Table Of ContentEmotion, Cognition, Health,
and Development
in Children and Adolescents
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/
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Emotion, Cognition, Health,
and Development
in Children and Adolescents
Edited by
Elizabeth J. Susman
Lynne V. Feagans
William J. Ray
The Pennsylvania State University
IfA
LAWRENCE ERLBAUM ASSOCIATES, PUBLISHERS
1992 Hillsdale, New Jersey Hove and London
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Copyright © 1992, by Lawrence Erlbaum Associates, Inc.
All rights reserved. No part of this book may be reproduced in
any form, by photostat, microfilm, retrieval system, or any other
means, without the prior written permission of the publisher.
Lawrence Erlbaum Associates, Inc., Publishers
365 Broadway
Hillsdale, New Jersey 07642
Library of Congress Cataloging-in-Publication Data
Emotion, cognition, health, and development in children and
adolescents / edited by Elizabeth J. Susman, Lynne V. Feagans,
William J. Ray.
p. cm.
Includes bibliographical references and index.
ISBN 0-8058-0548-6
1. Health behavior in children-Congresses. 2. Health behavior in
adolescents-Congresses. I. Susman, Elizabeth J. II. Feagans,
Lynne V. III. Ray, William J., 1945-
RJ47.53.E46 1992
6l8.92-dc20 91-32896
CIP
Printed in the United States of America
10 9 8 7 6 5 4 3 2 1
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Contents
Historical and Theoretical Perspectives on Behavioral
Health in Children and Adolescents: An Introduction 1
Elizabeth J. Susman, Lorah D. Dorn, Lynne V. Feagans,
and William J. Ray
Here's Looking at You, Kid!
New Ways of Viewing the
1 Development of Health Cognition 9
David S. Gochman
PART I DEVELOPMENTAL TRAJECTORIES
IN BEHAVIORAL HEALTH 25
Development of Attachment, Health Risks,
2 and Health Control 27
Colleen Frobose and Elizabeth J. Susman
The Role of Individual Differences in Infant Personality
3 in the Formation of Attachment Relationships 31
Nathan A. fox
The Development of Autonomy in Children's Health
4 Behaviors 53
Ronald J. Iannotti and Patricia J. Bush
Risk-Taking Behaviors and Biopsychosocial Development
5 During Adolescence 75
Charles E. Iwin, Jr. and Susan G. Millstein
v
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vi CONTENTS
PART II DEVELOPMENTAL PROCESSES AND DISEASE 103
6 Disease Processes and Behavior 105
William J. Ray
7 Iron Deficiency Anemia and Infant Behavior 111
Betsy Lozoft
Cognitive Maturity, Stressful Events, and
8 Metabolic Control Among Diabetic Adolescents 121
Gary M. Ingersoll, Donald P. Orr, Michael D. Vance,
and Michael P. Golden
Ego Development Paths and Adjustment to Diabetes:
Longitudinal Studies of Preadolescents and Adolescents
9 With Insulin-Dependent Diabetes Mellitus 133
Stuart T. Hauser, Alan Jacobson, Janet Milley, Donald Wertlieb,
Joseph Wolfsdorf, Raymonde D. Herskowitz, Phillip Lavori,
and Robin L. Bliss
PART III NEW PERSPECTIVES ON HEALTH
AND DEVELOPMENT 153
10 Wellness, Illness, Health, and Disease Concepts 155
Arthur H. Parmelee, Jr.
Intervention Strategies to Promote Healthy Children:
Ecological Perspectives and Individual Differences
11 in Development 165
Lynne V. Feagans
Author Index 171
Subject Index 179
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Historical and Theoretical Perspectives
on Behavioral Health in Children
and Adolescents: An Introduction
Elizabeth J. Susman
The Pennsylvania State University
Lorah D. Dorn
National Institute of Mental Health, Bethesda, MD
Lynne V. Feagans
The Pennsylvania State University
William J. Ray
The Pennsylvania State University
The scientific study of health and behavior has been integrated over the past two
decades to form entirely new interdisciplinary areas of inquiry. These new dis
ciplines focus on health, illness, and behavior as processes reciprocally influenc
ing each other. The existing literature emphasizes these processes primarily in
adults rather than in children and adolescents, and the research tends not to ad
dress the issue of change across the life span. Consequently, developmental con
siderations have been underemphasized in theoretical and research perspectives.
This volume attempts to fill that gap by including chapters that focus on emotion,
cognition, and health as important developmental processes in a new scientific
frontier, behavioral health in children and adolescents.
, A developmental perspective in behavioral health is important because bio
logical and behavioral processes unique to each developmental period have far
reaching implications for health promotion, disease prevention, and disease recov
ery in childhood and adolescence. Promotion of health during childhood and
adolescence is important because it is during these early critical periods that major
organ systems develop and learning of health-related behaviors, attitudes, values,
and perceptions takes place. The development of a healthy lifestyle during child
hood and adolescence will cast the mold for a similar lifestyle throughout the
life span. Prevention of disease and rapid recovery from illness at all phases of
the life span are byproducts of a healthy lifestyle in the early years.
This book is an outgrowth of a conference on emotion and cognition as an
tecedents and consequences of health and disease processes in children and adoles
cents. The theoretical rationale for the conference was based on the assumption
1
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2 SUSMAN, DORN, FEAGANS, RAY
that the development of emotion, cognition, health, and illness are processes that
influence each other through the life span and that these reciprocal interactions
begin in infancy. In the chapters to follow, developmental theories, research, and
implications for interventions are discussed as they relate to promoting health,
preventing disease, and treating illness in children and adolescents.
HISTORICAL PERSPECTIVE
ON BEHAVIORAL HEALTH
The modern integration of mind and body in the scientific literature has provided
the foundation for the evolution of multiple new frontiers devoted to explaining
the development of health and illness. These new fields include behavioral medi
cine, health behavior, health psychology, and the more inclusive term for con
sidering all of these fields, behavioral health (Matarazzo, 1984). Behavioral medi
cine was the first new discipline to emerge. It is defined as an interdisciplinary
field concerned with the development and integration of behavior and the bio
medical sciences (Schwartz & Weiss, 1978). The focus of behavioral medicine
is on how behavior influences disease processes and on treatment rather than on
prevention. A later discipline, health behavior, focuses on personal attributes (e.g.,
beliefs and expectations), personality characteristics, emotions and cognitions that
relate to health maintenance, and health restoration and improvement (Gochman,
1982). A discipline evolving parallel to health behavior is health psychology. In
1980 at the annual meeting, the Division of Health Psychology adopted an offi
cial working definition of the field of health psychology:
Health psychology is the aggregate of the specific educational, scientific, and profes
sional contributions of the disciplines of psychology to the promotion and main
tenance of health, the prevention and treatment of illness, the identification of etio
logic and diagnostic correlates of health, illness, and related dysfunction, and the
analysis and improvement of the health care system and health policy formation.
(Stone, 1987, p. 27)
In this introduction, behavioral health is used as an inclusive term to represent
the new disciplines discussed as well as other interdisciplinary efforts that focus
on the integration of health, illness, and behavior.
Although behavioral health in children and adolescents has only recently be
gun to receive systematic attention, behavioral pediatrics has been in existence
for about a decade. Behavioral pediatrics is developmentally oriented because
of the nature of the discipline of pediatrics itself. Within the behavioral pedi
atrics perspective, Krasnegor, Arasteh, and Cataldo (1986) published one ofthe
first books examining child health and behavior in terms of perspectives, deter
minations, prevention, and treatment. Recently, child health and behavior was
the focus of a national working conference on health and behavior (Drotar et al.,
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BEHAVIORAL HEALTH IN CHILDREN AND ADOLESCENTS 3
1989). The new focus on child health and behavior offers the potential for promot
ing optimal health in the current generation of children as well as in future
generations.
Behavioral health in childhood and adolescence may not have gained in promi
nence because, historically, these periods have been considered healthy stages
of the life span. In childhood, chronic and debilitative diseases are not promi
nent. With the advent of antibiotic therapy to treat infectious diseases, mortality
now is confined primarily to accidents, genetic diseases, and neoplasms. Mor
bidity in childhood currently tends to be the result of preventable nutritional deficits
(e.g., iron deficiency) and infectious processes. Both conditions were assumed,
heretofore, to be benign conditions (e.g., otitis media). Nonetheless, these con
ditions may adversely affect the emotional and cognitive development of chil
dren resulting in less than optimal adult health and functioning.
In adolescence, morbidity and mortality often are the result of preventable so
cial, environmental, and behavioral factors (Irwin & Millstein, 1986). Preventa
ble morbidity and mortality include accidents, homicide, suicide, and injury. Thus,
there remains reason for concern for the health of children and adolescents in
spite of overall prevention and treatment of major life-threatening childhood
illnesses.
BEHAVIORAL HEALTH IN CHILDREN
AND ADOLESCENTS
In the past, when children were considered in behavioral health, research, or clin
ical practice, it was in terms of how child health behavior affects adult health
(Maddux, Roberts, Sledden, & Wright, 1986). This focus led to a lack of theory
on the integration of health and behavior in children and adolescents. The de
velopmental perspective on behavioral health, in this volume, is different from
this earlier approach in terms of its conceptualization and the importance it places
on health and behavior during childhood and adolescence. Theoretical perspec
tives on child and adolescent health and health behaviors should be different from
those for adults, primarily because of physical, emotional, cognitive, and social
developmental differences between children, adolescents, and adults. When con
sidering strategies for optimizing health and development, the uniqueness of emo
tional and cognitive processes in early developmental periods should be consid
ered. The immature emotional and cognitive status of children and adolescents
may impede efforts to change their behavior to promote health or adaptation to
disease states. Nonetheless, in spite of immaturity in emotional and cognitive
processes, plasticity in psychological and organ systems is a major advantage in
the child and adolescent years in developing a lifestyle conducive to optimizing
health and development throughout the life span.
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