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Guilfoyle S.M.,Cincinnati Childrens Hospital Medical Center | Guilfoyle S.M.,University of Cincinnati | Wagner J.L.,Medical University of South Carolina | Smith G.,Medical University of South Carolina | And 2 more authors.
Epilepsy and Behavior | Year: 2012

Youth with epilepsy often have co-occurring psychological symptoms that are due to underlying brain pathology, seizures, and/or antiepileptic drug side effects. The primary study aim was to compare the psychological comorbidities of youth with new-onset epilepsy versus chronic epilepsy. Primary caregivers of youth with either new-onset (n=82; Mage=9.9±2.9) or chronic epilepsy (n=76; Mage=12.8±3.3) completed the Behavioral Assessment Scale for Children-2nd Edition. Compared to those with new-onset epilepsy, the chronic group had significantly higher depressive and withdrawal symptoms, as well as lower activities of daily living. A higher proportion of youth with chronic epilepsy exhibited at-risk/clinically elevated depressive symptoms and difficulties with activities of daily living compared to the new-onset group. Proactive screening in youth with epilepsy to ensure timely identification of psychological symptoms and to guide early psychological intervention is warranted. © 2012 Elsevier Inc. Source

Guilfoyle S.M.,Center for the Promotion of Treatment Adherence and Self Management | Goebel J.W.,Cincinnati Childrens Hospital Medical Center | Pai A.L.H.,University of Cincinnati
Families, Systems and Health | Year: 2011

The alarming rates of medication nonadherence and its detrimental effect on long-term graft survival in pediatric kidney transplantation has called attention to identifying modifiable factors that promote better adherence and subsequent transplant outcomes. In a sample of 45 adolescent kidney transplant recipients (14.7 ± 3.3 years, 77.8% Caucasian, 39.5% female) and their primary caregivers, study aims included: 1) identifying sociodemographic and medical correlates of both caregiver- and patient-reported general family functioning (i.e., efficacy, flexibility, and communication) and 2) determining the unique contributions of these family functioning indices to perceived posttransplant adherence barriers. During a routine clinic visit, caregivers completed a sociodemographic form and questionnaire on general family functioning. Both caregivers and the adolescents completed a measure on perceived medication adherence barriers. Data identified household income and family structure as persistent correlates of family functioning. Familial efficacy and flexibility contributed significant variance to perceived adherence barriers. Family-based interventions enhancing modifiable family factors, such as flexibility and efficacy, in overcoming medication adherence barriers would likely promote more optimal health outcomes in the pediatric kidney transplant population. © 2011 American Psychological Association. Source

Hommel K.A.,Center for the Promotion of Treatment Adherence and Self Management | Hommel K.A.,Medical Center | Hommel K.A.,University of Cincinnati | Baldassano R.N.,University of Pennsylvania | Baldassano R.N.,Childrens Hospital of Philadelphia
Journal of Pediatric Psychology | Year: 2010

Objective To examine perceived barriers to medication adherence in inflammatory bowel disease (IBD) treatment and their relationship with adherence using a combined forced choice and semi-structured interview assessment approach. Methods Sixteen adolescents with IBD and their parents participated in an open-ended interview regarding adherence barriers and completed quantitative measures of adherence, barriers to treatment, and disease severity. Results The most commonly identified barriers to adherence were forgetting, interference with other activities, difficulty swallowing pills, and not being at home. Number of reported barriers was positively correlated with objective nonadherence for 6-MP/azathioprine. Nonadherence frequency was 42 for 6-MP/azathoprine and 50 for 5-ASA medications. Conclusions Using a combined assessment approach, patients and parents reported several barriers to treatment adherence that are appropriate for clinical intervention. This is critical given the significant medication nonadherence observed in this sample and the relationship between total number of barriers and disease management problems. © 2009 The Author. Source

Ingerski L.M.,Center for the Promotion of Treatment Adherence and Self Management
Journal of pediatric psychology | Year: 2010

OBJECTIVE: To identify family-reported, adherence-related barriers for adolescents with inflammatory bowel disease (IBD) and examine their relationship to 6-MP/azathioprine and 5-ASA medication adherence. METHODS: Participants included 74 adolescents, aged 13-17 years, diagnosed with IBD and their caregivers. Adolescents and caregivers jointly completed a measure of barriers to medication adherence. Adherence to medication was measured by family-report, pill-count, and serum assay. RESULTS: Families endorsed one to seven total barriers to medication adherence. The most commonly reported barriers included forgetting, being away from home, and interference with an activity. Neither demographic nor disease severity variables were related to the total number of reported barriers. Fewer total reported barriers was related to better adherence by adolescent and maternal report. CONCLUSION: Most families experience at least one barrier to treatment adherence. Effective problem-solving around these barriers and its integration into future treatment protocols may help improve medication adherence in the pediatric IBD population. Source

Herzer M.,Center for the Promotion of Treatment Adherence and Self Management | Hood K.K.,Center for the Promotion of Treatment Adherence and Self Management | Hood K.K.,University of Cincinnati
Journal of Pediatric Psychology | Year: 2010

Objective: To examine the prevalence of anxiety symptoms and their association with blood glucose monitoring (BGM) and glycemic control in adolescents with type 1 diabetes.Methods: 276 adolescents and their caregivers completed measures of anxiety symptoms. Adolescents completed a measure of depressive symptoms. Demographic and family characteristics were obtained from caregiver report. Diabetes duration, regimen type, BGM frequency, and glycemic control were also collected.Results: Trait anxiety symptoms that suggest further clinical assessment is needed were present in 17 of adolescents; the rate was 13 for state anxiety symptoms. Higher levels of state anxiety symptoms were associated with less frequent BGM F(14, 261) = 6.35, p <. 0001, R2 =. 25, and suboptimal glycemic control, F(15, 260) = 7.97, p <. 0001, R 2 =. 32. State anxiety symptoms were correlates of BGM frequency and glycemic control independent of depressive symptoms.Conclusions: State anxiety symptoms are associated with less frequent BGM and suboptimal glycemic control in adolescents with type 1 diabetes. © The Author 2009. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. Source

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