title: Influence of family environment on long-term psychosocial functioning of adolescents with juvenile fibromyalgia.
abstract: OBJECTIVE
  Little is known about the impact of family environment on the long-term adjustment of patients with juvenile-onset fibromyalgia (JFM). Our objective was to evaluate whether family environment in early adolescence predicted later physical functioning and depressive symptoms of adolescents with JFM as they transitioned to early adulthood in the context of a controlled long-term followup study.
  
  
  METHODS
  Participants consisted of 39 youth (mean age 18.7 years) with JFM and 38 healthy matched controls who completed web-based surveys about their health status (Short Form 36 health survey) and depressive symptoms (Beck Depression Inventory II) ~4 years after a home-based, in-person assessment of child and family functioning. During the initial assessment, parents of the participants (94% mothers) completed the Family Environment Scale and adolescents (mean age 14.8 years) completed self-report questionnaires about pain (visual analog scale) and depressive symptoms (Children's Depression Inventory).
  
  
  RESULTS
  The results indicated that family environment during early adolescence significantly predicted greater depressive symptoms in early adulthood for both the JFM group and the healthy controls. In particular, a controlling family environment (use of rules to control the family and allowing little independence) during early adolescence was the driving factor in predicting poorer long-term emotional functioning for patients with JFM. Family environment did not significantly predict longer-term physical impairment for either group.
  
  
  CONCLUSIONS
  Adolescents with JFM from controlling family environments are at an increased risk for poorer emotional functioning in early adulthood. Behavioral and family interventions should foster independent coping among adolescents with JFM and greater parenting flexibility to enhance successful long-term coping.
authors.affiliation: Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. Soumitri.Sil@cchmc.org
authors.forename: Soumitri
authors.initials: S
authors.lastname: Sil
authors.forename: Anne
authors.initials: A
authors.lastname: Lynch-Jordan
authors.forename: Tracy V
authors.initials: TV
authors.lastname: Ting
authors.forename: James
authors.initials: J
authors.lastname: Peugh
authors.forename: Jennie
authors.initials: J
authors.lastname: Noll
authors.forename: Susmita
authors.initials: S
authors.lastname: Kashikar-Zuck
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological; D000293:Adolescent; D016022:Case-Control Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D004777:Environment; D005190:Family / Q000523:psychology*; D005260:Female; D005356:Fibromyalgia / Q000503:physiopathology* / Q000523:psychology*; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D011584:Psychology; D011795:Surveys and Questionnaires; D055815:Young Adult