Emotional adaptation of children undergoing bone marrow transplantation

Objective: To examine stress reactions and psychic adaptation of children a ged 8-12 years in single-room treatment under isolation conditions after bo ne marrow transplantation (BMT). Methods: The prospective longitudinal study included free diagnostic interv iews and a targe test battery. We used a mixture of projective tests questi onnaires and an intelligence test (the German version of the revised Wechsl er Intelligence Scale for Children) to evaluate different adaptation proces ses. Results: The questionnaires clearly showed children's strong tendencies to adapt to the situation and to normalize their behaviour under isolation con ditions. In contrast, the psychoanalytic interview and the projective tests demonstrated a very differentiated emotional adjustment. Before transplant ation, coming to terms with the life-threatening situation was deferred. Af ter transplantation, very intensive emotional examination of the situation and superficial adaptation (protective denial) were observed. Conclusions: It is very important to intensify the child's and the family's psychosocial support before admitting the child for hospital treatment Fam ily conflicts and neurotic developments should be regarded as risk factors for marked and potentially dangerous stress reactions.