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Perceptions of self and short stature: effects of two years of growth hormone treatment
T J Boulton1, S M Dunn, C A Quigley
1University of Newcastle, Australia.
Insights
Growth hormone (GH) therapy improved children's perception of short stature over two years. Younger children showed the greatest positive changes in attitude towards their height.
Area of Science:
- Pediatrics
- Endocrinology
- Psychology
Background:
- Short stature affects children's perception and emotional adjustment.
- Growth hormone (GH) therapy is used for children with short stature.
- Understanding the psychological impact of GH therapy is crucial.
Purpose of the Study:
- To evaluate changes in children's perception of short stature during GH therapy.
- To assess the psychological effects of GH treatment over two years.
Main Methods:
- A cohort study of 66 children (5-15 years) with short stature without GH deficiency.
- Children received authentic recombinant GH for two years in a multicenter trial.
- Attitude to Growth (ATG) scale and Piers Harris Childrens Self Concept Scale were used for assessment.
Main Results:
- Mean ATG scores significantly increased from 34.2 to 37.2 over two years of GH therapy.
- Younger children experienced a greater improvement in ATG scores (p < 0.05).
- Piers Harris scores were within the normal range and correlated positively with ATG scores.
Conclusions:
- GH treatment positively impacts children's attitudes towards short stature.
- The beneficial effects are particularly notable in younger children.
- GH therapy may improve self-concept and reduce emotional preoccupation with height.
Abstract:
A cohort study was carried out to determine whether childrens' perception of the problem of short stature changed over 2 years of growth hormone (GH) therapy. A total of 66 children (age range, 5-15 years; mean 10.2 years) were selected on the basis of height below the 3rd centile for chronological age, height velocity below the 25th centile for bone age, prepubertal status, and absence of any organic condition causing growth failure or likely to interfere with GH action. The children were taking part in a 2-year multicentre trial to assess the effect of authentic recombinant GH on short, slowly growing children without GH deficiency (GHD). The childrens' and parents' attitudes and emotional adjustment to shortness were assessed before GH therapy commenced, and at 6 months and 2 years, using a growth-specific psychological instrument, the Attitude to Growth scale (ATG). The children were also assessed using the Piers Harris Childrens Self Concept Scale at 2 years. The mean ATG scores increased from 34.2 (95% confidence interval, 33.2-35.2) at intake to 37.2 (95% confidence interval, 36.2-38.2) at 2 years. Younger subjects had a greater increase (p less than 0.05). No sex differences occurred. Two separate factors were identified in the childrens' attitudes: emotional preoccupation with stature and a concrete focus on practical aspects. No differences were present between childrens' and parents' mean scores, though parents' estimates differed on selected items. The mean Piers Harris score at 2 years was within the normal range, and was positively correlated to the ATG but was unrelated to height. It is concluded that GH treatment may have a beneficial effect on childrens' attitudes to being short, particularly in the younger child.(ABSTRACT TRUNCATED AT 250 WORDS)