Title

Children with Chronic Illness: Do Narratives Reflect Family and Child Adjustment

Date of Completion

January 2010

Keywords

Psychology, Developmental

Degree

Ph.D.

Abstract

This study examined the role of narratives from mothers and young children as a way to further understand family and individual experiences with type 1 diabetes and moderate to severe asthma. Participants were 44 mothers and 31 fathers of children with diabetes or asthma, and 30 mothers and 23 fathers of healthy children. Both parents completed validated measures of coping, psychological distress, family functioning, and child adjustment. Only mothers completed an interview of their reaction to their child's diagnosis. In addition, 75 children in this study completed a story telling task reflecting representations of parents (e.g., positive, negative, and disciplining), representations of family conflict, and family cohesion. Nearly a third of mothers and fathers in the illness group reported significant psychological distress. In addition, mothers who were unresolved with their child's diagnosis reported lower levels of family expressiveness and had children incorporate more frequent representations of family conflict in their stories. Different relationships emerged between the chronic illness and healthy group on parent reported measures and associations with children's representations. Moreover, children in the healthy group reported more frequent representations of parents as ineffective despite higher levels of parental psychological distress in the chronic illness group. Several explanations for this finding are discussed. This work highlights the importance of working with the entire family system when helping young children with chronic illness. In addition, physicians and clinicians may consider screening psychological distress in mothers and fathers who have a child with a chronic illness. ^