Chronic illness and behavior problems in children: Mediating and moderating influences

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Research indicates that children living with a chronic illness have a higher level of behavior problems than children not living with an illness. However, mediating factors must be examined in order to create a clearer picture of the influence of a chronic health condition on children. Therefore, this research examined the mediating influence of economic strain, child's health stress, parental psychological distress, and parenting behaviors on child behavior, as well as the moderating impact of social support on all previously mentioned variables. Structural equation modeling was used to model each of these relationships. Data came from responses to the Panel Study of Income Dynamics Child Development Supplement that included both children not living with an illness (n=806) and children living with a chronic illness (n=693) who were between the ages of 6 and 13 and their primary caregivers. The chronic illnesses included in the sample are anemia (n=120), asthma (n=157), diabetes (n=3), and chronic otitis media (n=522). Comorbidity was present with 102 children living with two illnesses and four children living with three illnesses. The findings indicate that the presence of a chronic illness has a relationship with higher levels of child behavior problems, but health stress and parental psychological distress contribute more to child behavior problems than the presence of illness. Social support was found to buffer the relationships between the presence of illness and economic strain and the presence of illness and health stress. Findings suggest that researchers, practitioners, and policymakers should focus on the alleviation of economic strain, health stress, and parental psychological distress because of their relationship with poorer parenting and higher levels of child behavior problems. Possible directions for future research were also discussed.