to the first author and a grant from Columbus Children's Hospital to the second author. We also a... more to the first author and a grant from Columbus Children's Hospital to the second author. We also acknowledge the technical assistance provided by Avril Murphy and Robert Sisney for this project, as well as the helpful comments of Stephanie Hahl.
Objective As a field, pediatric psychology has focused considerable efforts on the education and ... more Objective As a field, pediatric psychology has focused considerable efforts on the education and training of students and practitioners. Alongside a broader movement toward competency attainment in professional psychology and within the health professions, the Society of Pediatric Psychology commissioned a Task Force to establish core competencies in pediatric psychology and address the need for contemporary training recommendations. Methods The Task Force adapted the framework proposed by the Competency Benchmarks Work Group on preparing psychologists for health service practice and defined competencies applicable across training levels ranging from initial practicum training to entry into the professional workforce in pediatric psychology. Results Competencies within 6 cluster areas, including science, professionalism, interpersonal, application, education, and systems, and 1 crosscutting cluster, crosscutting knowledge competencies in pediatric psychology, are presented in this report. Conclusions Recommendations for the use of, and the further refinement of, these suggested competencies are discussed.
Objective To determine the feasibility and acceptability of an interdisciplinary intervention for... more Objective To determine the feasibility and acceptability of an interdisciplinary intervention for mothers of children newly diagnosed with cancer and to estimate effect sizes for the intervention in reducing distress. Management of illness uncertainty was a key framework for the intervention. Methods Mothers (N ¼ 52) were randomly assigned to the intervention or a treatment as usual group, completing measures at baseline and follow-up time points. Results Mothers' satisfaction ratings were consistently high, and intervention implementation appeared feasible. Significant mean effects or trends in favor of the intervention group were found for pre-to-post change on measures of distress. Evidence of a preventative effect was also observed; mothers in the intervention group tended to improve or remain stable in their adjustment, whereas many parents in the treatment as usual group showed worsening outcomes. Conclusions An interdisciplinary intervention targeting maternal illness uncertainty has clinical value within this sample.
This preliminary study longitudinally examined the relationship of illness uncertainty and attrib... more This preliminary study longitudinally examined the relationship of illness uncertainty and attributional style to psychological distress among parents of children with type 1 diabetes mellitus. Thirty parents who had participated in a larger study 5 to 6 years earlier completed measures of illness uncertainty, attributional style, and psychological distress. Time 1 illness uncertainty significantly predicted Time 2 distress; Time 1 negative attributional style did not. Post hoc probing revealed that Time 1 illness uncertainty did not mediate Time 1 and Time 2 distress. Results suggest that illness uncertainty continues to be a salient and robust predictor of parental adjustment outcomes over time.
To examine the relationship between asthma and psychological distress among adolescents already a... more To examine the relationship between asthma and psychological distress among adolescents already at-risk for adjustment problems secondary to lower economic strata and educational or vocational failure. Twenty-five high-risk adolescents with asthma and 25 high-risk controls without asthma 16 to 21 years old completed the Brief Symptom Inventory, the Beck Depression Inventory, and the Beck Anxiety Inventory. Adolescents with asthma had significantly higher scores on multiple measures of psychological distress. Specifically, adolescents with asthma evidenced higher levels of anxiety, depression, and global psychological distress than those without asthma. High-risk adolescents with asthma may be more likely to experience psychological distress than those without asthma. Our findings suggest that asthma constitutes an additional significant independent stressor or risk factor among adolescents who already are at high risk for multiple adjustment problems.
To reexamine members of the Society of Pediatric Psychology (SPP) to document trends in training ... more To reexamine members of the Society of Pediatric Psychology (SPP) to document trends in training experiences of individuals who identify themselves as pediatric psychologists. Using the 1999 SPP membership list, we asked respondents to complete a survey describing their degree status, theoretical orientation of graduate program, type of internship/fellowship, current employment setting, and orientation to assessment and treatment of pediatric problems. The majority of the respondents matriculated from doctoral programs in the last two decades. Compared to a previous survey (Mullins, Harbeck-Weber, Olson, & Hartman, 1996), this survey had a higher percentage of respondents who completed accredited predoctoral or postdoctoral training in pediatric psychology. Over half of the respondents were primarily employed in medical centers or academic institutions; fewer respondents reported working in private practice settings than in the previous survey 10 years ago. Respondents' current ...
Purpose. To measure health-related quality of life (HRQOL) in children and adolescents ages 5-18 ... more Purpose. To measure health-related quality of life (HRQOL) in children and adolescents ages 5-18 years. This measure consists of child report (ages 10 -18 years) and 2 versions of parent-proxy report (ages 5-18 years) of the child's HRQOL. It can be used with healthy children and those with both acute and chronic health conditions. Content. Assesses for 14 physical and psychosocial domains: general health perceptions, physical functioning, role/social physical functioning, bodily pain, role/social emotional functioning, role/social behavioral functioning, parent impact-time, parent impact-emotional, self-esteem, mental health, behavior, family activities, family cohesion, and change in health.
In the previous edition of this chapter we noted that for the most part clinical and basic scienc... more In the previous edition of this chapter we noted that for the most part clinical and basic science research in the field of myasthenia gravis (MG) had largely focused on understanding the etiology, clinical sequelae, and treatment of the disease with little attention directed toward the psychological aspects of the condition. Unfortunately, this situation has not improved. Despite evidence that
Journal of American college health : J of ACH, Jan 7, 2015
The current study investigated the mediating role of fear of negative evaluation on the relations... more The current study investigated the mediating role of fear of negative evaluation on the relationship between self-focused attention and self-esteem among college students with and without asthma. Young adults with (N = 148) and without (N = 530) childhood-onset asthma were recruited from a college student population. Self-focused attention and fear of negative evaluation measures were completed. Participants also answered questions about inclusion in a social activity. Higher levels of self-focused attention and fear of negative evaluation were associated with lower self-esteem in both groups within the context of social activity participation. Fear of negative evaluation mediated the relationship between self-consciousness and self-esteem. No significant differences were found between groups. Findings indicate significant relationships among self-focused attention, fear of negative evaluation, and self-esteem in the context of social activity participation. Further examination of s...
Journal of Pediatric Endocrinology and Metabolism, 2014
To examine whether male and female caregivers of children with a disorder of sex development (DSD... more To examine whether male and female caregivers of children with a disorder of sex development (DSD) differ in levels of anxious and depressive symptoms. Participants included 80 caregivers (40 males, 40 females) of 40 children with a DSD. Children were categorized based on illness characteristics including ambiguous genitalia, life-threatening, and life-threatening with ambiguous genitalia. Caregivers completed measures of anxious and depressive symptoms. A significant caregiver × diagnosis interaction for anxious symptoms emerged, with male caregivers of children with both ambiguous genitalia and a life-threatening condition reporting significantly lower levels of anxious symptoms than female caregivers of the same children. The findings are surprising because of the low level of anxious symptoms reported by male caregivers of children with a complex DSD. It is possible that they have disengaged themselves from the child and/or diagnosis, causing their female counterparts to take on more responsibility.
In this study, we longitudinally examined the influence of a brief (3-7 day) respite care admissi... more In this study, we longitudinally examined the influence of a brief (3-7 day) respite care admission on psychological distress and parenting stress in parents of children admitted to a center for developmental disabilities. A comparison group of parents of children who were admitted for short-term (30-day) inpatient treatment was utilized. Parents (N = 80) completed the Brief Symptom Inventory (Derogatis, 1993a) and the Parenting Stress Index (Abidin, 1990) at time of admission, discharge, and at 6-month follow-up. Therapists completed measures of functional ability at admission and discharge. Analyses indicate that psychological distress was significantly lower at discharge and 6-month follow-up for both groups. Parenting stress was significantly lower at discharge, but at 6-month follow-up had returned to admission levels. Notably, both groups demonstrated improved functional ability from admission to discharge despite the respite care group receiving little formal therapy over a much shorter stay in the center. Respite care appears to result in reductions in psychological distress in parents of children with developmental disabilities; such reductions are comparable to that of a longer term stay. It is important to note that these improvements in functioning are maintained over time.
Posttraumatic growth (PTG), a positive change in values and major life goals experienced as a res... more Posttraumatic growth (PTG), a positive change in values and major life goals experienced as a result of the struggle with a highly challenging life circumstance, has been shown to be related to the construct of hope, the belief that goals can be met. To date, no studies have examined the relationship between PTG and hope in parents of children with cancer. Participants were parents (N = 85) of children and adolescents (ages 2-18 years, M = 7.72 years) receiving treatment for cancer. Parents completed a demographic questionnaire, the Posttraumatic Growth Inventory (PTGI), and Hope Scale (HS). Hope was found to be related to PTG in parents of children with cancer, with higher levels of hope associated with greater PTG. Exploratory analyses on the subscales of the PTGI revealed that hope was also related to higher scores on the Relating to Others, New Possibilities, Personal Strength, and Appreciation of Life subscales. Spiritual change was not related to hope in parents. Findings suggest that experiencing hope during the pediatric cancer experience may facilitate posttraumatic growth in parents. The construct of hope may be an important target of intervention for promoting positive adjustment in this population.
The current study examined the relationship between self-reported allergy severity, depressive an... more The current study examined the relationship between self-reported allergy severity, depressive and anxious symptoms, and attitude toward illness in adolescents and young adults (AYAs) with allergies. Participants were 214 undergraduate students between the ages of 17-25 years with self-reported allergies. Participants completed the Center for Epidemiological Studies Depression Scale (CES-D), the Zung Self-Rating Anxiety Scale (SAS), and the Child Attitude Toward Illness Scale (CATIS) as measures of depressive symptoms, anxious symptoms, and attitude toward illness, respectively. Using the bootstrapping method, results revealed that attitude toward illness mediated the relationship between self-reported disease severity and depressive and anxious symptoms. Results of the current study suggest that attitude toward illness is one pathway by which subjective disease severity impacts psychological functioning in AYAs with allergies.
We appreciate the thoughtful commentaries by Cohen and by Steele, Borner, and Roberts on our reco... more We appreciate the thoughtful commentaries by Cohen and by Steele, Borner, and Roberts on our recommendations for competencies in pediatric psychology . This type of dialogue is exactly what we hoped to see and we encourage continued discussion concerning training in competency development in pediatric psychology.
to the first author and a grant from Columbus Children's Hospital to the second author. We also a... more to the first author and a grant from Columbus Children's Hospital to the second author. We also acknowledge the technical assistance provided by Avril Murphy and Robert Sisney for this project, as well as the helpful comments of Stephanie Hahl.
Objective As a field, pediatric psychology has focused considerable efforts on the education and ... more Objective As a field, pediatric psychology has focused considerable efforts on the education and training of students and practitioners. Alongside a broader movement toward competency attainment in professional psychology and within the health professions, the Society of Pediatric Psychology commissioned a Task Force to establish core competencies in pediatric psychology and address the need for contemporary training recommendations. Methods The Task Force adapted the framework proposed by the Competency Benchmarks Work Group on preparing psychologists for health service practice and defined competencies applicable across training levels ranging from initial practicum training to entry into the professional workforce in pediatric psychology. Results Competencies within 6 cluster areas, including science, professionalism, interpersonal, application, education, and systems, and 1 crosscutting cluster, crosscutting knowledge competencies in pediatric psychology, are presented in this report. Conclusions Recommendations for the use of, and the further refinement of, these suggested competencies are discussed.
Objective To determine the feasibility and acceptability of an interdisciplinary intervention for... more Objective To determine the feasibility and acceptability of an interdisciplinary intervention for mothers of children newly diagnosed with cancer and to estimate effect sizes for the intervention in reducing distress. Management of illness uncertainty was a key framework for the intervention. Methods Mothers (N ¼ 52) were randomly assigned to the intervention or a treatment as usual group, completing measures at baseline and follow-up time points. Results Mothers' satisfaction ratings were consistently high, and intervention implementation appeared feasible. Significant mean effects or trends in favor of the intervention group were found for pre-to-post change on measures of distress. Evidence of a preventative effect was also observed; mothers in the intervention group tended to improve or remain stable in their adjustment, whereas many parents in the treatment as usual group showed worsening outcomes. Conclusions An interdisciplinary intervention targeting maternal illness uncertainty has clinical value within this sample.
This preliminary study longitudinally examined the relationship of illness uncertainty and attrib... more This preliminary study longitudinally examined the relationship of illness uncertainty and attributional style to psychological distress among parents of children with type 1 diabetes mellitus. Thirty parents who had participated in a larger study 5 to 6 years earlier completed measures of illness uncertainty, attributional style, and psychological distress. Time 1 illness uncertainty significantly predicted Time 2 distress; Time 1 negative attributional style did not. Post hoc probing revealed that Time 1 illness uncertainty did not mediate Time 1 and Time 2 distress. Results suggest that illness uncertainty continues to be a salient and robust predictor of parental adjustment outcomes over time.
To examine the relationship between asthma and psychological distress among adolescents already a... more To examine the relationship between asthma and psychological distress among adolescents already at-risk for adjustment problems secondary to lower economic strata and educational or vocational failure. Twenty-five high-risk adolescents with asthma and 25 high-risk controls without asthma 16 to 21 years old completed the Brief Symptom Inventory, the Beck Depression Inventory, and the Beck Anxiety Inventory. Adolescents with asthma had significantly higher scores on multiple measures of psychological distress. Specifically, adolescents with asthma evidenced higher levels of anxiety, depression, and global psychological distress than those without asthma. High-risk adolescents with asthma may be more likely to experience psychological distress than those without asthma. Our findings suggest that asthma constitutes an additional significant independent stressor or risk factor among adolescents who already are at high risk for multiple adjustment problems.
To reexamine members of the Society of Pediatric Psychology (SPP) to document trends in training ... more To reexamine members of the Society of Pediatric Psychology (SPP) to document trends in training experiences of individuals who identify themselves as pediatric psychologists. Using the 1999 SPP membership list, we asked respondents to complete a survey describing their degree status, theoretical orientation of graduate program, type of internship/fellowship, current employment setting, and orientation to assessment and treatment of pediatric problems. The majority of the respondents matriculated from doctoral programs in the last two decades. Compared to a previous survey (Mullins, Harbeck-Weber, Olson, & Hartman, 1996), this survey had a higher percentage of respondents who completed accredited predoctoral or postdoctoral training in pediatric psychology. Over half of the respondents were primarily employed in medical centers or academic institutions; fewer respondents reported working in private practice settings than in the previous survey 10 years ago. Respondents' current ...
Purpose. To measure health-related quality of life (HRQOL) in children and adolescents ages 5-18 ... more Purpose. To measure health-related quality of life (HRQOL) in children and adolescents ages 5-18 years. This measure consists of child report (ages 10 -18 years) and 2 versions of parent-proxy report (ages 5-18 years) of the child's HRQOL. It can be used with healthy children and those with both acute and chronic health conditions. Content. Assesses for 14 physical and psychosocial domains: general health perceptions, physical functioning, role/social physical functioning, bodily pain, role/social emotional functioning, role/social behavioral functioning, parent impact-time, parent impact-emotional, self-esteem, mental health, behavior, family activities, family cohesion, and change in health.
In the previous edition of this chapter we noted that for the most part clinical and basic scienc... more In the previous edition of this chapter we noted that for the most part clinical and basic science research in the field of myasthenia gravis (MG) had largely focused on understanding the etiology, clinical sequelae, and treatment of the disease with little attention directed toward the psychological aspects of the condition. Unfortunately, this situation has not improved. Despite evidence that
Journal of American college health : J of ACH, Jan 7, 2015
The current study investigated the mediating role of fear of negative evaluation on the relations... more The current study investigated the mediating role of fear of negative evaluation on the relationship between self-focused attention and self-esteem among college students with and without asthma. Young adults with (N = 148) and without (N = 530) childhood-onset asthma were recruited from a college student population. Self-focused attention and fear of negative evaluation measures were completed. Participants also answered questions about inclusion in a social activity. Higher levels of self-focused attention and fear of negative evaluation were associated with lower self-esteem in both groups within the context of social activity participation. Fear of negative evaluation mediated the relationship between self-consciousness and self-esteem. No significant differences were found between groups. Findings indicate significant relationships among self-focused attention, fear of negative evaluation, and self-esteem in the context of social activity participation. Further examination of s...
Journal of Pediatric Endocrinology and Metabolism, 2014
To examine whether male and female caregivers of children with a disorder of sex development (DSD... more To examine whether male and female caregivers of children with a disorder of sex development (DSD) differ in levels of anxious and depressive symptoms. Participants included 80 caregivers (40 males, 40 females) of 40 children with a DSD. Children were categorized based on illness characteristics including ambiguous genitalia, life-threatening, and life-threatening with ambiguous genitalia. Caregivers completed measures of anxious and depressive symptoms. A significant caregiver × diagnosis interaction for anxious symptoms emerged, with male caregivers of children with both ambiguous genitalia and a life-threatening condition reporting significantly lower levels of anxious symptoms than female caregivers of the same children. The findings are surprising because of the low level of anxious symptoms reported by male caregivers of children with a complex DSD. It is possible that they have disengaged themselves from the child and/or diagnosis, causing their female counterparts to take on more responsibility.
In this study, we longitudinally examined the influence of a brief (3-7 day) respite care admissi... more In this study, we longitudinally examined the influence of a brief (3-7 day) respite care admission on psychological distress and parenting stress in parents of children admitted to a center for developmental disabilities. A comparison group of parents of children who were admitted for short-term (30-day) inpatient treatment was utilized. Parents (N = 80) completed the Brief Symptom Inventory (Derogatis, 1993a) and the Parenting Stress Index (Abidin, 1990) at time of admission, discharge, and at 6-month follow-up. Therapists completed measures of functional ability at admission and discharge. Analyses indicate that psychological distress was significantly lower at discharge and 6-month follow-up for both groups. Parenting stress was significantly lower at discharge, but at 6-month follow-up had returned to admission levels. Notably, both groups demonstrated improved functional ability from admission to discharge despite the respite care group receiving little formal therapy over a much shorter stay in the center. Respite care appears to result in reductions in psychological distress in parents of children with developmental disabilities; such reductions are comparable to that of a longer term stay. It is important to note that these improvements in functioning are maintained over time.
Posttraumatic growth (PTG), a positive change in values and major life goals experienced as a res... more Posttraumatic growth (PTG), a positive change in values and major life goals experienced as a result of the struggle with a highly challenging life circumstance, has been shown to be related to the construct of hope, the belief that goals can be met. To date, no studies have examined the relationship between PTG and hope in parents of children with cancer. Participants were parents (N = 85) of children and adolescents (ages 2-18 years, M = 7.72 years) receiving treatment for cancer. Parents completed a demographic questionnaire, the Posttraumatic Growth Inventory (PTGI), and Hope Scale (HS). Hope was found to be related to PTG in parents of children with cancer, with higher levels of hope associated with greater PTG. Exploratory analyses on the subscales of the PTGI revealed that hope was also related to higher scores on the Relating to Others, New Possibilities, Personal Strength, and Appreciation of Life subscales. Spiritual change was not related to hope in parents. Findings suggest that experiencing hope during the pediatric cancer experience may facilitate posttraumatic growth in parents. The construct of hope may be an important target of intervention for promoting positive adjustment in this population.
The current study examined the relationship between self-reported allergy severity, depressive an... more The current study examined the relationship between self-reported allergy severity, depressive and anxious symptoms, and attitude toward illness in adolescents and young adults (AYAs) with allergies. Participants were 214 undergraduate students between the ages of 17-25 years with self-reported allergies. Participants completed the Center for Epidemiological Studies Depression Scale (CES-D), the Zung Self-Rating Anxiety Scale (SAS), and the Child Attitude Toward Illness Scale (CATIS) as measures of depressive symptoms, anxious symptoms, and attitude toward illness, respectively. Using the bootstrapping method, results revealed that attitude toward illness mediated the relationship between self-reported disease severity and depressive and anxious symptoms. Results of the current study suggest that attitude toward illness is one pathway by which subjective disease severity impacts psychological functioning in AYAs with allergies.
We appreciate the thoughtful commentaries by Cohen and by Steele, Borner, and Roberts on our reco... more We appreciate the thoughtful commentaries by Cohen and by Steele, Borner, and Roberts on our recommendations for competencies in pediatric psychology . This type of dialogue is exactly what we hoped to see and we encourage continued discussion concerning training in competency development in pediatric psychology.
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Papers by Larry Mullins