title: Psychological adjustment in caregivers of school-age children infected with HIV: stress, coping, and family factors.
abstract: OBJECTIVE
  To assess for significant differences in psychological functioning between caregivers of HIV-infected children and caregivers of healthy children, and to examine the utility of applying a stress and coping model to caregivers of children with HIV disease.
  
  
  METHODS
  Participants included caregivers of HIV-infected children (n = 36) and caregivers of a demographically matched control group of healthy children (n = 32). During their child's pediatric clinic visits, caregivers completed measures of psychological adjustment, stress, coping style, and family resources and support. They also completed a measure of their child's psychological adjustment.
  
  
  RESULTS
  Caregiver psychological distress scores did not significantly differ between the HIV and control groups, and clinically significant rates of psychological distress were reported by more than a third of caregivers in both groups. Hierarchical multiple regression analyses revealed that independent of their child's illness status, stress and coping style were significant predictors of caregiver's psychological adjustment. In addition, caregiver psychological distress was a significant predictor of children's maladjustment.
  
  
  CONCLUSIONS
  High rates of psychological distress were observed in caregivers of children with HIV disease; however, similarly high rates of psychological adjustment problems were found in caregivers of healthy children. Caregivers who reported high levels of daily stress and emotion-focused coping styles tended to report more psychological distress. Further, caregivers who reported more psychological distress also reported more internalizing and more externalizing behavior problems in their children, regardless of the child's illness status. These findings reflect the impact of poverty and environmental stress on caregivers' adjustment.
authors.affiliation: Pediatric Infectious Disease Program, Emory University School of Medicine, Atlanta, Georgia 30308, USA. pbachan@emory.edu
authors.forename: P J
authors.initials: PJ
authors.lastname: Bachanas
authors.forename: K A
authors.initials: KA
authors.lastname: Kullgren
authors.forename: K S
authors.initials: KS
authors.lastname: Schwartz
authors.forename: J S
authors.initials: JS
authors.lastname: McDaniel
authors.forename: J
authors.initials: J
authors.lastname: Smith
authors.forename: S
authors.initials: S
authors.lastname: Nesheim
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000151:congenital* / Q000523:psychology; D006801:Humans; D007389:Internal-External Control; D008297:Male; D010552:Personality Assessment; D010553:Personality Development; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications*