Advertisement

Chronic Illness and Anxiety in Children

  • Laura Nabors
Chapter
Part of the Springer Series on Child and Family Studies book series (SSCFS)

Abstract

Children with chronic illnesses may experience internalizing problems, such as anxiety. Distraction (through imagery and play) and relaxation may be powerful strategies for children facing medical procedures. Parents can be coaches for their child, teaching anxiety management strategies. This can provide parents with a role in the child’s positive functioning so that they feel they are helping their children. Having a role can reduce parent anxiety and increase their support of the child, and both of these actions can reduce child anxiety. Moreover, parents who have a role can teach the child to cope, and reduce chances of unexpectedly reinforcing or accommodating a child’s anxiety responses. Research in the field supports the use of cognitive-behavioral strategies to reduce anxiety for children who have different types of illnesses. Strategies include distraction (games, toys, music), relaxation, social support, and imagery.

Keywords

Chronic illnesses SCARED Somatic complaints Coping menu Personalizing strategies Relaxation Breathing Imagery 

References

  1. Anthony, K. K., Gil, K. M., & Schanberg, L. (2003). Brief report: Parental perceptions of child vulnerability in children with chronic illness. Journal of Pediatric Psychology, 28, 185–190.  https://doi.org/10.1093/jpepsy/jsg005CrossRefPubMedGoogle Scholar
  2. Birmaher, B., Brent, D. A., Chiappetta, L., Bridge, J., Monga, S., & Baugher, M. (1999). Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A replication study. Journal of the American Academy of Child and Adolescent Psychiatry, 38(10), 1230–1236.  https://doi.org/10.1097/00004583-199910000-00011CrossRefPubMedGoogle Scholar
  3. Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., & Neer, S. M. (1997). The Screen for Child Anxiety Related Emotional Disorders (SCARED): Scale construction and psychometric characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 36(4), 545–553.  https://doi.org/10.1097/00004583-1997040000-00018CrossRefPubMedGoogle Scholar
  4. Blackman, J. A., Gurka, M. J., Gurka, K. K., & Oliver, M. N. (2011). Emotional, developmental and behavioural co-morbidities of children with chronic health conditions. Journal of Paediatrics and Child Health, 47(10), 742–747.  https://doi.org/10.1111/j.1440-1754.2011.02044.xCrossRefPubMedGoogle Scholar
  5. Compas, B. E., Jaser, S. S., Dunn, M. J., & Rodriguez, E. M. (2012). Coping with chronic illness in childhood and adolescences. Annual Review of Clinical Psychology, 8, 455–480.  https://doi.org/10.1146/annurev-clinpsy-032511-143108CrossRefPubMedGoogle Scholar
  6. Crawley, S. A., Caporino, N. E., Birmaher, B., Ginsburg, G., Piacentini, J., Albano, A. M., … Kendall, P. C. (2014). Somatic complaints in anxious youth. Child Psychiatry and Human Development, 45(4), 398–407.  https://doi.org/10.1007/s10578-013-0410-xCrossRefPubMedPubMedCentralGoogle Scholar
  7. Dahlquist, L. M., Busby, S. M., Slifer, K. J., Tucker, C. L., Eischen, S., Hilley, L., & Sulc, W. (2002). Distraction for children of different ages who undergo repeated needle sticks. Journal of Pediatric Oncology Nursing, 19, 22–34.  https://doi.org/10.1053/jpon.2002.30009CrossRefPubMedGoogle Scholar
  8. Drake, K. L., & Ginsburg, G. S. (2012). Family-based cognitive-behavioral treatment of chronic pediatric headache and anxiety disorders: A case study. Child & Youth Care Forum, 41, 579–598.  https://doi.org/10.1007/s10566-012-9174-xCrossRefGoogle Scholar
  9. Dudeney, J., Sharpe, L., Jaffe, A., Jones, E. B., & Hunt, C. (2017). Anxiety in youth with asthma: A meta-analysis. Pediatric Pulmonology, 52(9), 1121–1129.  https://doi.org/10.1002/ppul.23689CrossRefPubMedGoogle Scholar
  10. Eccleston, C., Fisher, E., Law, E., Bartlett, J., & Palermo, T. M. (2015). Psychological interventions for parents of children and adolescents with chronic illness. Cochrane Database of Systematic Review (4): Art. No. CD009660, 142 p.  https://doi.org/10.1002/14651858.CD009660.pub3
  11. Ferro, M. A., & Boyle, M. H. (2015). The impact of chronic physical illness, maternal depressive symptoms, family functioning, and self-esteem on symptoms of anxiety and depression in children. Journal of Abnormal Child Psychology, 43, 177–187.  https://doi.org/10.1007/s10802-014-9893-6CrossRefPubMedGoogle Scholar
  12. Fidler, A., Lawless, C., LaFave, E., Netz, M., McConville, A., Turner, E., & Fedele, D. (2019). Anxiety among adolescent with asthma: Relationships with asthma control and sleep quality. Clinical Practice in Pediatric Psychology, 7(2), 151–156.  https://doi.org/10.1037/cpp0000267CrossRefGoogle Scholar
  13. Fisher, E., Heathcote, L. C., Eccleston, C., Simons, L. E., & Palermo, T. M. (2018). Assessment of pain anxiety, pain catastrophizing, and fear of pain in children and adolescents with chronic pain: A systematic review and meta-analysis. Journal of Pediatric Psychology, 43(3), 314–325.  https://doi.org/10.1093/jpepsy/jsx103CrossRefPubMedGoogle Scholar
  14. Kendall, P. C., Settipani, C. A., & Cummings, C. M. (2012). No need to worry: The promising future of child anxiety research. Journal of Clinical Child and Adolescent Psychology, 41, 103–115.  https://doi.org/10.1080/15374416.2012.632352CrossRefPubMedGoogle Scholar
  15. Knight, A., Weiss, P., Morales, K., Gerdes, M., Rearson, M., Vickery, M., & Keren, R. (2015). Identifying differences in risk factors for depression and anxiety in pediatric chronic disease: A matched cross-sectional study of youth with Lupus/Mixed Connective Tissue Disease and their peers with diabetes. Journal of Pediatrics, 167(6), 1397–1403.e1.  https://doi.org/10.1016/j.jpeds.2015.07.048CrossRefPubMedGoogle Scholar
  16. Koller, D., & Goldman, R. D. (2012). Distraction techniques for children undergoing procedures: A critical review of pediatric research. Journal of Pediatric Nursing, 27, 652–681.  https://doi.org/10.1016/j.pedn.2011.08.001CrossRefPubMedGoogle Scholar
  17. Li, W. H. C., Chung, J. O. K., Ho, K. Y., & Kwok, B. M. C. (2016). Play interventions to reduce anxiety and negative emotions in hospitalized children. BMC Pediatrics, 16, 36–45.  https://doi.org/10.1186/s12887-016-0570-5CrossRefPubMedPubMedCentralGoogle Scholar
  18. McCarthy, A. M., & Kleiber, C. (2006). A conceptual model of factors influencing children’s responses to a painful procedure when parents are distraction coaches. Journal of Pediatric Nursing, 21, 88–98.  https://doi.org/10.1016/j.pedn.2005.06.007CrossRefPubMedGoogle Scholar
  19. Morawska, A., Calam, R., & Fraser, J. (2015). Parenting interventions for childhood chronic illness: A review and recommendations for intervention design and delivery. Journal of Child Health Care, 19(1), 5–17.  https://doi.org/10.1177/1367493513496664CrossRefPubMedGoogle Scholar
  20. Mullins, L. L., Molzon, E. S., Suorsa, K. I., Tackett, A. P., Pai, A. L. H., & Chaney, J. M. (2015). Models of resilience: Developing psychosocial interventions for parents of children with chronic health conditions. Family Relations, 64, 176–189.  https://doi.org/10.1111/fare.12104CrossRefGoogle Scholar
  21. Nabors, L., & Elkins, J. (2017). Coping positively with my worries manual for kids: Getting off the worry racetrack! Cincinnati, OH: University of Cincinnati.Google Scholar
  22. Nabors, L., Liddle, M., Graves, M. L., Kamphaus, A., & Elkins, J. (2019). A family affair: Supporting children with chronic illnesses. Child: Care, Health and Development, 45, 227–233.  https://doi.org/10.1111/cch.12635CrossRefGoogle Scholar
  23. Nabors, L., Odar Stough, C., Combs, A., & Elkins, J. (2019). Implementing the coping positively with my worries manual: A pilot study. Journal of Child and Family Studies, 28(10), 2708–2717.  https://doi.org/10.1007/s10826-019-01451-3CrossRefGoogle Scholar
  24. Norman, K. R., Silverman, W. K., & Lebowitz, E. R. (2015). Family accommodation of child and adolescent anxiety: Mannerisms, assessment, and treatment. Journal of Child and Adolescent Psychiatric Nursing, 28(3), 131–140.  https://doi.org/10.1111/jcap.12116CrossRefPubMedPubMedCentralGoogle Scholar
  25. Pao, M., & Bosk, A. (2011). Anxiety in medically ill children and adolescents. Depression and Anxiety, 28, 40–49.  https://doi.org/10.1002/da.20727CrossRefPubMedGoogle Scholar
  26. Patel, A., Schieble, T., Davidson, M., Tran, M. C. J., Schoenberg, C., Delphin, E., & Bennett, H. (2006). Distraction with a hand-held video game reduces pediatric preoperative anxiety. Pediatric Anesthesia, 16, 1019–1027.  https://doi.org/10.1111/j.1460-9592.2006.01914.xCrossRefPubMedGoogle Scholar
  27. Peterson, L., & Shigetomi, C. (1981). The use of coping techniques to minimize anxiety in hospitalized children. Behavior Therapy, 12(1), 1–14.  https://doi.org/10.1016/S0005-7894(81)80102-5CrossRefGoogle Scholar
  28. Pinquart, M., & Shen, Y. (2011). Anxiety in children and adolescents with chronic physical illnesses: A meta-analysis. Acta Paediatrica, 100, 1069–1076.  https://doi.org/10.1111/j.1651-2227.2011.02223.xCrossRefPubMedGoogle Scholar
  29. Quittner, A. L., Abbott, J., Georgiopoulos, A. M., Goldbeck, L., Smith, B., Hempstead, S. E., … the International Committee on Mental Health. (2016). International Committee on Mental Health in Cystic Fibrosis: Cystic Fibrosis Foundation and European Cystic Fibrosis Society consensus statements for screening and treating depression and anxiety. Thorax, 71, 26–34.  https://doi.org/10.1136/thoraxjnl-2015-207488CrossRefPubMedGoogle Scholar
  30. Reigada, L. C., Benkov, K. J., Bruzzese, J.-M., Hoogendoorn, C., Szigeth, E., Briggie, A., … Warner, C. M. (2013). Integrating illness concerns into cognitive behavioral therapy of children and adolescents with inflammatory bowel disease and co-occurring anxiety. Journal for Specialists in Pediatric Nursing, 18, 133–143.  https://doi.org/10.1111/jspn.12019CrossRefPubMedGoogle Scholar
  31. Stapersma, L., van den Brink, G., van der Ende, J., Szigethy, E. M., Beukers, R., Korpershoek, T. A., … Utens, E. M. W. J. (2018). Effectiveness of disease-specific cognitive behavioral therapy on anxiety, depression, and quality of life in youth with inflammatory bowel disease: A randomized controlled trial. Journal of Pediatric Psychology, 43(9), 967–980.  https://doi.org/10.1093/jpepsy/jsy029CrossRefPubMedPubMedCentralGoogle Scholar
  32. Stein, R. E. K., & Jessop, D. J. (1982). A noncategorical approach to chronic childhood illness. Public Health Reports, 97, 354–362.PubMedPubMedCentralGoogle Scholar
  33. Uman, L. S., Chambers, C. T., McGrath, P. J., & Kisely, S. (2008). A systematic review of randomized controlled trials examining psychological interventions for needle-related procedural pain and distress in children and adolescents: An abbreviated Cochrane review. Journal of Pediatric Psychology, 33, 842–854.  https://doi.org/10.1093/jpepsy/jsn031CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Laura Nabors
    • 1
  1. 1.School of Human ServicesUniversity of CincinnatiCincinnatiUSA

Personalised recommendations