Introduction: Pediatric patients may be at higher risk for depression and a lower self-concept when difficulties within the family arise. The Mastering Each New Direction (MEND) program is a psychosocial intervention aimed at addressing adherence and family issues in adolescent CI. Methods: Drawing data from 50 MEND participants, we used multilevel modeling techniques to test changes in self-concept over time as predicted by number of weeks in MEND, depression, family cohesion and flexibility, and baseline levels of maternal and paternal attachment. Results: At Level 1, depression negatively predicted self-concept over time. At Level 2, higher baseline maternal and paternal avoidant attachment predicted higher initial self-concept. Higher maternal avoidant attachment was also associated with a stronger relationship between self-concept and depression. Discussion: Given that avoidant attachment predicted affective well-being and identity stabilization in youth with CI, targeting the parent-child relationship may be key to reducing co-morbid psychological issues in this population. Programs like MEND by focusing on family well-being and health may help adolescents individuate while maintaining adherence.
School of Behavioral Health
Neece, Cameron L.
Morrell, Holly E. R.
Doctor of Philosophy (PhD)
Year Degree Awarded
Date (Title Page)
Library of Congress/MESH Subject Headings
Depression; Chronic Disease -- child; Pediatrics;
Subject - Local
Parent-Child Attachment; Self-Concept; Mastering Each New Direction (MEND) Program; Avoidant Attachment
Loma Linda University Libraries
This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.
Emerson, Natacha Donoghue, "Multi-level Model of Parent-Child Attachment, Depression & Self-Concept in Pediatric Chronic Illness" (2016). Loma Linda University Electronic Theses, Dissertations & Projects. 375.
Loma Linda University Electronic Theses and Dissertations
Loma Linda University. Del E. Webb Memorial Library. University Archives