Handicapped kids stand up to family stress.
Researchers have long noted that children with physical disabilities stemming from brain disorders, such as cerebral palsy, also contend with more than their share of psychological disorders. According to one highly regarded theory, the brain disorders render these children more vulnerable to stress and conflict within their families, thus creating a greater risk of mental problems.
But a five-year study conducted by psychologist Naomi Breslau of the Henry Ford Hospital in Detroit finds more vulnerability in the theory itself than in the children it encompasses.
"Children with physical handicaps involving the brain are no more vulnerable to stress within the family than are healthy children," Breslau maintains.
The psychological difficulties that stand out among these youngsters are symptoms of depression related to social isolation and to other negative experiences confronting chronically ill or handicapped persons in general, Breslau reports in the January ARCHIVES OF GENERAL PSYCHIATRY. Handicapped children in the study also displayed substantial problems in maintaining concentrating, particularly in school. Symptoms of inattention may result directly from brain damage, Breslau asserts, but investigators have yet to establish this connection.
Breslau's study compares two groups of children: 157 youngsters with cerebral palsy, myelodysplasia (spinal cord defects) or multiple physical handicaps linked to a brain disorder, and 339 healthy children randomly selected from families living in Cleveland. Children and their mothers were interviewed separately in 1978 and again five years later, when the youngsters averaged 15 years of age.
Interviews with children focused on symptoms of psychological disturbance, such as depression, anxiety, persistent anger and aggression, inattention and hyperactivity. Mothers answered a "family cohesion" questionnaire gauging the amount of support and encouragement among family members.
Disabled children reported significantly more symptoms of depression and inattention than healthy controls, regardless of whether their family cohesion was strong or weak, Breslau says. However, in families providing low levels of support and encouragement, depression increased to the same degree among healthy youngsters as among handicapped ones.
"The physically handicapped children may have depressive reactions to the adversities posed by their condition," Breslau says. "But they do not necessarily have a psychiatric disorder." For example, handicapped children often reported signs of demoralization and sadness that Breslau had previously observed among children with cystic fibrosis, a disabling, life-shortening disease that does not involve the brain.
Inattention and difficulty in concentrating are not problems for cystic fibrosis patients, she adds. In her view, this suggests that these two symptoms may indeed have a biological root among children with brain-induced physical handicaps.
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|Date:||Jan 27, 1990|
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