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An increasing proportion of newly diagnosed AIDS cases is being reported among African American urban women. Recent research regarding the psychosocial and behavioral impact of a mother's HIV status on her uninfected children as well as a growing body of clinical evidence suggest that these children are extremely vulnerable and at risk for problems in psychosocial adjustment. The present paper reports the results of research designed to examine the pathways by which a mother's HIV-positive status affects the psychosocial adjustment of her uninfected school-age child. The principal predictor variables of the model are family sociodemographic characteristics, social support available to mother and child, HIV-related symptom distress in the mother, coping strategies of both mother and child, emotional distress of the mother, and quality of the parent-child relationship. The dependent variable is the psychosocial adjustment of the child. Data were collected on 147 mother-child dyads using standardized questionnaires and personal interviews. Eighty-six percent of the mothers were African American and over 96% were on public assistance. Structural equation modeling was used to test the proposed model of mother-child coping and adjustment. After adding three paths, the model had a good fit to the data (comparative fit index = 0.94; root mean square estimate of error = 0.06). Five model constructs accounted for 36% of the variance in child adjustment. The constructs in order of importance were maternal HIV-associated stressors, maternal emotional distress, child social support, child coping, and quality of parent-child relationship. rights reserved. Keywords: USA; HIV/AIDS; Mother-child relationship; Parent-child relationship; Psychosocial health; Coping

The objectives for this longitudinal study were to: (a) compare colon cancer patients' and their spouses' appraisal of illness, resources, concurrent stress, and adjustment during the first year following surgery; (b) examine the influence of gender (male vs female) and role (patient vs spouse caregiver) on study variables; (c) assess the degree of correlation between patients' and spouses' adjustments; and (d) identify factors that affect adjustment to the illness. Fifty-six couples were interviewed at one week post diagnosis, and at 60 days and one year post surgery. Based on a cognitive-appraisal model of stress, the Smilkstein Stress Scale was used to measure concurrent stress; the Family APGAR, Social Support Questionnaire, and Dyadic Adjustment Scale were used to measure social resources; the Beck Hopelessness Scale and Mishel Uncertainty in Illness Scales were used to measure appraisal of illness; and the Brief Symptom Inventory and Psychosocial Adjustment to Illness Scale were used to measure psychosocial adjustment. Repeated Measures Analysis of Variance indicated that spouses reported significantly more emotional distress and less social support than patients. Gender differences were found, with women reporting more distress, more role problems, and less marital satisfaction, regardless of whether they were patient or spouse. Both patients and spouses reported decreases in their family functioning and social support, but also decreases in emotional distress over time. Moderately high autocorrelations and modest intercorrelations were found among and between patients' and spouses' adjustment scores over time. The strongest predictors of patients' role adjustment problems were hopelessness and spouses' role problems. The strongest predictors of spouses' role problems were spouses' own baseline role problems and level of marital satisfaction. Interventions need to start early in the course of illness, be family-focused, and identify the couples at risk of poorer adjustment to colon cancer.