Childhood cancer is widely viewed as a traumatic event, and application of traumatic stress models has become the dominant approach in pediatric psychooncology research. This approach to understanding the experiences of children with cancer presupposes 'cancer as trauma', and focuses on psychopathology rather than adjustment. These biases have influenced research design, and contribute to proliferation of deficit- oriented models, despite the fact that the majority of studies have not shown an increased incidence of post- traumatic stress disorder (PTSD) or of subclinical levels of post-traumatic stress symptoms (PTSS) in children with cancer. This proposal is based on the assumption that the diagnosis of cancer represents a significant life event that is not only a potential trauma, but also a potential catalyst for growth and positive change, calling for examination of positive outcomes such as post-traumatic growth (which we now refer to as challenge-related growth) and benefit-finding (CRG), constructs that have been studied primarily in adults with cancer but not in children. The proposed study will address several gaps in our understanding of PTSD outcomes in pediatric cancer, while broadening the focus to include simultaneous assessment of positive outcomes. Guided by positive psychology theory, we will examine determinants of PTSD and CRG outcomes, focusing on several resilience-related personality variables, including adaptive style, optimism, and dispositional positive affect.
The aims of this proposal will be addressed with a two-group (cancer and healthy control), cross-sectional design, using patient self-report, parent-report, and structured diagnostic interviews as the primary sources of data. A frequency matching approach will be used to ensure demographic comparability of the cancer and healthy comparison groups. Measures of child PTSS and CRG along with dichotomous PTSD diagnosis will be obtained as primary outcomes. Measures of parental PTSS/PTSD and CRG will be obtained as secondary outcomes. Determinants of child PTS and CRG outcomes will be identified from child personality factors, life events history, medical factors (within the cancer group), parental PTSS/CRG, and parenting behavior. Separate predictive models will be developed for PTSS/PTSD and CRG outcomes. These analyses will advance our understanding of risk factors for the development of PTSD, which will improve targeting of intervention efforts to those most in need, while identification of factors associated with resilient, or growth outcomes will inform the development of intervention strategies and approaches.
This study will address gaps in our understanding of the traumatic effects of childhood cancer, while simultaneously examining positive outcomes such as growth and benefit-finding. Determinants of posttraumatic stress and posttraumatic, or 'challenge-related'growth outcomes will be examined, focusing on resilience-promoting factors. Separate predictive models will be developed for posttraumatic stress and growth outcomes. These analyses will advance our understanding of risk factors for the development of posttraumatic stress disorder, which will improve targeting of intervention efforts to those most in need, while identification of factors associated with resilient, or growth outcomes will inform the development of novel intervention strategies and approaches.
|Schepers, Sasja A; Long, Alanna M; Russell, Kathryn et al. (2018) Youth and parent perceptions of parenting in childhood cancer survivors and healthy peers. Support Care Cancer 26:4143-4149|
|Howard Sharp, Katianne M; Willard, Victoria W; Barnes, Sarah et al. (2017) Emotion Socialization in the Context of Childhood Cancer: Perceptions of Parental Support Promotes Posttraumatic Growth. J Pediatr Psychol 42:95-103|
|Sharp, Katianne M Howard; Lindwall, Jennifer J; Willard, Victoria W et al. (2017) Cancer as a stressful life event: Perceptions of children with cancer and their peers. Cancer 123:3385-3393|
|Okado, Yuko; Howard Sharp, Katianne M; Tillery, Rachel et al. (2016) Profiles of Dispositional Expectancies and Affectivity Predict Later Psychosocial Functioning in Children and Adolescents With Cancer. J Pediatr Psychol 41:298-308|
|Willard, Victoria W; Long, Alanna; Phipps, Sean (2016) Life stress versus traumatic stress: The impact of life events on psychological functioning in children with and without serious illness. Psychol Trauma 8:63-71|
|Okado, Yuko; Tillery, Rachel; Sharp, Katianne Howard et al. (2016) Effects of Time since Diagnosis on the Association between Parent and Child Distress in Families with Pediatric Cancer. Child Health Care 45:303-322|
|Tillery, Rachel; Howard Sharp, Katianne M; Okado, Yuko et al. (2016) Profiles of Resilience and Growth in Youth With Cancer and Healthy Comparisons. J Pediatr Psychol 41:290-7|
|Howard Sharp, Katianne M; Willard, Victoria W; Okado, Yuko et al. (2015) Profiles of Connectedness: Processes of Resilience and Growth in Children With Cancer. J Pediatr Psychol 40:904-13|
|Phipps, Sean; Long, Alanna; Willard, Victoria W et al. (2015) Parents of Children With Cancer: At-Risk or Resilient? J Pediatr Psychol 40:914-25|
|Howard Sharp, Katianne M; Rowe, Anjoli E; Russell, Kathryn et al. (2015) Predictors of psychological functioning in children with cancer: disposition and cumulative life stressors. Psychooncology 24:779-86|
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