Objective To examine the relationship of parent-reported overprotection (OP), perceived child vulnerability (PCV), and parenting stress (PS) to youth-reported illness uncertainty, and to explore potential developmental differences. Method Eighty-two children and 82 adolescents (n ¼ 164) diagnosed with Type 1 diabetes mellitus (DM1) or asthma, completed a measure of illness uncertainty, while their parents completed measures of OP, PCV, and PS. Results After controlling for demographic and illness parameters, both PCV and PS significantly predicted youth illness uncertainty in the combined sample. Within the child group, only PS significantly predicted illness uncertainty, whereas only PCV significantly predicted uncertainty for adolescents. Conclusion Specific parenting variables are associated with youth-reported illness uncertainty; however, their relationship varies according to developmental level. Although OP has been identified as a predictor of child psychological outcomes in other studies, it does not appear to be associated with illness uncertainty in youth with DM1 or asthma.

This pilot study reports findings from a randomized clinical trial of a novel intervention for parents of children newly diagnosed with Type 1 diabetes. The intervention was designed to decrease parental uncertainty and distress as well as child behavioral problems by teaching parents skills to manage uncertainty. Thirty-four families were randomly assigned to either an intervention (IG) or a treatment as usual (TAU) group. Parents completed measures of distress, uncertainty, and child behavior problems at baseline, 1 month, and 6 months postintervention. In the IG, significant reductions were observed for maternal and paternal distress as well as maternal ratings of child behavior problems. No changes were observed for the TAU, except for father-reported reductions in child internalizing symptoms at 1 month postintervention. Preliminary data suggest that, with further development and testing, the intervention has potential to be an effective tool to reduce paternal distress and possibly child behavior problems.

Study findings suggest that T1-depressive symptoms play a role in the longitudinal course of pain symptoms in children with JIA but not in children with SCD.

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This study examined the relationship between illness uncertainty, perceived control, and psychological distress among adolescents with type 1 diabetes. Sixty-eight adolescents age 13 to 18 years with type 1 diabetes completed the Children's Uncertainty in Illness Scale, the Perceived Control Scale Media Relations, and the Brief Symptom Inventory. Increased uncertainty was significantly associated with both decreased perceived control and increased psychological distress. Further analyses indicated that the relationship between illness uncertainty and psychological distress was direct and was not mediated or moderated by perceived control. These findings suggest that interventions aimed at managing uncertainty may help decrease psychological distress among adolescents with diabetes.

A situational analysis was conducted to evaluate challenges with the treatment regimen (a low protein diet and special supplemental formula) for children and adolescents with phenylketonuria (PKU) and their caregivers. A semistructured interview was administered to 19 caregivers and 11 children with PKU to describe formula and dietary problems and their frequency, difficulty, and affective intensity. Information was also gathered on attempted solutions to problems and their perceived effectiveness. Caregivers who rated dietary problems as less frequent, difficult, and emotionally upsetting and strategies as more effective for solving problems had children with significantly lower phenylalanine (Phe) levels, a biological indicator of adherence (i.e., better adherence; all p values <.05). Caregivers who reported using strategies coded as representing an authoritarian parenting style to solve dietary problems were significantly more likely to have lower household incomes and older children with higher Phe levels than were those who did not report such strategies (all p values <.05).

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This study provides an objective method for identifying patients at risk for treatment failure due to suboptimal 6-MP therapy; the clinical significance of this approach should be examined in future studies.