{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T17:52:37Z","timestamp":1782409957262,"version":"3.54.5"},"reference-count":21,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Child and Adolescent Psychopharmacology"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Children with Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) experience sudden onset neuropsychiatric symptoms after infection or other triggers. Symptoms range from mild to severe, potentially lasting days, weeks, months, or longer. Exacerbation-related functional decline presents in many aspects of daily life, generally accompanied by family stress and caregiver burden. We sought to investigate the relationship between severity of PANS symptoms and caregiver burden\/stress and the relationship between severity of PANS symptoms and degree of caregiver\/child cohesion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This cross-sectional online study surveyed caregivers recruited from PANS-related social media support sites. The Pediatric Acute Neuropsychiatric Symptom Scale - Parent Version (PNSS) measured current severity. Caregiver Burden Inventory (CBI) and Caregiver Self-Assessment Questionnaire (CSAQ) assessed caregiver burden\/stress. Inclusion of Other in the Self (IOS) scale determined caregiver-perceived current and desired cohesion with their child(ren) with PANS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the 216 respondents 79.6% exceeded CBI threshold indicating need for respite in adult care receiver populations. On the CSAQ, 72.9% expressed high distress, 80.5% reported feeling overwhelmed, and 58.1% reported crying spells, meeting cutoffs for support\/respite used in adult care receiver populations. Most caregivers reported not having the desired degree of cohesion with their child on the IOS (85.5%). Parents of children with more severe PNSS symptoms fared significantly worse on all measures (CBI:\n                      <jats:italic toggle=\"yes\">H<\/jats:italic>\n                      \u2009=\u200957.83; CSAQ:\n                      <jats:italic toggle=\"yes\">F<\/jats:italic>\n                      \u2009=\u200929.26; IOS:\n                      <jats:italic toggle=\"yes\">H<\/jats:italic>\n                      \u2009=\u200938.04;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001 for all). Content analysis of comments revealed five themes: (1) severe caregiver and\/or family emotional distress and trauma; (2) caregivers wondering what happened to their child; (3) lack of awareness and support among health and education professionals; (4) relationship strain with family, friends, and significant others; and (5) financial and\/or legal struggles because of their child's diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>There is strong need for support and respite for children with PANS and their families. Long-term effects including posttraumatic stress symptoms among family members should be studied.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/cap.2023.0030","type":"journal-article","created":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T10:10:52Z","timestamp":1700043052000},"page":"378-386","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Caregiver Burden, Stress, and Relationship Cohesion Among Self-Identified Caregivers of Children with Pediatric Acute-Onset Neuropsychiatric Syndrome"],"prefix":"10.1177","volume":"33","author":[{"given":"Janice T.","family":"Tona","sequence":"first","affiliation":[{"name":"Rehabilitation Science Department, University at Buffalo, Buffalo, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Ash","sequence":"additional","affiliation":[{"name":"Rehabilitation Science Department, University at Buffalo, Buffalo, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Brown","sequence":"additional","affiliation":[{"name":"Rehabilitation Science Department, University at Buffalo, Buffalo, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Campagna","sequence":"additional","affiliation":[{"name":"Rehabilitation Science Department, University at Buffalo, Buffalo, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kellie","family":"Kostek","sequence":"additional","affiliation":[{"name":"Rehabilitation Science Department, University at Buffalo, Buffalo, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Lawton","sequence":"additional","affiliation":[{"name":"Rehabilitation Science Department, University at Buffalo, Buffalo, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Rieth","sequence":"additional","affiliation":[{"name":"Rehabilitation Science Department, University at Buffalo, Buffalo, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Machiko","family":"Tomita","sequence":"additional","affiliation":[{"name":"Rehabilitation Science Department, University at Buffalo, Buffalo, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,11,15]]},"reference":[{"key":"e_1_3_4_2_1","unstructured":"American Medical Association. The Caregiver Self-Assessment Questionnaire. 2015. Available from: https:\/\/www.healthinaging.org\/sites\/default\/files\/media\/pdf\/Caregiver-Self-Assessment-Questionnaire.pdf [Last accessed: November2 2023]."},{"key":"e_1_3_4_3_1","doi-asserted-by":"crossref","unstructured":"Aron A Aron EN Smollan D. Inclusion of other in the self scale and the structure of interpersonal closeness. J Pers Soc Psychol 1992; 63:596\u2013612. Tool available from Stanford SPARQ tools https:\/\/sparqtools.org\/mobility-measure\/inclusion-of-other-in-the-self-ios-scale","DOI":"10.1037\/0022-3514.63.4.596"},{"key":"e_1_3_4_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1995.tb02031.x"},{"key":"e_1_3_4_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2023.0022"},{"key":"e_1_3_4_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2016.0105"},{"key":"e_1_3_4_7_1","unstructured":"Columbia University Mailman School of Public Health. Content Analysis. 2022. 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Pediatric Acute Neuropsychiatric Symptom Scale - Parent Version. 2012. Available from: from https:\/\/pandasnetwork.org\/wp-content\/uploads\/2018\/11\/pandas_pans_scale.pdf [Last accessed: November 2 2023]."},{"key":"e_1_3_4_16_1","unstructured":"Merrill M Celebi J Engel R et al. A comparison of burden among caregivers of children with cerebral palsy and Tourette syndrome. 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