The Social and Cultural Context of Coping with Sickle Cell Disease: II. The Role of Financial Hardship in Adjustment to Sickle Cell Disease

Recent evidence on the negative psychological effects of poverty suggests that economic status alone might account for the adjustment problems attributed to sickle cell disease (SCD). The relationship of SCD and financial hardship to adjustment was examined in 327 ill children and their parents. SCD and hardship contributed independently to impaired child and parental functioning. For parents, illness severity had more negative effects than did financial hardship, but forPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66919/2/10.1177_0095798499025003003.pd

The Social and Cultural Context of Coping with Sickle Cell Disease: III. Stress, Coping Tasks, Family Functioning, and Children’s Adjustment

Conceptions of individual and family coping with sickle cell disease (SCD) must incorporate several disease and sociocultural factors. This article proposes an integrative model and tests the relative contribution of model parameters to the prediction of social, academic, and psychological adjustment of children with SCD. The individual coping and family functioning variables most highly predictive of the child’s psychological outcomes (anxiety, depression, and positive mood) include parental psychological functioning, maturity demands made of the ill child, and the quality of relations with parents and siblings. Academic adjustment was significantly predicted by parental academic expectations and by the child’s rejection of a restrictive sick role. Competent social functioning also was predicted by the extent to which the ill child rejected the role of being sick.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67288/2/10.1177_0095798499025003006.pd