Parent and Adolescent Adjustment to Pediatric Cancer: Associations with Coping,Social Support,and Family Function

Abstract

This article presents preliminary results investigating the relationship between parental and adolescent adjustment and coping and their relationship to social support and family functioning in a sample of adolescents (ages 11-18) with cancer and one of their parents. Parents and adolescents from two pediatric oncology clinics completed measures of distress, coping, social support, and family cohesion/adaptability. Low levels of distress were reported by both children and their parents with positive correlations noted between parent and child adjustment. Adolescents reported that their parents and a close friend were the greatest sources of social support and described their families as having a high degree of cohesion and adaptability. Both adolescents and parents used more adaptive than maladaptive coping strategies, although distress was asso ciated with reduced use of adaptive coping. Adolescents are able to adapt to cancer in the context of strong family and social supports. In addition, there is a relationship between parental and adolescents adjustment, and between greater use of adaptive coping styles and lower distress

Get full access to this article

View all access options for this article.

References

Achenbach, T. , & Edelbrock, C. (1987). Manual for the Youth Self Report and the revised behavior profile. Burlington, VT: University Associates in Psychiatry.

Allen, R. , Newman, S.P. , & Souhami, R.L. (1997). Anxiety and depression in adolescent cancer: findings in patients and parents at the time of diagnosis. European Journal of Cancer, 33(8), 1250-1255.

Brown, R.T. , Kaslow, N.J. , Hazzard, A.P. , Madan-Swain, A. , Sexson, S.B. , Lambert, R. , & Baldwin, K. (1992). Psychiatric and family functioning in children with leukemia and their parents. Journal of the American Academy of Child Psychiatry, 31, 495-502.

Cavusoglu, H. (2000). Problems related to the diagnosis and treatment of adolescents with leukemia. Issues in Comprehensive Pediatric Nursing, 23, 15-26.

Compas, B.R. , Worsham, N.L. , & Ey, S. (1992). Conceptual and developmental issues in children's coping with stress. In La Greca, A. M. , Siegel, L. J. , Wallander, J. L. , & Walker, C. E. (Eds.), Stress and Coping in Child Health (pp. 7-24). New York: The Guildford Press.

Creasey, G. , Ottlinger, K. , Devico, K. , Murray, T. , Harvey, A. , & Hesson-McInms, M. (1997). Children's affective responses, cognitive appraisals, and coping strategies in response to the negative affect of parents and peers. Journal of Experimental Child Psychology, 67, 39-56.

Dahlquist, L.M. , Czyzewski, D.I. , Copeland, K.G. , Jones, C.L. , Taub, E. , & Vaughan, J.K. (1993). Parents of children newly diagnosed with cancer: Anxiety, coping, and marital distress. Journal of Pediatric Psychology, 18, 365-376.

Derevensky, J.L. , Tsanos, A.P. , & Handman, M. (1998). Children with cancer: An examination of their coping and adaptive behavior. Journal of Psychosocial Oncology , 16(1), 37-61.

Derogatis, L.R. (1977). The SCL-90 manual I: Scoring, administration, and procedures for the SCL-90. Baltimore: Clinical Psychometric Research.

10.

Derogatis, L.R. (1992). The Brief Symptom Inventory (BSI) administration, scoring, and procedures manual-II. Baltimore: Clinical Psychometric Research.

11.

Derogatis, L.R. & Melisaratos, N. (1983). The Brief Symptom Inventory: An introductory report. Psychological Medicine, 13, 595-605.

12.

Dodge, K.L. (1997). Coping with pediatric cancer: The importance of family member coping on the outcomes of other members. Dissertation Abstracts International: Section B: The Sciences and Engineering, 58 (6-B), 3313.

13.

Eaton, M.H. , & Minnick, P. (1994). Living with cancer: Children with extraordinary courage. Oncology Nursing Forum, 21, 1025-1031.

14.

Elkin, T.D. , Phipps, S. , Mulhern, R.K. , & Fairclough, D. (1997). Psychological functioning in adolescents and young adult survivors of pediatric malignancy. Medical & Pediatric Oncology, 29(6), 582-588.

15.

Feldman, S.S. , & Elliott, G.R. (1990). At the Threshold: The Developing Adolescent Cambridge, MA: Harvard University Press .

16.

Fife, B. , Norton, J. , & Groom, G. (1987). The family's adaptation to childhood leukemia . Social Science and Medicine, 24, 159-168.

17.

Fritz, G.K. & Williams, J.R. (1988). Issues of adolescent development for survivors of childhood cancer. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 712-715.

18.

Fritz, G.K. , Williams, J.R. , & Amylon, M. (1988). After treatment ends: Psychosocial sequelae in pediatric cancer survivors. American Journal of Orthopsychiatry , 58, 552-561.

19.

Frank, N.C. , Blount, R.L. , & Brown, R.T. (1997). Attributions, coping, and adjustment in children with can cer. Journal of Pediatric Psychology 22, (4), 563-577.

20.

Gilk, K.M. , Williams, D.A. , Thompson, R.J. , Jr., & Kinney, T.R. (1991). Sickle cell disease in children and adolescents: the relation of child and parent pain coping strategies to adjustment. Journal of Pediatric Psychology, 16, 643-663.

21.

Grootenhuis, M.A. & Last, B.F. (1997a). Adjustment and coping by parents of children with cancer: A review of the literature. Support Care Cancer , 5, 466-484.

22.

Grootenhuis, M.A. , & Last, B.F. (1997b). Predictors of parental emotional adjustment to childhood cancer. Psychooncology, 6, 115-128.

23.

Grootenhuis, M.A. , & Last, B.F. (2001). Children with cancer with different survival perspectives: Defensiveness, control strategies, and psychological adjustment. Psycho-Oncology 10, 305-314

24.

Harter, S. (1985). Manual for the Self-Perception Profile for Children . Denver, CO: University of Denver .

25.

Hoekstra-Weebers, J.E. , Jaspers, J.P. , Kamps, W.A. , & Klip, E.C. (1998). Gender differences in psychological adaptation and coping in parents of pediatric cancer patients. Psycho-oncology , 7, 26-36.

26.

Kazak, A.E. , Segal Andrews, A.M. , & Johnson, K. (1995). Pediatric Psychology research and practice: A family/systems approach. In M. Roberts (Ed.), Handbook of Pediatric Psychology (ed 2., pp. 84-104). New York: Gmldford Press.

27.

Kotchick, B.A. , Forehand, R. , Armistead, L. , Klein, K. , & Wierson, M. (1996). Coping with illness: Interrelationships across family members and predictors of psychological adjustment. Journal of Family Psychology, 10, 358 370.

28.

LaGreca, A. , Auslander, W.F. , Greco, P. , Spetter, D. , Fisher, E.B. , & Santiago, J.V. (1995). I get by with a little help from my family and friends: Adolescents' support for diabetes care. Journal of Pediatric Psychology, 20, 449-476.

29.

Lansky, S.B. , List, M.A. , & Ritter-Sterr, C. (1986) Psychosocial consequences of cure. Cancer, 58, 529 533.

30.

Last, B.F. & Grootenhuis, M.A. (1998). Emotions, copmg, and the need for support in families of children with cancer: A model for psychosocial care. Parent Education and Counseling, 33, 169-179.

31.

Leitenberg, H. , Greenwald, E. , & Cado, S. (1992 A retrospective study of long-term methods of coping with having been sexually abused during childhood. Child Abuse and Neglect, 16, 399-407.

32.

Magni, G. , Silvestro, A. , Carli, M. , & De Leo, D. (1986). Social support and psychological distress of parents of chil dren with acute lymphocytic leukemia. British Journal of Medical Psychology, 59, 383-385.

33.

Manne, S.L. , Lesamcs, D. , Meyers, P. , Wollner, N. , Stemherz, P. , & Redd, W. (1995). Predictors of depressive symptomatology among parents of newly diagnosed children with cancer. Journal of Pediatric Psychology, 20, 491-510.

34.

McCubbin, H.I. , & McCubbin, M.A. (1996). Family system assessment in health care. In H. I. McCubbin , A. I. Thompson , & M. A. McCubbin (Eds.), Family assessment: resiliency, coping and adaptation: inventories for research and practice (pp. 53-78). Madison, WI: University of Wisconsin Publishing.

35.

Nezu, A.M. , Nezu, C.M. , Friedman, S.H. , Faddis, S. , & Houts, P.S. (1998). Helping cancer patients Cope: A Problem-solving Approach. Washington, DC: American Psychological Association.

36.

Noll, R.B. , Gartstem, M.A. , Vannatta, K. , Correll, J. , Bukowski, W.M. , & Dames, W.H. (1999). Social, emotional, and behavioral furictioning of children with cancer. Pediatrics, 103, 71 78.

37.

Olson, D.H. , McCubbin, H.I. , Barnes, H. , Larsen, A. , Muxen, M. , & Wilson, M. (1989). Families: What Makes Them Work (rev. ed.). Los Angeles, CA: Sage Publishing.

38.

Olson, D.H. , Portner, J. , & Bell, R.Q. (1981) FACES II.-Family Adaptability and Cohesion Evaluation Scales. St. Paul, MN: Family Social Science, University of Minnesota.

39.

Olson, D.H. , Bell, R. , & Portner J. (1992). FACES II. In D. H. Olson (Ed.), Family Inventories Manual. Minneapolis, MN: Life Innovations.

40.

Rait, D.S. , Ostroff, J.S. , Smith, K. , Cella, D.F. , Tan, C. , & Lesko, L.M. (1992). Lives in a balance: perceived family functioning and the psychosocial adjustment of adolescent cancer survivors. Family Process, 31(4), 383-397.

41.

Roth, S. & Newman, E. (1991). The process of coping with sexual trauma. Journal of Traumatic Stress, 4, 279-297.

42.

Sanger, M. , Copeland, D.R. , & Davidson, E.R. (1991). Psychosocial adjustment among pediatric cancer patients: A multidimensional assessment. Journal of Pediatric Psychology, 16 (4), 463 474.

43.

Sawyer, M.G. , Antoniou, G. , Toogood, I. , Rice, M. , & Baghurst, P.A. (1993). A prospective study of the psychological adjustment of parents and families of children with cancer . Journal of Pediatric Child Health, 29, 352-356.

44.

Sloper, P. (1996). Needs and responses of parents following the diagnosis of childhood cancer. Child.- Care, Health and Development , 22(3), 187-202.

45.

Tobm, D.L. , Holroyd, K.A. , & Reynolds, R. (1984). User's manual for the Coping Strategies Inventory . Athens, OH: Department of Psychology at Ohio University.

46.

Tobin, D.L. , Holroyd, K.A. , Reynolds, R.V. , & Wigal, J.K. (1989). The hierarchical factor structure of the coping strategies inventory. Cognitive Therapy and Research, 13(4), 343-361.

47.

Varni, J.W. , Katz, E.R. , Colegrove, R. , & Dolgin, M. (1994). Perceived social support and adjustment of children with newly diagnosed cancer. Developmental and Behavioral Pediatrics, 15(4), 20-26.

48.

Varni, J.W. , Rubenfeld, L.A. , Talbot, D. , & Setoguchi, Y. (1989). Family functioning, temperament, and psychological adaptation in children with congenital/acquired limb deficiencies. Pediatrics, 84, 323-330.

49.

Varm, J.W. , Setoguchi, Y. , Rappaport, L.R. , & Talbot, D. (1991). Effects of stress, social support, and self-esteem on depression in children with limb deficiencies. Archives of Physical Medicine and Rehabilitation, 72, 1053 1058.