terms of which chronic physical illnesses were included. As well,
there is no way of knowing how patients under the umbrella term CFS
were selected - the definition substantially impacts the results and
conclusions. Nor does this abstract mention whether such studies
grouped children based on whether or not psychiatric co-morbidities
were present, whether they were secondary to the disease or condition
and whether they were present prior to the child contracting or
developing a chronic physical illness. All of these variables will
impact the accuracy of the study and in turn the meta-analysis. The
authors also acknowledge other factors that may have had an overall
impact on the meta analysis. Depression and anxiety often accompany
many physical illness and the situational reaction is not necessarily
abnormal. (Nisevic et al 2006).
Behavior problems may affect how a child relates to his or her
environment. Some emotional or behavioral disorders manifest
themselves outwardly. Externalizing behaviors constitute an acting-out
style that could be described as aggressive, impulsive, coercive, and
noncompliant. Other disorders are more accurately described as
"inward." Internalizing behaviors are typical of an inhibited style
that could be described as withdrawn, lonely, depressed, and anxious.
Grief related to loss of function and normalcy, stigmatization and
lack of support by medical personnel could all have an impact on the
internalizing of a child who contracts a physical illness.
J Pediatr Psychol. 2011 Aug 1. [Epub ahead of print]
Behavior Problems in Children and Adolescents With Chronic Physical
Illness: A Meta-Analysis.
Pinquart M, Shen Y.
Department of Psychology, Philipps University.
Abstract
OBJECTIVE:
To examine the risk of emotional and behavioral problems among
children with a chronic physical illness.
METHODS:
Random-effects meta-analysis was computed to integrate the results of
569 studies that used the Child Behavior Checklist, Youth Self Report,
and the Teacher Report Form.
RESULTS:
Young people with a chronic physical illness have higher levels of
internalizing (g=E2=80=89=3D=E2=80=89.47 standard mean difference), externa=
lizing (g=E2=80=89=3D
.22) and total behavior problems (g=E2=80=89=3D=E2=80=89.42) than healthy p=
eers. The
largest differences were found in parental ratings and the weakest
differences in adolescent self-ratings. Strongest elevations of
internalizing problems were found for chronic fatigue syndrome and
strongest elevations of externalizing problems were observed for
epilepsy and migraine/tension-type headache. Effects also varied by
country and, in part, by age, gender, year of publication, and study
design.
CONCLUSIONS:
The results call for regular screens for psychological distress and
referrals for mental health services, when needed.
---------------------------------------------
Send posts to CO-CURE@listserv.nodak.edu
Unsubscribe at http://www.co-cure.org/unsub.htm
---------------------------------------------
Co-Cure's purpose is to provide information from across the spectrum of
opinion concerning medical, research and political aspects of ME/CFS and/or
FMS. We take no position on the validity of any specific scientific or
political opinion expressed in Co-Cure posts, and we urge readers to
research the various opinions available before assuming any one
interpretation is definitive. The Co-Cure website <www.co-cure.org> has a
link to our complete archive of posts as well as articles of central
importance to the issues of our community.
---------------------------------------------
