Childhood brain tumor survivors experience significant neurocognitive and social deficits secondary to their disease and related medical treatments that contribute to them having the poorest health- related quality of life among childhood cancer survivors. Although children surviving brain tumors have significant social adjustment difficulties (e.g., fewer friendships, less accepted by peers), little research has examined their social competence over time or identified predictors of their social adjustment. Findings from other pediatric brain injury populations (e.g., traumatic brain injury) suggests deficits in social information processing and illustrates the influence of family functioning on social outcomes yet these associations have not been explored in pediatric brain tumor survivors. This proposal would be the first known prospective investigation of survivor social competence and one of the few studies to examine the interrelations between components of social information processing, family functioning and social adjustment.
The specific aims of this application are to 1) qualitatively describe caregivers'perspectives on the factors contributing t survivor social adjustment after treatment;2) compare components of social information processing (social problem- solving, social affective functions, neurocognitive functioning) between pediatric brain tumor and solid tumor survivors and examine associations between components of social information processing and social adjustment over time;and 3) examine the influence of risk and resilience factors (treatment intensity, family functioning, parent-survivor relationship quality) on survivor social information processing and social adjustment. Methods: Participants will be recruited from The Cancer Center at The Children's Hospital of Philadelphia. A qualitative phase at the outset of the project with a separate sample of caregivers of long-term pediatric BT survivors will inform the prospective design by exploring perspectives on the factors that shape survivor social adjustment outcomes. In the longitudinal phase, participants will include survivors of pediatric brain tumor and survivors of pediatric soli tumor, ages 7-14, and a parent or caregiver. Data collection will occur about one month after the end of tumor-directed treatment and again one and two years later. Assessments at each time point will include measures of survivor social information processing, neurocognitive functioning, social skills and social adjustment, as well as family functioning and parent-survivor relationship quality. It is hypothesized that(1) pediatric brain tumor survivors will have worse social information processing than solid tumor survivors, (2) poorer social-affective function and social problem-solving will be associated with worse survivor social adjustment over time, (3) neurocognitive functioning will be associated with poorer social-affective functioning, social problem-solving and social adjustment, and (4) better family functioning at baseline will be associated with smaller declines across domains of social information processing and social adjustment over time. Career Goals: This K07 award will provide the necessary training and mentorship for Matthew Hocking, Ph.D. to become an independent clinical researcher and leader in the field of pediatric psycho-oncology and pediatric neuro-oncology survivorship. Through this award, Dr. Hocking will 1) gain expertise in specific content areas relevant to understanding the interplay between biological, psychological and social context factors in contributing to survivor psychosocial outcomes;2) acquire expertise in methodological (e.g., healthcare economics, cognitive neuroscience) and statistical approaches to examining the neurodevelopmental late effects of pediatric brain tumor survivors;3) enhance skills related to the development and testing of psychosocial interventions directed at improving the social functioning of pediatric cancer survivors;and 4) advance scientific skills in grant writing and peer-reviewed research publication. To advance these training goals, Dr. Hocking has assembled a highly experienced mentorship team, led by Drs. Lamia Barakat and Anne Kazak, and a carefully constructed training plan that includes coursework, seminars, journal clubs, national research conferences, writing groups, and different research lab experiences. With the outlined training and support associated with this award, Dr. Hocking will be well poised to initiate an independent research career dedicated to improving the social functioning and quality of life of pediatric brain tumor survivors Importance: Findings from this study could inform clinical care with childhood brain tumor patients and subsequent research among a broader group of survivors affected by central nervous system disease. This study might identify potential mechanisms that mitigate the effects of cancer treatment on survivor social functioning and improve quality of life for survivors and their families. The proposed K07 award will prepare Dr. Hocking to apply for R01-level funding to advance this research and for R21-level funding to pilot a family- based intervention directed at improving social adjustment outcomes in pediatric brain tumor survivors.
Childhood brain tumor survivors experience significant social difficulties that impact quality of life. Little research has examine predictors of these social difficulties or studied their development over time. The proposed research will explore the influences of neurocognitive functioning, social information processing and family functioning on survivor social adjustment and potentially identify targets for interventions that ameliorate the impact of medical treatments directed at the developing brain on social functioning.
|Hocking, Matthew C; McCurdy, Mark; Turner, Elise et al. (2015) Social competence in pediatric brain tumor survivors: application of a model from social neuroscience and developmental psychology. Pediatr Blood Cancer 62:375-84|