Joseph P. Bush

Mother-child patterns of coping with anticipatory medical stress.

Maternal influences on childrens fear and coping behaviors during a medical examination were studied in a pediatric outpatient clinic using the Dyadic Prestressor Interaction Scale (DPIS) to measure anticipatory reactions just prior to contact with the physician. Analysis of 50 mother-child dyads, including children from 4 to 10 years of age, revealed that the behaviors emitted by mother and child are likely to influence the childs ability to tolerate the medical experience. Maternal use of distraction and low rates of ignoring were associated with lower child distress and increased prosocial behaviors. Childrens active exploration of the situation was more likely to occur when mothers provided their children with information, and was less likely when mothers reassured their children. Maternal reassurance of children and overt maternal agitation were associated with more maladaptive child responses. Age trends were also found in interactive patterns. Younger children were more likely to receive reassurance from mothers when they showed attachment. There was a stronger association between mothers information giving and childs exploring for children under 5 years, 9 months of age. Results supported the usefulness of the DPIS for investigation of child management techniques in this situation. Theoretical extension to attachment and stranger-approach situations was made. Suggestions for future studies to clarify the reciprocity of interactions or to determine causal direction between mother and child behaviors, as well as to evaluate the specificity or generality of these findings, were provided.

Predicting Jealous Responses: The Influence of Adult Attachment and Depression on Threat Appraisal

This study tested a model of romantic jealousy based on cognitive motivational theory (White & Mullen, 1989) and formulations from adult attachment studies (Hazan & Shaver, 1987). A causal model was tested in which attachment, depression and situational threat were hypothesized to predict jealous responses through their effects on appraisal of threat. Imagery scenes, depicting varying levels of threat by a romantic relationship rival, were presented to 135 undergraduates. The model fit the data very well. Threat appraisal was predicted by attachment, depression and level of situational threat. Appraisal, in turn, predicted positive and negative relationship perceptions and emotions reported in response to jealousy-evoking situations. Results were interpreted as suggesting that attachment style and depression indirectly influence affective and cognitive responses to jealousy-evoking situations by functioning as schemas which influence the appraisal of a rival relationship. Insecure attachment and depression were also found to be related to less effective coping strategies. Findings regarding depression and ineffective coping suggested implications for the personal and relationship adjustment of persons with secure and insecure attachment.

Pain in children: A review of the literature from a developmental perspective

Abstract This article presents a review of the current psychological literature about pediatric pain. Prevalence and types of pain problems encountered in children are considered briefly, followed by a developmental perspective on the experience of pain in children, encompassing physical, cognitive, social and behavioral factors. A discussion of the clinical significance of pain in children includes its use in differential diagnosis and the impact of pain on a developing child. Recommendations are made for assessing pain and factors relevant to managing its effects in children. The review concludes with an overview of clinical techniques for management, and recommendations for future research.

An Introduction to Program and Research Initiatives of the STARBRIGHT Foundation

Media and technology-based interventions offer promise for helping children with chronic illness cope with physiological and psychosocial challenges of illness. Research evaluating the efficacy of such interventions is critical to their acceptance and implementation in clinical practice. This article provides an overview of 2 interventions developed by the STARBRIGHT(r) Foundation: STARBRIGHT World(tm), a private online network connecting children in hospitals in the United States and Canada, and STARBRIGHT Hospital Pals(tm), a program designed to ease the anxiety of preschool children undergoing radiation therapy treatment. Behavioral models for program design, as well foundations for research to assess program impact, are presented.

Distress in Pediatric Hematology-Oncology Patients Undergoing Intravenous Procedures: Evaluation of a CD-ROM Intervention

This study assessed the influence of a developmentally specific CD-ROM intervention on cognitive appraisals, fear, behavioral distress, and pain in pediatric hematology-oncology patients scheduled for intravenous (IV) procedures. Thirty children, 7 to 18 years of age, were randomly assigned either to a standard medical care group or a standard medical care plus CD-ROM intervention group. It was hypothesized that using the CD-ROM would decrease threat appraisals of the IV procedure, causing decreased fear of the IV, less behavioral distress, and less pain during the IV. It was also hypothesized that intervention-enhanced secondary appraisal would be seen in children in the CD-ROM intervention group and that they would cope more effectively with the IV procedure. Self-report and observational ratings were used to assess the following dependent variables: primary and secondary appraisal, fear, behavioral distress, and pain. Results indicated significant effects for the reduction of threat appraisals following CD-ROM intervention (p ??.05). Children in the CD-ROM intervention group used cognitive restructuring coping more effectively than did the control group (p ??.05). No significant effects were found for fear, behavioral distress, or pain.

New Directions in Research on STARBRIGHT Interventions

This special issue of Children’s Health Care focuses on a presentation of the preliminary database regarding interventions developed by the STARBRIGHT Foundation. The studies included in this issue help to establish baseline data for more definitive outcome evaluations, as well as to elucidate areas for future theoretical development regarding innovative approaches to facilitating optimal outcomes for children facing the challenges of hospitalization and chronic illness. Advances in medical management of childhood chronic illnesses have resulted in an increased focus on psychosocial factors mediating or otherwise impacting the course of, and adaptation to, hospitalization and illness. Recent emphasis within pediatric psychology has focused on the development of empirically validated treatment models for intervention in a number of childhood conditions. Furthermore, research has moved beyond the mere identification of adverse psychosocial outcomes for chronically ill children toward the development of complex, interactive, risk-resiliency models that include medical, temporal, developmental, and psychosocial factors. Efforts to help hospitalized children and children with chronic illnesses have moved beyond traditional service delivery to include program development, staff training, and policy formulation. Psychologists and other multidisciplinary health care providers also have become involved in the development of children’s media, including educational television programming; psychoeducational videotapes; and more recently, interactive psychoeducational software. During this CHILDREN’S HEALTH CARE, 31(1), 87–91 Copyright