Perceived Control as a Predictor of Distress in Children Undergoing Invasive Medical Procedures

Abstract

Children's anticipatory attributional assessment of the source(s) of perceived control is hypothesized to play an important role in the etiology of distress in children undergoing invasive medical procedures. Four perceived control types, based on learned helplessness theory, are specified by a conceptual model that guides this research: Mutual, Powerful Other, Personal, and Unknown. Among 73 children between the ages of 4 and 18 having their blood drawn, it was predicted that children with an attributional analysis of unknown perceived source of control prior to the impending medical procedures would experience a heightened level of anxiety (procedure-related distress). As predicted, children with an anticipatory attributional assessment of unknown perceived control interfered with or extended the medical procedure significantly more (41%) than children who could attribute some perceived source of control (13%). They were also rated by themselves, the parents, and a trained clinical observer as manifesting significantly greater (p < .05) anticipatory procedural distress using both cognitive (subjective) and behavioral (objective) assessment perspectives. These findings were independent of children's age. This paper supports the need for additional theory-driven research and the importance of investigating the role of attributional variables in the etiology of procedure-related distress in children.