Millions of children and adolescents have a parent with cancer and are at risk for a number of adjustment problems, such as anxiety, depression, acting out, and school difficulty. However, little is known about the demanding physical and psychological effects of cancer on the patient affect the family. However, there has been a recent increase in research focused on the problems in adjustment and coping of children and adolescents who have a recent increase in research focused on the problems and adjustment and coping of children and adolescents who have a parent with cancer. Yet, this area of research remains underdeveloped and does not describe the mechanisms through which parental cancer affects children and adolescents. The proposed study will use the well-established framework of attachment theory (which describes how the parent-child bond influences child development) to investigate the relationships between parental cancer, attachment, adolescent coping, and adjustment to identify ways in which cancer impacts the family as well as adolescent risk and protective factors. It is predicted that parental cancer affects adolescent adjustment through disruptions in the parent-child attachment bond, which affects coping styles. This cross-sectional study will use semi-structured interviews and questionnaires to gather information from 150 cancer patients and their adolescent children as well as a matched comparison group. The information gathered will include: severity of illness and their adolescent children as well as a matched comparison group. The information gathered will include: severity of illness, psychosocial adjustment to illness in the patient, psychological adjustment of each parent and the adolescent, coping strategies used by the adolescent, and attachment security of the adolescent to parents and peers. Participants for the strategies used by the adolescent, and attachment security of the adolescent to parents and peers. Participants for the target group will be recruited through two large hospital cancer centers ( the Comprehensive Cancer Center at Wake Forest University and the Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill). The proposed study will greatly expand on prior research in several methodological and conceptual ways. This research will further knowledge in the under-studied area of psychosocial adjustment of cancer patients and their families. This project improves upon past research in that it is theoretically based, comprehensive (gathering information from both the parent and the adolescent), clinically applicable, and contains a comparison group. Knowledge gathered about the effects of parental cancer on adolescents will provide information to clinicians that will allow for the creation of appropriate and specific interventions to help the child coping with an ill parent. Information about which aspects of cancer most affect children, and identification of risk and protective factors will enable intervention early on, and the prevention many adjustment problems. The findings will also be used to illustrate the need for and possibly guide future longitudinal research as well as other much needed psychosocial research on cancer survivorship and the effects of cancer on the family.
