Abstract
Achenbach's Child Behavior Check List, a standardized test of psychosocial functioning, was used to assess the following groups (ages 6-16): Crohn's Disease (N=42), Ulcerative Colitis (UC)(N=27), Recurrent Abdominal Pain (RAP)(N=41) and healthy siblings (N=66). Groups were contrasted by scores on two subscales derived from factor analysis of test items. The “Internalizing” (I) subscale reflects depression, anxiety and withdrawal. The “Externalizing” (E) subscale reflects hyperaetivity, aggression and anti-social behavior. A standardized Disease Activity Index measured degree of illness.
RESULTS: 1) Patient groups had higher “I” scores than sibling groups (p <.001). 2) RAP “I” scores were higher than Crohn's and UC's (p. <.001). 3) “I” scores correlate with disease activity for Crohn's (r =.5, p <.001), but not for UC. 4) Siblings of UC patients “externalize” (p<.001), as compared to siblings of Crohn's and RAP.
CONCLUSIONS: A) “Internalizing” types of psychological problems occur with chronic gastrointestinal illness, and are worse for patients with non-organic abdominal pain syndromes. B) Crohn's and UC patients differ in the mechanisms underlying the relationship between psychological and disease factors. C) These findings indicate that psychological intervention should focus on “internalizing” types of symptoms and that Crohn's patients may be especially vulnerable during flares. D) Differences among sibling groups show that family patterns of behavior differ according to disease group. This indicates the importance of taking family context into account when developing and carrying out a treatment plan.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Wood, B., Watkins, J., Boyle, J. et al. 68 “INTERNALIZING” IN CHILDREN WITH CHRONIC GASTROINTESTINAL DISORDERS. Pediatr Res 19, 122 (1985). https://doi.org/10.1203/00006450-198504000-00098
Issue Date:
DOI: https://doi.org/10.1203/00006450-198504000-00098