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Cited by 42Childhood Cancer Survivors' Quality of LifeCancer survivorship and careFamily Support in Illness

Adjustment in childhood cancer survivors, healthy peers, and their parents: The mediating role of the parent-child relationship

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Schepers, Sasja A, Okado, Yuko, Russell, Kathryn, Long, Alanna M, Phipps, Sean·2019·Journal of Pediatric Psychology
DOI 10.1093/jpepsy/jsy069PMC PMC6365093
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Abstract

Objectives: Aims were to (1) determine whether the associations between parent psychological functioning and adjustment outcomes of childhood cancer survivors (CCS) were mediated by the parent-child relationship and (2) examine possible differences in pathways for CCS and healthy peers. Method: The study included CCS (n = 206), healthy peers (n = 132), and their primary caregivers. Youth (8-21 years) reported on the quality of the parent-child relationship and on their positive and negative adjustment outcomes. Parents reported on their own distress, posttraumatic growth, quality of the parent-child relationship, and their child's positive and negative adjustment outcomes. Two mediation models were tested, first examining youth-reported adjustment as the outcome and second examining parent-reported youth adjustment. Differences between model path coefficients of CCS and healthy peers were assessed by multigroup analyses. Results: In the youth-reported model, the parent-child relationship mediated the relation between parental distress and adjustment, with more care leading to better youth-reported adjustment outcomes and more overprotection leading to poorer adjustment outcomes. In the parent-reported model, relational frustration and attachment mediated the link between parental distress/growth and parent-reported youth adjustment, with more relational frustration and less attachment relating to poorer youth adjustment outcomes. Multigroup analyses revealed no differences in model path coefficients between CCS and healthy peers. Conclusions: Parental distress and the parent-child relationship likely play an important role in both youth- and parent-reported adjustment, and associations among these constructs do not differ between CCS and healthy peers. Families with less optimal parental functioning may benefit from interventions improving the quality of parent-child interactions.

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  • Parents' (particularly mothers') QOL is closely associated with their child's QOL.

    “Some evidence suggests that parents’ (particularly mothers’) QOL is closely associated with their child’s QOL [5,14,15,16].”

    From Providing psychological support to parents of childhood cancer survivors: ‘cascade’ intervention trial results and lessons for the future (2021) · cites this paper as [15]

    The introductory passage labeled Abstract (page unavailable) identifies impaired parental quality of life as a determinant of poor adjustment in youth with cancer. It does not establish a close association between parents’ and children’s quality-of-life scores, and the Discussion (page unavailable) says the parent sample was predominantly mothers without showing that the association is particularly strong for mothers. (LLM, conf=0.78)

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  • Poor parent mental health may compromise parenting skills and may subsequently exacerbate anxiety, depression, and behavioral problems in survivors and siblings.

    “Poor parent mental health may compromise parenting skills and may subsequently exacerbate anxiety, depression,_ENREF_24 and behavioral problems in survivors and siblings [15,17,18,19,20].”

    From Providing psychological support to parents of childhood cancer survivors: ‘cascade’ intervention trial results and lessons for the future (2021) · cites this paper as [15]

    The Results (Parent-Reported Youth Adjustment Outcomes; page unavailable) link greater parental distress to a poorer parent-child relationship and more youth internalizing problems. But the study compares childhood cancer survivors with healthy peers, not siblings, and reports internalizing problems and adaptive skills rather than separate effects on anxiety, depression, and behavioral problems. Its mediation findings support a possible relationship pathway, not a demonstrated decline in parenting skills. (LLM, conf=0.86)

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  • CBT interventions that increase parents' use of adaptive coping strategies may enhance their parenting skills, reduce parents' risk of depression/anxiety, and in turn benefit the whole family.

    “Cognitive behavior therapy (CBT) interventions that increase parents’ use of adaptive coping strategies may also enhance their parenting skills, reduce parents’ risk of depression/anxiety, and in turn benefit the whole family [15,19,30].”

    From Providing psychological support to parents of childhood cancer survivors: ‘cascade’ intervention trial results and lessons for the future (2021) · cites this paper as [15]

    The Discussion (page not provided) suggests that reducing parental distress and supporting the parent-child relationship may improve outcomes for childhood cancer survivors. It does not examine CBT or show that increasing parents’ adaptive coping improves parenting skills or reduces their depression or anxiety. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • CBT can be helpful for parents.

    “Despite strong evidence that CBT can be helpful for parents [15,19,30], it is also possible that CBT was not the ideal therapeutic approach with which to tackle parents’ concerns, with other therapeutic approaches also potentially adding value to parents at this timepoint (e.g., acceptance and commitment therapy [22]).”

    From Providing psychological support to parents of childhood cancer survivors: ‘cascade’ intervention trial results and lessons for the future (2021) · cites this paper as [15]

    The Discussion says interventions to reduce parental distress and support the parent–child relationship may promote resilience, but it does not identify CBT or report evidence of its benefit for parents. A search for CBT and cognitive behavioral therapy found no passage addressing that specific claim. (LLM, conf=0.75)

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Cites

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Research works printed but not linked: 3

  1. Kamphaus, R. W., & Reynolds, C. R. (2010). Test review- Parenting Relationship Questionnaire. Journal of Psychoeducational Assessment, 28, 270.
  2. Muth en, L. K., & Muth en, B. O. (1998-2012). Mplus User's Guide (7th ed.). Los Angeles, CA: Muth en & Muth en.
  3. Van Schoors, M., Caes, L., Verhofstadt, L. L., Goubert, L., & Alderfer, M. A. (2015). Systematic review: Family resil- ience after pediatric cancer diagnosis. Journal of Pediatric Psychology, 40, 856-868.

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Authors
Schepers, S. A., Okado, Y., Russell, K., Long, A. M., & Phipps, S.
Affiliations
  • St. Jude Children's Research Hospital (US)
  • Department of Psychology, California State University
Corresponding author
Phipps, Sean
ORCID
Venue
Journal of Pediatric Psychology
Publisher
Oxford University Press (OUP)
Published
2018-09-20
Volume
44
Issue
2
Pages
186-196
ISSN
  • 0146-8693 (ISSN-L)
  • 1465-735X
DOI
10.1093/jpepsy/jsy069
PMC
PMC6365093
OpenAlex
W2891744800
Cited by
42
References
39
Citations by year
2026: 7 · 2025: 3 · 2024: 2 · 2023: 8 · 2022: 10 · 2021: 6 · 2020: 3 · 2019: 3
FWCI
3.31
Type
journal article
Language
en
Open access
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor, 1 d)
Locations
  • Journal of Pediatric Psychology (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (R01 CA136782)
  • American Lebanese Syrian Associated Charities
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Social Sciences › Sociology and Political Science › Family Support in Illness
Keywords
childhood cancer survivors, peer comparison, parent-child relationship, parental distress, parental overprotection, posttraumatic growth, youth adjustment, attachment, mediation
MeSH terms
Cancer Survivors, Adaptation, Psychological, Adolescent, Adult, Child, Female, Humans, Male, Parent-Child Relations, Parents, Peer Group, Young Adult

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