ESTIMATING RATES OF PSYCHOSOCIAL PROBLEMS IN URBAN AND POOR CHILDREN WITH SICKLE-CELL-ANEMIA

The risk of adjustment problems increases when a child has a serious l ife-threatening illness. This article estimates the frequency of adjus tment problems across multiple domains for children and adolescents wi th sickle cell anemia (SCA). Parents provided information on the socia l, 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 the se children had emotional adjustment problems in the form of internali zing symptoms such as anxiety and depression. In addition, at least on e child in five had problems related to social functioning and academi c performance. These impairments were related significantly to the fre quency 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.