Family environment of adolescents and coping in the hospital

The purpose of this study was to test the relationship between social environment and the activity of the HPA axis in adolescents. Ten elective admissions to Children's Hospital at Stanford were assessed by standard psychiatric interview. Five fulfilled criteria for a DSM-III diagnosis, five others did not. The groups were comparable in age, height, weight, SES, and number of previous hospitalizations. All subjects and their families completed the Family Environment Scale. All subjects had plasma cortisol concentrations determined on days 1, 3, and 5 of hospitalization and at the time of discharge. Samples were drawn under standardized conditions, after a brief interview during which potentially stressful events of the day were discussed. Results revealed that the five individuals with poor coping skills, as defined by the presence of a DSM-III diagnosis, had significantly higher peak concentrations of plasma cortisol, than the five psychiatrically normal subjects. Peak cortisol elevations occurred upon discharge from the hospital. Family environment in the two groups differed significantly on the dimensions of cohesion, conflict, control, and incongruence of perception of the environment among family members themselves. The findings support the hypothesis that social environmental characteristics are associated with psychiatric and physiological measures of coping.