Review Emotional and behavior problems in children and adolescents with chronic physical health conditions: an updated meta-analysis 2026 Pinquart

[Andy]

Abstract​

Objective
The study updated a meta-analysis on emotional and behavioral problems among children with chronic physical health conditions (CPHCs) as assessed with the Achenbach System of Empirically Based Assessment.

Method
A systematic search in electronic databases (PsycInfo, Medline, Web of Science, and PSYNDEX) identified 1,337 studies that were analyzed with multilevel meta-analysis.

Results
Young people with CPHCs had, on average, higher levels of internalizing (g = .51 standard mean difference), externalizing (g = .25), and total behavior problems (g = .49) than peers without CPHCs or test norms. Elevations of total problems were larger than in the past meta-analysis. The largest elevations of internalizing problems were found for chronic fatigue syndrome, while the largest elevations of total problems and externalizing problems were observed in the case of thalassemia. Effect sizes tended to be larger when parent reports were used rather than adolescent self-reports. Effect sizes also varied by country and, in part, by duration of the CPHCs, sampling, target of comparison, equivalence of the compared groups, response rate, age, and gender.

Conclusions
The results call for regular screening for psychological distress in children with CPHCs.

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[rvallee]

And how do they imagine anyone is able to tell the difference between behavioral disorders and a normal response to lives broken by illness? Which, of course, no one can.

The results call for regular screening for psychological distress in children with CPHCs.

Because then, no, it does not. What would anyone even do with that anyway? Especially in illnesses that are systematically confused as behavioral problems?

This is just old thinking backed up by pretend science.

 

[bobbler]

And how do they imagine anyone is able to tell the difference between behavioral disorders and a normal response to lives broken by illness? Which, of course, no one can.

Because then, no, it does not. What would anyone even do with that anyway? Especially in illnesses that are systematically confused as behavioral problems?

This is just old thinking backed up by pretend science.

It is an interesting result to posit actually

having read thalessemia tend to have externalising problems and cfs internalising

I then looked these up to see what type of 'behavioural and emotional problems' they might have meant by these

thalessemia seems to lead to exhaustion too.

The list for cfs makes me wonder how on earth those witnessing it but in medicine and allieds in particular as well as those who are new to being trained in dodgy cfs ideas or therapies (so have perspective potentially 'coming in'.. before that becomes 'something they do' and then you have that denial due to being responsible for having done it issue) wouldn't see that most of that list wouldn't be almost entirely caused by the misinformation/information by bps, bacme, old guidelines etc inciting exactly this.

It tells them to blame themself, and try to do things that make them worse over time with a dangling false carrot of 'it might make you better' and the inference that suggestion to everyone else causes of 'you perhaps/probably/certainly aren't better because you aren't doing that right/hard enough etc'

Are they 'blaming themselves' or 'being wrongly blamed' - and there is a term for that 'scape-goated' and then been taught that they have to choose between feeling unjustly bullied and noone is going to even acknowledge that so you live in an alternate universe or going along with it and 'realising I'm just a loser for not fixing myself'.

And that strange 'acceptance' which just reminds me of when you read about the mental health industry issue that really its behavioural psychology and noone can escape (even if they were mystery shoppers who were well) without being seen to admit and take on that label given to them, otherwise they are in denial. And then of course having to swear the oath 'that they would endeavour to fix their flaws that others insist they have'

VS whether these people even felt safe being honest giving answers in this research - were they 'accompanied' and did they know that what they answered wouldn't be either/both reported back and/or easily identifiable once the research was done.

Something about use of power and coercion charading as if it were therapy by pretending the end-result is 'desireable'. It is funny that behavioural now seems to have become 'behavioural and emotional' when really what they mean is 'emotional behaviour' and not actual psychology and people being happy and what is emotionally healthy as a response to x. I just remember the early 2000s and the important message that making sad people 'act chipper' was harmful and letting them be honest and who they are in talking to someone was so important. And how that has been changed backwards based on no evidence. Or should I say propaganda misappropriating catastrophisation based on no evidence.

 

[bobbler]

BUT ALSO As these are potentially the most vulernable age group who have not just huge risks whilst they aren't an adult due to being under control of things to do with school and parents and/or outsiders having FII as a potential weapon etc. and then will know that unless a miracle happens then they've all the issues with adulthood after that to look forward to but whilst carrying the scars (including how it affected their qualifications and therefore choices even if they were well enough to do anything) in dealing with that.

SO you've the behavioural psychology (punishment and reward to coerce the right responses) issue of rightly scared people, if they weren't scared before 'the system' being in a position where they've been fully trained in the risks of 'being honest' and are having to work out the pros and cons of each answer to their own future and safety etc.

I raise this issue because without it/until I see it being tackled in a convincing section (that also has ethics committees who are appropriate overseeing it) in every single paper that covers certain illnesses and people in certain situations I find the whole thing frankly disturbing that it still goes on. Even if someone has done something really well to manage 'perceived threats' how can we know that is definitely what those involved really felt, and even then thought it was still worth risking it 'just in case'.

And I guess it is here that we need some form of social scientist, but as I said is it more 'law-based' or some other subject than sociology in its most traditional, academic terminoloyg, to be mapping out and making clear the situation in which those in certain grouping live. WIthout asserting that as being 'due to' or 'chosen by' the individuals, because it comes like that whatever their personality is and wasn't 'deserved' or 'just in case'.

And I think the context under which people are answering any questions to do with research is highly important to be understood.

Part of me can't help but think this is the bps anti-psychology showing up where those who might, if allowed to have healthy for them (but inconvenient for others around them to have to deal with) psychological reactions get suppressed and forced to people-please to minimise harm to their safety you just get the internalised + of course the directly internalised injuries by the bps misinformation and the regime under which people live under.

Real psychology when it still looked at science before being filibustered by bps papers would always say that it was more healthy to let someone be sad and describe why than it is to expect someone being hurt to 'manage their emotions' for the convenience of others pretending what they said didn't hurt. Psychosomatic which sometimes I just can't help but think is 'what narcissists/certain personalities without empathy, those who act without care, make of how to understand what doing certain things to others (because they themselves react just like everyone else but normal even more over-offended and over-sensitive to 'perceived slights') causes as consequences' just based on how much of what it says seems to marry with what those I've met who have that personality type seem to do when they psychologise others and how it seems to be putting what they did into a different world-view.