title: Social support and adaptation outcomes in children and adolescents with cerebral palsy.
abstract: OBJECTIVE
  This study had two main objectives: first, to describe the social support and psychological maladjustment of children and adolescents with cerebral palsy (CP); and second, to test a mediation model where psychological maladjustment was hypothesized to mediate the link between social support and health-related quality of life (HRQL). In addition, the moderating role of gender and age was examined for this mediation model.
  
  
  METHODS
  Self- and proxy-report questionnaires on the aforementioned variables were administered to a sample of 96 children/adolescents with CP and 118 healthy controls, as well as one of their parents. Univariate and multivariate analyses of covariance were conducted to examine differences in social support and psychological maladjustment, respectively. PROCESS computational tool was used for path analysis-based mediation, moderation and moderated mediation analyses.
  
  
  RESULTS
  Children/adolescents with CP reported lower levels of social support than their healthy peers, but no significant differences emerged in terms of their psychological maladjustment. For children/adolescents with CP, internalizing and externalizing problems were found to mediate the link between social support and HRQL, and these indirect effects were not conditional upon age or gender.
  
  
  CONCLUSIONS
  Children and adolescents with CP are likely have more negative perceptions of social support, but not necessarily more psychological adjustment problems than their healthy, able-bodied peers. Results further suggest that interventions targeting social support perceptions may positively affect HRQL outcomes in children/adolescents with CP, through the improvement of internalizing and externalizing dimensions of their psychological adjustment.
  
  
  CONCLUSIONS
  Social support perceptions are important intervention targets in psychosocial rehabilitation with children and adolescents with CP. Children and adolescents with CP do not necessarily present increased psychological maladjustment. Interventions targeting these children and adolescents' social support may promote their psychological adjustment and health-related quality of life. Developmental specificities, such as age and gender differences, should be considered when planning and implementing psychosocial interventions.
authors.affiliation: Faculty of Psychology and Education Sciences, The University of Coimbra , Coimbra , Portugal.
authors.forename: Carlos
authors.initials: C
authors.lastname: Carona
authors.forename: Helena
authors.initials: H
authors.lastname: Moreira
authors.forename: Neuza
authors.initials: N
authors.lastname: Silva
authors.forename: Carla
authors.initials: C
authors.lastname: Crespo
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Canavarro
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001526:Behavioral Symptoms / Q000209:etiology* / Q000503:physiopathology; D002547:Cerebral Palsy / Q000150:complications / Q000523:psychology / Q000534:rehabilitation; D002648:Child; D003258:Consumer Behavior; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D019727:Proxy; D011599:Psychopathology; D011788:Quality of Life; D012737:Sex Factors; D012917:Social Adjustment; D012944:Social Support; D011795:Surveys and Questionnaires