Functional symptoms, defined as symptoms in the absence of organic disease, are common among pediatric patients. Differences exist in the clinical application of the biomedical versus biopsychosocial model in the explanation of functional symptoms. Parents perceive greater symptom severity, have more emotional distress, and more protectively parent their children when uncertainty is high and expectations are unmet for receiving diagnostic, treatment, and prognostic information for childrens symptoms. The current study examined effects of maternal trait anxiety (high versus low), diagnosis (functional versus organic), and physicians presentation of medical information (biomedical versus biopsychosocial) on mothers cognitive, emotional, and behavioral responses to childrens symptoms. Mothers were hypothesized to have more negative responses to functional versus organic diagnoses presented from a biomedical versus biopsychosocial model, particularly for high anxious mothers. Mothers (N = 160) read a vignette describing a child with chronic abdominal pain and completed baseline questionnaires assessing their cognitive, emotional, and behavioral responses imagining themselves as the mother of the child in the vignette. Mothers then viewed one of four videos of a physician giving a functional versus organic diagnosis from a biomedical versus biopsychosocial presentation pertaining to the child in the vignette. Finally, mothers completed questionnaires assessing cognitive, emotional, and behavioral responses to childrens symptoms in response to the medical information received. Controlling for baseline, main effects of anxiety and diagnosis indicated that anxious mothers and those who received a functional diagnosis reported more severe symptom appraisals, pain catastrophizing, negative affect, and protective parenting after the medical evaluation vignette. Interaction effects demonstrated that anxious mothers who received a functional diagnosis presented from a biomedical framework reported significantly higher catastrophizing and negative affect than mothers in any other condition. Results underscore the importance of taking these three factors together in understanding parents responses to childrens symptoms, especially for cognitive and emotional variables. Identifying parent and provider characteristics that influence parents responses to childrens symptoms has the potential to improve the clinical encounter and enhance health outcomes for pediatric patients with functional symptoms.
| Identifer | oai:union.ndltd.org:VANDERBILT/oai:VANDERBILTETD:etd-12062007-121910 |
| Date | 17 December 2007 |
| Creators | Williams, Sara Elizabeth |
| Contributors | Bruce E. Compas, Ph.D., Craig A. Smith, Ph.D., Lynn S. Walker, Ph.D., Stephen P. Bruehl, Ph.D. |
| Publisher | VANDERBILT |
| Source Sets | Vanderbilt University Theses |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.vanderbilt.edu/available/etd-12062007-121910/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to Vanderbilt University or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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