Short communication: the importance of psychosocial factors in understanding child distress during routine X-ray procedures.

Thirty-eight children, aged 1-4 years, with a query or definite diagnosis of congenital heart disease (CHD) were observed during an X-ray procedure and their behaviour rated on an amended version of the Observational Scale of Behavioural Distress. Families were followed up and assessed on a number of psychosocial variables. High rates of behavioural distress were found to be associated with children's low stranger sociability and parental style of discipline. Possible patterns of interaction between CHD children and their families are discussed.