John M. Chaney

The relationship of parental overprotection, perceived vulnerability, and parenting stress to behavioral, emotional, and social adjustment in children with cancer

To examine the relationship of self‐reported parental overprotection, perceived child vulnerability, and parenting stress to parent‐reported behavioral, emotional, and social adjustment of children currently on treatment for cancer.

The Relationship of Parental Overprotection and Perceived Child Vulnerability to Depressive Symptomotology in Children With Type 1 Diabetes Mellitus: The Moderating Influence of Parenting Stress

Our study examined the relationship between parental overprotection and perceived child vulnerability to self-reported depressive symptoms in 8- to 12-year-old children diagnosed with type 1 Diabetes Mellitus. The moderating influence of parenting stress was also examined. Mothers (N = 43) completed measures of parental overprotection, perceived child vulnerability, and parenting stress, and the children completed a measure of child depression. Findings revealed that both child vulnerability and parenting stress were associated with higher levels of depressive symptoms; no relationship was found between overprotection and child depressive symptoms. Regression results further indicated that parenting stress moderated the relationship between perceived child vulnerability and depressive symptomotology. Thus, parenting stress appears to magnify the relationship between perceived child vulnerability and child-reported depressive symptoms. Our findings lend additional empirical support for the transactional relationship between discrete parenting variables and child distress. These results also support the view that overprotection and child vulnerability are distinct but overlapping constructs. Interventions that target specific parenting approaches and general parenting stress may be effective in ameliorating child distress.

PSYCHOLOGICAL CONSULTATION WITH PRIMARY CARE PHYSICIANS : OBSTACLES AND OPPORTUNITIES IN THE MEDICAL SETTING

This article discusses the relationship between psychologists and primary care physicians and describes the training and practice of physicians in the areas of mental and behavioral health care. Issues affecting the relationship between psychologists and primary care physicians are then reviewed. Different models of psychological consultation are discussed, and an integrated behavioral systems model of psychological consultation is presented as a potentially effective model for consultation with primary care physicians. This model provides a framework for psychologists to function as coproviders of primary health care services. Practical strategies to enhance collaboration between psychologists and primary care physicians in private practice are discussed. The need for more research on primary care and for the inclusion of psychologists in managed care and health care reform are also highlighted. Primary practice and the role of the primary care physician will likely assume increasing importance as health care reform proceeds through the 1990s and into the 21 st century. Likewise, because psychologists have assumed fundamental research, clinical servke, and training roles in primary health care settings, it can be anticipated that these roles will become paramount in shaping the delivery of primary care services in the future. As evidence of the growing interest in this topic, the American Psychological Association (APA) recently sponsored

Measures of general pediatric quality of life: Child Health Questionnaire (CHQ), DISABKIDS Chronic Generic Measure (DCGM), KINDL‐R, Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales, and Quality of My Life Questionnaire (QoML)

Purpose. To measure health-related quality of life (HRQOL) in children and adolescents ages 5–18 years. This measure consists of child report (ages 10–18 years) and 2 versions of parent-proxy report (ages 5–18 years) of the child’s HRQOL. It can be used with healthy children and those with both acute and chronic health conditions. Content. Assesses for 14 physical and psychosocial domains: general health perceptions, physical functioning, role/social physical functioning, bodily pain, role/social emotional functioning, role/social behavioral functioning, parent impact-time, parent impact-emotional, self-esteem, mental health, behavior, family activities, family cohesion, and change in health. Number of items. The child-report questionnaire (CHQCF87) consists of 87 items. The long parent-report questionnaire (CHQ-PF50) consists of 50 items, and the short parent-report questionnaire (CHQ-PF28) consists of 28 items. Response options/scale. The response options for the CHQ are ordinal scales that vary by the item. Each item consists of 4–6 response options. Additionally, each scale consists of varying numbers of items. Recall period for items. Varies by subscale. Most scales have a recall period of 4 weeks. The change in health subscale has a recall period of 1 year, and the global health, general health perception, and family cohesion subscales ask about the child’s health “in general.” Endorsements. No information. Examples of use. Apaz MT, Saad-Magalhaes C, Pistorio A, Ravelli A, de Oliveira Sato J, Marcantoni MB, et al, for the Paediatric Rheumatology International Trials Organisation. Health-related quality of life of patients with juvenile dermatomyositis: results from the Paediatric Rheumatology International Trials Organisation multinational quality of life cohort study. Arthritis Rheum 2009; 61:509–17. Brunner HI, Higgins GC, Wiers K, Lapidus SK, Olson JC, Onel K, et al. Health-related quality of life and its relationship to patient disease course in childhoodonset systemic lupus erythematosus. J Rheumatol 2009;36: 1536–45 (1). Gutierrez-Suarez R, Pistorio A, Cespedes Cruz A, Norambuena X, Flato B, Rumba I, et al. Health-related quality of life of patients with juvenile idiopathic arthritis coming from 3 different geographic areas: the PRINTO multinational quality of life cohort study. Rheumatology (Oxford) 2007;46:314–20 (2). Oliveira S, Ravelli A, Pistorio A, Castell E, Malattia C, Prieur AM, et al, for the Pediatric Rheumatology International Trials Organization (PRINTO). Proxy-reported healthrelated quality of life of patients with juvenile idiopathic arthritis: the Pediatric Rheumatology International Trials Organization multinational quality of life cohort study. Arthritis Rheum 2007;57:35–43 (3). Ruperto N, Buratti S, Duarte-Salazar C, Pistorio A, Reiff A, Bernstein B, et al. Health-related quality of life in juvenile-onset systemic lupus erythematosus and its relationship to disease activity and damage. Arthritis Rheum 2004; 51:458–64. Selvaag AM, Flato B, Lien G, Sorskaar D, Vinje O, Forre O. Measuring health status in early juvenile idiopathic arthritis: determinants and responsiveness of the Child Health Questionnaire. J Rheumatol 2003;30:1602–10 (4). Takken T, Elst E, Spermon N, Helders PJ, Prakken AB, van der Net J. The physiological and physical determinants of functional ability measures in children with juvenile dermatomyositis. J Rheumatol 2002;42:591–5. Stephanie E. Hullmann, MS, Jamie L. Ryan, MS, Rachelle R. Ramsey, MS, John M. Chaney, PhD, and Larry L. Mullins, PhD: Oklahoma State University, Stillwater. Address correspondence to Stephanie E. Hullmann, MS, Oklahoma State University, 116 North Murray Hall, Stillwater, OK 74078. E-mail: stephanie.hullmann@okstate.edu. Submitted for publication January 23, 2011; accepted in revised form May 10, 2011. Arthritis Care & Research Vol. 63, No. S11, November 2011, pp S420–S430 DOI 10.1002/acr.20637

An Intervention to Decrease Uncertainty and Distress Among Parents of Children Newly Diagnosed With Diabetes: A Pilot Study

This pilot study reports findings from a randomized clinical trial of a novel intervention for parents of children newly diagnosed with Type 1 diabetes. The intervention was designed to decrease parental uncertainty and distress as well as child behavioral problems by teaching parents skills to manage uncertainty. Thirty-four families were randomly assigned to either an intervention (IG) or a treatment as usual (TAU) group. Parents completed measures of distress, uncertainty, and child behavior problems at baseline, 1 month, and 6 months postintervention. In the IG, significant reductions were observed for maternal and paternal distress as well as maternal ratings of child behavior problems. No changes were observed for the TAU, except for father-reported reductions in child internalizing symptoms at 1 month postintervention. Preliminary data suggest that, with further development and testing, the intervention has potential to be an effective tool to reduce paternal distress and possibly child behavior problems.

Anxiety and Depression in Older Adolescents With Long-Standing Asthma: The Role of Illness Uncertainty

This study examined the differential contribution of illness uncertainty to self-reported anxiety and depression in a sample of older adolescents with childhood-onset asthma. Fifty-six individuals completed measures of illness uncertainty, anxiety, and depression. In addition, objective assessments of illness severity were obtained via a semistructured interview and pulmonary function test. Results revealed that illness uncertainty contributed significant variance to anxiety after statistically controlling the effects of demographic and disease parameters and depressive symptomatology; illness uncertainty did not contribute significant variance to depression. Findings suggest that interventions should target illness uncertainty and psychosocial education, as well as early identification and treatment of anxiety in this understudied population.

The Influence of Respite Care on Psychological Distress in Parents of Children With Developmental Disabilities: A Longitudinal Study

In this study, we longitudinally examined the influence of a brief (3-7 day) respite care admission on psychological distress and parenting stress in parents of children admitted to a center for developmental disabilities. A comparison group of parents of children who were admitted for short-term (30-day) inpatient treatment was utilized. Parents (N = 80) completed the Brief Symptom Inventory (Derogatis, 1993a) and the Parenting Stress Index (Abidin, 1990) at time of admission, discharge, and at 6-month follow-up. Therapists completed measures of functional ability at admission and discharge. Analyses indicate that psychological distress was significantly lower at discharge and 6-month follow-up for both groups. Parenting stress was significantly lower at discharge, but at 6-month follow-up had returned to admission levels. Notably, both groups demonstrated improved functional ability from admission to discharge despite the respite care group receiving little formal therapy over a much shorter stay in the...

The Relationship Between Single-Parent Status and Parenting Capacities in Mothers of Youth with Chronic Health Conditions: The Mediating Role of Income

OBJECTIVE To retrospectively examine the relationship of single-parent status to parenting capacity variables in mothers of youth with a chronic health condition. METHODS Parental overprotection, perceived vulnerability, and parenting stress were assessed in 383 mothers (308 married and 75 single parents) of youth with one of six chronic health conditions (i.e., type 1 diabetes, asthma, cancer, cystic fibrosis, hemophilia, or sickle cell disease). RESULTS Single mothers evidenced higher levels of both perceived vulnerability and parenting stress, but not overprotection, than married parents. These differences disappeared in the presence of income as a predictor. CONCLUSIONS Single parents appear to evidence differences in parenting capacity; however, low income appears to account in large part for the higher level of risk associated with single-parent status.

Illness uncertainty, perceived control, and psychological distress among adolescents with type 1 diabetes.

This study examined the relationship between illness uncertainty, perceived control, and psychological distress among adolescents with type 1 diabetes. Sixty-eight adolescents age 13 to 18 years with type 1 diabetes completed the Children’s Uncertainty in Illness Scale, the Perceived Control Scale Media Relations, and the Brief Symptom Inventory. Increased uncertainty was significantly associated with both decreased perceived control and increased psychological distress. Further analyses indicated that the relationship between illness uncertainty and psychological distress was direct and was not mediated or moderated by perceived control. These findings suggest that interventions aimed at managing uncertainty may help decrease psychological distress among adolescents with diabetes.

The Relationship of Illness Uncertainty, Illness Intrusiveness, and Asthma Severity to Depression in Young Adults with Long-Standing Asthma

This study examined the potential mediating/moderating influence of both illness intrusiveness and asthma severity on the association between illness uncertainty and depression in a college sample of older adolescents and young adults (N = 40) with histories of childhood asthma. There was a significant association between increased illness uncertainty and increased levels of depression. However, analyses indicated that neither illness intrusiveness nor asthma severity served as mediators in the uncertainty–depression relationship. Examination of moderator effects of intrusiveness and severity on the uncertainty–depression relationship revealed an interaction for severity only; thus, the significant effect of uncertainty on depression was at its maximim under conditions of increased illness severity. Results suggest that cognitive appraisal mechanisms involving decreasing ambiguity about illness may be worthwhile targets for intervention.