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Psychosocial adjustment in preschool children with atopic eczema
L R Daud1, M E Garralda, T J David
1Department of Child Psychiatry, University of Manchester.
Insights
Children with severe atopic eczema show increased behavioral issues and sleep difficulties. However, their mother-child attachment remains secure, despite maternal stress and reduced social support.
Area of Science:
- Pediatrics
- Psychology
- Dermatology
Background:
- Atopic eczema is a chronic childhood skin condition impacting development.
- Early childhood is a critical period for social and emotional growth.
Purpose of the Study:
- To compare psychiatric adjustment and mother-child attachment in preschool children with severe atopic eczema versus controls.
- To investigate maternal well-being and attitudes in relation to childhood atopic eczema.
Main Methods:
- Comparative study involving 30 preschool children with severe atopic eczema and 20 matched controls.
- Assessment of psychiatric adjustment, behavior symptoms, and mother-child attachment security.
- Evaluation of maternal employment, social support, stress, and parenting attitudes.
Main Results:
- Children with eczema exhibited more behavioral symptoms, dependency, fearfulness, and sleep difficulties.
- No significant differences were found in mother-child attachment security between groups.
- Mothers of children with eczema reported less outside employment, reduced social support, and increased parenting stress.
- Mothers demonstrated positive empathic attitudes towards their children, contrary to previous literature.
Conclusions:
- Severe atopic eczema in early childhood is associated with increased child behavior problems and maternal distress.
- Atopic eczema does not negatively impact mother-child attachment security.
- Maternal well-being and social support are crucial factors in managing childhood atopic eczema.
Abstract:
Atopic eczema is a chronic skin disorder that is most common in early childhood, an important stage in the child's social and emotional development. The psychiatric adjustment and mother-child attachment in 30 preschool children with severe atopic eczema was compared with 20 matched controls. Patients with eczema had a significant increase in behaviour symptoms, 7/30 (23%) v 1/20 (5%); with significant excess of dependency/clinginess, 15/30 (50%) v 2/20 (10%); fearfulness, 12/30 (40%) v 2/20 (10%); and sleep difficulty, 19/30 (63%) v 9/20 (45%), but there was no significant difference between the two groups in the security of attachments, 25/29 (86%) v 14/20 (70%). Significantly fewer mothers of children with atopic eczema were in outside employment, 8/29 (27%) v 13/20 (65%), or felt supported socially, 10/29 (34%) v 13/20 (65%). Significantly more of them, 9/30 (30%) v 1/20 (5%), felt particularly stressed in relation to their parenting and less efficient in their disciplining of the affected child. In spite of this and at variance with earlier reports in the literature, they did not display negative attitudes towards their child. On the contrary mothers had a positive empathic attitude towards the child, 7/14 (50%) v 2/16 (12%). Child behaviour problems, 7/14 (50%) v 2/16 (12%), and maternal distress, 12/14 (85%) v 5/16 (31%), were significantly more common in the more severely affected children. Minor behaviour problems and parenting distress are important features of severe atopic eczema in early childhood but atopic eczema does not lead to insecurity of the mother-child attachment.