Purpose: Adolescents and young adults (AYA) with a chronic medical condition (CMC) who are pursuing higher education must also learn to independently manage their own healthcare (i.e., transition readiness). Additionally, levels of maturity, have been previously linked to positive outcomes in AYAs (i.e., life satisfaction). Previous research has also established a positive relationship between transition readiness and quality of life. In this manner, it may be that transition readiness is a mediator of maturity and quality of life. Thus, the current study aimed to examine a mediation model of perceived maturity transition readiness mental and physical quality of life. Design and methods: College students (N = 153) with a chronic medical condition completed self-report questionnaires.Results: The perceived maturity → transition readiness → mental quality of life indirect path was significant (a b = 1.96, 95% CI = 0.53 to 3.62). The perceived maturity → transition readiness → physical quality of life direct and indirect paths were not significant.Conclusions: First, our results showed a strong, positive association between maturity and transition readiness, supporting the notion that these two constructs are related. Additionally, transition readiness appears to be one potential mechanism by which maturity results in enhanced quality of life in AYAs with a CMC.Practice Implications: Our findings highlight that the value of enhancing strengths such as maturity to promote AYA independence/autonomy. Future research should continue to explore promotive factors that could bolster AYAs’ skills in transitioning to adult care and ultimately improve their quality of life.
Abstract Objective Individuals with asthma experience increased depressive symptoms, which is associated with deleterious health outcomes. No studies have examined depressive symptom trajectories among individuals with asthma despite increased risk. This study expanded prior literature by identifying the following: (1) depressive symptoms trajectories for individuals with and without asthma and (2) predictors of baseline levels and changes in symptoms across time for individuals with asthma. Methods Adolescents with (N = 965) and without (N = 7,392) asthma self-reported on depressive symptoms (CESD-9) across development. Covariates included: demographics and persistence of asthma. Latent growth curve modeling (LGCM) was used to identify depressive symptom trajectories and their predictors. Results A multigroup LCGM identified no significant differences between depressive symptom trajectories of individuals with and without asthma. Depressive symptoms followed a quadratic shape across time for individuals with asthma (Mintercept = 5.73, p < .00; Mlinear = −0.38,p < .001; Mquad = 0.03, p < .001), with a linear deceleration in depressive symptoms during adolescence and an acceleration of symptoms into adulthood. Next predictors of depressive trajectories among individuals with asthma were examined. Female sex (B = 0.58, p < .001), lower parent education (B = −0.57, p < .001), older age (B = 0.19, p < .001), and identifying as Black (B = 0.31, p = .04) were associated with greater baseline depressive symptoms. Older individuals exhibited faster linear symptom decelerations (B = −0.56, p < .001) and faster symptom accelerations (B = 0.73, p < .001). American Indian (AIAN) individuals exhibited faster linear symptom decelerations (B = −1.98, p = .005) and faster quadratic accelerations (B = 3.33, p = .007). Discussion Our results suggest that the depressive symptom trajectories of individuals with asthma are curvilinear and similar to individuals without asthma. When examining predictors of depressive symptom trajectories for those with asthma, socioeconomic disadvantage and racial marginalization were associated with greater baseline depressive symptoms. Although AIAN youth demonstrated more favorable trajectories in adolescence, they also exhibited worse trajectories across young adulthood and adulthood. Findings suggest the need to better understand the impact of multilevel risk and protective factors on depressive symptoms trajectories for individuals with asthma, especially marginalized populations.
Somatoform disorders have a long history as an entity of focus for both psychologists and physicians. Psychologists in medical settings are often called upon to diagnose and treat conversion reactions, psychogenic pain disorders, somatization disorders, and various other physical symptoms that have a psychological component. In the pediatric psychology literature and clinical practice, family factors are often ignored or not emphasized in the conceptualization and treatment of somatoform disorders. This current position paper overviews the familial context in the etiology and maintenance of these disorders. Both social learning and family systems approaches are emphasized, and a synthesis of these perspectives is offered. A retrospective analysis of referrals to an inpatient consultation/liaison service provides initial evidence to support a continued focus on social learning and familial factors. Case study examples are provided to exemplify such etiological and maintenance factors in somatoform disorders in children.
Posttraumatic growth (PTG), a positive change in values and major life goals experienced as a result of the struggle with a highly challenging life circumstance, has been shown to be related to the construct of hope, the belief that goals can be met. To date, no studies have examined the relationship between PTG and hope in parents of children with cancer. Participants were parents (N = 85) of children and adolescents (ages 2-18 years, M = 7.72 years) receiving treatment for cancer. Parents completed a demographic questionnaire, the Posttraumatic Growth Inventory (PTGI), and Hope Scale (HS). Hope was found to be related to PTG in parents of children with cancer, with higher levels of hope associated with greater PTG. Exploratory analyses on the subscales of the PTGI revealed that hope was also related to higher scores on the Relating to Others, New Possibilities, Personal Strength, and Appreciation of Life subscales. Spiritual change was not related to hope in parents.
We evaluated demographic, financial and support predictors of distress for parents of young children with disorders of sex development including atypical genital development, and characterized early parental experiences. This work extends our previous findings to identify those parents at risk for distress.Participants included mothers (76) and fathers (63) of a child (78) diagnosed with disorders of sex development characterized by moderate to severe genital atypia. Parents completed a demographic questionnaire, measures of anxious and depressive symptoms, quality of life, illness uncertainty and posttraumatic stress symptoms, and rated their satisfaction with the appearance of their child's genitalia.Depressive and posttraumatic stress symptoms of caregivers were comparable to standardized norms while levels of anxious symptoms were below norms. A subset of parents reported clinically elevated symptoms. Overall 26% of parents reported anxious symptoms, 24% reported depressive symptoms and 17% reported posttraumatic stress symptoms. Levels of illness uncertainty were lower than those of parents of children with other chronic illnesses. Differences by parent sex emerged, with mothers reporting greater distress. Lower income, increased medical care and travel expenses, and having no other children were related to increased psychosocial distress.Early psychosocial screening is recommended for parents of children with disorders of sex development. Clinicians should be aware that financial burden and lack of previous parenting experience are risk factors for distress.
