosed families failing to meet inclusion criteria (40%) and an unexpectedly low participation rate (23%). However, movement through the protocol was generally completed in a timely manner and those completing the intervention provided positive feedback. Outcome data showed no significant differences between the arms of the RCT. Conclusions There are many challenges inherent in conducting a RCT shortly after cancer diagnosis. Consideration of alternative research designs and optimal timing for interventions are essential next steps.

Brief Report: Problem Solving and Maternal Distress at the Time of a Child's Diagnosis of Cancer in Two-Parent Versus Lone-Parent Households

Thu, 20 Aug 2009 08:55:34 PDT

Objective To examine negative affectivity and problem-solving abilities for lone mothers and those who are married/partnered subsequent to a child's diagnosis with cancer. Methods Negative affectivity and problem-solving strategies were assessed for 464 mothers (87 lone and 377 married/partnered) within 2–16 weeks of their child's diagnosis with cancer. Results The two groups of mothers did not differ significantly on measures of perceived posttraumatic stress or problem-solving; lone mothers reported significantly more symptoms of depression. This difference was no longer significant when maternal education was taken into account. Conclusions Negative affectivity and problem-solving abilities were similar for lone mothers and those that are married/partnered shortly after their child has been diagnosed with cancer. Findings are discussed within the context of contemporary strategies to assess marital status as proxy variable for various underlying constructs.

Brief Report: Body Dissatisfaction, Weight Criticism, and Self-Reported Physical Activity in Preadolescent Children

Jensen, C. D., Steele, R. G. — Thu, 20 Aug 2009 08:55:34 PDT

Objective To examine the associations among physical activity, weight criticism during physical activity, and body dissatisfaction in a sample of pre-adolescent children. Methods A community sample of 376 fifth- and sixth-grade students (M age = 10.8, SD = 0.65) completed measures of physical activity, weight criticism during physical activity, and body dissatisfaction. Results Girls who reported experiencing high levels of weight criticism and high body dissatisfaction engaged in significantly fewer vigorous activities than girls who experienced criticism in the absence of body dissatisfaction. These results were not evident among boys. Conclusions These findings highlight the importance of body dissatisfaction in girls' propensity to engage in physical activity, and lend preliminary support to obesity prevention efforts that address body dissatisfaction and weight criticism among girls.

Trajectories and Predictors of the Development of Very Young Boys with Fragile X Syndrome

Thu, 20 Aug 2009 08:55:34 PDT

Objective To describe the development of young boys with fragile X syndrome (FXS). Methods Fifty-five boys (aged 8–48 months at study entry) with the full mutation FXS received multiple developmental assessments. Results As expected, the boys’ rate of development was significantly lower than chronological age expectations. No evidence of slowing in the rate of development was found. Autistic behavior was negatively associated with development, but maternal IQ was not. Developmental delays were evident in some domains as early as 9 months; however, initial detection of delays is complicated by measures and criteria used. Developmental age scores at 31 months of age were related to scores obtained at 61 months of age only in the global composite and visual reception domain. Conclusions Developmental delays are evident in some infants with FXS as young as 9 months of age. Pediatric psychologists need to be informed about the developmental profiles in young children with FXS to accurately diagnose, treat, and support these children and their families.

A Transactional Model of Sleep-Wake Regulation in Infants Born Preterm or Low Birthweight

Schwichtenberg, A.J. M., Poehlmann, J. — Thu, 20 Aug 2009 08:55:34 PDT

Objective To test a transactional model of sleep–wake development in infants born preterm or low birthweight (PT LBW), which may inform clinical practice, interventions, and future research in this at risk population. Methods One hundred and twenty-eight mother–infant dyads participated from hospital discharge to 4 months postterm. Assessments of prematurity, infant sleep–wake patterns, maternal interaction quality, depression, feeding route, and sociodemographic factors were conducted. Results Path analyses revealed that maternal interactions directly related to infant sleep patterns and family sociodemographic risks related to less optimal parenting. In addition, bottle fed infants experienced fewer night wakings and more nighttime sleep. Conclusions Two potential pathways to sleep patterns in PT LBW infants were identified. The findings suggest directions for clinical work, such as supporting healthy infant sleep through parenting interventions or supporting interpersonal relations between parents and their PT LBW infants by encouraging more daytime naps. Additionally, clinicians should assess parents’ nighttime sleep concerns within the larger sociodemographic and feeding context.

Psychometric Properties of the Chinese Version of the Swanson, Nolan, and Pelham, Version IV Scale-Teacher Form

Thu, 20 Aug 2009 08:55:34 PDT

Objectives To examine the psychometric properties of the Chinese version of Swanson, Nolan and Pelham IV Scale (SNAP-IV)-Teacher Form. Methods The sample included a representative sample of 3,653 first to eighth graders (boys, 52.3%) and 190 children diagnosed with ADHD (aged 6–15). Teachers completed the Chinese versions of the SNAP-IV, and Strengths and Difficulties Questionnaire. Results The confirmatory factor analysis revealed a four-factor structure (inattention, hyperactivity, impulsivity, and opposition) with an adequate fit (Comparative Fit Index = 0.990; root mean square error of approximation = 0.058). The test–retest reliability (intraclass correlations = 0.60–0.84), internal consistency ( = .88–.95), and concurrent validity (Pearson correlations = 0.61–0.84) were satisfactory. Children with both ADHD and oppositional defiant/conduct disorders had the highest scores, followed by children with ADHD only who had intermediate scores and then school-based participants who had the lowest scores. Conclusions Our findings suggest that the Chinese SNAP-IV-Teacher Form is a reliable and valid instrument for rating ADHD and oppositional symptoms (ClinicalTrials.gov number, NCT00491361).

Brief Report: Factors Associated with Asthma Management Self-Efficacy Among 7th and 8th Grade Students

Ayala, G. X., Yeatts, K., Carpenter, D. M. — Thu, 20 Aug 2009 08:55:34 PDT

Objective Examine correlates of asthma self-management among 12,154 adolescents with physician-diagnosed asthma. Methods All 7th and 8th grade students in North Carolina completed a survey to assess asthma prevalence and self-management behaviors among those with asthma. Results Adolescents who were allowed to carry their inhaled medication at school, shown how to use a peak flow meter, and had access to more asthma care resources were more confident that they could prevent an asthma exacerbation. Adolescents who were allowed to carry their inhaled medication at school and who had a private doctor were more confident that they could control their symptoms. Adolescents taking anti-inflammatory medicine were less confident that they could prevent an exacerbation and control their symptoms. Conclusions Various indicators of autonomy and control were associated with greater self-efficacy for managing asthma. Adolescents who require anti-inflammatory medicines would benefit from additional intervention efforts to improve their asthma management self-efficacy.

Collaborative Involvement of Primary and Secondary Caregivers: Associations with Youths' Diabetes Outcomes

Thu, 20 Aug 2009 08:55:34 PDT

Objective Collaboration between youths with type 1 diabetes (T1D) and their adult caregivers may be central to effective management of T1D. This article includes analysis of cross-sectional associations between T1D outcomes (adherence, glycemic control, quality of life, family conflict, depression, and self-efficacy) and scores on the Collaborative Parent Involvement (CPI) Scale obtained from 309 youths with T1D about their primary and secondary caregivers. Methods MANCOVA, controlling for age, evaluated associations of diabetes outcomes with youths’ CPI scores for each caregiver. Results Diabetes outcomes were poor when both caregivers obtained CPI scores below the median. Diabetes outcomes were more strongly associated with CPI scores of primary, rather than secondary, caregivers. CPI scores at or above the median among primary caregivers were associated with more favorable status on multiple youth outcomes. When both caregivers obtained CPI scores at or above the median, children had significantly lower HbA1C and parents retained more responsibility for diabetes care. Conclusions Higher collaborative involvement, particularly among primary caregivers, was associated with favorable status along a variety of diabetes outcomes. Longitudinal studies could confirm if youth–parent collaboration is a justifiable intervention target.

School Functioning in Adolescents With Chronic Pain: The Role of Depressive Symptoms in School Impairment

Logan, D. E., Simons, L. E., Kaczynski, K. J. — Thu, 20 Aug 2009 08:55:34 PDT

Objective To explore associations between depressive symptoms and school functioning, including school attendance, academic performance, self-perceived academic competence, and teacher-rated school adjustment among predominantly Caucasian and female adolescent chronic pain patients. Methods A total of 217 clinically referred adolescents (aged 12–17 years) and their parents completed measures of pain characteristics, depression, and school functioning. Additional data were collected from school records and teacher reports. Results Depressive symptoms strongly correlated with school functioning indicators. In linear regression analyses, higher levels of depressive symptoms predicted more school impairment. A model testing whether depressive symptoms mediated the association between current pain intensity and parent perceptions of the interference of pain on school functioning was supported by the data. Conclusions Depressive symptoms play a key role in influencing the extent of school impairment in adolescents with chronic pain. Interventions to alleviate depressive symptoms may enhance treatments designed to improve school functioning in this population.

Adherence to Treatment in Adolescents with Cystic Fibrosis: The Role of Illness Perceptions and Treatment Beliefs

Bucks, R. S., Hawkins, K., Skinner, T. C., Horn, S., Seddon, P., Horne, R. — Thu, 20 Aug 2009 08:55:34 PDT

Objectives This study was conducted to explore the relationships between illness perceptions, emotional representations, treatment beliefs and reported adherence in adolescents with cystic fibrosis (CF). Methods Thirty-eight adolescents completed questionnaires assessing their perceptions of CF, beliefs about prescribed treatments and reported adherence to chest physiotherapy, enzyme supplements, and antibiotics. Results Reported non-adherence to chest physiotherapy was associated with the way in which patients judged their personal need for treatment relative to their concerns about potential adverse effects. Patients reported strong doubts about the necessity of chest physiotherapy. Reported non-adherence to antibiotics was related to doubts about the necessity of antibiotics, believing that CF is not amenable to treatment control. Despite these beliefs about treatment, participants perceived CF as a chronic condition. Conclusions The findings provide preliminary support for the self-regulatory model, using the necessity-concerns framework to operationalize treatment beliefs, in explaining adherence to treatment in adolescents with CF.