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Preview: Journal of Pediatric Psychology - recent issues

Journal of Pediatric Psychology - recent issues



Journal of Pediatric Psychology - RSS feed of recent issues (covers the latest 3 issues, including the current issue)



 









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2016-10-12T23:21:57-07:00










Commentary: The Wright Ross Salk Award: Worker Bees and Benefits to the Hive: Service Contributions to the Profession and Society of Pediatric Psychology

2016-10-12T23:21:57-07:00

This article reflects on service contributions upon receiving the 2016 Society of Pediatric Psychology Wright Ross Salk Distinguished Service Award. As the title implies, worker bees make service contributions for the overall benefit of the hive and colony. So too, the scientific discipline, clinical profession, and the Society of Pediatric Psychology need the service contributions of multiple individuals to survive and thrive. Many people have made professional contributions to benefit the field and its organizational home; many more worker bees will volunteer in the future to fill important service roles and sustain the hive. The article discusses lessons learned about service.







Pioneers in Pediatric Psychology: Smashing Silos and Breaking Boundaries

2016-10-12T23:21:57-07:00

As part of the Pioneers in Pediatric Psychology series, this article provides a brief personal account of my career as a pediatric psychologist. Educational and professional experiences often involved confrontations with silos and boundaries set by traditions limiting understanding and impact on children’s healthy development. A pedigree in developmental psychology clashed with identity, guild, and loyalty dimensions of clinical psychology. A research emphasis challenged the emergent harmony of the scientist–practitioner models. The medical center and its silos collided with those of arts and sciences academia. Evolving as an applied developmental scientist specializing in pediatric psychology allowed for a gratifying and meaningful career with a range of scientific, pedagogical, and policy contributions. An abiding orientation toward human rights and social justice sustained progress and generativity.




Introduction to the Special Section: Psychology in Integrated Pediatric Primary Care

2016-10-12T23:21:57-07:00

Interest in providing integrated psychological and medical services in pediatric primary care is growing rapidly. Efforts to incorporate psychological services into primary care settings are leading to new models and innovative approaches to evaluation and treatment in a variety of settings. Presently, there is a need to expand the empirical base for such work and to critically evaluate what is being done. The introduction to this special section discusses some of the background for the development of integrated care, and provides some context for the articles that follow. These articles address issues related to screening in integrated pediatric primary care, the variety of services provided in the context of integrated primary care, and outline the competencies needed for providing high-quality care in such settings. Suggestions for future research directions are provided.




Screening for Mental Health Problems: Addressing the Base Rate Fallacy for a Sustainable Screening Program in Integrated Primary Care

2016-10-12T23:21:57-07:00

Objective The Affordable Care Act has stimulated interest in screening for psychological problems in primary care. Given the scale with which screening might occur, the implications of a problem known as the base rate fallacy need to be considered. Methods The concepts of sensitivity and specificity, positive and negative predictive value, and the base rate fallacy are discussed. The possibility that a screening program may not improve upon random selection is reviewed, as is the possibility that sequential screening might be useful. Results and Discussion Developing effective screening programs for pediatric mental health problems is highly desirable, and properly addressing the high rate of false positives may improve the likelihood that such programs can be sustained. Consideration needs to be given to the use of sequential screening, which has both advantages and disadvantages, depending upon the type of problem to be screened for and the availability of resources for follow-up evaluations.




Systematic Review: Classification Accuracy of Behavioral Screening Measures for Use in Integrated Primary Care Settings

2016-10-12T23:21:57-07:00

Objective To examine the classification accuracy of measures of overall psychopathology recommended for pediatric primary care screening. Method A systematic review identified relevant instruments described in the literature. Subsequent systematic reviews identified studies of sensitivity (SE) and specificity (SP) of each measure for various cutoffs and different criteria for disorder (e.g., caseness determined by structured interview, exceeding a cutoff score, referral for psychiatric evaluation). Results Measures include the Child Behavior Checklist (CBCL), Pediatric Symptom Checklist (PSC), Strengths and Difficulties Questionnaire (SDQ), Brief Infant-Toddler Social Emotional Assessment (BITSEA), and the Ages and Stages Questionnaire: Social-Emotional scale (ASQ:SE). For three measures (CBCL, PSC, and SDQ) studied extensively, achieving relatively high SE and SP values (≥ .70) simultaneously occurred in only 30–55% of the studies reviewed. There are relatively few studies of the ASQ:SE and BITSEA, or of relatively new measures. Discussion Documented utility of these measures as screening instruments is limited.




Topical Review: Mind Your Language--Translation Matters (A Narrative Review of Translation Challenges)

2016-10-12T23:21:57-07:00

Objective Translation of developmental-behavioral screening tools for use worldwide can be daunting. We summarize issues in translating these tools. Methods Instead of a theoretical framework of "equivalence" by Pena and International Test Commission guidelines, we decided upon a practical approach used by the American Association of Orthopedic Surgeons (AAOS). We derived vignettes from the Parents’ Evaluation of Developmental Status manual and published literature and mapped them to AAOS. Results We found that a systematic approach to planning and translating developmental-behavioral screeners is essential to ensure "equivalence" and encourage wide consultation with experts. Conclusion Our narrative highlights how translations can result in many challenges and needed revisions to achieve "equivalence" such that the items remain consistent, valid, and meaningful in the new language for use in different cultures. Information sharing across the community of researchers is encouraged. This narrative may be helpful to novice researchers.




The Scope of Behavioral Health Integration in a Pediatric Primary Care Setting

2016-10-12T23:21:57-07:00

Objective: The current study examines the scope of integrated behavioral health services provided by behavioral health clinicians in pediatric primary care. Methods: A cross-sectional electronic health record review was conducted to characterize integrated behavioral health services including consultation types, recommendations, and medical diagnoses. Services were provided over a 6-year period in an urban, residency-training clinic serving a primarily publicly insured population. Results: Of the 4,440 patients seen by behavioral health clinicians (BHCs), 2,829 (63.7%) were seen during well-child checks to address a wide array of presenting problems. The five consultation types "Healthy Steps (6%), pregnancy-related depression (17.7%), developmental (19.2%), mental health (53.2%), and psychopharmacology (5%)" were characterized by differences in demographics, presenting problems, recommendations, and medical diagnoses. Conclusions: Pediatric BHCs provide a wide range of services to pediatric populations in the context of integrated behavioral health programs. Implications for workforce capacity development, evaluation of outcomes and impact, and sustainability are discussed.




An Exploration of Behavioral Health Productivity and Billing Practices Within Pediatric Primary Care

2016-10-12T23:21:57-07:00

Objectives To provide descriptive information on behavioral health (BH) productivity and billing practices within a pediatric primary care setting. Methods This retrospective investigation reviewed 30 months of electronic medical records and financial data. Results The percent of BH provider time spent in direct patient care (productivity) was 35.28% overall, with a slightly higher quarterly average (M = 36.42%; SD = 6.46%). In the 646.75 hr BH providers spent in the primary care setting, $52,050.00 was charged for BH services delivered ($80.48 hourly average). Conclusions BH productivity and billing within pediatric primary care were suboptimal and likely multifactorially derived. To promote integrated primary care sustainability, the authors recommend three future aims: improve BH productivity, demonstrate the value-added contributions of BH services within primary care, and advocate for BH-supporting health care reform.




Topical Review: Building Competency: Professional Skills for Pediatric Psychologists in Integrated Primary Care Settings

2016-10-12T23:21:57-07:00

Objectives In the midst of large-scale changes across our nation’s health care system, including the Affordable Care Act and Patient-Centered Medical Home initiatives, integrated primary care models afford important opportunities for those in the field of pediatric psychology. Despite the extensive and growing attention, this subspecialty has received in recent years, a comprehensive set of core professional competencies has not been established. Methods A subset of an Integrated Primary Care Special Interest Group used two well-established sets of core competencies in integrated primary care and pediatric psychology as a basis to develop a set of integrated pediatric primary care-specific behavioral anchors. Conclusions The current manuscript describes these behavioral anchors and their development in the context of professional training as well as with regard to Triple Aim goals and securing psychology’s role in integrated pediatric primary care settings.




Commentary: Integrated Pediatric Primary Care: Moving From Why to How

2016-10-12T23:21:57-07:00

Whether to address behavioral health issues in pediatric primary care is no longer debated; instead, we are challenged to determine "how" and who can best deliver services in an effective and sustainable manner. This commentary explores how pediatric psychology can contribute to this discussion by developing and evaluating innovative clinical models (such as a hybrid Collaborative Care/Primary Care Behavioral Health model) and expanding workforce and teaching initiatives.













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2016-09-12T22:33:47-07:00







Parent Perceptions of Illness Uncertainty and Child Depressive Symptoms in Juvenile Rheumatic Diseases: Examining Caregiver Demand and Parent Distress as Mediators

2016-09-12T22:33:47-07:00

Objective Examine caregiver demand and general parent distress as mediators in the parent illness uncertainty—child depressive symptom association in youth with juvenile rheumatic diseases. Methods Children and adolescents completed the Child Depression Inventory; caregivers completed the Parent Perceptions of Uncertainty Scale, the Care for My Child with Rheumatic Disease Scale, and the Brief Symptom Inventory. The pediatric rheumatologist provided ratings of clinical disease status. Results Analyses revealed significant direct associations between illness uncertainty and caregiver demand, and between caregiver demand and both parent distress and child depressive symptoms. Results also revealed significant parent uncertainty -> caregiver demand -> parent distress and parent uncertainty -> caregiver demand -> child depressive symptom indirect paths. Conclusions Results highlight the role of illness appraisals in adjustment to juvenile rheumatic diseases, and provide preliminary evidence that parent appraisals of illness uncertainty impact parent distress and child depressive symptoms indirectly through increased perceptions of caregiver demand.




Neighborhood Stress, Depressive Symptoms, and Asthma Morbidity in Youth

2016-09-12T22:33:47-07:00

Objective Living in a dangerous and disadvantaged neighborhood is consistently linked with poor health outcomes; however, few studies have investigated psychosocial mechanisms of this relationship. We hypothesized that a specific facet of depression—anhedonia—would partially explain the relationship between stressful neighborhoods and poor health in youth with asthma. Method 156 youths provided reports on their depressive symptoms, daily asthma symptoms, and peak expiratory flow rate (PEFR). Caregivers provided reports on neighborhood characteristics. Results Youth residing in more at-risk neighborhoods experienced more symptoms of depression, greater asthma symptoms (both during the day and night), and marginally lower PEFR. Indirect effect analyses revealed that the relationship between neighborhood stress and youth asthma symptoms was partially explained by a key symptom of depression, anhedonia. Conclusions These findings suggest that the neighborhood-health link is partially explained by symptoms of depression tapping into difficulties experiencing pleasure and motivation.




Maternal Depressive Symptoms and Household Income in Relation to Sleep in Early Childhood

2016-09-12T22:33:47-07:00

Objective Sleep health is critical for children to adapt to evolving cognitive-socioemotional contexts. Given that sleep timing in early childhood is instituted under caregiver control, the family context likely has an influential role on children’s sleep. This study investigated links between maternal depressive symptoms and variability in children’s sleep, and whether household income moderated this relation. Method 90 children (Mage = 53 ± 9 months) wore actigraphs to objectively measure sleep for 4–16 days. Mothers reported income and depressive symptomatology. Results Higher maternal depressive symptoms were related to greater variability in 24-hr sleep duration. Income moderated this relation. Lower income, but not maternal depressive symptoms, was linked to greater variability in sleep onset time. Conclusions Findings demonstrate important relations between maternal depressive symptoms, income, and children’s sleep. Understanding distal and proximal family characteristics that may be related to children’s developing sleep schedules could help identify populations and strategies for promoting optimal sleep health.




Childhood Bedtime Problems Predict Adolescent Internalizing Symptoms Through Emotional Reactivity

2016-09-12T22:33:47-07:00

Objective Sleep problems are frequent in children and robustly predict internalizing symptoms in adolescence and adulthood. Longitudinal investigations have nonetheless used broad measures of childhood sleep problems, precluding understanding of the specific sleep problems that presage affective disturbances. Similarly, prospective examinations of mechanistic variables linking early sleep with subsequent internalizing symptoms are lacking. Method Childhood bedtime and nighttime waking problems were examined as independent predictors of adolescent internalizing symptoms within a community sample from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (N = 1,089). The mediational role of emotional reactivity in late childhood also was examined. Results Bedtime but not nighttime waking problems significantly predicted adolescent internalizing problems. This relationship was partially explained by child emotional reactivity. Conclusions Some childhood sleep problems may more reliably predict later internalizing symptoms than others. Temperamentally based emotional reactivity may potentiate affective risk associated with childhood sleep difficulties.




Daily Bidirectional Relationships Between Sleep and Mental Health Symptoms in Youth With Emotional and Behavioral Problems

2016-09-12T22:33:47-07:00

Objective The present study examined the daily, bidirectional relationships between sleep and mental health symptoms in youth presenting to mental health treatment. Methods Youth aged 6 to 11 (36% female, 44% European American) presenting to outpatient behavioral health treatment (N = 25) were recruited to participate in the study. Children and parents completed daily questionnaires regarding the child’s sleep, mood, and behavior for a 14-day period, while youth wore an actigraph watch to objectively measure sleep. Results Examining between- and within-person variance using multilevel models, results indicate that youth had poor sleep duration and quality and that sleep and mental health symptoms were highly related at the daily level. Between-person effects were found to be most important and significant bidirectional relationships exist. Conclusions Identifying and addressing sleep problems in the context of mental health treatment is important, as poor sleep is associated with increased symptomology and may contribute to worsened mental health.




An Evaluation of the Childrens Report of Sleep Patterns Using Confirmatory and Exploratory Factor Analytic Approaches

2016-09-12T22:33:47-07:00

Objective To explore the psychometric properties of the Children’s Report of Sleep Patterns (CRSP) in school-aged children by conducting a factor analysis of the Sleepiness Scale and the Sleep Disturbances Scales. Methods Participants included 155 children from two elementary schools (Mage = 9.82) who completed the self-report CRSP. A confirmatory factor analysis (CFA) was conducted using the originally hypothesized structure. A subsequent exploratory factor analysis (EFA) was conducted to determine an alternative factor structure. Results CFA revealed that the hypothesized factor structure was not supported. The EFA produced an alternative six-factor solution, which supports the conceptualization of three new scales, Restless Legs Report, Sleep Initiation, and Sleep Maintenance/Night Wakings. Conclusion The revised measure adds increased specificity with scales related to insomnia and restless leg symptoms. Researchers and clinicians interested in using the CRSP should continue to assess its validity by exploring the relationship between the measure and objective measures of sleep behavior.




Stressful Events in Early Childhood and Developmental Trajectories of Bedwetting at School Age

2016-09-12T22:33:47-07:00

Objective To examine whether early stressful events are associated with developmental trajectories of bedwetting. Methods This is a prospective cohort study comprising 8,761 participants from the Avon Longitudinal Study of Parents and Children. Stressful events were measured using a maternal questionnaire completed at 3 time points before their child was 4 years old. The association between stressful events and trajectories of bedwetting from 4 to 9 years was examined using multinomial regression. Results The association with stressful events was strongest for the frequent persistent bedwetting trajectory (wetting at least twice a week up to age 9). A 1 standard deviation increase in the stressful events score was associated with a 29% (13–47%) increase in the odds of experiencing frequent persistent bedwetting compared with normal attainment of nighttime bladder control. Conclusions Clinicians and parents should be aware that continence is a developmental outcome that is associated with high levels of stress in the family.




Trajectories of Health-Related Quality of Life Among Children With Newly Diagnosed Epilepsy

2016-09-12T22:33:47-07:00

Objective To identify two-year trajectories of health-related quality of life (HRQOL) among children with newly diagnosed epilepsy, and evaluate key predictors of HRQOL trajectories. Methods This study is part of a prospective study of adherence and HRQOL outcomes in children with epilepsy. Caregivers completed an HRQOL questionnaire at one month post diagnosis and every three months thereafter for two years. Chart review and additional questionnaires were used to collect medical variables and seizure outcomes. Results Participants included 120 children with epilepsy and their caregiver. Unique trajectories for overall HRQOL and PedsQL™ subscales were identified and were predominantly stable. A total side effects score emerged as a consistent predictor of all HRQOL domains. Other variables (i.e., socioeconomic status, seizures, internalizing and externalizing problems) uniquely predicted HRQOL domains. Conclusions Medical and psychosocial interventions should be implemented soon after treatment initiation to target modifiable factors (e.g., side effects, anxiety symptoms), which could improve HRQOL.




Adolescents Spirituality and Cystic Fibrosis Airway Clearance Treatment Adherence: Examining Mediators

2016-09-12T22:33:47-07:00

Objective Adolescent cystic fibrosis (CF) treatment adherence is a significant multidimensional issue. Using the Theory of Reasoned Action (TRA), this study examined the role of spiritual factors in adherence. Methods Forty-five 11–19-year-olds diagnosed with CF completed questionnaires concerning psychosocial, spiritual, and adherence-related constructs and Daily Phone Diaries to calculate treatment adherence. Exploratory Factor Analysis identified two spiritual factors used in subsequent analyses. The mediating roles of attitude toward the treatment’s value (utility), subjective behavioral norms (the product of perceived behavioral norms and one’s motivation to comply with them), self-efficacy for completing the treatments and treatment intentions in the relationship between spiritual factors and treatment adherence were tested with path analysis. Results Lower ‘spiritual struggle’ and greater ‘engaged spirituality’ predicted treatment attitude (utility) and subjective behavioral norms, which, together with self-efficacy, predicted treatment intentions. Finally, treatment intentions predicted airway clearance adherence. Conclusions Findings were consistent with the TRA. Engaged spirituality supports pro-adherence determinants and behavior. Spiritual struggle’s negative associations with outcomes warrant screening and intervention.




Adaptation of the State-Trait Inventory for Cognitive and Somatic Anxiety for Use in Children: A Preliminary Analysis

2016-09-12T22:33:47-07:00

Objective Anxiety has both state/trait and cognitive/somatic dimensions, and these distinctions may be particularly relevant for children with medical problems. This two-part study adapted the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) and confirmed its factor structure in a sample of children in a primary care clinic. Methods STICSA items were adapted for reading level and piloted in a small group of children. Next, 250 children (12.3 ± 2.7 years) completed the adapted version, the STICSA-C. Results Separate confirmatory factor analyses conducted on the State and Trait forms of the STICSA-C confirmed the two-factor structure of the original measure (i.e., cognitive and somatic anxiety) and suggested an improved parsimonious model. Conclusions Support was found for use of the STICSA-C as a reasonably good internally consistent measure for assessing cognitive and somatic anxiety in pediatric samples. Further investigation of its reliability and validity with replication in pediatric populations is warranted.










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2016-08-12T08:53:37-07:00










Targeting Health Behaviors to Reduce Health Care Costs in Pediatric Psychology: Descriptive Review and Recommendations

2016-08-12T08:53:37-07:00

Objective Recent efforts to enhance the quality of health care in the United States while reducing costs have resulted in an increased emphasis on cost containment and the introduction of new payment plans. The purpose of this review is to summarize the impact of pediatric health behavior change interventions on health care costs. Methods A review of PubMed, PsycINFO, and PEDE databases identified 15 articles describing the economic outcomes of pediatric health behavior change interventions. Data describing the intervention, health outcome, and economic outcome were extracted. Results All interventions targeting cigarette smoking (n = 3) or the prevention of a chronic medical condition (n = 5) were predicted to avert hundreds of dollars in health care costs per patient. Five of the seven interventions targeting self-management were associated with reductions in health care costs. Conclusions Pediatric health behavior change interventions may be a valuable component of efforts to improve population health while reducing health care costs.




The Cost-Effectiveness of Intensive Interdisciplinary Pediatric Chronic Pain Rehabilitation

2016-08-12T08:53:37-07:00

Objective Examine the cost-effectiveness of a 3-week interdisciplinary pediatric chronic pain rehabilitation program. Methods Self-reported health care utilization and parent missed work of youth with chronic pain (n = 127) at admission and 1-year follow-up were compared. Financials were calculated from program revenue and established national costs for health care and wages. Results Data indicate significant reductions in days hospitalized, physician office visits, physical/occupational therapy services, psychotherapy visits, and parental missed work. Estimated health care expenses were $61,988 in the year before admission and $14,189 in the year after admission (–$58,839). Estimated cost of missed work was $12,229 in the year prior and $1,189 in the year after (–$11,039). Conclusions Comparing estimated expenses before ($74,217) and after ($15,378) minus program costs ($31,720), yielded estimated savings of $27,119 per family in the year following admission. These findings extend the benefit of the program beyond clinical improvement, to outcomes important to both families and insurers.




Estimated Cost-Effectiveness of Intensive Interdisciplinary Behavioral Treatment for Increasing Oral Intake in Children With Feeding Difficulties

2016-08-12T08:53:37-07:00

Objective To examine the cost-effectiveness of intensive interdisciplinary behavioral treatment (IIBT) to address severe pediatric feeding difficulties and lead to the removal or prevention of gastrostomy tubes (G tubes) from the perspective of the insurance company. Methods Costs associated with G tubes and IIBT were compiled from the available literature and national databases. Costs were updated to price at the start of 2015 to allow data from different years to be analyzed on the same scale. Results One-way sensitivity and two-way threshold analyses demonstrated that IIBT may be a cost-effective treatment for prevention and removal of G tubes over 5 and 10 years. Discussion Data from this study can be used to justify cost of services for IIBT, and programs can use these data to discuss conservative savings of IIBT based on their treatment model and level of effectiveness.




Making the Business Case for Coverage of Family-Based Behavioral Group Interventions for Pediatric Obesity

2016-08-12T08:53:37-07:00

Background Pediatric obesity presents a significant burden. However, family-based behavioral group (FBBG) obesity interventions are largely uncovered by our health care system. The present study uses Return on Investment (ROI) and Internal Rate of Return (IRR) analyses to analyze the business side of FBBG interventions. Methods ROI and IRR were calculated to determine longitudinal cost-effectiveness of a FBBG intervention. Multiple simulations of cost savings are projected using three estimated trajectories of weight change and variations in assumptions. Results The baseline model of child savings gives an average IRR of 0.2% ± 0.08% and an average ROI of 20.8% ± 0.4%, which represents a break-even IRR and a positive ROI. More pessimistic simulations result in negative IRR values. Conclusions Under certain assumptions, FBBGs offer a break-even proposition. Results are limited by lack of data regarding several assumptions, and future research should evaluate changes in cost savings following changes in child and adult weight.




Financial Analysis of Behavioral Health Services in a Pediatric Endocrinology Clinic

2016-08-12T08:53:37-07:00

Objective This article addresses a current need in psychological practice by describing a financially feasible model that moves toward integrated care of behavioral health services in a pediatric endocrinology clinic. Methods Financial information (costs and revenue associated with behavioral health services) for the clinic, over an 18-month period (July 2012 to December 2013), was obtained through the hospital’s financial department. The clinic meets one half day per week. Results Over the 18-month period, the behavioral health services generated a net gain of $3661.45 in the favor of the clinic. We determined that the psychologist and clinical psychology residents needed to see a total of four patients per half-day clinic for the clinic to "break-even." Conclusions We describe one financially feasible way of integrating behavioral health services into a pediatric endocrinology clinic in the hope that this will be generalizable to other medical settings.




Quality of Life Changes and Health Care Charges Among Youth With Epilepsy

2016-08-12T08:53:37-07:00

Objective To examine differences in health care charges following a pediatric epilepsy diagnosis based on changes in health-related quality of life (HRQOL). Methods Billing records were obtained for 171 youth [M (SD) age = 8.9 (4.1) years] newly diagnosed with epilepsy. Differences in health care charges among HRQOL groups (stable low, declining, improving, or stable high as determined by PedsQL scores at diagnosis and 12 months after diagnosis) were examined. Results Patients with persistently low or declining HRQOL incurred higher total health care charges in the year following diagnosis (g = .49, g = .81) than patients with stable high HRQOL after controlling for epilepsy etiology, seizure occurrence, and insurance type. These relationships remained consistent after excluding health care charges for behavioral medicine or neuropsychology services (g = .49, g = .80). Conclusions Monitoring HRQOL over time may identify youth with epilepsy at particular risk for higher health care charges.




Commentary: Demon$trating (Our) Value

2016-08-12T08:53:37-07:00







Early Maternal Reflective Functioning and Infant Emotional Regulation in a Preterm Infant Sample at 6 Months Corrected Age

2016-08-12T08:53:37-07:00

Objective This study investigated the influence of maternal reflective functioning (RF) on 6-month-old infants’ emotional self-regulating abilities in preterm infant–mother dyads. Methods 25 preterm (gestational age 28–34.5 weeks) infants’ affect, gaze toward mother, and self-soothing behaviors (thumb-sucking and playing with clothing) were measured during the still-face procedure at 6 months corrected age. Maternal RF was measured at 7–15 days post-delivery using the Parent Development Interview. Results Infants with high RF mothers showed the most negative affect during the still-face episode (M = 21.33s, SE = 5.44), whereas infants with low RF mothers showed the most negative affect in the reunion episode (M = 18.14s, SE = 3.69). Infants with high RF mothers showed significantly more self-soothing behaviors when distressed (Ms > 14.5s) than infants with low RF mothers (Ms < 1s), p’s < .01. Conclusion Maternal RF was associated with infants’ self-regulating behavior, providing preliminary evidence for the regulatory role of maternal RF in preterm infants’ emotion regulation capacity.




Early Parental Adaptation, Prenatal Distress, and High-Risk Pregnancy

2016-08-12T08:53:37-07:00

Objectives To examine the examined the effects of high risk pregnancy and prenatal distress on parental postnatal adaptation. Methods A sample of 111 expecting parents, consisting of 32 high risk pregnancy (HRP) mothers and 21 spouses and 36 matched low risk pregnancy (LRP) mothers and 22 spouses completed reports of depression symptoms (BDI) and pregnancy related concerns prenatally. At three months postpartum, parent-infant direct observations and reports of parenting alliance (PAI), stress (PSI-SF), satisfaction and efficacy (PSOC) were gathered. Data was analyzed with GLM multivariate analyses and the actor-partner interdependence model. Results Parents’ prenatal BDI predicted postnatal parental stress. BDI and concerns predicted postnatal satisfaction, but only for mothers. Mother’s concerns predicted low maternal and high paternal parenting alliance. Partner effect was found so that high concerns predicted high reports of parenting alliance by spouse. Mean-group differences were found between HRP and LRP during parent-infant observations, so that HRP parents displayed lower sensitivity and reciprocity. Conclusions Prenatal distress, and to some degree high risk pregnancy, are risk factors that may interfere with the early formation of parent-infant relationship. Clinical implications of these findings are presented.




Examining Biopsychosocial Factors in Relation to Multiple Pain Features in Pediatric Sickle Cell Disease

2016-08-12T08:53:37-07:00

Objective To examine biopsychosocial variables in relation to multiple pain features in pediatric sickle cell disease (SCD). Methods 76 children with SCD (M = 14.05, SD = 3.26), ages 8–19 years, and 70 caregivers completed measures of coping, mood, and family functioning and reported on multiple pain features via retrospective interviews during routine hematological visits. Sickle cell genotype and health care utilization were collected via medical record review. Using hierarchical regression, biological (genotype), child psychological (coping and mood), and social factors (caregiver coping and family functioning) were evaluated in relation to multiple pain features. Results Genotype was associated with pain intensity, and child psychological factors were associated with pain frequency. Multiple biopsychosocial factors were related to health care utilization. Conclusions Biopsychosocial factors may have distinct relationships with pain features in pediatric SCD. Understanding these relationships may refine the biopsychosocial model and inform integrated medical and psychosocial approaches in SCD.