Psychological, behavioural, and social adjustment in children and adolescents with juvenile chronic arthritis
- aDepartment of Paediatric Psychology, University Medical Centre Utrecht, Wilhelmina Children's Hospital, Utrecht, the Netherlands, bDepartment of Paediatric Rheumatology, University Medical Centre Utrecht, Wilhelmina Children's Hospital
- Dr Sinnema, University Medical Centre Utrecht, PO Box 85090, KA.00.004.0, 3508 AB Utrecht, the Netherlands
- Accepted 15 December 1999
OBJECTIVE To assess the psychological, behavioural and social adjustment of children (7–11 years) and adolescents (12–16 years) with juvenile chronic arthritis (JCA). Higher rates of maladjustment were expected to be found in these patients.
METHODS Self report questionnaires were used within the context of personal interviews. Family functioning and social support were studied as well. Forty seven patients with JCA, 52 healthy peers and their respective parents participated in the study.
RESULTS Self esteem, perceived competence and body image in patients with JCA were as positive as they were in healthy participants. There were no differences between ill and healthy youngsters with respect to the incidence of psychopathology. Patients with JCA, in general, perceived themselves as socially competent, but they seemed to have somewhat less opportunity or energy to participate in social activities. Children with JCA showed a high level of aspiration to cope with social expectations. This aspiration seemed to be even stronger in case the disease caused more strains, for example, in periods of inflammation and in the systemic onset type. The high level of social adjustment in children with JCA seemed to be supported by highly cohesive family structures. Generally, adolescents with JCA experienced much social support.
CONCLUSIONS In contrast with our expectation, children and adolescents with JCA seemeed to cope quite well with the psychological and social consequences of their long term condition. For future studies, it is hypothesised that the high levels of adaptation might imply an enduring psychological strain, which is reflected in an altered function of the autonomic nervous system.
Funding: this research project was financed by the “Stichting Het Zieke Kind in Beweging” (the Foundation for Physical Fitness in Chronically Ill Children).