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Estimating rates of psychosocial problems in urban and poor children with sickle cell anemia
O A Barbarin1, C F Whitten, S M Bonds
1University Center for the Child and Family, School of Social Work, University of Michigan, Ann Arbor 48104-1690.
Insights
Children with sickle cell anemia (SCA) frequently experience adjustment problems, including emotional, social, and academic difficulties. These issues are linked to pain frequency, not family income, and affected by age and gender.
Area of Science:
- Pediatric Hematology
- Child Psychology
- Chronic Illness Management
Background:
- Serious childhood illnesses like sickle cell anemia (SCA) are associated with increased adjustment challenges.
- Understanding the scope of these problems in SCA is crucial for effective care.
Purpose of the Study:
- To estimate the frequency of adjustment problems in children and adolescents with SCA across social, emotional, academic, and family domains.
- To identify factors associated with these adjustment difficulties.
Main Methods:
- Parental reports were collected for 327 children with SCA treated at a urban clinic.
- Adjustment was assessed across emotional, social, academic, and family functioning.
Main Results:
- Over 25% of children with SCA exhibited emotional adjustment problems (anxiety, depression).
- At least 20% experienced social and academic functioning issues.
- Impairments correlated significantly with pain episode frequency, but not family income.
- Age and gender were significant factors influencing the illness's disruptive effects.
Conclusions:
- Children with SCA face significant adjustment challenges in multiple life domains.
- Pain management and age/gender-specific interventions are critical for improving outcomes in pediatric SCA.
- Socioeconomic status, as indicated by family income, did not appear to be a primary driver of these adjustment issues in this cohort.
Abstract:
The risk of adjustment problems increases when a child has a serious life-threatening illness. This article estimates the frequency of adjustment problems across multiple domains for children and adolescents with sickle cell anemia (SCA). Parents provided information on the social, emotional, academic, and family adjustment of 327 children with SCA who were being treated at a comprehensive sickle cell clinic serving a predominantly poor and urban population. More than 25 percent of these children had emotional adjustment problems in the form of internalizing symptoms such as anxiety and depression. In addition, at least one child in five had problems related to social functioning and academic performance. These impairments were related significantly to the frequency of serious pain episodes but not to absolute family income. No significant differences in the data were found based on family income. The data also showed that the disruptive effects of the illness were related to gender and age.
