Age-Related Discrepancies in Parent Proxy and Patient-Reported Psychosocial Function of Children with Craniofacial Anomalies
Julia R. Ayeroff, BA1, Elizabeth J. Volpicelli, BA1, Miles J. Pfaff, MD1, David S. Foulad, MD1, James P. Bradley, MD2, Libby Wilson, MD3, Justine C. Lee, MD, PhD1.
1Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA, 2Division of Plastic and Reconstructive Surgery, Temple University Hospital, Lewis Katz School of Medicine, Philadelphia, PA, USA, 3Orthopaedic Institute for Children, Los Angeles, CA, USA.
PURPOSE: Young children between 8 to 10 years of age with craniofacial anomalies report higher anxiety, depression, and lower peer relationships compared to their older counterparts. In this study, we evaluate the concordance of parental assessments for psychosocial functioning of children with craniofacial anomalies to pediatric reports with respect to age.
METHODS: 160 patients with craniofacial anomalies (age 8-17 years, 48.8% male) and their caregivers were prospectively evaluated at UCLA and the Orthopaedic Institute for Children using the parent proxy and pediatric Patient-Reported Outcomes Measurement Information System (PROMIS) to assess anger, anxiety, depression, and quality of peer relationships. Patients were grouped by age in years: Group A (8-10); Group B (11-13); Group C (14-17). Analyses of variance and paired samples t-tests were performed. P<0.05 was considered statistically significant.
RESULTS: Age-related differences in psychosocial functioning were reported by children across all measures (p<0.01) and by parents for anxiety and depression (p<0.05). Differences were found in parental assessments of children with respect to age, however, severity of dysfunction was inversely related to child self-reports. When parents and children were directly compared within each age group, parents underestimated depression (48.1±8.6 vs. 51.1±9.0; p<0.05) and overestimated the quality of peer relationships (49.8±10.3 vs. 44.7±9.5; p<0.01) for Group A, and overestimated depression (52.0±7.8 vs. 46.1±9.7; p<0.001) and anxiety (53.4±7.1 vs. 45.8±9.5; p<0.001) for Group C.
CONCLUSION: Parents deemed the youngest children as having better psychosocial functioning than the oldest children despite children self-reporting the opposite trend.
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