Coping and adjustment in children with primary immunodeficiency disorders and kidney diseases: The role of illness severity

The purpose of this study was to assess illness severity and its relation to psychosocial factors in children with primary immunodeficiency disorders (PIDD) and kidney diseases (KD), two chronic health conditions having received little empirical study in the pediatric psychology literature. A secondary goal was to assess families' use of physicians for psychosocial support. Participants included 64 caregiver-youth (youths aged 8-20 years) dyads. Children with diagnoses of PIDD or KD were placed into one of three illness severity groups (mild, moderate, severe) based on objective ratings and compared with a healthy comparison group. Results indicated that children with mild illness reported less adaptive coping, and their caregivers reported more maladaptive coping compared to the other groups. In addition, children in the mild severity group were reported to have higher levels of internalizing behavior problems. Physicians were being utilized at a high rate by all groups regarding families's concerns of psychosocial issues. These findings have a number of clinical implications, including the importance of intervention for children and their caregivers across illness severity levels and the need for adequate education for physicians regarding psychosocial issues.