Huygen A C, Kuis W, Sinnema G
Department of Paediatric Psychology, University Medical Centre Utrecht, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
Ann Rheum Dis. 2000 Apr;59(4):276-82. doi: 10.1136/ard.59.4.276.
To assess the psychological, behavioural and social adjustment of children (7-11 years) and adolescents (12-16 years) with juvenile chronic arthritis (JCA). Higher rates of maladjustment were expected to be found in these patients.
Self report questionnaires were used within the context of personal interviews. Family functioning and social support were studied as well. Forty seven patients with JCA, 52 healthy peers and their respective parents participated in the study.
Self esteem, perceived competence and body image in patients with JCA were as positive as they were in healthy participants. There were no differences between ill and healthy youngsters with respect to the incidence of psychopathology. Patients with JCA, in general, perceived themselves as socially competent, but they seemed to have somewhat less opportunity or energy to participate in social activities. Children with JCA showed a high level of aspiration to cope with social expectations. This aspiration seemed to be even stronger in case the disease caused more strains, for example, in periods of inflammation and in the systemic onset type. The high level of social adjustment in children with JCA seemed to be supported by highly cohesive family structures. Generally, adolescents with JCA experienced much social support.
In contrast with our expectation, children and adolescents with JCA seemeed to cope quite well with the psychological and social consequences of their long term condition. For future studies, it is hypothesised that the high levels of adaptation might imply an enduring psychological strain, which is reflected in an altered function of the autonomic nervous system.
评估患有青少年慢性关节炎（JCA）的儿童（7至11岁）和青少年（12至16岁）的心理、行为及社会适应情况。预计这些患者中适应不良的发生率会更高。
在个人访谈的背景下使用自我报告问卷。同时也研究了家庭功能和社会支持。47名患有JCA的患者、52名健康同龄人及其各自的父母参与了该研究。
JCA患者的自尊、感知能力和身体形象与健康参与者一样积极。在精神病理学发生率方面，患病青少年与健康青少年之间没有差异。一般来说，JCA患者认为自己具有社交能力，但他们参与社会活动的机会或精力似乎略少。患有JCA的儿童表现出很高的愿望来应对社会期望。在疾病造成更多压力的情况下，例如在炎症期和全身发病型中，这种愿望似乎更强。JCA儿童较高的社会适应水平似乎得到了高度凝聚力的家庭结构的支持。一般来说，患有JCA的青少年获得了很多社会支持。
与我们的预期相反，患有JCA的儿童和青少年似乎能很好地应对其长期疾病带来的心理和社会后果。对于未来的研究，据推测，高度的适应水平可能意味着一种持久的心理压力，这反映在自主神经系统功能的改变上。
