Child Psychopathology

Chronic Childhood Illness

Diabetes, Childhood cancer

Reading: Chapter 12

What chronic illnesses in childhood are you aware of?

Psychology’s role in a Children’s Hospital Trauma of child and family Adjustment/ coping with chronic illness, medical

regimens, transplants, surgery Assessment in conjunction with medical diagnosis Management of problem behaviors such as poor

eating, noncompliance Bereavement counselling: For death, as well as

loss of “healthy self”, or “ideal child” Family stressors associated with child illness

Normal variation in children’s expression of health concerns

Did you ever use your health to try to avoid goinbg to school? What happened?

Children experience pain in the same way as adults Children often express fears, worries, anxiety by somatic

complaints (“I have a sore tummy”) Children commonly use pain for secondary gain (e.g.,

increased parental attention) Girls report more symptoms of pain than boys, although

differences likely stem from social expectations and not physiological differences

Family influences and social learning impact pain expression

Chronic illnesses in children

Affect 10 to 20% of population, 1/3 of these are severe

Asthma is the most common chronic illness in childhood

Social class and ethnicity not factors, with the exception of racially-linked disorders – Sickle-cell anemia– Tay Sachs

Low SES may affect survival/outcome rate

Symptoms Of Childhood Diabetes

Insulin-dependent (onset is usually sudden):

frequent urination excessive thirst excessive irritability extreme hunger accompanied by loss of weight nausea and vomiting weakness and fatigue

Non-insulin-dependent (may develop slowly):

any of the above insulin-dependent symptoms, though not necessarily weight loss and/or tingling or numbness in hands or feet recurring or hard-to-heal skin, gum, or bladder infections fatigue blurred vision

itching

Diabetes Can Cause:

Retinopathy: Nearly 39,000 Americans lose their sight to diabetes each year.

Nephropathy: 1 out of 3 people with insulin-dependent diabetes develops kidney failure and need kidney transplants.

Arteriosclerosis: Diabetes can cause arteriosclerosis which leads to heart disease, gangrene and loss of extremities.

People with diabetes are 2-4 times more likely to have heart disease than the general population.

Neuropathy: Diabetic neuropathy leads to severe pain and loss of sensation in extremities. Intestinal problems may

also occur. Over 54,000 lower extremity amputations are performed each year on people with diabetes.

Therefore metabolic control and treatment adherence is a key

Childhood cancer In comparison to adults, onset is more sudden

and disease at advanced state when detected Most common is acute lymphoblastic leukemia White Blood cells reproduce uncontrollably,

attack red blood cells and other organs Survival used to be low, now 2/3’s children

survive to adulthood Treatment: chemotherapy, blood marrow

transplants, reduced psychosocial stress

Do power lines cause leukemia?

Electromagnetic Fields (EMF) measured in the current and former homes and schools of 638 children with leukemia and 620 children without leukemia living in nine different state.

The study included homes where their mothers lived during pregnancy. The New England Journal of Medicine recently published the results of the study

Conclusion: Risk of acute lymphoblastic leukemia is not correlated with exposure to electromagnetic field levels.

Imagery in childrenhttp://coninfo.nursing.uiowa.edu/sites/pedspain/CancerCh/

Terrill Tyrannosaurus the Tyrant

Captain Chemo - One of our heroes!!

What happens to Terrill after Captain Chemo Works!!

Brenda Bone makes blood: Ben Blood (red cells) and Monte, Lenny, Benny, Neut & Bob (white cells).

Zapman, Captain Chemo and Surgery may all work together to help you get well or may work alone. It all depends on where Terrill the Terrible is attacking you.

Who has has their tonsils out?

What most frightening about the surgery?

What was most helpful?

Pain management in children

Analgesics: Acetaminophin, Codeine Behavioral techniques

– Breathing excercises– Muscle relaxation– Distraction, information/ control

Chronic procedures– LP Punctures for CSF– Blood samples– Chemotherapy, surgery recovery

Psychosocial impact of childhood illness

At risk for emotional problems– anxiety and depression may be high, self esteem may

be low Family risk: PTSD Symptoms

– How was the illness dx? Accident or trauma? Marital stress? Sibling impact?

Severe disruptive illnesses have greatest impact on children

Academic problems due to disruption in schooling or neurological involvement

Time permitting, we will see a videotape on obesity.