UBC Theses and Dissertations
Models of psychological adjustment in adolescent cancer survivors Papsdorf, Michael Paul
Previous research on pediatric cancer populations has reported considerable variability in psychological adjustment. The present study was designed to examine different models of predicting adjustment in adolescent cancer survivors. In particular, this study sought to clarify the role of child factors (i.e., personality, appraisal, and coping) in predicting self-esteem and psychological distress while controlling for more established predictors, such as disease, family, and support variables. Additive and moderated mediational models of prediction were tested in a mail-out questionnaire study with a sample of 65 adolescent survivor-parent dyads. Support was obtained for an additive model in which optimism, peer support, and age at diagnosis predicted significant variance in self-esteem while controlling other factors. Support was also obtained for an additive model in which neuroticism and a disengagement coping strategy, cognitive avoidance, predicted significant variance above and beyond family, support, and disease covariates. The hypothesized moderated mediational models were not supported; however, support for a simpler model, in which cognitive avoidance partially mediated the relationship between neuroticism and psychological distress was obtained. Results of this study underscore the importance of considering child factors, which have largely been neglected in previous research, in predicting adjustment in pediatric cancer survivors. In particular, the results of the present study help to paint a picture of what a more resilient adolescent cancer survivor might look like. This adolescent would be lower in neuroticism, higher in optimism, and would engage in less cognitive avoidance and possibly less protective buffering, as trying to keep his or her distress from others may actually be detrimental to the adolescent. Finally, he or she would have a close and supportive peer network and a higher functioning, less distressed family. Research and clinical implications o f these findings are discussed.
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