Date of Graduation


Document Type


Degree Type



Eberly College of Arts and Sciences



Committee Chair

Kevin Larkin.


Routine childhood immunization injections result child distress, which may have lasting negative effects on children, parents, and staff, and impact adherence to schedules of immunization. Aims of the current study were to (a) examine the role of child and parent individual difference variables in relation to child immunization distress, and (b) determine whether child distress predicts future immunization schedule adherence.;Parents of 50 children (aged 12--18 months) attending a visit to a pediatric medical clinic for purposes of immunization completed measures of child temperament, parent psychopathology, immunization beliefs, and prior medical distress of the child. Child distress during the immunization injection was measured via parent and nurse ratings and a behavior observational scale. Adherence to the immunization schedule was assessed via the Immunization Delivery Effectiveness Score (IDEA) and the families' attendance at a follow-up immunization appointment.;Positive correlations were observed between child distress and prior medical distress of the child, difficult child temperament, and parent psychopathology. Negative correlations were found between child distress and child age and parent immunization beliefs. Boys exhibited more distress than girls. Child age and parent psychopathology each made unique contributions in explaining the variance in child distress. An interaction was observed between (a) prior medical experience and immunization adherence, and (b) health care attitudes and immunization adherence in the relation to child distress. Magnitude of child distress was greatest among children (a) with prior negative medical experiences and poorer adherence to schedules of immunization, and (b) with parents possessing negative immunization beliefs and poorer adherence to schedules of immunization. Child distress did not predict attendance at a subsequent clinic visit for purposes of immunization.;Several child and parent factors are related to various measures of child distress employed in this study. Results offer partial support for extant literatures (i.e., relations among immunization distress and age, gender, negative prior medical experiences, healthcare attitudes), and expand on a dearth in literature (i.e., relation between child distress and parent psychopathology). Findings may assist clinicians in identifying children at greatest risk for experiencing significant distress reactions during immunizations and providing training in effective interventions designed to minimize pain.