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iDEA: DREXEL LIBRARIES E-REPOSITORY AND ARCHIVES

iDEA: DREXEL LIBRARIES E-REPOSITORY AND ARCHIVES

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Illness parameters and stress processing variables in the psychological adjustment of three chronic illness groups

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Title
Illness parameters and stress processing variables in the psychological adjustment of three chronic illness groups
Author(s)
Lash, Laurie Ann Irene
Advisor(s)
Barakat, Lamia
Keywords
Clinical psychology; Chronic diseases in children--Psychological aspects; Diabetes in children--Psychological aspects; Diabetes in children--Psychological aspects; Sickle cell anemia in children--Psychological aspects; Asthma in children--Psychological aspects
Date
2005-08
Publisher
Drexel University
Thesis
Ph.D., Clinical Psychology -- Drexel University, 2005
Abstract
Objectives: The intent of the present study was to extend the literature on risk and resistance models (Thompson et al., 1995; Wallander & Varni, 1992) by examining the relationships among illness conditions (using constructs of Rolland’s (1987) Psychosocial Typology model), stress processing factors (appraisals, coping), and quality of life in adolescents with Insulin Dependent Diabetes Mellitus (IDDM), Sickle Cell Disease (SCD), and Asthma. It was hypothesized that illness groups would differ on DCF subscales, appraisals, and passive coping; that illness type would moderate the relationship between appraisals and passive coping; and that coping strategies would mediate the association of appraisals with adjustment.Method: Participants consisted of 87 adolescents, 12-18 years old, diagnosed with IDDM (N=30), SCD (N=28), or Asthma (N=29) and their primary caregiver. Participants were recruited from outpatient clinics at St. Christopher’s Hospital for Children and completed the study either in clinic or during a home visit. Adolescents completed the DCF, Children’s Attributional Style Questionnaire, the Children’s Hope Scale, the KIDCOPE, and the Miami Pediatric Quality of Life Questionnaire. Primary caregivers completed a general information form, the DCF, and the Miami Pediatric Quality of Life Questionnaire.Results: Findings suggest that disease characteristics (i.e. onset, course, outcome, and incapacitation) are more important than the disease itself and have a role in perceived disease severity, appraisals, coping, and quality of life (QOL). Illness groups were found to engage in similar levels of appraisals and coping; however, they engage in more negative attributions than healthy peers. Illness type was not a moderating variable in the relationship between appraisals and passive coping. In addition active coping did not mediate the association between positive appraisals and QOL. Internal attributions for positive events and hope were directly associated with QOL. Disease severity differed by informant as well as by illness group and was associated with QOL. Disease specific appraisals differed by illness group and were associated with appraisals, coping, and QOL.Conclusions: The present study provides support for the use of the noncategorical approach (Stein & Jessop, 1982) and risk and resistance models (Thompson et al., 1995; Wallander & Varni, 1992) in adolescents with IDDM, SCD, and Asthma. Disease characteristics and disease severity seem to better mechanisms in understanding appraisals, coping, and quality of life in adolescents with chronic illness than the disease itself.
URI
http://hdl.handle.net/1860/1316
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