Psychological adjustment in caregivers of school-age children infected with HIV: Stress, coping, and family factors

Objective: To assess for significant differences in psychological functioni ng between caregivers of HIV-infected children and caregivers of healthy ch ildren, and to examine the utility of applying a stress and coping model to caregivers of children with HIV disease. Methods: Participants included caregivers of HIV-infected children (n = 36) and caregivers of a demographically matched control group of healthy child ren (n = 32). During their child's pediatric clinic visits, caregivers comp leted measures of psychological adjustment, stress, coping style, and famil y resources and support. They also completed a measure of their child's psy chological adjustment. Results: Caregiver psychological distress scores did not significantly diff er between the HIV and control groups, and clinically significant rates of psychological distress were reported by more than a third of caregivers in both groups. Hierarchical multiple regression analyses revealed that indepe ndent of their child's illness status, stress and coping style were signifi cant predictors of caregiver's psychological adjustment. In addition, careg iver psychological distress was a significant predictor of children's malad justment. Conclusions: High rates of psychological distress were observed in caregive rs of children with HIV disease; however, similarly high rates of psycholog ical adjustment problems were found in caregivers of healthy children. Care givers who reported high levels of daily stress and emotion-focused coping styles tended to report more psychological distress. Further, caregivers wh o reported more psychological distress also reported more internalizing and more externalizing behavior problems in their children, regardless of the child's illness status. These findings reflect the impact of poverty and en vironmental stress on caregivers' adjustment.