PSYCHOLOGICAL MODEL AND INTERVENTION FOR PEDIATRIC SICKLE CELL DISEASE

本研究提出了一种评估和 治疗已被诊断为镰状细胞病（SCD）的青年。 第一个目的是调查与之相关的风险和耐药因素 儿童和青少年对SCD的适应。 的危险因素 包括疾病/残疾参数、功能 独立性和社会心理压力。 个人和社会- 生态变量和胁迫处理是抗性因子 这将被检查。 据推测，高风险青年 因素和/或低阻力因素将证明最 适应障碍，以其心理健康、社会 功能和身体健康。 样本将包括200个 来自格鲁吉亚、 镰状细胞中心设在格雷迪纪念医院， 埃默里大学埃格斯顿儿童医院。 年龄的影响， 性别和社会经济地位对各领域职能的影响将是 考察 据推测，年龄较大的青年，特别是来自 较低的阶级背景，将证明最大的障碍， 功能正常，并将报告重大风险因素， 与适应性应对相关的阻力因素。 审查 风险和抵抗因素与适应的关系 基于风险抵抗-适应模型的SCD儿童（1）， 将使用结构方程模型。 该项目的第二个目标是进行初步干预， 一项比较认知行为家庭干预与 常规治疗（TAU）对照组。 那些最初 评估数据显示，它们是高风险、低抵抗力和/或差的 在心理社会和精神适应方面将被随机分配到 实验或对照干预条件。 八 会话认知行为家庭干预的重点是 心理教育，解决和管理可控的风险因素， 增强抵抗能力，改善适应功能 跨域。 这两种情况将在治疗后进行比较。 评估和三个月的随访。 据预测，青年和 参与实验条件的家庭将证明 提高抵抗能力，改善精神和心理社会状况 适应

This research proposes to develop a methodology for assessing and treating youth in whom sickle cell disease (SCD) has been diagnosed. The first aim is to investigate risk and resistance factors associated with children and adolescents' adaptation to SCD. The risk factors to be studied include disease/disability parameters, functional independence, and psychosocial stressors. Intrapersonal and social- ecological variables and stress processing are the resistance factors which will be examined. It is hypothesized that youth high on risk factors and/or low on resistance factors will evidence the most impairment in adaptation, as measured by their mental health, social functioning, and physical well-being. the sample will include 200 female and male children, ranging in age from 8-18, from the Georgia Sickle Cell Center based at Grady Memorial Hospital and from the Egleston Children's Hospital of Emory University. The effects of age, gender, and socio-economic status on functioning across domains will be examined. It is hypothesized that older youth, particularly males from lower class backgrounds, will evidence the greatest impairments in functioning and will report significant risk factors and possess few resistance factors associated with adaptive coping. To examine the relationship between risk and resistance factors and adaptation in children with SCD based upon a risk resistance-adaptation model (1), structural equation modeling will be utilized. The project's second aim is to conduct an initial intervention outcome study comparing a cognitive-behavioral family intervention with a treatment as usual (TAU) control group. Those youth whose initial assessment data reveal them to be high risk, low resistance, and/or poor in psychosocial and psychiatric adaptation will be assigned randomly to either an experimental or control intervention condition. The eight session cognitive-behavioral family intervention focuses on psychoeducation, addressing and managing controllable risk factors, enhancing resistance capacities, and improving adaptive functioning across domains. The two conditions will be compared at a post-treatment assessment and a three month follow-up. It is predicted that youth and families who participate in the experimental condition will evidence enhanced resistance skills and improved psychiatric and psychosocial adaptation.