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The Effect of Optimism and Connectedness on Psychological Adjustment of Children with Cancer and Comparison Peers

Ehman, Anandi C., MA; Schepers, Sasja A., PhD; Phipps, Sean, PhD

Journal of Developmental & Behavioral Pediatrics: April 2019 - Volume 40 - Issue 3 - p 208–216
doi: 10.1097/DBP.0000000000000641
Original Articles
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Objective: The present study aimed to examine the relationship of optimism and connectedness with psychological adjustment outcomes in children with cancer and determine whether these relations differ for children with cancer and comparison peers.

Methods: Participants were 155 children with cancer and 143 comparison youth without a history of cancer, aged 8 to 17 years at study entry, who were followed longitudinally over a 3-year period. Participants completed self-report measures at 3 time points: baseline optimism at study entry (T1), connectedness at 1 year after baseline (T2), and emotional symptoms at 3 years after baseline (T3). A series of regression analyses were conducted using conditional process analysis to examine whether connectedness mediated the relationship between optimism and psychological adjustment and whether this was moderated by health status (i.e., history of childhood cancer vs no history of cancer or other serious or chronic illness).

Results: Connectedness to parents, peers, and friends significantly mediated the relationship between optimism and psychological adjustment (b parents = −0.1387, 95% confidence interval [CI] [–0.2341 to −0.0515]; b peers = –0.2021, 95% CI [–0.3575 to −0.0818]; b friends = −0.0703, 95% CI [–0.1640 to −0.0050]). However, this mediation was not significantly moderated by having a history of cancer. Cancer history did moderate the direct relationship between optimism and psychological adjustment and between connectedness to parents and psychological adjustment.

Conclusion: Findings suggest that patients with cancer are doing remarkably well with regard to adjustment. Connectedness with parents and peers mediates the relationship between optimism and psychological adjustment. As such, children with cancer who are identified as experiencing poor adjustment may benefit from interventions to foster connectedness.

Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN.

Address for reprints: Sean Phipps, PhD, Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS-740, Memphis, TN 38105; e-mail: sean.phipps@stjude.org.

This study was funded, in part, by a Grant from the National Institutes of Health (R01 CA136782) and by the American Lebanese-Syrian Associated Charities (ALSAC).

Disclosure: The authors declare no conflict of interest.

Received April 25, 2018

Accepted November 06, 2018

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