Change in the psychological adjustment of children with cystic fibrosis orsickle cell disease and their mothers

Objectives: This study has three interrelated objectives: (I) to track the adjustment of children anti adolescents with sickle cell disease (SCD) or c ystic fibrosis (CF) and their mothers through a third assessment point 2 ye ars after the initial assessment; (2) to determine whether the adaptational processes of the transactional stress and coping model associated with adj ustment at the initial assessment continue to be associated with adjustment 2 years later; and (3) to determine whether the pattern of association of adaptational processes,vith adjustments differs by illness subgroup. Method s: The study samples included 59 children with CF and 50 children with SCD and their mothers. Measures were obtained on maternal adjustment and apprai sals of daily and illness stress, coping methods, and family functioning. C hild measures included child-reported and mother-reported child adjustment and child perceptions of self-worth and health locus of control and pain co ping methods. Results: Consistency in adjustment classification was only 31 -32% for child self-report, 66% for mother-reported child behavior problems , anti 56-77% for mother self-reported adjustment for the CF and SCD groups , respectively. Support was provided for the association of adaptational pr ocesses with maternal adjustment and with the adjustment of children with S CD but,not for children with CF. Conclusion: The stability of adjustment ha s implications for prevention and treatment intervention and subsequent res earch steps. Intervention efforts should be focused on the relatively small subgroups of children with chronic illnesses and their mothers with consis tently poor adjustment.