The psychological profile of children with immune thrombocytopenia and the factors influencing well-being

Immune thrombocytopenia is a blood disorder, characterised by low platelet count, bleeding and bruising. In children, symptoms are generally mild and spontaneous remission is common. Literature relating to other paediatric conditions is reviewed and considered alongside limited studies with adults and children with ITP which suggest that their life is affected by the condition. A holistic approach to treatment should be adopted which is informed by the psychological profile of ITP. The current study used questionnaires completed by children with ITP and their parents attending haematology outpatient appointments. Questionnaires assessed adjustment variables of emotional and behavioural functioning, fatigue, quality of life, and executive functioning. A measure was created to examine the effect of subjective appraisal from parents and children on the other investigated variables. In total, 37 families took part. Results showed parents’ ratings of children on a measure of total psychological difficulties, and specifically on emotional symptoms, were higher for this sample compared with children without ITP. Fatigue as rated by parents and children was higher for children with ITP compared with a sample of children without ITP. Global executive functioning and the Behaviour Regulation Index were significantly poorer compared with normative values, with almost 20% of children displaying a high level of problems with executive functioning. Severity ratings of the condition varied between parent, child and clinician. Bleeding severity and platelet generally did not correlate with other measures. Some appraisal measures were significantly associated with adjustment variables. Possible explanations for the findings are discussed. Results are then considered relative to the Risk and Resistance model (Wallander & Varni, 1992). Despite limitations, this study provides important information that contributes to knowledge about the profile of ITP as well as the inter-relationship between factors that affect well-being in paediatric conditions more broadly.