ABSTRACT
Theoretically-driven investigations on the potentially modifiable predictors of individual differences among newly-diagnosed pediatric cancer patients may facilitate the identification of children at risk for adjustment problems. Within a risk and resistance conceptual model, family functioning was investigated concurrently and prospectively as a predictor of adjustment in newly-diagnosed pediatric cancer patients at Time 1 (within 1 month after diagnosis), Time 2 (6 months postdiagnosis), and Time 3 (9 months postdiagnosis). The family relationship dimensions of cohesion and expressiveness most consistently predicted the psychological and social adjustment of children with newly-diagnosed cancer over a 9-month period after initial diagnosis. These findings are discussed in terms of the treatment implications for enhancing child adjustment to newly-diagnosed cancer and biomedical treatment.
Subject(s)
Adaptation, Psychological , Child Behavior , Family Health , Neoplasms , Social Adjustment , Age Factors , Child , Child, Preschool , Female , Humans , Male , Prospective StudiesABSTRACT
More intensive medical treatment protocols have been initiated with the goal of improving survival of pediatric cancer patients. Evaluation of the adjustment of this cohort of children with newly diagnosed cancer being treated with these modern regimens is essential in order to enhance quality of life. Children with cancer who experience disease and treatment-related changes in physical appearance are hypothesized to be at greater risk for psychological and social adjustment problems given society's attitudes toward visible physical differences. Within a risk and resistance theoretical framework, perceived physical appearance was investigated as a predictor of depressive symptoms, social anxiety, and general self-esteem in newly diagnosed pediatric cancer patients. In support of the a priori conceptual model, path analysis findings indicate that perceived physical appearance has direct and indirect effects on depressive symptoms and social anxiety with the indirect effects mediated by general self-esteem. Exploratory analysis suggests that the effect of perceived physical appearance on general self-esteem may be attenuated by modifiable competence/adequacy domains which have implications for the development of treatment interventions for children with newly diagnosed cancer.
Subject(s)
Adaptation, Psychological , Body Image , Neoplasms/psychology , Personality Development , Sick Role , Adolescent , Anxiety/psychology , Child , Depression/psychology , Female , Humans , Male , Personality Assessment , Self ConceptABSTRACT
Examined the intelligence, academic achievement, behavior, and social competency of 37 school-aged boys with hemophilia, 56% with HIV infection. IQ scores fell in the average range, but total reading scores were almost 1 standard deviation below the mean. Parent and teacher ratings of social functioning and behavior fell in the normal range. Absenteeism, an average of 27 days for the previous school year, was inversely correlated with most teacher ratings, indicating that absenteeism may be a significant factor in the academic and social adaptation of children with hemophilia. Overall, boys infected with HIV demonstrated the same level of academic and behavioral adaptation as those uninfected. The need for special education programs and interventions to enhance competency in the school setting is discussed.
Subject(s)
HIV Seropositivity/complications , Hemophilia A/complications , Hemophilia A/psychology , Absenteeism , Achievement , Adaptation, Psychological , Adult , Child , Child Behavior Disorders/etiology , Chronic Disease , HIV Seropositivity/psychology , Humans , Male , Schools , Social Adjustment , StudentsABSTRACT
The negative impact on psychologic adjustment from the stress of living with newly diagnosed cancer is hypothesized to be affected by perceived social support. Thirty children with newly diagnosed cancer completed standardized assessment instruments measuring depressive symptoms, state anxiety, trait anxiety, social anxiety, general self-esteem, and perceived social support from classmates, parents, teachers, and friends. Their parents completed a standardized assessment instrument measuring internalizing and externalizing behavior problems. Perceived classmate, parent, and teacher social support were variously correlated with the psychologic adjustment parameters in the hypothesized direction of greater support predicting lower psychologic distress and higher self-esteem. Hierarchical multiple regression analyses identified perceived classmate social support as the most consistent predictor of adaptation, providing further evidence of the essential function of the social environment of the school setting in affecting the adjustment of children with newly diagnosed cancer.
Subject(s)
Adaptation, Psychological , Neoplasms/psychology , Sick Role , Social Support , Adolescent , Child , Female , Hodgkin Disease/psychology , Humans , Internal-External Control , Male , Peer Group , Personality Assessment , Precursor Cell Lymphoblastic Leukemia-Lymphoma/psychology , Self ConceptABSTRACT
Randomized 64 children ages 5 to 13 years with newly diagnosed cancer to either a Social Skills Training experimental treatment group or a School Reintegration standard treatment group. Children who received explicit training in social skills reported higher perceived classmate and teacher social support at the 9-month follow-up in comparison to pretreatment levels, while parents reported a decrease in internalizing and externalizing behavior problems and an increase in school competence. Methodological improvements for Phase III clinical trials are addressed.
