title: Relating familial stress to the psychosocial adjustment of adolescents with Duchenne muscular dystrophy.
abstract: Adolescence is a time that offers significant challenges to families dealing with Duchenne muscular dystrophy (DMD). A major developmental task in the adjustment process for the adolescent is the achievement of a sense of self-identity. Mastering stress in families of adolescents with DMD has also been shown to be a major task in the adjustment process for the family. In this study, the relationships between familial stress and psychosocial adjustment in adolescents with DMD were investigated. The study participants (36 caregivers and 32 adolescents) were all registered with the Muscular Dystrophy Association of Canada and all resided in the province of Ontario. The Offer Self-Image Questionnaire for Adolescents (Offer et al., 1982, 1989) was used to measure psychosocial adjustment of adolescents with DMD. Family stress was measured by the Questionnaire on Resources and Stress (Holroyd, 1987). All but a few of the participants were interviewed and completed self-report instruments in their own homes. The other families were interviewed in other settings (e.g., clinic, adolescent's school). The results indicate that, overall and in several specific areas, the adolescents demonstrate lower levels of psychosocial adjustment than their normal reference group. The results also indicate that familial stress is not related to sociodemographic variables, but is associated with psychosocial adjustment in the adolescent (P = 0.0004), and with intellectual function of the adolescent (P = 0.001). In fact, the results of a regression analysis show that the level of stress experienced by the family predicts the degree of psychosocial adjustment of the adolescent with DMD (R2 = 0.38, P = 0.0003). These findings underscore the importance of a holistic approach with these families. Limitations of the study, and implications of the results, are discussed in terms of clinical practice and future research.
authors: Graduate Department of Rehabilitation Science, University of Toronto, Ontario, Canada.
authors: D T
authors: DT
authors: Reid
authors: R M
authors: RM
authors: Renwick
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005192:Family Health; D006801:Humans; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000523:psychology*; D012649:Self Concept; D013315:Stress, Psychological