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Parental support, internalizing symptoms, perceived health status, and quality of life in adolescents with congenital heart disease: influences and reciprocal effects

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Abstract

Caring for adolescents with congenital heart disease requires attention to physical health but also to psychosocial functioning. Identifying how such psychosocial variables influence one another over time is important for designing health care strategies. The present study examined how depressive symptoms, loneliness, paternal and maternal support, and quality of life predicted one another. A total of 429 mid- to late adolescents with congenital heart disease (53.4 % boys) participated in a three-wave longitudinal study. Cross-lagged analyses indicated that depressive symptoms and loneliness mutually reinforced one another over time and led to relative decreases in quality of life. Paternal- and not so much maternal-support predicted relative decreases in depressive symptoms and loneliness and relative increases in quality of life. Maternal and paternal support, in turn, were negatively predicted by previous levels of adolescent depressive symptoms. In sum, important temporal sequences were uncovered potentially providing information for prevention and intervention targeting psychosocial functioning in adolescents with congenital heart disease.

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References

  • Barber, B. K., Stolz, H. E., & Olsen, J. A. (2005). Parental support, psychological control, and behavioral control: Assessing relevance across time, method, and culture. Monographs of the Society for Research in Child Development, 70(4, Serial No. 281).

  • Berg, C. A., Butler, J. M., Osborn, P., King, G., Palmer, D. L., Butner, J., et al. (2008). Role of parental monitoring in understanding the benefits of parental acceptance on adolescent adherence and metabolic control of type 1 diabetes. Diabetes Care, 31, 678–683.

    Article  PubMed  Google Scholar 

  • Blatt, S. J. (1990). Interpersonal relatedness and self-definition: Two personality configurations and their implications for psychopathology and psychotherapy. In J. Singer (Ed.), Repression: Defense mechanisms and personality (pp. 299–335). Chicago: University of Chicago Press.

    Google Scholar 

  • Bouma, J., Ranchor, A. V., Sanderman, R., & van Sonderen, E. (1995). Het meten van symptomen van depressie met de CESD: Een handleiding [The measurement of symptoms of depression with the CESD: A manual]. Groningen, The Netherlands: Noordelijk Centrum voor Gezondheidsvraagstukken.

  • Casey, F. A., Sykes, D. H., Craig, B. G., Power, R., & Mulholland, H. C. (1996). Behavioral adjustment of children with surgically palliated complex congenital heart disease. Journal of Pediatric Psychology, 21, 335–352.

    Article  CAS  PubMed  Google Scholar 

  • Chaney, J. M., Mullins, L. L., Frank, R. G., Peterson, L., Mace, L. D., Kashani, D. A., et al. (1997). Transactional patterns of child, mother, and father adjustment in insulin-dependent diabetes mellitus: A prospective study. Journal of Pediatric Psychology, 22, 229–244.

    Article  CAS  PubMed  Google Scholar 

  • Chen, C. A., Liao, S. C., Wang, J. K., Chang, C. I., Chiu, I. S., Chen, Y. S., et al. (2011). Quality of life in adults with congenital heart disease: Biopsychosocial determinants and sex-related differences. Heart, 97, 38–43.

    Article  PubMed  Google Scholar 

  • Cohen, J. (1988). Statistical power analyses for the behavioral sciences (2nd ed.). Hillsdale, NY: Erlbaum.

    Google Scholar 

  • Coyne, J. C. (1976). Toward an interactional description of depression. Psychiatry: Interpersonal and Biological Processes, 39, 28–40.

    CAS  Google Scholar 

  • Dillman, D. A. (1983). Mail and other self-administered questionnaires. In P. H. Rossi, J. D. Wright, & A. B. Anderson (Eds.), Handbook of survey research (pp. 359–377). New York: Academic Press.

    Chapter  Google Scholar 

  • Enders, C. K. (2010). Applied missing data analysis. New York: Guilford.

    Google Scholar 

  • Fredriksen, P. M., Diseth, T. H., & Thaulow, E. (2009). Children and adolescents with congenital heart disease: Assessment of behavioural and emotional problems. European Child and Adolescent Psychiatry, 18, 292–300.

    Article  PubMed  Google Scholar 

  • Karsdorp, P. A., Everaerd, W., Kindt, M., & Mulder, B. J. M. (2007). Psychological and cognitive functioning in children and adolescents with congenital heart disease: A meta-analysis. Journal of Pediatric Psychology, 32, 527–541.

    Article  PubMed  Google Scholar 

  • Kline, R. B. (2006). Principles and practices of structural equation modeling (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Kovacs, A. H., Saidi, A. S., Kuhl, E. A., Sears, S. F., Silversides, C., Harrison, J. L., et al. (2009). Depression and anxiety in adult congenital heart disease: Predictors and prevalence. International Journal of Cardiology, 137, 158–164.

    Article  PubMed  Google Scholar 

  • Kovacs, A. H., Sears, S. F., & Saidi, A. S. (2005). Biopsychosocial experiences of adults with congenital heart disease: Review of the literature. American Heart Journal, 150, 193–201.

    Article  PubMed  Google Scholar 

  • Little, R. J. A. (1988). A test of missing completely at random for multivariate data with missing values. Journal of the American Statistical Association, 83, 1198–1202.

    Article  Google Scholar 

  • Luyckx, K., Goossens, E., Missotten, L., & Moons, P. (2011a). Adolescents with congenital heart disease: The importance of perceived parenting for psychosocial and health outcomes. Journal of Developmental and Behavioral Pediatrics, 32, 651–659.

    Article  PubMed  Google Scholar 

  • Luyckx, K., Goossens, E., Van Damme, C., & Moons, P. (2011b). Identity formation in adolescents with congenital cardiac disease: A forgotten issue in the transition to adulthood. Cardiology in the Young, 21, 411–420.

    Article  PubMed  Google Scholar 

  • Luyckx, K., Missotten, L., Goossens, E., & Moons, P. (2012). Individual and contextual determinants of quality of life in adolescents with congenital heart disease. Journal of Adolescent Health, 51, 122–128.

    Article  PubMed  Google Scholar 

  • Mitchell, S. C., Korones, S. B., & Berendes, H. W. (1971). Congenital heart disease in 56,109 births. Incidence and natural history. Circulation, 43, 323–332.

    Article  CAS  PubMed  Google Scholar 

  • Moons, P., Bovijn, L., Budts, W., Belmans, A., & Gewillig, M. (2010). Temporal trends in survival to adulthood among patients born with congenital heart disease from 1970–1992 in Belgium. Circulation, 122, 2264–2272.

    Article  PubMed  Google Scholar 

  • Moons, P., Budts, W., & De Geest, S. (2006a). Critique on the conceptualisation of quality of life: A review and evaluation of different conceptual approaches. International Journal of Nursing Studies, 43, 891–901.

    Article  PubMed  Google Scholar 

  • Moons, P., Sluysmans, T., De Wolf, D., Massin, M., Suys, B., Benatar, A., et al. (2009). Congenital heart disease in 111,225 births in Belgium: Birth prevalence, treatment and survival in the 21st century. Acta Paediatrica, 98, 472–477.

    Article  PubMed  Google Scholar 

  • Moons, P., Van Deyk, K., De Bleser, L., Marquet, K., Raes, E., De Geest, S., et al. (2006b). Quality of life and health status in adults with congenital heart disease: A direct comparison with healthy counterparts. European Journal of Cardiovascular Prevention and Rehabilitation, 13, 407–413.

    PubMed  Google Scholar 

  • Moons, P., Van Deyk, K., Marquet, K., Raes, E., De Bleser, L., Budts, W., et al. (2005). Individual quality of life in adults with congenital heart disease: A paradigm shift. European Heart Journal, 26, 298–307.

    Article  PubMed  Google Scholar 

  • Mussatto, K. (2006). Adaptation of the child and family to life with a chronic illness. Cardiology in the Young, 16, 110–116.

    Article  PubMed  Google Scholar 

  • Muthén, L. K., & Muthén, B. O. (2002). Mplus user’s guide. Los Angeles, CA: Muthén & Muthén.

    Google Scholar 

  • Petersen, A. C., Compas, B. E., Brooks-Gunn, J., Stemmler, M., Ey, S., & Grant, K. E. (1993). Depression in adolescence. American Psychologist, 48, 155–168.

    Article  CAS  PubMed  Google Scholar 

  • Roberts, R. E., Lewinsohn, P. M., & Seeley, J. R. (1993). A brief measure of loneliness suitable for use with adolescents. Psychological Reports, 72, 1379–1391.

    Article  CAS  PubMed  Google Scholar 

  • Schludermann, E. H., & Schludermann, S. M. (1988). Children’s report on parent behavior (CRPBI-108, CRPBI-30) for older children and adolescents. Technical report. Winnipeg, MB, Canada: University of Manitoba, Department of Psychology.

  • Seiffge-Krenke, I. (2002). “Come on, say something, dad!”: Communication and coping in fathers of diabetic adolescents. Journal of Pediatric Psychology, 27, 439–450.

    Article  PubMed  Google Scholar 

  • Shorer, M., David, R., Schoenberg, M., Levavi-Lavi, I., Phillip, M., & Meyerovitch, J. (2011). Role of parenting style in achieving metabolic control in adolescents with type 1 diabetes. Diabetes Care, 34, 1735–1737.

    Article  PubMed  Google Scholar 

  • Spijkerboer, A. W., Helbing, W. A., Bogers, A. J. J. C., Van Domburg, R. T., Verhulst, F. C., & Utens, E. M. W. J. (2007). Long-term psychological distress and styles of coping in parents of children who underwent invasive treatment for congenital cardiac disease. Cardiology in the Young, 17, 638–645.

    Article  PubMed  Google Scholar 

  • Utens, E. M., Verhulst, F. C., Duivenvoorden, H. J., Meijboom, F. J., Erdman, R. A., & Hess, J. (1998). Prediction of behavioural and emotional problems in children and adolescents with operated congenital heart disease. European Heart Journal, 19, 801–807.

    Article  CAS  PubMed  Google Scholar 

  • van der Linde, D., Konings, E. E. M., Slager, M. A., Witsenburg, M., Helbing, W. A., Takkenberg, J. J. M., et al. (2011). Birth prevalence of congenital heart disease worldwide. Journal of the American College of Cardiology, 58, 2241–2247.

    Article  PubMed  Google Scholar 

  • Vander Velde, E. T., Vriend, J. W., Mannens, M. M., Uiterwaal, C. S., Brand, R., & Mulder, B. J. (2005). CONCOR, an initiative towards a national registry and DNA-bank of patients with congenital heart disease in The Netherlands: Rationale, design, and first results. European Journal of Epidemiology, 20, 549–557.

    Article  CAS  PubMed  Google Scholar 

  • Vanhalst, J., Klimstra, T. A., Luyckx, K., Scholte, R. H. J., Engels, R. C. M. E., & Goossens, L. (2012). The interplay of loneliness and depressive symptoms across adolescence: Exploring the role of personality traits. Journal of Youth and Adolescence, 41, 767–787.

    Article  Google Scholar 

  • Warnes, C. A., Liberthson, R., Danielson, G. K., Dore, A., Harris, L., Hoffman, J. I. E., et al. (2001). Task force 1: The changing profile of congenital heart disease in adult life. Journal of the American College of Cardiology, 37, 1170–1175.

    Article  CAS  PubMed  Google Scholar 

  • Wysocki, T., & Gavin, L. (2006). Paternal involvement in the management of pediatric chronic diseases: Associations with adherence, quality of life, and health status. Journal of Pediatric Psychology, 31, 501–511.

    Article  PubMed  Google Scholar 

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Acknowledgments

Funding was provided through grant OT/11/033 from the Research Fund-Catholic University of Leuven (Belgium).

Conflict of interest

The authors have no conflict of interest to disclose.

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Authors and Affiliations

  1. School Psychology and Child and Adolescent Development, KU Leuven, Tiensestraat 102, 3000, Louvain, Belgium

    Koen Luyckx, Jessica Rassart & Janne Vanhalst

  2. Center for Health Services and Nursing Research, KU Leuven, Kapucijnenvoer 35, 3000, Louvain, Belgium

    Eva Goossens, Silke Apers & Philip Moons

  3. University Hospitals of Leuven, Louvain, Belgium

    Philip Moons

  4. The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark

    Philip Moons

Authors
  1. Koen Luyckx
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  2. Eva Goossens
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  3. Jessica Rassart
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  4. Silke Apers
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  5. Janne Vanhalst
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  6. Philip Moons
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Corresponding author

Correspondence to Koen Luyckx.

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This study is conducted on behalf of the i-DETACH investigators.

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Luyckx, K., Goossens, E., Rassart, J. et al. Parental support, internalizing symptoms, perceived health status, and quality of life in adolescents with congenital heart disease: influences and reciprocal effects. J Behav Med 37, 145–155 (2014). https://doi.org/10.1007/s10865-012-9474-5

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  • DOI: https://doi.org/10.1007/s10865-012-9474-5

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