Journal of Pediatric Psychology最新文献

Objective: Although sleep disturbances are common and impairing side effects of treatment for pediatric acute lymphoblastic leukemia (ALL), no research has studied whether prevention programs are effective. The current study assessed feasibility and acceptability of a brief sleep health education program during maintenance chemotherapy for ALL.

Methods: Twenty-five caregivers of children with ALL aged 4-8 years old (M = 5.6 years, SD = 1.3) receiving maintenance chemotherapy enrolled. An oncology nurse navigator (ONN) met individually with caregivers (15-30 min) to introduce them to a psychoeducational website on sleep during ALL treatment and a sleep action plan. Questionnaires were collected at baseline and 1-month follow-up. Medical records were reviewed for the 3 months prior to and following the ONN meeting for appointments documenting sleep discussions.

Results: The program was feasible (of 27 caregivers approached, 25 [93%] enrolled; of 25 enrolled, 22 [88%] completed the follow-up assessment), and the majority of caregivers (77%) rated the intervention as acceptable. Approximately 40% of children experienced clinically meaningful improvements in sleep disturbance or impairment from baseline to follow-up. The average proportion of physician appointments per patient with documented sleep discussions was lower at follow-up (34%) than at baseline (41%), although this was not statistically significant (p = .17).

Conclusions: A brief sleep health education program is feasible and acceptable during maintenance therapy for pediatric ALL. Providing families with comprehensive information on sleep during ALL treatment may improve child sleep and reduce the need to discuss sleep with oncologists. Findings support evaluation of Sleep ALL Night in a statistically powered, randomized trial.

Objective: Increasing numbers of caregivers in the United States face challenges caring for children with special health care needs. Research has identified unique challenges for caregivers, including limited resources and mental health issues. Caregiver burden involves various strains from the ongoing care of a loved one. This scoping review explored the emotional, financial, physical, and social dimensions of burden among caregivers of children with multiple conditions. It also examined study characteristics, measurement tools, and associations among constructs.

Method: A scoping review followed PRISMA-ScR guidelines using PubMed and PsycINFO for literature searches focused on caregiver burden and experiences.

Results: Eighteen studies met inclusion criteria with three categories emerging: studies on children with medical complexity (n = 3), varied pediatric conditions (n = 7), and specific conditions (n = 8). Significant associations between caregiver burden and the number of co-occurring conditions were noted overall, as well as differences in burden for caregivers of children with and without co-occurring conditions.

Conclusions: This review discusses the general findings, strengths, and limitations of the existing body of research. Future research should aim for more diverse samples and assess caregiver burden longitudinally. Pediatric psychologists should work to assess and reduce caregiver burden in families, especially for caregivers whose children have multiple diagnoses.

Objective: Supporting pediatric psychologists who identify as women in overcoming barriers to scientific writing is critical for the career development and advancement of pediatric psychology science priorities of the Society of Pediatric Psychology 2022-2026 Strategic Plan. The purpose of this topical review is to introduce structured writing retreats as a promising strategy for supporting scientific writing among pediatric psychologists.

Methods: Recent literature was reviewed to identify barriers to scientific writing and the impacts of structured writing retreats.

Results: Service burdens, social inequities, and environmental factors impact scientific writing productivity. Structured writing retreats are multi-day, off-campus sessions that can address barriers to writing by providing the protected time and space, supportive peer environment, and behavior change strategies critical for writing. Recommendations for faculty, mentors, and institutions to support engagement in structured writing retreats are provided.

Conclusions: This topical review is a call for leaders in pediatric psychology to champion structured writing retreats as a strategic approach to overcoming writing barriers and increasing research productivity.

Objective: Up to 25% of youth may develop long COVID following COVID-19 infection. Mood changes are commonly reported; however, few studies use validated measures. This study describes prevalence of self-reported anxious and depressive symptoms among youth with long COVID. We also examined the association of these symptoms with prior mental health diagnosis and health-related quality of life.

Methods: We conducted a retrospective study of pediatric patients (n = 139) evaluated in a pediatric post-COVID-19 rehabilitation clinic who met criteria for long COVID. Patients were included if they completed the Pediatric Quality of Life Inventory (PedsQL), the Multidimensional Anxiety Scale for Children, second edition (MASC 2), and/or the Children's Depression Inventory, second edition (CDI 2). Relationships between prior anxiety or mood disorder and current depressive and anxious symptoms were assessed using chi-square tests. Relationships between depressive and anxious symptoms and health-related quality of life were examined using multiple linear regression.

Results: Almost 40% of patients had elevated scores for anxious or depressive symptoms. Prior anxiety or mood disorder diagnosis was associated with higher scores. Depression scores, and specifically the Ineffectiveness subscale, were inversely associated with PedsQL scores.

Conclusions: Prevalence of anxious and depressive symptoms in this clinical sample was high. Screening measures for mood and anxiety overlap with physical symptoms of long COVID and use of collateral information is recommended. The relationship between the Ineffectiveness subscale and the PedsQL warrants further investigation to evaluate if they assess the same domain or if negative perception of abilities contributes to health-related quality of life.

Objective: The aim of this study was to examine the direct and interactive effects of cognitive and family factors on psychosocial, academic, and adaptive functioning outcomes in youth with spina bifida (SB).

Methods: Participants included 41 families of youth with SB (ages 3-16 years old). Caregivers reported on child functioning (i.e., executive, psychosocial, and adaptive functioning), as well as family factors, such as family environment, marital adjustment, caregiver distress, and parenting stress. Youth completed performance-based assessments of vocabulary and academic functioning. Direct effects of cognitive and family factors on youth psychosocial, academic, and adaptive outcomes were examined using hierarchical multiple regression analyses, whereas interactive effects were examined using moderation models in PROCESS.

Results: Regression analyses revealed that both cognitive (i.e., executive dysfunction, vocabulary) and family (i.e., parenting stress) factors accounted for variability in youth outcomes. Interactive effects between cognitive and family factors were also revealed when predicting youth emotional and behavioral problems, as well as adaptive skills. Specifically, greater executive dysfunction was associated with greater emotional and behavioral problems in low and moderate, but not high, quality family environments. Additionally, analyses revealed that youth with higher levels of executive dysfunction generally demonstrated poorer adaptive skills, regardless of caregiver distress. However, those with low levels of executive dysfunction demonstrated poorer adaptive skills only in the presence of more caregiver distress.

Conclusions: Both cognitive and family factors may contribute to adjustment outcomes in children with SB. Findings highlight the importance of developing comprehensive family-based interventions in the context of SB.

Objective: The aim of this study was to investigate whether we could identify groups of adolescents with juvenile fibromyalgia (JFM) based on their subjective perception of non-painful multisensory stimuli in daily life and to study brain function differences between these groups.

Method: 43 female adolescents with JFM (16.56 ± 1.01 years) and 34 healthy controls (16.21 ± 0.89 years) completed validated measures of multisensory hypersensitivity and an fMRI multisensory task. We conducted average linkage cluster analyses, including measures of multisensory sensitivity, and tested between-group differences in core disease-related features, affect-related measures, and task-evoked brain activation in a priori defined regions of interest.

Results: We identified two clusters of participants. The first cluster included 22 patients with higher multisensory sensitivities, and the second one consisted of 21 patients and 34 healthy controls with lower multisensory sensitivities. A second cluster analysis, including only adolescents with JFM, confirmed the same patient division. The two patient subgroups were similar in affective symptoms and coping efficacy but differed in core symptoms of JFM. Adolescents with JFM who experienced higher sensory sensitivities showed increased brain activation in the left primary motor cortex and the left amygdala.

Conclusions: We found two clusters of adolescents with JFM with regard to their non-painful multisensory sensitivities. Greater multisensory hypersensitivity was associated with greater severity of core disease symptoms without compromising affective/cognitive regulation. It was also associated with increased activity of the primary motor cortex and amygdala in response to multisensory stimulation. The study highlights the potential of patient subtyping to understand contributing psychobiological mechanisms.

Objectives: Juvenile idiopathic arthritis (JIA) is a group of childhood-onset inflammatory rheumatic conditions characterized by pain as one of the most common and distressing symptoms. This cross-sectional study aimed to investigate whether relationships between reported pain and disease activity in JIA affected beliefs about pain, known as "personal models."

Methods: 187 out of a possible 363 participants with JIA who completed questionnaires about function and pain perception were recruited through the Childhood Arthritis Prospective Study (CAPS). A pre-selected pain score threshold and validated disease activity score cut-offs were used to assign the participants into four groups: low pain/low disease, low pain/high disease, high pain/low disease, and high pain/high disease. Multivariable linear regressions examined associations between the groups and their "personal models."

Results: Compared to participants with low pain/low disease, those with high pain/high disease and those with high pain/low disease were more likely to sense greater threat, have more negative emotional representations, and perceive less control over their pain. Participants with low pain/high disease had similar pain beliefs compared to those with low pain/low disease.

Conclusion: This is the first study to compare "personal models" of pain in JIA. Children and young people who experience high pain severity regardless of disease activity perceived high pain threat, low controllability, and negative emotional representations. This highlights the importance of considering and addressing personal models of pain at diagnosis, especially those who present high levels of pain.