The role of attachment patterns and family functioning on psychophysical well-being in children with Cystic Fibrosis Preliminary Results

Abstract

(1) Introduction Scientific literature evidences a link between the quality of personal relationships and health status: the attachment style has a role on health and growth outcomes (Feeney, 2000) especially in chronic illness representing a threatening situation (Ciechanowski, 2003). Cystic fibrosis (CF) is a chronic genetic condition compromising the exocrine glands functioning and requiring intensive daily therapies (White et al., 2009). In pediatric condition, infant-mother relationship constituted an important element for nutritional status in CF children (Simmons et al., 1995; Anthony et al. 1999) which is one of the major factors contributing to improve longevity and quality of life. The study aims to explore attachment patterns of CF children and their mothers, and to examine their relationship with children health status, in terms of quality of eating behaviors and treatment adherence. (2) Method At this stage, 29 mothers of CF children (age ranged 4-7 years, M=5,2; SD=1,3) completed Relationship Questionnaire (Bartholomew and Horowitz, 1991) to assess attachment pattern, and Children's Eating Behavior Questionnaire (Wardle et al., 2001) to assess children's eating behaviors. With Separation Anxiety Test (Klagsbrun and Bowlby, 1976) we assessed children's attachment styles. Diet adherence evaluation by FC Centre’s nutritionist, socio-demographic and disease information were recorded and correlated with other outcomes. (3) Results/discussion No mother reported Preoccupied attachment pattern and distribution across Secure (N=9), Dismissing (N=11) and Fearful one (N=9) is balanced. According to the literature on clinical group (Cassiba et al., 2011), we found an high rate of insecure infants (N=20). The most frequent children insecure attachment style is disorganized (N=9) which is mostly linked with maternal dismissing attachment. Significant correlation between dysfunctional eating behaviors (low food responsiveness and enjoyment, high satiety responsiveness, slowness and fussiness) and compromised health status (low BMI, high hospitalizations number) confirms multidimensionality and dynamicity of pediatric adherence construct (De Civita, Dobkin, 2004). Furthermore, relation between maternal Fearful Attachment and dietary adherence (r=441; p<0,05) confirms how the family functioning plays an important and complex role on the well-being in children with chronic illness (Rolland, 1993) and with CF (Spieth et al., 2001; Zindani et al., 2006).