Journal of Pediatric Psychology - current issue

Structural Equation Modeling in Pediatric Psychology: Overview and Review of Applications

Nelson, T. D., Aylward, B. S., Steele, R. G. — 2008-07-03

Objective To describe the use of structural equation modeling (SEM) in the Journal of Pediatric Psychology (JPP) and to discuss the usefulness of SEM applications in pediatric psychology research. Method The use of SEM in JPP between 1997 and 2006 was examined and compared to leading journals in clinical psychology, clinical child psychology, and child development. Results SEM techniques were used in <4% of the empirical articles appearing in JPP between 1997 and 2006. SEM was used less frequently in JPP than in other clinically relevant journals over the past 10 years. However, results indicated a recent increase in JPP studies employing SEM techniques. Conclusions SEM is an under-utilized class of techniques within pediatric psychology research, although investigations employing these methods are becoming more prevalent. Despite its infrequent use to date, SEM is a potentially useful tool for advancing pediatric psychology research with a number of advantages over traditional statistical methods.

Brief Report: Reporting Practices of Methodological Information in Four Journals of Pediatric and Child Psychology

Raad, J. M., Bellinger, S., McCormick, E., Roberts, M. C., Steele, R. G. — 2008-07-03

Objective To replicate Sifers, Puddy, Warren, and Roberts (2002) examining reporting rates of demographic, methodological, and ethical information in articles published during 1997, and to compare these rates to those found in articles published during 2005, in order to determine whether and how reporting practices of these variables have changed over time. Methods We examined reporting demographic, methodological, and ethical information in articles in four journals: Journal of Pediatric Psychology, Journal of Clinical Child and Adolescent Psychology, Journal of Abnormal Child Psychology, and Child Development. Reporting rates during 2005 were compared to articles published during 1997. Results These four journals improved on many of the 23 variables compared to Sifers et al. including increases in the reporting of ethnicity, attrition, child assent procedures, socioeconomic status, reliability, and reward/incentive offered to participants. Conclusions Improvements in descriptive information have implications for interpretation, replication, and generalizability of research findings.

Assessment of Parental Psychological Stress in Pediatric Cancer: A Review

2008-07-03

Objectives We present an overview of the literature between 1997 and 2007 on parental stress reactions following the diagnosis of childhood cancer and we evaluate methodological strengths and weaknesses of the studies. Methods PubMed, PsychInfo, and Cinahl databases were used. Sixty-seven were included in the review. Results The conceptualization of parental stress and timing of assessment varies considerably between the studies, which makes comparison difficult. Most emotional stress reactions are seen around the time of diagnosis, with mothers reporting more symptoms than fathers. As a group, parents seem relatively resilient, although a subset of parents reports continuing stress even up to 5 years or more postdiagnosis. Conclusions The authors recommend clear definitions of parental stress, fixed points in time to assess parental stress, and an approach that highlights both parental strengths and weaknesses. Improved assessment can contribute to tailoring psychological care to those parents most in need.

Outcome and Predictors of Functional Recovery 5 Years Following Pediatric Traumatic Brain Injury (TBI)

Catroppa, C., Anderson, V. A., Morse, S. A., Haritou, F., Rosenfeld, J. V. — 2008-07-03

Objectives The aim was to examine functional outcomes following traumatic brain injury (TBI) during early childhood, to investigate impairments up to 5 years postinjury and identify predictors of outcome. Methods The study compared three groups of children (mild = 11, moderate = 22, severe = 15), aged 2.0–6.11 years at injury, to a healthy control group (n = 17). Using a prospective, longitudinal design, adaptive abilities, behavior, and family functioning were investigated acutely, 6, 30 months and 5 years postinjury, with educational progress investigated at 30 months and 5 years postinjury. Results A strong association was suggested between injury severity and outcomes across all domains. Further, 5-year outcomes in adaptive and behavioral domains were best predicted by preinjury levels of child function, and educational performance by injury severity. Conclusion Children who sustain a severe TBI in early childhood are at greatest risk of long-term impairment in day-to-day skills in the long-term postinjury.

Glycemic Control in Youth with Type 1 Diabetes: Family Predictors and Mediators

2008-07-03

Objective This study examined predictive and mediated relationships among youth perception of critical parenting, Child Behavior Checklist Externalizing Subscale (CBCL) externalizing problem scores, adherence, and (hemoglobin A_1c HbA_1c), in youth with type 1 diabetes from low socioeconomic status families. Methods Caregiver/youth dyads (n = 120) completed diabetes specific measures of family functioning regarding diabetes management and structured adherence interviews. Parents completed the CBCL, while assays of youth HbA_1c were performed. Analyses were conducted using hierarchical linear regression. Results Combined measures predicted 44% of the variance in HbA_1c. Adherence partially mediated critical parenting and HbA_1c, while critical parenting and adherence mediated CBCL externalizing problem scores and HbA_1c. CBCL externalizing problem scores did not mediate critical parenting and HbA1_c. Conclusions The presence of youth perceptions of critical parenting and youth externalizing behavior problems may interfere with adherence, leading to increases in HbA_1c.

Psychosocial Functioning in Youth with Glycogen Storage Disease Type I

Storch, E., Keeley, M., Merlo, L., Jacob, M., Correia, C., Weinstein, D. — 2008-07-03

Objective To assess the quality of life and psychosocial functioning among pediatric patients with Glycogen Storage Disease (GSD) types Ia and Ib. Methods Thirty-one youth with GSD types Ia and Ib and 42 healthy controls participated. Quality of life ratings from the GSD types Ia and Ib sample were compared with a previously reported clinical comparison sample. Children completed measures of quality of life, loneliness, family functioning, and sibling relationship quality (e.g., warmth, conflict). Parents completed measures of parental distress, parenting stress, child adaptive behavior, and child emotional and behavioral functioning. Results Quality of life was generally lower in youth with GSD relative to healthy controls but similar to those with a chronic illness. Children with GSD were rated as having more internalizing symptoms, social problems, and lower independent functioning relative to healthy controls. Parents reported greater distress and parenting stress relative to healthy controls. Conclusions The presence of GSD types Ia and Ib are associated with reduced quality of life and independent functioning, and elevated levels of internalizing distress and parental stress relative to healthy peers. Relative to their children, parents generally reported that their child was more impaired, which suggests the need for multiple informants during assessment and active parental involvement during psychological treatment. These points should be kept in mind when assessing and treating youth with this disease and their families as psychological interventions that target areas of concern (e.g., adherence, coping with having a chronic disease) may be helpful for improving child and family outcomes.

Early Childhood Risk Factors Associated with Daytime Wetting and Soiling in School-age Children

Joinson, C., Heron, J., von Gontard, A., Butler, U., Golding, J., Emond, A. — 2008-07-03

Objective To examine the impact of a range of early childhood factors on the risk for daytime wetting and soiling. Methods This is a longitudinal study based on a UK population of over 10,000 children from age 4 to 9 years. Parents completed questionnaires on child development (at 18 months); child temperament (24 months); maternal depression/anxiety (21 months), and parenting behaviors (24 months). The analysis examined whether these risk factors distinguish between children with normal development of daytime bladder and bowel control and those with delayed acquisition of daytime continence; persistent daytime wetting/soiling, and relapse in wetting/soiling. Results Delayed development, difficult temperament, and maternal depression/anxiety were associated with an increase in the odds of experiencing problems with bladder and bowel control. Conclusions The current findings provide evidence that risk factors in early childhood are associated with a subsequent increase in the odds of children experiencing daytime wetting and soiling at school age.

Exposure to Cigarette Advertising and Adolescents' Intentions to Smoke: The Moderating Role of the Developing Self-Concept

Shadel, W. G., Tharp-Taylor, S., Fryer, C. S. — 2008-07-03

Objective Increased exposure to cigarette advertisements is associated with increases in adolescent smoking but the reasons for this association are not known. This study evaluated whether the developmental maturity of the self-concept, operationalized as self-conflict, moderated smoking intentions following exposure to cigarette advertisements among adolescents who have never smoked. Methods Eighty-seven adolescents (ages 11–17): (a) completed measures of self-conflict; (b) were exposed to 30 contemporary cigarette advertisements; and (c) rated their intentions to smoke following exposure to each ad. Results Younger adolescents with higher numbers of self-conflicts who also said that cigarette advertising was relevant to them had stronger smoking intentions compared to younger adolescents with lower numbers of self-conflicts after exposure to cigarette advertising. Self-conflict did not play as strong a role with older adolescents. Conclusions Younger adolescents (i.e., middle school aged) who are having the most difficulty figuring out "who they are" are most susceptible to the effects of cigarette advertising.

Lifestyle Factors, Body Mass Index, and Lipid Profile in Adolescents

2008-07-03

Objective and methods A model specifying body mass index (BMI) as mediating the relationship between lifestyle factors (aerobic fitness determined by peak oxygen consumption; physical activity by 7-day physical activity recall; diet by 24 hr dietary recall), and lipid profile were tested in a sample of 205 adolescents (73% boys), who were on average at risk of overweight, aerobically unfit, and from ethnic minority groups. Results In this well-fitting model, consuming a diet low in fat and cholesterol, and being aerobically fit predicted lower BMI, which together resulted in increases in high-density lipoprotein cholesterol and decreases in triglycerides and low-density lipoprotein cholesterol. Being physically active, predicted greater aerobic fitness. Conclusions In addition to furthering understanding of the interrelationships among predisposing, major, and conditional coronary heart disease risk factors in adolescents, these data suggest that improving diet and aerobic fitness will reduce BMI and result in a better lipid profile.

Associations Among the Perceived Parent-Child Relationship, Eating Behavior, and Body Weight in Preadolescents: Results from a Community-based Sample

Schuetzmann, M., Richter-Appelt, H., Schulte-Markwort, M., Schimmelmann, B. G. — 2008-07-03

Objective Data on associations between the parent–child relationship, eating behavior, and body weight in a community-based sample of preadolescent children are presented. The aim of our study was to replicate the finding from clinical samples that families of overweight children demonstrate adverse characteristics of the parent–child relationship. Methods A community-based sample of 373 fourth-grade students was given self-report questionnaires on the perceived parent–child relationship and on eating behavior, and each child's height and weight was measured. Results No meaningful associations between children's body weight and the parent–child relationship were apparent. Deviant eating behavior was strongly linked to an adverse parent–child relationship irrespective of children's body weight. Conclusions It is suggested that previous findings from clinical samples of overweight children cannot simply be generalized to the population of overweight children and that deviant eating behavior, not overweight itself, is linked to an adverse parent–child relationship in preadolescent children.

Child versus Parent Report of Parental Influences on Children's Weight-related Attitudes and Behaviors

Haines, J., Neumark-Sztainer, D., Hannan, P., Robinson-O'Brien, R. — 2008-07-03

Objective To compare parent and child report of parental weight-related behaviors and examine their respective associations with child's weight-related outcomes. Methods Seventy-three parent–child dyads completed self-administered surveys that assessed parent and child report of parental direct weight-related behaviors (comments to child about weight, encourage child to diet) and indirect behaviors (dieting, comments about own weight/appearance). Outcome variables included child's body dissatisfaction, weight concerns, and dieting. Results Considerable disagreement (21–30%) was found between parent and child report of parental weight-related behaviors. Both the parent and child report of direct parental behaviors were associated with child's outcomes. Child report of parental indirect behaviors was more consistently associated with child's outcomes than parent report. Conclusion Parent weight-related behaviors, both direct and indirect, are positively associated with child's weight-related attitudes and behaviors.

A Meta-analysis of Interventions to Increase Adherence to Medication Regimens for Pediatric Otitis Media and Streptococcal Pharyngitis

Wu, Y. P., Roberts, M. C. — 2008-07-03

Objective The current study quantitatively synthesized the adherence intervention literature for two common acute childhood illnesses and examined the magnitude of change in adherence as indicated by different outcome measures and the relationship between type of intervention and adherence outcome. Methods Meta-analysis was used to synthesize the results of 12 interventions to increase medication adherence in pediatric otitis media and streptococcal pharyngitis. Effect sizes were analyzed using homogeneity tests and an analog to the analysis of variance. Results Combination interventions were more effective than single strategy interventions. However, families receiving educational interventions alone did not demonstrate better adherence than control groups. Indirect measures of adherence showed more change in adherence than direct measures. Conclusions Further work is needed to develop effective interventions for improving adherence for the medication regimens required for short-term illness and for optimizing health outcomes.

Letter to the Editor: Single Parents of Children with Chronic Illness: An Understudied Phenomenon

Powell, P., Holmes, C. — 2008-07-03