Desjardins Leandra, Thigpen Jennifer C, Kobritz Molly, Bettis Alexandra H, Gruhn Meredith A, Ichinose Megan, Hoskinson Kristen, Fraley Claire, Vreeland Allison, McNally Colleen, Compas Bruce E
a Department of Psychology & Human Development , Vanderbilt University , Nashville , TN , USA.
Child Neuropsychol. 2018 Oct;24(7):959-974. doi: 10.1080/09297049.2017.1365828. Epub 2017 Oct 2.
Neurocognitive problems in childhood survivors of brain tumors are well documented. Further, research has shown that problems in cognitive functioning may be associated with impairment in the use of complex strategies needed to cope with stress, including secondary control coping strategies (e.g., acceptance and cognitive reappraisal) which have been associated with fewer adjustment problems. The present study measured cognitive function, coping strategies, and adjustment in children ages 6-16 years at the time of brain tumor diagnosis and at two follow-up time-points up to 1 year post-diagnosis. In a prospective design, working memory was assessed in a total of 29 pediatric brain tumor patients prior to undergoing surgery, child self-reported coping was assessed at 6 months post-diagnosis, and parent-reported child adjustment was assessed at 12 months post-diagnosis. Significant correlations were found between working memory difficulties and secondary control coping. Secondary control coping was also negatively correlated with child attention and total problems. Regression analyses did not support secondary control coping mediating the association between working memory difficulties and child attention or total problems. These findings represent the first longitudinal assessment of the association between working memory, coping, and adjustment across the first year of a child's brain tumor diagnosis and suggest a possible role for early interventions addressing both working memory difficulties and coping in children with brain tumors.
脑肿瘤儿童幸存者的神经认知问题已有充分记录。此外,研究表明,认知功能问题可能与应对压力所需的复杂策略运用受损有关,包括二级控制应对策略(如接受和认知重新评估),这些策略与较少的适应问题相关。本研究在脑肿瘤诊断时以及诊断后长达1年的两个随访时间点,测量了6至16岁儿童的认知功能、应对策略和适应情况。在前瞻性设计中,对总共29名小儿脑肿瘤患者在手术前评估工作记忆,在诊断后6个月评估儿童自我报告的应对方式,在诊断后12个月评估家长报告的儿童适应情况。发现工作记忆困难与二级控制应对之间存在显著相关性。二级控制应对也与儿童注意力和总体问题呈负相关。回归分析不支持二级控制应对介导工作记忆困难与儿童注意力或总体问题之间的关联。这些发现代表了对儿童脑肿瘤诊断后第一年工作记忆、应对和适应之间关联的首次纵向评估,并表明早期干预可能在解决脑肿瘤儿童的工作记忆困难和应对方面发挥作用。