Examined the utility of a new parent-report measure designed specifically for pediatric inpatients, the Behavioral Upset in Medical Patients-Revised (BUMP-R). The BUMP-R was administered to 151 mothers of hospitalized children ages 4-12 years the day following the child's hospital admission. The BUMP-R demonstrated good internal consistency and a factor analysis revealed four factors identified as negativity/agitation, amiability, dysphoria, and noncom-pliance. Children exhibiting behavioral distress at home were more likely to experience adjustment problems upon hospitalization. Demographic and illness-related variables were not substantial risk factors for hospital adjustment difficulties. © 1994 Plenum Publishing Corporation.