Couples experiencing private life constraints to their career: understanding home-to-career interference from a couple's perspective

Purpose

This paper examines home-to-career interference (HCI), i.e., the extent to which employees perceive that their private life has constrained their career decisions to date, from a couple perspective. Building on scarcity theory, the authors expect higher levels of HCI among couples that need more and have less resources and, within couples, among the partner who is most likely to take care of home demands. Therefore, the authors explore the role of children and social support as between-couple differences and gender, relative resources and work centrality as within-couple differences. Moreover, the authors examine how one partner's HCI is related to both partners' life satisfaction.

Design/methodology/approach

Hypotheses are tested using hierarchical linear modeling and APIM-analysis with a sample of 197 heterosexual dual-earner couples (N = 394).

Findings

As hypothesized, employees in couples with more children and less social support reported more HCI. No support was found for within-couple differences in gender, educational level or work centrality. Next, HCI was negatively related to employees' own life satisfaction but not to their partner's life satisfaction.

Originality/value

The authors enrich the understanding of HCI by examining this phenomenon from a couple perspective and shed light on couple influences on career experiences.

A Cross-Lag Panel Analysis of Low Self-Esteem as a Predictor of Adolescent Internalizing Symptoms in a Prospective Longitudinal Study

Self-esteem, generally regarded as an important indicator of adolescents' mental health, was assessed by a self-report questionnaire in a school sample of 593 subjects who had been assessed at 3 time points over 7 years between 11 and 25 years of age within the Zurich Psychology and Psychopathology Study (ZAPPS). Cross-lagged panel analyses of the longitudinal data from ZAPPS indicated that self-esteem was predictive of internalizing problems and had an impact on internalizing symptoms when the analyses were adjusted for coping behavior, efficiency of social networks, and impact of stressful life events. Self-esteem was also stable (r = .37-.60) within the observed age range, after controlling for prior levels of the predicted variables. The findings support the impact of self-esteem on mental health and indicate the importance of addressing self-esteem in prevention and intervention programs.

Parent/Adolescent Relationships

This study used longitudinal data from 517 adolescents to examine whether the associations of negative stressful events with symptoms of depression and conduct disorderwere modified by adolescents' reports of parental warmth and harsh discipline. The central questions were (a) Does a positive relationship with just one parent moderate the association of stress with symptoms? ("one good parent" hypothesis) and (b) Does a positive relationship with two parents afford more protection from stress? ("parental agreement" hypothesis). The results indicated that adolescents who reported relatively warm parenting by both mothers andfathers had a smallerassociation of stressful events with symptoms of depression as compared to other adolescents. Further; those adolescents who reported relatively harsherdiscipline by both parents had a higherassociation of stress with depressive symptoms as compared with other adolescents. Generally, there was some supportfor the parental-agreement hypothesis but notfor the one-good-parent hypothesis.

Stress, Coping, and Family Environment

This study extended previous research by assessing the specific coping responses of adolescents as a function of age, type of stressor, and quality of family environment. The findings demonstrated that adolescents employ a range of coping strategies in response to stressors within and external to the family. These strategies varied as a function of age, type of stressor, and perceptions of the quality of the family environment. Specifically, among those who identified interpersonal conflicts as their primary stressor, younger adolescents were more likely to use emotion-based coping strategies than were older adolescents. Using emotion-based strategies, however, was associated with less adaptive family functioning. Further, these coping strategies were orderable on the dimension ofpreference. Thefindings underscored the importance of examining moderating factors and individual differences when studying coping responses to stressful situations.

School-Related Stress, School Support, and Somatic Complaints

This study examines the relationship between school-related stress, social support from teachers and classmates, and somatic complaints in the general population of Norwegian adolescents. The study was undertaken as part of the World Health Organization’s survey “Health Behaviour in School-Aged Children” (HBSC). A representative sample of 4,952 Norwegian 11- to 15-year-olds completed self-report measures on school-related stress, social support from teacher and classmates, and the HBSC symptom checklist. Multivariate logistic regression analysis revealed that students with high levels of school-related stress had a higher odds ratio (OR) for weekly headache (4.1), abdominal pain (3.9), backache (4.8), dizziness (5.4), and coexisting somatic complaints(6.1). For social support, the associations were weaker but students with low classmate support had a consistently higher OR for weekly symptoms. Interaction terms of school-related stress and social support did not reach significance. Findings suggest that adolescents’ frequency of somatic complaints partly may reflect their adaptation to ordinary school demands.

Gender Differences in Adolescents' Reactions to the Murder of Their Teacher

One month following the murder of their teacher, 63 adolescents responded to a questionnaire concerning different aspects of the event. Those adolescents who learned about the murderfrom siblings andfriends reported sufferingfrom more intrusive images and depressive thoughts than those adolescents who learned about the event from parents. Girls reported reacting more strongly and talking more with both theirfriends and their parents about the event than did boys. Differing explanations regarding the observed gender differences are suggested Correlations in the data indicate that those students who reported being the most depressed and anxious were those who talked with their friends about the event. Talking with one's parents was associated with less depressive thinking and less avoidance.

Adolescents with Cancer

This study compared 48 adolescents with cancer and a contrast group of 40 healthy adolescents on two indexes of adjustment, self-image, and perceived social support. Overal4 the findings suggested that adolescents with cancer were relatively well-adjusted, although they exhibited, in comparison to healthy adolescents, a less positive self-image in terms of their social and sexual self Several differences were found when the relationship between stressors appraised as most difficult to deal with and perceived social support was examined. Adolescents with cancer dealing with stressors related to family and interpersonal relationships perceived relatively higher levels of social support than did healthy adolescents. In contrast, healthy adolescents perceived greater levels of social support than did adolescents with cancer when stressors related to external demands were identified as most difficult to manage. These results support the importance of considering the relationship between situations appraised as stressful and the process of adjustment to cancer for adolescents.

Promoting Optimal Adolescent Development through Conflict Resolution Education, braining, and Practice

The purpose of this article is to examine how the problem-solving approach taken by the emerging field of youth-oriented conflict resolution is developmentally appropriate for a full range of adolescents and thereby promotes optimal development. The application of conflict resolution modalities to adolescents is conceptualized within an educational/developmental, preventive, and remedial framework that provides the context for reviewing the positive effects of conflict resolution on adolescents. A comprehensive approach to the use of conflict resolution modalities with adolescents as a basis for promoting optimal development is proposed, with attention given to the issues of culture and diversity. The potential interface between the fields of counseling and conflict resolution and the role that counseling psychologists can play in the development of this emerging field is discussed.

School-Related Stress and Psychosomatic Symptoms among Norwegian Adolescents

This study examines the relationships between school-related stress, gender and psychosomatic symptoms in a sample of 531 adolescents pupils in years (grades) 8, 9 and 10 (aged 13-16 years) from two compulsory schools in Norway. Results showed that 18.1 percent reported being ‘very much’ affected by at least one of the assessed psychosomatic symptoms. Girls reported significantly more psychosomatic symptoms than did boys. Tests of the dimensionality of the school-related stress that was assessed in the present study showed four main categories: (1) difficulties with peers at school; (2) worries about school achievement; (3) schoolwork pressure and (4) conflicts with parents and/or teachers. Results from multiple regression analyses showed that scores for the different stressors were significantly associated with psychosomatic symptoms. Findings suggest that frequency of psychosomatic symptoms might be related to how well or otherwise pupils adapt to the demands of school and to the interpersonal climate of the school. Gender seems to play a differentiating role here. Girls reported significantly more stress that was related to worries about school achievement, whereas boys reported significantly more stress arising from conflicts with parents and/or teachers. Finally, stress due to difficulties with peers at school was more closely correlated with psychosomatic symptoms among boys than among girls.

Academic stress, self-efficacy, social support, and health behaviours in female Victorian Certificate of Education (VCE) students

This study examined academic stress in female Victorian Certificate of Education (VCE) students in terms of somatic symptoms and mood disturbance before, during, and after the midyear examination period and also examined the role of self-efficacy, number of social supports, social support satisfaction, and health behaviours in mediating the effects of stress on symptoms and mood disturbance. It was hypothesised that (a) student would report increased somatic symptoms and mood disturbance during the examination period and that (b) self-efficacy, social support (number and satisfaction), and health behaviours would account for a significant proportion of variance for somatic symptoms and mood disturbance before, during, and after the exam period. The participants were 51 VCE students from a large Catholic girls’secondary college in Melbourne. Four weeks before the exam period, the Generalized Self-Efficacy Scale, Reported Health Behaviours Checklist, Short Form Social Support Questionnaire, Symptoms Checklist, and Profile of Mood States were administered.The Symptoms Checklist and Profile of Mood States were administered again during the exam week and four weeks after the exam period. Statistical analyses showed that the VCE examination period was associated with significantly increased self-reports of somatic symptoms and mood disturbances that were strongly indicative of high levels of stress. Self-efficacy was found to have a weak role in mediating the stress response during the exam week. Social support did not account for any of the variation in academic stress. Health behaviours accounted for a small but significant proportion of the variance in stress after the exam period. It was concluded that there is a need to study other factors that may attenuate the academic stress response in adolescent secondary school students. The perceptual and cognitive appraisal of academic stressors is suggested as an area that may be worthy of examination.The implications of the findings are discussed in terms of the impact that academic stress may have on adolescents’ health during this critical period of development.

A family intervention to reduce sexual risk behavior, substance use, and delinquency among newly homeless youth

PURPOSE

We evaluate the efficacy of a short family intervention in reducing sexual risk behavior, drug use, and delinquent behaviors among homeless youth.

METHODS

A randomized controlled trial of 151 families with a homeless adolescent aged 12 to 17 years. Between March 2006 and June 2009, adolescents were recruited from diverse sites in Southern California and were assessed at recruitment (baseline), and at 3, 6, and 12 months later. Families were randomly assigned to an intervention condition with five weekly home-based intervention sessions or a control condition (standard care). Main outcome measures reflect self-reported sexual risk behavior, substance use, and delinquent behaviors over the past 90 days.

RESULTS

Sexual risk behavior (e.g., mean number of partners; p < .001), alcohol use (p = .003), hard drug use (p < .001), and delinquent behaviors (p = .001) decreased significantly more during 12 months in the intervention condition compared with the control condition. Marijuana use, however, significantly increased in the intervention condition compared with the control condition (p < .001).

CONCLUSIONS

An intervention to reengage families of homeless youth has significant benefits in reducing risk over 12 months.

Psychological correlates of depression in children with recurrent abdominal pain

OBJECTIVE

To examine the associations between coping style, social support, self-efficacy, locus of control, maternal adjustment, and depressive symptoms in children with recurrent abdominal pain (RAP) of childhood.

METHODS

Fifty children with RAP (8-18 years) and their mothers were recruited from a gastroenterology clinic (GI) and community medical practices. Participants completed questionnaires that assessed coping style, social support, self-efficacy, locus of control, maternal adjustment, and psychological adjustment.

RESULTS

Passive coping strategies such as isolating oneself from others, catastrophizing, and behavioral disengagement were associated with more child-reported depressive symptoms. Higher levels of self-efficacy and greater social support from teachers and classmates were associated with fewer child-reported depressive symptoms. Higher levels of maternal adjustment problems, higher social support from parents, and lower social support from classmates were associated with maternal reports of more child internalizing symptoms.

CONCLUSIONS

These findings suggest that coping style, self-efficacy, social support, and maternal adjustment are correlates of depressive symptoms in children with RAP.

Cognitive Behavior Therapy for the Treatment of Recurrent Abdominal Pain

This article outlines the rationale and use of cognitive behavior therapy in the treatment of the gastrointestinal symptoms and illness behavior associated with Recurrent Abdominal Pain (RAP), often described as the childhood variant of IBS. It begins with a conceptualization of the social learning perspective of RAP, and then covers the relationship between childhood social learning and adult and childhood illness behavior. Studies that have utilized a cognitive behavior therapy approach for treating adult pain are summarized. Finally, specific cognitive behavior therapy trials for treating RAP, as well as moderators of treatment effectiveness, are discussed.

Increased somatic complaints and health-care utilization in children: effects of parent IBS status and parent response to gastrointestinal symptoms

OBJECTIVES

Irritable bowel syndrome (IBS) runs in families. The aims of this study were (i) to exclude biased perception by a mother with irritable bowel as the explanation for increased gastrointestinal (GI) symptoms in their children, (ii) to determine whether non-GI as well as GI symptoms run in families, and (iii) to determine whether parent IBS status and solicitous responses to illness exert independent effects on children's symptom reports, medical clinic visits, and school absences.

METHODS

Two hundred and eight mothers with irritable bowel and their 296 children (cases: average age 11.9 yr; 48.6% male) and 241 nonirritable bowel mothers and their 335 children (controls: 11.8 yr; 49.0% male) were interviewed. Other factors assessed were stress, mother's and child's psychological symptoms, child's perceived competence, pain coping style, age, and sex. Children were interviewed apart from their parents.

RESULTS

Case children independently reported more frequent stomach aches (F(591) = 9.22; p= 0.0025) and non-GI symptoms (F(562) = 21.03; p < 0.001) than control children. Case children also had more school absences (F(625) = 26.53; p < 0.0001), physician visits for GI symptoms (F(602) = 8.09; p= 0.005), and non-GI clinic visits (F(602) = 27.92; p < 0.001) than control children. Children whose mothers made solicitous responses to illness complaints independently reported more severe stomach aches (F(590) = 11.42; p < 0.001), and they also had more school absences for stomach aches (F(625) = 5.33; p < 0.05), but solicitous behavior did not significantly impact non-GI symptom reporting, clinic visits, or school absences. Differences between cases and controls remained significant after adjusting for potential moderators.

CONCLUSIONS

(i) Frequent GI complaints in children whose mothers have irritable bowel are not explained by the mother's biased perceptions; (ii) children of mothers with irritable bowel have more non-GI as well as GI symptoms, disability days, and clinical visits; (iii) and parent IBS status and solicitous responses to illness have independent effects on the child's symptom complaints.

Changes in clinically relevant metabolites with psychological stress parameters

Psychological stress is associated with increased oxidative stress, a pro-inflammatory state, increased rate of infection, and cardiovascular disease. Cardiovascular disease also is associated with increased stress, homocysteine, and C-reactive protein (CRP) levels. In this study, the authors measured various markers of psychological stress and correlated with homocysteine, CRP, salivary IgA, and oxidative stress. The results of the study showed that psychological stress is associated with pro-oxidant and pro-inflammatory states as evidenced by either decreased NT levels and/or increased CRP concentrations. Conversely, positive or low stress parameters, indicating good life skill mechanisms were associated with increased NT and decreased CRP--indications of a low pro-oxidant state. Homocysteine was associated with increased anger (anger-suppression and anger-experience), psychological parameters associated with cardiovascular disease and also mildly elevated CRP and homocysteine levels. Psychological well-being and stress are correlated with biochemical parameters both positively and negatively in relation to immunity and cardiovascular disease processes. The cross-sectional design and correlational approach used in this study preclude any inferences of causality but suggest several potentially useful avenues for future research.

Mental health, life stress and social support among young Norwegian adolescents with immigrant and host national background

The first aim of the study was to investigate differences in level of mental health, life stress and social support among adolescents with immigrant and domestic background. A second aim was to identify culture group and gender specific sources of risk and protective factors and their relation to mental health. Questionnaire data were collected from 633 students, aged 13, in Oslo, Norway. Immigrant adolescents reported higher level of psychological distress and lower social support than host students. Of the four gender-culture groups, immigrant boys reported the highest level of problems, with a 28% prevalence of anxiety/depression. There were no significant differences in prevalence among the girls. Specific patterns of relationships between life stress, support, and mental health were found across gender and culture. The results were discussed within a framework of culture differences in values and gender role expectancies, underscoring the importance of studying each gender/culture group separately.

Health concerns of university women with a history of child physical and sexual maltreatment

Three health symptom checklists were used to measure physical health concerns among university women in relation to prior child physical maltreatment (CPM) (20%, n = 153) and child sexual abuse (CSA) (19%, n = 143). A history of CPM was related to all three general areas of health concerns as well as to many of the specific subscales comprising the measures (e.g., muscular-skeletal symptoms and gynerological problems), whereas an interaction between CSA and CPM was linked to greater premenstrual distress subscale scores (particularly emotional and behavioral symptoms). Overall, although CSA was not related to health symptoms, within the CSA subgroup, greater duration and severity of CSA was predictive of higher premenstrual distress even after controlling for CPM. This study emphasizes the need for greater awareness of the physical health-related correlates of both physical and sexual maltreatment in childhood and their associated implications for women's health care needs.

Psychosocial aspects of assessment and treatment of irritable bowel syndrome in adults and recurrent abdominal pain in children

This article presents a selective review of psychosocial research on irritable bowel syndrome (IBS) in adults and on a possible developmental precursor, recurrent abdominal pain (RAP), in children. For IBS the authors provide a summary of epidemiology, of the psychological and psychiatric disturbances frequently found among IBS patients, and of the possible role of early abuse in IBS. A review of the psychosocial treatments for IBS finds strong evidence to support the efficacy of hypnotherapy, cognitive therapy, and brief psychodynamic psychotherapy. The research relating RAP to IBS is briefly reviewed, as is the research on its psychological treatment. Cognitive-behavioral therapy that combines operant elements and stress management has the strongest support as a treatment for RAP.

School-related stress, support, and subjective health complaints among early adolescents: a multilevel approach

This study investigated the relationship between shared psychosocial school environment and subjective health complaints. A representative sample of 1585 Norwegian grade 8 students (mean age 13.5 years) from 82 schoolclasses completed scales on health complaints, academic stress, the teacher and classmate support scale, decision control, and noise and disturbance in class. Multilevel analysis (MlwiN) revealed that level of health complaints varied across schoolclasses (ICC=5.6%). School class differences in psychosocial environment accounted for 40% of the between-schoolclass variance in health complaints. Tests of cross-level interaction showed a statistically significant interaction between mean schoolclass-level of classmate support and individual level of academic stress. Findings suggest that shared schoolclass contextual factors may have main and stress-moderating effects on adolescent health complaints.

The relation of daily stressors to somatic and emotional symptoms in children with and without recurrent abdominal pain

Prior investigations of the relation between stressors and symptoms in children with recurrent abdominal pain (RAP) have focused on major negative life events. This study used consecutive daily telephone interviews to assess daily stressors and symptoms in 154 pediatric patients with RAP and 109 well children. Results showed that patients with RAP reported more frequent daily stressors than well children reported both at home and at school. Idiographic (within-subject) analyses indicated that the association between daily stressors and somatic symptoms was significantly stronger for patients with RAP than for well children. In contrast, the relation between daily stressors and negative affect did not differ between the groups. The relation between daily stressors and somatic symptoms was stronger for patients with RAP who had higher levels of trait negative affectivity.

Self-esteem and hopefulness in adolescents with cancer

Increased survivorship in childhood cancer has raised questions about adolescents' psychosocial functioning during the treatment experience and long-term adaptation as cancer survivors. This descriptive correlation study examines the relationships among the stages of adolescence, gender, self-esteem, and hopefulness in a sample of 45 adolescents with cancer. The perceived level of self-esteem was measured by using the Coopersmith Self-Esteem Inventory; the amount of hopefulness was measured by using the Hopefulness Scale for Adolescents. Mean scores for self-esteem and hopefulness were comparable to normative data reported for healthy adolescents on each scale. Perceived level of self-esteem and hopefulness did not significantly differ between boys and girls overall; early, middle, and late adolescents; or between boys and girls within each stage of adolescence. A stepwise multiple regression analysis showed self-esteem and the early stage of adolescence accounted for 27.3% (R2 = .306) of the variance in hopefulness scores. Self-esteem was the most significant predictor (F = 12.456, p = .001), explaining 20.7% of the variance (R2 = .225, p = .001). This study contributes to nursing the knowledge of the psychosocial response and the treatment experience in adolescents with cancer. These results can be used in future research to develop and test nursing actions that can influence a perceived sense of self-esteem and hopefulness and potentially allow for continued psychosocial development and effective coping among these adolescents during treatment and into survivorship.

Social support and subjective well-being among Hong Kong Chinese young adults

The associations between social support and 3 measures of subjective well-being--depressive symptomatology, negative affect, and positive affect--were studied among Hong Kong Chinese young adults (N = 475) between 16 and 19 years old. Significant bivariate relationships were found between positive affect and all dimensions of social support (including social network size, social contact frequency, satisfaction with social support, instrumental support, and helping others) except composition of social network. Helping others variables and relationship satisfaction variables were negatively related to both depressive symptoms and negative affect. Multiple regression models revealed that satisfaction with relationships with family members and friends was consistently associated with all measures of subjective well-being, and number of friends felt close to was positively related to positive affect.

Attachment and interpersonal communication in somatization

The authors review the research on childhood antecedents and personality contributions to the somatoform disorders, as well as research on social influences during adulthood. Based on these data, the authors hypothesize that somatizing patients display anxious attachment behavior that derives from childhood experiences with caregivers. Early exposure to illness increases the likelihood that distress will be manifested somatically. When under stress as adults, somatizers use physical complaints to elicit care. Somatizers' interpersonal interactions with others, including physicians, ultimately lead to rejection that reinforces the somatizer's belief that he or she will be abandoned. Modification of physicians' responses to these patients may improve treatment outcomes.

Independence of childhood life events and chronic adversities: a comparison of two patient groups and controls

OBJECTIVE

To examine the differences between independent and behavior-dependent stressful life events and chronic adversities in child psychiatric patients, community controls, and children with asthma.

METHOD

The Psychosocial Assessment of Childhood Experiences was used to assess recent severe events (life events with high long-term threat) and major adversities (long-term experiences with high negative impact on child) in children attending a psychiatric clinic (n = 99), community controls (n = 26), and children with chronic asthma (n = 94).

RESULTS

In the previous year, the psychiatric patients had, on average, experienced significantly more independent and behavior-dependent severe events and major adversities than either the controls or the asthmatic patients. The differences were most pronounced in relation to behavior-dependent high-threat life events and long-term-experiences. Among the psychiatric patients, one third of all severe events and one quarter of all major adversities were dependent on the child's behavior. The corresponding proportions in the controls and children with asthma were between one fifth and one twelfth.

CONCLUSIONS

Psychiatrically disturbed children have an increased risk of experiencing behavior-dependent life events and long-term adversities compared with their peers in the community at large and compared with children suffering from a chronic physical illness such as asthma. Future studies need to examine the possible contributions of such experiences to the development and maintenance of psychiatric and physical illness in children.

Computer-mediated social support: single young mothers as a model system

Forty-two single mothers with young infants were given access to a computer-mediated social support (CMSS) network concerned with parenting issues. The network operated 24 hours per day over a period of 6 months. It permitted public message exchanges, private e-mail, and text-based teleconferencing for as many as 8 participants at any one time. During the 6 month intervention, the 42 women accessed the network over 16,670 times. Individual differences in participation were significantly associated with indices of social isolation from peers. A descriptive analyses of the messages exchanged on the network disclosed that 98% of the replies to concerns posted in the public forum provided positive social support. The majority of the supportive replies fell into the category of emotional support, followed in order by informational and tangible support. Both the self-report data following the intervention, and qualitative data extracted from online discussions indicated that close personal relationships and a sense of community developed in this novel social environment. Finally, an analysis of pretest-posttest changes in the level of parenting stress revealed that mothers who participated regularly in this CMSS community were more likely to report a decrease in parenting stress following the intervention.

Psychosomatic problems and stress in adolescence

Psychosomatic problems are common in adolescents, and stress frequently plays a role in their development and maintenance. Armed with an understanding of the stressors experienced by adolescents, the individual's vulnerabilities and competencies and their level of social support, the physician can systematically assess each of these factors. Once the assessment is complete, a management plan can be formulated to address the particular psychosomatic problem. Symptom relief, stress reduction, and promotion of competence are important interventions that can be initiated by the primary care physician. When referrals are made for counseling and other stress management techniques, the primary care physician should maintain contact with the patient and family and remain an integral part of the management team. Incorporating brief discussions about the potential role of stress in health and illness into anticipatory guidance sessions may also help prevent the development of psychosomatic problems in adolescents.

Pre-adolescent chumship as a buffer against psychopathology in adolescents with weak family support and weak parental bonding

This study examines the degree to which the existence of a pre-adolescent "chum" interacts with family and social environments to buffer mental distress in adolescents. 831 high school students participated in this study, (male: 355; female: 476; mean age 16.7 +/- 1.0). Subjects were administered questionnaires assessing psychopathology and support systems. A pathway analyses model was used to investigate pathways and their interrelationships from chum to psychopathology and from social and family support to psychopathology. Only when adolescents experience weak parental bonding does chumship have a role in buffering distress.

Life stress, social support and psychological distress in late adolescence

Psychological distress in high-school students was examined in relation to negative life events, long-lasting adversities and perceived social support from the family, friends and the school class. Academic problems increased the symptom levels of psychological distress, and social support from family and social support from friends reduced the symptoms among males and females. For females, social support from school class-mates and problems with parents and friends also had direct independent effects on symptom levels. An effect of the total number of long-lasting adversities was significantly stronger for females than males. The buffer hypothesis was supported: both an increase in social support from parents and social support from peers reduced the effect of negative life events.

Somatization in children and adolescents

OBJECTIVE

To review the empirical literature on somatization in the pediatric age group, emphasizing prevalence, influence on health care utilization, issues in the development of somatization, comorbidity with other psychiatric disorders, assessment, and treatment.

METHOD

One hundred nineteen studies and reports addressing medically unexplained somatic symptoms in children and adolescents were compiled via MEDLINE search and extensive cross-referencing. All available controlled studies were included, as were selected case reports and collections of cases. Selected citations from the adult literature were chosen for relevance to pediatric somatization.

RESULTS

Recurrent, medically unexplained physical symptoms are common in the pediatric age group, are often associated with other psychiatric symptoms, and may represent a common presentation of psychiatric disorder in the primary care setting. DSM-III-R-defined somatization disorder is rare, and pseudoneurological symptoms are unusual. Patients may be at risk for potentially dangerous, costly, and unnecessary medical investigations and treatments, and they may excessively utilize health care services.

CONCLUSION

Our current understanding of pediatric somatization and its consequences is limited. Collaboration between mental health professionals and primary health care providers is essential. Consistent terminology, developmentally appropriate classification, and systematic future research will be necessary for the development of successful prevention and treatment strategies.

Self-efficacy in normal adolescents

This descriptive study, one component of the Carolina Adolescent Health Project (CAHP), measured self-efficacy in a voluntary sample of 432 normal freshmen and sophomore urban high school students. Using Coppel's Self-Efficacy Scale (SES), which is based on Bandura's conceptualization of self-efficacy, the research also examined the effect of gender, race, socioeconomic status, and self-reported religiosity on self-efficacy. The teenagers in this sample had a moderately high degree of self-efficacy with a mean SES score of 45.37 (SES range = 13-65). A series of t tests and one-way and two-way analyses of variance indicated no significant difference in SES scores by race, gender, socioeconomic status, or religiosity. Findings did not support the investigators' original expectation that these demographic and psychosocial variables would affect self-efficacy. The study provides normative data for future comparative studies using the SES.

Psychological adjustment and perceived social support in children with congenital/acquired limb deficiencies

The negative impact on psychological adjustment from the chronic strain of living with limb deficiencies appears to be mediated by perceived social support. A multifactorial investigation was conducted to identify empirically psychological adjustment correlates of perceived social support in 49 children with congenital/acquired limb deficiencies. A multiplicity of adjustment factors (depression, trait anxiety, self-esteem) was variously related to perceived parent, teacher, classmate, and friend social support. Hierarchical multiple regression analyses provide initial evidence of the potentially powerful effects of the social environment of the school setting, with perceived classmate social support the only significant predictor variable across depressive symptomatology, trait anxiety, and general self-esteem. The results are discussed as the first step in identifying the potential correlates of multiple perceived social support domains, which may provide empirical guidance for future intervention studies designed to modify adjustment factors in chronically ill and handicapped children.

Use of the Family Adaptability and Cohesion Evaluation Scales in child clinical research

Although the FACES has become a widely used instrument for assessing children's family relations, the possible linearity vs. curvilinearity of its cohesion and adaptability scales has been treated inconsistently by investigators. This study evaluated whether samples of adolescent repeat offenders, young adult prisoners, and adolescent nonoffenders were discriminated better by a linear or curvilinear treatment of the FACES scores. Between-groups comparisons showed that significant effects were observed for each of the three curvilinear measures (cohesion-curvilinear, adaptability-curvilinear, distance-from-center) and only one of the two linear measures (cohesion-linear). These findings support the superiority of a curvilinear treatment of the FACES. In light of these findings, it is suggested that investigators who use FACES evaluate the linearity of the scales and determine whether a linear or curvilinear treatment of the data produces more meaningful results.

Common problems and coping strategies. I: Findings with normal adolescents

This study investigated problems commonly experienced by adolescents and the strategies they use to cope with these events. Coping strategies were examined across the subjects' emotional state and their evaluation of the problem. In general, adolescents reported four common stressors that were similar across age groups and gender. However, males differed from females in the frequency of these problems. Further, while the stressors were similar, the frequency with which the coping strategies were employed and the efficacy ascribed to them differed across sex and across problem type. These findings are discussed in terms of the stress and coping literature with adults and the implications for clinical assessment and treatment of adolescents.

Social support and adjustment in chronically ill and handicapped children

The relationship between social support and adjustment was investigated in children with a chronic physical illness or handicap. Mothers of 153 children with juvenile diabetes, juvenile rheumatoid arthritis, chronic obesity, spina bifida, or cerebral palsy reported on these children's family support, peer support, externalizing behavior problems, and internalizing behavior problems. Children reported as having high social support from both family and peers showed a significantly better adjustment than those with high social support from only one of these sources. Chronically ill or physically handicapped children without high support from both family and peers were reported to have significantly more behavior problems than children in general. Both family and peer support contributed negatively and independently to the variance in externalizing behavior problems, whereas only peer support did so for internalizing behavior problems. There were no interactions between type of support and either sex or age in predicting adjustment.