Date of Graduation


Document Type



The purpose of this study was to examine children's behavioral functioning to two chronic health conditions having received little empirical study in the pediatric psychology literature: primary immunodeficiency disorders (PIDDs) and kidney disease (KD). Children with PIDD are at increased risk for infections, respiratory-related concerns, gastrointestinal difficulties, inflammatory bowel disease, and malignancy. Children with PIDD and KD seem to share many similar experiences (e.g., dialysis or IVIg treatments, frequent invasive medical procedures). As such, these children were compared to each other and to a healthy comparison group. The aims of this study were to: (a) compare the perceptions of children and caregivers on family functioning, (b) contrast family functioning, coping strategies, and child adjustment across illness groups, (c) examine psychosocial differences across illness severity levels, and (d) determine which variables significantly predict child adjustment. Participants were youth ages 8–21 years. Fifteen children with a PIDD, 17 children with a KD, and 32 comparison children participated. Children and caregivers each completed the: Family Assessment Device and Behavioral Assessment System for Children. To assess coping skills, caregivers and children completed the Brief COPE and Kidcope, respectively. Caregivers and children in the PIDD and healthy comparison groups appeared to agree only on the division of responsibilities among family members. Interestingly, caregivers and children in the KD group agreed on all areas of family functioning assessed. Significant group differences were not obtained for either coping skills or child behavioral functioning. Regression results indicated that caregiver report of family roles and affective responsiveness, as well as child report of family communication, were significantly involved in predicting child behavioral functioning. Thus, it appears that a family systems approach to intervention that addresses communication training and group problem solving may be advantageous to these families. Based on our findings, suggestions for future research and clinical intervention were discussed.