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Comprehensive Handbook of Childhood Cancer and Sickle Cell DiseaseA Biopsychosocial Approach$
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Ronald T. Brown

Print publication date: 2006

Print ISBN-13: 9780195169850

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780195169850.001.0001

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Biopsychosocial and Developmental Issues in Sickle Cell Disease

Biopsychosocial and Developmental Issues in Sickle Cell Disease

(p.431) 23 Biopsychosocial and Developmental Issues in Sickle Cell Disease
Comprehensive Handbook of Childhood Cancer and Sickle Cell Disease

Kathryn E. Gustafson

Melanie J. Bonner

Oxford University Press

As advances in health care have prolonged and improved the quality of life of children with chronic illnesses such as sickle cell disease (SCD), psychologists have sought to understand the impact of the illnesses on children and their families and to formulate effective interventions to enhance adaptation. These efforts have been informed by a biopsychosocial conceptual approach such that the biomedical, psychological, and social-ecological processes associated with successful adaptation and effective intervention have been explored (Thompson & Gustafson, 1996). Moreover, it has been recognized that chronic childhood illness occurs within the ongoing context of the child’s cognitive and socioemotional development. Development occurs as a consequence of the transactions between the innate qualities of the biological organism and life experiences occurring in a psychosocial context (Thompson, 1985). There is a continuous and mutual influence of the child and the child’s environment, and the implications of the chronic illness for the child’s cognitive, social and emotional development will vary depending on the impact of the disease at each stage of development (Perrin & Gerrity, 1984). The child’s interactions with the environment can be affected by SCD or other chronic illness both directly and indirectly (Thompson & Gustafson, 1996). There can be a direct effect in terms of the biological processes of the disease on systems of the body that result in cognitive, motor, sensory, or other functional impairments. SCD, for example, is a hematological disorder but poses a risk to cognitive processes through central nervous system (CNS) stroke. There can also be an indirect effect of the chronic illness in terms of the effects of the disease on the child’s attainment of normative psychosocial developmental tasks that arise during phases of the life course. The pain crises that are associated with SCD, for example, may interfere with a child’s developmental tasks, including gaining autonomy, participating fully in school, interacting with peers, and forming an integrated sense of self-identity (e.g., Robinson, 1999; Sexson & Dingle, 1997). This chapter reviews the biopsychosocial and developmental issues that are relevant to SCD. Because subsequent chapters in this volume also review the neuropsychological and psychosocial issues in detail, this review is not meant to be exhaustive.

Keywords:   behavior problems, ecological-systems theory perspective, risk-resistance adaptation model, social-ecological model

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