Am. Digirolamo et al., IDENTIFICATION AND ASSESSMENT OF ONGOING STRESSORS IN ADOLESCENTS WITH A CHRONIC ILLNESS - AN APPLICATION OF THE BEHAVIOR-ANALYTIC MODEL, Journal of clinical child psychology, 26(1), 1997, pp. 53-66
Applied Goldfried and D'Zurilla's (1969) Behavior-Analytic Model to th
e development of a context-specific measure of stressful situations fo
r adolescents with a serious, chronic illness. In completing the situa
tional analysis phase of the model, 45 adolescents with cystic fibrosi
s (CF), 20 parents of adolescents with CF, and 8 health care professio
nals completed structured interviews or daily diaries to obtain the wi
dest range of problematic situations. The adolescent sample was recrui
ted from two different medical centers, and stratified by sex and illn
ess severity. A total of 1,174 problem situations were elicited across
all participants and then content-analyzed into 164 nonredundant item
s in 10 domains (e.g., Medications and Treatment, and School). Few rel
ations were found between demographic variables (e.g., age and illness
severity) and the number or difficulty of problematic situations. Bot
h adolescents and parents mentioned the greatest number of problematic
situations in the domains of School, Medications and Treatment, and P
arent-Teen Relationship. In terms of difficulty, all three respondents
(i.e., teens, parents, and health care professionals) rated problems
with Clinic and Hospital Visits as very difficult. For the adolescent
sample, problems in the Parent-Teen Relationship and Health Concerns w
ere also highly difficult Significant associations were found between
the problematic situations we identified and standardized measures of
social and emotional functioning. Adolescents who rated their problems
as more difficult also endorsed more symptoms of depression and lower
perceptions of social competence. In a future study, the most salient
items will be selected to create a role-play measure to elicit adoles
cents' coping strategies.