Predicting children's presurgical anxiety and subsequent behavior changes.

Addressed, in two studies, issues of children's medical anxiety having implications for efficient psychological preparation. Study 1 assessed behavioral distress and physiological arousal of 4- to 10-year-old, unprepared, nonsedated children (N = 50) as they separated from parents, waited in the operating room, and were given general anesthesia for minor surgery. Anxiety intensity varied widely among children and was most intense at mask presentation. Mother's prediction of uncooperative behavior and a history of prior surgery were the best predictors. Study 2 examined anxiety of 37 children prior to surgery and behavior changes 2 weeks later. At follow-up, minor or transient problems were common; 4 children developed significant problems. Elevated presurgical anxiety predicted later problems, but only among children hospitalized after surgery. Findings suggest that presurgical anxiety and later behavior problems are partially predictable.