Journal of Pediatric Psychology最新文献

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.

Objective: Quality of life (QoL) has been found to be poorer among school-age children with overweight (OW) and obesity (OB) compared to their normal weight peers; however, research has yet to examine whether young children (i.e., <6 years old) with OW and OB also display poorer QoL. Therefore, this paper systematically reviewed the literature examining QoL among young children with OW or OB.

Methods: A systematic review using early childhood, pediatric, obesity, and QoL search terms was conducted in PubMed and PsycINFO in January 2024 and on January 29, 2025. A total of 1,340 articles were initially identified, with 13 studies meeting inclusion criteria (i.e., presented original research in English, participants were children with OW or OB <6 years old, included at least one measure of QoL, total participants across all studies, N = 79,581). A narrative review was used to synthesize results, and quality assessment ratings were conducted using previously developed scientific merit criteria.

Results: Most cross-sectional articles (n = 6) supported that young children with OW or OB displayed poorer QoL than normal weight peers. Poorer physical functioning among youth with OW and OB was consistent across studies. Intervention studies with lifestyle behavior components demonstrated success in improving physical functioning among youth with OW and OB.

Conclusions: QoL was found to be poorer for young children with OW or OB compared to their peers, and physical functioning was shown to improve in weight-management interventions, confirming the importance of screening QoL in this population.

Objective: To gather parents' perspectives on the experiences of siblings of young children with congenital heart disease (CHD), the impact of CHD on siblings, and the types of resources and supports they need to adjust to CHD within their family.

Methods: A community advisory council guided the study. Parents of children with CHD, currently 1-7 years old, who had surgery in their first year of life, were eligible for participation if they were fluent in written English and had internet access. Recruitment through several CHD-specific nonprofit organizations produced a national sample of parents (N = 108). Of the 73 who had non-bereaved heart-healthy children, 59 (81%) provided sibling-relevant data for this study. Most parents were non-Hispanic White (n = 54; 91.5%) mothers (n = 41; 69.5%; Mage = 36.10; SDage = 5.0) reporting on siblings older than the child with CHD (n = 44; 74.6%). Data were qualitative, collected through crowdsourcing, and coded to distill themes.

Results: Three themes emerged: (1) CHD directly affects siblings' psychosocial functioning and daily activities, (2) CHD alters roles and relationships within the family, with impacts to siblings, and (3) families seek and appreciate support for heart-healthy siblings from extended family and friends, the healthcare team, and the community, but resources are variable.

Conclusion: Parents described specific ways that CHD impacts their heart-healthy children, including their psychosocial functioning, role in the family, and support from the community. Findings highlight the need for family-centered care in CHD, including screening to identify siblings at risk for psychosocial difficulties and provision of appropriate supports to meet sibling and family needs.

Background: Caregiver-child relationships are closely related to early childhood development outcomes. This study explores the association between child sleep patterns and the caregiver-child relationship in rural China and the mediating role of caregiver depression.

Method: Drawing on a survey of 776 children aged 5-25 months and their primary caregivers, we used ordinary least squares regression to analyze whether children's sleep patterns are associated with the caregiver-child relationship. We conducted mediation analyses to explore how caregiver depression mediated the association between children's sleep patterns and the caregiver-child relationship, and whether the association differed between mother- and grandmother-caregiving households. In analyzing the caregiver-child relationship, we used two of the most widely examined descriptive axes: care and control, where care is measured by the degree of warmth between the caregiver and the child, and control is measured by invasiveness (as opposed to autonomy), which reflects the degree to which the caregiver perceives the child as intrusive or overly demanding.

Results: Results show that caregivers of children with more sleep difficulties perceived less warmth and more invasion in their relationship with the child. Maternal depressive symptoms mediated the relationship between children's sleep and caregiver-child interactions by predicting caregivers' perceived invasion.

Conclusion: The findings provide new evidence on the relationship between children's sleep patterns and caregiver-child relationships in rural areas. Efforts to improve child development in low-resource settings should attend to both caregiver depression and child sleep quality.

Objective: Type 1 diabetes (T1D) and life-threatening food allergies (FAs) are two diet-dependent chronic illnesses (DDCIs) that require rigorous self-management centered on strict dietary monitoring. Grounded in self-determination theory, this study aimed to investigate differences in motivation for healthy eating and well-being among adolescents coping with DDCI, compared to individuals without DDCI. Additionally, it explored the mediating role of general health practices in the relationship between motivation for healthy eating and well-being.

Methods: A total of N = 116 adolescents, aged 10-18 years (T1D: N = 36, M±SD age = 15.28 ± 1.85; FA: N = 39, M±SD age = 13.31 ± 2.40; no-DDCI: N = 41, M±SD = 14.71 ± 1.76), completed questionnaires assessing motivation for healthy eating, general health practices, and well-being.

Results: Internal motivation for healthy eating was positively associated with general health practices in all 3 groups. A moderated-mediation model revealed that among adolescents with DDCI, internal motivation for healthy eating was positively associated with psychological well-being. Internal motivation was also positively associated with physical well-being, but only among adolescents with FA. Conversely, only among adolescents with T1D, external motivation for healthy eating was negatively associated with psychological and physical well-being. Lack of motivation for healthy eating was negatively associated with general health practices among adolescents with T1D and individuals without DDCI.

Conclusions: Adolescents with DDCI face challenges in adhering to healthy eating recommendations and translating knowledge into action. Targeted interventions are necessary to enhance internal and autonomously driven motivation for dietary changes. Personalized nutrition programs for adolescents living with DDCI may effectively promote self-management and overall well-being in this population.

Objective: Adolescents with chronic health conditions (CCs) face unique developmental challenges that affect their psychological well-being. Benefit-finding and growth (BFG) may serve as a psychological resource for this population. However, longitudinal evidence on the hypothesized predictors of BFG and its impact on subjective well-being (SWB) remains scarce. This study explores the reciprocal associations between emotion-focused coping, BFG, and SWB in adolescents with CCs.

Methods: The sample included 498 adolescents (aged 12-21 years) with type 1 diabetes, juvenile idiopathic arthritis, or cystic fibrosis receiving care in Germany. Using latent cross-lagged panel models, we analyzed the directionality of the relationships between coping strategies (acceptance, cognitive reappraisal, seeking social support), BFG, and SWB (satisfaction with life, positive well-being) over 1 year. Sociodemographic and disease-related variables were controlled.

Results: Seeking social support at T1 was significantly associated with higher levels of BFG at T2, whereas no significant prospective associations were observed for T1 acceptance and reappraisal. An inverse cross-lagged association was found between BFG at T1 and reappraisal at T2. Furthermore, BFG at T1 was significantly associated with higher satisfaction with life at T2.

Conclusions: This study provides the first longitudinal evidence of bidirectional relationships between emotion-focused coping and BFG, as well as BFG and SWB in adolescents with CCs. The findings highlight the crucial role of seeking social support in promoting BFG, which enhances adaptive emotion regulation and satisfaction with life. Future interventions should target social resources and cognitive coping strategies to improve psychological well-being in this population.

Clinical trial registration: German Clinical Trials Register (DRKS), no. DRKS00025125. Registered on May 17, 2021.