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Psychosocial factors related to rheumatic diseases in childhood
1Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA.
Insights
Children with rheumatic diseases generally adjust well psychologically and socially. Interventions should target at-risk children and families, considering individual coping mechanisms like denial, rather than broad approaches.
Area of Science:
- Pediatric Rheumatology
- Child Psychology
- Psychosocial Adjustment
Background:
- Older literature and common beliefs suggest significant psychosocial difficulties for children with rheumatic diseases.
- However, current understanding indicates generally positive adjustment in this population.
Purpose of the Study:
- To review psychosocial adjustment features associated with childhood rheumatic diseases.
- To identify factors influencing positive and negative adjustment outcomes.
- To inform targeted intervention strategies.
Main Methods:
- Literature review synthesizing existing research on psychosocial adjustment in pediatric rheumatic diseases.
- Analysis of risk and protective factors for psychosocial well-being.
Main Results:
- Children with rheumatic diseases typically exhibit good psychological and social functioning.
- Risk factors for poor adjustment are similar to those affecting healthy children.
- Strong social support, especially maternal competence, is linked to better outcomes.
- Positive use of denial is a coping mechanism observed in some children.
Conclusions:
- Interventions should be individualized, focusing on at-risk children and families.
- Tailoring interventions to specific coping strategies, such as denial, is crucial.
- Generalized interventions and education for all children with rheumatic diseases are unnecessary and potentially detrimental.
Abstract:
This review discusses those features of psychosocial adjustment which have been found associated with rheumatic diseases in children. In spite of the older literature and widely held intuitive beliefs, children with those diseases tend to do well in both psychological and social development and function. Those who do least well have risk factors which are those which impinge on the adjustments of any healthy child. Those who do best are those who have a strong social support system, particularly maternal competence. Children may cope in part by positive use of denial. Thus, interventions should be tailored to just those children and families at risk and must take into account the individual child's method of coping. It is argued that generalized interventions and education are unnecessary and may be harmful.