The Social and Cultural Context of Coping with Sickle Cell Disease: III. Stress, Coping Tasks, Family Functioning, and Children’s Adjustment

Conceptions of individual and family coping with sickle cell disease (SCD) must incorporate several disease and sociocultural factors. This article proposes an integrative model and tests the relative contribution of model parameters to the prediction of social, academic, and psychological adjustment of children with SCD. The individual coping and family functioning variables most highly predictive of the child’s psychological outcomes (anxiety, depression, and positive mood) include parental psychological functioning, maturity demands made of the ill child, and the quality of relations with parents and siblings. Academic adjustment was significantly predicted by parental academic expectations and by the child’s rejection of a restrictive sick role. Competent social functioning also was predicted by the extent to which the ill child rejected the role of being sick.