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The Impact of Chronic Physical Illness, Maternal Depressive Symptoms, Family Functioning, and Self-esteem on Symptoms of Anxiety and Depression in Children

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Abstract

The present study extends earlier research identifying an increased risk of anxiety among children with chronic physical illness (CwCPI) by examining a more complete model that explains how physical illness leads to increased symptoms of anxiety and depression. We tested a stress-generation model linking chronic physical illness to symptoms of anxiety and depression in a population-based sample of children aged 10 to 15 years. We hypothesized that having a chronic physical illness would be associated with more symptoms of anxiety and depression, increased levels of maternal depressive symptoms, more family dysfunction, and lower self-esteem; and, that maternal depressive symptoms, family dysfunction, and child self-esteem would mediate the influence of chronic physical illness on symptoms of anxiety and depression. Data came from the National Longitudinal Survey of Children and Youth (N = 10,646). Mediating processes were analyzed using latent growth curve modeling. Childhood chronic physical illness was associated with increases in symptoms of anxiety and depression, β = 0.20, p < 0.001. Mediating effects were also observed such that chronic physical illness resulted in increases in symptoms of maternal depression and family dysfunction, leading to declines in child self-esteem, and in turn, increases in symptoms of anxiety and depression. CwCPI are at-risk for symptoms of anxiety and depression. Some of this elevated risk appears to work through family processes and child self-esteem. This study supports the use of family-centered care approaches among CwCPI to minimize burden on families and promote healthy psychological development for children.

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Conflict of Interest

Dr. Ferro was the recipient of a Banting Postdoctoral Fellowship from the Government of Canada and is currently supported by a Research Early Career Award from Hamilton Health Sciences. Dr. Boyle holds a Canada Research Chair (Tier I) in the Social Determinants of Child Health from the Canadian Institutes of Health Research. While the research and analyses are based on data from Statistics Canada, the opinions expressed do not represent the views of Statistics Canada.

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Authors and Affiliations

  1. Offord Centre for Child Studies, McMaster University, Chedoke Site, Central Building, Room 304, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada

    Mark A. Ferro & Michael H. Boyle

  2. Department of Pediatrics, McMaster University, Health Sciences Centre, Room 3A 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada

    Mark A. Ferro

  3. Department of Psychiatry and Behavioural Neurosciences, McMaster University, West 5th Campus, Administration - B3, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada

    Mark A. Ferro & Michael H. Boyle

  4. CanChild Centre for Childhood Disability Research, McMaster University, Institute for Applied Health Sciences, Room 408, 1400 Main Street West, Hamilton, ON, L8S 1C7, Canada

    Mark A. Ferro

  5. Department of Clinical Epidemiology and Biostatistics, McMaster University, Health Sciences Centre, Room 2C16, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada

    Michael H. Boyle

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Ferro, M.A., Boyle, M.H. The Impact of Chronic Physical Illness, Maternal Depressive Symptoms, Family Functioning, and Self-esteem on Symptoms of Anxiety and Depression in Children. J Abnorm Child Psychol 43, 177–187 (2015). https://doi.org/10.1007/s10802-014-9893-6

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