Mother-child communication and maternal depressive symptoms in families of children with cancer: integrating macro and micro levels of analysis.

OBJECTIVES: This study examines associations between maternal depressive symptoms and macro- and micro-level aspects of mothers' communication about their children's cancer. METHODS: Mothers reported depressive symptoms after diagnosis or relapse (child mean age = 10.4 years; 53% male). Mother-child dyads (N = 94) were subsequently observed discussing the child's cancer and maternal communication was coded. RESULTS: Macro-level indicators (positive and negative communication) were associated with certain micro-level indicators of communication (topic maintenance, reflections, reframes, and imperatives). Higher depressive symptoms predicted lower positive communication and higher negative communication. Maternal reflections and imperatives predicted positive communication, and topic maintenance and reframes predicted negative communication, beyond child age, family income, and depressive symptoms. CONCLUSIONS: Findings suggest concrete targets for improving communication in families after diagnosis or relapse.

Cancer-related sources of stress for children with cancer and their parents.

OBJECTIVES: The current study examines reports and correlates of cancer-specific stressors in children with cancer and their parents. Measures Mothers (n = 191) and fathers (n = 95) reported on their own and their child's stressors, general perceived stress, and posttraumatic stress symptoms. Children (n = 106) completed self-reports of their own stressors and posttraumatic stress symptoms. RESULTS: Mother and father self-reports were positively correlated, but mothers reported higher levels of stressors than fathers. Child and parent reports of children's stressors were positively correlated, but parents rated physical effects as more stressful while children rated role-functioning stressors as more stressful. Parents' and childrens' reports of stressors were also positively associated with general perceived stress and posttraumatic stress symptoms. CONCLUSIONS: The findings extend research on stress in children with cancer and their parents, and may help inform research on risk and intervention in pediatric cancer populations.