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October 1996, Vol 150, No. 10 >
Article | October 1996

The Psychological Effects of Parental Human Immunodeficiency Virus Infection on Uninfected Children FREE

Brian W. C. Forsyth, MB, ChB, FRCPC; Lisa Damour, MA; Steven Nagler, MSW; Jean Adnopoz, MPH
Arch Pediatr Adolesc Med. 1996;150(10):1015-1020. doi:10.1001/archpedi.1996.02170350017002.
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Objective:  To assess the mental health of children of mothers infected with the human immunodeficiency virus.

Design:  Matched comparison of 26 children of mothers infected with the human immunodeficiency virus and 26 children with no experience of human immunodeficiency virus infection within their families.

Setting:  Subject children were identified through hospital acquired immunodeficiency syndrome clinics and comparison children were identified through the primary care center of the same hospital.

Participants:  Subjects and controls were aged 6 to 16 years and matched by age, sex, race, and maternal marital and employment status.

Main Outcome Measures:  Parents completed the Child Behavior Checklist and the children completed the Revised Children's Manifest Anxiety Scale and the Children's Depression Inventory.

Results:  Controlling for confounding variables, subjects were found by the Child Behavior Checklist to be significantly more withdrawn (P<.05) and to have more problems with attention (P<.005) than controls, although total Child Behavior Checklist scores were not significantly different. Compared with control children, the subject children reported more depression on the Children's Depression Inventory (P<.05) but were not more anxious. However, compared with children of asymptomatic mothers, the children of symptomatic mothers were reported to be significantly more anxious and/or depressed on the Child Behavior Checklist (P<.01) and the children reported more anxiety on the Revised Children's Manifest Anxiety Scale (P<.05).

Conclusions:  This study focusing specifically on uninfected children in families affected by the human immunodeficiency virus demonstrates some of the psychological ramifications of this disease. Larger studies are required to identify factors that contribute to the vulnerabilities and resilience of such children. Attention needs to focus on ameliorating these adverse effects on the children of the acquired immunodeficiency syndrome epidemic.Arch Pediatr Adolesc Med. 1996;150:1015-1020

REFERENCES

1 +
Michaels D, Levine C.  Estimates of the number of motherless youth orphaned by AIDS in the United States . JAMA . 1992;;268:3456-3461.
2 +
Centers for Disease Control and Prevention.  US HIV and AIDS cases reported through December 1994 . HIV/AIDS Surveill Rep . 1995;;6:10.
3 +
Ellerbrock TV, Bush TJ, Chamberland ME, Oxtoby MJ.  Epidemiology of women with AIDS in the United States, 1981 through 1990: a comparison with heterosexual men with AIDS . JAMA . 1991;;265:2971-2975.
4 +
Niebuhr VN, Hughes JR, Pollard RB.  Parents with human immunodeficiency virus infection: perceptions of their children's emotional needs . Pediatrics . 1994;;93:421-426.
5 +
Sherwen LN, Boland M.  Overview of psychosocial research concerning pediatric human immunodeficiency virus infection . J Dev Behav Pediatr . 1994;;15( (suppl) ):S5-S11.
6 +
Taylor-Brown S, Kumetat SH.  Psychosocial aspects of pediatric human immunodeficiency virus-infected children . J Dev Behav Pediatr . 1994;;15( (suppl) ):S71-S76.
7 +
Drucker E, Rothschild J, Poust B, et al.  IV drug users with AIDS in New York City: a study of dependent children, housing and drug addiction treatment . In: Mackenzie N, ed. The AIDS Reader . New York, NY: Penguin; 1991;.
8 +
Forsyth BWC, Adnopoz J, Nagler S.  AIDS in childhood . In: Michels R, ed. Psychiatry . Philadelphia, Pa: JB Lippincott Co; 1992;:1-13.
9 +
Belfer ML, Krener PK, Miller FB.  AIDS in children and adolescents . JAmAcad Child Adolesc Psychiatry . 1988;;27:147.
10 +
Krener PK, Miller FB.  Psychiatric response to HIV spectrum disease in children and adolescents . J Am Acad Child Adolesc Psychiatry . 1989;;28:596.
11 +
Spiegel L, Mayers A.  Psychosocial aspects of AIDS in children and adolescents . Pediatr Clin North Am . 1991;;38:153-167.
12 +
Adnopoz J, Nagler SF. Supporting HIV infected children in their own families. In: Laughton CD, ed. Advancing Family Preservation Practice. Newberry Park, Calif: Sage Publications. In press.
13 +
Mellins CA, Ehrhardt M.  Families affected by pediatric acquired immunodeficiency syndrome: sources of stress and coping . J Dev Behav Pediatr . 1994;; 15( (suppl) ):S54-S60.
14 +
Bor R, Miller R, Salt H.  Secrecy-related problems in AIDS management . J R Coll Physicians Lond . 1989;;23:264-267.
15 +
Lipson M.  Disclosure of diagnosis to children with human immunodeficiency virus or acquired immunodeficiency syndrome . J Dev Behav Pediatr . 1994;:15 ( (suppl) ):S61-S65.
16 +
Roth J, Siegel R, Block S.  Clinical care update: identifying the needs of children living in families with AIDS or HIV infection . Community Ment Health J . 1994;;30:581-593.
17 +
Achenbach TM.  The child behavior profile, I: boys aged 6 through 11 . J Consult Clin Psychol . 1978;;46:478-488.
18 +
Achenbach TM.  The child behavior profile, II: boys aged 12-16 and girls aged 6-11 and 12-16 . J Consult Clin Psychol . 1979;;47:223-233.
19 +
Achenbach TM. Manual for the Child Behavior Checklist/4-18 and 1991 Profile . Burlington, Vt: University of Vermont Dept of Psychiatry; 1991;.
20 +
Reynolds CR, Richmond BO. Revised Children's Manifest Anxiety Scale . Los Angeles, Calif: Western Psychological Services; 1985;.
21 +
Kovacs M. The Children's Depression Inventory: A Self-Rated Depression Scale for School-Aged Youngsters . Pittsburgh, Pa: University of Pittsburgh; 1985;.
22 +
Reynolds CR, Paget KD.  National normative and reliability data for the Revised Children's Manifest Anxiety Scale . School Psychol Rev . 1983;;12:324-336.
23 +
Reynolds CR:  Concurrent validity of what I Think and Feel: the RCMAS . J Consult Clin Psychol . 1980;;48:774-775.
24 +
Smucker MR, Craighead WE, Craighead LW, et al.  Normative and reliability data for the Children's Depression Inventory . J Abnorm Child Psychol . 1986;;14:25-39.
25 +
Helsel WJ, Matson JL.  The assessment of depression in children: the internal structure of the Child Depression Inventory (CDI) . Behav Res Ther . 1984;;22:289-298.
26 +
Carey MP, Faulstich ME, Gresham FM, Ruggiero L, Enyart P.  Children's Depression Inventory: construct and discriminant validity across clinical and non-referred (control) populations . J Consult Clin Psychol . 1987;;55:755-761.
27 +
Kramer MS. Clinical Epidemiology and Biostatistics . New York, NY: Springer-Verlag; 1988;.
28 +
Brown F.  Childhood bereavement and subsequent psychiatric disorder . Br J Psychiatry . 1966;;112:1035-1041.
29 +
Wass A, Carr CA. Helping Children Cope With Death . New York, NY: McGraw-Hill; 1982;.
30 +
Berlinsky EB, Biller HB. Parental Death and Psychological Development . Lexington, Toronto: Lexington Books; 1982;.
31 +
Havens JF, Whitaker AH, Feldman JF, Ehrhardt AA.  Psychiatric morbidity in school-age children with congenital human immunodeficiency virus infection: a pilot study . J Dev Behav Pediatr . 1994;;15:518-525.
32 +
Gray RE.  Adolescent response to the death of a parent . J Youth Adolesc . 1987;; 16:511-525.
33 +
Garber B.  Some thoughts on normal adolescents who lost a parent by death . J Youth Adolesc . 1983;;12:175-183.
34 +
Buchsbaum BC.  Remembering a parent who has died: a developmental perspective . Ann Psychoanal . 1987;;15:99-12.
35 +
Saler L, Skolnick N.  Childhood parental death and depression in adulthood: roles of surviving parent and family environment . Am J Orthopsychiatr . 1992;;62:504-516.
36 +
Demb J.  Clinical vignette: adolescent 'survivors' of parents with AIDS . Fam Systems Med . 1989;;7:339-343.
37 +
Siegel K, Gorey E.  Childhood bereavement due to parental death from acquired immunodeficiency syndrome . J Dev Behav Pediatr . 1994;:15:566-570.

Figures

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Michaels D, Levine C.  Estimates of the number of motherless youth orphaned by AIDS in the United States . JAMA . 1992;;268:3456-3461.
2 +
Centers for Disease Control and Prevention.  US HIV and AIDS cases reported through December 1994 . HIV/AIDS Surveill Rep . 1995;;6:10.
3 +
Ellerbrock TV, Bush TJ, Chamberland ME, Oxtoby MJ.  Epidemiology of women with AIDS in the United States, 1981 through 1990: a comparison with heterosexual men with AIDS . JAMA . 1991;;265:2971-2975.
4 +
Niebuhr VN, Hughes JR, Pollard RB.  Parents with human immunodeficiency virus infection: perceptions of their children's emotional needs . Pediatrics . 1994;;93:421-426.
5 +
Sherwen LN, Boland M.  Overview of psychosocial research concerning pediatric human immunodeficiency virus infection . J Dev Behav Pediatr . 1994;;15( (suppl) ):S5-S11.
6 +
Taylor-Brown S, Kumetat SH.  Psychosocial aspects of pediatric human immunodeficiency virus-infected children . J Dev Behav Pediatr . 1994;;15( (suppl) ):S71-S76.
7 +
Drucker E, Rothschild J, Poust B, et al.  IV drug users with AIDS in New York City: a study of dependent children, housing and drug addiction treatment . In: Mackenzie N, ed. The AIDS Reader . New York, NY: Penguin; 1991;.
8 +
Forsyth BWC, Adnopoz J, Nagler S.  AIDS in childhood . In: Michels R, ed. Psychiatry . Philadelphia, Pa: JB Lippincott Co; 1992;:1-13.
9 +
Belfer ML, Krener PK, Miller FB.  AIDS in children and adolescents . JAmAcad Child Adolesc Psychiatry . 1988;;27:147.
10 +
Krener PK, Miller FB.  Psychiatric response to HIV spectrum disease in children and adolescents . J Am Acad Child Adolesc Psychiatry . 1989;;28:596.
11 +
Spiegel L, Mayers A.  Psychosocial aspects of AIDS in children and adolescents . Pediatr Clin North Am . 1991;;38:153-167.
12 +
Adnopoz J, Nagler SF. Supporting HIV infected children in their own families. In: Laughton CD, ed. Advancing Family Preservation Practice. Newberry Park, Calif: Sage Publications. In press.
13 +
Mellins CA, Ehrhardt M.  Families affected by pediatric acquired immunodeficiency syndrome: sources of stress and coping . J Dev Behav Pediatr . 1994;; 15( (suppl) ):S54-S60.
14 +
Bor R, Miller R, Salt H.  Secrecy-related problems in AIDS management . J R Coll Physicians Lond . 1989;;23:264-267.
15 +
Lipson M.  Disclosure of diagnosis to children with human immunodeficiency virus or acquired immunodeficiency syndrome . J Dev Behav Pediatr . 1994;:15 ( (suppl) ):S61-S65.
16 +
Roth J, Siegel R, Block S.  Clinical care update: identifying the needs of children living in families with AIDS or HIV infection . Community Ment Health J . 1994;;30:581-593.
17 +
Achenbach TM.  The child behavior profile, I: boys aged 6 through 11 . J Consult Clin Psychol . 1978;;46:478-488.
18 +
Achenbach TM.  The child behavior profile, II: boys aged 12-16 and girls aged 6-11 and 12-16 . J Consult Clin Psychol . 1979;;47:223-233.
19 +
Achenbach TM. Manual for the Child Behavior Checklist/4-18 and 1991 Profile . Burlington, Vt: University of Vermont Dept of Psychiatry; 1991;.
20 +
Reynolds CR, Richmond BO. Revised Children's Manifest Anxiety Scale . Los Angeles, Calif: Western Psychological Services; 1985;.
21 +
Kovacs M. The Children's Depression Inventory: A Self-Rated Depression Scale for School-Aged Youngsters . Pittsburgh, Pa: University of Pittsburgh; 1985;.
22 +
Reynolds CR, Paget KD.  National normative and reliability data for the Revised Children's Manifest Anxiety Scale . School Psychol Rev . 1983;;12:324-336.
23 +
Reynolds CR:  Concurrent validity of what I Think and Feel: the RCMAS . J Consult Clin Psychol . 1980;;48:774-775.
24 +
Smucker MR, Craighead WE, Craighead LW, et al.  Normative and reliability data for the Children's Depression Inventory . J Abnorm Child Psychol . 1986;;14:25-39.
25 +
Helsel WJ, Matson JL.  The assessment of depression in children: the internal structure of the Child Depression Inventory (CDI) . Behav Res Ther . 1984;;22:289-298.
26 +
Carey MP, Faulstich ME, Gresham FM, Ruggiero L, Enyart P.  Children's Depression Inventory: construct and discriminant validity across clinical and non-referred (control) populations . J Consult Clin Psychol . 1987;;55:755-761.
27 +
Kramer MS. Clinical Epidemiology and Biostatistics . New York, NY: Springer-Verlag; 1988;.
28 +
Brown F.  Childhood bereavement and subsequent psychiatric disorder . Br J Psychiatry . 1966;;112:1035-1041.
29 +
Wass A, Carr CA. Helping Children Cope With Death . New York, NY: McGraw-Hill; 1982;.
30 +
Berlinsky EB, Biller HB. Parental Death and Psychological Development . Lexington, Toronto: Lexington Books; 1982;.
31 +
Havens JF, Whitaker AH, Feldman JF, Ehrhardt AA.  Psychiatric morbidity in school-age children with congenital human immunodeficiency virus infection: a pilot study . J Dev Behav Pediatr . 1994;;15:518-525.
32 +
Gray RE.  Adolescent response to the death of a parent . J Youth Adolesc . 1987;; 16:511-525.
33 +
Garber B.  Some thoughts on normal adolescents who lost a parent by death . J Youth Adolesc . 1983;;12:175-183.
34 +
Buchsbaum BC.  Remembering a parent who has died: a developmental perspective . Ann Psychoanal . 1987;;15:99-12.
35 +
Saler L, Skolnick N.  Childhood parental death and depression in adulthood: roles of surviving parent and family environment . Am J Orthopsychiatr . 1992;;62:504-516.
36 +
Demb J.  Clinical vignette: adolescent 'survivors' of parents with AIDS . Fam Systems Med . 1989;;7:339-343.
37 +
Siegel K, Gorey E.  Childhood bereavement due to parental death from acquired immunodeficiency syndrome . J Dev Behav Pediatr . 1994;:15:566-570.

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