Springer Nature is making Coronavirus research free. View research | View latest news | Sign up for updates

Parental risk and resistance factors among children with juvenile rheumatic disease: A four-year predictive study

  • 1030 Accesses

  • 19 Citations


Examined the extent to which baseline functioning and parental risk and resistance factors predicted disease-related (functional disability and pain) and psychosocial functioning (social competence and behavior problems) 4 years later among 172 children with juvenile rheumatic disease. The study also examined the extent to which fathers' risk and resistance factors explained patients' adaptation, above and beyond maternal factors. Poorer baseline functioning was a strong risk factor that predicted poorer functioning 4 years later. In addition, parental risk and resistance factors at baseline predicted patients' adjustment after patients' age and baseline functioning were controlled. Mothers' and fathers' personal strain and depressed mood, and fathers' drinking problems, were associated with poorer patient adjustment; mothers' and fathers' social functioning appeared to aid patients' adjustment. Fathers' risk and resistance factors contributed independently from those of mother, to predict patients' outcomes.

This is a preview of subscription content, log in to check access.


  1. Achenbach, T. M., and Edelbrock, C. (1983).Manual for the Child Behavior Checklist and Revised Child Behavior Profile, University of Vermont, Department of Psychiatry, Burlington.

  2. Barnard, C. P., and Spoentgen, P. A. (1986). Children of alcoholics: Characteristics and treatment.Alc. Treat. Q. 3: 47–65.

  3. Billings, A. G., and Moos, R. H. (1983). Comparisons of children of depressed and nondepressed parents: A social-environmental perspective.J. Abnorm. Child Psychol. 4: 463–486.

  4. Billings, A. G., Moos, R. H., Miller, J. J., and Gottlieb, J. E. (1987). Psychosocial adaptation in juvenile rheumatic disease: A controlled evaluation.Health Psychol. 6: 343–359.

  5. Breslau, N. (1983a). Family care: Effects on siblings and mothers. In Thompson, G. H., and Rubin, I. L. (eds.),Comprehensive Management of Cerebral Palsy, Grune & Straton, New York, pp. 299–309.

  6. Breslau, N. (1983b). The psychological study of chronically ill and disabled children: Are healthy siblings appropriate controls?J. Abnorm. Child Psychol. 2: 379–391.

  7. Brewer, E. J., Bass, J., Baum, J., Cassidy, J. T., Fink, C., Jacobs, J., Hanson, V., Levinson, J. E., Schaller, J., and Stillman, J. S. (1977). Current proposed revision of JRA criteria.Arth. Rheum. 20: 195–199.

  8. Bristol, M., Gallagher, J. J., and Schopler, E. (1988). Mothers and fathers of young developmentally disabled and nondisabled boys: Adaptation and spousal support.Dev. Psychol. 24: 441–451.

  9. Brown, J. H., Kazis, L. E., Spitz, P. W., Gertman, P., Fries, J., and Meenan, R. F. (1984). The dimensions of health outcomes: A cross-validated examination of health status measurement.Am. J. Publ. Health 74: 159–161.

  10. Chaney, J. M., and Peterson, L. (1989). Family variables and disease management in juvenile rheumatoid arthritis.J. Ped. Psychol. 14: 389–403.

  11. Daniels, D., Moos, R. H., Billings, A. G., and Miller, J. J. (1987). Psychosocial risk and resistance factors among children with chronic illness, healthy siblings, and healthy controls.J. Abnorm. Child Psychol. 15: 295–308.

  12. Downey, G., and Coyne, J. C. (1990). Children of depressed parents: An integrative review.Psychol. Bull 108: 50–76.

  13. Finney, J. W., Moos, R. H., and Brennan, P. L. (1991). The Drinking Problems Index: A measure to assess alcohol-related problems among older adults.J. Subst. Abuse 3: 395–404.

  14. Fries, J. F., Spitz, P., and Young, D. Y. (1982). The dimensions of health outcomes: The Health Assessment Questionnaire, disability and pain scales.J. Rheumatol. 9: 789–793.

  15. Hanson, C. L., Henggeler, S. W., and Burghen, G. A. (1987). Model of associations between psychosocial variables and health-outcome measures of adolescents with IDDM.Diabetes Care 10: 752–758.

  16. Hanson, C. L., Henggeler, S. W., and Burghen, G. A. (1987). Social competence and parental support as mediators of the link between stress and metabolic control in adolescents with insulin-dependent diabetes mellitus.J. Consult. Clin. Psychol. 55: 529–533.

  17. Hirsch, B., Moos, R. H., and Reischl, T. (1985). Psychosocial adjustment of adolescent children of a depressed, arthritic, or normal parent.J. Abnorm. Psychol 94: 272–281.

  18. Hobfoll, S. E., and Lerman, M. (1988). Personal relationships, personal attributes, and stress resistance: Mothers' reactions to their child's illness.Am. J. Comm. Psychol. 16: 565–589.

  19. Johnson, S. B. (1988). Diabetes mellitus in childhood. In Routh, D. K. (ed.),Handbook of Pediatric Psychology, Grune & Stratton, New York, pp. 9–31.

  20. Kovacs, M., Iyengar, S., Goldston, D., Obrosky, D. S., Stewart, J., and Marsh, J. (1990). Psychological functioning among mothers of children with insulin-dependent diabetes mellitus: A longitudinal study.J. Consult. Clin. Psychol. 58: 189–195.

  21. Miller, J. J. (1983). Juvenile Arthritis. In Gershwin, M. E., and Robins, D. L. (eds.),Musculoskeletal Disease in Children, Grune & Stratton, Orlando, FL, pp. 73–94.

  22. Moos, R. H., and Billings, A. G. (1982). Children of alcoholics during the recovery process: Alcoholic and matched control families.Addict. Behav. 7: 155–163.

  23. Moos, R. H., Cronkite, R. C., and Finney, J. W. (1990a).Health and Daily Living Form Manual, 2nd ed., Center for Health Care Evaluation, Veterans Affairs and Stanford University Medical Centers, Palo Alto, CA.

  24. Moos, R. H., Finney, J. W., and Cronkite, R. C. (1990b).Alcoholism Treatment: Context, Process, and Outcome, Oxford University Press, New York.

  25. Perrin, E. C., Stein, R. E. K., and Drotar, D. (1991). Cautions in using the Child Behavior Checklist: Observations based on research about children with a chronic illness.J. Ped. Psychol. 16: 411–421.

  26. Potter, A. E., and Williams, D. E. (1991). Development of a measure examining children's roles in alcoholic families.J. Stud. Alc. 52: 70–77.

  27. Spitzer, R. L., Endicott, J., and Robins, E. (1978). Research Diagnostic Criteria: Rationale and reliability.Arch. Gen. Psych. 35: 773–782.

  28. Stein, R. E. K., and Reissman, C. K. (1980). The development of an impact-on-family scale: Preliminary findings.Med. Care 18: 465–472.

  29. Thompson, K. L., Varni, J. W., and Hanson, V. (1987). Comprehensive assessment of a pain in juvenile rheumatoid arthritis: An empirical model.J. Ped. Psychol. 12: 241–255.

  30. Timko, C., Stovel, K. W., Moos, R. H., and Miller, J. J. (1992a). Adaptation to juvenile rheumatic disease: A controlled evaluation with a one-year follow-up.Health Psychol. 11: 67–76.

  31. Timko, C., Stovel, K. W., Moos, R. H., and Miller, J. J. (1992b). A longitudinal study of risk and resistance factors among children with juvenile rheumatic disease.J. Clin. Child Psychol. 21: 132–142.

  32. Varni, J. W., and Wallander, J. L. (1988). Pediatric chronic disabilities: Hemophilia and spina bifida as examples. In Routh, D. K. (ed.),Handbook of Pediatric Psychology, Guilford, New York, pp. 190–221.

  33. Varni, J. W., Wilcox, J. L., and Hanson, V. (1988). Mediating effects of family social support on child psychological adjustment in juvenile rheumatoid arthritis.Health Psychol. 7: 421–431.

  34. Varni, J. W., Setoguchi, Y., Rappaport, L. R., and Talbot, D. (1992). Psychological adjustment and perceived social support in children with congenital/acquired limb deficiencies.J. Behav. Med. 15: 31–44.

  35. Walco, G. A., Varni, J. W., and Ilowite, N. T. (1992). Cognitive-behavioral pain management in children with juvenile rheumatoid arthritis.Pediatrics 89: 1075–1079.

  36. Wallander, J. L., Varni, J. W., Babani, L., Banis, H. T., and Wilcox, K. T. (1988). Children with chronic physical disorders: Maternal reports of their psychological adjustment.J. Ped. Psychol. 13: 197–212.

  37. Wallander, J. L., Varni, J. W., Babani, L., Banis, H. T., DeHaan, C. B., and Wilcox, K. T. (1989a). Disability parameters, chronic strain, and adaptation of physically handicapped children and their mothers.J. Ped. Psychol. 14: 23–42.

  38. Wallander, J. L., Varni, J. W., Babani, L., Banis, H. T., and Wilcox, K. T. (1989b). Family resources as resistance factors for psychological maladjustment in chronically ill and handicapped children.J. Ped. Psychol. 14: 157–173.

  39. Werner, E. E. (1986). Resilient offspring of alcoholics: A longitudinal study from birth to age 18.J. Stud. Alc. 47: 34–40.

  40. Woodside, M. (1988). Research on children of alcoholics: Past and future.Br. J. Addict. 83: 785–792.

Download references

Author information

Correspondence to Christine Timko.

Additional information

This research was supported by Multipurpose Arthritis Center Grant AM20610 from the National Institute of Health and Department of Veterans Affairs Medical and Health Services Research and Development Services research funds.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Timko, C., Baumgartner, M., Moos, R.H. et al. Parental risk and resistance factors among children with juvenile rheumatic disease: A four-year predictive study. J Behav Med 16, 571–588 (1993).

Download citation

Key words

  • childhood chronic illness
  • juvenile rheumatic disease
  • disability
  • pain
  • psychosocial adaptation