Behavioral Problem, Self-Perceived Competence, Social Competence, and Parental Stress in Children with Atopic Dermatitis

아토피 피부염 아동의 문제행동, 자아 역량 인식, 사회적 능력과 양육 스트레스와의 관계

  • Published : 2008.06.30

Abstract

Atopic dermatitis is the fastest growing skin disorder among children from infancy to adolescence in Korea. The side-effects of atopic dermatitis not only include physical discomfort, but also psychological trauma which ultimately affects the developmental growth of children. This study was conducted in order to investigate the behavioral characteristics of an atopic dermatitis sufferer. As part of this research, the relative influence of behavioral problems and, self-perceived competence were analyzed in relation to the social competence of an atopic child. In total, 301 atopic and non-atopic children, between 2 and 6 years of age, and their mothers and teachers participated in the study. From this number, 109 children had atopic dermatitis, while 192 children did not. Mothers were asked to complete a parent-report questionnaire that required information on parental stress, according to the scale parenting methodology of Abbdin(1990) and Cho(1999). Teachers were subjected to teacher-report questionnaires which included topics on social competence, socia-emotional assessment and behavioral problems of an atopic child. Furthermore, children also completed questionnaires on self-perceived competence. According to analysis on K-CBCL, ITSEA, social competence, self-perceived competence and parental stress, children with atopic dermatitis showed higher scores in depression/anxiety and depression/withdrawal, compared to children in the normal control group. In relation to parental stress, daily stress, parental role stress, and stress related disease, mothers with atopic dermatitis children exhibited higher scores. In establishing relationships among the related variables, atopic children who demonstrated more social competence were more likely to suffer less from withdrawal, attention problems, and depression/anxiety. Stress related disease in mothers with atopic children was positively related to attention problems of the child. In terms of relative influences, behavioral problems was the most significant variable, accounting for 23% of variance. Lower behavioral problems was positively related to more social competence. In summation, this study investigated the general characteristics of atopic children. In conclusion, atopic children and their mothers had difficulty in dealing with this disease. It is our belief that an atopic child would not only require physical treatment, but also need appropriate psychological care.

Keywords

References

  1. 김금순, 강지연(1994). 비디오테잎을 이용한 간호정보 제공이 수술전 수면 및 불안에 미치는 영향-위수술환자를 중 심으로- 기본간호학회지, 1(1), 9-36
  2. 김기현, 강희경(1997). 양육스트레스 척도의 개발. 대한가정학회지, 35(5), 141-150
  3. 김동현(2003). 기질과 자아개념이 유아의 사회성 발달에 미치 는 영향. 상주대학교 산업대학원 석사학위 청구논문
  4. 김정아(2000). 아동의 사회적 능력과 관련된 제 변인에 관한 연구. 이화여자대학교 석사학위 청구논문
  5. 김홍식, 신용우, 박향준, 김유찬, 이경규(1998). 소아 아토피 피부염 환자의 우울 및 불안에 관한 임상적 연구. 대한피부과학회지, 36(4), 628-635
  6. 대한의사협회(편)(2003). 성장기에 흔한 알레르기 :천식, 비염, 아토피 피부염. 대한의사협회지, 46(3), 231-243
  7. 도현심(1994). 유치원 아동 및 6학년 아동의 사회적 능력: 부 모의 관심, 보호성, 아동의 성 및 출생범주와의 관계. 이화여자대학교 박사학위 청구논문
  8. 신지연(2004). 2세 영아의 어머니와 보육교사에 대한 복합 애착과 사회.정서적 행동. 서울여자대학교 석사학위 청구논문
  9. 신채윤(2004). 아토피 피부염이 있는 자녀를 둔 어머니의 양 육태도, 스트레스 대처방식에 관한 연구. 이화여자대 학교 석사학위 청구논문
  10. 오경자, 이혜련, 홍강의, 하은혜(1995). 한국반 CBCL의 문제 행동 증후군 지도 재구성을 위한 연구. 정신의학, 20(1), 45-52
  11. 오재원, 김규언, 편복양, 이혜란, 정지태, 홍수종 외(2003). 1995년과 2000년의 학동기와 2003년 학동전기 소아에 서의 아토피피부염의 역학적 변화에 관한 전국적인 연 구. 소아알레르기 및 호흡기학회지, 13(4), 227-237
  12. 이계숙(2003). 초등학생이 지각한 부모 양육태도와 자아존중 감 및 사회성과의 관계. 한국교원대학교 교육대학원 석사학위 청구논문
  13. 이 영, 김명순(1999). 유아교육기관 유형에 따른 교사, 또래 관계 및 아동 발달에 관한 연구. 대한가정학회지, 37(8), 103-115
  14. 이은해, 최혜영, 김미해(1990). 아동의 사회적 능률성 척도 개 발에 관한 연구. 생활과학논집, 4, 175-189
  15. 이해성, 김종서, 편복양(2002). 소아 아토피 피부염의 빈도와 원인의 변화 소아알레르기 및 호흡기학회지, 12(4), 263-271
  16. 이현성(1988). 만성질환아 어머니의 스트레스와 대응에 관한 연구. 연세대학교 석사학위 청구논문
  17. 정재석(2000). 아토피 피부염 소아청소년에 대한 정신과적 고찰. 서울대학교 석사학위 청구논문
  18. 정재석, 김규한, 홍강의(1999). 아토피 피부염 소아 청소년에 서의 정신병리와 양육태도 연구. 소아 청소년 정신의학, 10(1), 34-42
  19. 최경순(1995). 어머니의 취업에 따른 보육시설 유아의 사회적 능력과 관련변인. 부산여자대학교 논문집, 40, 315- 335
  20. Abidin, P. R.(1990). Parenting Stress Index: Short Form. Charlottesville, VA: Pediatric Psychology Press
  21. Absolon, C. M., Cottrell, D., Eldridge, S. M., & Glover, M. T.(1997). Psychological disturbance in atopic eczema: the extent of the problem in schoolaged children. British Journal of Dermatology.137(2), 241-245 https://doi.org/10.1046/j.1365-2133.1997.18121896.x
  22. Achenbach, T. M.(1991). Integrative guide for the 1991 CBCL/4-18, YSR, and TRF profiles. Burlington, VT: University of Vermont, Department of Psychiatry
  23. Aziah, M. S., Rosnah, T., Mardziah, A., & Norzila, M. Z.(2002). Childhood atopic dermatitis: a measurement of quality of life and family impact. Medical Journal of Malaysia. 57, 329-39
  24. Balkrishnan, R., Housman, T. S, Carroll, C., Feldman, S. R., & Fleischer, A. B.(2003). Disease severity and associated family impact in childhood atopic dermatitis. Pediatry Dermatology, 20, 5-10 https://doi.org/10.1046/j.1525-1470.2003.03002.x
  25. Barnetson, R. S. C., & Rogers, M.(2002). Childhood atopic eczema. British Medical Journal, 107, 669-75
  26. Ben-Gashir, M. A., Seed, P. T., & Hay, R. J.(2002). Are quality of family life and disease severity related in childhood atopic dermatitis. Journal of the European Academy of Dermatology and Venereology, 16, 455-62 https://doi.org/10.1046/j.1468-3083.2002.00495.x
  27. Briggs-Gowan, M., & Carter, A. S.(2001). New instruments for evaluating 12- to 48-month-old social-emotional/behavioral problems and competencies. The University of Massachusetts, Boston
  28. Chamlin, S. L., Cella, D., & Frieden, I. E.(2005). Development of the childhood atopic dermatitis impact scale: initial validation of a quality-of-life measure for young children with atopic dermatitis and their families. Journal Invest Dermatology, 14, 231-41
  29. Cotterill, J.(1989). Psychiatry and the skin. British Journal of Hospital Medicine. 42, 401-4
  30. Crnic, K., & Booth, C.(1991). Mothers' and Fathers' Perceptions of Daily Hassles of Parenting across Early Childhood. Journal of Marriage and the Family, 53(4), 1042-1050 https://doi.org/10.2307/353007
  31. Dahl, R. E., Bernhisel-Broadbent, J., Scanlon-Holdford, S., Sampson, H. A., & Lupo, M.(1995). Sleep disturbances in children with atopic dermatitis, Archives of Pediatrics & Adolescent Medicine, 149, 856-60 https://doi.org/10.1001/archpedi.1995.02170210030005
  32. Diepgen, T. L.(2001). Atopic dermatitis: The role of environmental and social factors, the European experience. Journal of Academic Dermatology, 45, 44-48 https://doi.org/10.1067/mjd.2001.110880
  33. Fortune, D. G., Richards, H. I., & Kirby, B.(2003). Psychological distress impairs clearance of psoriasis in patients treated with photochemotherapy. Archives of Dermatology, 139, 752-6 https://doi.org/10.1001/archderm.139.6.752
  34. Garralda, M. E., & Palanca, M. I.(1994). Psychiatric adjustment in children with chronic physical illness. British Journal of Hospital Medicine, 52(5), 230-234
  35. Gustafsson, D., Sjoberg, O., & Foucard, T.(2000). Development of allergies and asthma in infants and young children with atopic dermatitis -a prospective follow-up to 7 years of age, Allege, 55, 240-245
  36. Hanifin, J. M., & Saurat, J.(2001). Understanding atopic dermatitis :pathophysiology and etiology - Introduction. Journal of Academic Dermatology, 45, SI
  37. Harter, S., & Pike, R.(1984). The pictorial scale of perceived competence and social acceptance for young children. Child Development, 55(6), 1969- 1982 https://doi.org/10.2307/1129772
  38. Hashiro, M., & Okumura, M.(1997). Anxiety, depression, and psychosomatic symptoms in patients with atopic dermatitis: comparison with normal controls and among groups of different degrees of severity. Journal of Dermatology Science, 14, 63-67 https://doi.org/10.1016/S0923-1811(96)00553-1
  39. Horne, D. J., White, A. E., & Varigos, G. A.(1989). A preliminary study of psychological therapy in the management of atopic eczema. British Journal of Medical Psychology, 62, 241-248 https://doi.org/10.1111/j.2044-8341.1989.tb02832.x
  40. Kemp, A. S.(1999). Atopic eczema: its social and financial costs. Journal of Pediatric Child Health, 35, 229-231 https://doi.org/10.1046/j.1440-1754.1999.00343.x
  41. Lapidus, C. S., & Kerr, P. E.(2001). Social impact of atopic dermatitis. Medicine and Health, 84, 294-295
  42. Lawson, V., Lewis-Jones, M. S., Finlay, A. Y., Reid, P., & Owens, R. G.(1998). The family impact of childhood atopic dermatitis: The Dermatitis Family Impact questionnaire. British Journal of Dermatology, 138, 107-13 https://doi.org/10.1046/j.1365-2133.1998.02034.x
  43. Lewis-Jones, M. S., Finlay, A. Y., & Dykes P. J.(1995). The Children's Dermatology Life Quality Index (CDLQI): initial validation and practical use. British Journal of Dermatology, 132, 942-9 https://doi.org/10.1111/j.1365-2133.1995.tb16953.x
  44. Lynam, J.(1987). The parent network in pediatric oncology: supportive or not? Cancer Nursing, 10, 207-216 https://doi.org/10.1097/00002820-198708000-00007
  45. Mann, M, B., & Thornberg, K, R.(1987). Guilt of Working Women with Infant and Toddlers in Day Care. Early Child Development and Care, 27(3), 451-464 https://doi.org/10.1080/0300443870270304
  46. Meijer, S. A., Sinnema, G., & Bijstra, J. O.(2000). Social functioning in children with a chronic illness. Journal of Child Psychology and Psychiatry, 41, 309-17 https://doi.org/10.1111/1469-7610.00615
  47. Ondersma, S. J., lumley, M. A., Corlis, M. E., Tojek, T. M., & Tolia, V.(1997). Psychiatric adjustment in children with chronic renal failure. Journal of Child Psychology and Psychiatry, 29, 79-90 https://doi.org/10.1111/j.1469-7610.1988.tb00691.x
  48. Paller, A. S., McAlister, R. O., Doyle, J. J., & Jackson, A.(2002). Perception of physicians and pediatric patients about atopic dermatitis, its impact, and its treatment, Clinical Pediatry(Phila), 41, 323- 332 https://doi.org/10.1177/000992280204100505
  49. Pearce, N., William, S., Keil, U., Langridge, P., Anderson, H. R., & Struchan, D.(1993). Selfreported prevalence of asthma symptoms in children in Austrailia, England, Germany and New Zealand: An International comparison using the ISAAC protocol. European Respiratory Journal, 6, 1445-61
  50. Picarda, A., Abeni, D., & Mclachi, C. F.(2000). Psychiatric morbidity in dermatological outpatients, an issue to be recognized. British Journal of Dermatology, 143, 983-91 https://doi.org/10.1046/j.1365-2133.2000.03831.x
  51. Reid, P., & Lewis-Jones, M. S.(1995). Sleep disturbance in preschoolers with atopic eczema. Clinical and Experimental Dermatology, 20, 38-41 https://doi.org/10.1111/j.1365-2230.1995.tb01280.x
  52. Richman, N.(1981). A community survey of characteristics of one- to two- year-olds with sleep disruptions. Journal of the American Academy of Child Psychiatry, 20, 281-91 https://doi.org/10.1016/S0002-7138(09)60989-4
  53. Schilder, P.(1950). The Image and Appearance of the Human Body. New York: International University Press
  54. Sharma, N., Koranne, R. V., & Singh, R. K.(2001). Psychiatric morbidity in psoriasis and vitiligo, a comparative study. Journal of Dermatology, 28, 419-23 https://doi.org/10.1111/j.1346-8138.2001.tb00003.x
  55. Snyder-Halpern, & Verran, J. A.(1987). Instrumentation to describe subjective sleep characteristics in healthy subjects. Research in Nursing and Health, 10, 156-163
  56. Staughton, R.(2001). Psychological approach to atopic skin disease. Journal of Academic Dermatology, 45, S53-54 https://doi.org/10.1067/mjd.2001.117014
  57. Stores, G., Burrows, A. B., & Crawfors, C.(1998). Physiological sleep disturbance in children with atopic dermatitis: A case controlled study. Pediatry Dermatology, 15, 264-268 https://doi.org/10.1046/j.1525-1470.1998.1998015264.x
  58. Sugiura, H., Tanaka, K., & Sawai, T.(1998). Prevalence of childhood and adolescent atopic dermatitis in a Japanese population, Comparison with the disease frequency examined 20 years ago. Acta Dermato- Venereologeca, 78(4), 293-294 https://doi.org/10.1080/000155598441891
  59. Warschburger, P., Buchholz, H., & Petermann, F.(2004). Psychological adjustment in parents of young children with atopic dermatitis, which factors predict parental quality of life? British Journal of Dermatology, 150, 304-311 https://doi.org/10.1111/j.1365-2133.2004.05743.x