Kathryn Vannatta

Social, Emotional, and Behavioral Functioning of Children With Cancer

Objective. It was hypothesized that children with cancer would have more social problems and difficulties with emotional well-being than case control, same race/gender, similarly aged classmates. Study Design. Using a case controlled design, children with any type of cancer requiring chemotherapy except brain tumors (n = 76), currently receiving chemotherapy, ages 8 to 15, were compared with case control classroom peers (n = 76). Peer relationships, emotional well-being, and behavior were evaluated based on peer, teacher, parent, and self-report, and were compared using analysis of variance and structural equation modeling. Results. Relative to case controls, children with cancer were perceived by teachers as being more sociable; by teachers and peers as being less aggressive; and by peers as having greater social acceptance. Measures of depression, anxiety, loneliness, and self-concept showed no significant differences, except children with cancer reported significantly lower satisfaction with current athletic competence. There were also no significant differences in mother or father perceptions of behavioral problems, emotional well-being, or social functioning. Scores on all standardized measures were in the normal range for both groups. Comparisons of the correlation matrices of children with cancer and to the correlation matrix of the comparison children using structural equation modeling suggested they were not significantly different. Conclusions. Children with cancer currently receiving chemotherapy were remarkably similar to case controls on measures of emotional well-being and better on several dimensions of social functioning. These findings are not supportive of disability/stress models of childhood chronic illness and suggest considerable psychologic hardiness.

Social, emotional, and behavioral functioning of children with juvenile rheumatoid arthritis

OBJECTIVEnTo investigate the hypothesis that children with juvenile rheumatoid arthritis (JRA) would have more social and emotional problems than case-control classmates.nnnMETHODSnUsing a case-control design, children with JRA (n = 74), ages 8-14, were compared with case-control classmates (n = 74). Peer relationships, emotional well-being, and behavior, based on peer-, teacher-, parent-, and self-report scores on common measures, were compared using analysis of variance.nnnRESULTSnRelative to case-control classmates, children with JRA were similar on all measures of social functioning and behavior. Mothers reported more internalizing symptoms in the child with JRA, but child self reports and father reports showed no differences. Scores on all standardized measures were in the normal range for both the JRA and the case-control groups.nnnCONCLUSIONnChildren with JRA were remarkably similar to case-control children on measures of social functioning, emotional well-being, and behavior. These findings are not supportive of disability/stress models of chronic illness in childhood and suggest considerable psychological hardiness among children with JRA.

Childhood Aggression and Chronic Illness: Possible Protective Mechanisms

This study evaluated the development of children with severe chronic illness and matched comparison peers (COMPs) who were not chronically ill over a 2-year period. Differences between children with chronic illness and COMPs in the levels of aggression in the classroom and at home were examined. Additionally, the impact of childhood chronic illness, related biological variables, and parental monitoring on aggression were evaluated, controlling for potentially influential background characteristics (e.g., socioeconomic status) and difficult temperament. Results indicated that children with chronic conditions were perceived as less aggressive than COMPs by teachers and peers, whereas the mothers of children with chronic illness reported more aggressive behaviors than mothers of COMPs. In addition, fatigue, monitoring, and temperament had an impact on the level of aggression, and some support was obtained for monitoring as a moderator. Results indicated different perceptions of children with chronic illness in the classroom and at home. Disagreements over issues related to chronic illness (e.g., treatment compliance) could be responsible for the mothers report of greater behavioral difficulties.

Correlates of sociometric status in school children in Buenos Aires

Teacher ratings on Spanish translations of the Comprehensive Behavior Rating Scale for Children and peer nominations were obtained for 110 school children (42 boys and 68 girls) in grades 2– 5 at a public elementary school in Buenos Aires. Nominations of “likes best” were negatively correlated with language processing deficits, attention problems, and sluggish tempo as rated by both teachers and peers, and positively correlated with teacher ratings of social competence, for both boys and girls. The reverse pattern was found for nominations of “likes least.” Children were assigned to sociometric status groups of popular (n=27), rejected (n=28), neglected (n=7) controversial (n=11), and average (n=37) based on number of LL and LB nominations. Rejected and popular children could be differentiated by teacher and peer ratings of linguistic information processing deficits, inattention, and sluggish tempo. Behavioral characteristics of motor hyperactivity, impulsivity, and aggression were significantly associated with being male but did not differ by sociometric status group.

Parent perceptions of nutritional issues during their child's treatment for cancer.

To examine family mealtime interactions, parental concerns about nutrition, and body mass index (BMI) among children with cancer who did not have primary central nervous system involvement. Parents of 95 children receiving treatment for cancer and 95 comparisons completed the About Your Childs Eating-Revised (AYCE-R) measure. Anthropometric data for children with cancer were obtained from medical charts at diagnosis and again when the AYCE-R was administered. No differences in mealtime interactions were found between children with cancer and comparisons, but parents of children with cancer reported greater concern about their childs weight. Anthropometric measures for children with cancer were consistent with national norms. However, children with cancer were somewhat underweight at diagnosis and became heavier over time. Lower BMI was associated with mother and father report of greater resistance from the child at mealtime, father report of his own aversion to family meals, and more severe treatment. The impact of cancer on family mealtime interactions and BMI appeared minimal during treatment. However, further longitudinal research is needed given the risk for late effects, such as growth problems and obesity, among cancer survivors. Families also may benefit from ongoing education to optimize healthy lifestyles among survivors.

Stress, coping, and substance use: More than “just saying no?”

An urgent problem in todays society is the increased prevalence of substance abuse. Current social, political and economic problems challenge academicians, researchers, and clinicians to formulate both theoretical models of addiction and treatment programs for addicts. Professionals need to address a number of pressing questions such as the following: Is addiction best described by the traditional medical model? What can we learn from looking at community as well as treatment samples? What can be gained from comparing substance use phases such as initiation, maintenance, cessation, and relapse? What information can be obtained by studying individuals across the life span? What are the commonalities in addiction processes of different substances? Are there ways to synthesize research utilizing human and animal samples? How does current knowledge contribute to the development of treatment and prevention programs? In recent years there has been a proliferation of publications, selfhelp groups, and items in the popular press addressing the topics of drug addiction, stress, and coping separately. The two books reviewed here consolidate research which integrate these topics. They are Coping and Substance Use edited by Shiffman and Wills and Stress and Addiction edited by Gottheil, Druley, Pashko, and Weinstein. The former is a compilation of 15 chapters contributed by 22 authors. The latter, the ninth volume in the Bruner/Mazel Psychosocial Stress Series, consists of 21 chapters contributed by 27 authors. While the books titles suggest considerable overlap, readers will find a number