An Exploration of Family Problem-Solving and Affective Involvement as Moderators Between Disease Severity and Depressive
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An Exploration of Family Problem-Solving and Affective Involvement as Moderators Between Disease Severity and Depressive Symptoms in Adolescents with Inflammatory Bowel Disease Shana L. Schuman • Danielle M. Graef David M. Janicke • Wendy N. Gray • Kevin A. Hommel
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Ó Springer Science+Business Media New York 2013
Abstract Little is known about how family functioning relates to psychosocial functioning of youth with inflammatory bowel disease (IBD). The study aim was to examine family problem solving and affective involvement as moderators between adolescent disease severity and depressive symptoms. Participants were 122 adolescents with IBD and their parents. Measures included self-reported and parentreported adolescent depressive symptoms, parent-reported family functioning, and physician-completed measures of disease severity. Disease severity was a significant predictor of adolescent-reported depressive symptoms, but not parentreported adolescent depressive symptoms. Family affective involvement significantly predicted parent-reported adolescent depressive symptoms, while family problem-solving significantly predicted adolescent self-report of depressive symptoms. Neither affective involvement nor problemsolving served as moderators. Family affective involvement may play an important role in adolescent emotional functioning but may not moderate the effect of disease severity on depressive symptoms. Research should continue to examine effects of family functioning on youth emotional functioning and include a sample with a wider range of disease severity to S. L. Schuman (&) D. M. Graef D. M. Janicke Department of Clinical and Health Psychology, University of Florida, P.O. Box 100165, Gainesville, FL 32610-0165, USA e-mail: [email protected] D. M. Janicke Department of Pediatrics, University of Florida, Gainesville, FL, USA W. N. Gray K. A. Hommel Division of Behavioral Medicine and Clinical Psychology, Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
determine if interventions aimed to enhance family functioning are warranted. Keywords Adolescent Inflammatory bowel disease Disease severity Family functioning Depression
Introduction Inflammatory bowel disease (IBD) is a broad term used to classify a group of chronic IBD, two of the most common being ulcerative colitis and Crohn’s disease (Bousvaros et al., 2006; Deshmukh, Kulkarni, & Lackamp, 2010). Ulcerative colitis inflammation occurs in the large bowel, whereas Crohn’s disease can impact any portion of the gastrointestinal tract (Burke, Neigut, Kocoshis, Chandra, & Sauer, 1994). Overall, IBD affects 71 in 100,000 youth under 20 years of age in the United States (43 per 100,000 for Crohn’s disease and 28 per 100,000 for ulcerative colitis), with approximately 20–30 % of IBD patients diagnosed before the age of 20 (Hanauer, 2006; Kappelman et al., 2007). Prevalence of IBD is greater in adolescents between the ages of 15 and 19 years, with 143 per 100,00
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