Graduation Year

2016

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Psychological and Social Foundations

Major Professor

Kathy L. Bradley-Klug, Ph.D.

Committee Member

John M. Ferron, Ph.D.

Committee Member

Shannon Suldo, Ph.D.

Committee Member

Richard Weinberg, Ph.D.

Keywords

pediatric oncology, childhood cancer, pediatric school psychology, biopsychosocial, family systems, repressive

Abstract

Although almost 16,000 children and adolescents are diagnosed with cancer each year, the incident rates have remained stable over recent years, and mortality has decreased consistently since 1975 (American Cancer Society, 2016). With increased survivorship, research and practice in pediatric oncology has focused more on the psychosocial well-being of patients during and after treatment. With research repeatedly indicating that patients and families appear to exhibit great resilience and adjustment, and low incidences of psychosocial difficulties (e.g., Kazak, 1994, Eiser et al. 2000), some researchers have examined adaptive style as a possible construct that may help explain the predominantly positive outcomes (e.g., Phipps and Srivastava, 1997). The current study examined adaptive styles and coping strategies in youth diagnosed with cancer to determine relationships between these variables, as well as between each of these constructs and measures of subjective well-being, and psychosocial and educational adjustment. This study was also the first to examine relationships between youth and parent adaptive styles.

A total of 180 youth between 9 and 17 years old who have been diagnosed with cancer participated in this study. Each youth also had one parent who participated. Each youth participant completed a packet of self-report measures used to determine adaptive style group, coping strategy use, and subjective well-being scores. Each parent participant completed a questionnaire to provide sociodemographic information about the youth and parent, as well as information about their child’s illness and school experience. Parents also completed a packet of measures used to provide information about their child’s psychosocial adjustment and risk and to determine parent adaptive style. Data were analyzed to examine relationships between parent and youth adaptive style, group differences on measures of subjective well-being, psychosocial adjustment/risk, and academic variables, relationships between adaptive style and coping strategy use, and the predictive strength of adaptive style and coping strategies for the outcome variables.

Although the distribution of adaptive styles was similar among participants in the current study compared to those in previous studies of adaptive style for Repressive, Low Anxious, and Defensive High Anxious adaptive styles, there was a higher percentage of participants with High Anxious adaptive style in the current study. A statistically significant bidirectional relationship was found between youth and parents with a Repressive adaptive style. Results revealed significant differences between groups on measures of subjective well-being and internalizing behaviors, with Repressive adaptive displaying the highest subjective well-being and lowest internalizing behavior scores. Repressive and Low Anxious adaptive style differed significantly from the two High Anxious groups on the school scale scores, with the Repressive and Low Anxious groups having more positive outcomes on the measure. Relating to coping strategies, youth in the two High Anxious groups used more strategies all together, including both adaptive and non-adaptive strategies. However adaptive strategies were more frequently related to positive adaptive styles and outcomes, while non-adaptive strategies tended to have a stronger relationship to High Anxious adaptive style and negative outcomes. Limitations are discussed, and suggestions for future research and practical implications are offered, based on the results of the current study.

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