The aims of this study are to determine the differential coping strategies used by adolescent daughters whose mothers have breast cancer, and how this relates to the stress responses they exhibit. Adolescent age, and their relationship with their mothers will also be examined in relation to their coping. This group of adolescent daughters has reported a 25% increased rate of stress responses, specifically anxiety and depression, than a normative sample and than sons. They additionally report emotional distress and worries, and fear engaging in health promoting activities. Forty percent of adolescent daughters who are initially diagnosed with depression, like those whose mothers have breast cancer, will experience a second bout of depression, and 70% of those will have a relapse in adulthood. The strategies that adolescents use to cope with stress are potentially important mediators of the impact of stress on current and future adjustment. For example those that use problem-solving strategies can have a better mental health outcomes than those that use avoidance strategies. Yet little is known about the differential coping strategies used when adolescent daughters are faced with their mothers' breast cancer, and how these mediate that impact. Many cancer centers in the United States provide psychosocial support services for the over 200,000 women newly diagnosed with breast cancer each year. There are no supportive care services however that targets the coping of their adolescent daughters with the stress of their mother's breast cancer. Before developing these services we need to understand more about which coping strategies can mediate the stress of mothers' breast cancer and be included in any interventions. With the increased risk that these daughters face of acquiring breast cancer, developing fear about health screening, and potentially facing life-long depression, all important public health concerns, it is imperative to understand more about the coping strategies and factors that can mediate the stressfulness of this event. This cross-sectional, correlational study will target 90 adolescent daughters and their mothers with breast cancer recruited through the New York University Medical Cancer Center and Bellevue Hospital cancer clinics. Data collection will include an interview schedule and instruments that target adolescent daughters, the different coping strategies they use, and their level of adjustment or distress with the maternal disease within the first year following diagnosis. Ultimately, the knowledge gained from this study will lead to the development of interventions that target coping and promote adjustment in this vulnerable group. This cross-sectional, correlational study of adolescent daughters' coping and adjustment to their mothers' breast cancer addresses three major pubic health concerns: developing depression in adolescence which can lead to lifelong mental health problems; avoidance of engaging in health promoting screening like breast-self exams, that can facilitate earlier identification of breast cancer; and decreased health literacy based on a lack of information and fear regarding their breast cancer risks. A better understanding of which coping strategies can mediate the stressful impact of their mothers' breast cancer can lead to the development of health promoting interventions that target these concerns in this vulnerable population. ? ? ?
