Predictors of psychological adjustment in school-age children infected with HIV

Objective: To assess for significant differences in psychological functioni ng between HIV-infected children and a demographically matched healthy cont rol group and to examine the utility of applying a stress and coping model to children with HIV disease. Methods: Participants included HIV-infected children (ages 6-16) and their caregivers (n = 36) and a control group of healthy children and their careg ivers (n = 32). During routine clinic visits, children completed measures o f psychological adjustment, health locus of control, and coping style, and caregivers completed measures of their own and their child's psychological adjustment. Results: Caregiver-reported and child self-reported psychological adjustmen t scores did not significantly differ between the HIV and control groups, w ith the exception of significantly more internalizing behavior problems rep orted in the control group. Hierarchical multiple regression analyses revea led that the stress and coping model accounted for 36% of the variance in H IV-infected children's self-reported psychological adjustment. In addition, child age and coping style were significant predictors of child self-repor ted psychological adjustment, but not of caregiver-reported child adjustmen t. Conclusions: Approximately 25% of children with HIV disease exhibited clini cally significant emotional or behavioral problems; however, even higher ra tes of psychological adjustment problems were found in healthy children. Ch ildren with HIV disease who have not been told their diagnosis and children who endorse more emotion-focused coping strategies tend to exhibit more ps ychological adjustment problems.