The illness intrusiveness theoretical framework maintains that illness-induced lifestyle disruptions compromise quality of life in chronic life-threatening conditions and that this effect is moderated by social, psychological, and contextual factors. Considerable evidence indicates that lifestyle disruptions compromise quality of life in cancer and other diseases and that the effects differ across life domains. The hypothesis that contextual factors (e.g. age, education, income, stressful life events) moderate these effects has not been tested extensively. We investigated whether age, income, education, and/or recent stressful life events modify the experience of illness intrusiveness across three central life domains (Relationships and Personal Development, Intimacy, and Instrumental life) in six common cancers. A sample of 656 cancer outpatients with one of six common cancers (breast, prostate, lymphoma, lung, head and neck, and gastrointestinal, all n's>100) completed the Illness Intrusiveness Ratings Scale while awaiting follow-up appointments with an oncologist. Results indicated statistically significant (all p's<0.05) interactions involving each of the hypothesized moderator variables and the Life Domain factor. In each case, greatest divergence was evident when illness intrusiveness involved instrumental life domains (e.g. work, finances, health, and active recreation). The findings substantiate the illness intrusiveness theoretical framework and support its relevance for people with cancer. The psychosocial impact of chronic life-threatening disease differs across life domains and depends on the context in which it is experienced.
Analysis of longitudinal data for 145 children [51 healthy, 40 with cystic fibrosis (CF), and 54 with congenital heart disease (CHD)] was conducted: (a) to ascertain whether behavioral problems evident in older medically compromised children would be reported as early as 2–3 years-of-age; and (b) to test theoretical predictions concerning the role of infant-mother attachment in the etiology of behavior problems. As predicted, children with a medical diagnosis received higher scores from parents on the Child Behavior Checklist (CBCL), primarily on the Internalizing scale. Reports of somatic symptoms did not account for this effect. Contrary to predictions, children with CHD were reported to have more behavior problems than those with CF. Secure attachment was associated with lower CBCL scores for internalizing problems regardless of medical status. The increase in behavior problem reports associated with insecure attachment was shown to reflect an effect of avoidance rather than insecurity per se. The importance of distinguishing effects of different types of insecurity and the need for meta-analytic strategies to do so is emphasized.
A prospective longitudinal study assessed the development of the mother-child relationship within the context of other important aspects of transition to parenthood. In the prenatal phase, 238 women who were 8 months pregnant with their first child completed a set of questionnaires. At 1 month postpartum, 165 of these women completed a second set of questionnaires, and a subset of 86 were observed for 1 hour at home with their infants. When their child was 2 years old, 62 of the 86 mothers completed questionnaires and were observed in interaction with their toddler in the laboratory. The several hundred individual variables were reduced to internally consistent composite variables, 5 in the prenatal phase, 7 postpartum, and 14 in the toddler phase. Preliminary analyses reported in this paper assessed the structure of relationships among the composite variables within each phase (Pearson correlations) and whether there was significant prediction from one dimension to another across the phases, beyond stability in the predicted dimension (multiple regressions). Causal modeling analyses are still in progress.The results indicate that the development of maternal attachment is a gradual process and that feelings of attachment are related to a number of other measures of women's psychological well-being. Parenting confidence was found to play a central role in adaptation to motherhood within each phase, as well as from the prenatal to postpartum and postpartum to toddler phases. R!%UM& Une ktude longitudinale a kvalut le dkveloppement de la relation mbre-enfant dans le contexte d'autres aspects importants de la transition ii la condition de parents. Dans la phase prknatale, 238 femmes enceintes de huit mois de leur premier enfant ont rempli une serie de questionnaires. Un mois apres la naissance, 165 de ces femmes ont rempli une deuxitme skrie de questionnaires et un groupe de 86 mbres a ttk observe pendant une heure chez elles avec leur enfant. Quand leur enfant avait deux ans, 62 des 86 meres ont rempli des questionnaires et ont ttk observkes, en laboratoire, dans leur interaction avec leur enfant qui commence a marcher. Les centaines de variables individuelles ont t t t reduites A quelques
In view of Canada's commitment to immigration, understanding the sources of successful adaptation by immigrant and refugee children is vital. This paper reviews the literature on the mental health of migrant children and suggests an agenda for future research.
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