Kenneth J. Tarnowski
Florida Gulf Coast University

Ronald T. Brown
Medical University of South Carolina

Few events are as distressing to parents as a child or adolescent who is seriously ill or in-
jured. Virtually all children and their parents have experience with common childhood
afflictions, such as acute viral infections, stomachaches, headaches, and minor inju-
ries. Unfortunately, many children experience more threatening forms of acute or
chronic illness and injury (e.g., cancer, burns). There is significant mortality associated
with several of these conditions. In addition, many disorders are associated with
marked medical (i.e., residual physical disability) and psychological (i.e., disruption of
normal developmental processes) morbidity. Children and families experience nega-
tive psychological sequelae (e.g., depression) in response to a variety of specific pedi-
atric conditions. Importantly, behavioral factors also have been demonstrated to be
integral in determining onset, course, and prognosis of many disorders and injuries.

Even children suffering with benign and common conditions such as a cold may
evidence behavioral changes (e.g., reduced cognitive efficiency, dysphoric mood);
make specific causal attributions (e.g., I was out in the rain and now I am sick); and
experience a variety of associated environmental responses (e.g., increased parental
attention). It is apparent that psychological variables are relevant to discussion of any
pediatric illness. For our purposes, we exemplify the role and diversity of psychologi-
cal factors in childhood illness by considering two conditions: pediatric burn injuries
and sickle cell disease (SCD).

Burn injuries were selected because they represent not a disease, but rather an
acute injury that can pose serious long-term physical and psychological sequelae. Al-

-131-