Abstract
It is well established that children with short stature frequently have problems in cognitive development, personality, self-esteem and social relations. This is partly due to the fact that many parents view them as more vulnerable than other children of normal stature and do not allow them to face the normal experiences that correspond to their actual age. The aim of the present study was to assess, through the administration of appropriate psychological tools, a series of psychological and cognitive characteristics [i.e. anxiety, depression, good adjustment, social functioning, feeling of guilt, interpersonal relationship, intelligence quotient (IQ)], as well as variables linked to development of body image, in a group of children suffering from normal growth variants [familial short stature (FSS), no. 10, 4 males/6 females; with constitutional growth delay (CGD), no. 4,4 males; height standard deviation score (HSDS) ranging between −2.4 and −1.9] and in a control group children of normal stature (HSDS between −0.1 and +0.1). Children with short stature significantly differed from normal statured controls as far as Colored Progressive Matrices (CPMs, centiles), IQ (IQ, obtained using the Goodenough test), “Good Adjustment” (Draw-a-Person index, DAP), “Feelings of Guilt” (DAP index), “Height” (as emerges from drawings of the body) are concerned. Significant relationships were found between the height of the subjects (in centiles) and cognitive skills, measured both using CPMs (r=0.408; p=0.017) and Draw-a-Man (DAM) (r=0.359; p=0.037) and between height and feelings of guilt (r=0.325; p=0.027), measured using DAP. CPM scores correlated positively with the “Good Adjustment” index of DAP (r=0.354; p=0.05) and negatively with Children’s Depression Inventory (CDI) (r=−0.609; p=0.01), “School Anxiety” index (r=−0.427; p=0.05) and “Total Anxiety” index (r=−0.436; p=0.05) of the Anxiety Scale Questionnaire for the Age of Development, and with 2 indices of DAP, namely, “Feelings of Guilt” (r=−0.461; p=0.01) and “Interpersonal Relationships (Difficulty in Establishing)” (r=−0.455; p=0.01). A significant positive correlation was found between the height of the subject and both the measurement of the “Body of Drawing 3” (r=0.450, p=0.01) and the measurement of the “Body of Drawing 4” (r=0.461, p=0.01), as well as the with the “Total Height of Drawing 4” (r=0.464, p=0.01). Higher indices for anxiety, depression, feelings of guilt and difficulty in establishing interpersonal relationships and lower indices for good adjustment were found in children with CGD as compared to subjects with FSS or normal statured children. Although further additional studies on larger samples are needed to confirm these preliminary observations, the present study underlines the importance of psychological support also during the growth and development in short normal children.
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Molinari E., Sartorio A. Psiche e bassa statura: aspetti biologici e psico-sociali dello sviluppo umano. Raffaello Cortina Editore, Milano, 1999.
Wiklund I. Short stature and psychological assessment. Acta Paediatr. Scand. 1995, 411 (Suppl.): 69–74.
Frish H., Hausler G., Lindebauer S., Singer S. Psychological aspects in children and adolescents with hypopituitarism. Acta Paediatr. Scand. 1990, 79: 644–651.
Schumacher A. On the significance of short stature in human society. J. Hum. Evol. 1982, 11: 697–701.
Stabler B., Siegel P.T., Clopper R. Growth hormone deficiency in children has psychological and educational comorbidity. Clin. Pediatr. 1991, 30: 156–160.
Stabler B., Clopper R.R., Siegel P.T., Stoppani C., Compton P.G., Underwood L.E. Academic achievement and psychological adjustment in short children. J. Dev. Behav. Pediatr. 1994, 15: 1–6.
Siegel P.T., Clopper R., Stabler B. Psychological impact of significantly short stature. Acta Paediatr. Scand. 1991, 377 (Suppl.): 14–18.
Skuse D., Gilmour J., Tian C.S., Hindmarsh P. Psychosocial assessment of children with short stature: a preliminary report. Acta Paediatr. Scand. 1994, 406 (Suppl): 11–16.
Pilpel D., Leiberman E., Zadik Z., Carel, C.A. Effect of growth hormone treatment on quality of life of shortstature children. Horm. Res. 1995, 44: 1–5.
Busschbach J.J., Rikken B., Grobbee D.E., De Charro F.T., Wit J.M. Quality of life in short adults. Horm. Res. 1998, 49: 32–38.
Rotnem D., Cohen D.J., Hintz R., Genel M. Psychological sequelae of relative “treatment failure” for children receiving human growth hormone replacement. J. Am. Acad. Child. Adolesc. Psychiatry 1979, 18: 505–520.
Gilmour J., Skuse D. Short stature- the role of intelligence in psychosocial adjustment. Arch. Dis. Child. 1986, 75: 25–31.
Sandberg D.E., Brook A.E., Campos S.P. Short stature: a psychosocial burden requiring growth hormone therapy? Pediatrics 1994, 94: 832–840
Zimet G.D., Cutler M., Litvene M., Dahms W., Owens R., Cuttler L. Psychological adjustment of children evaluated for short stature: a preliminary report. J. Dev. Behav. Pediatr. 1995, 16: 264–270.
Zimet G.D., Owens R., Dahms W., Cutler M., Litvene M., Cuttler L. Psychosocial outcome of children evaluated for short stature. Arch. Pediatr. Adolesc. Med. 1997, 151: 1017–1023.
Bernasconi S., Street M.E., Volta C., Mazzardo G. Final height in non-growth hormone deficient children treated with growth hormone. The Italian Multicentre Study Group. Clin. Endocrinol. (Oxf.) 1997, 47: 261–266.
Gallagher S. Body image and body schema: a conceptual clarification. J. Mind Behav. 1986, 4: 541–554.
Gallagher S. Body schema and intentionality. In: Bermudez J.L., Marcel A., Elian N. (Eds.), The body and the self. MIT Press, Cambridge, 1995.
Molinari E., Riva G., Morabito, F. Immagine corporea e problemi psicosociali in soggetti con deficit di GH. Arch. Psicol. Neurol. Psichiatria 1994, 1–2: 389–404.
Riva G., Molinari E. Body image and social attitude in growth hormone deficient adults. Percept. Mot. Skills 1995, 80: 1083–1088.
Sartorio A., Molinari E., Riva G., Conti A., Morabito F., Faglia, G. Growth hormone treatment in adults with childhood onset growth hormone deficiency: effects on psychological capabilities. Horm. Res. 1995, 44: 6–11.
Raven J.C. Coloured Progressive Matrices. Organizzazioni Speciali, Firenze, 1984.
Goodenough F.L. Measurement of intelligence by drawings. World Book Company, Chicago, 1926.
Busnelli C., Dall’Aglio E., Faina P. Questionario Scala d’Anxiety per l’Età Evolutiva — Manuale. Organizzazioni Speciali, Firenze, 1974.
Kovacs M. Children’s Depression Inventory. Questionario di autovalutazione — Manuale. Organizzazioni Speciali, Firenze, 1988.
Machover K. Personality projection in the drawing of human figure. Thomas, Springfield, 1949.
Castellazzi V., Nannini M. II disegno della figura umana come tecnica proiettiva. LAS, Roma, 1992.
Sartorio A., Conti A., Molinari E., Riva G., Morabito F., Faglia G. Growth, growth hormone and cognitive functions. Horm. Res. 1996, 45: 23–29.
Widlocher D. L’interpretazione dei disegni infantili. Armando Editore, Roma, 1965.
Abraham A. Le identificazioni del bambino attraverso il disegno. Ferro Editore, Milano, 1976.
Allamani A., Allegranzi P., Dei M., Rosselli M. Immagine corporea: dimensioni e misure. Una ricerca clinica. Arch. Psicol. Neurol. Psichiatria 1990, 51: 171–195.
Martinelli R. II problema dell’immagine del corpo: contributi della neurologia, della psicoanalisi, della psichiatria, della psicologia genetica. Arch. Psicol. Neurol. Psichiatria 1974, 3: 281–305.
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Partially supported by Progetti di Ricerca Corrente, Istituto Auxologico Italiano, IRCCS, Milan, Italy.
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Molinari, E., Sartorio, A., Ceccarelli, A. et al. Psychological and emotional development, intellectual capabilities, and body image in short normal children. J Endocrinol Invest 25, 321–328 (2002). https://doi.org/10.1007/BF03344012
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DOI: https://doi.org/10.1007/BF03344012