Award Date

2009

Degree Type

Dissertation

Degree Name

Doctor of Philosophy in Psychology

Department

Psychology

Advisor 1

Christopher Kearney, Committee Chair

First Committee Member

Marta Meana

Second Committee Member

Murray Millar

Third Committee Member

Jennifer Keene

Number of Pages

229

Abstract

Currently, there is a paucity of literature regarding children's experiences in a pediatric intensive care unit (PICU) relative to caregivers' experiences. Children admitted to a PICU and their caregivers are at risk for various psychopathology. Disorders commonly identified in seriously ill children include depression, anxiety, acute stress disorder, and posttraumatic stress disorder. Caregivers of seriously ill children are at increased risk of depression, generalized anxiety disorder, acute stress disorder, and posttraumatic stress disorder. Researchers often fail to examine all relevant psychopathology and contributing factors and stressors, such as family environment, in seriously ill children and their caregivers. This study assessed 54 children admitted to a local PICU and their caregivers for relevant psychopathology. The mediating factors between the development of acute stress disorder and posttraumatic stress disorder were examined.

The first hypotheses was parental psychopathology, specifically symptoms of anxiety, depression, and ASD, would mediate the relationship between (1) youth ASD symptoms during PICU admission and (2) the development of PTSD symptoms 4-7 weeks after discharge from the PICU. The second hypotheses was a child's psychological functioning prior to admission, specifically symptoms of anxiety and depression, would mediate the relationship between (1) youth ASD symptoms during PICU admission and (2) the development of PTSD symptoms 4-7 weeks after discharge from the PICU. The third hypothesis was that parental psychopathology, specifically symptoms of anxiety and depression, will mediate the relationship between (1) parental ASD symptoms during their child's PICU admission and (2) the development of PTSD symptoms 4-7 weeks after their child is discharged from the PICU. The fourth hypothesis was that family environment impacted symptoms of psychopathology in both the youth and the caregiver. Specifically, control and conflict were hypothesized to be positively correlated with symptoms of depression and anxiety. With respect to cohesion and expressiveness a negative relationship was hypothesized. A relationship between independence and the symptoms of depression and anxiety was also hypothesized. Analyses did not confirm hypotheses one or three. For hypothesis three, results supported a full mediation by youth anxiety as measured, however, a subsequent Sobel test for the model was not significant.

ASD symptoms were a predictor for PTSD, replicating findings of previous research. Study findings also implicate subjective experience and anxiety in the development of ASD and PTSD. A discussion of study results indicate children admitted to a PICU and their parents are at increased risk for psychopathology and assessment should occur as well as intervention consideration.

Keywords

Acute stress disorder (ASD); Anxiety; Caregivers; Parents; Pediatric intensive care unit (PICU); Pediatric patients; Posttraumatic stress disorder (PTSD)

Disciplines

Clinical Psychology | Pediatrics

Language

English


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