Psychological adjustment of children and adolescents with chronic arthritis: a meta-analytic review.
OBJECTIVE
To review studies of psychological adjustment among children and adolescents with chronic arthritis to determine whether they are at more risk for development of adjustment problems than controls.


METHODS
We used meta-analytic techniques to review 21 studies reporting overall adjustment problems, internalizing symptoms, externalizing symptoms, or self-concept among youths with arthritis.


RESULTS
Youths with arthritis displayed increased risk for overall adjustment problems and internalizing symptoms, but not for externalizing symptoms or poor self-concept. Risk was greater in studies making comparisons to study controls rather than to norms and in studies including mixed disease samples (arthritis plus other rheumatic diseases) rather than samples of youths with arthritis only.


CONCLUSIONS
Results suggest the importance of assessing for internalizing problems among youths with chronic arthritis. Future research may benefit from inclusion of child self-report of adjustment problems, diagnostic specificity in reporting results, and use of adjustment measures without somatic items.
LeBovidge
Jennifer Soriano
JS
Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Lavigne
John V
JV
Donenberg
Geri R
GR
Miller
Michael L
ML
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001168:Arthritis / Q000523:psychology*; D001171:Arthritis, Juvenile / Q000523:psychology; D002648:Child; D002908:Chronic Disease; D003674:Defense Mechanisms; D006801:Humans; D012649:Self Concept