Social-environmental factors and cognitive and behavioral functioning in pediatric sickle cell disease
Social-environmental factors and cognitive and behavioral functioning in pediatric sickle cell disease
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DOI：
10.1080/09297049.2019.1577371
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发表时间：
2020-01-02
影响因子：
2.2
通讯作者：
Reinman, Laura
中科院分区：
文献类型：
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作者：
Bills, Sarah E.;Schatz, Jeffrey;Reinman, Laura
镰状细胞病（SCD）是一种遗传性血液疾病，主要影响非洲裔个体，与严重的医疗并发症以及许多社会环境风险因素有关。这些社会环境因素与长期存在的社会不平等有关，如经济困难和种族歧视，这两者都会影响青年的认知和行为功能。以前的研究社会环境风险和心理功能之间的关系主要依赖于不可修改的，一维的社会经济地位（SES）的措施，如收入和父母的教育，作为社会环境风险的代理。目前的研究旨在通过比较SES与更有针对性和可修改的社会环境因素（例如，父母和家庭功能）与儿科SCD中认知和行为调整的特定领域。70名4-8岁的儿童及其父母完成了社会环境风险和心理适应措施。探索性因素分析表明，父母和家庭功能的措施，在很大程度上是独立的SES。父母和家庭功能预测语音处理和ADHD症状以上，超越SES单独。此外，社会环境风险因素的预测能力似乎因社会功能和数学问题解决能力的基因型严重程度而异。未来的研究需要探索更具体和更好的支持模型，可修改的社会环境风险和社会环境风险对认知和行为功能的相对影响。
Sickle cell disease (SCD), an inherited blood disorder that primarily affects individuals of African descent, is associated with serious medical complications as well as numerous social-environmental risk factors. These social-environmental factors are linked to long-standing social inequities, such as financial hardship and racial discrimination, both of which impact cognitive and behavioral functioning in youth. Previous research on the relationship between social-environmental risk and psychological functioning has primarily relied on non-modifiable, unidimensional measures of socioeconomic status (SES), such as income and parental education, as a proxy for social-environmental risk. The current study aimed to address the limitations associated with typical SES-type measures by comparing the unique and shared association of SES and more targeted and modifiable social-environmental factors (e.g., parent and family functioning) with specific areas of cognitive and behavioral adjustment in pediatric SCD. Seventy children ages 4-8 years old and their parents completed measures of social-environmental risk and psychological adjustment. Exploratory factor analysis indicated parent and family functioning measures were largely independent of SES. Parent and family functioning predicted phonological processing and ADHD symptoms above and beyond SES alone. In addition, the predictive ability of social-environmental risk factors appears to vary by genotype severity for measures of social functioning and math problem-solving ability. Future studies are needed to explore more specific and well-supported models of modifiable social-environmental risk and the relative impact of social-environmental risk on cognitive and behavioral functioning.