Correlates of psychological adjustment to pediatric physical disorders: a meta-analytic review and comparison with existing models.

Thirty-eight studies of correlates of children's adjustment to physical disorders were reviewed in a meta-analysis and compared with existing models. Results indicate (1) considered collectively, disease/disability risk factors, parent/family risk factors, and child characteristics are significantly correlated with child adjustment although stressors (including socioeconomic status) are not; (2) disease/disability risk factors show significantly lower correlations than do parent/family or child characteristics; (3) child characteristics show the strongest correlation to adjustment, but these measures may be contaminated because items on some of these scales (e.g., self-concept, temperament) sometimes overlap with those on measures of total adjustment. With the exception of studies of disease severity, the number of studies meeting criteria for inclusion, with quantifiable correlates and measures of adjustment, was quite small. Inclusion of child, family/parent, social and medical risk/protective factors in future models is most appropriate, but greater emphasis needs to be placed on the child and family/parent characteristics. Greater attention also must be devoted to examining the interaction of risk/protective factors, including those that may be general and those that may be specific to a particular disability.