The Impact of Childhood Chronic Illness on Mental Health: A Review of Parent and Child Reports of Stress and Maladaptive Behaviors in a Longitudinal Study

An estimated 16 million children live with at least one chronic medical condition in the United States. These children and their parents must contend with a variety of challenges that affect their everyday lives, as well as their future and potential outcomes. This study analyzed the relationship between having a child with a chronic medical condition and the mental health/well-being of both the child and the primary caregiver using data from the Bellevue Project for Early Language, Literacy, and Education Success (BELLE). Parent and child reports of children’s socioemotional function, and parent’s feelings of stress and depression were used as indicators of mental health/well-being. Forty-three children in this study were identified as having a chronic medical condition; they were compared to a healthy sample (n= 602) from the same data set. Children with chronic medical conditions exhibited aggressive behaviors more than their healthy peers. Regardless of the child’s medical condition, these types of externalizing behaviors were associated with parenting stress, and lower levels of cognitive stimulation by the parent. Analysis of covariance controlling for SES, gender, country of origin, and early aggressive behavior suggest that parents who provide cognitive stimulation to their chronically ill children mitigate the likelihood of the children developing aggressive behaviors. In addition to providing an illness-centered care plan, pediatricians should screen chronically ill children for internalizing and externalizing symptoms. Furthermore, given the pivotal role parental mental health/well-being plays in children’s developmental outcomes, pediatricians should also screen the parents for symptoms of depression, stress, and/or anxiety in order to safeguard positive parent-child relationships and interactions