Daily Hassles and Social Support as Predictors of Adjustment in Children With Pediatric Rheumatic Disease

Objective: To test hypotheses that social support moderates the effects of microstressors on the psychosocial adjustment of children with pediatric rheumatic diseases (PRDs) and that among multiple sources of support, classmate and parent support are significant predictors of adjustment, after controlling for demographic and disease severity variables. Methods: Children with PRDs (N = 160 children; 8-17 years) were recruited from three pediatric rheumatology centers and completed measures of daily hassles, social support, depressive symptoms, and state and trait anxiety; their parents completed measures of internalizing and externalizing behaviors. Results: Fewer daily hassles and higher social support predicted fewer adjustment problems. Among the sources of support, classmate and parent support were significant predictors. Tests for moderation were significant only for a Hassles × Classmate Support interaction in the prediction of depression. A plot of the interaction between hassles and classmate support showed that children with high classmate support had lower levels of depression than children with low classmate support under high or low levels of daily hassles. Furthermore, children with high classmate support had lower levels of depression under conditions of low versus high daily hassles. Discussion: Results are consistent with a main effect rather than buffering model for social support. Conclusions: Interventions should focus on management of daily hassles and increasing social support for children with PRDs.