Department of Psychology, California State University, Fullerton.
Department of Psychology, St. Jude Children's Research Hospital.
J Pediatr Psychol. 2018 Oct 1;43(9):1047-1058. doi: 10.1093/jpepsy/jsy037.
To examine individual differences in pediatric cancer survivors' psychosocial adjustment and test the psychosocial predictors, assessed 2-3 years earlier, of those differences.
Pediatric cancer survivors (n = 209, aged 8-17 years at baseline) and their parents were followed for 4 years. They provided reports of survivors' psychosocial adjustment at 3 years post-baseline, and latent profile analysis (LPA) was used to identify subgroups of survivors who differed on those reports. Multinomial logistic regression was used to predict group membership from self- and parent-reported psychosocial factors at baseline (child adjustment, disposition, and parental functioning) and at 1 year post-baseline (child social relations).
The LPA revealed a 3-class model as the best fit: a "Resilient" group (65%), characterized by good psychosocial adjustment; a "Self-Reported At-Risk" group (23%), characterized by subclinical elevations in self-reported internalizing and attention problems; and a "Parent-Reported At-Risk" group (12%), characterized by subclinical elevations in parent-reported internalizing, externalizing, and attention problems and in self-reported attention problems. Several psychosocial predictors, including child posttraumatic stress, affectivity, and connectedness to school, as well as parental distress and overprotection, differentiated the Resilient group from the other groups, in expected directions.
The majority of pediatric cancer survivors exhibit enduring resilience. The protective factors identified for them-including positive affectivity and strong connectedness to school-may inform targeted prevention strategies for the minority of survivors who are at risk for maladjustment.
考察儿科癌症幸存者心理社会适应的个体差异，并检验 2-3 年前评估的心理社会预测因素对这些差异的影响。
对 209 名儿科癌症幸存者（基线时年龄为 8-17 岁）及其父母进行了 4 年的随访。他们在基线后 3 年报告了幸存者的心理社会适应情况，采用潜在剖面分析（LPA）来识别在这些报告上存在差异的幸存者亚组。采用多项逻辑回归分析，从基线时（儿童适应性、性格和父母功能）和基线后 1 年（儿童社会关系）的自我报告和父母报告的心理社会因素预测分组情况。
LPA 显示 3 类模型是最佳拟合：“有韧性”组（65%），表现出良好的心理社会适应；“自我报告有风险”组（23%），表现为自我报告的内化和注意力问题有亚临床升高；“父母报告有风险”组（12%），表现为父母报告的内化、外化和注意力问题以及自我报告的注意力问题有亚临床升高。几个心理社会预测因素，包括儿童创伤后应激、情感和与学校的联系，以及父母的痛苦和过度保护，以预期的方向将有韧性组与其他组区分开来。
大多数儿科癌症幸存者表现出持久的韧性。为他们确定的保护因素，包括积极的情感和与学校的紧密联系，可能会为那些有适应不良风险的少数幸存者提供有针对性的预防策略。
